Comparison of the efficacy and safety of phloroglucinol and magnesium sulfate in the treatment of threatened abortion: A meta-analysis of randomized controlled trials

Application effect of phloroglucinol injection in elderly patients with spastic abdominal pain in emergency department

BACKGROUND

Although norepinephrine injection is commonly used in emergency situations, it is associated with risks for elderly patients with spasmodic liver pain. This study explores the safety and effectiveness of mebendazole injection, an alternative treatment option, for the emergency management of spasmodic abdominal pain, while minimizing adverse reactions, in elderly patients.

AIM

To explore the development of norepinephrine injection and the adverse reactions of this drug in emergency elderly patients with spasmodic liver pain.

METHODS

The control group consisted of 56 elderly patients visiting our hospital from January 2021 to December 2021. After hospital admission, the control group was intravenously administered tolopin. The experimental group consisted of 56 emergency patients with spasmodic abdominal pain who visited our hospital until June 2022. After hospital admission, the experimental group was intravenously administered toloxazole. The two groups were treated for 3 d. The disappearance of clinical symptoms was observed before and after the treatment, and the difference in adverse reactions between the two groups was compared.

RESULTS

The pain of the wife, fire, diarrhea, drowning, and surrounding time disappeared in the experimental group. No statistical difference was observed between the experimental and control groups in visual pain analog scale (VAS) scores before and after the treatment (P > 0.05). The VAS scores of abdominal pain severity after 0.5 h, 1.0 h, and after 6.0 h of treatment were significantly lower for the experimental group than for the control group. After the treatment, the therapeutic effect in the experimental group was higher and statistically significant than that in the control group (P < 0.05). The probability of adverse reactions before the treatment was lower in the experimental group than in the control group.

CONCLUSION

During emergency, mebendazole injection exhibited a good therapeutic value when used for the clinical treatment of elderly patients with spasmodic stomach pain. It accelerated the disappearance of clinical symptoms such as stomach pain, reduced the stomach weight, and improved clinical activity. Reducing and promoting the frequency of high treatment safety with mebendazole injection is worthwhile.

Analysis of the effect of phloroglucinol on pregnancy outcomes involving frozen embryo transfers in patients with endometriosis: A retrospective case-control study

Objective

Abnormal contraction of uterus and vascular smooth muscle lead to the formation of hypoxia environment in uterus. Abnormal contraction may be the basis of dysmenorrhea, endometriosis, infertility and other diseases. Phloroglucinol is a non-atropine and non-papaverine smooth muscle spasmolytic agent, which can reduce the abnormal contraction of uterine smooth muscle. This study investigated the effect of phloroglucinol on frozen embryo transfer in patients with endometriosis.

Methods

The data of patients with endometriosis who underwent a frozen embryo transfer in Shanghai Changzheng Hospital from August 2018 to August 2021, comprising a total of 453 cycles, were retrospectively analyzed. The patients for whom phloroglucinol was included over 217 cycles were administered intramuscully 40 mg phloroglucinol starting on the day of progesterone administration, then once daily up to day 7 after the embryo transfer. Those for whom phloroglucinol was not administered over 236 cycles were used as the control group. The age of 35 years was used as a boundary in this study to observe the pregnancy outcomes of patients in the two different age groups.

Results

The biochemical pregnancy rate (63.13% vs. 51.27%), embryo implantation rate (44.64% vs. 33.60%), clinical pregnancy rate (59.64% vs. 48.30%), and live birth rate (52.99% vs. 36.86%) after the administration of phloroglucinol were higher than for patients in the control group, and the early abortion rate (7.75% vs. 20.18%) was also lower. The differences were statistically significant (P < 0.05). In particular, in the age group <35 years old, the embryo implantation rate (51.81% vs. 39.38%), clinical pregnancy rate (69.34% vs. 57.55%), and the live birth rate (63.50% vs. 44.60%) after phloroglucinol intervention rose significantly, and the abortion rate dropped (6.32% vs. 17.5%), indicating a statistically significant difference (P < 0.05). However, pregnancy outcomes showed no difference in the age group ≥35 years old (P > 0.05).

Conclusion

Continuous low-dose phloroglucinol pretreatment before and after frozen embryo transfer can improve both the clinical pregnancy and live birth rates and reduce the risk of abortion in younger infertile patients with endometriosis.

