不同位置复杂性输尿管上段结石输尿管镜气压弹道碎石术疗效分析

采用输尿管镜治疗复杂性输尿管上段结石,常发生结石上漂回肾脏.输尿管上段长约13~14cm[1],行程较长,不同位置的复杂性输尿管上段结石采用输尿管镜气压弹道碎石术的疗效可能不同.本文回顾性分析我院收治的136例复杂性输尿管上段结石患者的临床资料,旨在对比分析不同位置结石患者的治疗效果,现报道如下.     

干化学法测定尿液的影响因素

为了保证尿液分析的准确性 ,将用干化学法测定尿液的影响因素介绍如下 ,以免测得结果造成临床误诊漏诊。1　PH测定 :尿液的PH4 5～ 9 0范围内时 ,试剂条应该按规定的时间浸泡及分析 ,时间过长 ,则PH有下降的趋势。2　蛋白测定 :标本必须新鲜 ,变质的尿液PH变化后 ,将影响指示剂的蛋白检测结果 ,当PH >8时 ,易出现假阳性 ,PH<3时 ,易出现假阴性。排除方法将PH调至 5～ 7再作测定 ,该方法只用于白蛋白 ,不完全适用于病理性尿液标本的检查 ,因为大剂量青霉素、头孢菌素、庆大霉素滴注的患者 ,测定蛋白出现假阴性。而且干化学法测定尿中球…     

前列腺癌患者血清miR-221水平与临床特征的关系及诊断价值

目的探讨前列腺癌患者血清miR-221水平与临床特征的关系及诊断价值。方法选择118例前列腺癌患者、30例健康体检者和30例良性前列腺增生（BPH）患者为研究对象。采用RT-PCR法检测并比较3组对象血清miR-221相对表达量,分析前列腺癌患者血清miR-221相对表达量与临床特征的关系以及与血清前列腺特异抗原（PSA）水平的相关性;绘制ROC曲线分析血清miR-221相对表达量对前列腺癌的诊断价值。结果前列腺癌组、BPH组和健康组血清miR-221相对表达量分别为0.57±0.09、0.19±0.03和0.27±0.05,差异有统计学意义（P＜0.05）。不同血清PSA水平、Gleason评分、病理分期、临床分期的前列腺癌患者血清miR-221相对表达量比较,差异均有统计学意义（均P＜0.05）。前列腺癌患者血清miR-221相对表达量与血清PSA水平呈正相关（r=0.47,P＜0.05）。血清miR-221相对表达量诊断前列腺癌的AUC为0.738（95%CI：0.714~0.885,P＜0.01）;截断值为0.577时,血清miR-221相对表达量诊断前列腺癌的灵敏度为0.786,特异度为0.645。结论前列腺癌患者血清miR-221表达明显升高,与其临床特征密切相关。血清miR-221高表达对前列腺癌具有一定的诊断价值。     

合并前列腺炎的前列腺增生组织中COX-2、VEGF的表达

Objectives To study the expressions of Vascular endothelial growth factor ( VEGF) and cyclooxygenase-2 in benign prostatic hyperplasia combined with Prostatitis,analyze their correlation and to investigate the effect and molecular mechanism of prostatitis on BPH.Methods 60 specimens were obtained from patients undergoing transurethral prostatic resection(TURP).The paraffin section of the specimens were stained with hematoxylin and eosin,and observed under light microscope to examine the inflammation pathological changes.Depending on whether the benign prostatic hyperplasia combined with prostatitis,those specimens were divided into group of simple benign prostatic hyperplasia ( A group) and group of benign prostatic hyperplasia combined with prostatitis ( B group),using inununohistochemistry and Real-time fluorescence quantitative PCR ( RT-PCR) to detect the expressions of COX-2 and VEGF in prostate tissues.Results (1) immunohistochemical staining: COX-2 and VEGF expressed in the A group and B group,but in the B group of tissues were significantly higher than A group of tissues( p <0.05); COX-2 and VEGF expression in the B group of organizations had a positive correlation ( R = 0.92,p <0.05) (2) COX-2 mRNA in the A group,the relative ratio; 0.141 ± 0.019,in the B group,the relative ratio: 0.161 ± 0.013;VEGF mRNA in the A group relative ratio: 0.2S4 ± 0.015,in the B group,the relative ratio; 0.341 ± 0.012,The expressions of COX-2mRNA and VEGF mRNA in the B group were significantly higher than the expressions of A group ( p <0.05) .Conclusions The inflammatory factor COX-2 and proliferative factor VEGF in the tissues of benign prostatic hyperplasia combined with prostatitis are significantly increased and the expression levels of both positive correlation,COX-2 by the way of up-regulating VEGF expression may be involved in the development process of benign prostatic hyperplasia.     

