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卷 10, 编号 3 (2020)

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Original study

实验中用组织工程结构置换尿道成形术

Gorelova A., Murav’ev A., Vinogradova T., Gorelov A., Yudintseva N., Nashchekina Y., Samusenko I., Yablonsky P.

摘要

研究现实性。为为了消除在传统的外科手术中在尿道置换术范围内出现的困难,近年来已经使用组织工程技术开发了替代材料。这项研究致力于使用各种组织来源的细胞和生物聚合物开发新型的尿素塑料组织工程结构,这是现代医学迫切需要解决的问题。

目的:实验证明了使用组织工程结构替代尿道缺损的可能性。

材料与方法。两阶段的研究,实验,控制。致力于基于植入间充质干细胞或颊上皮细胞的生物聚合物的组织工程构建体(TEC)的开发。将准备好的TECs植入兔子的急性创伤模型中,插入尿道中。TEC申请结果与金标准的比较—口腔塑料。

结果。通过尿道造影,在所有动物组中都获得了相似的结果,无论植入材料的类型如何。没有发现尿道不正常现象,共聚焦显微镜检查尿道冰冻切片发现粘液层中存在有纳米颗粒标记的间充质干细胞/口缘上皮细胞具有在尿路上皮方向上分化的迹象。

结论。替代尿素塑料的试验条件下,展示了使用生物聚合物组织日内瓦结构的可能性,就含自体工程学中层干细胞或口缘上皮细胞。实验中发达的TEC可以作为颊道尿道成形术的替代方法。

Urology reports (St. - Petersburg). 2020;10(3):201-208
pages 201-208 views

我们在红色光谱中进行低强度激光疗法治疗男性特发性不育症的经验

Potapova M., Borovets S., Slesarevskaya M., Al-Shukri S.

摘要

绪论由于药物治疗对于特发性分泌型男性不育症的有效性不足,因此有必要开发和引入更有效的治疗方法。

研究目的。评估红色光谱中的低强度激光疗法(LLLT)对射精参数的影响,特发性不育男性的精子DNA片段化(FDNA)和MAR检测。

患者与方法。检查了85位特发性不育男性,其中50位(第1组)接受了LLLT,35位(第2组,对照组)未进行LLLT。第一组患者的平均年龄为31.4±1.3岁,第二组患者的平均年龄为32.3±1.4岁。LLLT在红色光谱中在“Rubin-C”设备(俄罗斯)上进行:隔天进行10次操作,每个睾丸10分钟。治疗前后,评估荷尔蒙状况,精子参数,MAR-test,PDNKS。

结果。第1组患者的LLLT导致射精量,精子活力和正常形式数量的显着增加(分别平均增加11%,9%和23%)。1个月和2个月后平均进行性精子活动率分别为14%和19% 分别。在第一组中最初有FDNS升高的12名患者中,其正常化在治疗结束后开始。第1组患者中,MAR-检验显着降低,该指标的初始水平作为治疗的结果,在50对已婚夫妇中,有10对(20%)怀孕了。第二组患者中,两个月内射精参数和血浆中激素浓度发生显着变化。没有观察到;婚姻中没有怀孕。

结论。红谱中的尼罗河能可靠地改善自发性男性不育症的射精质量,使疾病防治基金正常化,降低MAR-测试率。

Urology reports (St. - Petersburg). 2020;10(3):209-216
pages 209-216 views

Possibilities of proteolytic enzymes in the treatment of some forms of male infertility

Neymark A., Neymark B., Nozdrachev N., Davydov A., Kablova I., Yakovets Y., Levin V., Plotnikova A.

摘要

In the study 46 men with impaired fertility and the presence of viscosipathy were included. The patients’ age ranged from 22 to 45 years, the average duration of infertility in marriage was 3.5 ± 2.4 years. All patients with Longidaza drugs according to the following scheme were treated. First, ten intramuscular injections of Longidaza® lyophilisate were performed to prepare a solution of 3000 IU once every five days, then Longidaza® suppositories 3000 IU rectally once every three days were prescribed, for a total of 15 suppositories. The total duration of the course of treatment is 90 days. A decrease in sperm viscosity from 2.1 ± 0.05 cm to 0.6 ± 0.07 cm (p < 0.05), an increase in total sperm motility (from 32.6 ± 2.9 to 61 ± 3.1%, p < 0.05) and the number of sperm with progressive movement (from 22 ± 1.1 to 36.7 ± 2.9 %, p < 0.05) after the treatment were revealed. Also, in the course of treatment, the restoration of the antioxidant protection of the ejaculate was noted, as evidenced by an increase in the activity of glutathione peroxidase and superoxide dismutase and a decrease in the content of malon dialdehyde. During the first year after the end of treatment, conception in marriage was registered in 21 (45.7%) patients. The results of the study indicate that a violation of the lipid peroxidation system can lead to both an increase in sperm viscosity and a disruption in the activity of acrosomal enzymes, as a result of which it becomes difficult for spermatozoa to penetrate the ovum. Longidaza is able to increase the hyaluronidase activity of the sperm acrosome, thereby improving the fertilizing ability of the ejaculate.

