1.Identification of a JAK-STAT-miR155HG positive feedback loop in regulating natural killer (NK) cells proliferation and effector functions.
Songyang LI ; Yongjie LIU ; Xiaofeng YIN ; Yao YANG ; Xinjia LIU ; Jiaxing QIU ; Qinglan YANG ; Yana LI ; Zhiguo TAN ; Hongyan PENG ; Peiwen XIONG ; Shuting WU ; Lanlan HUANG ; Xiangyu WANG ; Sulai LIU ; Yuxing GONG ; Yuan GAO ; Lingling ZHANG ; Junping WANG ; Yafei DENG ; Zhaoyang ZHONG ; Youcai DENG
Acta Pharmaceutica Sinica B 2025;15(4):1922-1937
The Janus kinase/signal transducers and activators of transcription (JAK-STAT) control natural killer (NK) cells development and cytotoxic functions, however, whether long non-coding RNAs (lncRNAs) are involved in this pathway remains unknown. We found that miR155HG was elevated in activated NK cells and promoted their proliferation and effector functions in both NK92 and induced-pluripotent stem cells (iPSCs)-derived NK (iPSC-NK) cells, without reliance on its derived miR-155 and micropeptide P155. Mechanistically, miR155HG bound to miR-6756 and relieved its repression of JAK3 expression, thereby promoting the JAK-STAT pathway and enhancing NK cell proliferation and function. Further investigations disclosed that upon cytokine stimulation, STAT3 directly interacts with miR155HG promoter and induces miR155HG transcription. Collectively, we identify a miR155HG-mediated positive feedback loop of the JAK-STAT signaling. Our study will also provide a power target regarding miR155HG for improving NK cell generation and effector function in the field of NK cell adoptive transfer therapy against cancer, especially iPSC-derived NK cells.
2.Comparison of therapeutic effects between human amniotic membrane plugging and internal limiting membrane flap insertion for macular hole retinal detachment in high myopia
Chuqiao WANG ; Jibo ZHOU ; Tengteng YAO ; Zeqi WANG ; Huiqin GAO ; Zhaoyang WANG
Chinese Journal of Experimental Ophthalmology 2024;42(1):47-52
Objective:To compare the efficacy of pars plana vitrectomy (PPV) combined with human amniotic membrane (hAM) plugging technique or internal limiting membrane (ILM) flap insertion technique for high myopia macular hole retinal detachment (MHRD).Methods:A non-randomized controlled clinical study was performed.Sixteen eyes of 15 patients with high myopia MHRD treated in the Ninth People's Hospital of Shanghai Jiao Tong University School of Medicine from July 2020 to August 2021 were included.All patients underwent PPV and were divided into hAM plug group (7 eyes of 7 patients) and the ILM insertion group (9 eyes of 8 patients) based on the different plugging materials.The best corrected visual acuity (BCVA) and intraocular pressure were measured before surgery and at 1 week, 1, 3, and 6 months postoperative, respectively.Slit-lamp microscopy combined with lenses, scanning laser ophthalmoscope and optical coherence tomography (OCT) were used to examine the fundus, the macular hole closure and retinal reposition.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine (No.SH9H-2021-T322-2). Written informed consent was obtained from each subject.Results:The retinal reattachment was achieved in 6 eyes in the hAM plug group and all 9 eyes in the ILM insertion group after initial surgery.The macular hole closure was observed in 5 eyes in the hAM plug group and 8 eyes in the ILM insertion group after initial surgery, and there was no statistical difference in the macular hole closure rate between the two groups ( P>0.05). There were significant differences in the overall comparison of BCVA between the two groups over time ( Ftime=4.420, P<0.05). Postoperative BCVA at different time points was better than preoperative BCVA in each group, but the differences were not significant (all at P>0.05). There was no significant difference in the overall comparison of BCVA between the two groups ( Fgroup=0.183, P>0.05). Two eyes in the hAM plug group and 4 eyes in the ILM insertion group developed transient ocular hypertension, which returned to normal after 1 week of treatment. Conclusions:Both PPV combined with hAM plugging technique and ILM insertion technique are safe and effective for the treatment of MHRD in high myopia.The hAM plugging technique can not only achieve anatomical reduction but also functional recovery of the retina even in complicated fundus conditions.