不同手术方案治疗高危良性前列腺增生症患者的疗效对比研究

目的比较经尿道前列腺电切除术(TURP)、经尿道前列腺剜除术(TUEP)、经尿道选择性绿激光前列腺汽化术(PVP)、经尿道前列腺等离子剜除术(TUPKEP)、经尿道前列腺等离子切除术(TUPKRP)5种手术方法治疗高危患者良性前列腺增生症(BPH)疗效。方法选取2016年4月至2017年5月杭州市富阳区第一人民医院诊治的263例高危BPH患者作为研究对象。根据手术方法,将患者分为五组,其中TURP组56例,TUEP组52例,PVP组54例,TUPKEP组51例,TUPKRP组50例。记录患者术中、术后指标手术时间(T1)、术中出血量(AB)、术后膀胱冲洗时间(T2)、术后留置导尿管时间(T3)、前列腺体体积(PV)和术后住院时间(T4)并发症情况;记录患者术前、术后3个月的最大尿流率(Q_(max))、残余尿量(PVR)、国际前列腺状态评分(IPSS)和生活质量评分(QOL)。结果 PVP组T1、AB、T3、T4较TURP组、TUPKRP组、TUEP组、TUPKEP组均显著降低,差异具有统计学意义(P0.05);TUPKEP组T1、AB、T2、T3、T4较TURP组、TUPKRP组、TUEP组均显著降低,差异具有统计学意义(P0.05);TUEP组AB、T2、T3、T4较TURP组均显著降低,差异具有统计学意义(P0.05),较TUPKRP组显著升高,差异具有统计学意义(P0.05);TUPKRP组AB、T2、T3、T4较TURP组均显著降低,差异具有统计学意义(P0.05)。术前五组IPSS、Q_(max)、PV、PVR、QOL比较无差异(P0.05),术后3个月五组组间IPSS、Q_(max)、PV、PVR、QOL比较差异无统计学意义(P0.05),IPSS、Q_(max)、PV、PVR、QOL均较手术前有显著改善,差异具有统计学意义(P0.05);五组组间术后各并发症发生率比较差异无统计学意义(P0.05);各组随访期间无复发。结论 TURP、TUPKRP、TUEP、TUPKEP、PVP治疗高危BPH有效性及并发症发生率无显著差异,TUPKRP、TUEP、TUPKEP、PVP安全性均高于TURP,以PVP最优。     

浅谈档案信息电子化

随着办公自动化、无纸化等事物的出现，使档案的生成方式发生了很大变化，诸如文件的起草、签发、催办、归档等运作过程在计算机和通讯线路中进行，这样档案的前身必须以机读文件为主要形态，那么档案也自然以机读形式存在，这些档案的利用方式与纸质载体档案的利用方式有很大差异，这种变化预示着档案工作者将面对更多的机读形式以磁盘为载体的档案。     

不同引流术急诊处理输尿管结石梗阻合并尿脓毒血症的比较

目的比较2种不同引流术急诊处理输尿管结石梗阻合并脓毒血症的有效性及安全性。方法 2003年3月～2011年3月52例输尿管结石梗阻合并尿脓毒血症,27例采用输尿管镜直视下逆行置入双J管引流术(输尿管镜组),25例采用B超引导下经皮肾穿刺造瘘术治疗(经皮肾组)。结果输尿管镜组由6名不同级别术者完成,经皮肾组由2名高级别术者完成。输尿管镜组置管引流成功率(100%)明显高于经皮肾组(21/25,84.0%)(Fisher’s检验,P=0.047);2组术后尿脓毒血症控制时间无统计学差异[(6.5±1.2)d vs.(6.4±1.2)d,t=0.300,P=0.765];2组无输尿管穿孔、大出血及死亡等严重并发症。结论输尿管镜直视下逆行置入双J管引流术和经皮肾穿刺造瘘术均为急诊处理输尿管结石梗阻合并尿脓毒血症安全有效的方法;输尿管镜直视下逆行置入双J管引流术置管成功率更高;对于超声技术不熟练的术者和患肾轻度积水的患者,推荐首选输尿管镜手术。     

合并前列腺炎的前列腺增生组织中COX-2、VEGF的表达

Objectives To study the expressions of Vascular endothelial growth factor ( VEGF) and cyclooxygenase-2 in benign prostatic hyperplasia combined with Prostatitis,analyze their correlation and to investigate the effect and molecular mechanism of prostatitis on BPH.Methods 60 specimens were obtained from patients undergoing transurethral prostatic resection(TURP).The paraffin section of the specimens were stained with hematoxylin and eosin,and observed under light microscope to examine the inflammation pathological changes.Depending on whether the benign prostatic hyperplasia combined with prostatitis,those specimens were divided into group of simple benign prostatic hyperplasia ( A group) and group of benign prostatic hyperplasia combined with prostatitis ( B group),using inununohistochemistry and Real-time fluorescence quantitative PCR ( RT-PCR) to detect the expressions of COX-2 and VEGF in prostate tissues.Results (1) immunohistochemical staining: COX-2 and VEGF expressed in the A group and B group,but in the B group of tissues were significantly higher than A group of tissues( p <0.05); COX-2 and VEGF expression in the B group of organizations had a positive correlation ( R = 0.92,p <0.05) (2) COX-2 mRNA in the A group,the relative ratio; 0.141 ± 0.019,in the B group,the relative ratio: 0.161 ± 0.013;VEGF mRNA in the A group relative ratio: 0.2S4 ± 0.015,in the B group,the relative ratio; 0.341 ± 0.012,The expressions of COX-2mRNA and VEGF mRNA in the B group were significantly higher than the expressions of A group ( p <0.05) .Conclusions The inflammatory factor COX-2 and proliferative factor VEGF in the tissues of benign prostatic hyperplasia combined with prostatitis are significantly increased and the expression levels of both positive correlation,COX-2 by the way of up-regulating VEGF expression may be involved in the development process of benign prostatic hyperplasia.     

VEGF和前列腺增生的研究进展

血管内皮生长因子(vascular endothelial growth facor,VEGF)是一类能促进内皮细胞分裂增殖、促进新生血管的形成、提高血管通透性的生长因子.它与细胞表面的血管内皮生长因子受体结合,通过激活酪氨酸激酶信号转导途径发挥功能.血管内皮生长因子可通过增加新生血管的生成和血管的通透性来促进前列腺的增生.目前,国内外已进行过很多的相关研究,现给予简要综述.