The electrovesicogram in the overactive bladder: role in determining pathogenesis and diagnostic significance

We investigated the hypothesis that the abnormal contractility of the smooth musculature of the overactive bladder (OAB) may be due to derangement of its electrical activity. Percutaneous electrovesicography was performed in 22 patients (mean age 46.3 years, 12 men, ten women) with OAB and 14 healthy volunteers (mean age 45.6 years, eight men, six women). Recording was performed with the bladder full and empty. Three electrodes were applied suprapubically and one reference electrode was applied to a lower limb. Reproducible regular triphasic slow waves (SWs) were recorded in the volunteers. The pattern of the full and empty bladder were similar except for the higher amplitude of the waves in the former (P<0.05). The OAB patients showed a dysrhythmic pattern with irregular frequency, amplitude and conduction velocity in both the empty and full bladders. We obtained tachyrhythmic, bradyrhythmic and arrhythmic areas in the same recording. The OAB exhibited a dysrhythmic electrical pattern with areas of different electrical activity in the same recording. The tachyrhythmic, bradyrhythmic and arrhythmic areas are suggested to explain the abnormal vesical contractions and clinical manifestations of OAB. Further studies are required to investigate the cause of the dysrhythmic pattern and the electrovesicogram is suggested as an investigative tool in OAB diagnosis.     

人脐血中血管内皮祖细胞体外扩增和鉴定的实验研究

目的：探讨从人脐血中分离、培养、体外扩增血管内皮祖细胞(EPC)的方法及体外进行EPC的鉴定。方法：采用密度梯度离心法从脐血中分离EPC，体外分别培养在包被有FN和不包被FN的培养皿中，采用免疫组织化学技术(SABC法)鉴定培养贴壁细胞表面标志CD31、CD34及KDR的表达；流式细胞仪检测细胞表面标志CD133及表达CD133细胞比例。结果：包被FN的培养皿中细胞贴壁及增殖均比未包被的多，免疫组化染色CD31、CD34及KDR均呈阳性，培养第4天流式细胞仪检测CD133^ 占21．3％。结论：密度梯度离心法可用于体外分离脐血中EPC进行实验研究，FN对于体外培养EPC有非常重要的作用。     

中晚期肝癌患者经导管化疗栓塞治疗后序贯射频消融手术治疗时机的选择

目的 探讨中晚期肝癌患者经导管化疗栓塞（TACE）治疗后序贯射频消融手术（RFA）治疗的时机。方法 选取2017年7月至2020年6月河北医科大学第四医院收治的102例中晚期原发性肝癌患者,以随机数字表法分为研究组和对照组,每组51例。对照组TACE后行RFA的时间间隔>7 d,研究组TACE后行RFA的时间间隔≤7 d,治疗后3个月观察效果,并随访12个月。比较两组近期抗肿瘤疗效、病灶内生物学标志基因及血液肿瘤标志物表达、术后并发症发生情况和预后。结果 研究组临床控制率高于对照组（P<0.05）。研究组治疗后的基质金属蛋白酶-11(MMP-11)、Slug mRNA相对表达量均低于对照组（P<0.05）,研究组治疗后的基质金属蛋白酶组织抑制因子1(TIMP1)mRNA相对表达量高于对照组（P<0.05）。研究组治疗后的AFP、肿瘤特异性生长因子（TSGF）、碱性成纤维细胞生长因子（BFGF）、细胞缺氧诱导因子-1α(HIF-1α)、核因子κB(NF-κB)均低于对照组（P<0.05）。两组总并发症发生率差异无统计学意义（P>0.05）。两组患者无病...     

人血管生成素2原核表达载体的构建及鉴定

目的 构建人血管生成素2( Angiopoietin2)原核表达载体.方法 体外培养人脐静脉内皮细胞(HUVECs),通过逆转录-聚合酶链反应(RT-PCR)扩增获取Angiopoietin2基因片段,然后将其克隆入pET32a质粒载体表达系统,实现Angiopoietin2在大肠杆菌BL21中的稳定表达,并通过凝胶电泳、SDS-PAGE及基因测序等对表达蛋白进行鉴定.结果 从HUVEC中克隆出约1.5kb的Angiopoietin2基因,通过pET32a载体系统实现了Angiopoietin2蛋白的表达,SDS-PAGE、电泳及测序分析证实表达成功,融合蛋白相对分子质量为70×103.结论 应用基因重组技术成功构建了人Angiopoietin2原核表达载体.     