3.Overview of design and construction of hypertensive disorders of a pregnancy-cohort in Shenzhen
Yixuan CHEN ; Linlin WU ; Xiaoxia WU ; Liying YANG ; Jiaqi XU ; Ling WANG ; Zhaoyang JIANG ; Jingna YAO ; Danni YANG ; Ning SUN ; Jing ZHANG ; Yiwei ZHANG ; Ruowang HU ; Ying LIN ; Kui HUANG ; Bin LI ; Jianmin NIU
Chinese Journal of Epidemiology 2023;44(12):1858-1863
Hypertensive disorder of pregnancy (HDP) involves two major public health issues: mother-infant safety and prevention and controlling major chronic disease. HDP poses a serious threat to maternal and neonatal safety, and it is one of the leading causes of maternal and perinatal morbidity and mortality worldwide, as well as an important risk factor for long-term cardiovascular disease (CVD). In order to explore effective strategies to prevent and control the source of CVD and reduce its risk, we have established a cohort of HDPs in Shenzhen for the primordial prevention of CVD. The construction of the HDP cohort has already achieved preliminary progress till now. A total of 2 239 HDP women have been recruited in the HDP cohort. We have established a cohort data management platform and Biobank. The follow-up and assessment of postpartum cardiovascular metabolic risk in this cohort has also been launched. Our efforts will help explore the pathophysiological mechanism of HDP, especially the pathogenesis and precision phenotyping, prediction, and prevention of pre-eclampsia, which, therefore, may reduce the risk of adverse pregnancy outcomes, and provide a bridge to linking HDP and maternal-neonatal cardiovascular, metabolic risk to promote the cardiovascular health of mothers and their infants.
4.Application of nanofat grafting combined with fractional laser to improve depressed facial scars
Chaojie JIN ; Leilei CHEN ; Zhaoyang SHI ; Yi YAO ; Chen WANG ; Mengwen ZHANG ; Huan QIAN
Chinese Journal of Plastic Surgery 2021;37(6):606-611
Objective:To investigate the clinical effect of nanofat transplantation combined with CO 2 fractional laser in the treatment of depressed facial scars. Methods:Through a retrospective study, a total of 27 patients with depressed facial scars who got admitted to the plastic surgery department of our hospital from January 2016 to June 2018 were recruited for autologous nanofat transplantation and carbon dioxide fractional laser treatment in combination to treat moderate to severe depressed facial scars. The treatment was carried out as follows: autologous nanofat transplantation was performed, the depressed scar was subcutaneously separated with a 26 G needle, and injected with the autologous nanofat 0.5-1.0 ml/cm 2. After 3 months, the fractional CO 2 laser treatment was performed for a total of 2 times, with an interval of 3 months each time. Before and six months after treatment, patients and surgeons used the Patient and Observer Scar Assessment Scale (POSAS) to evaluate each aspect of scar. The total score for each item was 1-10 points. According to the total POSAS scores of patients and doctors, the degree of improvement of depressed scars was classified and evaluated. Grade 1: invalid, total score reduction ≤ 5 points; grade 2: mildly effective, total score reduction> 5 points and ≤ 10 points; grade 3, effective, total score reduction> 10 points and ≤ 20 points; grade 4, markedly effective, total score reduction> 20 points. Using SPSS 23.0 to do t-test on the data before and after treatment. P<0.05 indicates that the difference is statistically significant. Results:A total of 27 patients were enrolled, including 16 males and 11 females, aged (29.1±7.9) years old. Before and after six months of treatment, the difference between the scores of the patients on all indicators of scar was statistically significant ( P<0.05); the difference between the doctor’s scores was statistically significant ( P<0.01). The total scores of post-total POSAS were (43.7±10.8) and (23.3±3.2) points respectively, the difference was statistically significant ( P<0.01). After six months of treatment, the degree of pain, itching, color, hardness, thickness (depression), elasticity, tension of the depressed scar were significantly improved. Among them, there was 1 case of second-level improvement, 14 cases of third-level improvement, and 12 cases of fourth-level improvement. The total effective rate reached 96.3% (26/27). None of the 27 patients had lumps or cord-like indurations on the filling parts of the face. No embolism, infection, hematoma and other complications occurred after nanofat transplantation in all patients. Skin flushing, burning, edema, pain and other symptoms occurred early after the fractional CO 2 laser treatment, and no hyperpigmentation occurred in the 6-month follow-up after a treatment cycle. Conclusions:The combination of nanofat transplantation technology and carbon dioxide fractional CO 2 laser can produce a significant effect on improving depressed scar, reducing treatment period, rendering a simple operation with few complications.
