解脲支原体与不孕不育症的关系探讨

目的：对不孕不育与解脲支原体的关系进行分析。方法选取我院2010年9月~2013年8月收治的90例不孕患者作为观察组,进行解脲支原体检查,同时选择50例生育能力正常的正常人士采用同样的方法进行检测,研究分析孕不育与解脲支原体之间的关系。结果观察组分离出解脲支原体89株,其中解脲型48例（53.33%）,人型29例（32.22%）,解脲型与人型混合感染12例（13.33%）;对照组分离出11例,其中解脲型6例（12.00%）,人型3例（6.00%）,解脲型与人型混合感染2例（4.00%）。观察组的患者UU阳性概率为54.44%,CT阳性概率为8.89%,对照组的UU阳性率为4.00%,CT阳性概率为2.00%。两组结果比较,差异具有统计学意义（P＜0.05）。结论不孕不育与解脲支原体具有密切的关系。     

武汉地区非淋菌性尿道炎患者泌尿生殖道支原体感染及药敏分析

目的：调查武汉地区非淋菌性尿道炎（NGU）患者泌尿生殖道支原体感染及耐药情况,为临床选择治疗支原体感染的抗生素提供参考依据。方法：采用支原体分离、鉴定、计数、药敏试剂盒检测拟诊为NGU患者的解脲脲原体（UU）和人型支原体（MH）,并分析药敏试验结果。结果：630例患者中支原体总阳性率38．6％,以UU（30％）感染为主,男性感染率明显高于女性。药敏试验结果显示,UU、MH和UU＋MH对药物的敏感性最高者依次为阿奇霉素和美满霉素,uu对氧氟沙星、司帕沙星和罗红霉素耐药性高,MH及uu＋MH则对罗红霉素、红霉素和克拉霉素耐药性高。结论：uu成为本地区NGU的主要病原体,治疗本地区泌尿生殖道支原体感染可首选阿奇霉素和美满霉素。     

沙眼衣原体、解脲支原体感染与不孕的关系探讨

目的与方法：通过对宫颈粘液标本沙眼衣原体（CT）、解脲支原体（UU）及血清抗精子抗体（AsAb）的检测，探讨生殖道感染与不孕的关系。结果：CT、UU、AsAb在不孕组的检出率分别为29．41％、35．29％和38．23％；性病组分别为50．51％、67．01％和11．34％；对照组分别为5．75％、9．20％和1．15％。不孕组与对照组比较差异均高度显著（P＜0．001）。不孕组中CT或UU同时伴AsAb阳性者达69．23％。结论：作者认为CT和UU的生殖道感染是引起不孕的重要因素之一，建议作为不孕检测中的常规项目。     

解脲支原体、沙眼衣原体与精液白细胞及精子形态的关系

目的 探讨解脲支原体、沙眼衣原体、精液白细胞与精子形态的关系.方法 对1023例男性不育患者精液样本进行检测,解脲支原体采用培养法,沙眼衣原体采用生化酶法进行检测,白细胞采用联苯胺染色方法进行检测,精子形态检测采用计算机辅助系统下人工修正的方法进行分析.结果 UU阳性率为27.57%,CT阳性率为30.11%.UU阳性组、CT阳性组及UU CT阳性组正常形态精子百分率均显著低于对照组(P＜0.01),亦均显著低于阴性组(P＜0.05,P＜0.01).UU阳性组、CT阳性组及UU CT阳性组白细胞异常率均显著高于对照组(P＜0.001),亦均显著高于阴性组(P＜0.001).白细胞异常组正常形态精子百分率显著低于对照组和白细胞正常组(P＜0.001).结论 UU、CT感染、白细胞、精子形态关系密切,UU、CT感染可能直接影响精子形态,亦可能通过激发白细胞异常,通过白细胞机制影响精子形态.     

