Polymyxin B hemoperfusion as a feasible therapy after source control in abdominal septic shock

BACKGROUND Polymyxin B hemoperfusion(PMX-HP) has been used as a treatment for intraabdominal septic shock by absorbing and removing endotoxins of gram-negative bacilli.AIM To investigate the clinical efficacy of PMX-HP in patients with gram-negative septic shock who underwent abdominal surgery.METHODS From January 2012 to December 2018, patients who had septic shock secondary to peritonitis were enrolled. They were classified into PMX-HP treated and control groups based on postopreative intervention using PMX-HP. The clinical outcomes were compared using 1:1 propensity score matching methods to balance the overall distribution between the two groups.RESULTS After propensity score matching, 40 patients were analyzed(20 patients in the PMX group and 20 patients in the control group). The scores of total Sequential Organ Failure Assessment(SOFA) score, renal SOFA and coagulation SOFA were significantly improved in the PMX group but not in the control group.(from 11.2± 5.8 to 4.7 ± 3.5 in PMX group vs 10.0 ± 4.0 to 8.7 ± 7.3 in control group, P = 0.047 from 2.6 ± 1.0 to 0.7 ± 1.0 in PMX group vs 2.6 ± 1.5 to 2.8 ± 1.6 in control group, P= 0.000, from 1.6 ± 1.5 to 1.3 ± 1.3 in PMX group vs 1.2 ± 1.2 to 2.8 ± 1.8 in control group, P = 0.014, respectively). Further, the length of intensive care unit(ICU)stay was significantly shorter in PMX group. However, no statistically significant difference was found in ICU mortality(50% in PMX group vs 50% in control group).CONCLUSION PMX-HP is a feasible adjunct treatment for peritonitis in ICU patients with peritonitis for improved organ impairment and to stabilize hemodynamics. It would be helpful to enhance clinical outcomes especially in patients with complete elimination of the source of gram-negative bacilli infection by surgical procedure accompanied with conventional treatment of sepsis.     

索利那新加坦索罗辛治疗膀胱过度活动症的疗效分析

目的 探讨索利那新加坦索罗辛治疗膀胱过度活动症(OAB)的疗效.方法 OAB患者53例,男15例,女38例.年龄29～72岁,平均43岁.随机分为2组,A组为单用索利那新组(27例),B组为索利那新加用坦索罗辛组(26例).服药方法:索利那新5 mg/d,坦索罗辛0.2 mg/d.连续14 d后随访,再进行OABSS评分.结果 A组患者治疗前后尿急评分分别为(3.3±1.0)与(1.9±0.6)分,OABSS评分分别为(10.8±4.9)与(5.2±1.8)分;B组患者治疗前后尿急评分分别为(3.6±1.0)与(0.9±0.1)分,OABSS评分分别为(10.7±1.9)与(3.9±1.8)分,2组治疗前后差异均有统计学意义(P＜0.05),2组治疗后尿急评分和OABSS评分差异有统计学意义(P＜0.05).结论 索利那新加用坦索罗辛可以有效缓解OAB患者的尿急症状并降低OABSS评分,索利那新加用坦索罗辛疗效好于单用索利那新.

Abstract：

Objective To evaluate the efficacy of solifenacin with or without tamsulosin in patients with overactive bladder (OAB).Methods Fifty-three patients with OAB were randomly divided into two groups (group A 27 patients, group B 26 patients).The patients received either solifenacin 5 mg/day in group A or combined with Tamsulosin 0.2 mg/day in group B for two weeks.During the treatent period all the patients recorded voiding and adverse events in a diary.The symptoms of urgency, frequency, incontinence were evaluated by OABSS scores at the begining and end of the therapy period.The results of the efficacy and safety were analyzed by using SPSS 13.0.Results The OABSS scores at the begining and end for the two groups were significantly different ( P ＜ 0.01 ).In both groups the efficacy was obvious.The OABSS scores at the end of the therapy between group A and B were significantly different (P ＜0.05 ).The efficacy of group B was better than that of group A.Conclusion The efficacy of solifenacin combined with tamsulosin was better than solifenacin alone in OAB.     

