Background and purpose:Bladder carcinoma is the most common tumor in the urogenital system in China. For patients with non-invasive bladder cancer, intravesical therapy is an important part of treatment after complete transurethral resection (TURBt). Bacillus Calmette-Guerin (BCG) remains the most effectively used immune agent, and epirubicin (EPI) has been reported to have an improved antitumor activity and high remission rate. However, the results differed significantly from study to study. To compare the efficacy and treatment-induced side effects of intravesical epirubicin versus BCG on postoperative recurrence of non-invasive bladder carcinoma, we completed a meta-analysis of the published literature. Methods:According to the criteria in the paper, we retrieved published comparative studies on intravesical epirubicin versus BCG for non-invasive bladder carcinoma. Data were extracted from each identified paper and Revman4.2 software was used for statistical analysis.Results:6 trials including 1 288 patients were eligible according to the eligibility criteria. Of 657 cases that were treated with epirubicin and 631 with BCG, recurrence occurred in 253 and 184 respectively. Pooling data of a meta-analysis indicated that BCG statistically reduced the incidence of tumor recurrence (Peto OR=1.60, 95%CI=[1.26, 2.03], P=0.000 1). With regard to tumor progression, BCG was also statistically superior to epirubicin (Peto OR=1.70, 95%CI=[1.16, 2.49], P=0.006). 5 studies reported the comparison on main local side effects in terms of hematuria, cystitis or irritative symptoms. Combined results showed that the incidence of hematuria (Peto OR=0.47, 95%CI=[0.35, 0.62], P

Objective To compare the clinical efficacy of laparoscopic surgery and open surgery for intraperitoneal bladder rupture.Methods From January 2004 to August 2013,the clinical data and therapeutic methods of 50 patients with intraperitoneal bladder rupture were retrospectively reviewed,inclu-ding 26 cases of laparoscopic surgery and 24 cases of open surgery.The operative time,intraoperative blood loss,postoperative intestinal recovery,hospital stay,analgesic use rate and complication ratio were com-pared between the two groups.Results All surgeries were successfully performed.There were significant differences in intraoperative blood loss [(54.24 ±5.38)ml vs(89.35 ±12.17)ml],intestinal recovery time [(23.24 ±2.39)h vs(38.42 ±6.98)h],hospital stay [(4.64 ±1.42)d vs(7.04 ±1.29)d]and analgesic use rate [38.64%(10 /26)vs 75.00%(18 /24)]between laparoscopy group and open surgery group,respectively(P <0.05 ).No significant differences in operative time [(56.12 ±8.53 )min vs (64.48 ±13.21)min]and incidence of postoperative complication [7.69%(2 /26)vs 8.33%(2 /24)] were observed between laparoscopy group and open surgery group,respectively(P >0.05).Conclusion Laparoscopic treatment of intraperitoneal bladder rupture has the advantages of mini-invasion and rapid re-covery compared with traditional open surgery.

Objective To study the influence of blood glucose, blood lipids and other cerebral infarction risk factors in the mean platelet volume (MPV). Methods A total of 562 patients with cerebral infarction and type 2 diabetes mellitus (DM) and 216 cerebral infarction patients without DM (non-DM) were included in this study. The platelet parameter of peripheral blood and other laboratory indexes were detected including platelet count (PLT), MPV, platelet distribution width (PDW), plateletcrit (PCT), fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c), triglycerides (TG), total cholesterol (TC), high-density lipoprotein (HDL-C), low density lipoprotein (LDL-C) and very low density lipoprotein (VLDL-C), urea nitrogen (BUN), creatinine (Cr), uric acid (UA), high-sensitivity C-reactive protein (hs-CRP) and homocysteine (HCY). The patients were scored by the National Institute of Health stroke scale (NIHSS) after hospitalization. The MPV changes in patients with cerebral infarction were observed, and different influences of blood glucose, blood lipids to MPV were analysed. Results Values of FBG, HbA1c, TC, TG, LDL-C, BUN, UA, HCY, hs-CRP, and NIHSS were significantly higher in DM group than those of non-DM group. The score of NIHSS was significantly higher in DM group than that of non-DM group. The level of HDL-C was significantly lower in DM group than that of non-DM grou. The MPV was significantly higher in DM group than that of non-DM group [(9.60 ± 1.35) fL vs. (9.27 ± 1.01) fL, P<0.05). There was a positive correlation between MPV and FBG, HbA1c, hs-CRP, WBC, VLDL-C and NIHSS, r=0.438, 0.410, 0.336, 0.164, 0.321 and 0.249 (P<0.05). Multiple regression analysis showed that FBG, VLDL-C, HbA1c, hs-CRP and NIHSS were the independent influential factors of MPV (P<0.05). Conclusion The influencing factors of MPV should be controlled in patients with cerebral infarction combined with type 2 diabetes mellitus, reducing the activation of platelet, and delaying the progress of cerebral infarction.

