Comparison of gemcitabine and anthracycline antibiotics in prevention of superficial bladder cancer recurrence.

BACKGROUND: Because of the failure, shortage and related toxicities of Bacillus Calmette-Guérin (BCG), the other intravesical chemotherapy drugs are also widely used in clinical application. Gemcitabine and anthracycline antibiotics (epirubicin and pirarubicin) are widely used as first-line or salvage therapy, but which drug is better is less discussed. METHODS: A total of 124 primary NMIBC patients administered intravesical therapy after transurethral resection of bladder tumor (TURBT) at Nanjing Drum Tower hospital from January 1996 to July 2018. After TURBT, all patients accepted standard intravesical chemotherapy. Recurrence was defined as the occurrence of a new tumor in the bladder. Progression was defined as confirmed tumor invading muscular layer. Treatment failure was defined as need for radical cystectomy (RC), systemic chemotherapy and radiation therapy. RESULTS: Of the 124 patients who underwent intravesical chemotherapy, 84 patients were given gemcitabine, 40 patients were given epirubicin or pirarubicin, with mean follow-up times (mean ± SD) of (34.8 ± 17.9) and (35.9 ± 22.1) months respectively. The clinical and pathological features of patients show no difference between two groups. Recurrence rate of patients given gemcitabine was 8.33% (7 out of 84), the recurrence rate was 45% (18 out of 40) for epirubicin or pirarubicin (P < 0.0001). The progression rates of gemcitabine, anthracycline antibiotics groups were 2.38% (2 out of 84) and 20% (8 out of 40), respectively (P < 0.001). The rate of treatment failure is 8.33% (7 out of 84) and 25% (10 out of 40), respectively (P = 0.012). Gemcitabine intravesical chemotherapy group was significantly related to a lower rate of recurrence (HR = 0.165, 95% CI 0.069-0.397, P = 0.000), progression (HR = 0.160, 95% CI 0.032-0.799, P = 0.026) and treatment failure (HR = 0.260, 95% CI 0.078-0.867, P = 0.028). CONCLUSION: In conclusion, gemcitabine intravesical chemotherapy group was significantly related to a lower rate of recurrence, progression and treatment failure. Gemcitabine could be considered as a choice for these patients who are not suitable for BCG.

[Prevalence, awareness, treatment and control of hypertension in rural adult residents of Liaoning Province].

OBJECTIVE: The objective of this study was to estimate the current status of prevalence, awareness, treatment and control rate of hypertension in adult residents living in rural area of Liaoning Province, North China. METHODS: The screening was finished in 2008, probability proportional to size sampling method was used to select the representative sample. Blood pressure was measured in 153481 adults (aged > 35 yr), information on history of hypertension and use of antihypertensive medications was obtained by use of a standard questionnaire. RESULTS: Overall, hypertension prevalence rate was 41.9%, the age-specific hypertension prevalence rate was 25.0%, 37.7%, 50.2%, and 64.9% in men and 22.1%, 41.1%, 56.6% and 70.2% in women age 35 to 44 years, 45 to 54 years, 55 to 64 years, and above 65 years, respectively. Among hypertensive patients, awareness rate was only 54.1%, 39.7% patients received antihypertensive medication and blood pressure control rate (< 140/90 mm Hg) was 6.9% in all participants and was 9.3% in treated hypertensive patients. CONCLUSION: Our results indicates that hypertension prevalence is highly while awareness, treatment and control rate of hypertension was low in rural areas of northeast China. These results underscore the urgent need to develop comprehensive strategies to improve prevention, detection, and treatment of hypertension in rural population of Liaoning province.