Sacral Neuromodulation Using a Novel Device with a Six-contact-point Electrode for the Treatment of Patients with Refractory Overactive Bladder: A Multicenter, Randomized, Single-blind, Parallel-control Clinical Trial.

BACKGROUND: A novel sacral neuromodulation system (SacralStim) which has an electrode with six contact points was recently designed. OBJECTIVE: To evaluate the effectiveness and safety of the SacralStim system for treating patients with refractory overactive bladder (OAB). DESIGN, SETTING, AND PARTICIPANTS: This was a multicenter, randomized, single-blind clinical trial. Patients with refractory OAB were enrolled from January 2018 to May 2020. INTERVENTION: Participants were randomly allocated to the treatment group (SNM on) or the control group (SNM off) for a single-blind period of 12 ± 2 wk. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The primary outcome was the percentage of patients with a reduction in the average number of voids/24 h of at least 50% at the 12-wk follow-up visit. Other follow-up evaluations, including voiding diary outcomes, questionnaires on Overactive Bladder Symptom Score (OABSS), quality of life (QoL), device satisfaction, and causes of adverse events (AEs), were performed over the first 48 wk after implantation. RESULTS AND LIMITATIONS: The therapeutic success rate at 12 wk was 56.76% in the treatment group and 11.11% in the control group (p < 0.001). There were significant differences in voiding diary variables between the two groups, including changes in the average number of voids/24 h, micturition volume/void, and improvement in the urge incontinence ratio. No severe AEs occurred. A limitation is the sham stimulation used as a control in the study. A head-to-head study is required to make a direct comparison of devices with six and four contact points. CONCLUSIONS: This clinical trial provides strong evidence that patients with refractory OAB benefit from the novel SacralStim system. More research is required for direct comparison of the SacralStim system with traditional four-contact-point devices. PATIENT SUMMARY: This study confirms the effectiveness and safety of a novel SacralStim system that stimulates the sacral nerve for treatment of overactive bladder. The system has an electrode with six contact points and can provide more programming options after implantation.

Hengli® Chinese Botulinum Toxin Type A for Treatment of Patients With Overactive Bladder: A Multicenter, Prospective, Randomized, Double-Blind, Placebo-Controlled Trial.

Objective: To evaluate the efficacy and safety of Hengli® Chinese botulinum toxin type A (BTX-A; 100 U) in Chinese patients with overactive bladder. Methods: This study was a multicenter, randomized, double-blind, placebo-controlled trial in Chinese patients who were inadequately managed with anticholinergic medications. Eligible patients were randomized 2:1 to receive intradetrusor injections of Hengli® BTX-A (n = 144) or placebo (n = 72). The primary endpoint was the change in the number of daily micturition episodes at week 6 from baseline. The secondary efficacy endpoints included the average frequency of urgency and urinary incontinence (UI) episodes per day, urgency score, average micturition volume per day, OABSS, and QoL score. Results: In the Hengli® BTX-A group, there was a significantly greater reduction in the average number of micturition episodes per 24 h compared with the placebo group (3.28 vs. 1.43; p = 0.003). Moreover, there was a significantly greater improvement in the daily number of urgency episodes, micturition volume and OABSS score. An increased post-void residual urine volume, dysuria, and urinary tract infection represented adverse events (AEs) in the Hengli® BTX-A group. Most AEs were mild or moderate in severity. One patient in the BTX-A group initiated clean intermittent catheterization (CIC) during treatment. Conclusion: Hengli® BTX-A treatment was well-tolerated and resulted in significant improvements in OAB symptoms among Chinese patients inadequately managed by anticholinergics. Clinical Trial Registration: http://www.chinadrugtrials.org.cn/clinicaltrials.prosearch.dhtml, Identifier: CTR20131190.

The performance of intravoxel-incoherent motion diffusion-weighted imaging derived hypoxia for the risk stratification of prostate cancer in peripheral zone.