丙泊酚复合不同剂量阿芬太尼用于无痛人流术的临床观察

目的观察阿芬太尼联合丙泊酚用于无痛人流术的安全性与有效性。方法选择ASAⅠ或Ⅱ级拟在静脉全身麻醉下行无痛人流术患者90例,随机均分为三组:分别静注芬太尼1μg/kg（F1组）、阿芬太尼5μg/kg（F2组）、10μg/kg（F3组）,泵注丙泊酚2.0 mg·kg^-1·min^-1直至改良清醒镇静（MOAA/S）评分为0分为止。记录注药前（T₁）、睫毛反射消失时（T₂）、手术开始时（T₃）、手术开始后1min（T₄）、术毕（T₅）及清醒时（T₆）的MAP、HR、SpO₂、SNAP指数（SI）,各组丙泊酚的总用量、起效时间、手术时间、意识恢复时间、清醒时间,手术过程中体动反应,患者清醒后10、30 min的疼痛VAS评分,记录不良反应的发生率。结果 T₂时F1组S1明显低于F2、F3组,T₃时F2组MAP及SI均明显高于、HR明显快于F1、F3组（P<0.05）,T₂、T₃时F3组的SpO₂明显低于F1组（P<0.05）,但均在正常值范围。F3组丙泊酚总用量明显少于F1与F2组（P<0.05）,F2、F3组起效时间、意识恢复时间、F3组的清醒时间均明显短于F1组（P<0.05）,F2组发生体动反应的例数明显高于F1、F3组（P<0.05）。结论阿芬太尼10μg/kg与丙白酚联合用于无痛人流术是安全有效的。     

下腹部多个真皮下血管网皮瓣在手外伤修复中的应用

目的：应用下腹部多个真皮下血管网皮瓣修复手外伤，方法：在下腹形成以旋髂浅血管为蒂的髂腰部皮瓣及以腹壁浅血管为蒂的下腹部皮瓣，二皮瓣共蒂形成双叶皮瓣，同时将其修薄，形成有轴心血管的真皮下血管网皮瓣，修复两指完全脱套伤。在下腹部形成多个真皮下血管网的任意皮瓣，修复多个指背皮肤缺损伴有肌腱及骨外露的创面。供区如不能直接拉拢缝合，可取断层皮片修复供区创面.结果：本组10例中，8例采用下腹部双叶真皮下血管网轴型皮瓣修复，2例采用下腹部真皮下血管网任意皮瓣修复，术后效果。结论：采用多个真皮下血管网皮瓣修复手外伤的创面，伤指不需并指，去脂，分指，术后外形佳，是目前较理想的修复手外伤的手术方法。     

Effect of urethral dilation on vesical motor activity: identification of the urethrovesical reflex and its role in voiding

PURPOSE: We investigated the hypothesis that mild urethral distention, which presumably occurs during the passage of urine through the urethra, stimulates stretch receptors in the urethral wall, leading reflexively to vesical contraction. MATERIALS AND METHODS: We evaluated 9 male and 10 female healthy volunteers with a mean age +/- SD of 39.6 +/- 8.3 years. The posterior urethra was distended by a balloon filled with saline in 1 ml. increments up to 6 ml., while recording vesical pressure. The test was repeated after individual anesthetization of the urethra and bladder. RESULTS: Vesical pressure increased significantly at 1 and 2 ml. urethral distention (p <0.01). Increases in urethral distention effected further vesical pressure elevation (p <0.001), although there was no significant difference in distention at 3 to 6 ml. (p >0.05). No significant vesical pressure response of the individually anesthetized urethra or bladder occurred during urethral distention. CONCLUSIONS: Urethral distention is thought to cause vesical contraction through the stimulation of urethral stretch receptors. Vesical contraction at urethral distention postulates a reflex relationship that was abolished by individual anesthetization of the urethra and bladder. This relationship, which we call the urethrovesical reflex, appears to have a role in maintaining vesical contraction during voiding. Further studies are required to investigate the role of this reflex in voiding disorders.     

