Backgroud:Summarize the formula rule of traditional Chinese medicine fOr preventing and treating bladder cancer recurrence after operation and explore the molecular mechanism of core medicines.Methods:Literatures coll...Backgroud:Summarize the formula rule of traditional Chinese medicine fOr preventing and treating bladder cancer recurrence after operation and explore the molecular mechanism of core medicines.Methods:Literatures collected from CNKI,Wanfang Med Online,CMJD,PUBMED and Elsiver databases were as prescription sources,and association rules and complex system entropy clustering analysis were carried out using the Traditional Chinese Medicine Inheritance Support System(TCMISSV2.5).BATMAN-TCM online analysis tool was used to construct target-pathway-disease correlation map to reveal the potential mechanism of action.Results:A total of 122 prescriptions were eligible for data analysis.The high-frequency traditional Chinese medicines are Poria,Radix et Rhizoma Rhei,Radix Astragali,Herba Hedyotidis Diffusae and Rhizoma Atractylodis Macrocephalae.The high-frequency drug pairs are Rhizoma Atractylodis MacrocephalaeIPoria,Poria/Rhizoma Alismatis,Radix Astragali/Rhizoma Atractylodis Macrocephalaeand and Herba Hedyotidis Diffusae/Herba Scutellariae Darbatae..There are 5 groups of drug pairs with high correlation strength.Cluster analysis shows 6 core drug combinations and 3 new prescriptions.In clinical practice,the core compatibility of traditional Chinese medicines for preventing postoperative recurrence of bladder cancer is Poria,Radix Astragali and Herba Hedyotidis Diffusae.The possible signaling pathways are the neuroactive ligand receptor interaction signaling pathway and calcium signaling pathway.Conclusion:Prevention and treatment of postoperative recurrence of bladder cancer mainly use medicines with effects of eliminating dampness and diuresis for removing edema,heat-clearing and detoxifying,and qi-invigorating.The potential mechanism of the compatibility of core drugs may be realized by interfering with the signal pathway of neuroactive ligand receptor interaction and calcium signal pathway.展开更多
Objective To study the therapeutic efficacy of combined interventional chemotherapy and intravesical instillation of mitomycin on preventing bladder cancers from recurring after local ablation. Methods 28 patients wit...Objective To study the therapeutic efficacy of combined interventional chemotherapy and intravesical instillation of mitomycin on preventing bladder cancers from recurring after local ablation. Methods 28 patients with superficial bladder cancers were randomized into combined interventional chemotherapy and intravesical instillation of mitomycin or intravesical instillation of mitomycin alone for preventing recurrence after local ablation. The result was assessed by x2 test. Results The patients have been followed up for 12-26 months (mean 21 months). 1 case has had tumor recurrence in the combined modality therapy group and 4 in the intravesical instillation alone group, the tumor recurrence rate being 7% (1/14) and 29% (4/14) respectively (P【0.05). Conclusion Combined use of interventional chemotherapy and intravesical instillation of mitomycin is effective in preventing superficial bladder cancer from recurring after local ablation with fewer adverse effects. The ragimen is not only reliable but展开更多
To investigate the effects of intravesical therapy with elemene in preventing postoperative recurrence of superficial bladder cancer and its toxic and side effects.Methods This series included 123 patients with superf...To investigate the effects of intravesical therapy with elemene in preventing postoperative recurrence of superficial bladder cancer and its toxic and side effects.Methods This series included 123 patients with superficial bladder cancer (T1),consisting of transitional cell carcinoma GⅠ in 37 cases,GⅡ in 73 and GⅢ in 13.They all underwent surgical treatment.Postoperatively,they were randomly assigned to 2 groups;63 patients in elemene group received instillation of elemene (400 mg,once a week) 2 weeks after operation and 60 patients in mitomycin C (MMC) group received instillation of MMC (40 mg,once a week) 2 weeks after operation.The instillations were repeated for 6 weeks and thereafter monthly for 1 year.The recurrence rates,side effects,and NK cell activity before and after treatment were evaluated.Results The recurrence rate of elemene group (mean follow-up of 19.7 months) was 7.9% (5 cases),which was significantly lower than that (25.0%,15 cases) of MMC group (mean follow-up of 19.4 months;P<0.05).The side effect in elemene group (3.2%,2 cases) was significantly milder than that in MMC group (25.0%,15 cases)(P<0.05).In elemene group,the NK cell activity after treatment (28±2)% was significantly higher than that before treatment(20±2)%(P<0.05).Conclusion Instillation of elemene after operation is effective and safe in preventing postoperative recurrence of bladder cancer.8 refs.展开更多