人肝细胞生长因子基因转染对大鼠肾脏缺血再灌注损伤的保护作用

Objective To compare the efficacy of two hHGF gene electroporation methodologies(muscle and kidney) in order to reduce the deleterious effects induced by renal warm ischemia. Methods Thirty male SD rats were divided into three groups, 10 in each group. One group was warm ischemia without pretreatment as control. The other two groups received hHGF gene muscle injection and subsequent electroporation and hHGF gene kidney electroporation respectively 3 days before renal warm ischemia. Pharmacokinetic, function and histology were assessed in ischemic kidney. Scr levels were measured at day 1,3,5 after injury. Results Plasma hHGF levels and hHGF expression of renal tissue in kidney electroporation group were higher than those in muscle electroporation group（P<0.01）. Both treated groups showed lower Scr than control[(79.4±23.4), (109.7±18.6) vs (164.8±55.5) ?滋mol/L,P<0.05]. The kidney electroporation group showed faster recovery of renal function, with significantly lower Scr level compared to muscle electroporation group. The tubular necrosis score was lower in both HGF-treated groups(P<0.05). The tubular necrosis score of the hHGF gene kidney electroporation group(1.365±0.186) was lower than that of hHGF gene muscle electroporation group (1.864±0.389) (P<0.05). hHGF-treated groups had fewer macrophages and lymphocytes than control group, as well as lower values of MPO activity(P<0.01), but no significant difference was found between 2 hHGF-treated groups(P>0.05). Conclusion Kidney direct electrotransfer is shown to be more efficient not only in pharmacokinetic but also in therapy as compared to muscle electrotransfer, so it may become a clinically practical alternative in renal transplantation.     

Emergency iliosacral screw fixation assisted by TiRobot for unstable posterior pelvic ring fracture北大核心CSCD

Objective To evaluate the emergency iliosacral screw fixation assisted by TiRobot for unstable posterior pelvic ring fracture. Methods The 26 patients with unstable pelvic fracture were analyzed retrospectively who had undergone emergency iliosacral screw fixation at Department of Orthopedics & Traumatology, Beijing Jishuitan Hospital from June 2018 to December 2020. They were divided into 2 groups depending on whether orthopaedic TiRobot was used to assist screw insertion. In the observation group of 14 cases subjected to TiRobot-assisted insertion of iliosacral screws, there were 10 males and 4 females with an age of (45.9 ± 10.1) years; in the control group of 12 cases subjected to conventional manual insertion of iliosacral screws, there were 9 males and 3 females with an age of (49.2 ± 11.3) years. All the surgeries were conducted within 24 hours after injury. The 2 groups were compared in terms of screw insertion time, pin insertion, intraoperative blood loss, fluoroscopy time, postoperative screw position, fracture reduction and Harris hip score at the final follow-up. Results The 2 groups were comparable because there was no significant difference between them in their preoperative general clinical data or follow-up time (P>0.05). The screw insertion time [(16.1 ± 3.4) min] and fluoroscopy time [(8.1 ± 3.3) s] in the observation group were significantly shorter than those in the control group [(26.4 ± 5.4) min and (25.2 ± 7.4) s], and the pin insertions [1 (1, 2) times] and intraoperative blood loss [(10.5 ± 6.4) mL] in the former were significantly less than those in the latter [6 (3, 8) times and (24.8 ± 6.7) mL] (all P<0.05). Postoperatively, the sacroiliac screw position was excellent in 18 cases and good in 2 in the observation group while excellent in 14 cases, good in 2 and poor in 2 in the control group; the fracture reduction was excellent in 12 cases, good in one and fair in one in the observation group while excellent in 10 cases, good in one and fair in one in the control group, showing insignificant differences in the above comparisons (P>0.05). There was no significant difference either in the Harris hip score at the final follow-up between the 2 groups (P>0.05). Conclusion Compared with conventional manual insertion of iliosacral screws, emergency iliosacral screw fixation assisted by TiRobot can effectively decrease surgical time and reduce operative invasion due to a higher accuracy rate of screw insertion. © 2022 Chinese Journal of Orthopaedic Trauma. All rights reserved.     

