益气行水汤治疗肛肠术后尿潴留的临床效果

目的:探讨益气行水汤治疗肛肠术后尿潴留患者的有效性及对患者膀胱残存尿量、自行排尿时间的影响。方法:选取2019 年1 月—2020 年6 月因肛肠术后尿潴留来我院接受治疗的60 例患者,随机分为研究组与对照组,各30 例。对照组采用常规治疗,研究组采用常规治疗联合益气行水汤治疗,比较两组疗效、临床指标及治疗前后疼痛评分。结果:研究组总有效率为93%,对照组为77%,研究组治疗总有效率高于对照组,差异有统计学意义(P ＜ 0.05);研究组的膀胱残存尿量(119.0±18.2) mL、自行排尿时间(38.4±17.3) min、排便时间(34.0±8.4) h 及住院时间(4.6±2.1)d 均少于对照组的(168.0±22.9) mL、(54.2±18.8) min、(75.1±6.0) h 及(8.5±3.0) d,差异有统计学意义(P ＜ 0.05);研究组治疗后3 d 与7 d 的视觉疼痛模拟量表(VAS)评分分别为(3.1±0.4)分、(1.9±0.3)分,均低于对照组的(4.3±1.0)分、(3.0±0.5)分,差异有统计学意义(P ＜ 0.05)。结论:对肛肠术后尿潴留患者采用益气行水汤治疗,效果较好,能有效减少患者膀胱残存尿量,缩短其自行排尿时间,疼痛情况得到显著改善,缩短其病情恢复时间。     

人膀胱粘膜抗菌多肽的部分纯化及抗菌活性研究

以５％乙酸冲洗正常人膀胱，获得膀胱粘膜酸溶性提取物。电泳凝胶琼脂糖弥散法抗菌实验分析表明，膀胱粘膜酸溶性提取物中有一条主蛋白带（称之为ＨＢＰ）对致病性大肠杆菌ＭＬ－３５Ｐ株有抗菌活性。以超滤方法对膀胱粘膜酸溶性提取物进行分离纯化，获得分子量低于１×１０~４的超滤纯化样品，其中主要含ＨＢＰ。琼脂糖弥散法抗菌实验结果表明，超滤纯化样品对大肠杆菌ＭＬ－３５Ｐ株、绿脓杆菌ＡＴＣＣ２７８５３株、金黄色葡萄球菌ＡＴＣＣ２５９２３株及血链球菌Ｓ_３４Ｓｒ株均有很强的抗菌活性。采用Ｔｒｉｃｉｎｅ－ＳＤＳ－ｐＡＧＥ鉴定，超滤纯化样品主要显示为两条分子量分别为６．７×１０~３和８．５×１０~３的多肽。研究结果首次提示，人膀胱粘膜内存在抗菌活性很强的内源性抗生肽，是膀胱抗感染防御的主要因素。     

皮肤电导率在早期糖尿病肾病筛查中的应用价值

目的 探讨皮肤电导率（ESC）在早期糖尿病肾病筛查中的应用价值。方法 选取2022年10月至2023年2月于安徽医科大学第二附属医院分泌科住院的176例2型糖尿病患者,根据尿白蛋白/肌酐比值（UACR）和肾小球滤过率（eGFR）将其分为两组,糖尿病肾病组（DKD组,n=68）和糖尿病非肾病组（non-DKD组,n=108）,所有患者均完善SUDOSCAN仪检测,获得双手、双足ESC(HESC、FESC),肾病风险分数（SUDOSCAN-DN）,采用Spearman相关性分析UACR与SUDOSCAN各指标的关系。采用受试者工作特征（ROC）曲线判断SUDOSCAN各指标对糖尿病肾病的诊断效能。结果 与non-DKD组相比,DKD组年龄较大,病程较长,收缩压较高,三酰甘油（TG）、血尿酸及肌酐、促甲状腺激素（TSH）水平较高,HbA1c水平偏低,HESC、FESC、SUDOSCAN-DN值均较低,差异有统计学意义（P<0.05）;Spearman相关分析显示,UACR与TC、LDL-C、血肌酐、TSH呈正相关（r值分别为0.202、0.207、0.378、0.174,P<0....     

