Urinary Tract

尿路
  • 文章类型: Journal Article
    背景:腹膜是新生小马驹的典型疾病,这种情况很少但经常发生。超声检查被认为是诊断该疾病的最重要的成像方法。到目前为止,只有一个由31只患有尿腹膜的小马驹组成的较旧病例系列系统地列出了超声检查的结果。
    目的:本文介绍了34只有尿腹膜的小马驹的超声检查结果,以便将来对可疑的尿腹膜病例的超声检查数据进行解释。
    方法:分析了2006年至2022年间34只被诊断为尿路腹膜的14日龄新生马驹的超声图像数据。
    结果:大多数小马驹表现出高度增加的游离水平(97%),腹部无回声(91%)的液体。尽管膀胱经常可见(50%),膀胱壁不连续性仅偶尔可检测到(18%).
    结论:经腹部超声检查已被证明是诊断可疑尿腹膜的非常可靠的成像方法。建议在可疑的尿腹膜病例中使用,以排除鉴别诊断。
    BACKGROUND: Uroperitoneum is a typical disease of the newborn foal, which occurs rarely but regularly. Ultrasonography is considered the most important imaging method for diagnosing this disease. Thus far, only one older case series comprising 31 foals suffering from uroperitoneum has systematically listed results of ultrasound examinations.
    OBJECTIVE: This paper presents the findings of an ultrasonographic examination of 34 foals with uroperitoneum in order to inform future interpretation of ultrasonographic data in suspected uroperitoneum cases.
    METHODS: Ultrasonographic data of 34 neonatal foals up to the age of 14 days diagnosed with uroperitoneum between 2006 and 2022 were analysed.
    RESULTS: Most foals demonstrated highly increased levels of free (97%), anechogenic (91%) fluid in the abdomen. Although the urinary bladder was frequently visible (50%), bladder wall discontinuity was only occasionally detectable (18%).
    CONCLUSIONS: Transabdominal ultrasonography has proved to be a very reliable imaging method for diagnosing suspected uroperitoneum. It is recommended that it be used in every case of suspected uroperitoneum in order to exclude differential diagnoses.
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  • 文章类型: Journal Article
    本研究的目的是评估微管相关蛋白1轻链3β(LC3B)的时空免疫表达模式,葡萄糖调节蛋白78(GRP78),热休克蛋白70(HSP70),和溶酶体相关膜蛋白2A(LAMP2A)在正常人胎儿肾脏发育(CTRL)和患有先天性肾脏和泌尿道异常(CAKUT)的肾脏中。人类胎儿肾脏(对照,马蹄铁,发育不良,双工,和发育不全)从第18到第38周的发育周用抗体染色后进行了落射荧光显微镜分析。在各种肾脏结构中定量了免疫反应性,并使用线性和非线性回归模型检查表达动力学。LC3B的点状表达主要在肾小管和肾小球细胞中,发育不良的肾脏显示不同的染色模式。在对照组的肾小球中,LAMP2A显示出零星的,点状信号;与其他表型相比,双重肾脏在曲小管中显示出明显更强的表达。GRP78在CAKUT肾脏中表达较弱,尤其是发育不良的,而正常肾脏表现出曲小管和肾小球的点状染色。HSP70染色因表型而异,与对照组相比,发育不良和发育不良的肾脏表现出更强的染色。表达动力学在观察到的自噬标志物和表型之间有所不同,表明它们在正常和功能失调的肾脏发育中的潜在作用。
    The purpose of this study was to evaluate the spatiotemporal immunoexpression pattern of microtubule-associated protein 1 light chain 3 beta (LC3B), glucose-regulated protein 78 (GRP78), heat shock protein 70 (HSP70), and lysosomal-associated membrane protein 2A (LAMP2A) in normal human fetal kidney development (CTRL) and kidneys affected with congenital anomalies of the kidney and urinary tract (CAKUT). Human fetal kidneys (control, horseshoe, dysplastic, duplex, and hypoplastic) from the 18th to the 38th developmental week underwent epifluorescence microscopy analysis after being stained with antibodies. Immunoreactivity was quantified in various kidney structures, and expression dynamics were examined using linear and nonlinear regression modeling. The punctate expression of LC3B was observed mainly in tubules and glomerular cells, with dysplastic kidneys displaying distinct staining patterns. In the control group\'s glomeruli, LAMP2A showed a sporadic, punctate signal; in contrast to other phenotypes, duplex kidneys showed significantly stronger expression in convoluted tubules. GRP78 had a weaker expression in CAKUT kidneys, especially hypoplastic ones, while normal kidneys exhibited punctate staining of convoluted tubules and glomeruli. HSP70 staining varied among phenotypes, with dysplastic and hypoplastic kidneys exhibiting stronger staining compared to controls. Expression dynamics varied among observed autophagy markers and phenotypes, indicating their potential roles in normal and dysfunctional kidney development.
