慢性非细菌性前列腺炎免疫学病因

目的 :探讨慢性非细菌性前列腺炎有关自身免疫方面的病因。方法 :对 33例慢性非细菌性前列腺炎患者进行血清和前列腺液免疫抑制因子 (IAP)、白细胞介素 6 (IL- 6 )、白细胞介素 8(IL- 8)的检测作为病例组 ,并对16例健康男性也进行此三项指标检测作为对照。结果 :病例组前列腺液中 IAP含量明显较血清低 ,对照组没有此变化。两组前列腺液和血清中 IL- 6、IL- 8均无明显变化。结论 :IAP与本病的发生有关 ,而 IL- 6、IL- 8与本病的发生无直接联系。     

UF-1000i尿有形成分分析仪细菌检测筛查尿路感染

探讨Sysmex UF-1000i尿有形成分分析仪细菌检测在尿路感染(UTI)筛查中的应用价值,报告如下. 一、对象和方法 以2007年12月至2010年1月疑为UTI的患者538例为研究对象,包括UTI 218例,非UTI 320例.留取清洁中段尿送检.使用Sysmex UF-1000i尿有形成分分析仪、长春迪瑞H-800尿干化学分析仪、美国BD微生物鉴定与药敏系统检测.     

前列腺液pH值测定在慢性前列腺炎诊断中的意义

目的:探讨慢性非细菌性前列腺炎患者前列腺液(EPS)的酸碱度(pH)值在鉴别Ⅲa和Ⅲb前列腺炎诊断中的意义。方法:回顾性分析慢性非细菌性前列腺炎患者84例(Ⅲa组39例,Ⅲb组45例)临床资料,按CPSI对疼痛症状(CPSI-P)和排尿症状(CPSI-U)分别评分,并测定EPS中pH值、白细胞计数和尿酸(UA)浓度。结果:Ⅲa和Ⅲb两组患者.EPS中的pH值(7.5±0.4 vs 6.3±0.3,P<0.05)、白细胞计数(17.4±7.5 vs 3.4±2.6,P<0.05)和UA浓度(328.4±78.2 vs 486.0±81.9,P<0.05)差异均有显著性意义;EPS中的pH值与UA浓度呈负相关,与EPS中的白细胞计数呈正相关。结论:慢性非细菌性前列腺炎Ⅲa和Ⅲb患者的EPS中不仅白细胞计数,而且pH值和UA浓度差异也有显著性意义;Ⅲa患者pH值高,UA浓度低;Ⅲb患者pH值低,UA浓度高。EPS中的pH值检测简单易行,有助于鉴别Ⅲa和Ⅲb患者。     

肾移植术后60例女性尿路感染的临床分析

目的:探讨肾移植术后女性尿路感染(UTI)的相关影响因素。方法:调查2012年1月~2012年12月在上海长征医院肾移植康复病房收治的肾移植术后UTI女性患者60例,依据年龄段分为低年组和高年组,比较两组患者UTI的临床资料,分析其临床特点,并探讨相关影响因素。结果:78.33%(47/60)患者至少出现UTI1例次;51.67%(31/60)患者UTI临床症状不典型;38.33%(23/60)患者尿标本以大肠埃希菌感染为主,但36.67%(22/60)患者却难以找到致病菌。其中高年组(占78.33%,47/60)比低年组(占21.67%,13/60)UTI发生率高,差异有统计学意义(P0.05)。进一步分析发现,在高年组UTI中,糖尿病和移植肾失功发生率均高于低年组患者(P0.05)。结论:年龄、糖尿病是肾移植术后女性UTI的重要影响因素,高年组UTI患者易增加移植肾失功的风险。     

