Efficacy and safety of solifenacin succinate tablets versus solifenacin succinate tablets with local estrogen for the treatment of overactive bladder in postmenopausal women--a multicenter, randomized, open-label, controlled comparison study.

OBJECTIVE: The aim of the study was to compare the effectiveness and safety of solifenacin succinate tablets alone or combined with local estrogen for overactive bladder treatment in postmenopausal women. METHODS: This multicenter, randomized, open, parallel-controlled clinical trial enrolled 104 women between January 2012 and August 2013. Participants meeting the inclusion criteria were randomized 1:1 to 12 weeks of treatment with group A (solifenacin 5 mg qd + promestriene vaginal capsules intravaginally) or group B (solifenacin 5 mg qd). Before and after 12 weeks of treatment, symptoms (urinary urgency, frequency, and urge incontinence) were analyzed. Our primary outcome was the change from baseline to the end of treatment in the mean number of voids in 24 hours. Quality of life (QoL) was assessed using International Prostate Symptom Score and Overactive Bladder Symptom Score questionnaires and safety according to the incidence of adverse events. The t test or the Mann-Whitney U test was used to compare continuous variables, and the χ(2) test or Fisher's exact test was used to compare categorical variables. RESULTS: The median decreases in the mean number of voids in 24 hours in groups A and B were 5.2. and 4.3, respectively, which were not significantly different. The median decreases in urgency episodes in groups A and B were 2.0 and 2.5, respectively. In addition, the QoL scores significantly changed in both groups (both P < 0.05). The most common adverse event was dry mouth (19.2% in both groups). CONCLUSIONS: Solifenacin with or without local estrogen was effective and safe for overactive bladder treatment in postmenopausal women. The addition of local estrogen improved subjective feelings and QoL.

Realgar-induced apoptosis of cervical cancer cell line Siha via cytochrome c release and caspase-3 and caspase-9 activation.

OBJECTIVE: To explore the molecular mechanism of realgar-induced apoptosis of cervical cancer cells. METHODS: The cervical cancer cell line Siha was used to determine the cell viability and apoptosis after treatment with realgar using MTT assay and flow cytometry. The activities of caspase-3, -8, and -9 were detected by fluorescence resonance energy transfer technology and colorimetric assay, while the levels of Bcl-2, cytochrome c, and Bax were detected by Western blot method. RESULTS: Induction of apoptosis by realgar was detected in Siha cell line in a dose-dependent manner. The apoptosis was accompanied by a significant increase in cytochrome c release and activation of caspase-3 and caspase-9 but not caspase-8. Further, the realgar-induced apoptosis was inhibited by a broad-spectrum caspase inhibitor, a caspase-3 inhibitor, and a caspase-9 inhibitor but not by a caspase-8 inhibitor. Bcl-2 and Bax protein expressions were not changed by realgar. CONCLUSION: The induction of apoptosis by realgar is mediated through a cytochrome c-dependent pathway, which sequentially activates caspase-9 and caspase-3.

Mesh erosion after pelvic reconstructive surgeries.

OBJECTIVE: To report our experience on the erosion of polypropylene mesh used in pelvic reconstructive surgeries, and to discuss the pathological changes of mesh erosion. METHODS: We conducted a retrospective study of 128 patients receiving pelvic reconstructive surgeries with polypropylene mesh from May 2006 to May 2009 in the Department of Gynecology and Obstetrics, Renmin Hospital of Wuhan University, Hubei, China. Data regarding patient demographics, operation notes, and follow up were collected. RESULTS: The mean follow-up time for the 128 patients was 15.2 (1.3-60) months. Seven patients were diagnosed with vaginal mesh erosion (Prolene mesh), and one of them suffered from anaphylactoid breakout related to the mesh. The mean (+/- standard deviation) time occurring in the mesh erosion was 9.1 +/- 7.6 months. All the 7 patients were treated with surgery. Chronic inflammation was the main pathological manifestations in the eroded tissue. CONCLUSION: Most cases of polypropylene mesh erosions occur within one year postoperatively. Removal of the mesh could be the best therapy for mesh erosion. Further study is needed to determine if the polypropylene mesh induces supersensitivity.