5.Application of nanofat grafting combined with fractional laser to improve depressed facial scars
Chaojie JIN ; Leilei CHEN ; Zhaoyang SHI ; Yi YAO ; Chen WANG ; Mengwen ZHANG ; Huan QIAN
Chinese Journal of Plastic Surgery 2021;37(6):606-611
Objective:To investigate the clinical effect of nanofat transplantation combined with CO 2 fractional laser in the treatment of depressed facial scars. Methods:Through a retrospective study, a total of 27 patients with depressed facial scars who got admitted to the plastic surgery department of our hospital from January 2016 to June 2018 were recruited for autologous nanofat transplantation and carbon dioxide fractional laser treatment in combination to treat moderate to severe depressed facial scars. The treatment was carried out as follows: autologous nanofat transplantation was performed, the depressed scar was subcutaneously separated with a 26 G needle, and injected with the autologous nanofat 0.5-1.0 ml/cm 2. After 3 months, the fractional CO 2 laser treatment was performed for a total of 2 times, with an interval of 3 months each time. Before and six months after treatment, patients and surgeons used the Patient and Observer Scar Assessment Scale (POSAS) to evaluate each aspect of scar. The total score for each item was 1-10 points. According to the total POSAS scores of patients and doctors, the degree of improvement of depressed scars was classified and evaluated. Grade 1: invalid, total score reduction ≤ 5 points; grade 2: mildly effective, total score reduction> 5 points and ≤ 10 points; grade 3, effective, total score reduction> 10 points and ≤ 20 points; grade 4, markedly effective, total score reduction> 20 points. Using SPSS 23.0 to do t-test on the data before and after treatment. P<0.05 indicates that the difference is statistically significant. Results:A total of 27 patients were enrolled, including 16 males and 11 females, aged (29.1±7.9) years old. Before and after six months of treatment, the difference between the scores of the patients on all indicators of scar was statistically significant ( P<0.05); the difference between the doctor’s scores was statistically significant ( P<0.01). The total scores of post-total POSAS were (43.7±10.8) and (23.3±3.2) points respectively, the difference was statistically significant ( P<0.01). After six months of treatment, the degree of pain, itching, color, hardness, thickness (depression), elasticity, tension of the depressed scar were significantly improved. Among them, there was 1 case of second-level improvement, 14 cases of third-level improvement, and 12 cases of fourth-level improvement. The total effective rate reached 96.3% (26/27). None of the 27 patients had lumps or cord-like indurations on the filling parts of the face. No embolism, infection, hematoma and other complications occurred after nanofat transplantation in all patients. Skin flushing, burning, edema, pain and other symptoms occurred early after the fractional CO 2 laser treatment, and no hyperpigmentation occurred in the 6-month follow-up after a treatment cycle. Conclusions:The combination of nanofat transplantation technology and carbon dioxide fractional CO 2 laser can produce a significant effect on improving depressed scar, reducing treatment period, rendering a simple operation with few complications.
