[Efficacy and safety of combination therapy with chemotherapy, programmed death-1 inhibitor and anlotinib in the treatment of advanced dedifferentiated liposarcoma].

Objective: To investigate the efficacy and safety of the combination therapy with chemotherapy, programmed death-1 (PD-1) inhibitor and anlotinib in the treatment of advanced dedifferentiated liposarcoma (DDLPS). Methods: The clinical data of patients with dedifferentiated liposarcoma who received chemotherapy combined with PD-1 inhibitor and anlotinib in the Department of Medical Oncology, Zhongshan Hospital Affiliated to Fudan University from January 1, 2020 to November 30, 2021 were retrospectively analyzed. A total of 24 patients were included in this study, including 12 males and 12 females, with a median age of onset of 56 years (range, 31-69 years). Efficacy and safety in those patients were assessed. Results: All patients had unresectable or metastatic dedifferentiated liposarcoma with G2 (moderate differentiation) or G3 (differential differentiation) in a concise three-grade grading scheme of tumor pathology. Twelve patients received the regimen as the first-line treatment, while the other 7 taken the regimen as second-line treatment and 5 as third-line or above. The median follow-up time for overall survival (OS) was 7.7 months. The overall response rate (ORR) was 20.8% (5/24) and disease control rate (DCR) was 83.3% (20/24) with 5 partial response (PR), 15 stable disease (SD) and 4 progressive disease (PD). Overall, the median progression-free survival (PFS) was 4.9 months (95%CI: 3.4-16.2 months). The ORR of anthracycline-based, eribulin-based or gemcitabine-based regimens was 1/12, 2/6 and 2/6, respectively; and the median PFS was 7.7, 7.3 and 4.4 months, respectively. Waterfall plots showed notable tumor shrinkage of any degree in eribulin and gemcitabine-based regimens(3/6 and 2/6, respectively), while there were more patients presented with SD in anthracycline-based group(9/12). Common adverse reactions included myelosuppression, fatigue, anorexia, rash, pruritus, palpitate, hypothyroidism and hypertension. Conclusions: The combination regimen with chemotherapy, PD-1 inhibitor and anlotinib in the treatment of advanced DDLPS is effective and well tolerable. There are more responders in eribulin or gemcitabine-based regimens.

Comparative study on efficacy of three sperm-separation techniques.

AIM: To evaluate the comparative effectiveness of real-time sperm separation technique (Wang's tube method) and other two conventional methods in isolating high-quality sperm preparation, and to compare the spouse pregnancy rate in intrauterine insemination (IUI) with sperm preparations isolated by these methods. METHODS: The effectiveness of the real-time sperm separation technique, the conventional swim-up and the Percoll discontinuous density gradient methods in isolating sperm preparations from 60 infertile patients (20 with apparently normal semen and 40, abnormal semen contaminated with microorganisms and other impurities) was evaluated and compared. The microorganisms to be removed included bacteria, virus, Chlamydia trachomaticum, Ureaplsama urealyticum, etc. The spouse pregnancy rates in IUI with sperm preparations isolated by these three techniques from 80 oligoasthenoteratospermic patients were also compared. RESULTS: The quality (including the percentages of normal form, normal-chromatin and motile sperm, and the grade of motility) of sperm obtained by the real-time sperm separation technique was much higher (P < 0.01) as compared with those by the other two methods. The Wang's tube method was also more effective in removing microorganisms and other impurities. The method provided a higher IUI pregnancy rate than the other two sperm separation techniques (P < 0.05). CONCLUSION: The real-time sperm separation technique is the most effective method so far available in isolating high-quality sperm samples to be used in assisted reproduction.

[Effects of semen Cuscutae, rhizoma Curculiginis, radix Morindae officinalis on human spermatozoan's motility and membrane function in vitro].

OBJECTIVE: To observe the effects of Semen Cuscutae (SC), Rhizoma Curculiginis (RC) and Radix Morindae Officinalis (RMO) on human sperm motility in vitro and cytomembrane function. METHODS: Compare the sperm motility of the above-mentioned medicinal plants with modified Tyrode's solution (MTS) and MTS added caffeine in vitro. Human spermatozoa were incubated with decoctions of medicinal plant at various concentrations in 37 degrees C for 30 minutes. The motility of sperm was evaluated by the sperm capillary penetrating test, sperm speed test and sperm activity index calculations. The spermatozoa membrane function was evaluated by spermatozoal hypo-osmotic swelling test together with eosin staining methods. RESULTS: The sperm motility improved markedly and sperm membrane function became more stabilized after incubation, the SC had best effect, RC took second place, RMO was relatively poor. CONCLUSIONS: SC decoction is an effective promoting preparation for sperm motility and the membrane function stabilized. Therefore, SC may be beneficial in treating male sterility and may raise success rate in artificial insemination.

[Clinical study on LRH-A contraception by luteolysis].

