损毁双侧蓝斑区引起血尿的实验研究

用电解损毁方法损毁Ｗｉｓｔａｒ成年雄性大鼠的双侧蓝斑区。结果出现膀胱扩张、尿液潴留和血尿等，膀胱和输尿管尿液有大量红细胞和血红蛋白，膀胱粘膜和肾脏充血。结果表明：损毁双侧蓝斑区后不仅有膀胱出血，还有肾脏出血。这个实验可用作研究“特发性”血尿的动物模型。     

损毁大鼠双侧蓝斑后泌尿系统病理学研究

Wistar大鼠双侧蓝斑损毁后，肾脏、输尿管、膀胱等明显充血，膀胱扩张，尿潴留。提示损毁双侧蓝斑后引起血尿的出血部泣不仅在膀胱．肾脏和输尿管也是造成血尿的因素。     

损毁大鼠双侧蓝斑后泌尿系统病理学研究

Ｗｉｓｔａｒ大鼠双侧蓝斑损毁后，肾脏，等明显充血，膀胱扩张，尿潴留。提示损毁双侧蓝斑后引起血尿的出血部位不仅在膀胱，肾脏和输出尿管也是造成血尿的因素。     

包皮环切术后尿道外口狭窄致尿毒症脑病昏迷1例

梗阻性肾病是尿路梗阻引起尿液引流不畅或排出障碍造成尿流梗阻引起的肾脏结构和功能的损害,膀胱以上的梗阻,仅影响一侧肾脏,而膀胱以下的梗阻,由于有膀胱的缓冲,对肾脏的影响一般发生比较晚,一旦梗阻加重引起肾积水,造成的损害是双侧肾脏,易引起肾衰竭。我院收治一例     

膀胱内多发畸胎瘤1例并文献复习

1病例报告 患者，女，15岁，以“尿频、尿急伴尿痛1个月余”为主诉入院。1个月前无明显诱因出现尿频、尿急伴尿痛，当时尿液混浊，但无明显肉眼血尿，无排尿中断，无发热寒战，自述下腹不适，触压时明显。当地医院B超提示：①双侧卵巢囊肿，考虑畸胎瘤；②膀胱内占位，未做特殊治疗。而后转入我院，行B超检查：①膀胱内占位性病变；②双侧附件区占位病变（畸胎瘤？）。膀胱镜检报告：①膀胱占位；②畸胎瘤恶变？     

老年晚期膀胱癌出血16例临床分析

目的:探讨髂内动脉化疗栓塞术治疗晚期膀胱癌并发出血的临床价值。方法:使用介入治疗技术对16例老年晚期膀胱癌并发出血患者进行双侧髂内动脉和相关供血支化疗栓塞治疗。结果:在栓塞术后1 d尿液颜色由深变浅16例,2 d后出血停止12例,3 d后出血减少4例。经止血、持续膀胱冲洗后,血尿症状明显改善或消失。结论:对于老年晚期膀胱癌并发血尿在保守治疗无效时,髂内动脉化疗介入栓塞治疗是一种安全、可靠的有效方法。     

刺激和损毁蓝斑核对缝际大核神经元自发放电及其伤害性反应的影响

在清醒麻痹大鼠观察了电刺激和损毁脑桥蓝斑核对缝隙大核神经元自发放电及其对伤害性刺激反应的影响。大多数神经元放电频率在刺激蓝斑核后减少;损毁后增加。大多数对伤害性刺激的反应可被蓝斑核刺激所压抑;损毁后则加强。损毁蓝斑核的效应在损毁后10分钟时最显著,以后随时间而减弱。本工作说明蓝斑核对缝隙大核神经元活动有紧张性抑制作用,这种抑制作用可能与蓝斑核在脑干水平拮抗镇痛有关。     