6.The 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: a randomized, controlled, multi-center clinical trial with 2 years’ follow-up
Hao YU ; Kaiwen LI ; Hailong HU ; Xiang LI ; Nan LIU ; Jian ZHANG ; Xudong YAO ; Xiaodong ZHANG ; Wei LI ; Liqun ZHOU ; Xiangbo KONG ; Jinjian YANG ; Youhan CAO ; Junli WEI ; Jiacun CHEN ; Zhaoyang WU ; Dongwen WANG ; Xuhui ZHANG ; Jinkai SHAO ; Qingwen LI ; Huiqing ZHANG ; Xiaolin WANG ; Shaozhong WEI ; Ye TIAN ; Tie ZHONG ; Hongshun MA ; Kun LI ; Benkang SHI ; Jin YANG ; Yuhua QIAO ; Hongxing HUANG ; Liming LI ; Zhimin WANG ; Jianhua TIAN ; Tianxin LIN ; Jian HUANG
Chinese Journal of Urology 2020;41(10):724-730
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.
7.Treatment of bromhidrosis by cutting off the apocrine glands under direct vision combined with micro electrocoagulation
Leilei CHEN ; Yihan WANG ; Chaojie JIN ; Zhaoyang SHI ; Cheng WU ; Xingqun ZHANG ; Yi YAO
Chinese Journal of Plastic Surgery 2020;36(3):304-307
Objective:To investigate the efficacy of treatment of bromhidrosis by cutting off the apocrine glands under direct vision combined with micro electrocoagulation.Methods:From January 2017 to December 2017, 25 patients (50 sides) with axillary osmidrosis admitted to the First People’s Hospital of Yuhang District were treated with direct vision cutting and micro electrocoagulation to destroy the apocrine sweat glands, including 13 males and 12 females, aged 14-38 years, with an average age of 23 years. According to Young-Jin Park′s criteria for judging axillary osmidrosis, 21 cases were classified as grade 3 and 4 cases as grade 2. After tumescent anesthesia, the subcutaneous apocrine sweat glands, fat and hair follicles were cut off under direct vision. The subdermal vascular network was preserved, and the basement was destroyed one by one by using high-frequency electrocoagulation mode. After the operation, the evaluation was conducted according to the criteria for judging axillary osmidrosis formulated by Young-Jin Park.Results:The symptoms of axillary osmidrosis reached the standard of cure in 24 patients after operation, 1 case failed to reach the cure standard. Among the patients who reached the standard, there were 2 cases of necrosis of the skin flap and 1 case of hematoma after operation unilaterally, which were given actively dressing change, secondary debridement, suturing and hematoma removal, The follow-up period was 6 months to 1 year. During the follow-up period, 24 cases were cured, including 21 cases of grade one and 3 cases of grade zero. The treatment effect was stable.Conclusions:The treatment of axillary osmidrosis by cutting off the apocrine sweat glands under direct vision combined with micro electrocoagulation, exposing the apocrine sweat glands as much as possible, effectively removing the apocrine sweat glands and hair follicles, and reducing the recurrence rate of axillary osmidrosis. It is a simple, safe and effective treatment technology for axillary osmidrosis.
8.Treatment of bromhidrosis by cutting off the apocrine glands under direct vision combined with micro electrocoagulation
Leilei CHEN ; Yihan WANG ; Chaojie JIN ; Zhaoyang SHI ; Cheng WU ; Xingqun ZHANG ; Yi YAO
Chinese Journal of Plastic Surgery 2020;36(3):304-307
Objective:To investigate the efficacy of treatment of bromhidrosis by cutting off the apocrine glands under direct vision combined with micro electrocoagulation.Methods:From January 2017 to December 2017, 25 patients (50 sides) with axillary osmidrosis admitted to the First People’s Hospital of Yuhang District were treated with direct vision cutting and micro electrocoagulation to destroy the apocrine sweat glands, including 13 males and 12 females, aged 14-38 years, with an average age of 23 years. According to Young-Jin Park′s criteria for judging axillary osmidrosis, 21 cases were classified as grade 3 and 4 cases as grade 2. After tumescent anesthesia, the subcutaneous apocrine sweat glands, fat and hair follicles were cut off under direct vision. The subdermal vascular network was preserved, and the basement was destroyed one by one by using high-frequency electrocoagulation mode. After the operation, the evaluation was conducted according to the criteria for judging axillary osmidrosis formulated by Young-Jin Park.Results:The symptoms of axillary osmidrosis reached the standard of cure in 24 patients after operation, 1 case failed to reach the cure standard. Among the patients who reached the standard, there were 2 cases of necrosis of the skin flap and 1 case of hematoma after operation unilaterally, which were given actively dressing change, secondary debridement, suturing and hematoma removal, The follow-up period was 6 months to 1 year. During the follow-up period, 24 cases were cured, including 21 cases of grade one and 3 cases of grade zero. The treatment effect was stable.Conclusions:The treatment of axillary osmidrosis by cutting off the apocrine sweat glands under direct vision combined with micro electrocoagulation, exposing the apocrine sweat glands as much as possible, effectively removing the apocrine sweat glands and hair follicles, and reducing the recurrence rate of axillary osmidrosis. It is a simple, safe and effective treatment technology for axillary osmidrosis.
