A double-blind trial on the effect of bunazosin hydrochloride for the symptoms of benign prostatic hypertrophy]

A multicenter clinical trial was carried out on 372 patients in double-blind conditions in order to determine the clinical effects of Ea-0643 (bunazosin hydrochloride) on voiding disorders in benign prostatic hypertrophy, compared with paraprost and placebo. Of the 372 patients, 129 were assigned to bunazosin hydrochloride, 118 to paraprost and 125 to placebo. The improvement rating for all five subjective symptoms improved with passage of time in all the bunazosin hydrochloride, paraprost and placebo groups. A higher improvement rating was obtained in the bunazosin hydrochloride group for retarded urination, urinary stream condition and abdominal pressure at voiding, while the improvement rating was higher for prolonged urination in the placebo group and for residual urine in the paraprost group, but there was no significant difference in improvement ratings between the groups. The daily frequency of voiding decreased to a significant extent in the bunazosin hydrochloride and placebo group at week 1, and there was a significant difference between the bunazosin hydrochloride and the paraprost groups and between the placebo and the paraprost groups. The improvement rating for conditions of voiding was higher with the bunazosin hydrochloride group, when "slightly or better improved" cases were taken into account, but there was no difference between the groups. As for objective symptoms, maximum and average flow rate, useful measures for clinical evaluation of drug effects on voiding disorders, were significantly increased, with a decrease to match in residual urine ratio in the bunazosin hydrochloride group. In terms of maximum and average flow rate bunazosin hydrochloride was significantly superior to paraprost at weeks 1 and 2 and superior to placebo at weeks 2 and 4 and at the final evaluation as well. In terms of residual urine ratio bunazosin hydrochloride was superior to both paraprost and placebo. The global improvement rating, as assessed by the U- and chi 2-tests, was significantly higher in the bunazosin hydrochloride group than in the paraprost group, and there was a significant difference in global improvement ratings, as assessed by the chi 2-test, between the placebo and the paraprost groups, when "moderately or better improved" cases were taken into account. The stratified analysis of the prostate glands, subjective symptoms, maximum flow rate and residual urine ratio revealed that in patients with more advanced conditions the bunazosin hydrochloride group showed significantly superior improvement rates than the paraprost and placebo groups.(ABSTRACT TRUNCATED AT 400 WORDS)     

Clinical efficacy of oxendolene (antiandrogen) and bunazosin hydrochloride (alpha-adrenergic blocker) in the treatment of prostatism--comparative study of oxendolone, bunazocin hydrochloride and their combination

Antiandrogen and alpha-adrenergic blockers have recently been tried in the medical treatment for benign prostatic hypertrophy and bladder neck contracture. We herein report our results of a randomized comparative study on the clinical efficacy of oxendolone, bunazosin hydrochloride (bunazosin) and their combination for the treatment of benign prostatic hypertrophy and bladder neck contracture. The attending doctors evaluated at twelve weeks the improvement rate for three treatment regimens, 400 mg/day oxendolone, 3 mg/day bunazosin and a combination of both. Oxendolone + bunazosin showed the highest improvement rate in the evaluation of each subjective symptom and objective finding and of both. Oxendolone + bunazosin tended to show a better clinical efficacy than the other of these regimens, when the improvement was defined as that with more than one degree in the severity of retarded voiding, prolonged voiding, urinary stream condition, abdominal pressure on voiding and residual urine sensation. The improvement of such subjective symptoms seemed to occur earlier with oxendolone + bunazosin or bunazosin than with oxendolone. A significant difference was shown among the three treatment regimens in the general improvement rate on four subjective symptoms, with oxendolone + bunazosin being the highest followed by bunazosin and oxendolone in this order. The improvement rates of maximum and mean flow rate which are most important parameters to evaluate the voiding condition, at twelve weeks were significantly higher with oxendolone + bunazosin. No serious side effects were observed in this study, although treatment regimens containing bunazosin caused some minor side effects. These side effects could be prevented by the use of initial low doses of bunazosin with a subsequent gradual increment up to 3 mg/day. Taking the differences in the mechanism of oxendolone and bunazosin and the results of our study into consideration, we believe that the combination of oxendolone and bunazosin would be more useful in a clinical situation.     

