Effect of partial and complete blockade of vanilloid (TRPV1-6) and ankyrin (TRPA1) transient receptor potential ion channels on urinary bladder motor activity in an experimental hyperosmolar overactive bladder rat model

The study investigated the mechanisms through which the hyperosmolarity might induce detrusor overactivity (DO). We compared the bladder activity in response to partial and complete blockade of TRPV1-6 and TRPA1 receptors. Experiments were performed on 42 rats. DO was induced by using hyperosmolar saline. All animals were randomly divided into six groups. The measurements represent the average of five bladder micturition cycles. Hyperosmolar saline induced DO. The complete blockade of TRPV1-6 and TRPA1 prevented DO. The partial blockade of TRPV1 didn't prevented DO. In the voiding phase periodical bladder contractions complexes occurred leading to slow urine flow due to bladder distension. Ruthenium red and capsaicin resulted in complete disorganisation of detrusor muscle contractility impairing urine voiding and leading to constantly lasting urine retention in healthy rats. Conclusions: hyperosmolar-induced DO is mediated by TRPV and TRPA1 channels; the hyperosmolar stimuli of urinary bladder might be transmitted mostly via ruthenium red sensitivity pathway.     

Urethral plugs and urine retention in male mice

Because MM male mice suffer from a high incidence of urinary tract infection, an assessment was made as to whether the urethral plugs, which occur in male rodents, might be involved in its aetiology. When killed, males more commonly retained urine in their bladders than females but there was no significant difference between strains or method of killing. Males also voided urine more often during stressful handling followed by abdominal pressure, but also retained some urine more often than females. The study of sexually immature mice demonstrated no sex differences and no urine was retained in any bladder. It was concluded that the high frequency of urine retention in mature males is attributable to the presence of urethral plugs but these could not be implicated in the cause of MM urinary tract infection because of comparable findings in the controls. However, the possibility was considered that the plugs might facilitate infection of the kidneys once a bladder infection had become established.     

Association Among Sources Exposure of Cadmium in the Adult Non-smoking General Population of Tehran

Acute and chronic exposure to cadmium can cause numerous health effects including poisoning, as well as, bone, liver, and kidney diseases. Cadmium competes with iron absorption in blood and can induce anemia. Cadmium body burden can be measured through urine and blood samples. Urine reflects chronic and blood indicates recent and cumulative exposures to cadmium. Dietary is considered as the main source of exposure to cadmium in non-smoking general population. The study was conducted to determine cadmium level in blood, urine, and in diet of 120 non-smoking adults in Tehran. Dietary components and consumption pattern of participants estimated by a food frequency questionnaire. Next, the correlation investigated between them. Moreover, serum ferritin measured as a marker of iron storage in blood to determine its association with cadmium. The prediction of cadmium fate in the body is determined by toxicokinetic models. This study tried to evaluate one of these models’ validity which is developed to predict urinary cadmium from dietary. Afterwards, the predicted urinary compared with the measured urinary cadmium. The correlation coefficient between dietary and blood cadmium equaled 0.66 which was statically significant, but the correlation between dietary and urinary cadmium was minimal and not statically significant (p > 0.05). An inverse and negative correlation was found between serum ferritin and blood cadmium. The mean predicted urinary cadmium calculated by the model was 2.5-fold higher than the measured value in the total population. Results of the present study revealed that blood cadmium reflected mainly acute exposure. There was no correlation between chronic and acute exposures to cadmium. The low serum ferritin level increased cadmium amount in blood. Moreover, the mean predicted urinary cadmium by the model was greater than the measured value. It can because of characteristics of populations and type of dietary exposure. Thus, it is suggested that the model coefficients are determined in each society based on their characteristics.

