单侧隐睾大鼠对侧睾丸组织中SCF/c-kit基因表达变化及意义

Objective To investigate the pathologic changes and expressions of SCF and c-kit in the contralateral testes in rat model of unilateral cryptorchidism. Methods Thirty male SD rats were maintained under controlled temperature and constant photoperiodic conditions with access to food and water. The rats were randomly assaigned to the control group and the experimental unilateral cryptorchidism group. The left testis of the rats in the unilateral cryptorchidism group was placed into the abdominal cavity. The control group rats were subjected to sham surgery. Three months later, the rats were sacrificed and their right testes were harvested. The pathological changes were observed under microscope. The mRNA and protein expression of SCF and c-kit were also investigated using quantitative Real-time RT-PCR, Western blotting and immunohistochemical staining. Apoptotic germ cells were detected by TUNEL staining. Results All rats survived to the endpoints. The right testes of rats of the unilateral cryptorichid group were smaller than those of the control group. Normal testes of the control group rats manifested active spermatogenesis and orderly arrangement of germ cells.However, disordered and sloughed germinal cells with less distinct seminiferous tubule borders were observed in the contralateral testes of rats with experimental unilateral cryptorichid under the microscope. Cmpared with the control testes, the mRNA and protein expression of SCF and c-kit of the contralateral testes of rats with experimental unilateral cryptorichid was decreased (P＜0.05). The apoptotic germ cells were increased (19.7±3.83 vs 5. 4 ± 1.02, P＜0. 05). The SCF/c-kit expression was positively correlated with the germ cell apoptosis (P＜0. 01 ). Conclusions The decreased expression of SCF and c-kit and increased germ cell apoptosis are found in the contralateral testes, which may contribute to thc infertility in the rat model of experimental unilateral cryptorchidism.     

液氮冷冻法在中耳癌和上颌窦癌手术中的应用

我科自１９９３年１０月以来,将液氮冷冻疗法应用在中耳癌和上颌窦癌手术中,取得了满意效果,现报道如下。１材料和方法用一只干燥热水瓶装满液氮,一个漏斗。备术中使用。７例中男６例,女１例年龄３６～６０岁;中耳癌２例,上颌窦癌５例,２例中耳癌均因左耳流血性分泌物,伴顽固性持续性头痛及１例出现患侧面瘫入院,病程３～６个月。病理均为中度分化鳞状上皮细胞癌。５例上颌窦癌３例左侧,２例右侧,均因鼻腔一侧进行性阻塞加重,血涕、头痛持续性加重,眼外突,复视等状症入院,病理诊断为未分化癌４例,大圆细胞癌１例,ＣＴ检查…     

保留肾单位手术与根治性肾切除术治疗T1b期肾癌疗效比较

目的比较根治性肾切除术(RN)和保留肾单位手术(NSS)治疗T1b肾癌的疗效。方法 T1b期肾癌患者40例,22例行RN(RN组),18例行NSS(NSS组),比较两组住院时间、出血量、手术时间、手术前后血肌酐变化、复发率及5年生存率。结果两组均未出现出血、感染、尿瘘及肾功能衰竭等并发症、随访期间患者均存活,均未发现局部复发和远处转移。两组手术时间、术中出血量及术后住院时间差异均无统计学意义(均>0.05),RN组术后7 d及5年的血清肌酐均明显高于术前(均<0.05)。结论 T1b期肾癌行PN和RN的术后疗效相当,而PN可以最大限度地保留患者肾单位,保护残肾功能,降低术后发生肾功能衰竭的危险性,值得在临床实践中大力推广。     

单侧隐睾对侧睾丸损害与HIF-1α和VEGF的关系

目的探讨单侧隐睾对侧睾丸损害与缺氧诱导因子-1α(HIF-1α)和血管内皮细胞生长因子(VEGF)表达的关系。方法24只SD雄性大鼠(35d龄)随机分为3组:单侧隐睾并生殖股神经离断组(A组),单侧隐睾组(B组),假手术组(C组),每组8只。动物模型建立30 d后,原位缺口末端标记法(TUNEL)检测对侧睾丸的生精细胞凋亡,免疫组织化学SP法检测睾丸组织中HIF-1α和VEGF基因的表达。结果B组对侧睾丸生精细胞凋亡指数、HIF-1α和VEGF的含量均显著升高(P<0．01),C组与A组各项指标无明显差异。结论HIF-1α和VEGF在单侧隐睾对侧睾丸的损害中起重要的作用,而生殖股神经离断能防止对侧睾丸的损害。     

