Bladder soft spot disease

　　As of now, the etiology of bladder soft spot disease has not been clarified. It is currently widely believed that the disease is a result of the interaction between immune response defects within the body and external infection factors. Currently, there are three theories about the etiology of bladder soft spot disease:

　　(1) Invasion of bacterial microorganisms, the most common being Escherichia coli, reaching 70% to 90%, followed by Proteus, Klebsiella, and E. coli can exist alone or in mixed infections. For AIDS patients, the common bacteria are Corynebacterium xylose fermentans.

　　(2) Abnormal immune response;

　　(3) Abnormal function of macrophages: Studies have shown that the macrophages of patients with bladder soft spot disease can phagocytize pathogens due to the abnormal defect of lysosomal function, but cannot digest or digest incompletely. Some incompletely digested bacteria contain calcium, which accumulates in monocytes or macrophages to form specific bodies for the diagnosis of bladder soft spot disease. Experimental evidence shows that the defective function of microtubules controlled by receptor nucleotides leads to the loss of intracellular killing ability. Some scholars believe that it is due to the dysfunction of monocytes, which leads to changes in the intracellular digestion process. The dysfunction is manifested by a decrease in the level of cyclic guanosine monophosphate, which reduces the release of β-glucuronidase.

　　Complications of bladder soft spot disease may include bladder pain, severe hematuria, and urinary retention. After surgery for bladder soft spot disease, a mass may occur at the bladder incision site or under the skin incision.

　　Other symptoms include bleeding, pelvic infection, rectal injury, anuria, and wound rupture. Adenitis cystitis may also occur, which is a benign lesion caused by the metaplasia of bladder mucosal glandular epithelium due to chronic bladder irritation factors such as urinary system infection, obstruction, and calculi. The normal bladder mucosa is composed of transitional epithelium, but under various physical and chemical factors, inflammation, obstruction, and chronic stimulation, local mucosal tissue transforms into glandular epithelium, leading to adenitis cystitis. Adenitis cystitis is more common in young and middle-aged women and is often misdiagnosed as urethritis. According to the latest research, adenitis cystitis is a precancerous lesion, and if not treated promptly, about 4% of patients may develop bladder cancer in a few years.

　　Patients with bladder soft spot disease often have gross hematuria and urinary tract irritation symptoms, such as frequent urination, urgency, and dysuria. Bladder soft spot disease is a rare non-specific granulomatous disease, most commonly occurring in the urogenital system, which can be solitary or multiple, and presents as a tumor-like mass.

　　Patients with bladder soft spot disease often have gross hematuria and urinary tract irritation symptoms, and upper urinary tract soft spot disease can manifest as varying degrees of fever, back pain, or masses. Clinically, the manifestations are similar to those of urinary tract epithelial tumors and other malignant diseases, and it is very difficult to diagnose them solely based on symptoms, and they are often misdiagnosed as urinary system tumors. When the renal parenchyma is involved, 64% of the patients have bilateral renal involvement, which can finally lead to renal failure. Unilateral renal soft spot disease often manifests as masses, renal enlargement, cystic or central calcification. Cases involving renal medulla, limited to renal papillae, or medulla are rare. Multifocal renal soft spot disease manifests as renal enlargement, multiple small masses in the renal cortex, and occasionally involvement of the renal medulla.

　　The clinical manifestations of soft spot syndrome are similar to those of urinary system tumors, and it is often difficult to distinguish them from urinary system inflammation or tumors clinically, with a high rate of misdiagnosis. Pathological diagnosis is mainly relied on, that is, it is necessary to find typical M-G receptors in the mononuclear cells of urine or living tissue. It is noteworthy that in the early stage of the disease, it is also an early change of inflammation, and atypical granulocytes can be seen in the mononuclear cells. Regular follow-up should be maintained to make a final clear diagnosis.

　　The secret to preventing bladder soft spot disease is very simple, adjusting the acid-base balance of body fluids is an effective way to prevent the disease. Cultivate good habits, quit smoking and limit alcohol consumption. Cigarettes and alcohol are highly acidic acidic substances, and people who smoke and drink for a long time are prone to form an acidic体质. Do not eat too much salty and spicy food, and do not eat food that is too hot, too cold, expired, or deteriorated.