Efficacy and Safety Analysis of Phloroglucinol in Combination with Oxytocin for the Induction of Labor in Women with Term Premature Rupture of Membranes (PROM)

Objective. The purpose of this study was to investigate the efficacy and safety of phloroglucinol in combination with oxytocin in the induction of labor in women who had experienced term premature rupture of membranes (PROM). Methods. Data from 100 women who experienced PROM between December 2020 and December 2021 were retrospectively evaluated in this study. The puerperae were categorized into observation and control groups based on their uterine contraction regimens. The observation group consisted of 53 participants that had been treated with phloroglucinol in combination with oxytocin, and the control group consisted of 47 participants that had been treated with oxytocin alone. It was observed and compared in terms of the Bishop score before and after the administration of the puerpera to see which group had the best index. A study was performed after the drug was administered to examine its effects on the duration of labor (including the first, second, and third stages of labor), the mode of delivery (including natural vaginal delivery and cesarean section), the incidence of adverse pregnancy outcomes (fetal distress and neonatal asphyxia), successful labor induction, and complication rates. Results. Patients in the observation group had a significantly higher Bishop score after administration than those in the control group ( $P<0.05$ ), although there was no difference between the two groups before administration. In comparison to the control group, the observation group had a significantly higher efficacy rate for drug administration ( $P<0.05$ ), as well as a significantly lower occurrence of the first stage of labor ( $P<0.05$ ), a higher rate of vaginal natural delivery and successful induction of labor ( $P<0.05$ ), and a significantly lower incidence of adverse pregnancy outcomes and complications ( $P<0.05$ ). Conclusion. In conclusion, the use of phloroglucinol in combination with intravenous oxytocin in the process of promoting cervical ripening and induction of labor for women with PROM who are at term was investigated. This study could help women speed up cervical dilation, improve the cervical Bishop scores, shorten the total labour process, improve the effective rate of vaginal delivery, and be very safe, making it a good candidate for clinical promotion and application.

γ-Cyclodextrin Inclusion of Phloroglucinol: Solid State Studies and Antioxidant Activity throughout the Digestive Tract

Phloroglucinol is a powerful antioxidant compound and an active pharmaceutical ingredient used in the management of intestinal spasms. In this report, we describe the interaction of γ-cyclodextrin with phloroglucinol to readily form a solid inclusion compound with 1:1 by co-dissolution and freeze-drying. Solid-state characterisation using FT-IR, thermal analyses (TGA and DTA) and X-ray powder diffraction confirmed the formation of a true inclusion compound (γ-CD·PG) in which the molecules of γ-CD are stacked into channels. This spatial arrangement is typical of γ-CD inclusion compounds, and it allows for the guest molecules to be located inside these channels. The evaluation of the antiradical potential of γ-CD·PG (against O2•− and NO•) on different steps of the digestive process (mouth, gastric and intestinal phases) led us to conclude that the inclusion of phloroglucinol promoted better antioxidant activity at the end of the digestion when compared to the free phloroglucinol.

Efficacy and safety of Yunkang oral liquid combined with conventional therapy for threatened miscarriage of first-trimester pregnancy a protocol for systematic review and meta-analysis

INTRODUCTION

Threatened miscarriages is a common complication of first-trimester pregnancy. Due to the beneficial effects, there are increasing clinical studies on Yunkang oral liquid(YKOL). However, the efficacy and safety of YKOL are still unknown. The aim of this systematic review was to assess the efficacy and safety of YKOL in the treatment of threatened miscarriage during the first-trimester pregnancy (TMFP).

METHODS

This protocol will be prepared according to the preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) statement. The systematic review will include all randomized controlled trials (RCTs) studies published until April 2021. Electronic sources including CNKI, WF, VIP, CBM, MEDLINE(PubMed), Embase, Cochrane Library, and Web of Science will be searched for potentially eligible studies. The international clinical trial registration platform and the Chinese clinical trial registration platform of controlled trials will be searched from their inception until April 1st, 2021. According to the inclusion and exclusion criteria, screening literature, extraction data will be conducted by two researchers independently. Statistical analysis will use RevMan 5.3.5 software. The strength of evidence from the studies will be evaluated with the Grading of Recommendation, Assessment, Development and Evaluation (GRADE) methods.

RESULTS

This study will provide evidence for YKOL combined with conventional therapy for TMFP.

CONCLUSION

The efficacy and safety of YKOL combined with conventional therapy for TMFP will be assessed.

SYSTEMATIC REVIEW REGISTRATION

INPLASY202140105 (https://www.doi.org/10.37766/inplasy2021.4.0105).

Efficacy and safety of traditional Chinese herbal medicine in the treatment of threatened abortion: A protocol for systematic review and meta-analysis

BACKGROUND

Threatened abortion (TA) is the commonest complication that occurs in early pregnancy, especially in 8-12 gestational weeks when the secretion of estrogen and progesterone shifts from corpus luteum to placental. Conventional therapies are little evidence of their value. In China, traditional Chinese herbal medicine has been widely used for the treatment of TA for a long time. The lack of strong scientific evidences make this a priority area for research. We aim to evaluate the efficacy and safety of traditional Chinese herbal medicine in the treatment of TA, provide medical staffs with more useful information, and provide patients with better advises.

