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Objective To investigate the safety of gemcitabine combined with cisplatin (GC) / carboplatin (GCa) regimen in adjuvant chemotherapy for upper urinary tract urothelial carcinoma.Methods The clinical and follow-up data of 80 patientswho underwent GC or GCa chemotherapy withinfourcycles of upper tract urothelial carcinoma (UTUC) admitted to Beijing Friendship Hospital,Capital Medical University from June 2012 to January 2018 were analyzed retrospectively,including 39 males and 41 females,aged 36 to 81 years,with a median age of 64.0 years.According to the chemotherapy regimen,all patients were divided into GC group (n =54) and GCa group (n =26).The software of SPSS 22.0 was used to calculate the incidence of adverse reactions of chemotherapy.The independent risk factors for serious adverse reactions were analyzed.The incidence of serious adverse reactions and the safety of renal function in patients with renal insufficiency during chemotherapy were explored.Results For adverse reactions to chemotherapy,GC group had 20 patients (37.0％) with severe myelosuppression,9 patients (16.4％) with non-hematological toxicity,3 patients (5.6％) with delayed chemotherapy due to serious chemotherapy adverse reactions,and 12 patients (22.2％) withdrawn chemotherapy early due to inability to tolerate chemotherapy toxicity.In GCa group,12 patients (46.2％) had severe myelosuppression,5 patients(19.2％) had severe non-hematologic toxicity,6 patients(23.1％) had delayed chemotherapy due to serious chemotherapy adverse reactions,and 6 patients (23.1％) had withdrawn chemotherapy early due to inability to tolerate chemotherapy toxicity.Pre-chemotherapye GFR ＜ 60 ml ·(min · 1.73 m2)-1 (OR =5.074,95％ CI:1.222-21.068) was an independent risk factor for severe myelosuppression in GC group (P ＜ 0.05).There was no significant difference in severe adverse reactions between the two groups (P ＜ 0.05).For the renal function decline between the two groups,Cr and eGFR decreased to a certain extent in the two groups during chemotherapy (P ＜ 0.05),but there was no significant difference in the extent and degree during chemotherapy (P ＜ 0.05).Conclusions Both GC and GCa adjuvant chemotherapy have certain toxicity and side effects.The process of chemotherapy needs to be closely monitored and timely symptomatic treatment if needed.Most patients can eventually endure chemotherapy.For patients with renal insufficiency,under the precondition of strict monitoring and adequate hydration,GC and GCa regimens adjuvant chemotherapy within four cycles may be the same safe level ofchemotherapy.
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Objective To study the safety and feasibility of tubeless percutaneous nephrostolithotomy by hemostasis gel closure of mini-percutaneous renal-channel.Methods Eighty patients after conventional percutaneous nephrostolithotomy are selected and divided into two groups according to the principle of randomization.Control group adopts conventional percutaneous nephrostolithotomy calculi lithotripsy with renal pelvis drainage tube placement whereas the experimental group adopts tubeless percutaneous nephrostolithotomy by hemostasis gel closure of mini-percutaneous renal channel.Both experimental group and control group will be scientifically and statistically analyzed via the incidence and the dose of using sedative for alleviating pain after operation,hospital stay,level of hemoglobin,and the occurrence of complications such as continuate hemorrhage,infection,urinary extravasation,etc.Results The operation of both groups are successful in phrase Ⅰ.The incidence and the dose of using sedative in control group are obviously higher than that in experimental group(45％ vs 20％).However,the incidence of postoperative complications like infection and hemorrhage and hospital stay between two groups are undifferentiated in statistics(P ＞ 0.05).Neither the experimental group nor the control group has perinephric hematoma,and seven cases of control group have urinary leakage after remove of fistula.Conclusion Tubeless percutaneous nephrostolithotomy by hemostasis gel closure of mini-percutaneous renal-channel is safe and feasible and it can reduce the incidence of postoperative pain and avoid urinary leakage.
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Objective To study the growth suppressive effect of demethylation drug 5-aza-2'-deoxycytidine on bladder tumor cells. Methods The growth suppressive effect of DAC on 4 transitional cell carcinoma (TCC) cell lines was measured using the Cell Proliferation Reagent WST-1 assay.The effects of DAC on apoptosis induction and cell cycle arrest were analyzed by flow cytometric analysis. Caspase 3, 9 activities were analyzed by APOPCYTO Caspase Colorimetric Assay Kit and PCNA expression was also investigated by Western blot to clarify the mechanism of DAC against TCC. Results DAC inhibited the growth of all TCC cell lines tested in a dose-dependant manner, however,growth suppressive effect of DAC was independent of p53 status in TCC. DAC inhibited proliferation via inducing G2/M cell cycle arrest but not via inducing apoptosis. After treated with 0, 1 and 8 μmol/L DAC, cells of RTl 12 in G2/M phase was (36.3 ± 3.4) %, (46.2 ± 4.6) % and (56.5 ±6.2) %, TCCsup was (37.5 ± 3.8) %, (48.4 ±4.9) % and (60.1 ± 6.7) %, respectively. The expression of PCNA was decreased by DAC, but caspase3, 9 activities were not activated. Conclusion DAC could suppress the growth of TCC cells and might be a new strategy to treat bladder malignancy in the future.