Clinical study of bunazosin hydrochloride, an alpha 1-adrenergic blocker, in benign prostatic obstruction and neurogenic bladder dysfunction

A newly developed alpha 1-adrenergic blocker, bunazosin hydrochloride (Detantol, Eisai) was clinically investigated in 17 patients with benign prostatic obstruction and 18 patients with neurogenic bladder dysfunction. Subjective symptoms improved in 11 of the 17 cases (64.7%) with prostatic obstruction and in 4 of the 10 cases (40%) with neurogenic bladder dysfunction. Dose-dependent subjective improvement was observed with dosages of 3 to 9 mg/day. A dosage of 12 mg/day did not improve subjective symptoms more than did the 9 mg/day dose. In prostatic obstruction, 7 of the 10 objective parameters improved significantly. However, for neurogenic bladder dysfunction, only two parameters improved significantly. Improvements in objective findings were generally dose-dependent in cases of prostatic obstruction, but not in neurogenic bladder dysfunction. Mild side effects, none of them serious, were reported in 9 of the total 35 cases (26%). They generally consisted of dizziness, nasal obstruction and headache. Comprehensive improvement, i.e., improvement of both subjective symptoms and objective parameters, occurred in 11 of the 17 cases (64.7%) of prostatic obstruction and 6 of the 18 cases (33.3%) of neurogenic bladder dysfunction.     

Roles of vascular and renal thromboxanes in the antihypertensive effects of alpha 1 adrenoceptor antagonists

In order to assess the roles of vasoconstrictor thromboxane in the antihypertensive action of alpha 1 adrenoceptor antagonist, we explored the influences of OKY-046, a selective thromboxane inhibitor, on the antihypertensive effects of bunazosin in spontaneously hypertensive rats (SHR). 2-week antihypertensive treatment with bunazosin (0.5 mg/kg/day) did not produce a significant decrease of systolic blood pressure in SHR, as compared to untreated controls. The blood pressure reduction was associated with a decrease of PGI2/TXA2 in vascular eicosanoids generation (p less than 0.02) and an increase of TXA2 excretion in urine (p less than 0.05). A combination treatment with OKY-046 almost completely abolished the enhanced TXA2 generation in the vascular wall and kidney, which was strikingly associated with a potentiation of the blood pressure reduction by bunazosin treatment (176 vs 186 mmHg, p less than 0.01). Bunazosin directly stimulated TXA2 biosynthesis in vascular smooth muscle cells in culture in a dose-dependent manner. Thus, these data clearly indicate that bunazosin, a quinazoline derivative, enhances vasoconstrictor TXA2 system in the vascular wall and kidney possibly through direct actions, which would attenuate the antihypertensive effects of alpha 1 adrenoceptor antagonism by bunazosin treatment.     

A double-blind trial on the effect of alpha-adrenergic blocker (bunazosin hydrochloride) in the symptomatic treatment of prostatism

A double-blind placebo-controlled study of bunazosin for the treatment of symptomatic prostatism is reported, incorporating urologic departments of 25 hospitals. Four different doses of bunazosin hydrochloride was administrated orally to 174 patients having benign prostatic hyperplasia and 31 with bladder neck contracture for a period of four weeks; high dose group (45 patients, 3 mg/day for the first week followed by 4.5 mg/day for the next three weeks), middle dose group (45 patients, from 1.5 mg/day for the first week to 3.0 mg/day for the next three), low dose group (39 patient, 0.15 mg/day for the first to 1.5 mg/day for the next three) and a control group (40 patients, 0.125 mg/day for the entire four weeks). Subjective symptoms (urinary frequency, retarded urination, prolonged urination, condition of urinary stream and abdominal pressure at voiding) and objective signs (residual ratio, maximum and mean flow rate, voiding time) were observed and analyzed statistically. No bias in the background features was confirmed between any of the four groups. The subjective improvement rates evaluated by the attending doctors demonstrated a significant dose-dependent efficacy of bunazosin by H-test (p less than 0.01), although the objective improvement rates revealed no significant difference between any of the four groups. The global improvement rate evaluated by the same means demonstrated that the middle dose group was significantly superior to the control group (p less than 0.05 by U-test). According to each subjective symptom evaluated by the criteria of the drug efficacy, a dose-dependent significant (p less than 0.01) was noticed between the four groups in the improvement of the voiding condition. Although there was no significant difference by use of the H-test, the middle dose group had a significant superiority to the control group in the improvement rate of retarded voiding by use of the U-test (p less than 0.05). Only in the symptomatic cases of prolonged voiding, were dose-dependent significant differences observed between all four groups by use of the H-test (p less than 0.05). On the other hand, there was no significant difference between the four groups in the subjective or global improvement rates. Judging from the real data and the graded classification of objective signs, the high and middle dose groups were significantly superior to the control in terms of voiding time, and the high and low dose groups were the same as the control for residual urine ratio.(ABSTRACT TRUNCATED AT 400 WORDS)     