80例男性不育症病因学新探

采用多聚酶链反应（RCR）技术．对80例男性不育症者进行生殖道解脲支原体（Uu）及沙眼衣原体（CT）检测，结果Uu－DNA阳性25例，CT－DNA阳性13例，3例Uu－DNA、CT－DNA均为阳性，经此病因学调查发现NGU（非淋菌尿道炎）与男性不育有密切关系。在治疗过程中首先治愈UU和CT感染后，再给予中医分型辨证施治,疗效明显提高。     

104例输卵管性不孕与性传播疾病病原体相关分析

输卵管原因是不育症中最常见的因素。任何原因引起输卵管炎症均可导致不孕。随着性传播疾病（STD）发病率的增高,性传播疾病病原体与急性盆腔炎的相关性也日益突出。常见的病原体为解脲支原体（UU）、沙眼衣原体（CT）、淋病奈瑟菌（NG）等。为此对本院104例输卵管性不孕患者的宫颈分泌物进行了UU、CT、NG检测。     

解脲支原体感染性精液不液化症的治疗

解脲支原体（ureaplasma urealyticum，UU）是人类泌尿生殖道常见寄生菌，近年来研究证实，解脲支原体感染与精液不液化密切相关_】12]。精液不液化患者中UU阳性检出率在48％左右，临床治疗效果欠佳。2003年9月-2005年6月我院系统观察280例，总结报道如下。     

聚合酶链技术在慢性前列腺炎诊治中的应用

目的：探索慢性前列腺炎的病因，提高其诊治水平。方法：应用聚合酶链技术(PCR)对门诊疑诊为慢性前列腺炎患者的前列腺液进行淋球菌(NG)、沙眼衣原体(CT)及解脲支原体(UU)检测。结果：检出单纯淋球菌感染33例，阳性率9．09％；沙眼衣原体感染32例，阳性率5．15％；解脲支原体感染250例，阳性率23．00％，沙眼衣原体与解脲支原体合并感染13例；淋球菌合并解脲支原体感染5例；淋球菌合并沙眼衣原体感染4例；并应用PCR监测治疗效果。结论：PCR检测慢性前列腺炎病原体快速、敏感性高、特异性强，是一种较为理想、值得推广的临床应用技术。     

p73基因在膀胱尿路上皮癌中的表达及临床意义

目的研究p73基因在膀胱尿路上皮癌组织中的表达及其与临床病理特征的关系。方法应用免疫组织化学SP法检测60例膀胱尿路上皮癌中p73基因的表达,统计分析其与肿瘤临床病理特征的关系。结果膀胱癌组织中p73阳性表达率为38.3%（23/60）,明显低于癌旁组织（78.3%,47/60,P〈0.01）及正常膀胱组织（86.7%,13/15,P〈0.01）。p73蛋白的表达与膀胱尿路上皮癌组织分化程度有关（P〈0.05）,且与临床分期、浸润及转移也密切相关（P〈0.05）。结论p73基因在膀胱尿路上皮癌的发生和发展中起抑制作用,p73蛋白的表达可能是预判膀胱癌预后的重要指标之一。     

MMP-2和MMP-9在膀胱移行细胞癌组织中的表达及临床意义

目的：探讨膀胱肿瘤组织巾MMP-2及MMP-9表达与膀胱移行细胞癌（TCCB）临床病理分期分级的关系。方法：选择同济医院2004年1～12月间手术治疗的TCCB患者38例作为实验组,以16例附带癌旁正常黏膜或膀胱镜下活检正常膀胱黏膜作为对照组。运用免疫组织化学SP法检测MMP-2及MMP-9在膀胱组织中的表达。结果：MMP-2和MMP-9在实验组的表达显著高于对照组（P〈0．01）,且与肿瘤临床分期呈显著正相关（r=0．51361,P〈0．01）,与肿瘤病理分级也呈正相关（r=0．59818,P〈0.05）。结论：TCCB患者膀胱组织中高表达的MMP-2及MMP-9与肿瘤细胞侵袭和转移密切相关,联合检测MMP-2及MMP-9,对TCCB的早期诊断及判断预后有参考价值。     