Arsenic trioxide albumin microspheres (As2O3-BSA-NS) were prepared by using methods of chemical cross-linking. The desirability function (DF), calculated according to the size (<1 microm) distribution, drug loading and drug trapping efficiency, was introduced as a total index for the microspheres formulation. Four factors, inculding W/O ratio, decentralization speed, BSA concentration and stirring stabilization time, were selected and arranged in an orthogonal experimental table. The release characteristic was studied by the drug release experiment in vitro. The four factors affected DF differently. Decentralization speed behaved as the maximum (P<0.01), followed by BSA concentration (P<0.05) and the W/O ratio dose (P<0.05). Stirring stabilization time did not influence DF (P>0.05). The release experiment in vitro showed that As2O3 in As2O3-BSA-NS was released more slower than pure As2O3. It was concluded that regular As2O3-BSA-NS may be prepared by the methods of chemical cross-linking, which was optimized by orthogonal experimental analysis of different factors, and the microspheres can release As2O3 slowly.
Arsenicals/*chemistry ; Cross-Linking Reagents/pharmacology ; Delayed-Action Preparations ; Drug Carriers/*chemistry ; Drug Delivery Systems ; Microspheres ; Oxides/*chemistry ; Serum Albumin, Bovine/*chemistry ; Technology, Pharmaceutical

Objective: To observe the clinical efficacy of warm needling moxibustion plus isokinetic muscle strength training for knee osteoarthritis (KOA).Methods: A total of 135 patients with KOA due to Yang deficiency and coagulated cold were randomized into a warm needling moxibustion group, an isokinetic muscle strength training group, and a combined group by the random number table method, with 45 cases in each group. The warm needling moxibustion group was treated with warm needling moxibustion. The isokinetic muscle strength training group was treated with isokinetic muscle strength training. The combined group was treated with warm needling moxibustion plus isokinetic muscle strength training. The Western Ontario and McMaster Universities osteoarthritis index (WOMAC) and visual analog scale (VAS) were scored before and after treatment, and isokinetic indicators of peak torque (PT), total work (TW) and average power (AP) were evaluated. Results: The total effective rate of the combined group was 92.5％, which was significantly higher than 83.3％ in the warm needling moxibustion group (P<0.05) and 72.5％ in the isokinetic muscle strength training group (P<0.05). After treatment, the scores of WOMAC (total, pain, stiffness, and function) and VAS, and isokinetic indicators (PT, TW, and AP) were all improved compared with those before treatment (P<0.05) in all three groups. The differences among the three groups were statistically significant (P<0.05). The WOMAC total score and score of stiffness in the combined group were lower than those in the warm needling moxibustion group and the isokinetic muscle strength training group (P<0.05), and the scores in the warm needling moxibustion group were lower than those in the isokinetic muscle strength training group (P<0.05). The WOMAC score of pain and VAS score in the warm needling moxibustion group and the combined group were lower than those in the isokinetic muscle strength training group (P<0.05). The differences between the warm needling moxibustion group and the combined group were not statistically significant (P>0.05). The WOMAC function score in the combined group was lower than that in the warm needling moxibustion group and the isokinetic muscle strength training group (P<0.05), while there was no statistical difference between the warm needling moxibustion group and the isokinetic muscle strength training group (P>0.05). PT, TW, and AP in the combined group were higher than those in the warm needling moxibustion group and the isokinetic muscle strength training group (P<0.05), and they were higher in the isokinetic muscle strength training group than in the warm needling moxibustion group (P<0.05). Conclusion: Warm needling moxibustion plus isokinetic muscle strength training has a better effect in the treatment of KOA due to Yang deficiency and coagulated cold than either warm needling moxibustion or isokinetic muscle strength training alone.