不同方法留取尿标本在FISH 技术诊断膀胱肿瘤的效果评价

目的 探讨如何留取有效尿标本,行荧光原位杂交(FISH)技术,以提高膀胱肿瘤的诊出率.方法 2009 年4 月至2011 年4 月230 例住院患者行FISH 试验,其中男性210 例,女性20 例,年龄7耀88 岁,平均年龄64.2 岁,随机分组留取尿标本,其中一次性留尿100 例(A 组),分次留尿80 例(B 组),膀胱冲洗留尿50 例(C 组).比较其尿脱落细胞总数超过100 个的比例.结果 采用一次性留尿脱落细胞超过100 个以上占83.0%,采用分次留尿脱落细胞超过100 个以上占62.5%,采用膀胱冲洗留尿脱落细胞超过100 个以上占84.0%.字2 检验提示,三组差异具有统计学意义(字2 =12.464,P=0.002).B 组与C 组有统计学差异(字2 =6.876,P=0.007),A 组与B 组有统计学差异(字2 =9.876,P=0.002).A 组与C 组无统计学差异(字2 =0.024,P=0.538),但膀胱冲洗留尿需要插入尿管及冲洗,为有创伤性方法.结论 FISH 试验是膀胱肿瘤的早期辅助诊断手段,采用一次性留取尿标本脱落细胞数优于其他方法,临床上值得推广.     

三种膀胱结石治疗方法的临床比较

目的:探讨开放手术、钬激光及超声波负压吸引联合气压弹道碎石清石系统在膀胱结石治疗中的临床疗效。方法:回顾性分析我院2006年5月～2009年8月收治104例膀胱结石患者的治疗方法。A组应用膀胱切开取石23例;B组应用钬激光碎石42例;C组应用超声波负压吸引联合气压弹道碎石清石系统碎石39例。分析比较三种方法在膀胱结石治疗中的差异。结果:A、B、C三组碎石清石的操作时间分别为(24.04±3.70)min、(41.88±17.30)min、(34.05±13.03)min,A组显著小于其他两组(P0.01),C组明显小于B组(P0.05),随结石长径增大,微创手术组操作时间明显延长。A、B、C三组的住院天数分别为(13.13±4.79)天、(11.38±3.36)天、(9.51±1.72)天,A组明显大于B组(P0.05)及C组(P0.01);C组明显小于B组(P0.05)。A、B、C三组的术后留置导尿时间分别为(7.00±2.54)天、(5.05±1.51)天、(4.03±0.99)天,A组显著大于其他两组(P0.01),C组显著小于B组(P0.01)。结论:超声波负压吸引联合气压弹道碎石清石系统在膀胱结石治疗中创伤小,安全,高效,患者恢复快;前列腺增生症并发膀胱结石可应用微创方式治疗;结石长径4 cm以上者可考虑行开放手术。     

Effect of combined dopamine and bunazosin on the ischemic heart after occlusion of the coronary artery

In order to investigate whether dopamine combined with bunazosin improves cardiac function, the global and regional cardiac function and regional blood flow of 7 anesthetized dogs were analyzed before and after occlusion of the left anterior descending coronary artery (LAD), then after 10 micrograms/kg/min dopamine infusion following the LAD occlusion, and again after a bolus infusion of bunazosin 250 micrograms/kg. Dopamine with bunazosin reduced left atrial pressure from 4.9 +/- 0.9 to 3.1 +/- 0.5 mmHg (p less than 0.05) and improved cardiac output from 1.22 +/- 0.15 to 1.50 +/- 0.14 L/min (p less than 0.05), maximum positive left ventricular dp/dt from 1721 +/- 202 to 3600 +/- 663 mmHg/sec (p less than 0.05) and the time constant from 45.2 +/- 5.0 to 27.5 +/- 4.6 msec (p less than 0.01). Bunazosin added to the dopamine reduced the elevated left ventricular peak systolic pressure caused by dopamine from 130 +/- 7 to 113 +/- 8 mmHg (p less than 0.01). With regard to the regional wall motion, the impaired LAD-delta L (the segment systolic shortening) and LAD-Elmax (the slope of peak systolic pressure--endsystolic length relation) following the LAD occlusion improved from 0.5 +/- 2.5 per cent to 5.9 +/- 2.6 per cent (p less than 0.01) and from 50 +/- 9 to 82 +/- 14 mmHg/mm (p less than 0.01) after the infusion of dopamine with bunazosin. Dopamine greatly increased the Rate Pressure Product (RPP) from 12610 +/- 1120 after LAD occlusion to 16950 +/- 1420, whereas dopamine in combination with bunazosin did not increase the RPP due to a drop of LV-PSP with little change in regional myocardial blood flow. It was concluded that combining dopamine with bunazosin was useful for improving both the global and regional cardiac functions of the ischemic heart.     