Urinaryα 1 as an index of proximal tubular function in early infancy

Urinary ₁-microglobulin (U-A₁M) was measured in healthy term infants on days 1, 4, 7, 14, 28, 90 and 180 of life. U-A₁M was high until day 14 and declined thereafter. It was significantly correlated with urinary ₂-microglobulin (U-B₂M) throughout the study, but not with serum A₁M on days 1 or 7. Similar to U-B₂M, U-A₁M in the clinically stable term infants with intrauterine growth retardation (n=4–7) was not elevated on days 1–7. In the sick infants who needed immediate resuscitatio at birth (n=4–8), U-A₁M as well as U-B₂M was high on days 1–7 and then decreased to normal levels, suggesting that U-A₁M can be used as a sensitive marker of acute proximal tubular damage and its recovery. These observations indicate that U-A₁M is a useful index of proximal tubular function in early infancy.     

The vesicocavernosus reflex: Role in the act of micturition

The paper studies the action and clinical significance of a reflex termed vesicocavernosus in 24 healthy volunteers (mean age 44.6 years, 15 men and 9 women). A balloon-tipped catheter was introduced into the urinary bladder and inflated with air in increments of 50 ml up to 300 ml. The response of the two cavernosus muscles to rapid vesical inflation and deflation, as well as to interruption and termination of micturition, was displayed on an EMG apparatus. The muscles contracted upon rapid vesical inflation or deflation, and upon the interruption or termination of micturition. These results were reproducible. In the male, bulbocavernosus muscle contraction seems to compress and expel the urine into the bulbous urethra. Ischiocavernosus muscle contraction helps to elevate the penile shaft. The role of the cavernosus muscles at micturition in women is unknown. The vesicocavernosus reflex could be of diagnostic significance in neurologic conditions.     

Urinary endothelin excretion in the neonate: influence of maturity and perinatal pathology

The present study was undertaken to establish the developmental pattern of urinary endothelin-1 (ET-1) excretion and to define its possible role in mediating pathophysiological changes related to perinatal asphyxia/infection and dopamine treatment. Urinary ET-1 levels were measured by radioimmunoassay in 7 full-term neonates (mean gestational age 39.3 weeks) on days 1, 3 and 5, and in 9 pre-term neonates (mean gestational age 30.8 weeks) on days 1, 3, 5, 7 and weekly thereafter for 5 consecutive, weeks. The results were compared with those of three age-groups of 30 normal children (4–8 years, 9–12 years and 13–18 years); each group, consisted of 10 children. The influence of severe cardiopulmonary distress (n=16, mean gestational age 33.9 weeks, post-natal age 3.3 days) and dopamine administration in a dose of 2 g/min per kg (n=10, mean gestational and post-natal ages 32.1 weeks and 5.6 days, respectively) were also studied. In full-term infants, ET-1 concentration fell from 34.3±1.8 pmol/l on day 1 to 21.5±1.5 pmol/l on day 5 (P<0.01). In premature infants its absolute value and its post-natal fall were similar in the 1st week and no further change occurred in weeks 2–5; it stabilized at levels between 17.1±2.2 and 16.7±1.7 pmol/l. These concentrations tended to be lower than those of 25.5±1.3, 23.0±1.0 and 26.2±0.7 pmol/l measured in three groups of older children. During the 1st week, daily ET-1 excretion remained unchanged in term infants (3.1±1.0 vs. 3.7±1.5 pmol/m² per day), but there was a significant increase from 6.5±1.0 to 12.4±0.7 pmol/m² per day (P<0.01) in premature infants. During weeks 2–5, preterm infants excreted more ET-1 than older children (P<0.01). In response to perinatal ashphyxia/infection and dopamine therapy, urinary ET-1 excretion markedly rose and there was a significant positive correlation between urine flow rate and ET-1 excretion (P<0.001). We conclude that ET-1 concentration rather than excretion rate may have a role in mediating the changes in renal functions that occur soon after birth. The pathophysiological significance of the flow-dependent increase in urinary ET-1 excretion needs to be further studied.     

