Objective To observe the change of bladder compliance and bladder interstitial cells of Cajal (ICCs) post-suprasacral spinal cord transection at different time points in rats and the effect of Imatinib mesylate on the complicance of neurogenic bladder caused by long-term suprasacral spinal cord transaction in rats.Methods One hundred and two female Wistar rats were randomly divided into 6 groups:group A (sham group of 6 weeks);group B (suprasacral spinal cord transaction group of 6 weeks);group C and group E (sham group of 12 weeks);group D and group F (suprasacral spinal cord transaction group of 12 weeks).The rats in groups A to D were used to study the change of bladder compliance and bladder ICCs post-suprasacral spinal cord transection at different time points.The rats in group E and group F were used to study the effect of Imatinib mesylate on the complicance of neurogenic bladder caused by long-term suprasacral spinal cord transaction.Spinal cord transection at T10 level was built in spinal cord transaction groups,while group A,group C and group F underwent sham operaion.Urodynamics was detected at 6th or 12th week after surgery.We observed the changes of ICCs in the bladder wall by immunohistochemistry.Urodynamics was also detected in group E and group F post-surgery 12 weeks before and after intravenous administration of Imatinib mesylate (5 μmol and 20 μmol respectively).Results The bladder compliance was significantly increased [(0.146 ±0.107) ml/cmH2O vs.(0.066 ± 0.019) ml/cmH2O,P=0.017] and the number of ICCs was significantly decreased [(3.180 ± 1.976)vs.(4.920 ± 1.564),P=0.014] in group B as compared with group A.The bladder compliance was significantly lower [(0.046 ± 0.023) ml/cmH2O vs.(0.063 ± 0.013) ml/cmH2O] and the number of ICCs was significantly higher [(7.710 ±2.024) vs.(4.750 ± 1.138),P =0.000] in group D than in group C.The bladder compliance in group E was increased by intravenous administration of 20 μmol Imatinib mesylate [from (0.070 ± 0.029) ml/cmH2O to (0.096 ± 0.036) ml/cmH2O].It increased the bladder compliance of group F in a dose-dependent manner.The bladder compliance in group F was increased by 5 μmol and 20 μmol Imatinib mesylate from (0.047 ±0.021) ml/cmH2O to (0.065 ±0.019) ml/cmH2O and (0.077 ±0.019) ml/cmH2O respectively,P =0.000.Conclusion The bladder compliance was increased first,then decreased and the number of ICCs changed adversely in the T10 spinal cord transection rats.The bladder compliance of the rats at 12th week post-suprasacral spinal cord transection could be improved by inhibiting the ICCs function.Not only the fibrosis,but also the number of ICCs of the bladder wall increased might be the pathological basis of the reduced bladder compliance in suprasacral spinal cord transaction rats.

Objective To observe the bladder compliance and morphological changes in rats post-suprasacral spinal cord transection at different time points.Methods Seventy-two female Wistar rats were randomly divided into four groups:group A (sham group of 6 weeks);group B (suprasacral spinal cord transaction group of 6 weeks),group C (sham group of 12 weeks),and group D (suprasacral spinal cord transaction group of 12 weeks).Spinal cord transection at T10 level was done in spinal cord transaction groups,while group A and group C underwent sham operaion.Urodynamics was detected at 6th or 12th week after surgery.The changes of smooth muscle,collagen and elastic fibers ratio in the area of bladder wall were observed by hematoxylin-eosin (HE) staining and Verhoeff-Van Gieson staining.Results The rats in spinal cord transaction groups had motor and voiding dysfunction.The bladder compliance in group B was significantly higher than in group A (P ＜0.05).The bladder compliance in group D was significantly lower than in group C (P ＜ 0.05).The morphologic changes of the bladder wall in spinal cord injury groups,including the muscle fibers arranged at random and the increased collagen were aggravated with time.As compared with group B,the bladder compliance in group D was significantly decreased [(0.046±0.023) ml/cmH20 vs.(0.146 ±0.107) ml/cmH2O (1 cmH2O =0.098 kPa),P＜0.01],the proportion of detrusor cross-sectional area was significant decreased [(46.137 ± 4.085)％ vs.(55,260 ± 6.873)％,P＜ 0.01],and the proportion of collagen fibers was significantly increased [(19.757 ± 2.071) ％ vs.(11.104 ± 1.125) ％,P ＜ 0.01].Conclusion The bladder compliance in the T10 spinal cord injury rats was increased first,then decreased.The fibrosis of the bladder wall,especially the proportion of collagen fibers was increased,which might be the pathological basis of the reduced bladder compliance.

目的:探讨肾脏滑膜肉瘤的临床表现、病理特点、诊断、鉴别诊断及治疗方法.方法:结合相关文献,回顾性分析1例转移性肾脏滑膜肉瘤患者的资料,女,49岁,因突发右腰腹部剧烈疼痛18h入院.B超及CT检查发现右肾上极囊实性占位,直径约12 cm,考虑右肾肿瘤破裂出血,肾动脉栓塞后在全麻下行经腹腔根治性右肾切除术,术中见右肾上极肿物与周围脏器粘连,右肾静脉未见瘤栓,切除整个右肾及肿物.结果:肿物标本大体观:肾门偏上可见一12.8 cm×11.2 cm囊壁,囊内充满灰白色、鱼肉状组织;光镜下肿瘤由丰富的单向梭形细胞组成,未见上皮分化成份,肿瘤细胞成束状或片状排列,瘤细胞中等大小,较肥胖,细胞界线不清,核呈卵圆形或杆状,可见核仁,有大量核分裂象,伴发大量出血坏死;免疫组化:EMA(+),Vimentin(+),Inhinbin-α(+),CD99(+),Bcl-2(+);CK、CGA、Nse、Desmin、CD117、CD34均阴性.支持肾脏滑膜肉瘤.结合患者滑膜肉瘤多次手术史及曾通过RT-PCR方法检测出SYT-SSX融合基因mRNA表达,诊断为转移性肾滑膜肉瘤.未行进一步治疗,术后2个月死于癌转移.结论:转移性肾脏滑膜肉瘤极为罕见,高度恶性,预后极差.术前确诊困难,确诊主要依靠既往病史,病理检查,免疫组化染色,必要时可行分子生物学诊断.治疗上首选外科手术,术后需辅助进一步化疗或放疗.