3H]bunazosin, a novel selective radioligand of alpha 1 adrenoceptors in human prostates.

The binding properties of a new radioligand, [3H]bunazosin, were studied in membranes of human prostates with benign prostatic hypertrophy (BPH). Specific binding of [3H]bunazosin was saturable, reversible, and of high affinity (Kd = 0.55 +/- 0.04 nM). The density of [3H]bunazosin binding sites (Bmax) was 676 +/- 33 fmol/mg. protein. [3H]Bunazosin rapidly associated with its binding sites in membranes of human prostates and reached steady state by 20 min. at 25C. The rate constants for association and dissociation of [3H]bunazosin binding were calculated to be 0.11 +/- 0.01/nM/min. and 0.05 +/- 0.02/min. (n = 4), respectively. Seven alpha 1 adrenoceptor antagonists competed with [3H]bunazosin for the binding sites in the rank order: R-(-)-YM-12617 greater than prazosin greater than SGB-1534 greater than bunazosin greater than terazosin greater than naftopidil greater than urapidil. In parallel studies with [3H]bunazosin, the Kd and Bmax values for [3H]prazosin binding in human prostates were slightly lower. There was a similarity in the potency and rank order of seven alpha 1, adrenoceptor antagonists for the inhibition of [3H] bunazosin and [3H]prazosin binding in human prostates. The new [3H]bunazosin binding assay in human prostates is remarkable for its low degree of nonspecific binding as compared to [3H]prazosin, especially at high ligand concentrations. Thus, [3H]bunazosin may become a useful radioligand for the further analysis of the alph 1 adrenoceptor binding sites in human prostates.     

Effect of combined dopamine and bunazosin on the ischemic heart after occlusion of the coronary artery

In order to investigate whether dopamine combined with bunazosin improves cardiac function, the global and regional cardiac function and regional blood flow of 7 anesthetized dogs were analyzed before and after occlusion of the left anterior descending coronary artery (LAD), then after 10 μg/kg/min dopamine infusion following the LAD occlusion, and again after a bolus infusion of bunazosin 250 μg/kg. Dopamine with bunazosin reduced left atrial pressure from 4.9±0.9 to 3.1 ±0.5 mmHg (p<0.05) and improved cardiac output from 1.22±0.15 to 1.50 ±0.14 L/min (p<0.05), maximum positive left ventricular dp/dt from 1721 ±202 to 3600±663 mmHg/sec (p<0.05) and the time constant from 45.2±5.0 to 27.5±4.6 msec (p<0.01). Bunazosin added to the dopamine reduced the elevated left ventricular peak systolic pressure caused by dopamine from 130±7 to 113±8 mmHg (p<0.01). With regard to the regional wall motion, the impaired LAD-ΔL (the segment systolic shortening) and LAD-Elmax (the slope of peak systolic pressure—endsystolic length relation) following the LAD occlusion improved from 0.5±2.5 per cent to 5.9±2.6 per cent (p<0.01) and from 50±9 to 82±14 mmHg/mm (p<0.01) after the infusion of dopamine with bunazosin. Dopamine greatly increased the Rate Pressure Product (RPP) from 12610±1120 after LAD occlusion to 16950±1420, whereas dopamine in combination with bunazosin did not increase the RPP due to a drop of LV-PSP with little change in regional myocardial blood flow. It was concluded that combining dopamine with bunazosin was useful for improving both the global and regional cardiac functions of the ischemic heart.     