Objective:To observe the clinical efficacy and safety of knee-balancing Tuina(Chinese therapeutic massage)manipulation for pes anserina bursitis(PAB). Methods:A total of 64 patients with PAB were enrolled and divided into a Tuina group and a medication group by the random number table method,with 32 cases in each group.The medication group was given votalin for external use,and the Tuina group was given knee-balancing Tuina manipulation based on treatment according to structure differentiation.Both groups were treated for 7 consecutive days.The visual analog scale(VAS)score,Lyshlom score,knee joint range of motion(ROM),and total effective rate were compared between the two groups.Adverse reactions were observed in both groups. Results:During the treatment,there was 1 dropout case in the medication group.The total effective rate was 93.8%in the Tuina group and 83.9%in the medication group.The difference between the two groups was statistically significant(P<0.05).After treatment,the VAS score in both groups decreased significantly(P<0.05),and the Lyshlom score and knee joint ROM increased significantly(P<0.05).The differences in the VAS score,Lyshlom score,and knee joint ROM between the two groups were all statistically significant(P<0.05). Conclusion:The knee-balancing Tuina manipulation based on treatment according to structure differentiation can effectively relieve pain and improve knee function in PAB,and its efficacy is superior to that of external use of votalin.

The killing effects of herpes simplex virus thymidine kinase gene/ganciclovir (HSV-tk/GCV) approach by the addition of several commonly clinical chemotherapeutic agents on hormone refractory prostate cancer (HRPC) cells PC-3m were investigated. After transferring of the HSV-tk gene into PC-3m cells, mRNA and protein expression of HSV-tk was detected by reverse-transcript polymerase chain reaction (RT-PCR) and strept avidin-biotin complex (SABC) immunohistochemical method. The killing effect of GCV, cisplatin (CDDP), etoposide (VP-16), vincristine (VCR), methotrexate (MTX), 5-fluorouracil (5-Fu), and suramin on PC-3m cells was evaluated by morphological assessment analysis, trypan blue exclusion assay and MTT assay respectively. Additionally, the cooperative effect of HSV-tk/GCV system combined with the above agents on the target cancer cells was determined by MTT. Furthermore, apoptosis and necrosis induced by GCV plus 5-Fu or suramin was analyzed by flow cytometry (FCM). The results showed that that there was HSV-tk mRNA and protein expression in pDR2-tk plasmid transduced PC-3m cell. Combination of GCV with VP-16, VCR, 5-Fu or suramin led to an enhanced cellular killing effect, but with CDDP resulted in a reduced one and with MTX in an approximate one. FCM revealed that synergistic use of GCV and 5-fu or suramin resulted in a rather large proportion of apoptosis and necrosis with the apoptosis index being 36.38% and 35.51%, and the proportion of necrosis being 33.05% and 28.87%, respectively. In conclusion, HSV-tk/CGV approach by addition of certain clinical available chemotherapeutic drugs brings on statistically significant enhanced cell killing over single-agent treatment. Our results highlight the potential for such new combination therapies for future treatments of HRPC.

