胰蛋白酶加乙二胺四乙酸钠溶解草酸钙结石实验研究

目的：探讨胰蛋白酶加乙二胺四乙酸钠（ethylenediamine traacetic acid,EDTA)合用溶解草酸钙结石的效果。方法：用自制玻璃肾盂灌注模型，以胰蛋白酶作为基质溶解剂与EDTA合用灌注溶解草酸钙结石，用原子吸收光谱法测定溶石剂中钙离子浓度，扫描电镜观察结石表面结构的变化，并灌注家兔膀胱，观察毒性反应。结果：胰蛋白酶明显增强EDTA溶解草酸钙结石的效果， 减轻EDTA引起家多兔胱粘膜的炎性反应。结论：胰蛋白可以胜任基质溶解剂，加速EDTA对草酸钙结石的溶解，并减轻EDTA引起的炎性反应。     

经尿道前列腺电切术治疗前列腺增生症所致尿路梗阻的临床研究

目的 探讨经尿道前列腺电切术治疗前列腺增生症所致尿路梗阻的临床疗效.方法 选取我院2013年6月—2015年6月收治的72例前列腺增生症所致尿路梗阻患者,依据手术方法 的不同分为2组,各36例.对照组予以常规手术治疗,研究组应用经尿道前列腺电切术治疗.观察并比较2组患者的残余尿流量(PUV)、最大尿流量(Qmax)、前列腺临床症状评分(IPSS)及夜尿次数.结果 手术后,2组患者PUV、Qmax、IPSS水平及夜尿次数均明显改善,但研究组PUV、Qmax、IPSS水平及夜尿次数均优于对照组,差异有统计学意义(P<0.05).结论 对前列腺增生症所致尿路梗阻患者予以经尿道前列腺电切术治疗,可取得良好效果,值得在临床中推广应用.     

Expression of miRNA-630 in bladder urothelial carcinoma and its clinical significance

Many studies informed that microRNAs (miRNAs) could function as diagnostic and prognostic indicators in several cancers. The aims of this study were to explore the expression of miR-630 in bladder urothelial carcinoma and its clinical significance for the evaluation of cancer prognosis. A total of 116 patients with bladder urothelial carcinoma were obtained in this retrospective study between May, 2012 and Sep. 2015. Quantitative real-time PCR (qRT-PCR) was conducted to evaluate the expression level of miR-630. The chi-square test was used to examine the associations between miR-630 expression and the clinicopathological features. The Kaplan-Meier method was conducted to explore the survival status of urothelial carcinoma patients. The log-rank test was used to analyze differences in survival rate. The results showed an obvious increase in miR-630 expression from normal bladder to bladder urothelial carcinoma (P=0.027). Additionally, patients with higher miR-630 expression had significantly shorter disease-free survival (DFS) (P=0.043) and overall survival (OS) (P=0.038) than those with lower miR-630 expression. Furthermore, multivariate analysis revealed that up-regulation of miR-630 was an independent prognostic factor for both DFS (P=0.042) and OS (P=0.046). It was demonstrated that miR-630 may be a novel and valuable prognostic factor for bladder urothelial carcinoma.     

磁共振波谱成像联合直肠指检及血清PSA在前列腺癌诊断中的价值

目的初步探讨磁共振波谱成像(MRS)联合直肠指检(DRE)与血清前列腺特异抗原(PSA)在前列腺癌诊断中的应用。方法选取血清PSA异常84例男性患者行前列腺MRS和DRE并与病理结果对照。再分析MRS联合DRE及不同水平PSA(低危组4 ng/ml20 ng/ml)诊断前列腺癌的灵敏度(Se)、特异度(Sp)和准确度(AR)。结果病理证实前列腺癌41例、非前列腺癌43例(良性增生41例,炎症1例,结核1例)。单纯MRS诊断前列腺癌的Se、Sp和AR分别为85.4%、83.7%和84.5%,与病理诊断有统计学一致性(K=0.69,P<0.05);MRS联合PSA低危组、中危组和高危组诊断的Se、Sp和AR分别为75.0%、90.0%和84.4%,66.7%、73.3%和71.4%,95.7%、87.5%和93.5%;MRS联合DRE诊断Se、Sp和AR分别为88.9%、87.5%和88.6%;MRS同时联合PSA高危组及DRE诊断Se、Sp和AR分别增加至95.7%、100%和95.8%,差异均有统计学意义(P<0.05)。结论 MRS诊断前列腺癌具有无创和简便优点,其联合直肠指检及PSA有助于提高诊断的准确性。     

止血敏在Madigan前列腺切除术中的应用

<正> 我们自1994年10月～1996年12月对12例良性前列腺增生症患者采用Madigan术,并在术中运用止血敏。疗效满意,报道如下。 1 资料与方法 1.1 一般资料 本组12例,年龄50～85岁,平均69岁。有排尿困难史0.5～13年,其中尿潴留3例,其余9例剩余尿量>50ml,最大为250ml。全部患者术前均经直肠指诊、B超、尿流率、膀胱镜检查诊断为前列腺增生,术后病理确诊。术前心电图异常者8例;脑梗死语言迟钝者1例;伴有双输尿管扩张、双肾积     

