Impact of intermittent androgen deprivation therapy on prostate volume and lower urinary tract symptoms in patients with prostate cancer combined with prostatic hyperplasia / 中华老年医学杂志

Objective To explore the impact of intermittent androgen deprivation therapy on prostate volume and lower urinary tract symptoms (LUTS) in patients with prostate cancer combined with prostatic hyperplasia (BPH),and to evaluate the clinical effect of intermittent androgen deprivation therapy as compared with conventional drug in patients with BPH.Methods Patients with prostate cancer (n=57) and BPH (n=83) were respectively treated with intermittent androgen deprivation therapy and finasteride combined with alpha-receptor antagonist.Prostate volume,international prostate symptom score (IPSS),quality of life index (QOL) and maximum urinary flow rate (Qmax) in patients were observed before and 1,3,6 and 12 months after treatment.Results The improvements in prostate volume,IPSS,QOL and Qmax were higher in prostate cancer patients treated with intermittent androgen deprivation therapy than in BPH patients treated with finasteride combined with alpha-receptor antagonist (P ＜ 0.05).Conclusions Intermittent androgen deprivation therapy can significantly reduce prostate volume and improve LUTS in patients with prostate cancer,and has a better clinical effect than finasteride combined with alpha-receptor antagonist treatment.

Analysis of compliance with medical therapy in elderly patients with benign prostatic hyperplasia / 中华老年医学杂志

Objective To investigate the compliance with medical therapy in elderly patients with benign prostatic hyperplasia (BPH).Methods The BPH patients aged 66 to 93 treated with 5α-reductase inhibitor (finasteride) and/or α-blockers (tamsulosin,doxazosin or terazosin) were followed up for 6 months.The retrospective data,including international prostatic symptom score (IPSS),quality of life (QOL),maximum flow rate (Qmax),prostate volume (PV),the information of medical types,total number of days of medication supplied,discontinuation and switching of therapy,and adverse effects were collected and analyzed.Results In all 103 subjects,30 patients (29.1％) received α-blockers,25 patients (24.3％) received finasteride,and 48 patients (46.6％)received combination therapy.After a follow-up of 6 months,the medication possession ratio (MPR)was 0.89±0.23 with a good-compliance rate (MPR≥0.8),discontinuation rate and switching rate were 79.6％ (82 cases),5.8％ (6 cases) and 6.8％ (7 cases),respectively,while the efficacy rate,the adverse reaction rate,incidence of acute urinary retention (AUR) and incidence of BPH related operations were 73.8％ (76 cases),12.6％ (13 cases),15.5％ (16 cases) and 4.9％ (5 cases),separately.The MPR (0.90±0.24) and good-compliance rate (84.0％) in patients treated with finasteride were both greater than those with α-blockers (0.87 ± 0.25,76.7％) and combination therapy (0.89 ±0.22,79.2％),but with no significant difference.Compared with patients with badcompliance,the efficacy ratio of medical therapy was significant higher in patients with goodcompliance (81.7％ vs.42.9％),while the incidence of adverse effects and AUR were significant fewer (7.3％ vs.33.3％ and 9.8％ vs.38.1％).Conclusions Elderly patients received either monotherapy or combination therapy with finasteride and α-blockers have good-compliance,which might be associated with the good effect of medical therapy and fewer adverse effects.

Diagnostic and therapeutic status of the elderly outpatients with benign prostatic hyperplasia in Guangzhou / 中华老年医学杂志

Objective To evaluate the diagnostic and therapeutic status of lower urinary tract symptoms (LUTS) in the elderly outpatients with benign prostatic hyperplasia (BPH) in Guangzhou.Methods The investigation was conducted in outpatient departments for elderly patients in 3 hospitals of Guangzhou. The eligible male patients with LUTS/BPH were chosen from patients who came to the clinic in the process of investigation. Results The 29.7% (1824/6140) of them had history of LUTS/BPH previously or presently. In 134 patients received medical questionnaire, the proportion of LUTS/BPH patients with mild, middle and severe degree based on international prostate symptom score (IPSS) was 24.5%, 72.5% and 3.0% respectively. The abnormal percentage of PSA was 37. 3 %. The most common examinations that patients received were directeral rectun examination (96.8%), PSA (88. 7%) and transabdominal ultrasonography (84.8%). The 44.7% of cases were given the treatment of 5α-reductase inhibitor, and 24.7% of cases received a combination therapy of 5α-reductase inhibitor plus α receptor blocker. The 16.7% of cases were given a combination treatment of 5α-reductase inhibitor plus herbs. The proportion of therapy with α receptor blocker and herbs was similar (6.8% and 7.1% respectively). Conclusions LUTS/BPH is one of the most common diseases in elderly male patients. The examinations conducted by doctors are unreasonable.The doctors are easy to ignore inquirement of patient's history and IPSS. The drugs conducted by doctors are reasonable basically.

Gallbladder Mucosal Ablation by Hysteroscopic Rollerball Electrocoagulation after Cholecystostomy / 中国微创外科杂志

Objective To explore the feasibility of gallbladder mucosal ablation by hysteroscopic rollerball electrocoagulation after cholecystostomy.Methods Under epidural or general anesthesia combined with local anesthesia,20 patients were examined and treated with hysteroscopy after cholecystostomy.After inserting a Storz endoscope,the epithelium of the proximal cystic duct and the mucosa of the gallbladder were ablated with the roller-ball and roller-barrel electrodes respectively.The electrocoagulation power was set at 60-70 W with the roller-barrel excursion rate between 10-15 mm/s,which makes the inner wall of the cyst homogenously brown-grey.Results The mean endoscopic operation time was 35 minutes(range: 25-55).Among the patients,the gallbladder lumen was completely obliterated within one month in 12 patients,and within 3 months in 5;3 patients developed retention cysts.Conclusion Endoscopic electrocoagulation of the cholecystic mucosa is feasible for obliteration of the gallbladder.

Urinalysis of transforming growth factor-β1 in old patients with diabetic nephropathy / 中国康复理论与实践

@#ObjectiveTo search detecting urine transforming growth factor-β1(TGF-β1) of type 2 diabetes mellitus(DM) in diagnosing early diabetic nephropathy in old patients.MethodsTGF-β1,microalbumin,microglobulin α1 and microglobulin β2 in urine from 53 cases of old type 2 diabetics and 27 cases of normal controls were detected.ResultsTGF-β1 was(21.2±7.32) ng/mmolCr in diabetics whose urine albumin were normal and was(58.79±25.93) ng/mmolCr in diabetics whose urine microalbumin was abnormal(P<0.01).Both were significantly higher than that of the normal control which was(7.79±3.58) ng/mmolCr(P<0.01).TGF-β1 was direct remarkably correlative with microablumin(r=0.5415),microglobulin α1(r=0.6282) and microglobulin β2(r=0.3248)(P<0.01 respectively),but was nothing with glycohemoglobin(r=0.2304,P>0.05).ConclusionTGF-β1 detection may be used as a sensitive and reliable guideline to diagnose early diabetic nephropathy in old diabetics.