腺性膀胱炎的影像学表现(附2例报告及文献复习)

目的探讨腺性膀胱炎的影像学表现。方法分析2例病理证实腺性膀胱炎的临床、B超、IVU、CT表现,并结合复习国内外有关文献。结果腺性膀胱炎影像学表现无特异性,影像学上可表现为肿块或膀胱壁的增厚,也可无异常表现。诊断依赖于病理学,主要表现为粘膜固有层存在Brunn’s巢、囊和腺体,并有不同程度的淋巴细胞和浆细胞浸润。结论肿块型腺性膀胱炎与膀胱癌相似,对于膀胱内肿块而无膀胱外浸润患者需考虑本病可能。     

Population based cohort to examine association between geospatial antibiotic factors and urinary tract infection outcomes

IntroductionUrinary tract infections (UTIs) pose a significant health care burden. Outpatient antibiotic geospatial factors (eg, geographic prescribing and geographic resistance) may be associated with inpatient outcomes. This study examined the relationship between these factors, severe UTI, and hospitalization for severe UTI.MethodsThe first cohort included hospitalized, female, Medicare beneficiaries, aged >50 years. The primary outcome was severe UTI (defined as CSS diagnosis code of 159 with an APR-DRG severity of illness code of 3 or 4). The association between geospatial first-line prescribing (FLP) and severe UTI was assessed. The second cohort examined the association between these geospatial FLP and risk of hospitalization with severe UTI. Multivariable regression was used to produce adjusted odds ratios and adjusted risk ratios.ResultsIn the first cohort (n = 14,474), low FLP was not associated with severe UTI (P = .87) in univariable analysis. In multivariable analysis, low FLP was associated with severe UTI was (aOR: 1.08 [95% CI 1.00, 1.16]). In the second cohort (n = 2,972,174), the admission rate was 47.0 and 49.8 per 10,000 (low FLP vs high FLP, respectively [P < .001]). The aRR for admission was 1.26 (95% CI 1.14, 1.39) in areas with low FLP.ConclusionsThis study suggests that geospatial antibiotic factors may influence inpatient outcomes in women aged >50 with UTI. Further research is needed to corroborate our findings.     

腺性膀胱炎的声像图及其彩色多普勒血流显像

目的探讨腺性膀胱炎的声像图及其彩色多普勒血流显像特征.方法本文10例病例均经超声和膀胱镜检查,并经病理证实.结果超声所见如下①病损发生于黏膜层,基层不受损.②扁平、宽基底、表面不规则的实性回声型.③较大的病变中可有低回声或无回声显示.④后侧无回声增高征,无明显衰减.⑤并有肾积水,憩室或结石时,可表现相应的超声图像改变.⑥彩色多普勒血流显像病变中血流信号稀少,RI＞0.60.结论腺性膀胱炎的早期诊断及动态观察均为超声检查的适应情况,且具有超声声像图特征.     

Phloroglucinol Protects the Urinary Bladder Via Inhibition of Oxidative Stress and Inflammation in a Rat Model of Cyclophosphamide-induced Interstitial Cystitis

Background:

Phloroglucinol plays an important role in oxidative stress and inflammatory responses. The effects of phloroglucinol have been proven in various disease models. The aim of the present study was to investigate the efficacy and possible mechanisms of phloroglucinol in the treatment of interstitial cystitis (IC).

Methods:

Thirty-two female Sprague-Dawley (SD) rats were used in this study. IC was induced by intraperitoneal injection of cyclophosphamide (CYP). Rats were randomly allocated to one of four groups (n = 8 per group): A control group, which was injected with saline (75 mg/kg; i.p.) instead of CYP on days 1, 4, and 7; a chronic IC group, which was injected with CYP (75 mg/kg; i.p.) on days 1, 4, and 7; a high-dose (30 mg/kg) phloroglucinol-treated group; and a low-dose (15 mg/kg) phloroglucinol-treated group. On day 8, the rats in each group underwent cystometrography (CMG), and the bladders were examined for evidence of oxidative stress and inflammation. Statistical analysis was performed by analysis of variance (ANOVA) followed by least square difference multiple comparison post-hoc test.

Results:

Histological evaluation showed that bladder inflammation in CYP-treated rats was suppressed by phloroglucinol. CMG revealed that the CYP treatment induced overactive bladder in rats that was reversed by phloroglucinol. Up-regulated tumor necrosis factor-α and interleukin-6 expression in the CYP-treated rats were also suppressed in the phloroglucinol treated rats. CYP treatment significantly increased myeloperoxidase activity as well as the decreased activities of catalase of the bladder, which was reversed by treatment with phloroglucinol.

Conclusions:

The application of phloroglucinol suppressed oxidative stress, inflammation, and overactivity in the bladder. This may provide a new treatment strategy for IC.     

腺性膀胱炎的诊断与治疗

目的：探讨腺性膀胱炎的临床特征与诊治效果。方法：通过对20例腺性膀胱患者行抗感染,经尿道汽化、电切、膀胱药物灌注等治疗方法。结果：本组20例获得随访,其中1例随访最长时间达到2年,1例6个月后复发,1例合并膀胱癌者9个月后膀胱癌复发,1例术后1年恶变,其余均治愈。结论：膀胱镜检查结合组织活检对诊断腺性膀胱炎具有重要意义,腺性膀胱炎具有恶变倾向,须定期随访复查。     

间质性膀胱炎病因学及治疗

目的探讨间质性膀胱炎（interstitial cystitis,IC）的诊断手段,以及病因学的多种模式,治疗的最新发展动向。方法对IC的30年来病因学、诊断学、治疗学、病理学、生理学发展资料汇总分析。结果IC其特点主要是膀胱壁的纤维化,并伴有膀胱容量的减少。以尿急、尿频、膀胱区胀痛为其主要症状。其发病机制到目前尚未完全清楚,主流医疗仍然认为免疫病变,感染因素、心理作用是IC的主要病因,间质性膀胱炎的诊断比较困难和复杂,易发生误诊,导致治疗无效。结论只有经过严谨的病因分析,诊断过程,良好的治疗方案,才可以极大的缓解并控制病情,但如果免疫治疗没有较大的突破性进展,IC的复发仍然是在很长时间内无法解决的问题,无法达到根治的目的。     

Xanthogranulomatous cystitis

Xanthogranulomatous cystitis (XC) is a rare benign chronic inflammatory disease of unknown etiology. We report a patient of XC managed with long-term antibiotics and augmentation cystoplasty. A 50-year-old man presented with urgency, frequency, hematuria and lower abdominal pain. Investigations revealed small capacity bladder with diverticula and cystoscopy showed inflamed bladder with multiple small polypoidal growth that had histological findings suggestive of XC on biopsy. Patient was treated with augmentation cystoplasty and prolonged administration of broad-spectrum antibiotics. Postoperative course was uneventful and patient remains asymptomatic at 1-year follow-up. XC is rare entity of unknown etiology. Patients may be given a trial of long-term broad-spectrum antibiotics.     

Acute urinary retention in a 7-year-old girl: an unusual complication of cytomegalovirus cystitis

Acute urinary retention in children is rare. There are a variety of causes about the disease. We report a case of a 7-year-old girl with acute urinary retention and hematuria. Pelvic sonogram revealed an isoechoic mass in the urinary bladder that appeared as a lobulated filling defect over the bladder neck on intravenous urography and computed tomography studies. The surgical specimen from cystoscopic examination showed reactive changes on pathologic analysis. Cytomegalovirus was isolated from urine culture. The girl recovered after supportive treatment.