9. Study on public dose burden in Suzhou from medical exposure in X-ray digital radiography and computed tomography
Zhe XU ; Bin SONG ; Yin ZHANG ; Guoqing SUN ; Zhaoyang WEI ; Jianhua YAO ; Yuexin YANG
Chinese Journal of Radiological Medicine and Protection 2019;39(12):940-945
Objective:
To estimate the effective dose burden to the public in Suzhoui induced by medical exposure from computed tomography (CT) and digital radiography (DR).
Methods:
Twenty-seven hospitals were selected by stratified random sampling. The application information was colleted from picture archiving and communication system (PACS) and radiology information system (RIS). For DR, DAP was measured by the dose-area product meter in different body parts, then the effective dose values were calculated by the DAP. For CT, effective dose was estimated by measuring CT dose index weighted (CTDIw) and scanning parameters in different parts of the body. The public dose burden caused by DR and CT medical exposure in Suzhou was estimated according to the scanning time and effective dose to each part.
Results:
The effective dose due to DR examination was abdomen AP 0.565 mSv, pelvis AP 0.280 mSv, skull LAT 0.016 mSv, skull AP 0.012 mSv, chest LAT 0.111 mSv, chest AP 0.060 mSv, thoracic spine LAT 0.100 mSv, thoracic spine AP 0.102 mSv, lumbar spine LAT 0.307 mSv and lumbar spine AP 0.152 mSv, respectively. The effective doses from CT scanning were 1.33 mSv for head, 5.75 mSv for thorax and 7.31 mSv for abdomen, respectively. The annual collective effective dose in Suzhou in 2017 from DR exposures and CT scans was 9 593.07 man·Sv, and the average annual effective dose was 0.898 mSv.
Conclusions
The contribution of CT medical radiation to the public dose is much greater than that of DR. Controlling the frequency of medical exposure and single scan dose is an effective way to reduce the public dose burden. The public dose burden from DR and CT medical exposure in Suzhou is at a high level and attention needs to be paid by relevant health administrative departments.
10.The efficacy and safety of BCG in the prevention of postoperative recurrence of intermediate and high-risk non-muscle invasive bladder cancer: a randomized, controlled, multi-center clinical trial (mid-term report)
Hao YU ; Tianxin LIN ; Xiang LI ; Hailong HU ; Nan LIU ; Jian ZHANG ; Xudong YAO ; Zhaoyang WU ; Xiangbo KONG ; Liqun ZHOU ; Jiacun CHEN ; Wei LI ; Jinjian YANG ; Dongwen WANG ; Xiaodong ZHANG ; Youhan CAO ; Shaozhong WEI ; Ye TIAN ; Huiqing ZHANG ; Benkang SHI ; Zhanpo YANG ; Qingwen LI ; Jinkai SHAO ; Tie ZHONG ; Xiaolin WANG ; Hongxing HUANG ; Liming LI ; Jianhua TIAN ; Zhimin WANG ; Jin YANG ; Lin QI ; Jian HUANG
Chinese Journal of Urology 2019;40(7):485-491
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.

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