膀胱癌的MRI诊断价值

目的:总结膀胱癌的MRI征象,探讨MRI对膀胱癌分期的作用及鉴别诊断要点。方法:对探讨经手术与病理证实23例膀胱癌的MRI回顾性对比分析。其中男性,19例,女性,4例,年龄50~90岁,平均年龄70岁。18例行MRI增强检查。结果:膀胱三角区及膀胱后侧壁是最常见好发部位,表现为膀胱壁突向腔内肿块和(或)膀胱壁局限性不规则增厚;肿瘤平扫T1WI等或略高信号,T2WI呈高信号,Gd-DTPA动态增强早期肿块显著强化。根椐肿瘤生长方式可分为:①小结节型,②广基肿块型,③浸润型。MRI对膀胱癌定位、定性诊断正确率分别为95.7%(22/23)、91.3%(21/23);术前MRI诊断与TNM分期符合率为82.3%(19/23),MRI较病理分期偏高。结论:膀胱癌的MRI表现具有独特性。T1加权主要用于肿瘤的定性诊断,T2加权主要用于肿瘤的术前分期;MRI检查多方位、多序列成像,是显示膀胱癌最理想的检查方法。     

保留盆腔植物神经对老年男性患者术后性功能及排尿功能的影响

目的:探讨保留盆腔植物神经的直肠癌手术对老年男性患者性功能及排尿功能的影响。方法:1999~2005年因直肠癌手术的170例老年男性患者分为PANP组(含规范的TME手术方法)和非PANP(TME规范情况不详),对两组术后性功能、排尿功能和局部复发率进行回顾性总结、比较。结果:PANP组性功能与排尿功能明显优于非PANP组,但统计学无显著差异(P<0.05)。而PANP组局部复发率低于非PANP组(P>0.05)。结论:老年直肠癌患者应重视性功能和排尿功能的保护。     

尿干化学法检测阴性不可偏废沉渣镜检

通过对 5 0 0例经尿 11项试纸检查阴性的标本 ,沉渣镜检发现尚有 6 7例阳性 ,阳性率为 13.4 %。提示尿沉渣镜检 ,不失为泌尿系统疾病检查的必要手段不应忽视及偏废     

Case of acute urinary retention as a result of non-steroidal anti-inflammatory drugs

Abstract:   A 19-year-old woman presented at our hospital with acute urinary retention in September 2005. She had experienced the same chief complaint twice previously. She had used non-steroidal anti-inflammatory drugs before acute urinary retention. The results of physical examinations were unremarkable, and her neurologic signs were not remarkable. The basic laboratory test values were all normal and a psychiatric assessment indicated that her symptoms were not psychogenic. Magnetic resonance imaging was carried out, but revealed only a slight bulging in the L3/L4/L5 disk. Water cystometry showed acontractile detrusor. We made a diagnosis of acute urinary retention as a result of non-steroidal anti-inflammatory drugs because of her use of such drugs before the development of symptoms on multiple occasions. This patient was regularly followed up as an outpatient, and she could void smoothly in February 2006. This is the first report which acute urinary retention associated with non-steroidal anti-inflammatory drugs in Japan.     

Urinary bladder carcinoma producing granulocyte colony stimulating factor (G-CSF): A case report with immunohistochemistry

A rare case of urinary bladder carcinoma with granulocyte colony stimulating factor (G-CSF) production was reported. In an 83-year-old female, marked neutrophilia in the peripheral blood decreased from 132,500/mm³ to 3,300/mm³ after tumour resection. The tumour was a transitional cell carcinoma. The serum G-CSF level reduced from 238 pg/ml pre-operatively to normal (60 pg/ml) after the operation. Immunohistochemical investigation of the resected tumour with monoclonal antibody specific for G-CSF revealed positive staining in the carcinoma cells, confirming G-CSF secretion.     