膀胱内灌注盐酸表柔比星预防膀胱癌术后复发92例临床对照研究

目的研究盐酸表柔比星膀胱灌注预防经尿道膀胱癌电切术(TURBt)术后复发的疗效。方法对184例膀胱癌患者在TVRBt术后行膀胱灌注化疗,平均分成两组:Ⅰ组(92例)定期膀胱内灌注盐酸表柔比星,术后第1天使用50 mg,膀胱内灌注保留2 h,1周后开始常规灌注化疗,每周1次连续3次,然后每月1次连续11次,共1年;Ⅱ组(92例)为对照组灌注丝裂霉素40mg,灌注方法同Ⅰ组。结果随访10～46个月,平均(30±4)个月。复发率Ⅰ组为6.5%,Ⅱ组为17.4%,差异有统计学意义(P0.05);不良反应包括尿路刺激症状、肉眼血尿等,两组比较差异无统计学意义。结论 TURBt后早期膀胱内灌注盐酸表柔比星化疗,可以显著降低膀胱肿瘤复发率。     

Usefulness and safety of bunazosin hydrochloride in neurogenic bladder after prolonged administration]

Bunazosin hydrochloride (Ea-0643), a selective alpha 1-blocker, was administered to 14 patients with neurogenic bladder over prolonged periods of time in order to determine its efficacy and safety. Subjective symptoms were classified into 4 grades, and their response assessed after 12 weeks of treatment. The proportion of patients showing improvement by at least one grade was 50.0% for retarded urination, 16.7% for prolonged urination, 25.0% for urinary stream condition, 25.0% for abdominal pressure at voiding, and 28.6% for residual urine. Objective symptoms were also assessed after 12 weeks of treatment, and a statistically significant improvement was recognized in the volume of spontaneously voided urine, the maximum and mean flow rates on uroflowmetry. It should be noted that both of those flow rates had improved significantly only 2 weeks into the treatment. The degree of improvement in subjective and objective symptoms and the degree of general improvement were all higher at week 12 than at week 2 of treatment. Current knowledge of the mechanism of action of this drug, coupled with the observations made in this study, suggests that, once it has improved the urodynamics, it exhibits a sustained effect for prolonged periods of treatment. However, further studies are warranted concerning the mechanisms of the pharmacological action of the drug from a pathological viewpoint. The proportion of patients in whom Ea-0643 was judged to be useful at 12 weeks of treatment was 41.7%, but when the assessment of 'slightly useful' was taken into consideration, the usefulness rate rose as high as 91.7%. Stomatitis was observed in only one case as a side effect of this drug.(ABSTRACT TRUNCATED AT 250 WORDS)     

膀胱内灌注纤维蛋白溶解抑制药物对卡介苗预防膀胱癌复发的影响

目的 探讨纤维蛋白溶解抑制药物作为卡介苗（BCG）的佐剂与BCG联合膀胱内灌注治疗对BCG预防膀胱癌术后复发的影响。方法 将行手术治疗后的326例浅表性膀胱移行细胞癌（BTCC）患者随机分成A组[66例,其中经尿道膀胱肿瘤电切术（TURBT）59例、膀胱部分切除术7例]、B组（64例,其中行TURBT60例,膀胱部分切除术4例）、C组（65例,其中行TURBT61例、膀胱部分切除术4例）、D组（64例,其中行TURBT59例、膀胱部分切除术5例）及E组（67例,其中行TURBT61例、膀胱部分切除术6例）,A组患者术后定期膀胱内灌注BCG 100～120mg＋氨甲苯酸（PAMBA）0．1g,B组灌注BCG 50～60mg＋PAMBA0．1g,C组灌注BCG100～120mg＋氨基己酸（EACA）2．0g,D组灌注BCG 50～60mg＋EACA2．0g,E组灌注BCG 100～120mg,每周1次,6次后每月1次。灌注后每3个月行膀胱镜检查。结果 术后随访4～69个月,平均28．5个月,A、B、C、D组膀胱癌的复发率分别为12％（7／59）,10％（6／58）,9％（5／54）和9％（5／56）,低于E组的30％（17／57）,差异均有统计学意义（x。值分别为5．699,6．818,7．380,7．867,P值分别为0．017,0．009,0．007,0．005）;BCG剂量减少的B、D组复发率与A组、C组比较,差异无统计学意义（P〉0．05）,毒副反应发生率B、D组分别为3％（2／60）、5％（3／59）,较A、C组的11％（7／66）、13％（8／62）降低。结论 纤维蛋白溶解抑制药物PAMBA、EACA可作为BCG的佐剂,与BCG联合膀胱内灌注治疗可增强BCG预防膀胱癌术后复发的疗效,BCG剂量减半后疗效不降低。     

Study on enhancement of fibronectin-mediated bacillus Calmette-Guérin attachment to urinary bladder wall in rabbits