Bladder cancer remains a commonly diagnosed malignancy worldwide,bringing huge economic burden and high morbidity for patients. Assessment of prognostic significance of lymphovascular invasion（LVI） is a critical iss...Bladder cancer remains a commonly diagnosed malignancy worldwide,bringing huge economic burden and high morbidity for patients. Assessment of prognostic significance of lymphovascular invasion（LVI） is a critical issue in the surgical management of bladder cancer after transurethral resection or radical cystectomy. A systematic search of Pub Med,Embase and Cochrane Library was performed up to Oct 10,2014 to identify eligible studies. Outcomes of interest were collected from studies comparing overall survival（OS）,cancer specific survival（CSS） and recurrence free survival（RFS） in patients with the LVI. Results of studies were pooled,and combined hazard ratios（HRs） with corresponding 95% confidence intervals（CIs） for survival were used as the effect size estimation. Funnel plots were done to show the publication bias,while the forest plots and subgroup analyses were used to limit the heterogeneity. A total of 20 studies（10 663 patients） met the eligibility criteria and were included for this meta-analysis. Our pooled results showed that there were significant differences in OS（pooled HR,1.71; 95%CI,1.52–1.92; P〈0.00001）,CSS（pooled HR,2.25; 95% CI,1.80–2.81; P〈0.00001） and RFS（pooled HR,1.91; 95% CI,1.57–2.32; P〈0.00001） between the patients with LVI and the patients without LVI. There were significant heterogeneities observed in the studies concerning the relationship between LVI and CSS,RFS. There was no clear evidence of publication bias. When tumor stage was beyond T3,LVI lost its predictive value for CSS and RFS. For the patients who had negative lymph nodes,LVI was still an adverse predictor. Our pooled results demonstrate that LVI indicates poor prognosis of patients with bladder cancer after surgical procedures,and it can be of particular importance in clinical practice. However,these results need to be further confirmed by more adequately designed prospective studies.展开更多
This study aimed to provide evidence of persistent uropathogenic Escherichia coli（UPEC） in female patients with recurrent urinary tract infection（UTI） after antibiotic therapy. We collected biopsies of the bladder...This study aimed to provide evidence of persistent uropathogenic Escherichia coli（UPEC） in female patients with recurrent urinary tract infection（UTI） after antibiotic therapy. We collected biopsies of the bladder, and clean-catch urine samples from 32 women who had episodes of recurrent UTI and were given antibiotic therapy. Urine samples and biopsies were analyzed by conventional bacteriological techniques. Phylogenetic group and 16 virulence factors（VFs） of UPEC were determined using polymerase chain reaction（PCR）. The infection capability of UPEC was confirmed in a mouse model. Immunofluorescence and electron microscopy were used to detect intracellular bacterial communities（IBCs） in the mouse model. The results showed that all urine specimens were detected sterile. E. coli was found in 6 of 32 biopsies（18.75%）, and was identified to be UPEC by PCR. Different VFs associated with the formation of IBCs were identified in all six UPEC isolates. Each UPEC isolate was capable of forming IBCs within the bladder epithelial cells of mice. In conclusion, UPEC with distinctive pathological traits and the capability of IBC formation was first found in the bladders of women after antibiotic therapy, suggesting that the IBC pathogenic pathway may occur in humans and it plays an important role in UTI recurrence.展开更多
Background Multiple recurrences are common in non-muscle invasive bladder cancer, but the-risk of multiple recurrences has not been fully described. Identifying patients at high risk of multiple recurrences will help ...Background Multiple recurrences are common in non-muscle invasive bladder cancer, but the-risk of multiple recurrences has not been fully described. Identifying patients at high risk of multiple recurrences will help to select an optimal therapeutic strategy and to improve prognosis. This study was conducted to identify the risk factors for multiple recurrences of non-muscle invasive bladder cancer. Methods We reviewed the clinical data of all patients with non-muscle invasive bladder cancer in our hospital between January 2003 and February 2010. Patients with at least one recurrence were included. Multivariate analysis was performed for theorized risk factors （age, gender, tumor stage, grade, size, location, number of lesions, adjuvant intra-vesical chemotherapy after transurethral resection, and recurrence-free survival after each resection） to clarify risk factors for multiple recurrences of non-muscle invasive bladder cancer. Results Of the 278 patients with non-muscle invasive bladder cancer, 84 were with at least one recurrence and a total of 222 recurrences among them were followed up for 6-70 months （mean, 36.1 months）. Recurrence-free survival after initial resection predicted the overall frequency of bladder cancer recurrence （risk ratio （RR） = 37.83, 95% confidence interval （C/）=3.45-396.13, P=0.001） and second recurrence （RR=6.15, 95% C/=1.28-29.57, P=0.023）. Similarly, recurrence-free survival after a second resection was the only significant risk factor for third recurrence （RR=31.08, 95% C1=2.53-381.47, P=0.007）. Moreover, recurrence-free survival after initial resection was the only significant factor to predict later progression to muscle invasive bladder cancer （RR=8.62, 95% C1=1.47-58.34, P=0.001）. Conclusions Recurrence-free survival after resection is an independent predictor of multiple recurrences of non-muscle invasive bladder cancer. The shorter the period between resection and recurrence is, the higher the risk of multiple recurrences.