     

Crede手法联合凯格尔运动对产后尿潴留产妇膀胱功能、盆底肌力及生活质量的影响

摘要 目的：观察Crede手法联合凯格尔运动对产后尿潴留产妇膀胱功能、盆底肌力及生活质量的影响。方法：选择2021年3月~2022年3月期间我院收治的产后尿潴留产妇92例,按照随机数字表法分为对照组（凯格尔运动,n=46）和研究组（Crede手法联合凯格尔运动,n=46）。对比两组临床疗效、膀胱功能、盆底肌力、临床指标及生活质量变化情况。结果：与对照组（73.91%）相比,研究组（93.48%）的临床总有效率更高（P<0.05）。干预4周后,研究组膀胱初感容积、最大膀胱容量、最大尿流率均高于对照组（P<0.05）。干预4周后,研究组0~2级例数低于对照组,3级及其以上例数高于对照组（P<0.05）。干预4周后,研究组健康调查量表（SF-36）各维度评分均高于对照组（P<0.05）。研究组的残余尿量少于对照组,首次排尿时间短于对照组（P<0.05）。结论：Crede手法联合凯格尔运动应用于产后尿潴留产妇,可促进膀胱功能、盆底肌力恢复,提高产妇生活质量,具有较好的临床应用价值。     

中医多途径综合疗法治疗宫颈癌术后尿潴留的临床效果评价

目的:评价中医多途径综合疗法治疗宫颈癌术后尿潴留的临床效果和安全性。方法:选择2013年12月至2016年9月我院收治的60例宫颈癌术后出现尿潴留症状的患者,按其意愿将其分为对照组(30例)与研究组(30例),对照组接受水流声诱导、盆底肌锻炼等常规治疗方法,研究组在对照组基础上加以中医多途径综合疗法,比较两组治疗前后中医症状症状积分、自主排尿功能恢复时间、膀胱残余尿量、尿路感染率等情况。结果:治疗前,两组排尿无力、小腹坠胀、倦怠乏力、腰膝酸软积分比较差异均无统计学意义(P0.05);治疗后,两组以上指标均较治疗前明显降低,且研究组小腹胀痛、倦怠乏力积分均明显低于对照组,差异具有统计学意义(P0.05);研究组自主排尿功能恢复时间、膀胱残余尿量均明显低于对照组,差异具有统计学意义(P0.05);研究组尿路感染率为6.78%,明显低于对照组(23.33%),差异具有统计学意义(P0.05)。结论:中医多途径综合疗法治疗宫颈癌术后尿潴留的疗效肯定,可明显缩短病程,并降低尿路感染发生率。     

Seasonal Variation in the Occurrence of Acute Urinary Retention

Objective: To determine whether acute urinary retention shows a seasonal variation. Methods: All acute urinary retentions observed in the emergency room of St. Anna Hospital, Ferrara, along an eight-year period (1991–1998) were considered. Diagnosis was made on the basis of history, physical examination, and bladder drainer by insertion of a catheter with registration of the retained urinary volume. The main determining cause of the acute urinary retention event was tentatively determined. Month and day of each event were categorized both by seasons and monthly intervals. For statistical analysis chi-square test for goodness of fit and partial Fourier series were used. Results: 1,133 acute urinary retention events were observed in 929 different subjects (871 males, 58 females). In 738 cases it was possible to define the main determining cause of the event. The seasonal distribution showed a higher frequency peak of events in summer and autumn both for total population and males subgroup. Analysis by determining cause of the event demonstrated a greater frequency of events in summer only in patients with prostatic hypertrophy. Chronobiologic evaluation showed a circannual pattern for acute urinary retention, both for total sample and male subgroup, with a significant peak in late summer (August–September). Analysis by main determining cause revealed a similar circannual pattern only for cases of acute urinary retention determined by prostatic hypertrophy. Conclusions: The present study shows that acute urinary retention exhibits a circannual distribution in its occurrence, particularly when caused by prostatic hypertrophy.     

Seasonal Variation in the Occurrence of Acute Urinary Retention

Objective: To determine whether acute urinary retention shows a seasonal variation.

