| ObjectiveEffective and sustainable protection of upper urinary tract are the basic principles of treatment on neurogenic urinary tract dysfunction (NUTD), but it can’t be blocked the occurrence of reflux upper urinary tract deterioration(RUUTD) completely only elimination of secondary urodynamic risk factors such as lower urinary tract dysfunction, and there may be a primary ureter dysfunction. L-type voltage dependent calcium channels (LVDCC) mediated extracellular Ca2+influx ureter smooth muscle cells (USMC) and played an important role in maintaining normal function of muscle systolic and diastolic. The purpose of this study is to establish a model of rabbit with NUTD, on that basis, made an assessment of morphology and function of ureter, explored the primary urodynamic factors related to RUUTD of ureter, and developed a new therapeutic approach for the initiative and effective in preventing the RUUTD and blocked its progress.MethodsThirty Japanese White Rabbits were randomly divided into NUTD group, sham groupand blank group. The NUTD group with a spinal cord transaction at the sixth lumbar level and destroyed the sacral cord to result a model with NUTD, Sham group was only bite spinous process at the same position, exposed spinal cord but not given a transaction, and blank group without any operation. Magnetic resonance imaging were carried on all the rabbits to observe spinal cord injury at the second months after operation, and video-urodynamics study to view urinary tract reflux and record urodynamic parameters such as the morphology of bladder tissue in filling period and maximum cystometric capacity and so on. After that, taken an abdominal incision to exposed urinary bladder, and free up the left ureter and record the number of ureter peristaltic (UP) and bladder urine volume (UV) in30minutes. At last, both ureters were dissociated and prevented of injury, cut one side and fixed with4%paraformaldehyde and embedded in paraffin, sectioned and stained with HE to observe morphological changes. Cut off the other side quickly and stored in-80℃refrigerator, analyzed the differential expression on mRNA and protein of LVDCC by RT-PCR and western blot methods among three groups.ResultsThe experimental group rabbit showed severe postoperative manifestation of hindlimb paralysis, Magnetic resonance imaging suggests spinal cord injury, and Video urodynamic study suggests to ACD, sham and control group had no significant spinal cord injury performance and urodynamic change. The maximum cystometric capacity, bladder compliance, detrusor leak point pressure and the maximum detrusor pressure during voiding of NUTD rabbit were statistically significant compared with others (P<0.001). All the rabbits had no vesicoureteral reflux. The bladder urine volume (UV) has no significant difference in30minutes, but the left ureteral peristalsis of the NUTD rabbits was significantly lower than others (P<0.001). The result of HE staining suggests congestive and inflammatory infiltration in ureter adventitia of NUTD group. Nevertheless, there is a reduced expression of LVDCC mRNA and protein in NUTD ureter compared with sham group and control group, the difference was statistically significantly (P<0.001), but the difference between sham group and control group shows no significance meaning.ConclusionTo establish a model with spinal cord transaction resulted neurogenic urinary tract dysfunction in rabbit. There is a primary ureter dysfunction although had not significantly vesicoureteral reflux and change of morphology, the reason may be the reduced expression of LVDCC in ureter smooth muscle tissue. |
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