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  • 文章类型: Journal Article
    grimontii克雷伯菌是产酸克雷伯菌复合体中的一种新发现的物种。这里,我们提供了三个K.grimontii菌株的基因组序列草案,这些菌株是从一项纵向研究的参与者收集的导管尿液样本中分离出来的。
    Klebsiella grimontii is a newly identified species within the Klebsiella oxytoca complex. Here, we present the draft genome sequence of three K. grimontii strains that were isolated from catheterized urine samples collected from a participant in a longitudinal study over ~6 months.
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  • 文章类型: Journal Article
    泌尿系统包括肾脏,输尿管,膀胱,尿道的主要功能是排泄,指将有害或多余的物质运出体外的生理过程。男性生殖系统由性腺(睾丸)组成,输精管,和前列腺等附属腺体。根据经典免疫学理论,上面提到的组织和器官不被认为产生免疫球蛋白(Igs),并且在生理和病理条件下存在于相关组织中的任何Ig被认为来源于B细胞。例如,大多数肾脏疾病与由肾脏中沉积的致病性Ig引起的不受控制的炎症有关。一般来说,推测这些病理性Ig是由B细胞产生的。最近的研究表明,肾实质细胞可以产生和分泌Igs,包括IgA和IgG。肾小球系膜细胞可以表达和分泌IgA,这与细胞存活和粘附有关。同样,人类足细胞表现出产生和分泌IgG的能力,这与细胞存活和粘附有关。此外,肾小管上皮细胞也表达IgG,可能参与上皮间质转化(EMT)。更重要的是,肾细胞癌,膀胱癌,前列腺癌已经被发现表达高水平的IgG,促进肿瘤进展。鉴于Ig在泌尿和男性生殖系统中广泛表达,继续努力阐明Ig在肾脏生理和病理过程中的作用是必要的。
    The urinary system comprises kidneys, ureters, bladder, and urethra with its primary function being excretion, referring to the physiological process of transporting substances that are harmful or surplus out of the body. The male reproductive system consists of gonads (testis), vas deferens, and accessory glands such as the prostate. According to classical immunology theory, the tissues and organs mentioned above are not thought to produce immunoglobulins (Igs), and any Ig present in the relevant tissues under physiological and pathological conditions is believed to be derived from B cells. For instance, most renal diseases are associated with uncontrolled inflammation caused by pathogenic Ig deposited in the kidney. Generally, these pathological Igs are presumed to be produced by B cells. Recent studies have demonstrated that renal parenchymal cells can produce and secrete Igs, including IgA and IgG. Glomerular mesangial cells can express and secrete IgA, which is associated with cell survival and adhesion. Likewise, human podocytes demonstrate the ability to produce and secrete IgG, which is related to cell survival and adhesion. Furthermore, renal tubular epithelial cells also express IgG, potentially involved in the epithelial-mesenchymal transition (EMT). More significantly, renal cell carcinoma, bladder cancer, and prostate cancer have been revealed to express high levels of IgG, which promotes tumour progression. Given the widespread Ig expression in the urinary and male reproductive systems, continued efforts to elucidate the roles of Igs in renal physiological and pathological processes are necessary.
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  • 文章类型: English Abstract
    As an internationally accepted diagnostic system, the Paris classification has achieved a global breakthrough in the standardization of diagnoses in urine cytology. Based on experience over the past few years since its first publication, the new edition of the Paris classification refines the diagnostic criteria and discusses diagnostic pitfalls. While the detection of high-grade urothelial carcinoma remains the main focus, other aspects of urine cytology, including cytology of the upper urinary tract and the associated challenges, have also been addressed. Low-grade urothelial neoplasia is no longer listed as a separate category but is now included in the category \"negative for high-grade urothelial carcinoma\" (NGHUC). Essentially, the Paris classification provides an important basis for estimating the risk of malignancy and further clinical management.