Urology reports (St. - Petersburg). 2020;10(3):217-221
pages 217-221 views

Effectiveness of melatonin use in treatment of premature ejaculation combined with erectile dysfunction

Kuzmenko A., Gyaurgiev T., Vishnyakov A., Tizyo D.

摘要

The article presents the results of the treatment of 60 patients with premature ejaculation in combination with erectile dysfunction. Patients were divided into three groups, in which patients were prescribed non-drug treatment, or sildenafil 50 mg on demand, or sildenafil 50 mg on demand in combination with melatonin 3 mg at night. Duration of treatment was 6 months. The psychoemotional status, quality of life, quality and duration of intercourse, erectile function and chrono-rhythms of patients were assessed. The results of the study showed that treatment with sildenafil in combination with melatonin was the most clinically effective, which manifested in prolongation of sexual intercourse, improvement of the quality of erection and normalization of the chronobiological status of patients.

Urology reports (St. - Petersburg). 2020;10(3):223-228
pages 223-228 views

高血压性肾病作为肾癌的单侧肾切除术的起源

Titjaev I., Andreev S., Andreeva S., Udalov K., Kas’janov D.

摘要

目的:研究肾切开术后单肾结构功能变化的适应机制。

材料与方法。肾癌患者接受了两种类型的179项外科手术:肾切除术和肾脏切除术。手术后期间,进行了超声波检查,对单侧肾血管的大小和多普勒进行了评估,对操作中的病人进行了血压监测。

结果与讨论。肾脏切除的情况下,保留了控制功能组织体积的自适应机制。器官的负担仍然是最低的,生理上的,没有重新分配。血压不变。肾切除术并没有导致单一肾功能的变化,而是由于等离子体压力升高而造成的适应-病理结构的损害,“重新启动”器官,其代偿性肥大,伴随着静脉水肿对组织的压力因素,动脉张力升高,发展二次器官缺血,循环缺氧和血压升高。所有这些都适合高血压肾病。

结论。与保乳手术后的患者相比,接受肾切除术的患者发生动脉高压和高血压性肾病的潜在风险明显更高。老年人动脉高血压的最重要表现之一是侵犯“目标器官”的结构和功能,这些器官包括大脑,心脏,血管和肾脏。肾切除术形成病理性恶性循环,有助于肾脏和心血管衰竭的发展和进一步发展

Urology reports (St. - Petersburg). 2020;10(3):229-234
pages 229-234 views

Results of extracorporeal shock wave lithotripsy in patients with high density kidney calculi

Ensebaev E., Bajgaskinov Z.

摘要

A study of the efficacy of extracorporeal shock wave lithotripsy (ESWL) in patients with urolithiasis with renal calculi of high-density (>1000 HU) and size less than 20 mm was carried out. A total of 18 patients underwent 54 ESWL sessions. The tolerability of the treatment was satisfactory. The best results were obtained in patients with structural heterogeneity of calculi with a difference in the density of different sections of the calculus according to multi-slice computer tomography data of more than 500 HU. Such calculi disintegrated more easily during ESWL.

Urology reports (St. - Petersburg). 2020;10(3):235-241
pages 235-241 views

Reviews

前列腺生物调节多PROSTATILEN:药理学性质和30年泌尿科临床经验

Kuzmin I., Borovets S., Gorbachev A., Al-Shukri S.

摘要

文章总结了前列腺生物调节肽Prostatilen 30年临床使用的结果。所报告的试验研究表明,该药物的生物活性很高,并描述了其治疗机制。提供了临床研究结果,证明了用于治疗慢性前列腺炎的用途的有效性和病原性,良好的前列腺增生,肾脏和膀胱感染炎症和其他疾病。在巴甫洛夫第一圣彼得堡国立医科大学中显示了使用Prostatilen的经验。

Urology reports (St. - Petersburg). 2020;10(3):243-258
pages 243-258 views

Сlinical observations

壁内膀胱平滑肌瘤

Protoshchak V., Sivakov A., Karandashov V., Skryabin M., Kushnirenko N., Chirsky V.

摘要

膀胱良性肿瘤是罕见的病理学。膀胱的非上皮良性肿瘤(纤维瘤,纤维肌瘤,肌瘤,血管瘤,横纹肌瘤,平滑肌瘤等)占影响该器官的所有形式的不到0.5%。所分析的文献描述了约300个观察膀胱莱奥米的情况。本文介绍了外科治疗壁内膀胱平滑肌瘤的临床案例。

Urology reports (St. - Petersburg). 2020;10(3):259-263
pages 259-263 views

Fibroma of epididymis

Protoshchak V., Sivakov A., Karandashov V., Gozalishvili S., Chirsky V., Erohina A., Lazutkin M., Alent’ev S.

摘要

Benign or malignant tumors of the epididymis are extremely rare. Fibroids of the epididymis and scrotal tissues are rare benign neoplasms. Over the past 10 years, there have been isolated cases in the medical literature describing fibroids of the epididymis and testicular membranes. This article describes a clinical case of surgical treatment of a tumor of the epididymis.

Urology reports (St. - Petersburg). 2020;10(3):265-268
pages 265-268 views