Connexin-43 (Cx43) expression in prostate cancer (PCa) cells and the potency of gap junctional intercellular communication (GJIC) in the cells were investigated, with an attempt to elucidate the reason why the so-called "bystander effect" mediated by thymidine kinase (TK) suicide gene therapy on PCa cells is not of significance and to explore the role of GJIC in PCa carcinogenesis. mRNA and protein expression of Cx43 in a PCa cell line PC-3m was detected by reverse-transcription polymerase chain reaction (RT-PCR) and strapt-avidin-biotin-enzyme complex (SABC) immunohistochemical staining, and inherent GJIC of PC-3m cells was assayed by scrape-loading and dye transfer (SLDT) assay. The expression of Cx43 in human normal and malignant prostate tissues was determined by SABC immunohistochemistry as well. It was found that Cx43 mRNA and protein expression in PC-3m cells was slightly reduced as compared with positive controls and the location of Cx43 protein was aberrant in cytoplasm rather than on membrane. Assessment of paraffin sections demonstrated that the expression of Cx43 protein in PCa cells was abnormally located and markedly diminished as compared with normal prostatic epithelial ones, displaying a negative correlation to the pathological grade (chi2=4.025, P<0.05). Additionally, capacity of inherent GJIC in PC-3m cells was disrupted, which was semi-quantified as (+) or (-). It was indicated that both down-regulated expression of Cx43 mRNA and aberrant location of Cx43 protein participated in the mechanisms leading to deficient GJIC in PC-3m cells. Lack of efficient GJIC is a molecular event, which may contribute not only to limited extent of "bystander effect", but also to initiation and progression of prostatic neoplasm.

The expression of survivin, a member of inhibitor of apoptosis (IAP) family, was examined in bladder transitional cell cancer (BTCC) tissue and adjacent normal tissues to examine its clinical implication in the development of BTCC. Thirty specimens of bladder cancer were detected for the expression of survivin by using immunohistochemistry and real-time quantitative reverse transcription polymerase chain reaction (RT-QPCR) in BTCC tissue and adjacent normal tissues. Our results showed that the positive rate of survivin immunostaining specimen were 0 and 60% (18/30) in the adjacent normal tissues, bladder cancer, respectively. The-DeltaDeltaCT value of survivin in bladder cancer tissue was 10.2829 (9.0034-11.5624) times that in the adjacent normal tissues. The expressions of survivin were correlated with the pathological grades of tumor and clinical stages. It is concluded that there was only weak expression of survivin mRNA in the adjacent normal tissues, but the expression of survivin mRNA in bladder cancer tissue was much higher than that in the adjacent normal tissues and the expression of survivin was correlated with pathological grades and clinical stages of tumor.
*Carcinoma, Transitional Cell/metabolism ; *Carcinoma, Transitional Cell/pathology ; Microtubule-Associated Proteins/genetics ; Microtubule-Associated Proteins/*metabolism ; Prognosis ; RNA, Messenger/genetics ; RNA, Messenger/metabolism ; Tumor Markers, Biological/genetics ; Tumor Markers, Biological/*metabolism ; Urinary Bladder Neoplasms/*metabolism ; Urinary Bladder Neoplasms/*pathology

Objective To study the clinical efficacy of percutaneous transluminal angioplasty (PTA) and vacuum sealing drainage technique on patients with diabetic foot and arteriosclerosis obliteration of the lower extremity.Methods Sixty-four patients were divided into two groups.Group A (32 patients) were treated by traditional methods,while 32 patients in Group B treated by vacuum sealing drainage technique in addition to percutaneous transluminal angioplasty.Results One week after surgery,ABI in group A was 0.53 ±0.17 vs 0.85 ±0.27 in group B,P =0.00.Ulcer healing rate increased from 31.25％ in group A to 81.25％ in group B,P ＜0.01.The amputation rate decreased from 56.25％ in group A to 18.75％ in group B,P =0.00.Claudication distance extended and ulcer recurrence rate in group A was 40％,while in group B it was 0,P =0.00.Conclusion The combination of PTA and vacuum sealing drainage significantly improves the prognosis of patients with diabetic foot and arteriosclerosis obliteration of the lower extremity.