血清IL-6、IL-8及IL-32水平对多发性骨髓瘤患者肾损伤的诊断价值

目的探讨多发性骨髓瘤(MM)患者中血清白细胞介素-6(IL-6)、白细胞介素-8(IL-8)及白细胞介素-32(IL-32)的表达及其预测肾损伤的价值。方法选取2017年1月至2020年5月在本院收治的74例MM患者作为MM组。依据国际分期系统(ISS)分为Ⅰ期(14例)、Ⅱ期(25例)和Ⅲ期(35例)。根据肾功能情况, 将其分为肾损伤组(26例)和无肾损伤组(48例)。另选取同期50例健康体检正常者作为对照组。检测各组血清IL-6、IL-8、IL-32及β2-微球蛋白(β2-MG)水平。应用ROC曲线分析血清IL-6、IL-8、IL-32及β2-MG水平诊断MM患者肾损伤的价值。结果 MM组的血清IL-6、IL-8、IL-32及β2-MG水平均高于对照组, 差异均有统计学意义(均P<0.001)。随着ISS分期的增加, 血清IL-6、IL-8、IL-32及β2-MG水平增加, 差异均有统计学意义(均P<0.001)。肾损伤组的血清IL-6、IL-8、IL-32及β2-MG水平均高于无肾损伤组(均P<0.001)。ROC曲线分析结果显示IL-6、IL-8、IL-32及...     

尿干化学分析与尿液沉渣检查对尿路感染诊断价值的比较

目的:探讨尿路感染(UTI)检验的较好方法。方法:以UTI诊断的金标准为参照,对124例UTI住院患者中段尿进行尿干化学分析和尿沉渣WBC计数检验,并作对比分析。结果:尿沉渣镜检的灵敏度、阴性预计值、准确率分别为79.6%、88.5%、81.7%,而尿液干化学分析亚硝酸盐(NIT)或WBC的灵敏度、阴性预计值、准确率分别为63.3%、81.2%、76.8%。结论:在UTI的尿筛查试验中,尿沉渣镜检WBC计数比尿干化学分析NIT、WBC的诊断价值为优。     

溃疡性结肠炎患者血清总胆红素和尿酸水平与炎症因子的相关性研究

目的:调查溃疡性结肠炎(UC)患者血清总胆红素(STB)和尿酸(UA)水平,探讨它们与机体炎症因子表达的关系.方法:将2019年3月至2021年1月我科收治的54例UC患者和同期50名健康体检者纳入本研究,所有受试者接受STB、UA、白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)及肿瘤坏死因子-α(TNF-...     

不同剂量乌司他丁对老年急腹症围术期血清TNF-a、IL-6的影响

目的 探讨不同剂量乌司他丁对老年急腹症围手术期血清肿瘤坏死因子(TNF-a)、白介素-6(IL-6)的影响.方法 120例手术治疗的老年急腹症患者,随机分为4组:C组(空白对照组)、U1组(UTI0.5万U/kg)、U2组(UTI 1.0万U/kg)、U3组(UTI 2.0万U/kg).分别于不同时间点取血,检测TNF...     

乌司他丁对急性胰腺炎患者炎性细胞因子的调节作用

目的 探讨乌司他丁（UTI）治疗急性胰腺炎的作用机制和f临床疗效。方法将52例急性胰腺炎患者采用随机数字表法分为UTI组和对照组,每组各26例。对照组予以禁食、制酸、胃肠减压、生长抑素、抗感染及营养支持等治疗。UTI组在对照组基础上,给予UTI10万U静脉滴注,2次,d,共5d。结果治疗前,两组白细胞介素（IL）-6、IL-8、肿瘤坏死因子（TNFF）-α含量基本一致（P〉0．05）;治疗后,UTI组IL-6、IL．8和TNF-α下降速度均明显快于对照组（P〈0．05）。UTI组痊愈率65．4％（17／26）,明显高于对照组的34．6％（9／26）（P〈0．01）;UTI组痊愈率＋显效率为92．3％（24／26）,明显高于对照组的76．9％（20／26）（P〈0．01）。结论UTI对急性胰腺炎患者IL-6、IL-8、TNF-α的分泌、释放有一定的调节作用,治疗急性胰腺炎临床疗效确切,有一定的临床推广价值。     

