脊髓损伤后的膀胱处理

由于我国经济发展迅速,安全措施不到位、工伤事故、车祸等原因,脊髓损伤（spinal cord injury,SCI）的发病率比较高。在发达国家每百万人口的发病率为11.5%—53.4%[1—2]。2013年我科收治的SCI患者达70余人,成为科内的主要病种之一。85%以上的SCI患者均有不同程度的膀胱功能障碍,严重影响其生存质量。

关于脊髓损伤神经源性膀胱处理的几个问题

脊髓损伤是一种严重的致残性损伤，而且有着较高的发病率。全球脊髓损伤的年发生率约为15—40例/百万［1］。随着我国交通和工业经济的发展，脊髓损伤患者明显增加。脊髓损伤除了造成躯体瘫痪外，还会导致其他神经系统功能障碍，其中神经源性膀胱就是最为常见的并发症之一，发生于绝大多数脊髓损伤患者［2］。

1972—2005年美国脊髓损伤后患者膀胱处理方式

脊髓损伤后留置尿管处理膀胱问题常导致结石、尿路感染、尿道狭窄和膀胱癌等泌尿系统并发症。但是，在临床实践中如何对这些患者的急性膀胱问题进行处理鲜有报道。作者利用国家脊髓损伤数据库，对康复出院后使用不同膀胱处理方式的患者每5年随访1次，共随访30年。结果：24762例康复出院患者中，使用阴茎套导尿管处理膀胱问题者由1972年的34．6％逐渐降至2001年的1．5％。

残疾妇女康复的有关问题

残疾妇女康复中涉及到生活质量、身体活动、性生活、膀胱处理、骨质疏松等问题。了解残疾妇女的困难 ,有利于更好地帮助她们康复 ,回归社会。

Preparation of Superparamagnetic Dextran-coated Iron Oxide Nanoparticles used as a Novel Gene Carrier into Human Bladder Cancer Cells'

Objective: Application of magnetic nanoparticles as gene carrier in gene therapy has developed quickly. This study was designed to investigate the preparation of superparamagnetic dextran-coated iron oxide nanoparticles (SDION) and the feasibility of SDION used as a novel gene carrier for plasmid DNA in vitro. Methods: SDION were prepared by chemical coprecipitation and separated by gel filtration on Sephacryl S-300HR, characterized by TEM, laser scattering system and Vibrating Sample Magnetometer Signal Processor. The green fluorescent protein (pGFP-C2) plasmid DNA was used as target gene. SDION-pGFP-C2 conjugate compounds were produced by means of oxidoreduction reaction. The connection ratio of SDION and pGFP-C2 DNA was analyzed and evaluated by agarose electrophoresis and the concentration of pGFP-C2 in supernatant was measured. Using liposome as control, the transfection efficiency of SDION and liposome was respectively evaluated under fluorescence microscope in vitro. Results: The diameter of SDION ranges from 3 nm to 8 nm, the effective diameter was 59.2 nm and the saturation magnetization was 0.23 emu/g. After SDION were reasonably oxidized, SDION could connect with pGFP-C2 to a high degree. The transfection efficiency of SDION as gene carrier was higher than that of liposome. Conclusion: The successes in connecting SDION with pGFP-C2 plasmid by means of oxidoreduction reaction and in transferring pGFP-C2 gene into human bladder cancer BIU-87 cells in vitro provided the experimental evidence for the feasibility of SDION used as a novel gene carrier.