Methods: All acute urinary retentions observed in the emergency room of St. Anna Hospital, Ferrara, along an eight-year period (1991-1998) were considered. Diagnosis was made on the basis of history, physical examination, and bladder drainer by insertion of a catheter with registration of the retained urinary volume. The main determining cause of the acute urinary retention event was tentatively determined. Month and day of each event were categorized both by seasons and monthly intervals. For statistical analysis chi-square test for goodness of fit and partial Fourier series were used.

Results: 1,133 acute urinary retention events were observed in 929 different subjects (871 males, 58 females). In 738 cases it was possible to define the main determining cause of the event. The seasonal distribution showed a higher frequency peak of events in summer and autumn both for total population and males subgroup. Analysis by determining cause of the event demonstrated a greater frequency of events in summer only in patients with prostatic hypertrophy. Chronobiologic evaluation showed a circannual pattern for acute urinary retention, both for total sample and male subgroup, with a significant peak in late summer (August-September). Analysis by main determining cause revealed a similar circannual pattern only for cases of acute urinary retention determined by prostatic hypertrophy.

Conclusions: The present study shows that acute urinary retention exhibits a circannual distribution in its occurrence, particularly when caused by prostatic hypertrophy.     

低频电刺激联合间歇导尿及Motomed运动训练对脊髓损伤致神经源性膀胱患者膀胱内压力及膀胱容量的影响

目的:探讨低频电刺激联合间歇导尿及Motomed运动训练对脊髓损伤致神经源性膀胱患者膀胱内压力及膀胱容量的影响。方法:选取我院2015年12月～2018年2月收治的脊髓损伤致神经源性膀胱患者92例,根据随机数字表法将其分为对照组(n=46)与研究组(n=46)。两组均给予间歇性导尿、盆底肌训练、膀胱功能训练等常规干预,对照组在此基础上采取低频电刺激,研究组于对照组基础上采取Motomed运动训练,两组均干预2个月。比较两组的临床疗效、治疗前及治疗2个月后的排尿情况(日均单次排尿量、日单次最大排尿量、日均排尿次数)、尿动力学情况(最大尿流率、膀胱容量、残余尿量、膀胱内压力)、LUTS(国际下尿路症状评分)及USDS(泌尿症状困扰评分)。结果:治疗后,研究组总有效率(93.48%)显著高于对照组(78.26%)(P0.05);治疗2个月后,两组日均单次排尿量、日单次最大排尿量、日均排尿次数、最大尿流率、膀胱容量、膀胱内压力均较治疗前显著增多,且研究组以上指标均明显高于对照组(P0.05);两组LUTS及USDS分值均较治疗前显著降低,且研究组以上指标均显著低于对照组(P0.05)。结论:间歇导尿联合低频电刺激与Motomed运动训练可有效改善脊髓损伤致神经源性膀胱患者尿动力学状态及排尿情况,增大膀胱容量及膀胱内压力等,缓解下尿路症状及泌尿症状困扰程度,提高治疗效果。     

Primary malignant melanoma of the urinary bladder diagnosed by urine cytology: a case report

BACKGROUND: Primary melanoma of the urinary bladder is a rare neoplasm, and there have been no prior reports in which the initial diagnosis was made by urinary cytology. CASE: An 82-year-old woman presented with vaginal spotting, gross hematuria and dysuria. Voided urine cytology revealed malignant cells, several of which exhibited cytoplasmic melanin pigment and were accompanied by many macrophages also containing melanin. Cystoscopy revealed a darkly pigmented, polypoid mass at the bladder neck. Biopsy confirmed the diagnosis. CONCLUSION: Primary melanoma of the urinary bladder is rare. The diagnosis can be made on cytologic examination of voided urine if careful study of exfoliated malignant cells reveals cytoplasmic melanin pigment. Macrophages may also harbor melanin pigment, and their presence should alert the cytopathologist to search carefully for pigmented malignant cells. Clinical and radiologic studies are essential to rule out melanoma metastatic to the bladder.     