Intratunical bupivacaine and methylprednisolone instillation for scrotal pain after testicular sperm retrieval procedures

Aim: To investigate the effect of intratunical instillation of bupivacaine and methylprednisolone for scrotal pain, swelling and peritesticular fibrosis due to testicular sperm retrieval procedures. Methods: A total of 65 patients were randomly divided into two groups. In the instillation group (GI), 34 patients were administered 2.5 mL of 0.5 % bupivacaine combined with 10 mg/mL methylprednisolone before closure of the tunica vaginalis. In the control group (GC), 31 patients only received analgesics postoperatively by intramuscular route. The pain (by visual analogue scale, VAS) and duration of pain-free period after surgery between the two groups were evaluated at 2 and 4 h and at days 2 and 7 postoperatively. Results: The mean pain scores were significantly lower in the GI than in the GC group at 2 and 4 h after surgery (P<0.05 and P<0.01, respectively). The mean duration of pain free interval after the procedure was 47.8±16.9 (12-72) h in GI, which was significantly longer than that in GC [(9.9±3.6     

Extracorporeal shockwave therapy for Peyronie＇s disease： an alternative treatment？

Aim： To determine retrospectively the safety and efficacy of extracorporeal shock wave therapy （ESWT） in patients with Peyronie＇s disease. Methods： Fifty-three patients with stable Peyronie＇s disease underwent ESWT （group 1）. Fifteen patients matched with the baseline characteristic of the patients in group 1, who received no treatment, were used as the control （group 2）. The patients＇ erectile function （International Index of Erectile Function [IIEF-5] score）, pain severity （visual analog scale）, plaque size and degree of penile angulation were assessed before and after the treatment in group 1 and during the follow-up in group 2. Results： The mean follow-up time was 32 months （range： 6-64 months） in group 1 and 35 months （range： 9-48 months） in group 2. All the patients were available for the follow-up. Considering erectile function and plaque size, no significant changes （P 〉 0.05） were observed in group 1 before or after the ESWT. A total of 39 patients （74%） reported a significant effect in pain relief in group 1 after ESWT. However, regarding improvement in pain, IIEF-5 score and plaque size, no significant differences were observed between the two groups. In 21 patients （40%） of group 1, the deviation angle was decreased more than 10° with a mean reduction in all patients of 11° （range： 6-20°）. No serious complications were noted considering ESWT procedure. Conclusion： ESWT is a minimally invasive and safe alternative procedure for the treatment of Peyronie＇s disease. However, the effect of ESWT on penile pain, sexual function and plaque size remains questionable.     

改良型腋窝顶定位穿刺锁骨下位点阻滞麻醉的临床研究

Objective To study the feasibility of subclavicular brachial plexus block with localized puncture at the apex of the axilla.Methods 520 adult patients who underwent upper limb emergency surgery were randomly assigned to receive subclavicular brachial plexus block with localized puncture at the apex of the axilla ( experimental group) and block anesthesia with intraclavicular route ( control group).Patients in both groups received 0.375% ropivacaine, volume (40.0± 2.7)ml.During the 30 minutes after the blockade, the onset and effect of motor and sensory block, the sensory block effect of each nerve branches and integrated effect of nerve block were recorded.The VAS score and acesodyne duration with tourniquet were compared between the two groups at 2, 4, 6 and 8 hours after the drug had been used for 30 minutes.Results Within 30 minutes after the drug was delivered, the onset of motor and sensory block in the experimental group was evidently shorter than that in the control group, while the duration of motor and sensory block was evidently longer ( P ＜ 0.01).There were no statistically significant differences in motor and sensory block score, median nerve block effect and ulnar nerve block effect between the two groups.The musculocutaneous nerve and radial nerve block effects in the experimental group were better than those in the control group ( P ＜ 0.05).After the drug had been used for 30 minutes, VAS score of the experimental group at each point time was significantly lower than that of the oontrol group ( P ＜0.01).The analgesia duration of tourniquet in the experimental group was significantly longer than that of the control group ( P ＜ 0.01 ).Conclusion The modified subclavicular brachial plexus block with localized puncture at the apex of the axilla can provide perfect blockade, satisfactory anesthetic effect and higher safety in upper limb surgery.     