Thirty-eight healthy female volunteers, aged 26-38 years with regular menstrual cycles entered into a clinical trial for contraception with Chinese made superactive stimulatory analog of LRH i.e., (D-Ala, des-GLY-EA10)-LRH yielding luteolysis. LRH-A 1 mg a day was administered by intranasal spray from the 15th through 25th day of the menstrual cycle for 1-12 consecutive cycles. During LRH-A administration no additional contraceptive was used. Luteolysis refers to reduction in plasma progesterone and shortening of the luteal phase. The results showed that luteolysis occurred in 154/158 cycles, 4 pregnancies occurred due to faulty administration. No severe side-effects were observed during administration and apparently normal cycles occurred immediately after the withdrawal of LRH-A spray. The above data indicated that LRH-A may provide a fairly good luteolytic effect. More intensive study is required for clinical application in contraceptive practice.

[A clinical study on the inhibitory effect of ovulation caused by interrupted administration of intranasal spray with China-made LRH-A in normal fertile women].

PIP: 28 health female volunteers, ages 26-42, with regular menstrual cycles entered into the trial with a new superactive stimulatory analog of the LRH-A (D-Ala6-EA10)-LRH for contraception by means of inhibition of ovulation. The LRH-A was interruptively administered intranasally by a spray device beginning on days 1-3 of the menstrual cycle. 1 treatment course included administration for 21 days and 7-10 days without the medication. In group 1, 10 women (LRH-A 0.5 mg daily) and group 2, 18 women (LRH-A 1.0 mg daily) received 1-4 courses of treatment, respectively. The treatment inhibited ovulation in all women during the 1-4 months of therapy with reduction of plasma estradiol, progesterone, and serum luteinizing hormone levels. No pregnancy occurred during 50 treatment months. No severe side effects were observed during treatment and apparently normal cycles occurred immediately after treatment withdrawal. The above data indicate that an interruption of treatment with LRH-A could provide a fairly good contraceptive benefit by inhibiting ovulation in women on days 1-3 of the menstrual cycle. (author's modified)^ieng

[Luteinizing hormone-releasing hormone (LRH) agonist in the treatment of breast cancer, osteosarcoma and prostate carcinoma--analysis of 12 patients].

This paper first reports the results of 12 patients with sex hormone-dependent neoplasms, including 9 women with breast cancer, 2 men with osteosarcoma and 1 man with prostate carcinoma, treated by LRH agonist, (D-Ala6, des-Gly-NH2(10))-LRH-ethylamide (LRH-A) 100-200 micrograms, IM, QD. After 15-30 days of administration, the concentrations of plasma mean estradiol, progesterone, testosterone, serum luteinizing hormone and follicle-stimulating hormone were lowered significantly in the peripheral blood of all patients, associating with improvement of the patients' general condition and reduction of the tumors and/or metastatic foci. No serious side effects were observed except vaginal irregular bleeding in isolated patients. Three patients died and the others were alive in follow-up of 4-30 months. The results suggest that LRH-A be useful in the treatment of the sex hormone-dependent tumors and worth further study.

[Clinical observations on LRH-A used for contraception by luteolysis in normal women--analysis of 88 cases].

PIP: 88 healthy female volunteers, ages 17-42, with regular menstrual cycles entered into the trail with a new superactive stimulatory analos of the LRH-A (D-A1a6-EA10) -LH for contraception by luteolysis. The LRH-A was administered intranasally or intramuscularly (im) on days 6-8 following the LH peak/BBT temperature rise for 1-5 successive cycles. Group 1 consisted of 12 women who were given 1000 mcg LRH-A intranasally for 4 days; group 2 consisted of 18 women who were given a single dose of 200 mcg LRH-A im; group 3 had 34 women who were given 200 mcg im b. i. d. for 1 day; and group 4 had 24 women who were given 200 mcg im g.d. for 3 days. During the treatment cycles, no additional contraceptive was used. Luteolysis was defined as the reduction in plasma progesterone and estradiol levels and the shortening of the luteal phase associated with an infertile cycle. Luteolysis occured in 9 of 12 cycles in group 1 with no shortening of the luteal phase in 3 cycles; in 13 of 18 cycles in group 2 with no shortening of the luteal phase in 5 cycles; in 32 of 34 cycles in group 3 with no decline of progesterone in i cycles; in 115 of 120 cycles in group 4 with 5 pregnancies occurring. The results showed that treatment with LRH-A seemed to be more efficient when applies in twice a day or q.d. for 3-4 successive days as compared with a single dose. No severe side effects were observed durin treatment and apparently normal cycles occurred immediately after withdrawal of treatment. The above data indicate that an adequate dose of LRH-A can provide a fairly good luteolysis result in women at the midluteal phase. However, more extensive study is necesary before a long-term application of LRH-A for contraception by luteolysis can be considered practical.^ieng