PURPOSE: To assess the association between intravoxel-incoherent motion diffusion-weighted imaging (IVIM) derived hypoxia and the aggressiveness of prostate cancer (PCa) and to explore its contribution to the risk stratification of PCa. METHODS: Seventy-five peripheral zone (PZ) PCa patients, who underwent multiparametric MRI (mpMRI), were included in this study. Systematic ultrasound guided biopsy was used as reference. IVIM was acquired with 5 b values (b = 0∼750 s/mm2). Apparent diffusion coefficient (ADC), pure tissue diffusion (Ds), volume fraction of pseudo-diffusion (fp), hypoxic fraction (HFDWI), hypoxia score (HSDWI) and relative oxygen saturation(rOSDWI), were calculated and histogram analysis was applied. Groups comparison was performed between low-intermediate-grade group (LG, the International Society of Urological Pathology (ISUP) Gleason Grade (GG) ≤2) and high-grade (HG, ISUP GG ≥ 3) group. The correlation between diffusion parameters and ISUP GG was assessed. Cross-validated Support Vector Machine (SVM) Classification was performed and compared with univariate ROC analysis to explore the risk stratification of PZ PCa. RESULTS: Mean, median, and the 10th percentile of Ds differed significantly between groups (p < 0.05). Several parameters significantly correlated with ISUP grade, and the 10th percentile of Ds showed the strongest correlation (ρ= - 0.284). The prediction model containing IVIM derived hypoxia yielded an area under the receiver operating characteristics curve (AUC) ranging 0.749-0.786 for cross-validation. The AUCs of the SVM modeling were higher than that of any single parameter. CONCLUSION: IVIM derived hypoxia demonstrated significant correlation with the aggressiveness of PCa. It's supplemental to the MRI assessment of PCa with a promising stratification of risk stratification of PZ PCa.

Efficacy and Safety of Serenoa repens Extract Among Patients with Benign Prostatic Hyperplasia in China: A Multicenter, Randomized, Double-blind, Placebo-controlled Trial.

OBJECTIVE: To evaluate the efficacy and safety of Serenoa repens among patients with benign prostatic hyperplasia (lower urinary tract symptoms/benign prostatic hyperplasia [LUTS/BPH]) in China. METHODS: We conducted a double blind, placebo-controlled study of 354 patients with LUTS/BPH from 19 institutions, to evaluate the efficacy and safety of Serenoa repens. Participants were randomly assigned (1:1) into the Serenoa repens extract (320 mg) or placebo groups for 24 weeks. Primary efficacy parameters were changes in International Prostate Symptom Score and peak urinary flow from baseline to each assessment. Secondary efficacy parameters included improvement of storage symptom and voiding symptom scores, prostate volume, urinary frequency, and total prostate-specific antigen level. Other parameters assessed were quality of life score, a four-item male sexual function questionnaire score, and International Index of Erectile Function score across the consecutive double-blind visits. RESULTS: Statistically significant improvement in the peak urinary flow, International Prostate Symptom Score, scores of storage symptoms and voiding symptoms, quality of life score, four-item male sexual function questionnaire score, and International Index of Erectile Function score were observed in the Serenoa repens extract group compared with those in the placebo group (P <.05). Two (1.18%) of 169 patients in the placebo group and 3 (1.89) of 159 patients in the Serenoa repens extract group experienced 1 or more adverse events. CONCLUSION: The Serenoa repens extract was effective, safe, well-tolerated, and clinically and statistically superior to placebo in the target LUTS/BPH population.

Development and external validation of a nomogram predicting prognosis of upper tract urothelial carcinoma after radical nephroureterectomy.