改良型腋窝顶定位穿刺锁骨下位点阻滞麻醉的临床研究

Objective To study the feasibility of subclavicular brachial plexus block with localized puncture at the apex of the axilla.Methods 520 adult patients who underwent upper limb emergency surgery were randomly assigned to receive subclavicular brachial plexus block with localized puncture at the apex of the axilla ( experimental group) and block anesthesia with intraclavicular route ( control group).Patients in both groups received 0.375% ropivacaine, volume (40.0± 2.7)ml.During the 30 minutes after the blockade, the onset and effect of motor and sensory block, the sensory block effect of each nerve branches and integrated effect of nerve block were recorded.The VAS score and acesodyne duration with tourniquet were compared between the two groups at 2, 4, 6 and 8 hours after the drug had been used for 30 minutes.Results Within 30 minutes after the drug was delivered, the onset of motor and sensory block in the experimental group was evidently shorter than that in the control group, while the duration of motor and sensory block was evidently longer ( P ＜ 0.01).There were no statistically significant differences in motor and sensory block score, median nerve block effect and ulnar nerve block effect between the two groups.The musculocutaneous nerve and radial nerve block effects in the experimental group were better than those in the control group ( P ＜ 0.05).After the drug had been used for 30 minutes, VAS score of the experimental group at each point time was significantly lower than that of the oontrol group ( P ＜0.01).The analgesia duration of tourniquet in the experimental group was significantly longer than that of the control group ( P ＜ 0.01 ).Conclusion The modified subclavicular brachial plexus block with localized puncture at the apex of the axilla can provide perfect blockade, satisfactory anesthetic effect and higher safety in upper limb surgery.     

The effect of α-blocker therapy on erectile functions in patients with lower urinary tract symptoms due to benign prostate hyperplasia

In this study we aimed to evaluate the impact of doxazosin treatment on erectile functions in patients with lower urinary tract symptoms （LUTS） and having erectile dysfunction （ED） at baseline. Fifty-three patients with LUTS （IPSS score 〉 7） whose maximum flow rate （Qmax） 〈 15 mL s-1 and PSA 〈 4 ng dL^-1 were enrolled in the study. Patients received doxazosin 4 nag once daily for 6 weeks. Subjective efficacy was assessed by IPSS, IPSS- Quality of Life （IPSS-QoL） for LUTS and efficacy was assessed by International Index of Erectile Function （IIEF） for erectile functions at baseline and sixth weeks. The objective efficacy was assessed by Q The patients were classified according to their self reported erectile status： group I had ED and group II did not have ED. At the endpoint, doxazosin significantly improved the total IPSS score （-7.7 ±6.1, P = 0.006）, IPSS-QoL score （-1.5 ± 1.5, P = 0.024） and Qmax （3.2 ± 4.6 mL s^-1, P = 0.002） over baseline. Mean decrease in IPSS and IPSS-QoL scores after the treatment period were 6.9 ＋ 6.4 （P 〈 0.001） and 0.95 4- 1.80 （P 〈 0.05） in group I, whereas 8.2 4- 5.8 （P 〈 0.001） and 1.9 4- 1.1 in group IX （P 〈 0.001）, respectively. Mean changes of Qmax values were 2.3 4- 3.3 mL s^-1 in group I （P 〈 0.05） and 3.7 4- 5.3 mL s-1 in group II （P 〈 0.001）. The improvement of IIEF-EF scores after the treatment period was only significant for group I. The efficacy of a-blocker therapy for LUTS was better by means of symptomatic relief for patients who did not have ED when compared with patients who had ED at baseline. However, slight improvement in erectile functions with a-blocker therapy was only seen in LUTS patients with ED.     

阻塞性黄疸术前经皮肝穿刺胆管引流对围手术期的影响

【Abstract】〓Objective〓To summarize the experience in treatment of the obstructive jaundice by preoperative percutaneous puncture of liver bile duct drainage. Methods〓Eight-six patients with obstructive jaundice were included and divided into two groups according to the operation procedure, 44 cases were given preoperative percutaneous transhepatic cholangial drainage(observation group) and then,.underwent internal or external drainage or radical operation,.42 cases were served as control group without preoperative percutaneous transhepatic cholangial drainage..Intraoperative blood loss, operative time,..hospital stay and complications were compared between two groups. The preoperative and postoperative liver function tests,such as total bilirubin(TB),.serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) were evaluated and compared in two groups. Results〓The operation time,.blood loss,.length of hospital stay and complication rates between observation group were lower than that in control group (P<0.05). The levels of TB, ALT, AST in 14 days after operation reduced in two groups, but were significantly decreased in observation group,.as compared to control group (P<0.05). Conclusion〓For patients with obstructive jaundice, preoperative percutaneous transhepatic cholangial drainage would shorten the length of hospital stay,.reduce complications occurrence,.and improve liver function.     