颈部异位胸腺误诊为甲状旁腺腺瘤一例报告

临床资料 男性患者，12岁。6年前因肉眼血尿就诊后被发现患有双侧肾脏多发性结石，因年龄小肾脏结石未治，其后血尿反复间断性发作。此次因肾脏功能损害(肌酐293μmol／L，尿素21．4mmol／L)入院，尿液常规检验提示红细胞形态正常；腹部超声常规检查发现双侧肾脏大小、形态正常，实质厚度12mm，皮质回声略增强，双肾各锥体均表现为致密的强回声，后方伴有声影，肾盂未见分离，肾盂内亦未见结石等，超声诊断为“双肾钙质沉积症”。     

血尿镜检在临床诊断中的应用分析

血尿是泌尿系统疾病的常见临床症状，也是泌尿系统可能有严重疾病的初始信号，血尿的出现意味着肾、输尿管、膀胱、前列腺和外尿道的病变或全身其他系统的疾病累及泌尿系统所致。因此对血尿的镜检一直为临床所重视。根据出血部位分为肾性与非肾性。肾性血尿是累及肾脏实质的病变，因而一旦筛检结果显示为肾性血尿，进一步的检查通常是尿沉渣中的管型、尿蛋白的测定，     

原发性膀胱淀粉样变1例

原发性膀胱淀粉样变１例吴洪昌，王斌，黄剑刚（附属一院泌尿外科）患者，女性，３９岁，炊事员，反复出现间歇性无痛性全程肉眼血尿一年，无尿急尿频及排尿困难，亦无发冷发烧等症状。膀胱镜检查：膀胱底、两侧壁有大片浸润肿块，表面隆起，高低不平，触及易出血，双侧输...     

三聚氰胺致大鼠泌尿系统组织损伤的实验观察

目的 为三聚氰胺泌尿系统组织损伤的研究建立动物模型. 方法 60日龄SPF级SD大鼠分为4组,3组分别给予三聚氰胺1.0、0.5、0.25 g/kg,连续灌胃6周;空白对照组每天灌胃10 g/L甲基纤维素溶液.于6周末处死动物,采用肉眼和体视显微镜观察大鼠肾脏、输尿管和膀胱形态改变,计算各脏器系数,同时检测大鼠血液生化指标,并利用小动物活体Micro CT对大鼠肾脏进行扫描,观察肾脏形态改变. 结果 给药6周末各组大鼠膀胱结石发生率为66.6%（20/30）,肾脏结石发生率为56.6%（17/30）.给药6周各组大鼠肾脏均肿大呈灰黄色,肾内均出现条索状黄色沉淀物,融合成片状或颗粒状,并在皮质和髓质之间形成黄色弧形光环,给药6周各组肾脏质量和脏器指数均显著性升高,血清CREA、BUN、磷、镁含量升高（P＜0.01）. 结论 使用0.5～1.0 g/kg三聚氰胺连续灌胃给药6周,可诱发部分SD大鼠产生不同程度的泌尿系统结石.     

氯胺酮大鼠戒断前后泌尿系统损害机制的初步研究

目的：初步探讨氯胺酮相关性泌尿系统损害的致病机制及了解戒断治疗后泌尿系统损伤的恢复情况。 方法：15只雄性健康SD大鼠,随机平均分给对照组、实验组和戒断组。对照组大鼠腹腔注射生理盐水;实验组大鼠 腹腔注射氯胺酮30 mg/kg,每日1次,连续30 d;戒断组大鼠完成与实验组相同的建模步骤后停药2周。实验周期结 束后,解剖取出各组大鼠肾、输尿管和膀胱。随机从各组选取1只大鼠的肾、输尿管和膀胱行HE染色,通过光镜观 察组织学存在的病理差异。各组余下4只大鼠膀胱组织行实时定量PCR检测H1R mRNA的表达。结果：1)与对照组相 比,实验组大鼠在给药后活动状态增强。药物戒断期的大鼠,未观察到明显行为学改变。各组大鼠体质量增长差异 无统计学意义(P>0.05)。2)与对照组相比,实验组与戒断组大鼠肾局灶可见单核炎症细胞浸润;膀胱上皮层变薄,上 皮下单核炎症细胞浸润。3)与对照组比较,实验组可提高大鼠膀胱组织中H1R基因mRNA表达水平(P<0.05)。与实验 组比较,戒断组膀胱组织中H1R基因mRNA表达水平下调(P<0.05)。结论：氯胺酮滥用大鼠可发生行为学改变。氯胺 酮所致单核炎症细胞浸润(肾和膀胱)、膀胱上皮层变薄和组胺受体高表达(膀胱)等可能是氯胺酮相关性泌尿系统损害 的重要致病机制,戒断氯胺酮能有效逆转氯胺酮相关性泌尿系统损害的致病过程。     

