Objective To evaluate the efficacy and safety of transcatheter arterial chemoembolization (TACE) combined with transurethral resection of bladder tumor (TURBT) for muscle-invasive bladder cancer (MIBC). Methods China National Knowledge Infrastructure, Chongqing VIP, Wanfang, SinoMed, PubMed, Web of Science, and Cochrane Library were searched from the establishment of databases until December 2023. All randomized controlled trials of TACE combined with TURBT for MIBC were collected and subjected to meta-analysis using RevMan 5.4 software. Results A total of 7 studies were included, involving 490 patients, with 246 in the TACE+TURBT group and 244 in the TURBT group. The meta-analysis results showed that compared with TURBT, TACE+TURBT had certain advantages in reducing recurrence rate [relative risk (RR)=0.49, 95% confidence interval (CI) (0.35, 0.68)], improving survival rate [RR=1.16, 95%CI (1.07, 1.27)], shortening surgical time [standardized mean difference (SMD)=?4.97, 95%CI (?7.54, ?2.40)], reducing intraoperative bleeding [SMD=?4.19, 95%CI (?5.78, ?2.60)], and improving quality of life [SMD=4.51, 95%CI (2.15, 6.86)]. The adverse reactions of the two groups were similar. Conclusions Existing evidence suggests that TACE may reduce intraoperative bleeding and shorten surgical time to help achieve maximum TURBT. TACE combined with TURBT may be superior to simple TURBT in terms of tumor recurrence rate and survival rate. TACE combined with TURBT can benefit MIBC patients in bladder-preserving treatment plans.
Infectious cystitis is an inflammatory disease of the bladder wall caused by pathogenic microorganisms invading the urinary tract and is one of the most common types of urinary tract infections in clinical practice. At present, China lacks evidence-based clinical practice guidelines for the integrated diagnosis and treatment of infectious cystitis with Chinese and Western medicine. Consequently, significant variations exist in diagnostic and therapeutic strategies across medical institutions, and the recurrence rate remains relatively high. To further standardize clinical decision-making for patients with infectious cystitis and to promote the translation of the latest clinical research evidence into practice, the working group has initiated the development of the Guidelines on Integrated Chinese and Western Medicine in the Diagnosis and Treatment of Infectious Cystitis. The guideline development will be conducted in accordance with the World Health Organization (WHO) handbook for guideline development, following the standards and requirements of the GRADE system and the Reporting Items for Practice Guidelines in Healthcare (RIGHT). It will also incorporate national health policies, classical medical texts, existing guidelines or consensuses, and the distinctive characteristics of traditional Chinese medicine (TCM) diagnosis and treatment. This proposal systematically outlines the background and significance of the guideline, the composition of the working group, the construction of clinical questions and the identification of outcome indicators, the methodology of evidence collection and systematic evaluation, the formation of recommendations and the consensus process, etc., to provide a methodological basis and technical guidance for the scientific development and standardized release of subsequent guidelines.