细胞色素氧化酶P4504B1基因突变与膀胱癌遗传易感性的关系

目的:探讨细胞色素氧化酶P450(CYP)4B1基因突变与膀胱癌遗传易感性的关系。方法:应用PCR-单链构象多态性(PCR-SSCP)分析和直接测序分析,分别检测152例膀胱癌患者和150例非肿瘤同期住院患者CYP4B1的各个常见突变基因位点,分析基因突变对膀胱癌发病的影响。结果:膀胱癌组CYP4B1 C517T、AT881-882del+G993A+C1018T和C1123T突变基因型频率高于对照组(χ2=8.266、16.218和15.347,P<0.05);不同病理分级及临床分期膀胱癌患者间CYP4B1各突变基因型频率差异无统计学意义(P>0.05)。结论:携带CYP4B1C517T、AT881-882del+G993A+C1018T和C1123T突变基因型者更易患膀胱肿瘤。     

坦索罗辛治疗输尿管远端结石的疗效观察

目的:评价坦索罗辛对输尿管远段结石的辅助排石作用。方法:将104例确诊为单纯输尿管远端结石患者随机分为两组:对照组及坦索罗辛治疗组(治疗组)。两组患者的年龄、性别、结石直径等差异均无统计学意义。随访2周,观察结石排出率、结石排出时间、肾绞痛发生率、镇痛剂使用情况和药物不良反应。结果:治疗组结石完全排出率为84.62%,显著高于对照组38.46%(P<0.05),平均排石时间治疗组为4.9d,对照组为9.2d,两组比较差异有统计学意义(P<0.05)。因肾绞痛发作而需使用镇痛剂的使用率治疗组为3.84%,对照组为19.2%。2周内两组患者未观察到明显的药物不良反应,无因不能耐受而退出者。结论:坦索罗辛可明显促进输尿管远端结石排出,缓解肾绞痛发作,可作为一种有效的输尿管远端结石的辅助治疗药物。     

合并神经原性膀胱活动低下非瘫痪脊髓功能障碍患者生命质量评估和尿动力学研究

Objective To investigate the change of quality of life and urodynamics after the enterocystoplasty combined with clean intermittent self-catheterisation (CISC) in nonparalytic spinal cord dysfunction (NSCD) patients with neurogenic underactive bladder by the Medical Outcomes study 36-item short-form general health survey (SF-36). Methods The quality of life of 72 NSCD patients with NUB were measured by SF-36 questionnaire, who had been taken enterocystoplasty combined with CISC or only CISC according to urodynamic results. In total, 58(81% ) patients were successfully followed for one year by SF-36 questionnaire and urodynamic examination, including 30 men (mean age 27±5 year) and 28 women (mean age 26±4 year). The normal volunteers without lower urinary tract symptom were set as control group, including 20 men (mean age 28 ± 4 year) and 20 women (mean age 29±4 year). Results At the follow-up, physical role, vitality and social function of men and women were 55±14 and 45±15, 76±19 and 74±15, 52±19 and 59±13 respectively, significantly higher than those before the treatment (35 ± 10 and 32 ±11, 27 ± 18 and 33 ± 17, 40 ±12 and 34 ±15). The bladder compliance and maximum cystometric capacity were (320 ± 44 ) ml and ( 338 ±50)ml,(55±15)cm H2O and (60±17)cm H2O respectively, also significantly higher than those before the treatment (131±30ml and 140±35ml,5±3 cm H2O and 6±4 cm H2O). However, detrusor leakage point pressures were (6±2)cm H2O and (6±3)cm H2O respectively, significantly lower than those before the treatment (28 ±9 cm H2 O and 25 ± 6 cm H2O). Except for physical function and bodily pain, the all domains of quality of life in both men and women patients were significantly lower than those in control group. Only 17 % of men and 7 % of women believed "their health is better than that one year ago". There was no significant difference in the remission rate between men and women (89% vs 76%) in the patients with RUUTD before treatment. Conclusions It is suggested that urodynamic parameters are significantly improved. Many domains of quality of life were not improved and the reduced quality of life still occurred in NSCD patients with NUB using enterocystoplasty and CISC.     

膀胱癌与UGT1A7 T622C基因多态性的相关性

目的探讨尿苷二磷酸葡萄糖醛酸转移酶1A7（UGT1A7）T622C基因多态性与膀胱癌易感性的关系。方法以病例对照研究方法,应用聚合酶链反应-限制性片段长度多态性方法（PCR—RELP）分别检测145例膀胱癌患者和160例非肿瘤人群UGT1A7 T622C基因多态性,对各基因型单独或联合吸烟行为进行统计学分析。结果膀胱癌组UGT1A7T622C突变型（T／C＋C／C）频率[53．1％（77／145）]高于对照组[40％（64／160）],两组间差异有统计学意义[P〈0．05;比值比（OR）=1．70（95％可信区间：1．08～2．68）]。吸烟人群中UGT1A7 T622C突变型（T／C＋C／C）的个体膀胱癌的发病风险高于野生型个体（T／T）,差异有统计学意义[P〈0．05,OR=2．16（95％可信区间：1．07～4．38）]。uGT1A7 T622C基因多态性与膀胱癌病理分级和临床分期均无相关性（P〉n05）。结论UGT1A7 622C基因多态性与膀胱癌易感性有关,该基因多态性与吸烟行为在膀胱癌的发生过程中存在交互作用。