OBJECTIVE: To create multivariable models with readily available clinicopathologic variables for predicting the prognosis of upper tract urothelial carcinomas (UTUC). PATIENTS AND METHODS: We retrospectively analyzed patients diagnosed as UTUC and underwent radical nephroureterectomy in 2 high volumes, tertiary care centers. A total of 445 patients and 227 patients met the inclusion criteria were included for constructing the prediction model and external validation, respectively. Univariable and multivariable Cox regression models were used to analyze independent risk factors, and nomogram and calibration curve were constructed by R project. RESULTS: The median follow-up for the development and external validation cohorts were 33.5 and 32.5 months, respectively. Multivariable analysis detected older age (≥65 years), with concurrent bladder cancer at diagnosis, with both ureter and renal pelvic tumor, lymphovascular invasion, urothelial carcinoma with divergent differentiation, higher pathological grade and stage, and positive lymph node were significantly associated with poorer outcome of UTUC. The c-index of the nomogram with these above-mentioned independent risk factors to predict the cancer specific survival was 0.74 (95% CI, 0.64-0.84) and 0.73 (95%CI, 0.59-0.87) for the development cohort and external validation cohort, respectively. CONCLUSIONS: We developed and externally validated a novel and accurate nomogram with readily available clinicopathological information for predicting the cancer specific survival of UTUC. This nomogram could help clinicians stratify patients with UTUC into different risk groups with distinct prognosis by the total scores obtained from the prediction tool, thus facilitate decision-making and clinical trial designing.

The application of a single-use fiberoptic flexible ureteroscope for the management of upper urinary calculi.

OBJECTIVE: To evaluate the clinical outcomes with a Chinese single-use fiberoptic flexible ureteroscope (YouCare Tech) from a prospective database. MATERIALS AND METHODS: A prospective study was conducted in a single center in China between January 2016 and October 2017. All consecutive patients who underwent flexible ureteroscopy performed by YouCare flexible ureteroscope were analyzed. Patients' demographics, clinical characteristics, intraoperative parameters, postoperative complications, and stone-free rate were evaluated and recorded. Stone-free status was defined as no visible stones or clinically insignificant residual stones < 2 mm on a postoperative image study. RESULTS: A total of 684 procedures were performed for 653 patients (31 patients had bilateral stones). A double J stent had been previously placed in 431 patients. The location of the calculi was upper calyx, middle calyx, lower calyx, and renal pelvis and proximal ureter in 74, 101, 211, 115, and 183 patients, respectively. The median operative time was 52 min. The postoperative stone-free rate for the first 2 weeks after surgery was 78.5%, which increased to 91.1% at the first month. The overall stone-free rate was 95.2%. The complication rate was minor and short-term, such as gross hematuria or flank pain. CONCLUSION: YouCare flexible ureteroscope can be considered effective and safe in the treatment of both upper ureteral and renal stones in selected patients. Further evaluation of comparison with other FURS's surgical outcomes and cost-effectiveness analysis will help to present the best utility of this single-use FURS in clinical practice.

Triptorelin relieves lower urinary tract symptoms in Chinese advanced prostate cancer patients: a multicenter, non-interventional, prospective study.

BACKGROUND: Although triptorelin is increasingly used in China for biochemical castration, its effects on primary prostate cancer symptoms remain unclear. This study aimed to assess the prevalence of lower urinary tract symptoms (LUTS) in Chinese prostate cancer patients and the effectiveness of triptorelin on LUTS. METHODS: In this 48-week multicenter, non-interventional, prospective study, we enrolled patients with locally advanced or metastatic prostate cancer. Patients received triptorelin (15 mg) intramuscularly at baseline and at weeks 12, 24, and 36 with symptom assessment using the International Prostate Symptoms Score (IPSS). The primary endpoints were the prevalence of LUTS at baseline per IPSS categories and the percentage of patients with moderate to severe LUTS (IPSS > 7) at baseline, having at least a 3-point reduction of IPSS score at week 48. RESULTS: A total of 398 patients were included; 211 (53.0%) and 160 (40.2%) among them had severe and moderate LUTS, respectively. Of the patients with IPSS scores available at baseline and at week 48 (n = 213), 81.2% achieved a reduction in IPSS of at least 3 points. Of the patients with moderate to severe LUTS at baseline and IPSS scores available at baseline and at week 48 (n = 194), 86.6% achieved a total IPSS reduction of at least 3 points. CONCLUSIONS: The vast majority of Chinese patients with locally advanced or metastatic prostate cancer scheduled to receive triptorelin as part of their standard treatment have severe or moderate LUTS. Triptorelin therapy resulted in sustained improvement of LUTS in these patients.

Emerging role of Hippo signalling pathway in bladder cancer.

