The efficacy of intravesical instillation of domestic BCG versus epirubicin in the prevention of recurrence of intermediate-risk or high-risk non-muscular invasive bladder cancer and predictive factors of BCG instillation: a randomized, controlled, multi-center clinical trial with 2 years’ follow-up / 中华泌尿外科杂志

Objective:To investigate the 2 years’ efficacy of intravesical instillation of domestic BCG versus epirubicin in the prevention of recurrence of intermediate-risk or high-risk non-muscular invasive bladder cancer and predictive factors of BCG instillation.Methods:From July 2015 to June 2020, 18-75 years old patients with moderate to high-risk non muscle invasive bladder cancer (NMIBC) confirmed by pathological examination were involved. The ECOG score was 0-2. Exclusion criteria included ①immune deficiency or impairment (such as AIDS), using immunosuppressive drugs or radiotherapy, suspected allergic to BCG or epirubicin or excipients of the two drugs, fever or acute infectious diseases including active tuberculosis or receiving anti tuberculosis treatment, with severe chronic cardiovascular and cerebrovascular diseases or chronic kidney disease; ②combined with other urogenital system tumors or other organ tumors; ③combined with muscle invasive bladder urothelial carcinoma (≥T 2); ④undergoing chemotherapy, radiotherapy or immunotherapy within 4 weeks (immediate instillation after surgery not included); ⑤ pregnant or lactating women; ⑥ comfirmed or suspected bladder perforation; ⑦gross hematuria; ⑧cystitis with severe bladder irritation that may affect the evaluation; ⑨participat in other clinical trials within 3 months; ⑩alcohol or drug addiction; ?any risk factors that may increasing the risk of patients. Epirubicin 50 mg was irrigated immediately after the operation(TURBT or laser resection). The patients were randomly divided into BCG15 group, BCG19 group and epirubicin group by the ratio of 2∶2∶1, and the patients were maintained intravescical instillation for 1 year. The recurrence and adverse events of the three groups were compared. Univariate and multivariate analysis was performed to predict the risk factors of BCG irrigated therapy failure. Result:By June 15, 2020, the median follow-up duration was 22.1 months(12.1, 32.3), and there was no statistical difference between the groups ( P=0.9024). There were 274 patients enrolled in BCG19 group, 277 patients enrolled in BCG15 group and 130 patients enrolled in the epirubicin group. The drop-off rate was 16.6%(113 cases)and made no difference between groups( P=0.6222). There were no significant difference in age, gender, BMI, or ECOG score( P>0.05). During the follow-up, 116 cases was detected recurrence or progression. The recurrence rate of the three groups was 14.2% and 14.8% in BCG19 group and BCG15 group, and 27.7% in the epirubicin group. There was no difference in recurrence rate between BCG19 and BCG15 group( P=0.9464). The recurrence rate of BCG19 group was lower than that of the epirubicin group ( P=0.0017). The recurrence rate of BCG15 group was lower than that of the epirubicin group ( P=0.0020). There was no difference in the cumulative recurrence free survival rate between BCG19 and BCG15 group (95% CI0.57-1.46, P=0.7173). The cumulative recurrence free survival rate of BCG 19 group was better than that of the epirubicin group( HR=0.439, 95% CI0.26-0.74, P=0.0006), and the cumulative recurrence free survival rate of BCG15 group was better than that of the epirubicin group ( HR=0.448, 95% CI0.29-0.80, P=0.0021). The total incidence of adverse events in 19 BCG19, BCG15 and epirubicin group were 74.5%, 72.6% and 69.8% respectively. There was no difference in the incidence of adverse events between BCG19 and BCG15 group( P=0.6153). The incidence of adverse events in epirubicin group was lower than that of BCG19( P=0.0051) and BCG15( P=0.0167) groups.There was no significant difference in the incidence of serious adverse events (SAE) among the three groups ( P=0.5064). Log rank test univariate analysis and Cox risk regression model multivariate analysis showed that the history of bladder cancer recurrence( HR=6.397, 95% CI1.95-20.94, P=0.0001)was independent risk factor for BCG irrigation failure. Conclusions:The 2 years’ efficacy of intravesical instillation of domestic BCG is better than than of epirubicin with good tolerance and safety. There is no difference between BCG19 and BCG15 group. BCG doesn’t increase SAE compared with epirubicin. Recurrence status was an independent prognostic factor regarding recurrence-free survival.

