Objective To observe the early efficacy and toxicity of gemcitabine plus tegafur, gimeracil and oteracil potassium (S-1) regimen (GS regimen) in patients with metastatic castration-resistant prostate cancer (mCRPC) after docetaxel failure. Methods From July 2013 to December 2015, sixteen mCRPC patients who failed in the treatment of docetaxel-based chemotherapy in West China Hospital of Sichuan University were collected. And the patients were treated with gemcitabine 1 000 mg/m2 intravenously on Day 1 and S-1 40–60 mg/m2 orally dividedly twice daily on Day 1–10, which repeated every two weeks. The main outcome measures were total prostate-specific antigen (T-PSA) decline rate and pain remission rate. Results Of the 13 evaluable patients, the T-PSA decline rate≥50% was observed in 4 patients (30.8%). Among the 11 patients with bone pain, remarkable pain relief was observed in 4 cases (36.4%). Myelosuppression, gastrointestinal reaction, rash and fatigue were the commonly observed adverse reactions and the toxicity of chemotherapy was tolerable. Conclusion The GS regimen is active and tolerable in patients with mCRPC after docetaxel failure.
Objective To investigate the application of the dynamic contrast enhanced MRI (DCE-MRI ) combined with magnetic resonance spectroscopy (MRS) in the diagnosis of prostate cancer. Method A total of 60 patients with prostate cancer and 60 patients with benign prostatic hyperplasia diagnoses in Sichuan Cancer Hospital from January 2011 to January 2014 were included as prostate cancer group and proliferative group respectively. Sixty healthy individuals during the same period were included as the control group. We used Siemens Avanto 1.5 T high field superconducting MRI for DCE-MRI scan and MRS scan. After the MRS scan was finished, we used the workstation spectroscopy tab spectral analysis. Eventually we got the crest lines of prostate metabolites choline (Cho), creatine (Cr) and citrate (Cit). Then we calculated Cho/Cit, (Cho+Cr)/Cit and their average. Results Comparing the signal value in 21 seconds, 1 minute, 2 minutes of DCE-MRI, the differences among the three groups were statistically significant (P<0.05). Comparing the results of spectral analysis, the differences among the three groups were statistically significant (P<0.05). The sensitivity was 89.67%, the specificity was 95.45% and the accuracy was 94.34% when using DCE-MRI combined with MRS. Conclusion DCE-MRI combined with MRS greatly improves the sensitivity, specificity and accuracy of the diagnosis of prostate cancer; it has a great application value in the diagnosis of prostate cancer.
Purpose To evaluate the prostag landins(PG) levels and to identify the effect of dexamethasone(DXM) on PG in response to photochemical insult in rat retina. Methods The experiments were performed on 36 SD rats which were separated into two groups,control and treated groups,and the latter received daily intraperitoneal injections of DXM (1 mg/kg) for 5 consecutive days,starting 3 days before light exposure.The animals were continually exposed to green fluorescent light(510-560 nm)with an illuminance level of (1900plusmn;106.9)lx for 24 hrs.The retinal concentration of PGE 2 and 6-keto-PGF1alpha; were tested at 6hrs,1,3,7 and 14 days after light exposure. Results The PGE2 and 6-keto-PGF1alpha; levels of the control groups (37.50plusmn;2.75,48.06plusmn;4.0 4,81.90plusmn;4.89) pg/mg and (4.68plusmn;0.69,7.50plusmn;0.57,10.40plusmn;0.71) pg/mg had significantly higher values than those of the treated rats(20.60plusmn;4.28,37.36plusmn; 3.34,54.85plusmn;4.57) pg/mg and (2.50plusmn;0.59,4．68plusmn;0.81,6.87plusmn;1.10)pg/mg (Plt;0.01) after 6 hrs,1 and 3 days light exposure respectively. Conclusion By inhibition of PG synthesis,the DXM may play an ameliorative effect on retinal photochemical injury of rats. (Chin J Ocul Fundus Dis,1999,15:94-96)
Prostate cancer is the most common malignant tumor in male urinary system, and the morbidity and mortality rate are increasing year by year. Traditional imaging examinations have some limitations in the diagnosis of prostate cancer, and the advent of molecular imaging probes and imaging technology have provided new ideas for the integration of diagnosis and treatment of prostate cancer. In recent years, prostate-specific membrane antigen (PSMA) has attracted much attention as a target for imaging and treatment of prostate cancer. PSMA ligand positron emission tomography (PET) has important reference value in the diagnosis, initial staging, detection of biochemical recurrence and metastasis, clinical decision-making guidance and efficacy evaluation of prostate cancer. This article briefly reviews the clinical research and application progress on PSMA ligand PET imaging in prostate cancer in recent years, so as to raise the efficiency of clinical applications.