A randomized study of prophylactic intravesical instillation of pirarubicin (THP) prior to transurethral resection of superficial bladder cancer

A prospective randomized study was conducted to evaluate the efficacy of prophylactic intravesical instillation of pirarubicin (THP) prior to transurethral resection (TUR) of superficial bladder cancer. A total of 63 patients were randomized into two groups, the THP group and the control group. In the THP group, 30 mg of THP dissolved in 50 ml saline was administered 4 times intravesically for 4 consecutive days before TUR. In the control group, no instillation was performed before TUR. The patients were followed by cystoscopy and urinary cytology every 3 months. The non-recurrence rates in the THP group and control group were 54.1% versus 37.6% at 1 year and 40.4% versus 26.8% at 2 years, respectively (P = 0.086). Time to recurrence for tumors larger than 1 cm was significantly longer in the THP group (P = 0.0137). Time to recurrence for single and grade 1+2 tumors tended to be longer in the THP group (P = 0.09, P = 0.079). No significant adverse effects were observed in any patient. Our findings suggest that intravesical THP instillation prior to TUR would be effective for patients with single, low grade lesions larger than 1 cm of superficial bladder cancer.     

术后膀胱灌注联合生物制剂预防膀胱癌复发的临床观察

目的：总结吡柔比星（THP）膀胱灌注联合乌苯美司片预防浅表性膀胱癌术后复发的疗效及安全性。方法：2008年10月～20n年10月对103例浅表性膀胱尿路上皮癌患者行经尿道膀胱肿瘤切除（TURBT）术,术后分成两组,其中THP膀胱灌注联合鸟苯美司片组56例,单纯THP膀胱灌注组47例。THP灌注方法为30mg／次,每次膀胱内保留30min,每周1次共8次,然后每月1次共8次;乌苯美司片服法30mg／d,早晨顿服,连用10个月。定期行膀胱镜检查。结果：103例患者获得随访,平均随访（12．5±6．28）个月,THP联合乌苯美司组1年和2年复发率分别为8．9％和10．7％;单纯THP组1年和2年复发率分别为12．8％和19．1％,差异有统计学意义。THP联合乌苯美司组副作用主要为膀胱刺激征及轻微血尿,全身副作用少,症状轻,较单纯THP组无明显差异。结论：THP膀胱灌注联合乌苯美司片预防浅表性膀胱癌术后复发疗效满意,副作用以下尿路局部症状为主,安全性好。     

Safety and efficacy of intensive instillation of low-dose pirarubicin vs. bacillus Calmette-Guérin in patients with high-risk non-muscle-invasive bladder cancer

ObjectivesTo evaluate the safety and efficacy of intensive intravesical instillation of low-dose pirarubicin (THP) for 6 times vs. bacillus Calmette-Guérin (BCG) without maintenance therapy after transurethral resection of bladder tumor (TURBT) in patients with primary high-risk non-muscle-invasive bladder cancer (NMIBC).Materials and MethodsWe retrospectively evaluated 370 patients with primary high-risk NMIBC who underwent TURBT from November 1993 to April 2019. The patients were divided into 2 groups: patients treated with intravesical instillation of BCG without maintenance therapy (BCG group) and intensive intravesical instillation of low-dose (20 mg) THP for 6 times within 10 days after TURBT (THP group). Safety was assessed using the Common Terminology Criteria for Adverse Events version 5.0. Background-adjusted multivariate analyses were performed to evaluate the effect of intensive intravesical instillation of low-dose THP on oncological outcomes, including intravesical recurrence-free survival (RFS), upper urinary tract RFS, muscle-invasive bladder cancer-free survival, metastasis-free survival, cancer-specific survival, and overall survival.ResultsOf the 370 patients with primary high-risk NMIBC, 180 (49%) and 190 (51%) were stratified into the BCG and THP groups, respectively. The incidence rate of adverse events of any grade in the BCG group was significantly higher than that in the THP group (P < 0.001). In the background-adjusted multivariate analyses, no significant differences were observed in oncological outcomes between the BCG and THP groups.ConclusionsIntensive intravesical instillation of low-dose THP for 6 times may be one of the treatment options in view of safety and efficacy after TURBT in patients with primary high-risk NMIBC.     