尿路复合性恶性肿瘤（附21例报告）

报告２１例尿路复合性恶性肿瘤，位于肾盂２例，膀胱１９例。主要临床表现为血尿，绝大多数病人伴有尿路刺激症状。低分化的移行细胞癌（ＴＣＣ）与继发性复合肿瘤有密切关系。２１例中１例为ＴＣＣ复合肉瘤，１１例为ＴＣＣ复合鳞癌，７例为ＴＣＣ复合腺癌，２例为腺癌复合鳞癌。本组２例肾盂肿瘤分别行肾输尿管全长加膀胱袖口状切除术和肾部分切除术，术后存活６个月和１年；膀胱肿瘤１４例行膀胱部分切除术，已生存３年４例，１年２例，未满１年２例，３例１～２年内死亡，失访３例；２例根治性膀胱全切术已生存５年和３年以上；３例行ＴＵＲＢｔ，已生存３年１例，１５年１例，未满１年１例。对尿路复合性恶性肿瘤的组织学、临床和病理特征进行了讨论。     

重质石油中含氮化合物的形态及分布分析Ⅱ．含氦杂环化合物的定性方法

探索了色谱保留值与质谱信息相结合的定性分析方法。用ＳＥ－５４柱代替ＳＥ－５２柱，选用六个多环芳烃化合物作为标准计算保留指数，从而改善了Ｍ．Ｌ．Ｌｅｅ保留指数的应用条件和范围；用文献值转换扩充了Ｌｅｅ的含氮杂环化合物保留指数表，并利用保留时间与沸点的关系作定性佐证。应用该法鉴定了重质石油样品子组分及萘油中的４６个含氮杂环化合物及其异构体，为质谱在异构体鉴定以及缺乏标样所产生的困难提供了可信、简便的定性鉴定方法。     

Dysgeusia related to urinary obstruction from benign prostatic disease: a case control and qualitative study

Anecdotal reports suggest that dysgeusia may be related to a variety of systemic factors, including bladder outflow obstruction. This is a hospital-based case-controlled study involving 111 patients who were admitted to urological wards for transurethral resection of the prostate for benign prostatic disease with age- and sex-matched control of 137 subjects. We used a semi-structured questionnaire by a trained interviewer at admission (preoperative), at the postoperative period and at follow-up between 4–6 months (median 5 months). Analysis used unpaired t-test and X₂ test. The incidence of dysgeusia was 22% in the study group and 13% in the control group (P=N.S.). However, strikingly, the dysgeusia in the study group was relieved promptly by relief of urinary obstruction in 100% of cases and did not return within the follow-up period. The mechanism of the dysgeusia associated with dysuria in benign prostatic disease is unknown, but we suggest that the dysgeusia could be from the stress of dysuria or due to a release of an unknown chemical from the urinary tract or an overflow of neural impulse from pontine/cortical micturition centres to the taste centres. An association between dysgeusia and dysuria has not been described before.     

Changing prevalence and knowledge of urinary incontinence among Hong Kong Chinese women

A territory-wide telephone survey was conducted in Hong Kong to assess the prevalence, knowledge, and treatment-seeking behaviour of Chinese women with urinary incontinence, using validated Chinese version of Urogenital Distress Inventory (UDI-6) and Incontinence Impact Questionnaire (IIQ-7). Women, 540, aged between 17 to 77 years were interviewed. Of the respondents, 40.8% reported stress urinary incontinence, 20.4% had urge incontinence and 15.9% had mixed incontinence. Among these, 16.0% reported quality of life impairment; 9.3% felt frustrated with low morale, and 15.2% had nervous and anxiety problems. However, as many as 78.3% of the respondents did not know that stress urinary incontinence is a disease entity, and 60.6% thought that leakage of urine was a normal aging process. For those respondents having stress urinary incontinence, the first treatment of choice was physiotherapy. The second choice was medication, and surgical treatment was the last option. Respondents with stress urinary incontinence showed higher education level.     

尿流改道术后输尿管肠代膀胱吻合口狭窄的腔内治疗

目的 探讨腔内技术治疗尿流改道术后输尿管肠代膀胱吻合口狭窄的临床应用价值.方法 膀胱癌尿流改道术后输尿管肠代膀胱吻合口狭窄患者9例,狭窄段长度1～3 cm,均采用腔内技术治疗,顺行经皮肾处理8例,逆行输尿管镜处理1例;术中使用高压气囊配合筋膜扩张器扩张,术后留置双J管.结果 随访0.5～5.0年.1例吻合口闭锁患者术后3个月仍为重度积水,患者拒绝开放手术而长期留置肾造瘘管;8例患者肾积水减轻,再次逆行扩张狭窄段并留置双J管,其中5例经2～3次扩张换管,拔除双J管后复查肾积水稳定于轻度状态;3例拔除双J管后腰痛不适,需要长期留置双J管.结论 尿流改道术后输尿管肠代膀胱吻合口狭窄腔内技术治疗效果良好,可避免开放手术的风险.