METHODS

We will search 8 databases and additional sources, including the Web of Science, PubMed, Cochrane Library, Embase, CBM, Wanfang, VIP, CNKI, and WHO ICTRP, ChiCTR, Clinical Trials, Grey Literature Database, for potentially eligible studies. Literature search, screening and retrieval are performed independently by two researchers. In the event of a dispute, a third party will be consulted to support the judgment. We will use RevmanV.5.3 to perform a fixed-effect meta-analysis for clinical homogeneity study data, and the level of evidence will be assessed using the GRADE method.

RESULTS

This systematic review and meta-analysis will put a high-quality synthesis of the efficacy and safety of traditional Chinese herbal medicine in the treatment of TA.

CONCLUSION

The conclusion of this systematic review will provide evidence to assess traditional Chinese herbal medicine therapy whether is an efficacy and safe intervention to treat TA.

ETHICS AND DISSEMINATION

Since this article does not contain patient personal information, ethical approval is not required. The contract is distributed by a peer-reviewed journal or conference report.

REGISTRATION NUMBER

10.17605/OSF.IO/DG3T8.

Modelling bioactivities of combinations of whole extracts of edibles with a simplified theoretical framework reveals the statistical role of molecular diversity and system complexity in their mode of action and their nearly certain safety

Network pharmacology and polypharmacology are emerging as novel drug discovery paradigms. The many discovery, safety and regulatory issues they raise may become tractable with polypharmacological combinations of natural compounds found in whole extracts of edible and mixes thereof. The primary goal of this work is to get general insights underlying the innocuity and the emergence of beneficial and toxic activities of combinations of many compounds in general and of edibles in particular. A simplified model of compounds’ interactions with an organism and of their desired and undesired effects is constructed by considering the departure from equilibrium of interconnected biological features. This model allows to compute the scaling of the probability of significant effects relative to nutritional diversity, organism complexity and synergy resulting from mixing compounds and edibles. It allows also to characterize massive indirect perturbation mode of action drugs as a potential novel multi-compound-multi-target pharmaceutical class, coined Ediceuticals when based on edibles. Their mode of action may readily target differentially organisms’ system robustness as such based on differential complexity for discovering nearly certainly safe novel antimicrobials, antiviral and anti-cancer treatments. This very general model provides also a theoretical framework to several pharmaceutical and nutritional observations. In particular, it characterizes two classes of undesirable effects of drugs, and may question the interpretation of undesirable effects in healthy subjects. It also formalizes nutritional diversity as such as a novel statistical supra-chemical parameter that may contribute to guide nutritional health intervention. Finally, it is to be noted that a similar formalism may be further applicable to model whole ecosystems in general.

Systems Pharmacology-Based Research on the Mechanism of Tusizi-Sangjisheng Herb Pair in the Treatment of Threatened Abortion

Threatened abortion (TA) is a common complication with high incidence in the first trimester of pregnancy, which will end in miscarriage if not treated properly. The Chinese herbs Cuscutae Semen (Tusizi in Chinese) and Herba Taxilli (Sangjisheng in Chinese) first recorded in the ancient classic medical book Shennong Bencao Jing are effective and widely used as an herb pair for the treatment of TA, while the active ingredients and the functional mechanism of Tusizi-Sangjisheng herb pair treating TA are still unknown. In order to exploit the relationship between those two herbs and TA, systems pharmacology analysis was carried out in this study. A total of 75 ingredients of Tusizi-Sangjisheng were collected from Traditional Chinese Medicine System Pharmacology Database and Analysis Platform (TCMSP). 12 bioactive compounds were screened, and 153 directly related targets were predicted by systematic models. Besides, Gene Ontology (GO) enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis were used to systematically explore the potential mechanisms of Tusizi-Sangjisheng treating TA. Meanwhile, Compound-Target (C-T), Target-Disease (T-D), and Target-Pathway (T-P) networks were constructed to further quest the underlying functional mechanisms of Tusizi-Sangjisheng. As a result, 31 targets and 3 key pathways were found to be directly related to TA that includes mitogen-activated protein kinases (MAPKs), phosphatidylinositol-3-kinase/protein kinase B (PI3K-Akt), and transforming growth factor-β (TGF-β) signaling pathways. The results in this study may provide some valuable clues about the molecular mechanisms of the efficient Chinese herb pair Tusizi-Sangjisheng in the treatment of TA.

Current Resources for Evidence-Based Practice, November 2019

A review of new resources to support the provision of evidence-based care for women and infants.