吡柔比星加卡介苗膀胱灌注预防肿瘤复发的效果及尿中IL-8变化的临床意义

目的 比较吡柔比星（THP）加卡介苗或单用卡介苗膀胱灌注预防膀胱肿瘤复发的疗效，并测定灌注后IL-8的变化，探讨其与疗效的关系。方法对62例膀胱部分切除术后患者分别给予THP加卡介苗或单用卡介苗膀胱灌注预防复发，用酶联免疫学方法测定灌注前后尿中IL-8的浓度。赔果联合用药组复发率明显低于单用BCG组，两组灌注后尿中IL-8的浓度均有明显的变化，但两组之间无显著性差别。结论THP加BCG膀胱灌注可有效降低膀胱肿瘤复发率，而这一效果是作用机制不同药物的叠加作用，而不是化疗药物对免疫药物疗效的放大作用。     

Prophylactic effect of pirarubicin (THP) on postoperative recurrence of superficial bladder cancer in terms of intravesical retention time]

In order to determine the modality of prophylactic intravesical instillation of pirarubicin (THP = tetrahydropyranyladriamycin) following transurethral resection (TUR) of superficial bladder cancer, a prospective randomized study was performed. A total of 79 patients were randomized into "2-hour instillation" (A), "5-min instillation" (B) and "control" (C) groups. Prophylactic efficacy and side effects were analyzed in each group. In groups A and B, 20 mg of THP was first dissolved in 10 ml of distilled water, adjusted to 40 ml with saline and was administered intravesically once a week for 10 weeks, starting from 1 week after TUR. The recurrence-free rate was calculated in 65 evaluable patients. The one-year recurrence-free rate was 70.2% in group A, 62.8% in group B and 52.1% in group C. The one-year recurrence-free rate was significantly higher in group A than in group C. Adverse effects were observed in 21.4% of the patients in group A and 40.7% in group B. There was no significant difference in the occurrence rate of side effects between these two groups. Taking the prophylactic efficacy and side effects into consideration, "2-hour instillation" seemed to be better than "5-min instillation".     

吡柔比星术后即刻膀胱灌注联合常规灌注预防表浅性膀胱癌术后复发的对照研究

目的：比较吡柔比星两种膀胱内灌注方法预防表浅性膀胱癌术后复发的有效性及安全性。方法：将52例经尿道膀胱癌电切术后表浅性膀胱癌患者随机分为两组。每次吡柔比星灌注剂量30mg,治疗组术后24h内膀胱灌注1次,此后每周灌注1次,连续8周,再改为每月灌注1次,至术后1年。对照组术后2周开始灌注,此后每周灌注1次,连续8周,再改为每月灌注1次,至术后1年。结果：全部病例均获随访,时间为12～24个月,平均随访16．3个月。其中治疗组随访期内2例复发,复发率8％;对照组随访期内4例复发,复发率14％,两组复发率比较差异有统计学意义（P〈0．05）,不良反应主要为尿路刺激症状。结论：本研究显示,吡柔比星膀胱灌注预防表浅性膀胱癌术后复发的疗效满意,用药方便,患者耐受性好;术后即刻膀胱灌注联合常规灌注较常规灌注可以降低肿瘤复发率,值得推荐。     

Interstitial cystitis: bladder training with intravesical oxybutynin

PURPOSE: We assess the efficacy of intravesical administration of oxybutynin chloride in patients with interstitial cystitis. MATERIALS AND METHODS: The study included 36 women with a mean age of 45 years with a diagnosis of interstitial cystitis. Patients were treated with gradual intravesical instillation of saline oxybutynin solution (oxybutynin group) or gradual filling of simple saline (control group). Evaluation parameters consisted of symptom problem index, voids per day, volume per void, functional bladder capacity, volume at first sensation, cystometric bladder capacity and cystometric volume at first sensation. RESULTS: Statistically significant improvement of all evaluated parameters was found in both groups. When comparing the outcomes statistically significant improvement of parameters favored the oxybutynin group. CONCLUSIONS: Bladder training alone produces a satisfactory result by gradually expanding the bladder, and an additional statistically significant improvement is evident with intravesical oxybutynin.     