    UNASSIGNED: Als ein international anerkanntes Befundungssystem hat die Paris-Klassifikation einen globalen Durchbruch in der Standardisierung der Diagnosen in der Urinzytologie erzielt. Basierend auf Erfahrungen der letzten Jahre seit der Erstveröffentlichung werden in der Neuauflage die diagnostischen Kriterien präzisiert und differentialdiagnostische Schwierigkeiten ausführlicher diskutiert. Während der Nachweis eines high-grade Urothelkarzinoms nach wie vor im Vordergrund steht, werden auch weitere Aspekte der Urinzytologie, u. a. die Zytologie des oberen Harntrakts, und die damit verbundenen Herausforderungen thematisiert. Neu werden die low-grade urothelialen Neoplasien nicht mehr als eigenständige Kategorie aufgeführt, sondern in die Kategorie „negativ für high-grade Urothelkarzinom“ (NGHUC) eingeordnet. Die Paris-Klassifikation ist eine wichtige Grundlage für die Abschätzung des Malignitätsrisikos und das weitere klinische Vorgehen.
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  • 文章类型: Journal Article
    利用常规孔眼导管(CEC)进行膀胱引流的间歇性导管插入术(IC)长期以来一直是护理标准。然而,当下尿路组织靠近孔眼时,经常发生粘膜抽吸,导致微创伤.这项研究调查了用具有多个微孔的排水区代替常规孔眼的影响,分布压力在一个更大的区域。较低的压力限制了周围组织吸入这些微孔,显着减少组织微创伤。使用体外模型复制膀胱的腹内压力状况,在引流期间测量导管内压力.当粘膜抽吸发生时,记录导管内图像.随后受影响的组织样品进行组织学研究。发现由粘膜抽吸引起的负压峰值对于CEC非常高,导致膀胱尿路上皮脱落和尿路上皮屏障破坏。然而,具有多孔眼引流区的微孔区导管(MHZC)显示出明显较低的压力峰值,峰值强度低4倍以上,因此诱发的微创伤要小得多。限制或甚至消除粘膜抽吸和导致的组织微创伤可以有助于在体内更安全的导管插入和增加患者的舒适度和顺应性。
    Intermittent catheterization (IC) utilizing conventional eyelets catheters (CECs) for bladder drainage has long been the standard of care. However, when the tissue of the lower urinary tract comes in close proximity to the eyelets, mucosal suction often occurs, resulting in microtrauma. This study investigates the impact of replacing conventional eyelets with a drainage zone featuring multiple micro-holes, distributing pressure over a larger area. Lower pressures limit the suction of surrounding tissue into these micro-holes, significantly reducing tissue microtrauma. Using an ex vivo model replicating the intra-abdominal pressure conditions of the bladder, the intra-catheter pressure was measured during drainage. When mucosal suction occurred, intra-catheter images were recorded. Subsequently affected tissue samples were investigated histologically. The negative pressure peaks caused by mucosal suction were found to be very high for the CECs, leading to exfoliation of the bladder urothelium and breakage of the urothelial barrier. However, a micro-hole zone catheter (MHZC) with a multi-eyelet drainage zone showed significantly lower pressure peaks, with over 4 times lower peak intensity, thus inducing far less extensive microtraumas. Limiting or even eliminating mucosal suction and resulting tissue microtrauma may contribute to safer catheterizations in vivo and increased patient comfort and compliance.
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  • 文章类型: Journal Article
    乳酸菌是“健康”女性泌尿和阴道社区的常见居民,通常与两个解剖部位缺乏症状有关。鉴于先前对两个群落中相似细菌物种的研究的鉴定,据推测,这两种微生物实际上是相连的。这里,我们对49株乳酸菌进行了全基因组测序,包括来自同一参与者的16个配对的泌尿生殖器样本。这些菌株代表了五种不同的乳杆菌:L.crispatus,L.Gasseri,L.iners,L.jensenii,还有L.paragasseri.平均核苷酸同一性(ANI),对齐,单核苷酸多态性(SNP),和CRISPR比较来自同一参与者的菌株。我们进行了基因组组装和ANI比较的模拟,并提出了一种统计方法来区分不相关的,相关,和相同的菌株。我们发现配对的样本中有50%具有相同的菌株,有证据表明泌尿和阴道是有联系的.此外,我们发现了菌株有共同祖先的证据.这些结果确定泌尿道和阴道之间的微生物共享不限于尿病原体。知道这两个解剖部位可以在女性中共享乳杆菌可以为未来的临床方法提供信息。
    Lactobacillus species are common inhabitants of the \'healthy\' female urinary and vaginal communities, often associated with a lack of symptoms in both anatomical sites. Given identification by prior studies of similar bacterial species in both communities, it has been hypothesized that the two microbiotas are in fact connected. Here, we carried out whole-genome sequencing of 49 Lactobacillus strains, including 16 paired urogenital samples from the same participant. These strains represent five different Lactobacillus species: L. crispatus, L. gasseri, L. iners, L. jensenii, and L. paragasseri. Average nucleotide identity (ANI), alignment, single-nucleotide polymorphism (SNP), and CRISPR comparisons between strains from the same participant were performed. We conducted simulations of genome assemblies and ANI comparisons and present a statistical method to distinguish between unrelated, related, and identical strains. We found that 50 % of the paired samples have identical strains, evidence that the urinary and vaginal communities are connected. Additionally, we found evidence of strains sharing a common ancestor. These results establish that microbial sharing between the urinary tract and vagina is not limited to uropathogens. Knowledge that these two anatomical sites can share lactobacilli in females can inform future clinical approaches.