　　Maintain a good mindset to cope with stress, combine work and rest, and do not overwork. Traditional Chinese medicine believes that stress leads to overwork and physical weakness, which in turn causes immune function to decrease, endocrine disorders, and internal metabolism to become disordered, leading to the deposition of acidic substances in the body. Stress can also lead to mental tension, causing Qi stasis and blood stasis, internal fire, and other symptoms. Strengthen physical exercise, enhance physical fitness, exercise more in the sun, and sweat more to expel acidic substances from the body through sweat, and avoid forming an acidic体质.

　　Live a regular life. People with irregular lifestyles, such as staying up all night to sing karaoke, play Mahjong, and not going home at night, will exacerbate acidification of the body and are prone to illness. Good habits should be cultivated to maintain an alkaline体质.

　　Do not eat contaminated foods such as polluted water, crops, poultry, fish eggs, and moldy food, and eat some green organic foods to prevent disease from entering through the mouth.

　　A recent study by American scientists has found that consuming an adequate amount of vitamin E through foods such as nuts, olive oil, and other foods can reduce the risk of disease. Researchers this time counted two of the most common types of vitamin E, namely alpha-tocopherol and gamma-tocopherol. The results showed that alpha-tocopherol had a more significant effect. Foods rich in this type of vitamin E include almonds, spinach, green wasabi, pepper, sunflower seeds, as well as olive oil, cottonseed oil, and rapeseed oil, etc. The effect of consuming vitamin E through vitamin supplements is also the same.

　　Experts suggest:Although drinking sufficient amounts of various liquids can reduce the risk of bladder soft spot disease, it is still better to drink water, with more than 10 cups of plain water a day, which has no side effects but brings great benefits, so why not do it.

　　Bladder soft spot disease is a rare non-specific granulomatous disease, most commonly occurring in the urogenital system, which can be solitary or multiple, presenting as a tumor-like mass. Clinically, it presents with symptoms similar to those of urinary tract tumors and other malignant diseases, and it is very difficult to diagnose based solely on symptoms, often misdiagnosed as urinary system tumors. Therefore, the diagnosis of this disease requires the help of relevant examinations to make a diagnosis.

　　1. Urine examination

　　In urine examination, except for those with hematuria, the urine routine examination and urine culture of most patients are negative. Gross hematuria can be seen during urine examination.

　　2. Intravenous urography

　　Intravenous urography is mostly normal.

　　3. Cystoscopy

　　Cystoscopy shows bladder masses and inflammatory changes, with irregularly sized, clearly defined, slightly elevated protuberances in the trigone area and both walls of the bladder, appearing grayish or slightly yellowish, without vessels, and with floating keratin fragments. Cystoscopy shows hyperplasia of inflammatory granulation tissue in the bladder, and surgical resection is performed. During the operation, a yellowish-white flocculent substance covering the bladder mucosa layer is visible, and there is no obvious adhesion between the mass and the bladder mucosa. It can be peeled off, and bleeding points can be seen on the peeled surface. The flocculent material is removed for pathological examination.

　　3. Pathological examination

　　Pathological examination findings: Under the microscope, there is a covering of transitional epithelial mucosal tissue, and there are diffuse hyperplastic epithelial-like tissue cells under the mucosa, with eosinophilic or amphiphilic cytoplasm. There are scattered round or oval inclusion bodies (MG) bodies within, which are alkalophilic and present as concentric calcified bodies, scattered in the stroma and tissue cells. The stroma shows inflammatory cell infiltration and lymphoid tissue hyperplasia, accompanied by the formation of germinal centers. MG bodies are positive for PAS, iron, and calcium stains.

　　In terms of daily diet, the incidence of bladder soft spot disease is reduced in people who consume a large amount of fruits and vegetables, especially those who consume cruciferous vegetables such as kale, cauliflower, radish, cabbage,油菜, shepherd's purse, as well as fresh fruits such as kiwi, fig, banana, and jujube.