展开更多
The result of intravesical instillation with interleukin-2 (IL-2) for preventing the recurrence of bladder cancer and discussion of its mechanism was reported. 20 patients with histologically confirmed bladder transit...The result of intravesical instillation with interleukin-2 (IL-2) for preventing the recurrence of bladder cancer and discussion of its mechanism was reported. 20 patients with histologically confirmed bladder transitional cell carcinoma were investigated. 2 000 u IL 2 was intravesically instillated every day for six days after resection of the neoplasm. The serum level of tumor necrosis factor (TNF) was significantly increased in 17 patients after IL-2 therapy. Recurrence occurred in 4 patients during the follow-up period of 10-18 months. The basic level of serum TNF was low and was not increased or even decreased after IL-2 in these patients. On the contrary, recurrence did not occur in another 5 patients with low basic level of TNF, but it was significantly increased after treatment of IL-2. TNF played a key role in preventing the recurrence of bladder cancer. The patients who had low basic level of TNF, which did not markedly increase or even decrease after IL-2 therapy were at high risk of recurrenc展开更多
Objective:To assess the efficacy of chlorophyl lderivative（CPD4）-Photodynamic therapy（PDT）in preventing postoperative recurrence of the in filtrativecancer of the urinary bladder-Methods:32 patients were treated w...Objective:To assess the efficacy of chlorophyl lderivative（CPD4）-Photodynamic therapy（PDT）in preventing postoperative recurrence of the in filtrativecancer of the urinary bladder-Methods:32 patients were treated with CPD4-PDT postoperationally to prevent therecurrence of can cerall of which being followedup.Results:There currenc erate was42.1%inT2 tumors and 69.2%inT3 tumors（P＜0.05）,and the survival period without tumor has been 19.8±14.8months in T2 tumors,and 22.67±19.72months in T3 tumors（P＞0.05）.There was verysignificant difference inrecurrent rate between grade I and gradeⅡ、Ⅲpatients（0%and66.7%,P<0.001）.ConcIusion:CPD4-PDT is a safe and effectiv emeasureto prevent the recurrence in infiltrative bladder cancer after operation.展开更多
基金the National Natural Science Foundation of Hebei(No.H2018201179)Hebei University of Science and Technology(No.QN2016077)Health and Family Planning Commission of Hebei(No.20160388).
文摘Backgroud:Summarize the formula rule of traditional Chinese medicine fOr preventing and treating bladder cancer recurrence after operation and explore the molecular mechanism of core medicines.Methods:Literatures collected from CNKI,Wanfang Med Online,CMJD,PUBMED and Elsiver databases were as prescription sources,and association rules and complex system entropy clustering analysis were carried out using the Traditional Chinese Medicine Inheritance Support System(TCMISSV2.5).BATMAN-TCM online analysis tool was used to construct target-pathway-disease correlation map to reveal the potential mechanism of action.Results:A total of 122 prescriptions were eligible for data analysis.The high-frequency traditional Chinese medicines are Poria,Radix et Rhizoma Rhei,Radix Astragali,Herba Hedyotidis Diffusae and Rhizoma Atractylodis Macrocephalae.The high-frequency drug pairs are Rhizoma Atractylodis MacrocephalaeIPoria,Poria/Rhizoma Alismatis,Radix Astragali/Rhizoma Atractylodis Macrocephalaeand and Herba Hedyotidis Diffusae/Herba Scutellariae Darbatae..There are 5 groups of drug pairs with high correlation strength.Cluster analysis shows 6 core drug combinations and 3 new prescriptions.In clinical practice,the core compatibility of traditional Chinese medicines for preventing postoperative recurrence of bladder cancer is Poria,Radix Astragali and Herba Hedyotidis Diffusae.The possible signaling pathways are the neuroactive ligand receptor interaction signaling pathway and calcium signaling pathway.Conclusion:Prevention and treatment of postoperative recurrence of bladder cancer mainly use medicines with effects of eliminating dampness and diuresis for removing edema,heat-clearing and detoxifying,and qi-invigorating.The potential mechanism of the compatibility of core drugs may be realized by interfering with the signal pathway of neuroactive ligand receptor interaction and calcium signal pathway.