Analysis on Pathogenesis of 50 Cases of Bladder Proliferative Lesions

VonBrunn’snests ,cystitiscystica ,cystitisglandularis ,andsquamousepitheliummetaplasiaaredifferentkindsofpathologicalmucousepithelialpro liferationoftheurinarybladder ,whichcanalsotakeplaceinanyplaceoftheurinarytract[1] Therewerealwaysmuchcontroversyontheprevalenceandclini calimplicationsofthem Manyresearchersbelievedthattheselesionsarenormalhistologicalvariantswhichwereconcernedwithchronicinflammationandverycommoninpeopleabove 2 0 years[2 ] Mostau thors ,however ,regardedallofthem ,oratle…     

脑梗塞对大鼠膀胱功能的影响

目的探讨脑梗塞对大鼠膀胱功能的影响。方法雄性SD大鼠,用线栓法制作大脑中动脉栓塞模型。脑梗塞24小时后,测定膀胱容量、排尿潜时、膀胱内压、尿流率、尿道抵抗值。结果大鼠脑梗塞后膀胱功能发生明显变化,排尿量减少、排尿潜时缩短、尿流率降低、尿道抵抗增强。结论脑梗塞可致大鼠膀胱过度活动症。*     

“INVERTED TUMOR” OF THE URINARY BLADDE

12 cases of inverted tumor of the urinary bladder collected from 300 cases of transitional cell tumors and tumor-like lesions seen in the years 1975-1984 in Tianjin Medical College were reported. The term '6inverted tumor" of the bladder is newly coined by the authors to define the tumor. Its histological morphology is different in some respects from 'firi. verted papilloma of the bladder," though it was grouped as such in the past. The anthors suggested a new classification of the inverted tumor of the bladder based upon materials held.     

急性尿潴留大鼠膀胱组织黄嘌呤氧化还原酶活性变化及其意义

目的探讨在急性尿潴留时大鼠膀胱组织黄嘌呤氧化还原酶(xanthine oxidoreductase,XOD)活性变化的意义.方法以2倍于正常膀胱容量充盈膀胱2 h建立大鼠急性尿潴留模型.分别于充盈2 h及排空后1、2、3、4 h检测膀胱功能及膀胱组织中XOD活性及脂质过氧化产物丙二醛(malondialdebde,MDA)含量;并观察超氧化物歧化酶(superoxide dismutase,SOD)对膀胱的保护作用.结果急性尿潴留期膀胱不稳定性收缩频率无显著改变,而排空后其不稳定性收缩频率增加.XOD活性在尿潴留期增高,排空后1 h活性降低,排空后2 h再次升高,随后逐渐降至正常.MDA在尿潴留期轻度增高,排空后早期明显增高,4 h后接近正常对照组水平.SOD治疗后逼尿肌不稳定性收缩频率、XOD活性及MDA含量与排空后2 h比较显著降低(P＜0.01,0.05).结论AUR时黄嘌呤氧化还原酶活性变化特征呈双相性改变.提示AUR后膀胱再灌注损害中内源性活性氧可能起诱导、促进炎症损害作用,外源活性氧在急性尿潴留排空后膀胱功能损害中可能起重要作用.     

Incontinence,bladder neck mobility,and sphincter ruptures in primiparous women

Objective

To compare the function of the pelvic floor in primiparae before and during pregnancy with the status post partum concerning symptoms of incontinence, sphincter ruptures, bladder-neck mobility and the influence of the different modes of deliveries.

Methods

Questionnaire evaluating symptoms of urinary and anal incontinence in nulliparous women before and after delivery and correlating these symptoms with functional changes of the pelvic floor based on a careful gynaecologic examination as well as perineal and endoanal ultrasound.