　　Boil 100g of glutinous rice to make porridge, add 30-50g of arrowhead powder. Add appropriate amount of brown sugar, which is often used for cancer prevention. Boil 100g of luffa (after washing, peeling, and cutting into pieces) with 100g of duck blood cubes and seasonings, and eat it. It can clear heat, promote diuresis, and detoxify.

　　Fresh grape juice 100g, fresh lotus root juice 100g, fresh rehmannia juice 60g, mixed in a clay pot and boiled, adjust with appropriate honey and served warm. It can be used for blood in urine and urinary pain due to bladder soft spot disease.

　　100g fresh radish sliced, soaked in white honey for a while, then roasted on an iron plate until dry, then dipped in honey repeatedly roasted until 50g white honey is exhausted. After cooling, chew slowly and drink a few sips of plain salt water, to treat bladder soft spot disease with urinary pain.

　　250g sugarcane (cut into small pieces), 100g Bai Mao Gen cut into small pieces, wrapped in a cloth together, cooked with 100g mung bean in water, until the beans are soft and cooked, remove the sugarcane and Bai Mao Gen, drink the soup and eat the beans, you can also add a little sugar, suitable for bladder soft spot disease with obvious hematuria.

　　30g red bean, 50g粳米, cook together. When it is about to be cooked, add 15g chicken kidney powder, and continue to cook until the congee is done. Eat it for breakfast, to assist in treating urethral pain and lower limb pain caused by bladder soft spot disease with concurrent infection.

　　One watermelon, one bowl of dried grapes. Cut a piece off the watermelon near the stem: Pour the cleaned and dried grapes into the loosened watermelon flesh, then cover the cut piece with the watermelon; seal it with mud, place it in a cool place, remove the mud after 10 days, remove the cover, pour out the juice, which is a wine containing a trace of alcohol with a refreshing and sweet taste, suitable for bladder soft spot disease with difficulty in urination or edema.

　　In traditional Chinese medicine, the treatment of bladder soft spot disease is mainly based on the characteristics of deficiency in the root and excess in the branch. The root is due to kidney qi deficiency, spleen qi deficiency, lung qi deficiency, liver qi stagnation, etc., and the branch is due to dampness-heat, toxic heat, phlegm turbidity, and blood stasis. The principle of herbal treatment should focus on invigorating the kidney, strengthening the spleen, and benefiting the lung, with additional measures to promote diuresis and hemostasis, clear heat and hemostasis, and detoxify and remove blood stasis.

　　Kidney Qi Deficiency Type

　　Symptoms: Difficulty in urination, or dripping uneasily, lack of strength in urination, lumbar pain and weakness, pale tongue, thin white fur, thin pulse.

　　Therapeutic Method: Invigorate the kidney and benefit the qi.

　　Prescription: Modified Shen Ha San. Shuwei, Qumai, Danzhu ye, Shengyiren each 60g, Zhuli, Wangbuluohxing each 30g, Bajie, Ren Shen each 10g (boiled separately and mixed with water), Huangqi 25g, Sanglaoxiao, Yunling, Danggui each 12g.

　　Spleen Qi Deficiency Type

　　Symptoms: Inability to urinate, or urination is small and not smooth, hematuria, fatigue and weakness of the limbs, muscle atrophy, loose stools, lack of appetite, lack of taste, shortness of breath, faint speech, pale tongue, white fur, deep, weak pulse.

　　Therapeutic Method: Strengthen the spleen and benefit the qi, promote the flow of water.

　　Prescription: Modified Bu Zhong Yi Qi Soup. Shuwei, Qumai, Danzhu ye, Shengyiren each 60g, Zhuli, Wangbuluohxing each 30g, Ren Shen 10g (boiled separately and mixed with water), Huangqi 25g, Baizhu, Danggui, Chenpi, Shengma, Chaihu each 10g, Gancao 6g.

　　Spleen and Kidney Deficiency Type

　　Symptoms: Lumbar pain, abdominal distension, lumbar abdominal mass, hematuria, poor appetite, nausea and vomiting, pain, pale complexion, weakness and shortness of breath, pale tongue, thin white fur, deep, thin, weak pulse.

　　Therapeutic Method: Strengthen the spleen and benefit the kidney, soften and disperse nodules.