【摘要】 目的 总结80 W绿激光汽化术治疗大体积良性前列腺增生症的技术及临床疗效。 方法 回顾性分析2007年9月-2009年11月完成经尿道80 W绿激光汽化术治疗体积gt;100 mL良性前列腺增生症患者围手术期及随访资料，包括术前前列腺体积、血红蛋白、国际前列腺症状评分（IPSS）、生活质量（QOL）评分，手术时间、汽化激光能量及术后血清钠、血红蛋白、术后留置尿管时间、IPSS、QOL评分、3个月后残余前列腺体积等。 结果 45例体积gt;100 mL的良性前列腺增生症患者均在持续硬膜外麻醉下完成手术，无中转开放手术。术前前列腺体积（128.82±24.82） mL，血红蛋白（138.5±6.85） g/mL，IPSS评分27.10±2.88，QOL 4.26±0.87，术前最大尿流率（6.53±3.76） mL/s，手术时间（141.00±30.19） min，汽化能量（36.14±11.64） MJ，术后3 d血红蛋白（124.33±7.64） g/mL，术后留置尿管时间（101.55±20.55） h，术前与术后血清钠无明显变化，血红蛋白轻度下降，无需输血。3个月后残余前列腺体积（44.63±10.31） mL，IPSS评分11.58±2.52，QOL 2.74±1.10。无尿道狭窄发生。 结论 经尿道80 W 绿激光汽化术治疗体积gt;100 mL的良性前列腺增生症，具有良好的安全性和临床疗效，可作为此类患者的首选治疗之一。【Abstract】 Objective To investigate the efficacy and safety of 80 Watt high-power potassium-titanyl-phosphate (KTP) photoselective laser vaporization of the prostate (PVP) in patients with large-volume benign prostate hyperplasia (gt;100 mL). Methods Retrospective analysis was performed in patients with large-volume benign prostatic hyperplasia (gt;100 mL), who were treated with the 80 Watt KTP transurethral photoselective laser vaporization of the prostate from September 2007 to November 2009. The preoperative evaluation included prostate volume by transrectal ultrasonic scanning, serum sodium and serum hemoglobin, international prostate symptom score (IPSS) and quality of life (QOL) score. The operative time and vaporization energy and average indwelling catheterization time were recorded. The postoperative serum sodium, serum hemoglobin after the operation were compared with those before the operation. After 3 months, the IPSS, QOL and residual prostate volume were evaluated. Results Forty-five patients of totally 219 patients with gt;100 mL prostate in volume were successfully operated under continuous epidural anesthesia. None was changed to open operation. The mean preoperative prostate volume was (128.82±24.82) mL, the mean IPSS was (27.10±2.88) and QOL were (4.26±0.87). The mean operative time was (141.00±30.19) minutes. The mean indwelling catheterization was (102.17±19.50) hours. The serum sodium did not change, while the serum hemoglobin level reduced mildly but without transfusion. After 3 month, the mean IPSS was (11.58±2.52) and QOL were (2.74±1.10) with residual prostate volume was (44.63±10.31) mL. No stricture was observed in 〖LM〗this group. Conclusion The transurethral photoselective vaporization of the prostate with 80 Watt KTP laser is a safe and effective therapy for patients with gt;100 mL prostate in volume in experienced PVP center.