To clarify whether intravesical usage of fibrin clot stabilizer epsilon-aminocaproic acid (EACA) or p-aminomethyl benzoic acid (PAMBA) and different injuries enhance fibronectin (FN)-mediated bacillus Calmette-Guérin (BCG) attachment to bladder wall. Thirty New Zealand male white rabbits were randomly divided into five groups and the bladder wall of each rabbit was injured by electrocautery, cryocautery or knife cutting on left lateral wall, right lateral wall and posterior wall in different groups, respectively. Different drug was instilled into the bladder: Group A: pure PBS; B: PBS and radiolabeled BCG (³H-BCG); C: EACA and ³H-BCG; D: PAMBA and ³H-BCG; E: heparin and ³H-BCG. After instillation, each injured and non-injured bladder wall were surgically harvested and digested. The quantity of BCG attachment was detected by liquid scintillation counter (scintillation times per min, STPM). Quantity of BCG attachment to injured bladder wall was significantly (P < 0.01) greater than that of non-injured one, no matter which injury was performed. The BCG attachment to bladder wall in Group C or Group D was significantly (P < 0.05) greater than that of Group B. The quantity of BCG attachment to bladder of Group E was significantly (P < 0.05) less than that of Group B, C and D, respectively. Intravesical instillation of fibrin clot stabilizer (PAMBA, EACA) enhances FN-mediated BCG attachment to bladder wall while heparin inhibits this process. Injuries; e.g., cutting, cryocautery or electrocautery of bladder wall can significantly increase BCG attachment to the bladder wall.     

Effect of radix paeoniae rubra on expression of p38 MAPK/iNOS/HO-1 in rats with lipopolysaccharide-induced acute lung injury

Objective: To investigate the effect of radix paeoniae rubra (RPR) on expression of p38 mitogen activated protein kinase ( MAPK )/iNOS/HO-1 in rats with lipopolysaccharide-induced acute lung injury and explore the molecular mechanism.Methods: Forty healthy male Wistar rats, weighing 200-250 g, aged 6-8 weeks (mean =7 weeks), provided by the Experimental Center, Medical College, Wuhan University, Wuhan, China, were employed in this study.Under anesthesia with 7% chloraldurat (5 ml/kg body weight) through intraperitoneal injection, the trachea of the rat was exposed and an arterial puncture needle pricked into the trachea via cricothyroid membrane. Then they were randomly divided into five groups: 8 rats receiving 1 ml normal saline through the puncture needle (Group A),8 receiving 1 ml lipopolysaccharide (LPS, 2.5 mg/kg,Group B), 8 receiving LPS and RPR (30 mg/kg, pumped through the femoral vein for 2 hours, Group C ), 8 receiving RPR 2 hours before dripping LPS ( Group D),and 8 receiving hemin (75 μmol/L through intraperitoneal injection) 18 hours before dripping LPS (Group E). After 6 hours of LPS dripping, blood samples were obtained through the carotid artery to perform blood gas analysis,then all the rats were exsanguinated to death and specimens of lung tissues were obtained. The pathomorphological changes of the lung tissues were observed. The expression of p38 MAPK/iNOS/HO-1, the neutrophil ratio, protein content in alveolar irrigating solution and malonaldehyde (MDA) content in the lung tissues were also detected.Results: Compared with Group A, the expression of p38 MAPK, iNOS and HO-1 markedly increased in Groups B, C, D, and E (P ＜0.01). But in Groups C, D, and E,the expression of p38 MAPK and iNOS were significantly lower than that of Group B, while expression of HO-1 was obviously higher than that of Group B ( P ＜ 0.05 ). The protein content, the ratio of neutrophils in bronchoalveolar lavage fluid ( BALF), the content of MDA and the activities of serum NO in Group B were significantly higher than those of Group A ( P ＜ 0.01 ). There was a significant decrease in the level of arterial bicarbonate and partial pressure of oxygen in Group B (P ＜ 0.01). Compared with Group B, these indexes of lung injury were significantly lower while the levels of arterial bicarbonate and partial pressure of oxygen increased significantly in Groups C, D,and E (P ＜ 0.05 or P ＜ 0.01 ). Under light microscope, the pathological changes induced by LPS were significantly attenuated by RPR and hemin.Conclusions: The high expression of MAPK plays an important role in lipopolysaccharide-induced acute lung injury. Protective effect of RPR on lipopolysaccharideinduced acute lung injury may be related to the inhibition of the abnormal high expression of p38 MAPK/iNOS/HO-1.     