Bladder cancer (BC) is one of the most common cancers worldwide with a high progression rate and poor prognosis. The Hippo signalling pathway is a conserved pathway that plays a crucial role in cellular proliferation, differentiation and apoptosis. Furthermore, dysregulation and/or malfunction of the Hippo pathway is common in various human tumours, including BC. In this review, an overview of the Hippo pathway in BC and other cancers is presented. We focus on recent data regarding the Hippo pathway, its network and the regulation of the downstream co-effectors YAP1/TAZ. The core components of the Hippo pathway, which induce BC stemness acquisition, metastasis and chemoresistance, will be emphasized. Additional research on the Hippo pathway will advance our understanding of the mechanism of BC as well as the development and progression of other cancers and may be exploited therapeutically.

Support Vector Machines (SVM) classification of prostate cancer Gleason score in central gland using multiparametric magnetic resonance images: A cross-validated study.

PURPOSE: To assess the performance of Support Vector Machines (SVM) classification to stratify the Gleason Score (GS) of prostate cancer (PCa) in the central gland (CG) based on image features across multiparametric magnetic resonance imaging (mpMRI). MATERIALS AND METHODS: This retrospective study was approved by the institutional review board, and informed consent was waived. One hundred fifty-two CG cancerous ROIs were identified through radiological-pathological correlation. Eleven parameters were derived from the mpMRI and histogram analysis, including mean, median, the 10th percentile, skewness and kurtosis, was performed for each parameter. In total, fifty-five variables were calculated and processed in the SVM classification. The classification model was developed with 10-fold cross-validation and was further validated mutually across two separated datasets. RESULTS: With six variables selected by a feature-selection and variation test, the prediction model yielded an area under the receiver operating characteristics curve (AUC) of 0.99 (95% CI: 0.98, 1.00) when trained in dataset A2 and 0.91 (95% CI: 0.85, 0.95) for the validation in dataset B2. When the data sets were reversed, an AUC of 0.99 (95% CI: 0.99, 1.00) was obtained when the model was trained in dataset B2 and 0.90 (95% CI: 0.85, 0.95) for the validation in dataset A2. CONCLUSION: The SVM classification based on mpMRI derived image features obtains consistently accurate classification of the GS of PCa in the CG.

Inhibition of microRNA-500 has anti-cancer effect through its conditional downstream target of TFPI in human prostate cancer.

PURPOSE: We investigated the prognostic potential and regulatory mechanism of microRNA-500 (miR-500), and human gene of tissue factor pathway inhibitor (TFPI) in prostate cancer. METHODS: MiR-500 expression was assessed by qRT-PCR in prostate cancer cell lines and primary tumors. Cancer patients' clinicopathological factors and overall survival were analyzed according to endogenous miR-500 level. MiR-500 was downregulated in DU145 and VCaP cells. Its effect on prostate cancer proliferation, invasion in vitro, and tumorigenicity in vivo, were probed. Possible downstream target of miR-500, TFPI was assessed by luciferase assay and qRT-PCR in prostate cancer cells. In miR-500-downregulated DU145 and VCaP cells, TFPI was silenced to see whether it was directly involved in the regulation of miR-500 in prostate cancer. TFPI alone was either upregulated or downregulated in DU145 and VCaP cells. Their effect on prostate cancer development was further evaluated. RESULTS: MiR-500 is upregulated in both prostate cancer cells and primary tumors. In prostate cancer patients, high miR-500 expression is associated with poor prognosis and overall survival. In DU145 and VCaP cells, miR-500 downregulation inhibited cancer proliferation, invasion in vitro, and explant growth in vivo. TFPI was verified to be associated with miR-500 in prostate cancer. Downregulation of TFPI reversed anti-cancer effects of miR-500 downregulation in prostate cancer cells. However, neither TFPI upregulation nor downregulation alone had any functional impact on prostate cancer development. CONCLUSION: MiR-500 may be a potential biomarker and molecular target in prostate cancer. TFPI may conditionally regulate prostate cancer in miR-500-downregualted prostate cancer cells.