Objective To study the interaction and mechanism of prostaglandin I2 (PGI2) receptor/thromboxane A2 (TxA2) receptor (IP/TP) and cyclooxygenase-2 (COX-2) in ischemia reperfusion injury after liver transplantation of rat. Methods Rats were randomly divided into three groups: control group （n=16), orthotropic liver transplantation group （n=32) and nimesulide intervention group （n=32). The samples were obtained at 3 h, 6 h, 12 h and 24 h after operation. The expressions of COX-2, IP and TP mRNA were detected by RT-PCR. Immunohistochemistry was used to detect the localization and expression of COX-2. Hematoxylin Eosin staining was used to classify the injury extent of liver. Serum ALT and AST levels were detected to evaluate the changes of liver enzyme. Results COX-2 protein expression detected by immunohistochemistry in orthotropic liver transplantation group mainly distributed in the district of liver sinusoidal endothelial cells, liver cells and macrophage cells, which was significantly higher than control group and nimesulide intervention group. Expressions of IP mRNA, TP mRNA and COX-2 mRNA in the orthotropic liver transplantation group were significantly increased than those in control group (P＜0.05), and the ratio of IP/TP increased (P＜0.05). Expressions of IP mRNA and TP mRNA in nimesulide intervention group were significantly lower than that in the orthotropic liver transplantation group at 6 h and 12 h after operation (P＜0.05), and the ratio of IP/TP decreased at 3 h, 6 h and 24 h after operation (P＜0.05). The expression of COX-2 mRNA in nimesulide intervention group was significantly lower than that in the orthotropic liver transplantation group at 6 h, 12 h and 24 h after operation. In orthotropic liver transplantation group liver injury was obvious by HE staining, and more severve than that in nimesulide intervention group. Serum AST (each time) and ALT (3 h, 6 h and 12 h) levels in the orthotropic liver transplantation group were significantly higher than that in control group and nimesulide intervention group (P＜0.05) and peaked at 6 h after operation. Conclusion The balance of IP/TP takes part in and plays an important role in the ischemia reperfusion injury of liver transplantation. Changing imbalance of IP/TP may reduce liver transplantation ischemia reperfusion injury by inhibiting COX-2 expression.
Objective To assess the efficacy of finasteride in treating perioperative bleeding in patients undergoing transurethral resection of the prostate (TURP). Methods We searched MEDLINE (1966 to 2005), EMBase (1984 to 2004), CBM (1980 to 2005), The Cochrane Library (Issue 4, 2005) and relevant journals to identify cl inical trials involving finasteride in patients undergoing TURP. We also checked the references in the reports of each included trial. The qual ity of randomized controlled trials (RCTs) was assessed according to the methods recommended by The Cochrane Collaboration, and the qual ity of non-RCTs was assessed based on the methods recommended by Jiang-ping Liu, Stroup and Hailey. Two reviewers extracted data independently and data analyses were conducted with The Cochrane Collaboration’ s RevMan 4.2. Result We included 4 RCTs and 1 non-RCT. The qual ity of 3 RCTs was graded C and the other one was graded B. The quality of the non-RCT was relatively high. Meta-analyses showed that with comparable age, international prostate symptom score, prostate specific antigen, preoperative volume of prostate and excision volume between the two groups (Pgt;0.05), the perioperative bleeding volume (WMD –85.44, 95%CI –117.31 to –53.58), the bleeding volume per gram of resected prostate tissue (WMD –3.5, 95%CI –6.34 to –0.58) and hemoglobin reduction (WMD –1.61, 95%CI –1.96 to –1.26) of the finasteride group were significantly smaller than those of the control group. Conclusion The evidence currently available indicates that preoperative use of finasteride may reduce bleeding in patients undergoing TURP.