医源性输尿管损伤的手术治疗38例报告

目的:总结38例医源性输尿管损伤的手术方法和治疗经验。方法:回顾性分析2010年1月～2017年12月我院收治的38例医源性输尿管损伤患者的临床资料。38例患者中,妇产科手术损伤15例,泌尿外科16例,普外科7例。术中发现25例,术后发现13例。确诊后均积极进行手术治疗。12例行输尿管镜下留置双J管术,8例行输尿管端端吻合术,6例行输尿管膀胱再植术,4例行输尿管膀胱角吻合术,3例行膀胱壁瓣输尿管吻合术,2例行输尿管松解术,2例先行经皮肾穿刺造瘘术,3个月后改行回肠代输尿管术,1例行患肾切除术。结果:术后平均随访18(6～36)个月,定期行B超、CT、静脉尿路造影等检查,12例输尿管镜下留置双J管术后输尿管狭窄合并中度肾积水5例,行输尿管膀胱再植术后好转;8例输尿管端端吻合术后输尿管狭窄合并中度肾积水2例,行输尿管镜球囊扩张后好转。其余患者患侧输尿管通畅无狭窄,患侧肾无积水。结论:医源性输尿管损伤的处理应根据输尿管损伤情况、患者的具体情况和医生所掌握的技术采用不同的手术治疗方案。复杂性医源性输尿管损伤行输尿管镜留置双J管和输尿管端端吻合术,术后远期输尿管狭窄发生率较高,需要密切随访,必要时进一步处理。     

人神经生长因子β亚基慢病毒载体的构建

背景：糖尿病神经源性膀胱的发病与神经生长因子缺乏有关,β亚基是构成神经生长因子（NGF）3种亚基中惟一具有生物活性的亚基,慢病毒载体是基因治疗的理想载体。目的：构建过表达人神经生长因子β亚基（β-NGF）基因的慢病毒载体。方法：通过目的基因的获得,载体质粒双酶切,载体质粒与目的基因的连接将人β-NGF基因克隆到慢病毒载体质粒pGC-FU中,构建重组慢病毒载体质粒pGC-FU-β-NGF。观察人β-NGF基因的克隆情况,并进行重组慢病毒载体质粒pGC-FU-β-NGF的PCR鉴定和测序。结果与结论：构建的重组慢病毒载体质粒pGC-FU-β-NGF进行PCR实际获得的产物与预计PCR产物大小一致,即初步判断为构建成功的重组质粒。所获得的β-NGF基因经测序后与GenBank报道序列完全一致。说明pGC-FU-β-NGF中携带有正确的β-NGF基因。结果证实,实验成功构建了携带人β-NGF基因的重组慢病毒载体质粒。     

慢病毒载体在基因治疗中的应用进展

慢病毒载体(1entiviral vector,LV)具有可感染非分裂细胞、转移基因片段容量较大、目的 基因表达时间长、不易诱发宿主免疫反应等优点,成为目前基因治疗中应用较为广泛的病毒载体.本文以人类免疫缺陷病毒I型(HIV-Ⅰ)为代表,综述对慢病毒载体的改进及其在基因治疗中的应用进展.     

神经生长因子基因修饰的骨髓间充质干细胞在糖尿病大鼠膀胱中的生长及表达

Objective To confirm that rat bone marrow mesenchymal stem cells (MSC) transfected with nerve growth factor (NGF) gene in the bladder tissue of diabetic rats bladder tissues can survive and stably express NGF. Methods A diabetic rat model was constructed. The BrdU-labelled MSC transfected with NGF gene were transplanted into the diabetic rats bladder tissues. BrdUlabelled immunohistochemistry was used to observe the growth of MSC transfected with NGF gene in the diabetic rats bladder tissues. The expression of NGF mRNA and protein were checked by RT-PCR and ELISA. Results A diabetic rat model was successfully built by a single intraperitoneal injectionof STZ. The blood glucose was still high after 8 weeks. NGF gene modified MSC could be detected in the bladder of diabetic rats by BrdU-labelled immunohistochemistry. The concentration of NGF in the control group, disease group and treatment group were ( 114 ± 3), ( 70 ± 2), ( 110 ± 2) pg/ml by ELISA and mRNA quantity by RT-PCR were 0. 183±0. 004, 0. 032±0. 139, 0. 130±0. 165, respectively. Compared with the control group, the expression of NGF gene was decreased (P＜0. 05) in the incidence group. The expression of NGF gene was increased (P＜0. 05) in the treatment group compared with the disease group. Conclusions The NGF gene-modified MSC could survive in diabetic rats bladder tissues. The NGF gene in MSC could stably express in diabetic rats bladder tissues.     