定制化敏感抗生素骨水泥螺钉治疗踝关节术后感染的临床研究

目的 评估定制化敏感抗生素骨水泥螺钉治疗踝关节术后感染的疗效。方法 回顾性分析2017年3月至2022年7月收治的22例踝关节术后感染病人的临床资料,其中男12例,女10例;年龄为（39.27±5.78）岁（31~52岁）。按内固定方式不同分为两组。观察组10例,采用定制化敏感抗生素骨水泥螺钉内固定;对照组12例,采用钛质克氏针和/或外固定架固定。记录两组病人伤口愈合等级、感染复发率、感染指标［降钙素原（procalcitonin,PCT）、白细胞计数（white blood cell count,WBC）、红细胞沉降率（erythrocyte sedimentation rate,ESR）、C反应蛋白（C-reactive protein,CRP）］、影像学特征等内容。结果 观察组伤口均甲级愈合,感染复发率为0,优于对照组（P＜0.05）。两组间的总体PCT、WBC、ESR、CRP比较,差异无统计学意义（P＞0.05）,但对照组术后6个月的PCT、WBC和CRP均高于观察组（P＜0.05）。术后6个月观察组的踝关节融合率为50.00%（5/10）,优于对照组的16.67%（2/12）（P＜0.05）。两组间在滑膜增厚、关节积液及软组织肿胀方面比较,差异无统计学意义（P＞0.05）,但观察组在骨髓水肿、钉道增宽水肿方面优于对照组（P＜0.05）。观察组未出现内固定松动、断裂现象,而对照组虽未出现内固定断裂病例,但6例出现克氏针松动,两组间的内固定物松动率比较,差异有统计学意义（P＜0.05）。结论 踝关节术后感染采用定制化敏感抗生素骨水泥螺钉内固定,既可增强局部抗感染能力,减少感染复发率,还可提高术后关节稳定性,减少二次融合手术率,可能是一种值得推荐的方法。     

腹腔镜治疗食管裂孔疝的临床应用

目的探讨使用腹腔镜行食管裂孔疝修补术的疗效和安全性。方法对26例食管裂孔疝患者使用腹腔镜行食管裂孔疝修补术，其中16例做胃底270。部分折叠术（Toupet术），10例做胃底360°胃底折叠术（Nissen术）。19例应用补片修补疵缺口，7例采用7号丝线缝合。结果26例腹腔镜食管裂孔疝修补术全部获得成功。手术时间30～190min，平均110min，失血10～50ml；术后24～48h进流质饮食，无术后并发症；术后平均住院5．7d。结论26例患者的反酸症状均在24h内缓解，术后停用抗酸药物，修补术具有疗效确定、安全和创伤小的优点。值得进一步推广应用。     

Electric waves recorded from the testicle: are they capsular or from the testicular tissue?

We demonstrated in a previous study that electric waves could be recorded from the testicle by applying the electrodes either directly to the tunica albuginea (TA) or transcutaneously. As the TA contains smooth muscle fibres which presumably transmit the electric waves, we investigated the hypothesis that the electric waves recorded from the testicle originated from the TA. During the repair of inguino-scrotal hernia in 24 men [age 36.6 +/- 8.6 years (mean +/- SD)], the tunica vaginalis was everted because of the presence of hydrocele. The electric activity of the TA was recorded by three surface electrodes and that of the testicle by three needle electrodes. The recorded potentials were amplified and displayed on an electromyographic apparatus. Triphasic slow waves (SWs) were recorded from the TA. They showed similar frequency, amplitude and conduction velocity from the three electrodes of the individual subject and were reproducible. They were followed or superimposed by bursts of action potentials (APs) which occurred randomly. No waves were recorded from the three needle electrodes inserted into the testicular tissue. The current study could demonstrate that the electric waves recorded from the electrodes applied to the testicle were derived from the TA and not from the testicular tissue. This finding apparently denotes that the TA has a resting tone and probably motile activity, the role of which in testicular function needs to be studied.