肌源干细胞注射治疗压力性尿失禁的研究进展**

背景：注射疗法治疗压力性尿失禁是一种微创的治疗手段,但是由于既往注射材料的限制,可出现各种并发症,远期疗效差,寻找新的注射材料具有重大意义。目的：对压力性尿失禁应用肌源性干细胞治疗的研究进行回顾分析。方法：由第一作者检索2003/2010 PubMed数据库、Springer数据库及中国知网数据库关于肌源性干细胞用于压力性尿失禁治疗研究方面的文献,英文检索词为“stress urinary incontinence, muscle-derived stem cell”,中文检索词为“压力性尿失禁,肌源干细胞”,排除重复性研究,计算机初检得到40篇文献,根据纳入标准保留24篇进一步归纳总结。结果与结论：压力性尿失禁的治疗方式主要包括非手术治疗和手术治疗,其中手术治疗存在多种并发症甚至出现矫枉过正的风险,而注射疗法作为一种非手术治疗方式,具有操作简便,患者可接受性更高。肌源性干细胞注射后可在体内长期存活,并具有不被分解、不易迁移、低免疫原性的优点,在注射治疗压力性尿失禁方面具有广阔的前景。     

Initial experience with a short,tension-free vaginal tape (the tension-free vaginal tape secur system)

Objective

The aim of this study is to present our first experience with a novel modification of the tension-free sling idea and to evaluate the safety and efficacy of this new procedure for the treatment of stress urinary incontinence in women.

Study design

Eighty-five women with previously untreated stress urinary incontinence were recruited to participate in a clinical study. The efficacy of this surgical procedure was evaluated perioperatively and 3 months (±1 week) after operation—objectively by cough test and subjectively by the questionnaires Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire and the International Consultation on Incontinence Questionnaire-Short Form. All data were processed and statistical analyses performed in statistical environment R, version 2.5.1.

Results

From our results we conclude that there were no perioperative complications, objectively 62% of these patients were completely dry and 25% of patients improved. We observed a higher proportion of vaginal wall erosion (7/85) and urgency de novo (5/85) in the learning period group with respect to the routine period group.

Conclusions

Our first experience with the tension-free vaginal tape secur system procedure is that it has a low percentage of perioperative complications. The learning curve has to be taken in account with reference to postoperative complications.     

A MEMS accelerometer-based real-time motion-sensing module for urological diagnosis and treatment

Abstract

This paper reports a real-time motion-sensing module, which is realized by incorporating multiple MEMS accelerometers into a standard Foley catheter, for assisting diagnosis and treatment of stressed urinary incontinence. The accelerometers measure the orientations of the catheter at multiple points, so the shape of the urethra and movement of the bladder neck can be tracked in real time. An algorithm for extracting tilting, position and shape information from 3-axis MEMS accelerometers has been developed. The model of measurement errors for both static and dynamic testing is also established. The experimental results indicate that the module tracks the movement of the Foley catheter successfully in a real-time environment and the absolute error for static measurement is no more than 1.1° within the operation range.     

模拟分娩损伤及绝经对压力性尿失禁模型大鼠尿道周围结缔组织转化生长因子β1和弹性蛋白表达的影响

目的:探讨模拟分娩损伤及绝经对压力性尿失禁(SUI)模型大鼠尿道周围结缔组织转化生长因子β1(TGFβ1)和弹性蛋白(elastin)表达的影响。方法:51只雌性SD大鼠随机分为3组:阴性对照组(正常未孕大鼠)、阳性对照组(分娩组)、SUI组(分娩、模拟产伤、卵巢去势),造模前和处死前均行尿道动力学检测,于术后4周处死大鼠,收集大鼠尿道周围结缔组织进行常规石蜡切片、HE染色、弹性纤维特殊染色,免疫荧光实验和Western blotting方法检测各组尿道周围结缔组织TGFβ1和弹性蛋白的蛋白表达情况。结果:SUI组最大膀胱容量和漏尿点压力明显较阳性对照组和阴性对照组下降(P均0.01)。弹性纤维特殊染色显示阴性对照组和阳性对照组弹性纤维完整致密,SUI组弹性纤维较对照组减少、稀疏、变细(P均0.01)。Western blotting检测结果显示阴性对照组和阳性对照组尿道周围结缔组织均见TGFβ1和弹性蛋白的高表达,2个对照组间比较差异均无统计学意义(P均0.05)。SUI组在造模后4周TGFβ1和弹性蛋白的表达均较对照组明显下降(P均0.01)。结论:尿道周围结缔组织弹性纤维的破坏和缺失可能与SUI的发生关系密切,弹性蛋白和TGFβ1的减少可能共同参与了SUI的发生、发展。     

眭道顺治疗手足癣经验

总结了眭道顺教授治疗手足癣的经验.眭道顺教授认为手足癣主要因风湿热毒之邪侵袭肌肤腠理,致气血不和,久则化燥伤血,肌肤失养而致本病.治疗以外治法为主,内外兼施,防护兼顾.眭道顺教授治疗手足癣的自拟治癣外洗方的药物组成为藿香、黄精、苦参、百部、白矾、芒硝、虎杖、艾叶、蛇床子、金银花、三叉苦等.辨证治疗手足癣时主要分为湿热毒...     

阴道无张力尿道中段悬吊带术治疗女性压力性尿失禁的临床观察

目的探讨应用经阴道无张力尿道中段悬吊带术（TVT）治疗女性压力性尿失禁（SUI）患者的疗效。方法回顾性分析采用TVT悬吊术治疗女性SUI患者56例。结果全部患者随访6～36个月,平均20.6个月。53例治愈,2例有效,1例术后6个月发现吊带部分嵌入膀胱颈,经尿道电切镜切除嵌入部分后再次出现尿失禁。结论TVT悬吊术是一种治疗女性SUI患者安全、有效和微创的治疗手段。     

经会阴超声在产后压力性尿失禁诊断及康复治疗疗效评价中的应用

目的观察会阴超声对生物反馈电刺激治疗产后女性压力性尿失禁的临床疗效。方法选择医院分娩的产妇80例,将其随机分成治疗组40例和对照组40例,治疗组患者行生物反馈电刺激治疗联合盆底肌锻炼治疗,对照组患者行盆底肌锻炼治疗,并通过会阴超声观察静息状态和Valsalva动作时膀胱颈下降度,尿道膀胱后角,盆膈裂孔面积等。结果治疗组患者的膀胱颈下降度、尿道膀胱后角及盆膈裂孔面积明显小于对照组患者,差异均有统计学意义（P〈0.05）。结论生物反馈电刺激联合盆底肌锻炼治疗产后女性压力性尿失禁效果显著,会阴超声（尤其是三维成像技术）观察压力性尿失禁成像清晰,操作简便,可重复检查,经济实用,可在临床上推广应用。