头孢唑肟钠对急性细菌性感染者的细菌学疗效与血清白细胞介素6及超敏C-反应蛋白影响

目的研究头孢唑肟钠对急性细菌性感染者的细菌学疗效以及对血清白细胞介素6(IL-6)和超敏C-反应蛋白(hs-CRP)水平的影响。 方法选取2017年1月至2017年8月于泰康仙林鼓楼医院接受治疗的急性细菌性感染者180例,按照随机数字表法分为对照组(90例)和观察组(90例)。对照组患者静脉注射头孢曲松钠,2.0 g/次、2次/d;观察组患者静脉注射头孢唑肟钠,2.0 g/次、2次/d。比较两组患者的细菌学疗效以及治疗前后血清IL-6和hs-CRP水平。 结果对照组和观察组患者有效率分别为92.22%和93.33%,差异无统计学意义(χ²= 1.267、P = 0.058)。两组患者细菌培养阳性率和细菌清除率差异均无统计学意义(χ²= 1.274、P = 0.062,χ²= 2.266、P = 0.067)。对照组和观察组患者治疗后血清IL-6水平均较治疗前显著降低,差异有统计学意义(t = 12.471、P= 0.032,t = 13.892、P = 0.031)。对照组和观察组患者治疗后hs-CRP水平均较治疗前显著降低,差异有统计学意义(t = 11.533、P= 0.023,t = 14.791,P = 0.019)。 结论头孢唑肟钠对急性细菌性感染者疗效较好,与头孢曲松钠疗效相当,能显著降低患者血清IL-6和hs-CRP水平。     

Treatment of stress urinary incontinence with artificial urinary sphincter

Stress urinary incontinence in women is usually due to either urethral hypermobility or intrinsic urethral weakness. Stress incontinence due to urethral hypermobility is usually cured with a cystourethropexy. That due to intrinsic urethral weakness, however, requires either periurethral injection, sling cystourethropexy or placement of an artificial urinary sphincter to achieve reasonable success rates. The artificial urinary sphincter has been used since 1972. Many modifications have been made to the original device, culminating in the currently available device, the AS-800, made by American Medical Systems. This paper reviews patient selection, surgical technique and complications of artificial urinary sphincter placement in the treatment of women with intrinsic urethral weakness (type III incontinence).     

Evaluation of urinary cytology for upper urinary tract disease

One hundred and seventy-two patients with upper urinary tract disease were examined by cytological study of ureteral urine which was taken by ureteral catheterization. Of 139 patients with benign disease or ureteral stricture due to non-urological cancer, only one case with renal cyst revealed positive findings (false positive rate: 0.7%). Two positive cases, which were a renal hemorrhage without followup and a uterine cervical cancer with squamous cancer cells in the ureteral urine, were excluded. Although 6 of 17 (35%) uroepithelial cancers in the upper urinary tract were registered as positive, this examination was little use for detecting stage pTa, grade 1 or papillary non-invasive tumors. However, 2 out of 12 (17%) renal pelvic or ureteral cancer patients with negative results of voided urine were cytologically detected by ureteral urine. Five out of 6 cases of these cancers demonstrated malignant cells in the renal pelvic urine sampled from surgical specimen. We have recently experienced aspiration cytology for upper urinary tract disease, using the percutaneous puncture method, and five of 7 upper urinary tract patients were cytologically diagnosed. This procedure could be valuable for detecting even patients with associated bladder cancer or failure of ureteral catheterization.     

