1.Efficacy and complications of intravesical instillation of BCG for prevention of recurrence of moderate and high-risk non muscle invasive bladder cancer
Weibing SUN ; Zhiyu LIU ; Quanlin LI ; Xishuang SONG ; Xiangbo KONG ; Chunxi WANG ; Qifu ZHANG ; Qingguo ZHU ; Changfu LI ; Wanhai XU ; Guanghai YU ; Cheng ZHANG ; Jinyi YANG ; Tianjia SONG ; Jiye ZHAO ; Qizhong FU ; Lixin WANG ; Quanzhong DING ; Xuehui CAI ; Chuize KONG
Chinese Journal of Urology 2019;40(1):14-19
Objective To assess the efficacy and side effects of intravesical instillation of BCG after transurethral resection of the bladder tumor (TURBT) in non-muscle invasive bladder cancer (NMIBC) patients.Methods The clinical data of patients treated with BCG 120 mg per course induced perfusion or more after TURBT from December 2013 to October 2016 in 18 hospitals of northeast China region,were analyzed retrospectively.The first part,data of 106 patients with moderate,high-risk NMIBC were collected.A total of 83 patients were male,while the other 23 patients were female.The average age was 66.7 years old.The clinical staging were T1 in 86(81.1%) cases,Ta in 20(18.9%) cases and carcinoma in situ in 6 (5.7%) patients.Intravesical instillation of BCG was executed after transurethral resection of the bladder tumor.The incidence rate of recurrence and progression during more than 6 months' follow-up time were observed.Multivariate analyses were done by using logistic analysis and Cox proportional hazards regression model with Kaplan-Meier method.The second part,treatment compliance of 276 patients with bladder cancer,including moderate/high-risk NMIBC in 263 cases,moderate/high-risk NMIBC followed with renal pelvis/ureteral carcinoma in 8 cases were and moderate/high-risk NMIBC with renal pelvis/ureteral carcinoma in 5 cases who treated with BCG after the surgeries,were observed.Patients consisted of 211 males and 65 females with average age of 68.3 years.Results With a median follow-up of 12 months,9 (8.5%) patients experienced tumor recurrence and 2 (1.9%) patients were found progression in the first part.The one-year cancer free recurrence rate of the patients was 91.5%.Statistically significant prognostic factors for recurrence identified by multivariable analyses were prior recurrence of the tumors (OR =3.214,95%CI0.804-12.845,P =0.099).In the second port,an incidence rate of adverse effects was 64.1% (177/276).The Ⅲ/Ⅳ degree complications were occurred in 11 patients and satisfactory outcomes achieved with active treatment.A total of 36 patients withdrawal with the major causes were recurrence and progression of bladder tumor in 12 cases (4.4 %),9 cases (3.3 %) with economic reasons and 11 cases (4.0%) with serious complications.Conclusions NMIBC patients treated with intravesical BCG therapy have approving cancer free recurrence rates and acceptable adverse effects.Prior recurrence may be prognostic factor of recurrence after intravesical BCG therapy.
2.Logistic regression analysis of positive rate of serum Mycoplasma pneumoniae IgM antibody in patients with acute exacerbation of AECOPD in Liangjiang New Area of Chongqing
Tianjia ZHU ; Feng JIN ; Chunfang LI
Journal of Public Health and Preventive Medicine 2023;34(6):89-91
Objective To analyze the positive rate of serum mycoplasma pneumoniae antibody IgM in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in Liangjiang New Area of Chongqing and the related risk factors, so as to provide a theoretical basis for clinical diagnosis and treatment of AECOPD. Methods Retrospective analysis of 728 cases of AECOPD patients from January 2020 to December 2021 in Chongqing Liangjiang New Area Third Class Hospital. ELISA was used to determine Mycoplasma pneumoniae IgM antibodies. According to the detection of Mycoplasma pneumoniae IgM antibodies, the patients were divided into infection group and non-MP infection group. Clinical data such as gender, age, length of stay, place of residence, smoking status, home oxygen therapy, GOLD grade of COPD, number of acute exacerbations in the previous year, mechanical ventilation, and application of anti-infective drugs were collected. Univariate analysis and logistic regression were used to analyze the risk factors of MP infection in AECOPD patients. Results The positive rate of MP-IgM in 728 AECOPD patients was 15.38% (112/728), including 67 males and 45 females. There was no significant difference in the positive rate of MP-IgM in AECOPD patients between different seasons (χ2=2.840, P>0.05). Age ≥60 (OR=3.243), smoking (OR=2.559) and GOLD grade 3-4 (OR=3.760) were independent risk factors for MP infection in AECOPD patients. Conclusion The incidence of MP infection in AECOPD patients in Liangjiang New Area of Chongqing is relatively high, especially in AECOPD patients with age ≥ 60, smoking, GOLD grade 3-4, which should be warned of the possibility of mycoplasma pneumoniae infection , and targeted treatment measures can improve the cure rate.
3.Epidemiological analysis on the susceptibility of CXCR3 gene polymorphism to COPD in the elderly population in Liangjiang New Area of Chongqing
Feng JIN ; Tianjia ZHU ; Huan YE
Journal of Public Health and Preventive Medicine 2023;34(6):152-156
Objective To explore and analyze the epidemiology of susceptibility to chronic obstructive pulmonary disease (COPD) among the elderly population in Liangjiang New Area of Chongqing based on CXC chemokine receptor 3 (CXCR3) gene polymorphism. Methods From January 2020 to September 2022, the Medical Laboratory Department of Chongqing Liangjiang New Area People's Hospital selected COPD patients and received treatment. Among the 276 patients who met the criteria were included in the study and included in the observation group. Among the 512 patients with healthy pulmonary function in the same period were included in the control group. The data of the two groups of patients were analyzed, and the genotypes were detected by SBaPhotoshot technology to analyze the relationship between gene polymorphism and the susceptibility and clinical characteristics of COPD. Results There was no significant difference between the two groups in age, sex, BMI and blood eosinophil granulocyte levels, which was comparable (P>0.05). There were significant differences in smoking history, pulmonary function index , MMP-9 and TIMP-1 levels (P<0.05). Compared with the control group, the homozygous TT of rs2280964 locus in the observation group had a higher risk of COPD than that of CC (P<0.05), but there was no significant difference in gene distribution between the two groups at rs34334103 locus (P>0.05). In the observation group, the MMP-9 level of rs2280964 locus was significantly different (P=0.003), while the TIMP-1 level was not significantly different (P=0.187); There was no significant difference in MMP-9 and TIMP-1 levels among the three genes at rs34334103 locus (all P>0.05). The level of MMP-9 in homozygous TT patients with rs2280964 locus was significantly higher than that in homozygous CC patients (P=0.024). There were differences in FEV1/FVC of patients with CXCR3 rs34,334,103 gene distribution (P=0.008), among which there were significant differences in CC+CT and TT recessive models (P<0.01), and the level of FEV1/FVC of TT type was the lowest. There was no significant correlation between other SNP loci and clinical symptoms of COPD (all P>0.05). Conclusion CXCR3 gene polymorphism is significantly associated with the susceptibility to COPD, and also with the serum levels of MMP-9 and FEV1/FVC, which can be used as a new target for clinical research and treatment.