腺性膀胱炎的诊断和治疗(附150例报告)

目的探讨腺性膀胱炎临床特征和诊治效果。方法报告腺性膀胱炎１５０例的诊治经验。结果主要症状为膀胱刺激症状、血尿和排尿困难。病变最常见部位为膀胱颈口和三角区,确诊依赖于膀胱镜下活检。３１例腺性膀胱炎与膀胱肿瘤有关。治疗采用经尿道电切,膀胱部分切除和膀胱全切。结合文献讨论了腺性膀胱炎的诊断和治疗。结论腺性膀胱炎有潜在的恶变倾向,需长期随访复查。     

女性腺性膀胱炎临床表现分析(附72例报告)

目的:分析女性腺性膀胱炎患者各种不同的临床表现,提高诊断水平.方法:回顾性分析2003～2004年145例存在尿道综合征、镜下血尿、反复尿路感染的女性患者及8例并发泌尿科其他疾患或妇科病的患者实施膀胱镜检查及活检.结果:占检查人数49%共72例女性患者经病理证实为腺性膀胱炎,其中10例同时伴有腺性后尿道炎.22例患者伴有尿道外口畸形或其他病变.其他原发病8例:膀胱子宫黏膜异位症1例,膀胱颈梗阻3例,膀胱嗜铬细胞瘤1例,肾炎性肉芽肿1例,妇科手术前输尿管插管定位2例.58例在本院手术(经尿道电切56例,开放手术2例).结论:腺性膀胱炎是女性常见病,可有多种临床表现,医师应该引起足够的重视.     

Population based cohort to examine association between geospatial antibiotic factors and urinary tract infection outcomes

IntroductionUrinary tract infections (UTIs) pose a significant health care burden. Outpatient antibiotic geospatial factors (eg, geographic prescribing and geographic resistance) may be associated with inpatient outcomes. This study examined the relationship between these factors, severe UTI, and hospitalization for severe UTI.MethodsThe first cohort included hospitalized, female, Medicare beneficiaries, aged >50 years. The primary outcome was severe UTI (defined as CSS diagnosis code of 159 with an APR-DRG severity of illness code of 3 or 4). The association between geospatial first-line prescribing (FLP) and severe UTI was assessed. The second cohort examined the association between these geospatial FLP and risk of hospitalization with severe UTI. Multivariable regression was used to produce adjusted odds ratios and adjusted risk ratios.ResultsIn the first cohort (n = 14,474), low FLP was not associated with severe UTI (P = .87) in univariable analysis. In multivariable analysis, low FLP was associated with severe UTI was (aOR: 1.08 [95% CI 1.00, 1.16]). In the second cohort (n = 2,972,174), the admission rate was 47.0 and 49.8 per 10,000 (low FLP vs high FLP, respectively [P < .001]). The aRR for admission was 1.26 (95% CI 1.14, 1.39) in areas with low FLP.ConclusionsThis study suggests that geospatial antibiotic factors may influence inpatient outcomes in women aged >50 with UTI. Further research is needed to corroborate our findings.     

Exploration of the protein-dependent mechanism of Lactobacillus crispatus GAI98322 to prevent recurrent cystitis

ObjectivesTo elucidate the mechanism of Lactobacillus crispatus (L. crispatus) suppositories to prevent patients from recurrent cystitis (RC), independent from viable-Lactobacilli-bacteria- and acid-dependent ones such as hydrogen peroxide and lactate.MethodsWe used the GAI98322 strain of L. crispatus in all experiments and pH-matched.cell-free culture supernatant of L. crispatus (CFCS) was collected. The growth inhibitory activity and the biofilm formation inhibitory activity of the CFCS against uropathogenic Escherichia coli (UPEC), Extended Spectrum beta (β) Lactamase producing (ESBL+) UPEC, and Pseudomonas aeruginosa (P. aeruginosa) was assessed by agar-disk diffusion tests and crystal violet assay. Also, CFCS was subjected to mass spectrometry to specify ingredients.ResultsThe CFCS suppressed the proliferation of E. coli, ESBL + E. coli, and P. aeruginosa. Also, the CFCS at a concentration of 40% significantly impeded the biofilm formation of these three bacteria. The aggregation-promoting factor and Lysin was detected from CFCS.ConclusionsThe cell-free supernatant from the GAI98322 strain of L. crispatus inhibits the growth/biofilm formation of broad pathogens by aggregation promoting factor and lysin, which may prevent hosts from RC regardless of the antimicrobial resistance of the pathogens and even under pH modulation.