Safety and efficacy of sacral neuromodulation therapy for lower urinary tract dysfunction in elderly people: A multicenter study / 中华老年医学杂志

Objective:To investigate the safety and efficacy of sacral neuromodulation(SNM)therapy for the treatment of lower urinary tract dysfunction(LUTD)in elderly patients.Methods:Clinical data of 91 elderly patients with LUTD from multiple medical institutions who received SNM during the period from January 2012 to December 2016 were retrospectively analyzed.Patients were divided into four groups: the interstitial cystitis(IC)group(n=28), the neurogenic bladder(NB)group(n=36), the overactive bladder syndrome(OAB)group(n=13)and the idiopathic dysuria(ID)group(n=14). Different sets of evaluation parameters were used for different diseases.Patients’ baseline data and data in stage I(test phase)and stage Ⅱ(permanent SNM)were recorded, statistically analyzed and compared.Results:Ninety-one people underwent SNM treatment.Of them, 53 patients received permanent implants(stage Ⅱ), and the total conversion rate of stage I to stage Ⅱ was 58.2%(53/91). Patients receiving permanent implants(stage Ⅱ)had a preoperative period ranging from 3 months to 30 years, and were followed up for 2 to 58 months after treatment, with an average follow-up of 19.6 months.The improvement rates in stage I for urinary urgency, daily urination frequency, daily nocturnal urination frequency, maximum urine volume, daily average urine volume, daily urine leakage frequency, and quality of life score were 35.4%, 31.6%, 33.7%, 32.6%, 49.2%, 43.2% and 13.2%, respectively.The improvement rates in stage Ⅱ for urinary urgency, daily urination frequency, daily nocturnal urination frequency, maximum urine volume, daily average urine volume, daily urine leakage frequency, and quality of life score were 43.2%, 40.0%, 37.8%, 50.5%, 70.5%, 70.4% and 43.2%, respectively.Three adverse events occurred, including 1 case of recurrent symptoms, 1 case of moderate infection, and 1 case of electrical lead dislocation.Conclusions:Sacral nerve stimulation has definitive and consistent curative effects on LUTD in elderly people.The follow-up time should be extended to further study the safety of sacral nerve stimulation.

The efficacy and safety of BCG in the prevention of postoperative recurrence of intermediate and high-risk non-muscle invasive bladder cancer: a randomized, controlled, multi-center clinical trial (mid-term report) / 中华泌尿外科杂志

