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

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

Objective To investigate the clinical effect of Yinhua Miyanling Tablets combined with naftopidil in treatment of chronic prostatitis.Methods Patients (106 cases) with chronic prostatitis in Wuxi People,s Hospital from January 2015 to December 2015 were randomly divided into control and treatment groups, and each group had 53 cases. Patients in the control group werepo administered with Naftopidil Tablets before bedtime, 25 mg/time, once daily. Patients in the treatment group werepo administered with Yinhua Miyanling Tablets on the basis of the control group, 4 tablets/time, three times daily. Patients in two groups were treated for 8 weeks. After treatment, the clinical efficacies were evaluated, and PVR,Qmax,Qave, MIP-2, and hs-CRP in two groups were compared.Results After treatment, the clinical efficacies in the control and treatment groups were 69.81% and 88.68%, respectively, and there was difference between two groups (P < 0.05). After treatment, the PVR in two groups were significantly decreased, butQmax andQave in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, MIP-2 and hs-CRP in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05).Conclusion Yinhua Miyanling Tablets combined with naftopidil has clinical curative effect in treatment of chronic prostatitis, can improve clinical symptoms, and relieve inflammatory reaction, which has a certain clinical application value.

Objective To assess the diagnosis,treatment and prognosis of cystic renal cell carcinoma(CRCC).Methods The epidemiological,pathologic,clinical and radiological features of 29 cases of CRCC were retrospectively analyzed.Results The clinical features of CRCC were similar to those of non CRCCs.Histopathologic examination demonstrated 19 cases of renal cell carcinoma cystic degeneration,7 multilocular cystic renal cell carcinoma and 3 preexisting simple cyst cancerization.27 cases were followed.The mean followup period was 68 months(ranging from 4 to 204).Conclusion Cystic renal cell carcinoma refers to any type of renal carcinomas with cystic features,with 3 different pathological types.Proper diagnosis of the subtype is important in choosing the surgical treatment and assessing the prognosis.

患者,男性,49岁,因"尿频、尿痛伴排尿不畅1个月"入院.入院前1天感觉排尿及排便困难,尿痛明显,予保留导尿.

<正>研究显示选择性的α1受体阻滞剂多沙唑嗪可以阻止前列腺癌细胞的增殖,那么多沙唑嗪是否可以阻止其他组织癌细胞的增殖呢?HuiH等人进行了一项相关研究,研究者于体外实验中发现多沙唑嗪治疗可以阻止乳腺癌细胞增殖,并介导其凋亡,但其机制并不是完全由阻断α-肾上腺素能受体实现的。此外,多沙唑嗪可以减少

Objective To explore the possible reason of NF-κB inhibition by A20 in urinary bladder cancer cell. Methods Green fluorescent protein fused A20(GFP-A20) plasmid and dominant-negative A20 [GFP-A20(1-368)] plasmid were transfected into bladder cancer cell line T24, their expressions in cancer cells were detected by fluorescence microscopy 24 hours and 48 hours later. Semi-quantitative RT-PCR was performed to study the change of TNFR-Ⅰ, RANKL, ⅠκBα mRNA levels. Results GFP-A20 and GFP-A20(1-368) plasmids were stably expressed in T24 cells 24 hours after transfection and increased furtherly at 48h. TNFR-I and RNAKL mRNA levels were not changed by A20(GFP-A20) and GFP-A20(1-368) plasmids 24h or 48h after transfection ( P 0.05). ⅠκBα was significantly inhibited in two time points after GFP-A20 transfection. However, ⅠκBα was not affected by GFP-A20(1-368) plasmid. The statistical analyses between GFP A20 group and untreated group, GFP-A20 group and GFP-A20(1-368) group by semi-quantitative assay were significantly different( P 0.01). Conclusion A20 acted at downstream of TNFR to produce NF-κB inhibition. ⅠκBα mRNA, a reporter gene of NF-κB, was inhibited by A20.

环氧化酶2(COX-2)是诱导型前列腺素内过氧化合成酶.目前研究表明COX-2对肿瘤的发生发展起着重要的作用.本文着重阐述COX-2在泌尿系肿瘤中的研究进展以及未来的研究方向