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  • 文章类型: Journal Article
    大约一半的儿童慢性肾病(CKD)病例是由先天性肾脏和泌尿道异常(CAKUT)引起的。特定的基因被鉴定为对于导致CAKUT表型的潜在遗传因素具有重要意义。在我们的研究中,我们专注于分析和比较外生体异常蛋白A2受体(EDA2R)的表达水平,protocadherin9(PCDH9),和TNF受体相关因子7(TRAF7)蛋白在健康对照肾脏的皮质和髓质在发育2,3和4阶段。我们还对健康胚胎和胎儿肾脏的皮质和髓质切片中提到的蛋白质的面积百分比进行了分析,与受CAKUT影响的那些相比,包括双肾(DK),马蹄肾(香港),发育不良的肾脏(HYP),和发育不良的肾脏(DYS)。我们发现CAKUT候选基因蛋白EDA2R,PCDH9和TRAF7都在正常人肾脏发育阶段表达。在DYS中,EDA2R的表达高于正常肾脏,可能是由于EDA2R在细胞凋亡中的作用,在特定情况下上调,可能有助于DYS的形成。PCDH9在HK中的表达较低,这可以归因于PCDH9在细胞迁移抑制中的可能作用。PCDH9表达减少与细胞迁移增加有关,有可能为香港的发展做出贡献。与正常肾脏相比,所有检查的肾脏疾病中的TRAF7表达水平均降低,这表明这种减少可能归因于TRAF7在内皮和纤毛形成中的关键作用,两者都是正常肾脏发育所必需的。需要进一步的研究来确定这些蛋白质在肾脏和CAKUT的典型发育中的功能。
    Approximately half of the cases of chronic kidney disease (CKD) in childhood are caused by congenital anomalies of the kidney and urinary tract (CAKUT). Specific genes were identified as having significant importance in regard to the underlying genetic factors responsible for the CAKUT phenotype, and in our research, we focused on analyzing and comparing the expression levels of ectodysplasin A2 receptor (EDA2R), protocadherin9 (PCDH9), and TNF receptor-associated factor 7 (TRAF7) proteins in the cortex and medulla of healthy control kidneys during developmental phases 2, 3, and 4. We also performed an analysis of the area percentages of the mentioned proteins in the cortical and medullary sections of healthy embryonic and fetal kidneys compared to those affected by CAKUT, including duplex kidneys (DK), horseshoe kidneys (HK), hypoplastic kidneys (HYP), and dysplastic kidneys (DYS). We found that the CAKUT candidate gene proteins EDA2R, PCDH9, and TRAF7 are all expressed during normal human kidney development stages. In DYS, the expression of EDA2R was higher than in normal kidneys, likely due to EDA2R\'s role in apoptosis, which was upregulated in specific cases and could possibly contribute to the formation of DYS. The expression of PCDH9 was lower in HK, which can be attributed to the possible role of PCDH9 in cell migration suppression. Decreased PCDH9 expression is linked to increased cell migration, potentially contributing to the development of HK. The level of TRAF7 expression was reduced in all examined kidney disorders compared to normal kidneys, suggesting that this reduction might be attributed to the crucial role of TRAF7 in the formation of endothelium and ciliogenesis, both of which are essential for normal kidney development. Further research is required to ascertain the function of these proteins in both the typical development of the kidney and in CAKUT.
