目的 探讨采用经腹超声测量的膀胱内前列腺突出度(IPP)与膀胱出口梗阻(BOO)相关性及其可否预测BOO.方法 选择2019年11月—2021年10月在本院住院诊断为前列腺增生,并接受尿动力学检查的101例患者作为研究对象,按照不同的IPP长度分为Ⅰ组、Ⅱ组和Ⅲ组三组,Ⅰ组38例、Ⅱ组42例、Ⅲ组21例.分析三组患者前列腺症状IPSS评分、生活质量QOL评分、前列腺体积(PV)及最大尿流率(Qmax)、膀胱残余尿(PVR)、最大尿流率时逼尿肌收缩力(Pdet.Qmax)、BOO程度、膀胱出口梗阻指数(BOOI)的差异.运用相关分析计算IPP与BOOI的相关性.运用受试者工作特征曲线(ROC)计算曲线下面积(AUC),并计算IPP预测BOO的敏感度及特异度.结果 三组患者的随着IPP长度的增加,IPSS评分、QOL评分、前列腺体积(PV)也随之增加,差异有统计学意义(P<0.05);三组患者的随着IPP长度的增加,膀胱残余尿(PVR)、BOO程度、膀胱出口梗阻指数(BOOI)、最大尿流率时逼尿肌收缩力(Pdet.Qmax)也随之增加,差异有统计学意义(P<0.05);三组患者的随着IPP长度的增加,最大尿流率(Qmax)随之减少,差异有统计学意义(P<0.05).相关分析显示IPP与BOO呈正相关(γ=0.690,P<0.05).以IPP≥11 mm作为判断膀胱出口梗阻的标准,曲线下面积为0.745,其敏感性及特异性较高.结论 IPP与膀胱出口梗阻在尿动力学方面具有相关性.经腹超声测量IPP是一种有价值的评价BPH患者膀胱出口梗阻状态及程度的无创性方法.

该研究探讨了苏氨酸和酪氨酸激酶(threonine and tyrosine kinase,TTK)在膀胱癌中的表达情况及其在膀胱癌细胞增殖、凋亡、侵袭及迁移中的作用.采用qRT-PCR和免疫组织化学分别检测TTK mRNA和蛋白在癌旁正常组织、非肌层浸润性膀胱癌组织、肌层浸润性膀胱癌组织中的表达水平;将TTK过表达质粒、TT敲除质粒借助脂质体分别稳定转染膀胱癌HT-1376细胞;用qRT-PCR和Western blot检测转染后TTK mRNA和蛋白的表达情况;应用CCK法和EdU方法检测细胞增殖活性;流式细胞术检测细胞周期分布及凋亡情况;transwell小室法检测细胞侵袭、迁移能力.结果 显示:TTK mRNA和蛋白在癌旁正常组织、非肌层浸润性膀胱癌组织、肌层浸润性膀胱癌组织中的表达水平逐渐升高,3者之间差异有统计学意义(P＜0.05);过表达TTK后,HT-1376细胞增殖能力增强,细胞凋亡减少,细胞体外侵袭和迁移能力增强;而敲除TTK后,HT-1376细胞生长受抑制,细胞周期阻滞在G0/G1期,细胞凋亡率增加,细胞体外侵袭和迁移能力减弱.该研究结果提示,TTK的表达与膀胱癌的发生、发展有关;TTK能促进膀胱癌HT-1376细胞的增殖、侵袭、迁移,并抑制细胞凋亡.

原发性睾丸淋巴瘤是临床上少见的睾丸恶性肿瘤,弥漫性大B细胞淋巴瘤是睾丸淋巴瘤最常见的一种病理类型[1-2],其主要的临床表现为无痛性睾丸肿大,少数表现为阴囊下坠感、阴囊肿痛等,部分合并有睾丸鞘膜积液、附睾囊肿等,单侧发病多见,但有学者发现,部分患者对侧临床上未受累的睾丸发现单克隆淋巴细胞[1].部分患者还表现为典型的B淋巴细胞瘤症状,如发热、盗汗、体重减轻等.现就我院诊治1例介绍如下.