尿流改道术后尿路结石的治疗

目的 探讨尿流改道术后尿路结石的治疗方法.方法 选取20例既往因膀胱癌接受尿流改道的尿路结石患者(肾结石6例,输尿管结石5例,储尿囊结石9例),接受个性化的治疗:其中经皮肾取石术8例,经皮肾顺行输尿管软镜碎石术3例,储尿囊流出道入路手术5例,经皮膀胱穿刺人路手术3例,开放取石1例.结果 手术时间60～130min,平均104min;术后结石清除率90％(18/20);术后发热4例(20％o),其中l例经皮肾镜技术(PCNL)术后液胸,行胸腔闭式引流.结论 针对尿流改道术后的尿路结石患者,采取个性化治疗方案,能够有效的清除尿路结石.     

人工尿道括约肌治疗真性尿失禁

目的：探讨人工尿道括约肌治疗真性尿失禁的效果和安全性。方法：对1例前列腺电切术后尿失禁患者进行AMS800人工尿道括约肌植入治疗。记录植入术前术后的排尿日记，并观察不良反应。结果：施行人工尿道括约肌植入术后6周开通人工尿道括约肌，尿失禁得到良好地控制，恢复自主排尿，未发生并发症，无其他不良反应，结论：人工尿道括约肌植入术是一种安全有效的治疗真性尿失禁的方法。     

Management of bowel and urinary tract complications after urinary diversion

Fortunately, the incidence of serious bowel and conduit problems in the immediate postoperative period and within the first year after diversion is low (5 to 10 per cent). The ileal or colon conduit still serves as the standard method of urinary diversion in adults with pelvic malignancy. Prevention of these complications should truly begin in the preoperative period, and careful judgement should be used postoperatively so that no therapeutic option is undertaken too early. The goal in managing these complications is the preservation of renal function, the maintenance of longest possible amount of functioning bowel, and the absence of indwelling stents and tubes. Patience is needed, along with the maintenance of drainage, adequate nutrition, observation for and treatment of sepsis, and a careful delineation of the anatomic defects. These patients, with their high reoperative mortality rate (approximately 50 per cent), present one of the most intriguing and complicated challenges to the urologist. Using the principles outlined here, we have had only one death in 22 consecutive patients referred to the Lahey Clinic for the management of complex bowel and urinary tract complications following urinary diversion.     

Mechanism of urinary calcium regulation by urinary magnesium and pH

Urinary magnesium and pH are known to modulate urinary calcium excretion, but the mechanisms underlying these relationships are unknown. In this study, the data from 17 clinical trials in which urinary magnesium and pH were pharmacologically manipulated were analyzed, and it was found that the change in urinary calcium excretion is directly proportional to the change in magnesium excretion and inversely proportional to the change in urine pH; a regression equation was generated to relate these variables (R(2) = 0.58). For further exploration of these relationships, intravenous calcium chloride, magnesium chloride, or vehicle was administered to rats. Magnesium infusion significantly increased urinary calcium excretion (normalized to urinary creatinine), but calcium infusion did not affect magnesium excretion. Parathyroidectomy did not prevent this magnesium-induced hypercalciuria. The effect of magnesium loading on calciuria was still observed after treatment with furosemide, which disrupts calcium and magnesium absorption in the thick ascending limb, suggesting that the effect may be mediated by the distal nephron. The calcium channel TRPV5, normally present in the distal tubule, was expressed in Xenopus oocytes. Calcium uptake by TRPV5 was directly inhibited by magnesium and low pH. In summary, these data are compatible with the hypothesis that urinary magnesium directly inhibits renal calcium absorption, which can be negated by high luminal pH, and that this regulation likely takes place in the distal tubule.     

Acute urinary retention in ileum conduit urinary diversion

Three years after ileum conduit urinary diversion, a 68-year-old patient was referred to us with acute urinary retention. Ultrasound examination demonstrated an extremely dilated, urine-filled ileum conduit and dilated kidneys. Placing a catheter into the subfascial part of the conduit to drain the urine was impossible because of extreme kinking and compression of the conduit in the fascial level. Ultrasound-guided puncture of the conduit was performed, and 170 mL of urine was aspirated. Afterward, a 16F catheter was easily placed. Clear urine drained. At last follow-up, no further episodes of urinary retention had occurred.