文摘Objective To study the therapeutic efficacy of combined interventional chemotherapy and intravesical instillation of mitomycin on preventing bladder cancers from recurring after local ablation. Methods 28 patients with superficial bladder cancers were randomized into combined interventional chemotherapy and intravesical instillation of mitomycin or intravesical instillation of mitomycin alone for preventing recurrence after local ablation. The result was assessed by x2 test. Results The patients have been followed up for 12-26 months (mean 21 months). 1 case has had tumor recurrence in the combined modality therapy group and 4 in the intravesical instillation alone group, the tumor recurrence rate being 7% (1/14) and 29% (4/14) respectively (P【0.05). Conclusion Combined use of interventional chemotherapy and intravesical instillation of mitomycin is effective in preventing superficial bladder cancer from recurring after local ablation with fewer adverse effects. The ragimen is not only reliable but
文摘To investigate the effects of intravesical therapy with elemene in preventing postoperative recurrence of superficial bladder cancer and its toxic and side effects.Methods This series included 123 patients with superficial bladder cancer (T1),consisting of transitional cell carcinoma GⅠ in 37 cases,GⅡ in 73 and GⅢ in 13.They all underwent surgical treatment.Postoperatively,they were randomly assigned to 2 groups;63 patients in elemene group received instillation of elemene (400 mg,once a week) 2 weeks after operation and 60 patients in mitomycin C (MMC) group received instillation of MMC (40 mg,once a week) 2 weeks after operation.The instillations were repeated for 6 weeks and thereafter monthly for 1 year.The recurrence rates,side effects,and NK cell activity before and after treatment were evaluated.Results The recurrence rate of elemene group (mean follow-up of 19.7 months) was 7.9% (5 cases),which was significantly lower than that (25.0%,15 cases) of MMC group (mean follow-up of 19.4 months;P<0.05).The side effect in elemene group (3.2%,2 cases) was significantly milder than that in MMC group (25.0%,15 cases)(P<0.05).In elemene group,the NK cell activity after treatment (28±2)% was significantly higher than that before treatment(20±2)%(P<0.05).Conclusion Instillation of elemene after operation is effective and safe in preventing postoperative recurrence of bladder cancer.8 refs.
基金supported by the National Natural Science Foundation of China(Nos.31072238,31172441,31372562,81170650)National Major Scientific and Technological Special Project for Significant New Drugs Development(No.2012ZX09303018)
文摘Bladder cancer remains a commonly diagnosed malignancy worldwide,bringing huge economic burden and high morbidity for patients. Assessment of prognostic significance of lymphovascular invasion（LVI） is a critical issue in the surgical management of bladder cancer after transurethral resection or radical cystectomy. A systematic search of Pub Med,Embase and Cochrane Library was performed up to Oct 10,2014 to identify eligible studies. Outcomes of interest were collected from studies comparing overall survival（OS）,cancer specific survival（CSS） and recurrence free survival（RFS） in patients with the LVI. Results of studies were pooled,and combined hazard ratios（HRs） with corresponding 95% confidence intervals（CIs） for survival were used as the effect size estimation. Funnel plots were done to show the publication bias,while the forest plots and subgroup analyses were used to limit the heterogeneity. A total of 20 studies（10 663 patients） met the eligibility criteria and were included for this meta-analysis. Our pooled results showed that there were significant differences in OS（pooled HR,1.71; 95%CI,1.52–1.92; P〈0.00001）,CSS（pooled HR,2.25; 95% CI,1.80–2.81; P〈0.00001） and RFS（pooled HR,1.91; 95% CI,1.57–2.32; P〈0.00001） between the patients with LVI and the patients without LVI. There were significant heterogeneities observed in the studies concerning the relationship between LVI and CSS,RFS. There was no clear evidence of publication bias. When tumor stage was beyond T3,LVI lost its predictive value for CSS and RFS. For the patients who had negative lymph nodes,LVI was still an adverse predictor. Our pooled results demonstrate that LVI indicates poor prognosis of patients with bladder cancer after surgical procedures,and it can be of particular importance in clinical practice. However,these results need to be further confirmed by more adequately designed prospective studies.