尿液蛋白质组在膀胱癌临床诊治中的应用

膀胱癌是一种常见的泌尿系统疾病,尿细胞学检查与膀胱镜检查是膀胱癌的主要临床诊断手段,但尿细胞学检查敏感性较差,膀胱镜检查为侵入性检查,易给病人带来强烈的不适感;且膀胱癌具有易复发的特点,大部分患者必须面临频繁的检查,临床亟需发展舒适、准确的检查手段.尿液存储是膀胱的主要生理作用,尿液可以直接接触肿瘤实体,肿瘤分泌的一些蛋白质分子极可能进入尿液中,并且患者尿液样本便于足量多次收集.同时,蛋白质组技术以及尿液蛋白质组研究的快速发展,为我们利用尿液研究膀胱癌提供了便利的途径.本文系统总结了尿液蛋白质组研究的主要技术手段,重点关注膀胱癌尿液蛋白质组研究趋势和应用方向,以期为利用尿液蛋白质组研究膀胱癌提供助力.     

Stimulation of ammonium ion excretion in the toad urinary bladder by an extract of human urine.

It is well known that ammonium ion excretion is increased during metabolic acidosis in mammals. The purpose of this study was to determine whether we could isolate from human urine during metabolic acidosis a factor that would stimulate NH+4 and/or H+ excretion in toad urinary bladder. Extracts of urine from six human subjects collected during NH4Cl-induced acidosis were prepared. These extracts were tested for their effect on NH+4 excretion in hemibladders mounted between plastic chambers. The extracts significantly increased NH+4 excretion in the toad urinary bladder. We found no effect on H+ excretion by these extracts. This ammoniuretic activity was not present in the urine when the same individuals were in metabolic alkalosis. We conclude that during metabolic acidosis a humoral factor is present which stimulates the excretion of NH+4. The factor could act as a permease in the bladder cell or as a stimulator of an NH+4 transport system.     

Structure of the urinary bladder in the Pacific cod

The urinary bladder of the Pacific cod,Gadus macrocephalus was investigated. A pair of ureters was found to unite and form a sac-like protrusion on the posteroventral aspect of the gonad. This protrusion was confirmed as the urinary bladder based on its histology and the presence of ammonia and urea in the fluid within this structure. The urinary bladder consisted of a central lumen and two lateral expansions found on the right and left sections. The luminal epithelial cells of the Pacific cod urinary bladder, unlike those of other animals, were characterized by microvilli on the free surface, and the presence of a number of vesicles and mitochondria across the apical portion on the cells. This suggests that the luminal epithelium of the urinary bladder might be actively engaged in transportation of water or other materials from the urine. The Pacific cod urinary bladder may therefore be closely associated with osmoregulation by reabsorbing water from the urine. Ammonia-N and urea-N levels of 65–213 μg/dl and 1.5–3.5 mg/dl were measured in the fluid which filled the urinary bladder.     

Biofeedback-assisted EMG relaxation for urinary retention and incontinence

A 27-year-old woman with chronic urinary retention and incontinence since infancy was treated for 8 months with frontal electromyographic relaxation training. Urinary control and sensations of bladder fullness were obtained for the first time in the patient's history. Residual urine readings showed marked improvement. Application of EMG biofeedback to other bladder disorders is discussed.     

6-Keto-prostaglandin F1 alpha is not added to urine during passage through the rat urinary bladder in vivo

Studies were conducted to determine whether prostaglandins are added to the urine during its passage through the rat urinary bladder in vivo. Control rats and rats with chronic streptozotocin-induced diabetes were anesthetized with Inactin, 100 mg/kg i.p., and urine was collected simultaneously from both kidneys. Urine from the left kidney was collected directly from the renal pelvis via a ureteral cannula, while urine from the right kidney was collected via a cannula in the urinary bladder. Prostaglandins in the urine were measured by radioimmunoassay. No difference in urinary concentration or rate of excretion of 6-keto-PGF1 alpha or PGE2 was seen between ureteral urine and bladder urine from either normal or diabetic rats. The results of this study indicate that in vivo there is no intralumenal addition of either 6-keto-PGF1 alpha or PGE2 to the urine by the ureteral bladder of rats.     