氯胺酮(K粉)相关性尿路损害的诊断和治疗

氯胺酮是一种非巴比妥类麻醉药,作为毒品滥用时俗称K粉,国内外陆续有报道关于K粉导致的各系统疾病。笔者医院于2009年01月-2010年9月收治5例因吸食K粉致严重下尿路症状（lower urinary tract symptoms,LUTS）患者,现总结临床资料,报告如下。     

阴囊内大网膜血管肌纤维母细胞瘤1例

患者,25岁。因“发现右侧阴囊增大20余年,加剧1个月”于2008年09月入院。体检：右侧阴囊增大约12cm×8cm×6cm,质地中等,透光试验阴性;右侧睾丸大小质地尚正常;右侧阴囊上极可触及一约5cm×4cm×3cm肿物,质地较硬,界清,有触痛。阴囊内容物可部分还纳,肿物不能还纳。     

体外冲击波碎石后肾包膜下血肿3例报告

体外冲击波碎石（ESWL）是治疗上尿路结石的一种安全有效微创的措施。但近年陆续有体外冲击波碎石治疗发生严重并发症的报道。2009年5月份以来我科收治的应用德国体外冲击波碎石机（型号Donier Lithotripter S）行体外冲击波碎石后肾包膜下血肿患者3例，报告如下。     

神经生长因子基因修饰的骨髓间充质干细胞在糖尿病大鼠膀胱中的生长及表达

目的 将转入神经生长因子(NGF)的大鼠骨髓间充质干细胞(MSC)移植于糖尿病大鼠膀胱平滑肌组织内,观察MSC在膀胱组织内的存活和NGF基因的表达情况.方法 糖尿病组(30只)大鼠按链脲佐菌素(STZ)60 mg/kg行单次腹腔注射,对照组(15只)腹腔注射等体积的柠檬酸缓冲液.实验分组:对照组(正常大鼠膀胱)、发病组(糖尿病大鼠膀胱)、治疗组(糖尿病大鼠膀胱内移植转染NGF基因的MSC).溴苷法示踪NGF基因修饰的MSC在大鼠膀胱内的存活情况;RTPCR、ELISA法检测NGF基因在糖尿病大鼠膀胱内的表达情况.结果 单次腹腔注射STZ造模成功,8周后血糖仍处高位.NGF基因修饰的大鼠MSC移植入糖尿病大鼠膀胱内4周仍存活.ELISA检测结果显示对照组、发病组、治疗组大鼠膀胱NGF蛋白含量分别为(114±3)、(70±2)、(110±2)pg/ml,RT-PCR检测mRNA表达量分别为0.183±0.004、0.032±0.139、0.130±0.165.发病组与对照组相比NGF表达下降(P＜0.05),治疗组与发病组相比NGF表达上升(P＜0.05).结论转入NGF基因的大鼠MSC能在糖尿病大鼠膀胱中存活并稳定表达.

Abstract：

Objective To confirm that rat bone marrow mesenchymal stem cells (MSC) transfected with nerve growth factor (NGF) gene in the bladder tissue of diabetic rats bladder tissues can survive and stably express NGF. Methods A diabetic rat model was constructed. The BrdU-labelled MSC transfected with NGF gene were transplanted into the diabetic rats bladder tissues. BrdUlabelled immunohistochemistry was used to observe the growth of MSC transfected with NGF gene in the diabetic rats bladder tissues. The expression of NGF mRNA and protein were checked by RT-PCR and ELISA. Results A diabetic rat model was successfully built by a single intraperitoneal injectionof STZ. The blood glucose was still high after 8 weeks. NGF gene modified MSC could be detected in the bladder of diabetic rats by BrdU-labelled immunohistochemistry. The concentration of NGF in the control group, disease group and treatment group were ( 114 ± 3), ( 70 ± 2), ( 110 ± 2) pg/ml by ELISA and mRNA quantity by RT-PCR were 0. 183±0. 004, 0. 032±0. 139, 0. 130±0. 165, respectively. Compared with the control group, the expression of NGF gene was decreased (P＜0. 05) in the incidence group. The expression of NGF gene was increased (P＜0. 05) in the treatment group compared with the disease group. Conclusions The NGF gene-modified MSC could survive in diabetic rats bladder tissues. The NGF gene in MSC could stably express in diabetic rats bladder tissues.     

SD大鼠骨髓间充质干细胞体外分离培养的实验研究

目的 建立一种简便有效的体外分离纯化及培养扩增大鼠骨髓间充质干细胞(BMSCs)的方法,研究BMSCs的生物学特性,为后续细胞移植和基因治疗提供理想的种子细胞.方法 全骨髓贴壁培养法分离大鼠BMSCs,体外培养和连续传代,在倒置相差显微镜下连续观察细胞的形态变化,利用MTT法测定其生长曲线,流式细胞仪鉴定其表面抗原,成...