　　Prescription: Modified Four-Ingredient Soup and Left Returning Decoction. Shuwei, Qumai, Danzhu ye, Shengyiren each 60g, Zhuli, Wangbuluohxing each 30g, Ren Shen 10g (boiled separately and mixed with water), Huangqi, Buguzhi, Duzhong each 10g, Baizhu 12g, Huangjing, Gouqizi each 30g, Gancao 6g.

　　Liver Qi Stagnation Type

　　Symptoms: Depressed mood, or frequent irritability, difficulty or incomplete urination, hematuria, lumbar pain,胁腹胀痛, thin or light yellow fur, red tongue, wiry pulse.

　　Therapeutic Method: Soothe the liver and regulate the qi, promote the flow of urine.

　　Prescription: Modified Chenxiang San. Shigu, Qumai, Danzhu Ye, Shengyiren each 60g, Zhuli, Wangbuluxing each 30g, Chenxiang, Jupi, Danggui each 10g, Dongkuizi 12g, Huashi 25g. If there is stagnation of Qi transforming into fire, add Longdancao, Shanzhizhi to clear the stagnated fire.

　　Damp-Heat Accumulating in the Lower Jiao Type

　　Symptoms: Difficulty in urination or small amount of hot and red urine, frequent and urgent urination, pain in the lower abdomen, hematuria, fullness in the lower abdomen, soreness in the lumbar and back, edema in the lower limbs, bitter and sticky mouth, or thirst without desire, yellow greasy coating, slippery and rapid or wiry and rapid pulse.

　　Treatment Method: Clearing Heat and Dampness, Activating Blood and Alleviating Pain.

　　Prescription: Modified Bazheng San. Shigu, Qumai, Danzhu Ye, Shengyiren each 60g, Zhuli, Wangbuluxing, Xiaojie, Baimao Gen each 30g, Danshi 12g, Ruixiang, Moxiao, Puhuang each 10g, Chishao, Yuanhu each 15g.

　　Lung Heat Exuberant Type

　　Symptoms: Difficulty or discomfort in urination, hematuria, fever, cough, dry and painful throat, rapid breathing, thirst, thin yellow coating, rapid pulse.

　　Treatment Method: Clearing Lung Heat and Promoting Urinary Function.

　　Prescription: Modified Qingfei Yin. Shigu, Qumai, Danzhu Ye, Shengyiren each 60g, Zhuli, Wangbuluxing each 30g, Huangqin, Sangbaipi, Maidong, Cheqianzi, Yunling, Mutong, Shanzhizhi each 10g. If there is excessive heart fire, red tip of the tongue, add Huanglian to clear heart fire. If there are symptoms such as nasal congestion, headache, floating pulse, add Bohe, Jiegeng to relieve the exterior and ventilate the lung.

　　Blood Stasis Obstruction Type

　　Symptoms: Dark complexion, pain in the waist and abdomen, mass in the waist and abdomen, discomfort in the renal area, purple or spotted tongue, thin yellow coating, wiry,涩, or knotted pulse.

　　Treatment Method: Activating Blood and Removing Blood Stasis, Regulating Qi and Dissipating Mass.

　　Prescription: Modified Taohong Siwu Decoction. Shigu, Qumai, Danzhu Ye, Shengyiren each 60g, Zhuli, Wangbuluxing, Danshen each 30g, Taoren, Honghua, Chuanxiong, Yuanhu, Xiangfu, Zhishen each 10g, Chishao 15g.

　　Yin Deficiency with Internal Heat Type

　　Symptoms: Dry mouth without desire for drinks, feverishness in the five interiors, short and red urine, dry stool, pain in the lumbar and sacral region, low fever, weight loss, red tongue with thin coating, fine and rapid pulse.

　　Treatment Method: Nourishing Yin and Clearing Heat, Activating Blood and Removing Blood Stasis.

　　Prescription: Modified Zhizi-Baihe Decoction. Shigu, Qumai, Danzhu Ye, Shengyiren each 60g, Zhuli, Wangbuluxing, Danshen each 30g, Zhimu, Huangbai, Shanyao, Zexie, Danshi, Yunling, Shudihuang each 10g, Chishao 15g, Zelan 12g.