女性压力性尿失禁风险预测的研究进展

综述女性压力性尿失禁(stress urinary incontinence,SUI)风险预测的研究进展。指出女性SUI风险预测相关文献普遍存在风险预测工具和指标缺乏临床大样本验证,指标、纳入人群不统一的现象,风险预测模型存在构建过程未按报告规范进行,未进行完整的模型验证以及模型性能评价指标不规范的情况。未来研究可以在现有风险预测工具或模型的基础上进行改进、完善,以期为女性SUI风险预测提供参考。     

尿液10项肾损伤标志物检测试剂的性能评价

摘要:目的对尿液 10项肾损伤标志物检测试剂进行性能评价,并评估其临床适用性。方法对北京利德曼公司尿液a1 微球蛋白(u-a|MG)、总蛋白(u-TP)、免疫球蛋白G(u-IgG) 、微量清蛋白(u-Alb)、中性粒细胞明胶酶相关脂质运载蛋白(u-NGAL)、半胱氨酸蛋白酶抑制剂C(u-CysC).视黄醇结合蛋白(u-RBP)、β2微球蛋白(u-β2MG)、N-乙酰-β-D-氨基葡萄糖苷酶(u-NAG).、转铁蛋白(u-Trf)检测试剂盒进行性能评价。正确度和精密度验证参考美国临床和实验室标准协会(CLSI)EP15-A3,验证物质采用ERM-DA470k、ERM-DA471、B2M-NIBSC等参考物质及纯度物质;线性验证参考CLSI EP06;抗干扰能力参考CISI EP07;不同检测系统间比对参考CISI EP09。结果正确度方面,10 项标志物检测试剂测定标准物质在低值、中值、高值的偏倚分别为-2.69% ~4.67%、-3.60% ~3.33% .-2.38% ~3.02%;不精密度方面,重复性以不精密度表示,在低值和高值处分别为1.90%~5.43%、0.63% ~2.42%,室内不精密度为2.27%~5.63%、1.09%~3.41%,均满足临床要求;10项尿液标志物线性范围在0.06~4.40 mg/L至21.83~2 146.77 mg/L之间。抗干扰方面,u-1 MG、u-Alb、u-β2MG、u-Trf 、u-CysC、u-NAG分别在血红蛋白终浓度≤8 g/L、≤8 g/L、≤4 g/L、≤4 g/L、≤2g/L、≤1 g/L时,未受到明显干扰(百分偏差≤+ 10%) ,而u-TP、u-IgG、 u-RBP、u-NGAL在血红蛋白终浓度≥0.125 g/L时即受干扰。不同检测系统间偏差超出临床允许范围。结论尿液 10项肾损伤标志物的正确度、精密度、线性范围和抗血红蛋白干扰能力满足临床需要,不同检测系统间标志物测量结果可比性欠佳。     

Claudin蛋白家族在泌尿系肿瘤中的研究进展北大核心

Claudin蛋白家族是构成细胞紧密连接(tight junctions,TJs)的重要骨架蛋白,在细胞极性、上皮屏障特性、细胞运动性和细胞间的稳定性等方面发挥着关键作用。最近研究发现,Claudin蛋白家族在人类多种肿瘤中都有表达失调,起着癌基因或者抑癌基因的作用。本文综述了近年来Claudin蛋白家族在泌尿系统肿瘤(膀胱癌、前列腺癌、肾癌)中的研究进展。     

Síntomas de tramo urinario inferior y síndrome de apnea obstructiva del sueño: evolución urodinámica antes y después de un año de tratamiento con presión continua positiva de la vía aérea

ObjectiveTo report the clinical evolution and the urodynamic behaviour of several lower tract urinary symptoms in patients with obstructive sleep apnea syndrome before and after the treatment with continuous positive airway pressure (CPAP) devices.MethodsA prospective study was performed; patients with recent diagnosis of sleep apnea confirmed by nocturnal sleep polygraphy and absence of medical urological past history. In order to discard important lower urinary tract conditions, urological examinations were previously performed. Urinary symptoms were evaluated using the IPSS and OAB-V8 validated questionnaires, three-day Bladder Diary and invasive urodynamic examinations with a gap of one year before and one year after using the CPAP.Results84 urodynamic studies were carried out in 43 patients. The IPSS score decreased by 3.58 points. The OAB-V8 score decreased by 2.87 points. Nocturia episodes decreased to one per night. The percentage of patients with nocturnal polyuria went down to 26%. The bladder compliance significantly increased (97.39 vs 200.40 ml/cm H2O). The presence of detrusor overactivity decreased from 11 (before CPAP) to 5 patients (after CPAP).ConclusionThe proper treatment with CPAP showed a statistical and clinical improvement of several LUTS with limited urodynamic modifications.     

