This article reviewed the recent advances in the research of noninvasive diagnostic methods for bladder outlet obstruction. Penile cuff test, detrusor wall thickness, ultrasound-estimated bladder weight and near-spectroscopy showed a promising diagnostic results. However, more rigorous and higher level clinical trials with larger sample size are needed to validate the diagnostic value of these tests.
Objective: To analyze the clinical features and spinal lesions related to micturitionin of chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS) patients. Methods: Patients with CP/CPPS were enrolled to this study at the outpatient department of Tongji Hospital between January and June 2019. The data of clinical features was collected and analyzed, including lower urinary tract symptoms(LUTS), bowel syndrome and pain over different parts of body, as well as lower urinary tract dysfunction, spinal lesions and pelvic organ morphological changes demonstrated by MRI. The potential role of spinal lesions in the development of CP/CPPS syndrome was investigated. Results: A total of 126 CP/CPPS patients were included, with an age[M(Q1,Q3)]of 41(31,53) years and a course of disease of 2(1,20) years. Among them, 126 (100.0%) were complicated with LUTS, 72(57.1%) with bowel dysfunction and 88(69.8%) with pain. MRI showed the cervical central disc herniation(126 cases, 100.0%), the ischemic changing in the cervical area of visceral efferant pathway(82 cases, 65.1%), the lumbar central disc herniation(65 cases, 51.6%), and the sacral nerve cysts(97 cases, 77.0%) are commonly seen. In addition, the morphological changes in the visceral organs containing smooth muscle were demonstrated, including thickened bladder wall(91 cases, 72.2%), distended seminal vesicles(70 cases, 55.6%) and distended sigmoid colon/rectum(59 cases, 46.8%). Conclusions: CP/CPPS patients were characterized by the co-existence of LUTS, bowel dysfunction and somatic pain in one individual. The presence of multi-organ symptoms, combined with the high prevalence of spinal lesions associated with micturition reflex, suggesting the potential role of the spinal lesions in the development of CP/CPPS.
当我们需要添置一新衣服时,最合身的衣服当然是定制的,但定制要花费的时间和金钱成本使普通大众很少采用这种方式.不过,对于那些身材特殊或有特别讲究又比较有钱的人来说,定制往往成为他们的选择.这实际上折射出了标准化与个性化之间的关系和各自的针对性.实际上,无论是生产还是服务,在大家越来越强调标准化的同时,个性化也成为企业赢得竞争优势的杀手锏.下面我们以人们经常接触到的饭店企业为例,来探讨标准化和个性化的关系及如何有针对性地实施个性化服务.