荧光探针定量聚合酶链反应检测684例女童泌尿生殖道淋球菌、沙眼衣原体、解脲支原体感染情况

目的了解女童泌尿生殖道淋病双球菌、沙眼衣原体、解脲支原体感染情况。方法对684例有泌尿生殖道感染症状的女童取阴道分泌物,采用荧光探针定量聚合酶链反应（PCR-荧光探针法）进行淋病双球菌、沙眼衣原体、解脲支原体检测。结果684例患儿19例淋病双球菌阳性,12例沙眼衣原体阳性,31例解脲支原体阳性。结论对于有反复泌尿生殖道感染的女童,临床上应考虑相关病原体感染的可能,建议进行此3种病原体的检查,以指导临床治疗。     

Ureaplasma Urealyticum and Male Infertility: An Animal Model/Ureaplasma urealyticum und männliche Infertilität — ein Tiermodell

Male Wistar rats were infected with Ureaplasma urealyticum, serotype 3 or 7, by injecting broth containing organisms into the urinary bladder following laparatomy. Animals were sacrificed 3, 7 and 21 days after infection. Ureaplasmas were detected in the organs of the genital tract by culture in 43% (serotype 3) and in 60% (serotype 7) of the animals. Type-specific ureaplasma antigen was detected in the genital organs in 44% (serotype 3) and 45% (serotype 7) of the animals. Control animals injected with sterile bouillon were negative for organisms and antigen. Male Wistar rats artificially infected with Ureaplasma urealyticum, serotype 3, were mated 3 and 6 months after infection with ureaplasma free female rats. The mating experiment revealed a smaller mean litter size and a lower birth weight in the offspring of infected males compared with the control animals, but no general influence on the fertility of infected animals.     

溶脲脲原体感染动物模型的建立──在泌尿生殖系中的分布

将１００只雄性ＳＤ大鼠分为３组。Ａ组４５只；Ｂ组２２只；Ｃ组３３只。Ａ组每只动物经膀胱注入血清８型溶脲脲原体（ｕｒｅａｐｌａｓｍａｕｒｅａｌｙｔｉｃｕｍ，ＵＵ）菌株（１９６０），浓度为１０５ＣＣＵ／ｍｌ。Ｂ组处理方法同Ａ组，在接种３个月后给予美满霉素（２０～１００ｍｇ／ｋｇ体重），连续１４天。Ｃ组为对照组，每只动物膀胱注入等量溶脲脲原体液体培养基。结果表明，在Ａ组动物的膀胱（８７．５％）、睾丸（６２．５％）、附睾（５５．０％）、精囊（６５．０％）和前列腺（５７．５％）中均检出溶脲脲原体。Ｂ组溶脲脲原体检出率显著低于Ａ组。Ｃ组上述器官溶脲脲原体培养均为阴性。     

Uncommon causes of irritative lower urinary tract symptoms

Bladder symptoms accompanying a spectrum of disorders, ranging from urethral syndrome to interstitial cystitis, may be caused by potentially reversible factors. Some non-steroidal anti-inflammatory agents, particularly tiaprofenic acid, can cause frequency, urgency and suprapubic pain which is reversed upon discontinuing the medication. Anabolic steroids and GnRH agonists can on occasion cause bladder i irritability. Approximately half of women with bladder endometriosis have frequency and dysuria, usually without hematuria. Mycoplasma, ureaplasma and chlamydia are all associated with urethral syndrome. Cystitis may be caused by herpes simplex virus, herpes zoster, human T-lymphotrophic virus type 1, cytomegalovirus, toxoplasma and candida. Some work-related toxins may cause bladder effects without neoplasm. Foods high in tyrosine, tyramine and aspartate may exacerbate painful bladder syndrome. A search for potential non-bacterial sources of irritative lower urinary tract symptoms is warranted in evaluating women with such symptoms.EDITORIAL COMMENT: Irritative urinary tract symptoms — frequency, urgency, postvoid fullness and dysuria — are common complaints voiced by female patients of all ages. The evaluation of irritative lower urinary tract symptoms should include an extensive history, including onset, chronicity, severity, associated symptoms and inciting activities. A voiding and fluid intake diary should be obtained to assess daily patterns. Clinical tests to consider include urine culture and sensitivity, urethral and vaginal cultures, postvoid residual determination, cystourethroscopy, bladder washing or bladder biopsy. In most cases this evaluation will uncover the cause of the symptoms and guide appropriate treatment. However, in some instances the etiology of the symptoms remains unknown. Dr Nygaard presents a thorough review of uncommon causes of irritative lower urinary tract symptoms that we should all keep in mind.     