Randomized study of single early instillation of (2r)-4-o-tetrahydropyranyl-doxorubicin for a single superficial bladder carcinoma.: Cancer 2002;94:363–8.

Background:Although transurethral resection of a bladder tumor (TUR-BT) alone has been standard treatment for single superficial bladder carcinoma, some authors reported a certain prophylactic effect of a single immediate intravesical instillation of chemotherapeutic agent after TUR-BT. A prospective randomized study was conducted to determine whether a single (2R)-4-O-tetrahydropyranyl-doxorubicin (THP) instillation immediately after TUR-BT is beneficial to patients with a single superficial bladder carcinoma.Methods:One hundred seventy patients with a single resectable superficial bladder carcinoma (Ta-1, primary or recurrent with no recurrence during the last 1 year) were enrolled in this study. THP (30 mg/30 mL of normal saline) was administered into the bladder within 6 hours after TUR-BT in arm A, whereas TUR-BT alone was done in arm B.Results:Of the 170 patients, 160 (94.1%) were eligible and were followed up for a median time of 40.8 months. There was a significant difference in the recurrence-free curve between the 2 arms (log-rank test; P = 0.0026), with 92.4% recurrence-free rate at 1 year, 82.7% at 2 years, and 78.8% at 3 years in arm A (84 patients) and 67.0%, 55.7%, and 52.6%, respectively, in arm B. The recurrence rate per year was 0.11 ± 0.22 in arm A and 0.24 ± 0.36 in arm B, with a significant difference (P = 0.007). Toxicity included pain with micturition in 9 patients (10.7%), urinary frequency/urgency in 5 patients (6.0%), and macroscopic hematuria in 7 patients (8.3%).Conclusions:These data indicate that a single THP instillation immediately after TUR reduces the recurrence of superficial bladder carcinoma.     

沙培林膀胱灌注对浅表性膀胱癌患者术后疗效观察

目的 研究沙堵林(OK-423)膀胱灌注预防浅表性膀胱癌术后的疗效及安全性.方法 将78例浅表型膀胱癌患者随机分成两组.沙培林组(40例)术后1周开始常规灌注沙培林5KE,膀胱内灌注保留2h,每周1次连续6周,之后每月1次连续8个月.对照组(38例)灌注吡柔比星30mg,灌注方法 同沙墙林组.结果随访6～36个月.原发...     

Intravesical hyaluronic acid for interstitial cystitis/painful bladder syndrome: A comparative randomized assessment of different regimens

Objectives: To compare the clinical effectiveness of different regimens of intravesical hyaluronic acid instillation for patients with interstitial cystitis/painful bladder syndrome. Methods: A total of 60 patients (age 16–77 years) diagnosed with interstitial cystitis/painful bladder syndrome were enrolled in this prospective, randomized study. A total of 30 patients were assigned to receive four weekly intravesical instillations of 40 mg of hyaluronic acid followed by five monthly instillations (hyaluronic acid‐9 group). Another 30 patients received 12 intravesical instillations of 40 mg hyaluronic acid every 2 weeks (hyaluronic acid‐12 group). Symptomatic changes after hyaluronic acid treatments were assessed using Interstitial Cystitis Symptom and Problem Indexes, pain visual analog scale, functional bladder capacity, frequency and nocturia in voiding diary, maximum flow rate, voided volume, postvoid residual volume, and Quality of Life Index at 1, 3 and 6 months. Results: Of the 60 patients, 59 were evaluable at the end of the study. The Interstitial Cystitis Symptom Index, Interstitial Cystitis Problem Index and total score, pain visual analog scale, functional bladder capacity, maximum flow rate, and Quality of Life Index improved significantly after 6 months in both groups. The frequency and voided volume improved significantly only in the hyaluronic acid‐12 group. However, patients with moderate and marked improvement were clinically similar in both groups. The measured variables did not differ between the two groups over the course of the study. Conclusion: No significant difference was noted in the therapeutic effect between two hyaluronic acid instillation regimens for treatment of interstitial cystitis/painful bladder syndrome patients. Both groups showed significant improvement in symptom scores and Quality of Life Index.