Kidney cell death in inflammation: The role of oxidative stress and mitochondria

Pyelonephritis is an infectious disease, and common treatment strategy is based on antibiotic therapy directed at the elimination of a pathogen. However, urinary tract infections are accompanied by inflammation and oxidative stress, which are major damaging factors, and therefore can serve as a target for therapeutic intervention. The goal of this study was to clarify the role of the mitochondrial reactive oxygen species (ROS) in kidney cell damage under experimental pyelonephritis. We investigated the mechanisms of inflammation and the role of mitochondria and oxidative stress in inflammation in kidney tissue using in vivo and in vitro models of pyelonephritis. We observed the development of oxidative stress in renal tubular epithelium in vitro, and resulting apoptotic cell death. This oxidative damage was caused by the leukocytes producing ROS after interaction with bacterial antigens. The essential role of mitochondria-mediated oxidative stress was confirmed using an experimental model of pyelonephritis in vivo. We revealed increased levels of malonic dialdehyde in kidneys of rats with experimental pyelonephritis that pointed to lipid peroxidation. Besides, high ROS levels were observed in blood leukocytes from rats with pyelonephritis. The mitochondria-targeted antioxidant SkQ1 significantly reduced the signs of kidney inflammatory injury, in particular the infiltration of neutrophils. Summarizing the data obtained, we assume the importance of mitochondrial ROS in different phases of acute pyelonephritis onset. Protection of kidney cells from infection-mediated damage can be attained by the induction of tolerance mechanisms and by antioxidant treatment.     

蛇毒抗菌肽OH-CATH对大肠杆菌引起家兔泌尿系感染的保护作用

为探讨蛇毒抗菌肽OH-CATH对大肠杆菌标准株和临床耐药株引起家兔泌尿系感染的保护作用,该文利用大肠杆菌标准株(E.coli ATCC 25922)和耐头孢菌素大肠杆菌临床耐药株建立雄性家兔泌尿系感染模型.通过膀胱直接给药的方式,分别给予动物感染模型生理盐水、蛇毒抗菌肽OH-CATH及头孢哌酮舒巴坦,并于给药后第1、5、l0及14天留取家兔中段尿用于尿液培养.将动物膀胱标本行H-E染色石蜡切片及透射电镜观察.结果显示:使用蛇毒抗菌肽OH-CATH的大肠杆菌标准株和临床耐药株不同组别中段尿培养阳性率明显降低;给予头孢哌酮舒巴坦可降低大肠杆菌标准株(E.coli ATCC 25922)引起感染的阳性率,但对耐头孢菌素大肠杆菌引起的感染的阳性率则无明显作用(P＜0.05);使用蛇毒抗菌肽OH-CATH组炎症细胞浸润、坏死及钙化组织较其他组为少.该结果提示蛇毒抗菌肽OH-CATH对大肠杆菌标准株(E.coli ATCC 25922)及耐头孢菌素大肠埃希菌临床耐药株有稳定活性,对其引起的家兔泌尿系感染有较好的保护作用,并为临床日益严重的耐药病原菌感染的治疗提供了新的思路和方向.     

Hydration status affects urea transport across rat urothelia

Although mammalian urinary tract epithelium (urothelium) is generally considered impermeable to water and solutes, recent data suggest that urine constituents may be reabsorbed during urinary tract transit and storage. To study water and solute transport across the urothelium in an in vivo rat model, we instilled urine (obtained during various rat hydration conditions) into isolated in situ rat bladders and, after a 1-h dwell, retrieved the urine and measured the differences in urine volume and concentration and total quantity of urine urea nitrogen and creatinine between instilled and retrieved urine in rat groups differing by hydration status. Although urine volume did not change >1.9% in any group, concentration (and quantity) of urine urea nitrogen in retrieved urine fell significantly (indicating reabsorption of urea across bladder urothelia), by a mean of 18% (489 mg/dl, from an instilled 2,658 mg/dl) in rats receiving ad libitum water and by a mean of 39% (2,544 mg/dl, from an instilled 6,204 mg/dl) in water-deprived rats, but did not change (an increase of 15 mg/dl, P = not significant, from an instilled 300 mg/dl) in a water-loaded rat group. Two separate factors affected urea nitrogen reabsorption rates, a urinary factor related to hydration status, likely the concentration of urea nitrogen in the instilled urine, and a bladder factor(s), also dependent on the animal's state of hydration. Urine creatinine was also absorbed during the bladder dwell, and hydration group effects on the concentration and quantity of creatinine reabsorbed were qualitatively similar to the hydration group effect on urea transport. These findings support the notion(s) that urinary constituents may undergo transport across urinary tract epithelia, that such transport may be physiologically regulated, and that urine is modified during transit and storage through the urinary tract.     