Relationship between preoperative renal cortical thickness and glomerular filtration rate before and after minimally invasive surgery in patients with unilateral upper urinary tract obstruction / 中国内镜杂志

Objective To investigate the relationship between preoperative renal cortical thickness and glomerular filtration rate (GFR) before and after minimally invasive surgery in patients with unilateral upper urinary tract obstruction. Methods 63 patients with upper urinary tract obstruction from July 2015 to June 2016 were enrolled in the study, including 34 males and 29 females, age ranged from 22 to 73 years old (52.21 ± 11.56). Their operation methods included 24 cases of ureteroscopic lithotripsy and lithotomy, 21 cases with one-stage percutaneous nephrostomy + two-stage percutaneous nephrolithotomy (PCNL), 18 cases of PCNL. The abdominal enhanced CT and single photon emission computed tomography (SPECT) were measured to RCT and GFR. Then all cases were divided into group A (moderate renal impairment, 15.0 ml/min ≤ GFR < 30 ml/min), group B (severe renal damage, 7.5 ml/min ≤ GFR <15.0 ml/min) and group C (extremely severe renal injury, GFR < 7.5 ml/min) according to preoperative renal GFR, and changes of GFR before and after surgery were compared among three groups. Simple linear correlation analysis was used to analyze the correlation between preoperative RCT and other indexes in group A and B. Results 9 patients were not measured RCT because of serious hydronephrosis, 54 patients included 20 cases of RCT >10 mm, 23 cases of 5 ～ 7 mm and 11 cases of <5 mm, and the average value was (10.75 ± 4.91) mm. The preoperative RCT in group A was significantly higher than that in group B (P < 0.05). GFR at 1 and 9 months after operation in three groups were significantly higher than that before operation in the same group (P < 0.05). GFR at 1 and 9 months after operation in group A were significantly higher than that the other two groups, and GFR at 9 months after operation in group B was significantly higher than that in group C (P < 0.05), but there were no significant differences in GFR at 1 month after operation between group B and C (P > 0.05). GFR recovery value at 1 month after operation in group B was significantly lower than that in other two groups (P < 0.05), but there were no significant differences in GFR at 9 months after operation among three groups (P > 0.05). Preoperative RCT was positively correlated with preoperative GFR (r = 0.613), GFR at 1 month after operation (r = 0.697) and the recovery value (r = 0.552), GFR at 9 months after operation ((r = 0.589) and recovery values (r = 0.488), and the differences were statistically significant (P < 0.05). Conclusion Removal of upper urinary tract obstruction could recover the renal function to varying degrees, even for patients with extremely severe renal injury, who could retrieve their kidney. Preoperative RCT could be helpful in judging the renal function during operation, especially for the postoperative recovery of renal function.

Compressive sensing based high-speed time-stretch optical microscopy for two-dimensional image acquisition.

In this paper, compressive sensing based high-speed time-stretch optical microscopy for two-dimensional (2D) image acquisition is proposed and experimentally demonstrated for the first time. A section of dispersion compensating fiber (DCF) is used to perform wavelength-to-time conversion and then ultrafast spectral shaping of broadband optical pulses can be achieved via high-speed intensity modulation. A 2D spatial disperser comprising a pair of orthogonally oriented dispersers is employed to produce spatially structured illumination for 2D image acquisition and a section of single mode fiber (SMF) is utilized for pulse compression in the optical domain. In our scheme, a 1.2-GHz photodetector and a 50-MHz analog-to-digital converter (ADC) are used to acquire the energy of the compressed pulses. Image reconstructions are demonstrated at a frame rate of 500 kHz and a sixteen-fold image compression is achieved in our proof-of-concept demonstration.

Fast time-lens-based line-scan single-pixel camera with multi-wavelength source.

A fast time-lens-based line-scan single-pixel camera with multi-wavelength source is proposed and experimentally demonstrated in this paper. A multi-wavelength laser instead of a mode-locked laser is used as the optical source. With a diffraction grating and dispersion compensating fibers, the spatial information of an object is converted into temporal waveforms which are then randomly encoded, temporally compressed and captured by a single-pixel photodetector. Two algorithms (the dictionary learning algorithm and the discrete cosine transform-based algorithm) for image reconstruction are employed, respectively. Results show that the dictionary learning algorithm has greater capability to reduce the number of compressive measurements than the DCT-based algorithm. The effective imaging frame rate increases from 200 kHz to 1 MHz, which shows a significant improvement in imaging speed over conventional single-pixel cameras.