Objective To investigate the efficacy and safety of intravesical instillation of BCG vaccine in the prevention of early recurrence of middle and high risk non-muscle invasive bladder cancer.Methods From July 2015,patients with non-muscle invasive bladder cancer aged 18-75 years with informed consent were screened and underwent transurethral resection of bladder tumor (TURBT).Immediately intravesical instillation of epirubicin 50 mg was given postoperatively.After pathology was comfirmed,patients was enrolled in group 1 (BCG15) or group 2 (BCG 19) or the control group (epirubicin 18) randomly with SAS 9.3 software.Data of follow-up and Adverse event was collected and analyzed.Results By May 31,2019,531 patients were enrolled in the study.The drop-off rate was 20.1％.167 patients (143 males and 24 females)in group 1,172 patients (141 males and 31 females)in group2 and 84(75 males and 9 females) in the control group with follow-up data were analyzed.There were no significant differences in age,gender,BMI,ECOG score,risk stratification between the three groups (P =0.8641,P =0.2906,P =0.9384,P =0.6126).The median follow-up time makes no statistical difference between the groups (P =0.9251),12.0 (6.0,22.5) months,13.0 (6.0,22.3) months,and 13.0 (7.0,22.3) months.The median recurrence time of the three groups was 4.0 (3.0,6.0) months,4.5 (3.0,9.8) months,4.5 (3.0,8.8) months.There was no statistical difference between the three groups (P =0.2852).Risk stratification in the patients got no significant difference between the three groups (P ＞ 0.05).The 1-year recurrence-free survival rates were 80.0％ in the group 1 and 88.3％ in the group 2 and 73.7％ in the control group.The group 2 was superior to the group 1 and the control group (P =0.0281,P =0.0031).There was no significant difference between group 1 and control group (P =0.2951).There was no significant difference in the cumulative recurrence-free survival between the experimental group 1 and the experimental group 2,(95％ CI 0.80-2.43,P =0.2433).The cumulative recurrence-free survival in the group 1 and the group 2 was better than the control group (95 ％ CI 0.31-0.92,P =0.0266;95 ％ CI 0.20-0.65,P =0.0008).All the cases underwent instillation were analyzed for adverse events.The incidence of overall AE(adverse events) in group 1 was 68.5％ (152/222),the incidence of grade Ⅰ-Ⅱ AE was 53.2％ (118/222),the incidence of grade Ⅲ-Ⅳ AE was 15.3％ (32/222).The incidence of overall AE in the group 2 was 71.8％ (160/223),the incidence of grade Ⅰ-Ⅱ AE was 60.1％ (134/223),and the incidence of grade Ⅲ-Ⅳ AE was 11.7％ (26/223).The overall AE rate in the control group was 53.2％ (59/111),of which the incidence of grade Ⅰ-Ⅱ AE was 42.4％ (47/111),and the incidence of grade Ⅲ-Ⅳ AE was 10.8％ (12/111).There was no difference in the incidence of overall AE between the group 1 and the group 2 (P =0.4497).The incidence of AE in the two experimental groups was higher than that in the control group (P =0.0062,P =0.0008).There was no difference in the incidence of grade Ⅲ-Ⅳ AE between the three groups (P =0.3902).Conclusions BCG(19 instillation schedule) has a better effect on preventing recurrence after 1 year of bladder surgery,which is superior to epirubicin group.The long-term efficacy of BCG in preventing recurrence and the efficacy of different schedules need to be further followed up.The lower urinary tract symptoms,which are mainly urinary frequency,are one of the causes of case fallout and should be fouced in future.Compared with epirubicin,BCG perfusion does not increase the incidence of grade Ⅲ-Ⅳ adverse reactions,and is safe to use.

Triterpenoid from Lycopodium obscurum L / 药学学报

To study the triterpenoid constituents from air-dried whole plants of Lycopodium obscurum L., the constituents were isolated by normal-phase and reverse-phase silica gel column chromatography from the EtOAc extract. Their structures were elucidated on the basis of spectral analysis. Five triterpenoids were purified and identified as 3beta, 19alpha-dihydroxy-20beta-acetate-serrat-14-en-21beta-ol (1), serratenediol (2), alpha-onocerin (3), 26-nor-8-oxo-alpha-onocerin (4), (3beta, 8beta, 14alpha, 21alpha)-26, 27-dinoronocerane-3, 8, 14, 21-tetrol (5). Compound 1 is a new serratane-type triterpene and compound 5 is isolated from this plant for the first time.

Research on relationship between angiotensinogen gene M235T and TCM syndrome type in essential hypertension patients / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To explore the relationship between angiotensinogen (AGT) gene M235T and TCM syndrome type in essential hypertension (ET) patients.</p><p><b>METHODS</b>The gene mutation frequency of AGT M235T in 168 ET patients and 42 nomotensive (NT) subjects were determined using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique.</p><p><b>RESULTS</b>There was a significant difference in AGT M235T gene mutation between patients of Gan-fire exuberant type and those of yin-yang deficiency type (P < 0.01), homozygote type TT appeared with higher frequency. Multivariate regression linear analysis demonstrated that the genotypes of AGT M235T was correlated with the prognosis of ET to a certain degree.</p><p><b>CONCLUSION</b>Gene mutation of AGT M235T may be associated with the genesis and development of ET, and the TCM syndrome type of ET has its own intrinsic molecular biological background.</p>

Analysis of the results of percent free prostate specific antigen detection among the men without prostate diseases in Xi'an / 南方医科大学学报