中医尿路排石汤联合体外冲击波碎石治疗上尿路结石的临床观察

目的：探讨中医尿路排石汤联合体外冲击波碎石中西医结合治疗上尿路结石的疗效。方法：回顾分析我院 2012年 6 月—2017 年 6 月治疗的上尿路结石患者 889 例，按治疗方式分为单纯体外冲击波治疗（对照组）与中西医结合治疗（治疗组）。对照组给予常规西医体外冲击波碎石治疗，治疗组采用尿路排石汤联合体外冲击波碎石中西医结合治疗。观察两组治疗效果、住院天数、平均需要碎石次数、腹痛减轻时间、肉眼血尿消失时间。结果：对照组总有效率为 80%，治疗组总有效率为 90%（P<0.05），对照组平均碎石治疗次数为（2.1±1.1）次，治疗组平均碎石治疗次数为（1.4±1.2）次（P<0.05），对照组平均腹痛时间为（3.76±2.24）天，治疗组平均腹痛时间为（3.01±1.54）天（P<0.05）。结论：中西医结合治疗效果优于单独使用体外冲击波碎石术治疗。     

七叶皂苷片促进合并组织学炎症的前列腺增生患者术后下尿路症状的改善

目的探讨将七叶皂苷片应用于合并前列腺组织学炎症的前列腺增生（BPH）患者，观察其对经尿道前列腺电切术（TURP）后早期下尿路症状（LUTS）的改善作用。 方法2015年11月至2018年5月，我院116例合并前列腺组织学炎症的BPH患者，随机分为治疗组（n=58）和对照组（n=58），均行TURP。治疗组在对照组基础上，从手术后第3天起开始口服七叶皂苷片2片/次，2次/d，直至拔导尿管后4周。记录两组患者术前、拔管后第7天和拔管后第28天的国际前列腺症状评分（IPSS）和生活质量（QOL）评分，并记录两组急性尿潴留（AUR）和急迫性尿失禁（UUI）发生的例数。 结果两组患者术后IPSS和QOL评分均较术前有明显下降，但治疗组较对照组的IPSS和QOL评分下降幅度更大，差异有统计学意义（P<0.05），治疗组发生UUI的例数明显少于对照组，差异有统计学意义（P<0.05），而两组发生AUR的例数差异无统计学意义。 结论七叶皂苷片可以促进合并前列腺组织学炎症的BPH患者TURP术后早期LUTS的改善。     

Interaction phenomena between a cuff of an artificial urinary sphincter and a urethral phantom

Male urinary incontinence is highly prevalent, leading to a miserable quality of life. The artificial urinary sphincter (AUS) is the device that closely simulates the function of the biological urinary sphincter. The precise evaluation of occlusion mechanisms and of interaction phenomena occurring between AUS cuff and urethral duct is fundamental for more reliable design. The action induced in the interaction with urethral duct under a specific pressure depends on its constitutive material and structural characteristics. The methods of experimental and computational bioengineering are exploited to investigate mechanical functionality of the coupled system, as AUS and urethral duct. Experimental tests are developed to investigate the response when the AUS is inflated around a urethral phantom. Numerical model of the cuff is developed mimicking the experimental tests for the validation. Subsequently, numerical models are exploited to interpret the interaction of the cuff with urethral phantoms considering the influence of urethral size and of tissues mechanical behavior, mimicking healthy and degraded configurations. The investigation provides useful information on the behavior of AUS cuff with urethral duct evaluating the action induced and represents a support for planning an extension of experimental tests on animal and human urethral samples.