目的 研究经尿道前列腺等离子双极电切用于前列腺增生治疗的意义.方法 将2014年1月至2016年2月在本院接受治疗的前列腺增生患者130例作为研究对象,根据随机数字表法将上述前列腺增生患者分为两组,分别为改良组66例和传统组64例.传统组给予经尿道前列腺电切术治疗;改良组采取经尿道前列腺等离子双极电切治疗.观察两组患者手术操作时间、术后膀胱冲洗时间、留置尿管时间、血红蛋白、术前术后生活质量、最大尿流率、前列腺症状评分和尿道狭窄等并发症发生率,并进行分析比较.结果 改良组尿道狭窄等并发症发生率低于传统组(P<0.05);改良组患者留置尿管时间与传统组比较无显著差异(P>0.05);改良组患者手术操作时间、术后膀胱冲洗时间、血红蛋白均优于传统组(P<0.05);两组患者术前生活质量、最大尿流率、前列腺症状评分无显著差异(P>0.05);术后改良组生活质量、最大尿流率、前列腺症状评分明显优于传统组(P<0.05).结论 经尿道前列腺等离子双极电切用于前列腺增生治疗的效果确切,可有效改善患者临床症状,手术操作简单,术后并发症少,恢复快,可有效改善患者生活质量,值得推广.

Objective:To evaluate the clinical efficacy of ureteroscopic holmium laser lithotripsy in the treatment of acute renal failure due to ureteral stones obstruction.Method:30 patients with acute renal failure caused by ureteral stones obstruction were treated with transurethral ureteroscopic holmium laser lithotripsy.Result:The obstruction of 30 cases were released completely.Renal function return to normal or near normal after treatment,blood urea nitrogen and creatinine are back to normal or near normal,urine volume of patients return to normal.Successful lithotripsy were made in 28 cases immediately.Few residual stones were founded in the renal pelvis in 2 case.The residual stones were spontaneously expelled after extracorporeal shock wave lithotripsy(ESWL).Conclusion:Ureteroscopic holmium laser lithotripsy is a minimally invasive,safe and effective treatment methods for acute renal failure due to ureteral stones obstruction.

Objective:To analyze the relationship between intravesical protrusion prostate and overactive bladder in patients with benign prostatic hyperplasia.Method:The clinical data of 128 patients with BPH in our hospital from January 2014 to February 2015 were analyzed retrospectively.They were divided into 3 groups according to IPP,analyzed the differences between IPP and age,IPSS,QOL score,prostate volume,Qmax,RUV,the occurrence rate of OAB .The correlation between IPP and OAB were analyzed by the multiple linear regression.Result:The age and QOL score had no statistical differences in different groups(P>0.05).The IPSS,Prostate volume,RUV,PSA,Qmax,the occurrence rate of OAB in different groups had statistical differences(P<0.05).IPP showed a positive correlation with OAB used by the multiple linear regression analysis(P<0.05).Conclusion:There is a significant correlation between IPP which reflects anatomical changes in the prostate and OAB in patients with benign prostatic hyperplasia.

Objective To discuss the influence of histological prostatitis (HP)on urodynamic parameters and urinary retention in patients with benign prostatic hyperplasia (BPH ). Methods 98 patients who underwent bipolar transurethral plasmakinetic prostatectomy (TUPKP)due to BPH were retrospectively reviewed and divided into two groups,BPH group and BPH with HP group,based on pathological characteristics of tissue samples. The International prostate symptom score(IPSS),prostate volume(PV),PSA level and urodynamic features including maximum urine flow,maximum bladder capacity, maximum detrusor contractility and bladder outlet obstruction index(BOOI)were compared between the&nbsp;two groups. The occurrence rate of involuntary detrusor contractions and urinary retention were analyzed in both groups. Results Patients in BPH with HP group presented significant higher IPSS total scores (P =0.020),higher PSA level(P =0.009),higher bladder outlet obstruction index (P =0.003)and lower maximum bladder capacity(P =0.004)than the patients in BPH group. Patients in BPH with HP group showed a higher occurrence rate of involuntary detrusor contraction(P =0.041)and urinary retention than that in the other group(P =0.010). Conclusion The occurrence of HP is associated with severer lower urinary tract symptoms,higher PSA level,urodynamic parameters changes such as lower maximum blad-der capacity,severer bladder outlet obstruction,higher proportion of detrusor over activity and urinary re-tention in patients with BPH.

目的:探讨输尿管镜联合钬激光治疗原发性输尿管息肉的疗效。方法:应用输尿管镜联合钬激光治疗原发性输尿管息肉25例。结果:术后21例随访3个月~8 a,肾积水消失或好转,18例息肉无复发或恶变,3例复发。结论:输尿管镜联合钬激光碎石治疗原发性输尿管息肉,是一种微创、安全而有效的治疗方法。