<p><b>OBJECTIVE</b>To measure the percentage of free prostate specific antigen (fPSA) among the men without prostate diseases in Xi'an, and understand the age-related changes in percent fPSA and its association with the pathological grade and clinical stage of prostate cancer, so as to determine the reference range of percent fPSA in Chinese men.</p><p><b>METHODS</b>A total of 829 men (including 775 men without prostate disease and 54 with prostate cancer) were enrolled into the study and the serum PSA and fPSA levels were measured for calculating the percent fPSA. The 775 prostate disease-free subjects were divided into 5 age groups to study the relations of PSA, fPSA and percent fPSA with age. In the 54 patients with prostate cancer, the relations of pathological grade and clinical stage with percent fPSA were investigated with reference to the related data of the men without prostate disease to establish the appropriate reference range of percent fPSA for Chinese men.</p><p><b>RESULTS</b>Serum PSA or fPSA levels, but not the percent fPSA, were correlated to age. In patients with prostate cancer, the percent fPSA was also correlated to the pathological grade and clinical stage. Among the men without prostate disease we investigated, the percent fPSA was significantly lower than that reported in other countries. The reference range of percent fPSA for Chinese men was > or =15%.</p><p><b>CONCLUSION</b>The percent fPSA is not correlated to age and has greater clinical value than PSA measurement in the detection of prostate cancer. The percent fPSA decreases in prostate cancer patients with lowered pathological grade, advanced clinical stage, and therefore increased malignancy. The reference range of percent fPSA reported in other countries does not apply to Chinese men, and according to our investigation, the reference range of percent fPSA> or =15% is appropriate for Chinese men.</p>

Isolation and identification of phenolic constituents from Juncus effusus / 药学学报

To study the phenolic constituents from the dry stem of Juncus effusus L. , the constituents were isolated by normal-phase and reverse-phase silica gel column chromatography from the EtOAc extract. Their structures were elucidated by spectral analysis. Six phenolic constituents were purified and identified as 7-carboxy-2-hydroxy-1-methyl-5-vinyl-9,10-dihydrophenanthrene (1) , 2,3-isopylidene-1-O-ferulic acid glyceride ( 2 ) , ( 2S )-2, 3-isopylidene-1-0-p-coumaroyl glyceride (3 ) , dehydroeffusal ( 4 ) , p-hydroxybenzaldehyde (5) and luteolin-5,3'-dimethyl ether (6). Compounds 1 and 2 are new compounds. Compounds 5 and 6 were isolated from Juncaceae plant for the first time. 13C NMR data of compound 6 were reported for the first time.

Clinical Observation of Clarithromycin for Treatment of Venereal Disease-related Prostatitis / 中国药房

OBJECTIVE:To evaluate the therapeutic effect of clarithromycin on prostatitis induced by NG,CT and U?U.METHODS:56cases of venereal disease-related prostatitis were treated with oral clarithromycin in combination with prostatic massage and hip bath.7days after withdrawing drug,examination of prostatic secretion(EPS)and detection of pathogens were carried out.RESULTS:Total effective rate was82.1%;negative turn rate was92.9%;87.5%EPS routine came back to normal;no obvious ARDs were found.CONCLUSION:Clarithromycin is high in therapeutic effect,slight in ad?verse reactions and convenient in administration.It is suitable for treatment of venereal disease-related prostatitis.

Changes of Urine Thromboxane A_2-Prostacyclin Balance in Patients with Lupus Nephritis and Their Clinical Significance / 第二军医大学学报

The levels of urine thromboxane B, (TXB2) and 6-keto-PGF1a were measured by radioimmunoassay in 24 patients with lupus nephritis and 12 normal subjects. The results showed that the level of TXB2 and the ratio of TXB2/6- keto- PGF1x in urine were significantly higher, while the level of urine 6-keto-PGF1x( was lower in patients with lupus nephritis than that in normal group. The ratio of TXB2/6-keto-PGF1a in urine was correlated positively to the content of urine protein. These results indicate that there is TXA2-PGI2 imbalance in the kidney in patients with lupus nephritis. TXA2 can play an important pathogenetic role in the progression of lupus nephritis in patients. The ratio of TXB2/6-keto-PGF1x in urine may serve as a parameter in evaluating patients with lupus nephritis.