Biomonitoring of polycyclic aromatic hydrocarbons in highly exposed coke plant workers by measurement of urinary phenanthrene and pyrene metabolites (phenols and dihydrodiols)

Summary A filter combination consisting of an impregnated glass fibre and a control filter was used for the collection of air samples in which gaseous and particulate polycyclic aromatic hydrocarbons (PAHs) were determined. To estimate the loss of lower boiling PAHs, d₁₀-phenanthrene was applied as internal standard. A simple, well-reproducible method for the determination of 1-, 2-, 3-, 4- and 9-hydroxyphenanthrene, 1,2-, 3,4- and 9,10 dihydroxydihydrophenanthrene, 1-hydroxypyrene and 1,2-dihydroxy-1,2-dihydropyrene is described. By means of personal air samplers the exposure to PAHs of four coke plant employees working at different locations was measured over 4 days. Simultaneously the 24-h urine was collected and stored frozen until analysed. The main excretion product of pyrene is a 1-hydroxypyrene conjugate, whereas phenanthrene is excreted predominantly as dihydrodiol conjugate. As expected, workers on the battery topside were exposed the most and accordingly excreted by far the highest amounts of PAHs. Up to 34.0 g phenanthrol conjugates (total of all isomeric phenols) and 195.5 g dihydrodiol conjugates (total of all isomeric dihydrodiols) were excreted in the 24-h urine (mean of 4 days). The metabolite profiles of five isomeric phenanthrene phenols and three isomeric dihydrodiols exhibited only small percentage variations within one individual whereas significant interindividual differences were observed. These findings may indicate a genetically determined enzyme pattern responsible for the metabolic conversion of PAHs.This paper is dedicated to Professor Dr. R. Preußmann on the occasion of his 65th birthday     

Capsaicin-like activity of some natural pungent substances on peripheral endings of visceral primary afferents

Summary 1. The effects of some naturally occurring pungent substances, piperine, mustard oil, eugenol and curcumin, were compared to those of capsaicin in the rat isolated urinary bladder. 2. All test compounds dose-dependently contracted the rat bladder and produced desensitization toward capsaicin (1 mol/l). Development of cross-tachyphylaxis among the natural pungent substances on one hand and capsaicin on the other, suggested a common site of action on visceral primary afferents. 3. Contractile responses to piperine, mustard oil and eugenol were partially tetrodotoxin and ruthenium red-sensitive, suggesting that activation of sensory terminals by these agents takes place indirectly, as well as by a direct action on sensory receptors. 4. The presence of the secondary acylamide linkage (present in the backbone of capsaicin, but not in that of test compounds) does not appear to be essential to produce desensitization of sensory nerve terminals. Send offprint requests to R. Patacchini at the above address     

MR水成像诊断胆道和尿路梗阻的临床评价

目的 评价ＭＲ水成像（ＭＲＨ）对胆道和尿路梗阻的临床诊断价值。材料与方法 收集临床拟诊为胆道和尿路梗阻行ＭＲＨ检查者１１９例,其中ＭＲ胰胆管成像（ＭＲＣＰ）９３例,ＭＲ尿路成像（ＭＲＵ）２６例。全部病例均经手术和病理证实。ＭＲＨ采用不屏气涡轮自旋回波（ＴＳＥ）序列,同时应用呼吸门控和脂肪抑制技术。原始图像以最大信号强度投影（ＭＩＰ）进行三维图像后处理。结果 全部病例ＭＲＨ检查均一次成功。ＭＲＣＰ图     

磁共振尿路造影诊断儿童先天性泌尿道畸形的意义

目的 探讨磁共振尿路造影（ＭＲＵ）技术在诊断儿童先天性泌尿道畸形中的应用价值。方法 回顾性分析２４例儿童先天性泌尿道畸形患者,采用快速自旋回波（ＴＳＥ）行ＭＲＵ检查,并与ＩＶＰ和手术结果对照。结果 ２４例中单侧性２０例,双侧性４例。ＭＲＵ的原始图象及ＭＩＰ图象清晰地显示梗阻的部位及程度,结合常规ＭＲＩ,诊断符合率达８８％。结论 ＭＲＵ这一无创性水成像技术,能显示无功能性肾脏的集合系统,并兼有无Ｘ线