文摘This study aimed to provide evidence of persistent uropathogenic Escherichia coli（UPEC） in female patients with recurrent urinary tract infection（UTI） after antibiotic therapy. We collected biopsies of the bladder, and clean-catch urine samples from 32 women who had episodes of recurrent UTI and were given antibiotic therapy. Urine samples and biopsies were analyzed by conventional bacteriological techniques. Phylogenetic group and 16 virulence factors（VFs） of UPEC were determined using polymerase chain reaction（PCR）. The infection capability of UPEC was confirmed in a mouse model. Immunofluorescence and electron microscopy were used to detect intracellular bacterial communities（IBCs） in the mouse model. The results showed that all urine specimens were detected sterile. E. coli was found in 6 of 32 biopsies（18.75%）, and was identified to be UPEC by PCR. Different VFs associated with the formation of IBCs were identified in all six UPEC isolates. Each UPEC isolate was capable of forming IBCs within the bladder epithelial cells of mice. In conclusion, UPEC with distinctive pathological traits and the capability of IBC formation was first found in the bladders of women after antibiotic therapy, suggesting that the IBC pathogenic pathway may occur in humans and it plays an important role in UTI recurrence.
文摘Background Multiple recurrences are common in non-muscle invasive bladder cancer, but the-risk of multiple recurrences has not been fully described. Identifying patients at high risk of multiple recurrences will help to select an optimal therapeutic strategy and to improve prognosis. This study was conducted to identify the risk factors for multiple recurrences of non-muscle invasive bladder cancer. Methods We reviewed the clinical data of all patients with non-muscle invasive bladder cancer in our hospital between January 2003 and February 2010. Patients with at least one recurrence were included. Multivariate analysis was performed for theorized risk factors （age, gender, tumor stage, grade, size, location, number of lesions, adjuvant intra-vesical chemotherapy after transurethral resection, and recurrence-free survival after each resection） to clarify risk factors for multiple recurrences of non-muscle invasive bladder cancer. Results Of the 278 patients with non-muscle invasive bladder cancer, 84 were with at least one recurrence and a total of 222 recurrences among them were followed up for 6-70 months （mean, 36.1 months）. Recurrence-free survival after initial resection predicted the overall frequency of bladder cancer recurrence （risk ratio （RR） = 37.83, 95% confidence interval （C/）=3.45-396.13, P=0.001） and second recurrence （RR=6.15, 95% C/=1.28-29.57, P=0.023）. Similarly, recurrence-free survival after a second resection was the only significant risk factor for third recurrence （RR=31.08, 95% C1=2.53-381.47, P=0.007）. Moreover, recurrence-free survival after initial resection was the only significant factor to predict later progression to muscle invasive bladder cancer （RR=8.62, 95% C1=1.47-58.34, P=0.001）. Conclusions Recurrence-free survival after resection is an independent predictor of multiple recurrences of non-muscle invasive bladder cancer. The shorter the period between resection and recurrence is, the higher the risk of multiple recurrences.
文摘The result of intravesical instillation with interleukin-2 (IL-2) for preventing the recurrence of bladder cancer and discussion of its mechanism was reported. 20 patients with histologically confirmed bladder transitional cell carcinoma were investigated. 2 000 u IL 2 was intravesically instillated every day for six days after resection of the neoplasm. The serum level of tumor necrosis factor (TNF) was significantly increased in 17 patients after IL-2 therapy. Recurrence occurred in 4 patients during the follow-up period of 10-18 months. The basic level of serum TNF was low and was not increased or even decreased after IL-2 in these patients. On the contrary, recurrence did not occur in another 5 patients with low basic level of TNF, but it was significantly increased after treatment of IL-2. TNF played a key role in preventing the recurrence of bladder cancer. The patients who had low basic level of TNF, which did not markedly increase or even decrease after IL-2 therapy were at high risk of recurrenc
文摘Objective:To assess the efficacy of chlorophyl lderivative（CPD4）-Photodynamic therapy（PDT）in preventing postoperative recurrence of the in filtrativecancer of the urinary bladder-Methods:32 patients were treated with CPD4-PDT postoperationally to prevent therecurrence of can cerall of which being followedup.Results:There currenc erate was42.1%inT2 tumors and 69.2%inT3 tumors（P＜0.05）,and the survival period without tumor has been 19.8±14.8months in T2 tumors,and 22.67±19.72months in T3 tumors（P＞0.05）.There was verysignificant difference inrecurrent rate between grade I and gradeⅡ、Ⅲpatients（0%and66.7%,P<0.001）.ConcIusion:CPD4-PDT is a safe and effectiv emeasureto prevent the recurrence in infiltrative bladder cancer after operation.
