Research for Residual bladder function using molecular biology and Suitable period of surgical treatment of Benign Prostatic Hyperplasia

本文报道了对膀胱出口梗阻（BOO）患者（如良性前列腺增生（BPH）患者）残留膀胱功能的评估，以及手术时机的确定。本研究主要研究维持膀胱功能的因素、培养蛋白对膀胱平滑肌细胞的作用及其结构变化。首先，我们对动物BOO模型患者残膀胱功能的影响因素进行了研究。从这些实验中，我们发现BOO引起的慢性膀胱缺血，以及随后膀胱血流再灌注损伤是影响膀胱缺血的重要因素。此外，我们发现自由基和活性氧影响膀胱功能。因此，我们发现服用自由基清除剂和维生素E对膀胱功能障碍有缓解作用。在膀胱缺血-再灌注动物模型中，我们注意到中性粒细胞弹性蛋白酶对膀胱平滑肌的保护作用，以及与膀胱剩余功能相关的各种因素。至于与膀胱血流量的关系，我们也检查了排尿负荷时间（利尿）。结果表明，即使在BOO前利尿，在BOO后停止利尿，膀胱平滑肌的保护和保存作用下降和消失，并且发现利尿影响剩余膀胱功能。其次，对BOO后大鼠膀胱平滑肌细胞的培养研究表明，膀胱肥大来源于平滑肌层，b-FGF可能是其中一种生长因子。此外，在使用表型概念检查大鼠膀胱平滑肌细胞的结构变化后，BOO后膀胱平滑肌细胞中非收缩表型的比例增加。同时，使用分子生物学方法，我们测量了与膀胱收缩相关的蛋白质标记物。此外，结果表明，caldesmon是掌握病态状态最有用的标记。我们在人膀胱平滑肌细胞上测试了这种方法，发现BOO和膀胱功能障碍后膀胱非收缩表型水平增加，这些变化可以作为确定前列腺增生症手术时机的参数。少

This paper reports the evaluation of the residual bladder function in patients with bladder outlet obstruction(BOO) such as those with benign prostatic hyperplasia(BPH), and determination of the appropriate timing for a surgical procedure. The study mainly researched factors contributing to preserve the bladder function, the use of culturing protain on bladder smooth muscle cells, and their structural changes.First of all, we examined factors affecting the residual bladder function in patients with animal BOO model. From these experiments, we found that the influence by chronic bladder ischemia that was derived from BOO, and following bladder blood flow reperfusion injury are important factors. In addition, we found that free radicals and active oxygen affect the bladder function. Accordingly, we found that dosing free radical scavengers and vitamin E provide relief for the bladder dysfunction. As for the bladder ischemia-reperfusion animal model, we noticed that neutrophil elastase in … More hibitors have a protective effect on bladder smooth muscle, and various factors related to the residual bladder function. As to the relationship with the bladder blood flow, we also examined urination load timing(diuresis). The results showed that even diuresis before BOO, by stopping diuresis after BOO, protection and preservation effects of the bladder smooth muscle decreased and disappear, and it was found that diuresis affects the residual bladder function. Next, the study of cultured bladder smooth muscle cells in rats after following BOO indicated that the bladder hypertrophy of bladder was derived from the smooth muscle layer, and it was possible that b-FGF is one of growth factor. Further, after examining the structural change of the bladder smooth muscle cells in rats using a phenotype concept, the ratio of non-contractile phenotype was increased in the bladder smooth muscle cells after BOO. At the same time, using a molecular biological method, we measured protein markers that are related to bladder contraction. Moreover, the result showed that caldesmon is the most useful marker for grasping a morbid state. We tested this method on human bladder smooth muscle cells and found that levels of non-contractile phenotype was increased in bladder after BOO and bladder dysfunction, and the change of these can be parameters to determine the suitable period of surgical procedures for the BPH. Less