索利那新治疗膀胱过度活动症对逼尿肌功能的影响

目的 评估索利那新治疗膀胱过度活动症(overactive bladder,OAB)患者12周前后逼尿肌功能的变化.方法 2010年3-7月,20例OAB患者服用索利那新治疗.男12例,女8例.年龄21～83岁,平均43岁.病程1～20年,平均8年.患者连续服用索利那新5 mg/d 12周.服药前后行尿动力学检查,观察逼尿肌功能变化、记录OABSS得分、感知膀胱症状量表(PPBC)评分,统计学比较治疗前后的差异.结果 患者治疗前后平均逼尿肌无抑制收缩波个数分别为2.3±2.4与0.6±1.3,差异有统计学意义(P＜0.05);其中6例患者服药后逼尿肌无抑制收缩完全消失.治疗前后膀胱初次排尿感容量(103±67 ml与178±89 ml)、膀胱容量(189±133 ml与299±89 ml)差异有统计学意义(P＜0.01);膀胱顺应性、最大尿流率时逼尿肌压力差异无统计学意义(P＞0.05).服药前后OABSS量表的尿急评分(5.0±0.0与2.8±2.0)、白天排尿评分(1.3±0.5与0.4±0.7)、夜尿评分(2.9±0.4与1.4±0.92)、尿失禁评分(3.3±2.1与1.6±2.1)、PPBC评分(5.5±0.5与2.9±1.6)差异均有统计学意义(P＜0.05).6例患者诉有口干现象.结论 索利那新12周治疗可明显降低OAB患者逼尿肌无抑制收缩,增加逼尿肌储尿量,减少OAB症状,提高生活质量.

Abstract：

Objective To investigate the effects of solifenacin on the detrusor instability of patients with overactive bladder (OAB).Methods A total of 20 outpatients with OAB of.1 - 20 ( mean, 8 )years, 12 males and 8 females, aged 21 - 83 ( mean, 43) years were included in this study.Five mg solifenacin was given orally once daily for 12 weeks.Before and after treatment, overactive bladder symptom score (OABSS), patient perception of bladder condition symptoms rating scale (PPBC), and filling cystometry was performed.Results Before and after solifenacin administration, significant decrease were detected in term of unstable detrusor waves ( 2.3 ± 2.4) vs (0.6 ± 1.3 ) ( P ＜ 0.05 ), and detrusor overactivity ( DO ) disappeared in 6 patients.Bladder capacities at first desire to void and maximum bladder capacity were significantly increased (P ＜0.01 ).Bladder compliance and detrusor pressure at maximum urine flow had no significant difference (P ＞ 0.05 ).All patients had significant improvement in OAB symptoms evaluating by OABSS and PPBC ( P ＜ 0.05 ).Six patients had mild side effect of dry mouth and could be relieved by drinking more water.Conclusion Urodynamically, solifenacin decreases the detrusor overactivity, increases the bladder capacity and improves the quality of life of OAB patients.     

Clinical studies of terodiline hydrochloride and clenbuterol hydrochloride for urinary frequency and incontinence]

The clinical effectiveness and safety of terodiline hydrochloride and clenbuterol hydrochloride were studied on 51 patients with neurogenic bladder, stress incontinence, unstable bladder and others, the chief complaints of which were urinary frequency or urinary incontinence. Overall improvement was graded as marked in 6 patients (11.8%), moderate in 20 patients (39.2%), slight in 11 patients (21.6%), unchanged in 13 patients (25.5%) and aggravated in one. The patients impression was "good" or better in 56.9%. There were a total of 13 cases (25.5%) of adverse reactions, namely, 7 cases of finger tremor, 3 cases of dry mouth and others. These reactions disappeared rapidly after the discontinuance of drug administration. The clinical efficacy in the treatment of subjective symptoms was 71.4% for urinary incontinence, 56.4% for diurnal pollakisuria. The examination of lower urethral functions demonstrated a significant (p less than 0.01) increase in bladder capacity at first desire and maximum desire to void. However, we found no significant increase in urethral clossure pressure. The findings of this study suggest that terodiline hydrochloride and clenbuterol hydrochloride are very useful for the treatment of urinary frequency and incontinence.     