A Prospective Randomized Trial Comparing Pneumatic Lithotripsy and Holmium Laser for Management of Middle and Distal Ureteral Calculi.

PURPOSE: The aim of this study was to compare the efficacy and safety between pneumatic and holmium:yttrium-aluminum-garnet (Ho:YAG) laser in the treatment of patients with ureteral stones located in the middle and distal ureter. PATIENTS AND METHODS: We conducted a prospective study in recruiting 982 eligible patients from 2009 to 2012. Patients were randomly divided into two groups-the pneumatic lithotripsy (PL) group or the Ho:YAG laser lithotripsy (LL) group. Patient demographics, stone characteristics, intraoperative parameters, and postoperative complications were evaluated and analyzed. RESULTS: The baseline demographics of patients and stone characteristics were similar in the two groups. The LL group showed significant benefits compared with the PL group in terms of mean operative time (28±9.2 vs 41±12.4 min, P=0.001) and early stone-free rate (80.8% vs 91.3%, P=0.04), but there was no statistically significant difference at the third month (92.6% vs 95.5%, P=0.15). In the LL group, 24 postoperative cases of stricture were seen, whereas only 5 cases occurred in the PL group (P=0.02). The other complications, such as perforation, bleeding, and mucosal injury, were comparable in the two groups. The average postoperative stay was also similar (1.7±2.4 days for PL and 1.5±3.1 days for LL (P=0.62). CONCLUSION: Both PL and LL are effective in the management of middle and distal impacted stones. Ho:YAG laser has advantages in better efficacy of stone fragmentation and a higher early stone-free rate but seems to have to face the increased risks of postoperative stricture.

Long noncoding RNA GHET1 promotes the development of bladder cancer.

In spite of the advances in the diagnosis and treatment of bladder cancer, the prognosis of bladder cancer remains relatively poor. As a result, it is vital to identify novel diagnostic and prognostic marker of bladder cancer. A growing volume of literature has implicated the vital role of long noncoding RNA in the development of cancer. GHET1, a recently identified lncRNA, was initially characterized in gastric cancer. However, its role in bladder cancer remains largely unknown. In this study, we demonstrated that GHET1 was upregulated in bladder cancer tissues compared to adjacent normal tissues and its over-expression correlates with tumor size, advanced tumor and lymph node status, and poor survival. GHET1 knockdown suppressed the proliferation and invasion of bladder cancer cells in vitro. In the meantime, inhibition of GHET1 reversed the epithelial-mesenchymal-transition in bladder cancer cell line. Taken together, our study suggests that the potential use of GHET1 as a prognostic marker and therapeutic target of bladder cancer.

Psychological distress, burnout level and job satisfaction in emergency medicine: A cross-sectional study of physicians in China.

BACKGROUND: Chinese physicians are not only facing heavy work overloads, but also abuse and injury because of patient mistrust of physicians. The primary objective of the present study was to measure psychological distress, burnout levels and job satisfaction among Chinese emergency physicians. METHODS: All the physicians from the EDs of three large general hospitals were recruited to undertake a questionnaire-based survey from March to April 2012. The Hospital Anxiety and Depression Scale (HADS), Maslach Burnout Inventory-General Survey and Minnesota Satisfaction Questionnaire were used. Correlations between job satisfaction and psychological distress and burnout were calculated using the Pearson correlation. An outcome was considered statistically significant if P < 0.05. RESULTS: Completed questionnaires were received from 205 (82.0%) physicians. The mean HADS anxiety subscale scores for the ED physicians and general population were 7.8 ± 3.4 and 4.7 ± 3.5, respectively (t = 1.526, P < 0.05). Additionally, the mean HADS depression subscale scores were 7.9 ± 3.6 and 4.7 ± 3.9, respectively (t = 1.567, P < 0.05). Fifty-two (25.4%) exhibited high levels of career burnout. All aspects of job satisfaction were significantly lower in the ED physicians compared with a previous report (P < 0.05). Burnout was significantly negatively correlated with intrinsic and extrinsic job satisfaction in the sampled population. CONCLUSION: Psychological distress is prevalent in this group of ED physicians, and it deserves attention from the whole society. Burnout and job satisfaction among ED physicians are at a 'moderate' level. Burnout is negatively associated with higher job satisfaction.