Relationship of leukoplakia to urothelial malignancy

The records of 108 patients presenting with leukoplakia of the urinary tract during the last 35 years were reviewed to define the natural history of this disease, with emphasis upon its association with urothelial cancer. Of the 108 patients 24 had upper urinary tract, 78 bladder and 10 urethral leukoplakia (1 with renal and bladder involvement, 3 with bladder and urethral involvement, and 1 with ureteral and renal involvement). Presenting complaints were primarily irritative. To date, 41 patients (37 per cent) have had associated carcinoma of the urothelium: 23 (21 per cent) presented with a concomitant or previous carcinoma and 18 of 85 (21 per cent) presenting without a concomitant or previous neoplasm have had documented progression to cancer. These figures support the concept that leukoplakia is a premalignant disease and that patients with this diagnosis deserve careful and frequent followup.     

拟诊性传播疾病人群中淋球菌、沙眼衣原体和解脲支原体带菌情况调查

本室自1996年3月对临床拟诊性传播疾病（STD）人群开展PCR淋球菌（NG）、沙眼衣原体（CT）和解脲支原体（UU）三联检测，将结果作回顾性统计分析。在664名拟诊STD病人中，NG、CT和UU感染率分别为32．2％、29．1％和9．8％，其中NG与CT阳性车无明显差异（X2=1．56，P＞0．05）。NG、CT、UU三者可见任意合并感染，统计表明NG与CT合并感染比例较高，NG＋CT占22．2％，UU＋CT、UU＋NG仅占1．6％和2．7％．以上结果提示，应对STD人群中非淋球菌感染，尤其是非淋菌性尿道炎（NGU）于以重视，对NG病人也应考虑同时感染其它病原体的可能性，进而总结出对拟诊STD病人的实验室诊断模式，供临床参考．     

前列腺电切术后尿道狭窄原因分析及治疗

经尿道前列腺电切术是治疗良性前列腺增生的首选手术方法,但前列腺电切术后尿道狭窄发生率较高,给老年患者带来了巨大痛苦。本文将就经尿道前列腺电切术后尿道狭窄发生原因、预防及治疗措施进行综述。经尿道前列腺电切术后尿道狭窄发生的主要原因有膀胱镜鞘过粗、手术操作暴力、手术切除速率慢、电流返流灼伤、尿路感染等。目前最佳治疗方式仍有许多争议,手术治疗方式主要包括尿道扩张术(金属探条尿道扩张术、高压球囊尿道扩张术等)、腔内尿道狭窄内切开术(钬激光、冷刀尿道狭窄内切开等)、尿道成形术(口腔黏膜、膀胱黏膜、阴茎皮瓣、组织工程移植物)等。     

Leiomyoma of the female urethra with upper tract dilation and treatment with transurethral resection: a case report and literature review

Leiomyoma of the female urethra is a rare condition. It is a benign mesenchymal tumor that commonly presents with recurrent urinary tract infections and various lower urinary tract symptoms. We report a case of urethral leiomyoma and review the literature. A 44-year-old woman presented with severe irritative voiding symptoms without urinary tract infection and bilateral upper urinary tract dilation. Ultrasound and cystoscopy revealed a smooth mass arising from the urethra and projecting into the bladder. Transurethral resection of the mass was performed and 32 g of tissue was removed. There were no complications and the symptoms resolved completely, indicating this to be a safe approach. Histopathology showed the tumor to be leiomyoma.