目的:观察经后腹腔镜肾囊肿去顶减压术治疗常染色体显性遗传性多囊肾病的临床效果。方法:2004~2007年经后腹腔镜囊肿去顶减压术治疗成人型多囊肾20例，术后随访6~36月，观察手术前后肾功能指标变化术后。结果:20例手术均获成功。平均手术时间71.0±5.28分钟，术后平均住院天数5±0.38天。结论:经后腹腔镜囊肿去顶减压术治疗多囊肾具有创伤小、出血少、恢复快等优点，是外科治疗成人型多囊肾安全有效的方法。
Objective To review the current research status and clinical application progress of extracellular matrix (ECM) material in tissue engineering. Methods The literature about the latest progress in the preparation, biocompatibility, mechanical property, degradability, and clinical application of ECM material was extensively reviewed. Results The improvement of the ECM preparation method and thorough understanding of the immunological properties have laid the foundation for the repair and reconstruction of the tissue. Moreover, a series of animal studies also confirm that the feasibility and effectiveness of the ECM such as small intestinal submucosa, bladder ECM grift, and acellular dermis which have been applied to the repair and reconstruction of the urethra, bladder, arteries, and skin tissue. It shows a wide prospect of clinical application in the future. Conclusion ECM material is a good bio-derived scaffold, which is expected to become an important source of alternative materials for the repair and reconstruction of the tissue.
【Abstract】 Objective To review the progress and cl inical appl ication of cellular therapy for stress urinaryincontinence (SUI). Methods The l iterature about cellular therapy of SUI was extensively reviewed. Results Becauseof having no or poor regeneration capacity, the cl inical application of chondrocytes and myoblasts were l imited. Based on the rapid progress in stem cell biology, an increasing number of animal experiments and cl inical trials about cellular therapy of SUI have been reported with encouraging results. All these show that cellular therapy has great potential in cl inical application. Stem cells are considered as ideal seeded-cells for treatment of SUI. Conclusion Cellular therapy, especially stem cells, provides a novel approach for treatment of SUI, but the mechanism needs further study.
【Abstract】 Objective To review the recent progress of cell therapy in cl inical appl ications. Methods Therecent l iterature about cell therapy in cl inical appl ications was extensively reviewed. Results Based on the advances in cell biology, especially the rapid progress in stem cell biology, an increasing number of cl inical trials about cell therapy for management of various diseases, such as cardiovascular system diseases, neural system diseases, musculo-skeletal diseases, diabetes, stress urinary incontinence, and others, had been reported with encouraging results. All these showed that cell therapy had great potentials in cl inical appl ication. Conclusion Cell therapy provides a novel approach for the treatment of many human diseases. However, the mechanism remains to be fully elucidated.
Objective To sum up the research advances in urethra reconstruction with tissue engineering techniques. Methods The recent original articles about urethra reconstruction with engineering techniques were extensively reviewed. Results At present, human urothelium and smooth muscle cells have been successfully harvested，cultivated, and expanded in vitro in sufficient quantitiesfor reconstruction. Tissue engineering for urethral reconstruction includes matrices alone, the body’s natural ability which induces new tissue growth, or the use of matrices with cells. Conclusion The tissue engineering materials for urethral reconstruction has been used successfully to repair defect of hypospadias and urethral strictures. The reconstructionof complex urethral defects need to be improved and developed.
Objective To assess the efficacy and the treatment-induced side effects of intravesically administered Epirubicin (EPI) following TUR in patients with Ta and T1 superficial bladder cancer compared to TUR alone. Methods According to the Cochrane reviewer’s handbook, included studies were those on patients with histologically confirmed Ta and T1 bladder cancer. EPI and EPI derivatives, dose and schedule would be considerd appropriate for inclusion. The search strategy was developed according to the Collaborative Review Group search strategy. Medline, EMbase, CBMdisc and the Cochrane library, articles of conference proceedings, and academic collections were searched for randomised controlled trials (RCTs) and quasi-RCT comparing intravesical EPI following TUR with TUR alone. Data were extracted from each identified paper independently by two reviewers. Trials were assessed for quality according to the method of Jadad scale. RevMan4.2 software developed by the Cochrane Collaboration was used for satistical analysis. Results Two hundred and thirteen related articles were identified, but only 10 were included in our systematic review. 3 articles were high quality and the rest were low. The pooled RR=1.51 (95%CI 1.32 to 1.72) and the pooled RR=1.49 (95%CI 1.35 to 1.66) in patients with Ta and T1 bladdercancer at 1 and 2 years respectively; The pooled RR=1.34 (95%CI 1.22 to 1.48) when comparing relative efficacy of intravesical EPI (drug doselt;50 mg) following TUR with TUR alone; The pooled RR=1.63 (95%CI 1.48 to 1.79) when comparing relative efficacy of intravesical EPI (drug dosegt;50 mg) following TUR with TUR alone. RR=1.49 (95%CI 1.33 to 1.66) and RR=1.56 (95%CI 1.36 to 1.84) when comparing relative efficacy of single intravesical EPI following TUR with TUR alone respectively. RR=0.79 (95%CI 0.53 to 1.17) when comparing the incidence of disease progression of intravesical doxorubicin following TUR with TUR alone. RR=4.34 (95%CI 2.62 to 7.19) when comparing side effect of intravesical EPI following TUR with TUR alone. Conclusions Intravesically administered EPI following TUR in patients with Ta and T1 superficial bladder cancer may reduce the incidence of tumour recurrence, but cannot reduce the incidence of disease progreesion. Intravesically administered EPI following TUR has some side effects but can be tolerated and has no influence on the life of patients.
Bladder cancer is a common malignant tumor of the urinary system. The incidence and mortality of bladder cancer in China have been at a high level. In the past, people generally believed that the bladder was a sterile environment, but it has been found that there are symbiotic microorganisms in the bladder. In addition, microorganisms and their metabolites in urine may be involved in the occurrence and development of various urinary system diseases such as bladder cancer. At the same time, microorganisms and their component products such as Bacillus Calmette-Guerin vaccine play an important role in the treatment of bladder cancer. This article reviews the research progress of urinary tract microorganisms and the occurrence, development and treatment of bladder cancer, and aims to provide new ideas for the early diagnosis and treatment, prevention and prognosis evaluation of bladder cancer.
Objective To sum up the common mode in urinary diversion after radical cystectomy. Methods The recent original articles about the common mode in urinary diversion after radical cystectomy were extensively reviewed. Results Urinary diversion includes no continent ureterocutaneostomy, continent ureterocutaneostomy and orthotopic neobladder. Ileal conduit, an ideal procedure of urinary diversion, has been widely used in patients after radical cystectomy and it is uncertain whether the health related quality of life in patients undergoing orthotopic ileal neobladder is superior to those undergoing ileal conduit. A series of basic researches of tissue engineering show a wide prospect of clinical application in the future. Conclusion Intestinal segment will remain the main material for urinary diversion and bladder reconstruction in a long time. Tissue engineering materials may be ideal for the substitution of bladder, and tissue engineering becomes the ultimate approach to solve the problem of missing bladder.