Docetaxel with or without zoledronic acid for castration-resistant prostate cancer.

PURPOSE: The aim of this study was to evaluate the efficacy and safety of zoledronic acid (ZA) in the combination of docetaxel-based chemotherapy for castration-resistant prostate cancer with bone metastases. METHODS: We conducted a prospective study in recruiting 105 prostate cancer patients with bone metastases from 2008 to 2010. Patients were randomly divided into two groups, 53 in the docetaxel-based chemotherapy + ZA(Group A) and 52 in the docetaxel-based chemotherapy + placebo(Group B). The different outcome between patients treated with chemotherapy combined with ZA and those with chemotherapy alone was evaluated. The Cox multivariate analyses of clinical features and different treatment methods of the 105 patients were conducted. RESULTS: There was a response of prostate-specific antigen (PSA) in 33 (62.3 %) in Group A and 28 (53.8 %) in Group B (P = 0.20). The combined approach group had better bone progression-free survival (BPFS) (9.0 vs. 6.0 months, P < 0.05) and overall survival (OS) (19.0 vs. 15.0 months, P = 0.02), but no statistical evidence of benefit was observed in terms of PSA response. Cox multivariate analysis identified the following independent prognostic factors: received ZA, high Hb level and more than 6 cycles of chemotherapy. There were no clinical relevant differences in the frequencies of adverse events between these two groups. CONCLUSIONS: Zoledronic acid treatment combined with docetaxel-based chemotherapy could have a better bone pain control and improve BPFS and OS for prostate cancer patients with bone metastases. The PSA response and SREs rate are similar.

Efficacy of daily low-dose sildenafil for treating interstitial cystitis: results of a randomized, double-blind, placebo-controlled trial--treatment of interstitial cystitis/painful bladder syndrome with low-dose sildenafil.

OBJECTIVE: To evaluate the efficacy of daily low-dose sildenafil for the treatment of nonulcer interstitial cystitis (IC) in women. PATIENTS AND METHODS: Forty-eight women with a clinical diagnosis of IC from 3 medical centers were randomly assigned to treatment with daily low-dose sildenafil (25 mg, n=24) or placebo (n=24) for 3 months. The O'Leary-Sant IC symptom and problem indices, visual analog scale scores, and a micturition diary with the interval of micturition, the frequency of nocturia, and urgency episodes were recorded before treatment, every 2 weeks after the treatment until 3 months. Patient Overall Rating of Improvement in Symptoms was assessed and regarded as effective when the value was above 50%. RESULTS: The IC symptom and problem indices scores and urodynamic index were significantly improved in sildenafil treatment group as compared with placebo group and baselines at week 4, 6, 8, 10, and 12, as well as 3 months after treatment (P<.05). Urodynamic index including first desire to void, strong desire to void, and maximum cystometric capacity was significantly improved in sildenafil treatment group at week 12 and at 3 months after treatment (P<.05). The efficiency of treatment reached 62.5%. However, no significant change of the visual analog scale values was observed between 2 groups except at week 12 in the sildenafil treatment group (P<.05). All adverse events were mild to moderate and transient. CONCLUSION: Daily low-dose sildenafil is an easy, well-tolerated, and effective treatment for IC in women.

Multiwavelength time-stretch imaging system.

A high-speed microscopic imaging system based on a multiwavelength source and time-stretch technique is proposed and demonstrated. We realize an imaging system at 1D scan rate of 80 MHz with 20 resolvable points. This scheme breaks the bottleneck of large bandwidth and high repetition rate in mode-lock lasers and has great potential for imaging system integration.