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  • 文章类型: Journal Article
    背景:CRS+HIPEC联合泌尿道切除和重建的安全性和有效性存在争议。本研究旨在总结CRS+HIPEC联合泌尿道切除重建的临床病理特征,评价其安全性和生存预后。
    方法:从我们的疾病特异性数据库中回顾性选择作为CRS手术一部分而接受尿路切除和重建的患者进行分析。临床病理特征,治疗相关变量,围手术期不良事件(AE),使用描述性方法和对数秩比较的K-M分析研究了生存结局。
    结果:纳入49例患者。11例(22.4%)患者围手术期出现严重不良事件(SAEs),3例患者发生尿SAE(6.1%)。此外,有23例(46.8%)涉及尿液不良事件(UAE)。整个队列的中位总生存期(OS)为59.2(95CI:42.1-76.4)个月。UAE组和No-UAE组的中位OS为59.2个月(未达到95CI),和50.5(95CI:11.5至89.6)个月,分别,差异无统计学意义(P=0.475)。此外,根据UAE的等级或UAE的数量,OS没有显着差异(分别为P=0.562和P=0.622)。
    结论:CRS+HIPEC与尿路切除和重建的组合与I-II级UAE的高发生率相关,对操作系统没有影响。这种组合技术的安全性是可以接受的。然而,这是一个回顾性的单中心单臂分析,具有普适性和潜在选择偏差的局限性。这些发现需要高级验证。
    BACKGROUND: The safety and efficacy of CRS + HIPEC combined with urinary tract resection and reconstruction are controversial. This study aims to summarize the clinicopathological features and to evaluate the safety and survival prognosis of CRS + HIPEC combined with urinary tract resection and reconstruction.
    METHODS: The patients who underwent urinary tract resection and reconstruction as part of CRS surgery were retrospectively selected from our disease-specific database for analysis. The clinicopathological characteristics, treatment-related variables, perioperative adverse events (AEs), and survival outcomes were studied using a descriptive approach and the K-M analysis with log-rank comparison.
    RESULTS: Forty-nine patients were enrolled. Perioperative serious AEs (SAEs) were observed in 11 patients (22.4%), with urinary SAEs occurring in 3 patients (6.1%). Additionally, there were 23 cases (46.8%) involving urinary adverse events (UAEs). The median overall survival (OS) in the entire cohort was 59.2 (95%CI: 42.1-76.4) months. The median OS of the UAE group and No-UAE group were 59.2 months (95%CI not reached), and 50.5 (95%CI: 11.5 to 89.6) months, respectively, with no significant difference (P = 0.475). Furthermore, there were no significant differences in OS based on the grade of UAEs or the number of UAEs (P = 0.562 and P = 0.622, respectively).
    CONCLUSIONS: The combination of CRS + HIPEC with urinary tract resection and reconstruction is associated with a high incidence of Grade I-II UAEs, which do not have an impact on OS. The safety profile of this combined technique is acceptable. However, this is a retrospective single-center single-arm analysis, with limitations of generalizability and potential selection bias. The findings need high-level validation.
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  • 文章类型: Journal Article
    草药茶被认为是每天消费的新型功能饮料的潜在成分。一种常用的草药茶是白桦树(BetulapendulaRoth)叶输液,传统上用于泌尿道疾病。在这项研究中,桦叶输液作为功能性饮料的潜力,强调其活性成分的生物利用度,抗炎,和关于泌尿道健康的抗粘连特性,被调查。提出了一种复杂的方法,其中包括植物化学筛选,生物利用度,肠道菌群生物转化,以及用于尿液代谢组学评估的体内测试。生物测定证实了显着的抗炎(白细胞介素IL-6和IL-8分泌)和抗粘附(泌尿致病性大肠杆菌和T24膀胱细胞)活性。高分辨率质谱代谢组学研究将肠道微生物群代谢物和尿液中存在的代谢物联系起来。在尿液中检测到几种与酚类物质消耗有关的代谢物,例如,咖啡酸和二羟苯基-γ-戊内酯的葡糖苷酸和硫酸盐。根据所提出的结果,桦树叶应被认为对设计功能性饮料有用,特别针对泌尿系疾病高危人群。
    Herbal teas are considered as a potential constituent of novel functional beverages consumed daily. One of the commonly used herbal teas is silver birch (Betula pendula Roth) leaf infusion, traditionally used in urinary tract diseases. In this study, the potential of birch leaf infusion as a functional beverage, emphasizing its active ingredients\' bioavailability, anti-inflammatory, and antiadhesive properties concerning urinary tract health, was investigated. A complex approach was proposed, which included phytochemical screening, bioavailability, gut microbiota biotransformation, and an in vivo test for urine metabolomics assessment. The bioassays confirmed significant anti-inflammatory (interleukins IL-6 and IL-8 secretion) and anti-adhesive (Uropathogenic Escherichia coli and T24 bladder cells) activities. The high-resolution mass spectrometry metabolomics studies linked gut microbiota metabolites and the metabolites present in the urine. Several metabolites connected with phenolics\' consumption were detected in the urine, e.g., glucuronides and sulfates of caffeic acid and dihydroxyphenyl-γ-valerolactones. Based on the presented results, the birch leaf should be considered useful in designing functional beverages, especially targeted to the groups at high risk of urinary diseases.
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