Objective To assess the clinical efficacy and treatment-induced side effects of intravesically administered bacillus calmette-guerin (BCG) plus chemotherapy following TURB-t in patients with superficial bladder cancer compared with BCG alone.Methods Randomized controlled trials (RCTs) were identified from PubMed (1950 to December 2006), Ovid (1966 to December 2006), EMbase (1984 to December 2006), The Cochrane Library (Issue 4, 2006), CBM (1978 to 2006) and VIP (1989 to 2006). We also handsearched relevant published and unpublished reports as well as their references.The quality of included trials was evaluated by two reviewers. We used The Cochrane Collaboration’ s RevMan 4.2.9 software for statistical analysis. Results Four studies involving 681 patients were included. Meta-analyses showed that, in patients with Ta and T1 bladder cancer, there was a significant difference in the recurrence rate between intravesically administered BCG plus chemotherapy and BCG alone (RR 0.69, 95%CI 0.53 to 0.90). In patients with Tis bladder cancer, no significant difference was found in the recurrence rate between the two groups (RR 1.22, 95%CI 0.97 to 1.54). In patients with Ta, T1 and Tis bladder cancer, no statistically significant difference was found in the incidence of side effects (RR 0.85, 95%CI 0.70 to 1.03). Conclusion Compared with BCG alone, intravesically administered BCG plus chemotherapy in patients with Ta and T1 superficial bladder cancer can reduce the incidence of tumor recurrence more effectively. For patients with Tis bladder cancer, the two therapeutic regimens do not differ in the incidence of tumor recurrence. The two regimens have similar side effects. There is a moderate possibil ity of selection bias, performance bias and publ ication bias in the small number of included studies, which weakens the strength of the evidence of our results. Better evidence from more high-quality double-blind randomized controlled trials is needed.
ObjectiveTo study the effect of bacillus calmette-guerin(BCG) polysaccharides nucleic acid on humoral immunity, interleukin(IL)-8 and tumor necrosis factor(TNF)-αin patients with chronic obstructive pulmonary disease (COPD), and to provide theoretical basis for evaluation of its clinical effectiveness. MethodsThirty hospitalized elderly patients with AECOPD treated from March 2012 to February 2013 and 60 patients with stable COPD treated at the same time were randomly selected as the study subjects. At the same time, 60 healthy people from our physical examination center were also enrolled and divided into two groups:the elderly healthy group (n=30) and nonelderly healthy group (n=30). IL-8, TNF-α, IgA, IgG and IgM levels were determined. The stable COPD group was randomly divided into two groups:group A (n=30) and group B (n=30). Group A received only routine therapy; group B received both routine therapy and intramuscular injection of BCG polysaccharide nucleic acid (0.35 mg/day, three times a week). IL-8, TNF-α, IgA, IgG and IgM levels in peripheral blood were investigated before treatment and one month later. ResultsThere were no statistically significant differences in IL-8 and TNF-αlevels in peripheral blood between elderly healthy group and nonelderly healthy group (P > 0.05), but the IgA, IgG and IgM levels were lower in the nonelderly healthy group than in the elderly healthy group (P < 0.05). Compared with the elderly healthy grouping, IgG and IgM levels were significantly lower in AECOPD group and stable COPD group (P < 0.05), but IL-8 and TNF-αlevels were significantly higher (P > 0.05). There were statistically significant differences in TNF-α, IgA, IgG and IgM levels between group B before and after treatment (P > 0.05). ConclusionsHuman's humoral immunity decreases with age. Elderly COPD patients are at high risks of abnormal immunologic function, particularly in the acute exacerbation period. The BCG polysaccharides nucleic acid can strength patients' humoral immunity. The levels of inflammatory cytokines can be reduced using BCG polysaccharides nucleic acid.