Results

112 women were included in our study and came for the first visit, 99 women returned for follow-up 6 months after childbirth. Stress and flatus incontinence significantly increased from before pregnancy (3 and 12%) to after childbirth (21 and 28%) in women with spontaneous delivery or vacuum extraction. No new symptoms occurred after c-section. There was no significant difference between the bladder neck position before and after delivery. The mobility of the bladder neck was significantly higher after vaginal delivery using a vacuum extraction compared to spontaneous delivery or c-section.The bladder neck in women with post partum urinary stress incontinence was significantly more mobile than in continent controls. The endoanal ultrasound detected seven occult sphincter defects without any correlation to symptoms of anal incontinence.

Conclusion

Several statistically significant changes of the pelvic floor after delivery were demonstrated. Spontaneous vaginal delivery or vacuum extraction increases the risk for stress or anal incontinence, delivery with vacuum extraction leads to higher bladder neck mobility and stress incontinent women have more mobile bladder necks than continent women.     

Unusual bladder outflow obstruction: case report

Hydatid disease, the parasitic infestation caused by the cestode, echinococcus granulosus involves mainly the liver and the lungs though no organ is immune. Genito urinary involvement has been found mainly in the kidneys and rarely in other structures such as, bladder and epididymis. Isolated retrovesical location of the hydatid cyst is a very rare condition whose manifestations appears after a long course of the disease and are due to compression of bladder, causing the bladder out flow obstruction. Such rare case of bladder out flow obstruction is presented.     

What harm does a second delivery to the pelvic floor?

Objective

To compare the pelvic floor function of primiparous women to women after a second delivery regarding symptoms of urinary and anal incontinence, anal sphincter ruptures and bladder-neck mobility.

Methods

A questionnaire evaluating symptoms of urinary and anal incontinence was used in nulliparous women before and 27 months after childbirth. Furthermore these symptoms were correlated with functional changes of the pelvic floor based on a careful gynecologic examination as well as perineal and endoanal ultrasound.

Results

112 nulliparous women were included, 49 women returned for follow-up on average 27 months (SD 4.4 months) after the first delivery. 39 women (group A) had just one delivery, 10 women (group B - 10/49) had had a second delivery. Apart from levator ani muscle strength, no significant difference between pelvic floor function of group A vs group B was demonstrable. Furthermore, we could show no significant difference for symptoms of urinary (11 (28.2%) vs. 5 (50.0%)) and anal incontinence (14 (35.9%) vs. 4 (40.0%)) between both groups. However, we found a lasting increase of stress urinary and anal incontinence as well as overactive bladder symptoms after one or more deliveries. The position of the bladder neck at rest was lower in both groups compared to the position before the first delivery and bladder neck mobility increased after one or more deliveries.

Discussion

Our study shows several statistically significant changes of the pelvic floor function even on average 27 months after delivery, but a subsequent delivery did not compromise the pelvic floor any further.     

性激素对雌性大鼠膀胱和子宫结构的影响

目的 性激素对女性泌尿生殖系统有重要作用,本研究就性激素对雌性大鼠子宫和膀胱结构的影响进行比较.方法 50只成年雌性大鼠分成5组:假手术组(SHAM)、单纯卵巢切除组(OVX)、卵巢切除 雌激素组(OVX E)、卵巢切除 孕激素组(OVX P)、卵巢切除 雄激素组(OVX T),除假手术组外其余均予以去势手术,且后三组分别给予苯甲酸雌二醇1 mg/kg,黄体酮1 mg/kg,丙酸睾酮3 mg/kg,隔日肌注,四周后处死,光镜下观察子宫和膀胱形态学变化.结果 卵巢切除后子宫肌层、内膜萎缩明显,膀胱壁与子宫肌层的变化类似.补充雌激素和雄激素均可使膀胱重量和膀胱壁厚度明显增加,孕激素对膀胱的作用不明显.结论 雌激素和雄激素均能促进子宫肌层和膀胱逼尿肌增生.