Clinical effect of oxybutynin hydrochloride (1 mg/tablet)

The clinical efficacy of oxybutynin hydrochloride was studied on 21 patients with neurogenic bladder or unstable bladder complaining of urinary frequency, urgency and urgent incontinence. Oxybutynin hydrochloride (1 mg/tablet) was administered orally for 26.7 days, on average, 3 mg per day in 3 and 6 mg per day in 18 patients and the usefulness of this drug was assessed subjectively and objectively. Of 21 patients treated, 9 had neurogenic bladder and 10 had unstable bladder. Urinary frequency was normalized in 6 out of 16 (37.5%), urgency ceased in 6 out of 17 (35.7%) and urgent incontinence disappeared in 9 out of 14 (50%) patients. The mean volume at the first desire to void and the maximum cystometric capacity increased significantly on the cystometrogram after the administration of oxybutynin hydrochloride (p less than 0.01). Furthermore, the maximum vesical pressure decreased significantly (p less than 0.05). The maximum urinary flow rate increased slightly (p less than 0.1) and the residual urine volume significantly increased (p less than 0.05) after medication, although no changes were observed in tidal voiding volume or mean urinary flow rate. Of 20 patients, 9 showed improvement globally (45%), although no subjective or objective improvement was observed in 4 (20%) patients. Marked side effects were observed in 5 cases (two of acute urinary retention, each of increased urgency, residual urine and liver dysfunction), and side effects were seen in 10 of the 21 (47.6%) patients.(ABSTRACT TRUNCATED AT 250 WORDS)     

亚高温盆腔区域热疗对原位膀胱肿瘤大鼠免疫状态影响的研究

目的 研究亚高温盆腔区域热疗致原位膀胱肿瘤大鼠发生热休克反应后机体免疫状态的改变.方法 经尿道膀胱灌注N-甲基亚硝基脲(MNU)制备大鼠膀胱肿瘤动物模型35只,随机分入短期组,包括肿瘤对照组(A组)、单次热疗组(B组)、间隔24 h再次热疗组(C组)、间隔72 h再次热疗组(D组)和长期组,包括肿瘤对照组(E组)、间隔24 h再次热疗组(F组)、间隔72 h再次热疗组(G组).用内生场热疗系统从体外加热大鼠盆腔至41 ℃.热疗后对肿瘤、引流淋巴结、脾脏中免疫细胞的变化进行病理研究,检测血清鼠 IFN-γ含量.结果 透射电镜观察到B、C、D组肿瘤组织中有较多中性粒细胞、巨噬细胞;F、G组中性粒细胞聚集,巨噬细胞吞噬凋亡小体.短期组中B、C、D组膀胱肿瘤组织、淋巴结及脾脏中S-100蛋白阳性细胞率均高于A组(P<0.01).膀胱肿瘤组织及脾脏中CD8阳性细胞率、血清鼠 IFN-γ含量A、B、C、D组间差异均无统计学意义(P=0.657、0.440、0.523).长期组中F、G组的各项数据均高于E组(P<0.01).结论 随着亚高温盆腔区域热疗次数的增加肿瘤鼠的免疫细胞重新分布,有利于肿瘤抗原提呈及效应细胞攻击肿瘤.     

Randomised controlled trial of two pressure-relieving systems

The primary objective of this randomised controlled trial was to determine whether there were significant differences between two pressure-relieving systems. A secondary aim was to investigate whether the availability of extra pressure-relieving equipment would reduce the incidence of ulcers in an acute hospital setting. A total of 141 patients in a care-of-the-elderly unit, who were assessed to have a high risk of developing pressure ulcers using the Waterlow score, were recruited; 70 were nursed using Huntleigh Nimbus 3 in conjunction with the Aura cushion (Group A), and 71 using the Pegasus Cairwave Therapy System in conjunction with the Proactive 2 Seating cushion (Group B). The main outcome measure was visual assessment, supported by a photographic record. There were three main findings: for non-heel ulcers and overall improvement, there was no statistically significant difference between the two products tested; for heel ulcers there was a significant difference (P = 0.019) with more patients healing in Group A than in Group B. The average length of stay of patients who completed the trial was 21.6 days (Group A) and 21.7 days (Group B) for patients completing a live (range 1-121 days) and for patients who died 29.7 days (Group A) and 24.3 days (Group B). Routine monitoring showed that, before the trial, the incidence of hospital-acquired pressure ulcers (Torrance grade 2+) was 0.2%; during the trial, this dropped to 0.13%. The study showed differences in the efficacy of different mattress products; with a sufficiently large study, it is possible to demonstrate statistically significant results. Provision of extra pressure-relieving equipment can reduce the incidence of pressure ulcers but may not influence length of stay.