颈外动脉或筛前动脉结扎术治疗中老年顽固性鼻出血

目的 探讨颈外动脉或筛前动脉结扎术治疗中老年顽固性鼻出血的临床价值。方法 根据鼻出血部位及全身情况分别采用颈外动脉和筛前动脉结扎术治疗中老年重症鼻出血36例。结果 34例患者手术后止血均成功，未发生明显的并发症，有效率94．4％。结论 颈外动脉或筛前动脉结扎术对中老年顽固性鼻出血有确切治疗效果，且方法简单，手术时间短，创伤小，并发症少。     

胶州市农村外资企业员工结核菌感染情况调查

胶州市农村外商投资所办企业较多,人员构成较为复杂,近年来,连续发现几例来自农村外资企业的新发结核病人。为了解外资企业员工的结核菌感染情况,制订相应的防治措施,1998年9月对辖区内农村两家外资企业员工进行了Ｘ线胸部透视、卡介苗接种后疤痕(卡痕)及结核菌素试验(结素试验)调查。1　对象与方法11　对象　在胶州市辖区内的农村中抽取两家外资企业,对所有中外籍管理人员与工人共1026人进行调查,年龄为18～35岁。12　方法121　胸透　用上海医用核子仪器厂生产的Ｆ30-Ⅲ-2电脑无线遥控移动式诊断Ｘ射线机(16Ａ/220Ｖ,频率50/60Ｈｚ,输出功…     

Habib4X双极射频辅助无肾动脉阻断腹腔镜下肾部分切除术的临床分析

目的 探讨Habib 4X双极射频辅助无肾动脉阻断腹腔镜肾部分切除术的临床效果.方法 2010年10月至2011年6月采用Habib 4X双极射频辅助腹腔镜肾部分切除术(laparoscopic partial nephrectomy with radiofrequency ablation,LRA)和腹腔镜肾部分切除术(laparoscopic partial nephrectomy,LPN)治疗肾肿瘤(T1N0M0)患者14例,肿瘤均为外向型生长.LRA组6例,男4例,女2例;年龄38 ～75岁,平均60岁;肿瘤位于左肾3例,右肾3例;肾上极2例、中极2例、下极2例;肿瘤最大径2.1 ～3.5 cm,平均3.1 cm.LPN组8例,男4例,女4例;年龄36 ～ 77岁,平均61岁;肿瘤位于左肾3例,右肾5例;肾上极3例、中极2例、下极3例;肿瘤最大径2.0～3.7 cm,平均3.0 cm.记录手术时间、术中出血量、术后住院时间、术后并发症等指标,比较手术前后Hb、SCr、患侧肾小球滤过率(glomeruar filtration rate,GFR)的变化. 结果 14例手术均获成功,无中转开放手术者.LRA组无需阻断肾蒂,手术前后Hb、SCr、患侧GFR比较分别为(127±19)和(124±19) g/L、(96 ±39)和(92±29) μmol/L、(42±12)和(40±13) ml/min,差异均无统计学意义(P＞0.05).LPN组术中阻断肾动脉20 ～ 52 min,平均31.5 min.手术前后Hb、SCr、患侧GFR分别为(130 ±17)和(112±15) g/L,(92 ±31)和(110±28)μmol/L,(43 ±14)和(30 ±11)ml/min,差异均有统计学意义(P＜0.05).LRA组和LPN组手术时间分别为(86±20)min、(112 ±43)min,术中出血量分别为(94±18) ml、(256 ±58)ml,术后住院时间分别为(5.0±0.8)d、(7.8±1.2)d,组间比较差异均有统计学意义(P＜0.05).LRA组术后无出血、肉眼血尿和漏尿等并发症. 结论 Habib 4X双极射频辅助腹腔镜无肾动脉阻断肾部分切除术治疗肾肿瘤安全有效,在手术时间、术中出血量和术后恢复等方面均优于LPN.     

输尿管镜治疗顽固性血精的临床疗效观察

我院自2008年8月以来开展经尿道精囊镜检诊治顽固性血精7例,疗效满意,报告如下. 资料和方法 本组7例,年龄22～65岁,其中小于30岁2例,大于30岁5例,平均46.7岁;血精病程6～60个月,平均12个月,药物和物理治疗无效.