Water pH and urinary excretion in silver catfish Rhamdia quelen

The effect of acute exposure to different water pH levels on urinary excretion and plasma ion levels in silver catfish Rhamdia quelen was analysed. Fish were exposed to pH 4·0, 5·0, 7·5, 8·0, and 9·0 for 4 days and urine was collected. Other specimens were also exposed to the experimental pH for 24 h and blood was sampled. Urine flow rate, urine and plasma pH showed a significant trend to increase with the increase of water pH. Urinary Na⁺ excretion rate also increased and ammonia urinary excretion rate decreased with the increase of water pH. There was a significant trend to decrease volume, ammonia, Cl⁻ and Na⁺ urinary excretion rate with increasing mass in fish exposed to all pH levels studied. Plasma ammonia levels showed a slight decrease in fish exposed to water pH from 4·0 to 8·0, but those exposed to water pH 9·0 presented the highest ammonia levels. Most plasma ions and urinary excretion changes observed in silver catfish exposed to acidic or alkaline water were similar to those already detected in rainbow trout Oncorhynchus mykiss . In addition, the kidney and urinary bladder might participate on acid–base balance in silver catfish, since urine pH changed according to plasma pH.     

荧光原位杂交应用于尿路上皮癌尿液早期诊断的研究进展

尿路上皮癌（urothelial carcinoma,uc）是泌尿系统最常见恶性肿瘤之一,早期诊断是提高该类疾病疗效的关键所在,荧光原位杂交（fluorescencein situ hybridization,FISH）通过尿液来检测UC,具有快速、无创伤性、敏感度高和特异性强等优点。FISH提高了尿细胞学在低级别或浅表性膀胱UC诊断的敏感性,且减少了血尿、尿路感染及膀胱内灌注治疗等对细胞形态的影响而引起的假阳性,提高检测的特异性。对于诊断上尿路UC,FISH的敏感性与特异性更高。膀胱UC患者9号染色体p16抑癌基因丢失与复发明显相关。FISH既能预测膀胱UC的复发性,更能监测UC的复发,但仍需大样本、多中心的前瞻性研究。本文将FISH在膀胱UC、上尿路UC早期诊断以及膀胱UC术后监测等方面的临床应用研究报道进行综述。     

Computed tomographic excretory urography for diagnosing ectopic ureter in a female rhesus macaque (Macaca mulatta)

Ectopic ureter is a congenital abnormality where the ureter terminates at a site other than the urinary bladder. A five-year-old female rhesus monkey presented with a urine odor, a wet perineum, and persistent dribbling of urine. An ultrasound examination revealed a cyst-like structure (1 × 0.75 cm) on the left side of the bladder. Computed tomographic excretory urography (CTEU) imaging revealed a left unilateral extramural ectopic ureter, which was connected to the vagina. The perineum and wet hair were dried and disinfected with 0.4% chlorhexidine for perineal hygiene and skin care. The animal was closely monitored for potential moist dermatitis near the perineum and for urinary tract infection. The complete blood count (CBC) and blood chemistry results showed no signs of inflammation during the observation period. This is the first report of detailed diagnosis of ectopic ureter by ultrasound and CTEU in a female rhesus monkey.