1. Temperature selection of intravesical sodium hyaluronate in the treatment of interstitial cystitis
Chinese Journal of Clinical Pharmacology and Therapeutics 2020;25(4):447-454
AIM: To investigate the efficacy of bladder infusion of sodium hyaluronate (HA) in the treatment of interstitial cystitis (IC) at different temperatures. METHODS: Forty patients with IC admitted in our hospital from March 2018 to April 2019 were simply randomized and divided into two groups for prospective study, with 20 patients in each group. The temperature of perfusion fluid in normal temperature group was 37 ℃, and the temperature of perfusion fluid in high temperature group was 43 ℃. Compared the two groups before treatment, one month after treatment, and three months after treatment of interstitial cystitis problem score (ICPI), interstitial bladder symptoms score (ICSI), pre-veeing pain visual analogue score (VAS), and anxiety self-assessment scale (SAS), depression self-assessment scale (SDS), quality of life score (QOL), daily urination times, maximum bladder volume, bladder mast cell count, and immune factors [interleukin (IL)-6, IL-10] expression. RESULTS:The ICPI, ICSI, VAS, SAS, and SDS scores of the hyperthermia group were lower than those of the normal temperature group after one month and three months of treatment, and the QOL scores were higher than those of the normal temperature group after three months of treatment (P<0.05). After one month and three months of treatment in the hyperthermia group, the daily urination frequency was lower than that in the normal temperature group, and the maximum bladder capacity after three months of treatment was greater than the normal temperature group (P<0.05). After three months of treatment in the hyperthermia group, the mast cell counts in the bladder mucosa were lower than those in the normal temperature group (P<0.05). IL-6 and IL-10 in the bladder mucosa were lower than those in the normal temperature group after three months of treatment in the high temperature group (P<0.05). There was no significant difference in the incidence of adverse reactions (0, 5.00%) between the two groups (P>0.05). CONCLUSION:Compared with 37 ℃, intravesical instillation of HA in the treatment of IC can effectively relieve the clinical symptoms and signs of patients when the perfusion fluid is at a temperature of 43 ℃, and it improves the maximum bladder capacity and anxiety and depression, improves the quality of life of patients, which is safe and reliable. The mechanism may be related to the regulation of large cell, IL-6, IL-10 of bladder mucosa.
2.Clinical value of fluorescence in situ hybridization positive of exfoliated urothelial cells in urothelial carcinoma
Jiayuan LIU ; Xiang PENG ; Xianghui NING ; Teng LI ; Shuanghe PENG ; Jiangyi WANG ; Shengjie LIU ; Yi DING ; Lin CAI ; Kan GONG
Journal of Peking University(Health Sciences) 2017;49(4):585-589
Objective: To analyze the clinical pathologic characteristics of cases with fluorescence in situ hybridization (FISH) positive of exfoliated urothelial cells, so as to evaluate the clinical utility of FISH in the diagnosis of urothelial carcinoma (UC).Methods: A total of 271 cases of FISH positive in Department of Urology of Peking University First Hospital from Apr.2012 to Sep.2015 were recruited in this study.Retrospective analysis was made on their clinical data.For FISH analysis, labeled probes specific for chromosomes 3, 7, 17, and the p16 (9p21) gene were used to assess chromosomal abnormalities indicative of malignancy.The positive predict values (PPV) of all the techniques were analyzed.Results: Of the 271 patients, 207 cases were UC, 7 cases were non-UC, and 57 cases were benign diseases.The PPV of FISH in detecting UC was 76.4%, while the 95% confidence interval (CI) 71.3% to 81.5%.In the cohort of FISH positive, this value was similar to that of urinary cytology (PPV 86.8%, 95% CI: 78.5%-95.0%).The PPV of FISH was lower than that of cystoscopy and ureteroscopy (PPV 96.1%, 95% CI: 91.7%-100.0%).There were significant differences between this study and the PPV of FISH reported abroad (PPV 53.9%, χ2=33.048, P<0.001).Of all the UC with FISH positive, bladder cancer showed an earlier pathological stage versus renal pelvic carcinoma and ureteral carcinoma, with significance (χ2=5.894, P=0.015, and χ2=13.601, P<0.001, respectively).However, no difference was found in the size, pathological stage and pathological grade of tumors between the urinary cytology positive group and the urinary cytology negative group.The rate of high-grade UC in ureteral carcinoma of FISH positive was 92.3%, much higher than that of ureteral carcinoma reported domestically.Conclusion: The PPV of FISH in detecting UC is higher relatively, with a better clinic value for Chinese patients.The ureteral carcinoma with FISH positive obtains a higher pathological grade, which is of great guiding significance for UC.
3.Effects of finasteride combined with tamsulosin hydrochloride on glandular microvessel density during the perioperative period in patients with benign prostatic hyperplasia
Jiacheng LI ; Jiangyi CAI ; Yao LIU ; Shaofeng SHAO
Chinese Journal of Primary Medicine and Pharmacy 2022;29(2):276-280
Objective:To investigate the effects of finasteride combined with tamsulosin hydrochloride administered during the perioperative period on glandular microvessel density in patients with benign prostatic hyperplasia.Methods:Ninety patients with benign prostatic hyperplasia who received treatment in Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from August 2017 to August 2019 were included in this study. They were randomly assigned to receive either oral tamsulosin hydrochloride alone (control group, n = 45) or oral finasteride combined with tamsulosin hydrochloride (observation group, n = 45) during the perioperative period of transurethral resection of the prostate. All patients received 6 weeks of medication. Clinical efficacy, adverse reactions, and urodynamic indexes, glandular microvessel density, International Prostatism Symptom Score, bother score, and urine color/degree of haematuria score pre- and post-treatment were compared between the two groups. Results:The maximum urinary flow rate in each group significantly increased 6 weeks after treatment compared with before treatment. The detrusor pressure and residual urine volume in each group decreased 6 weeks after treatment compared with before treatment. After 6 weeks of treatment, the maximum urinary flow rate was significantly higher in the observation group than in the control group [(15.63 ± 2.26) mL/s vs. (13.14 ± 2.23) mL/s], and residual urine volume was significantly lower in the observation group than in the control group [(29.19 ± 4.81) mL vs. (32.25 ± 5.52) mL, t = 5.26, 2.80, both P < 0.05). International Prostatism Symptom Score measured 6 weeks after treatment and urine color/degree of haematuria score measured 1 week after treatment were (12.09 ± 2.17) points and (1.51 ± 0.27) points, respectively in the observation group, which were significantly lower than those in the control group [(14.28 ± 2.22) points, (2.03 ± 0.38) points, t = 4.73, 7.48, both P < 0.05]. Factor VIII related antigen- and CD34-positive glandular microvessel density values in the observation group were (14.74 ± 3.05) counts/visual field and (19.41 ± 3.07) counts/visual field, respectively, which were significantly lower than those in the control group [(18.08 ± 3.16) counts/visual field, (22.27 ± 3.16) counts/visual field, t = 5.10, 4.35, both P < 0.05]. The incidence of postoperative hematuria was significantly lower in the observation group than in the control group [15.56% (7/45) vs. 35.56% (16/45), χ2 = 4.73, P < 0.05]. Conclusion:Compared with tamsulosin hydrochloride alone, finasteride combined with tamsulosin hydrochloride administered during the perioperative stage can greatly improve the urodynamic indexes of patients with benign prostatic hyperplasia, reduce microvessel density value, International Prostatism Symptom Score, bother score, and decrease the incidence of hematuria. The combined therapy provides a novel idea for preventing perioperative bleeding in patients with benign prostatic hyperplasia.