荧光原位杂交及其在泌尿男生殖系肿瘤中的应用

本文主要阐述了荧光原位杂交原理，比较基因组杂交，多巴多靶荧光原位杂交技术以及其它细胞分子生物学方法的比较，并对其在男生殖系肿瘤中的应用进行了文献综述。     

泌尿男生殖系统淋巴瘤的临床特征及预后分析

目的探讨泌尿男生殖系统淋巴瘤患者的临床特征,并对其预后进行分析。方法回顾性分析2014年8月至2019年8月北京友谊医院收治的9例泌尿男生殖系统淋巴瘤患者的临床资料。男5例,女4例。平均年龄62(50~69)岁。肿瘤位于肾脏3例,膀胱2例,睾丸4例。首发症状:肾肿瘤3例中2例为发热(1例伴腹痛及体重减轻),1例为体检发现肾盂占位;膀胱肿瘤1例为肉眼血尿伴腹痛,1例为尿急、尿痛;4例睾丸肿瘤均为睾丸无痛性肿大。5例行CT检查见低密度肿物伴轻中度强化,4例睾丸肿瘤行B超检查提示不规则、不均质肿块内见血流信号。术前诊断均为泌尿男生殖系统肿瘤。6例接受手术,3例行病灶穿刺获取病理。9例中4例接受手术治疗联合化疗,2例仅接受化疗,2例仅接受手术治疗,1例未治疗。肾肿瘤3例中,1例行B超引导下病灶穿刺活检术,术后予环磷酰胺+阿霉素+长春新碱+泼尼松+利妥昔单抗(R-CHOP)方案静脉化疗;1例肾盂占位性病变者行腹腔镜肾输尿管全长切除术,术后予R-CHOP方案静脉化疗;1例行B超引导下病灶穿刺活检术,术后患者拒绝进一步治疗。2例膀胱肿瘤者均行TURBT,术后均拒绝放化疗。4例睾丸肿瘤者中,3例行患侧睾丸切除术,1例行B超引导下病灶穿刺活检术;3例行R-CHOP方案化疗,1例于外院行化疗及对侧睾丸放疗,具体方案不详;4例均行鞘内注射化疗药物(甲氨蝶呤15 mg+阿糖胞苷50 mg+地塞米松5 mg)预防中枢神经系统浸润。结果本组9例术后恢复顺利,无手术及穿刺相关并发症发生。术后病理诊断均为非霍奇金淋巴瘤,其中8例为弥漫性大B细胞淋巴瘤,1例睾丸淋巴瘤为间变性大细胞淋巴瘤。按照Ann Arbor分期标准进行临床分期,确诊时Ⅰ~ⅡE期4例,ⅢE~ⅣE期5例。国际预后指数(IPI)评分0~2分6例,≥3分3例。随访时间平均18(6~66)个月。7例存活,其中3例完成化疗者中,2例完全缓解(睾丸淋巴瘤ⅡE期IPI评分1分和ⅣE期IPI评分2分各1例),1例部分缓解(肾盂淋巴瘤ⅣE期IPI评分3分);3例拒绝化疗者未见肿瘤复发或进展(膀胱淋巴瘤2例和肾盂淋巴瘤1例,均为ⅠE期IPI评分1分);1例化疗2个周期后因出现细菌真菌混合感染性肺炎停止化疗(睾丸淋巴瘤ⅢE期IPI评分3分)。肾淋巴瘤ⅢE期IPI评分3分1例和睾丸淋巴瘤Ⅲ期IPI评分2分1例,分别于确诊后6个月、17个月因肿瘤进展死亡。结论泌尿男生殖系统淋巴瘤以弥漫大B细胞淋巴瘤为主,临床表现特异性差,诊断时应根据症状及影像学表现与其他常见肿瘤进行鉴别,避免误诊误治。组织病理学是诊断的金标准,R-CHOP方案化疗为首选治疗手段。     

泌尿及男生殖系肉瘤15例报告

报告泌尿及男生殖系肉瘤１５例，发生于肾脏４例，输尿管１例，膀胱４例，前列腺３例，精索２例及附睾１例。在病理类型中横纹肌肉瘤占８例。年龄１．５～７０岁，平均３６．８岁。治疗以手术为主，配合化疗或放疗。预后不佳，１５例中６例不及２年死亡，１例失访，存活８例随访最长１例为前列腺肉瘤，已５．５年。精索及附睾肉瘤３例，术后未见复发或转移，但随访最长才３年。     

染色体端粒、端粒酶和泌尿男生殖系肿瘤

端粒是位于真核细胞染色体末端的一种特殊结构，由核酸和蛋白质构成，人类染色体端粒的核酸部分是由富含鸟嘌呤碱基的六连体（ＴＴＡＧＧＧ）形成的长度为５～１５Ｋｂ的ＤＮＡ重复序列片段，它与细胞衰老有关。体细胞在每次分裂时，端粒都丢失一定长度的ＤＮＡ片段，直至全部消失，细胞也进而死亡。端粒酶是一种以ＲＮＡ为模板的ＤＮＡ聚合酶，具有延长端粒的作用，是干细胞和精原细胞维持分裂能力的关键物质，与细胞不死化有直接关系。本文拟综述端粒和端粒酶的主要特性及其在泌尿男生殖系肿瘤领域的研究和应用现状。     

吉西他滨与泌尿男生殖系肿瘤化疗研究进展

本文就近年来新型嘧啶类抗肿瘤药物吉西他滨的作用机理、药理特点及其在膀胱癌，前列腺癌，肾癌化疗中的基础和临床研究进展等进行综述。     

吉西他滨与泌尿男生殖系肿瘤化疗研究进展

本文就近年来新型嘧啶类抗肿瘤药物吉西他滨的作用机理、药理特点及其在膀胱癌 ,前列腺癌 ,肾癌化疗中的基础和临床研究进展等进行综述     

Experimental male genital tuberculosis,the possibility of lymphatic spread

Summary The spread of experimentally induced tuberculosis in the male genital organs was studied in guinea pigs. 40 animals were inoculated with H₃₇Rv into the epididymis or seminal vesicle. Half of the animals in each series were prepared by resection of the ductus deferens before inoculation. — Canalicular, haematogenous and lymphatic spread are discussed. It is concluded that lymphatic spread is possible and often occurs.     

MR尿路造影在泌尿外科疾病诊断中的应用

自１９９６年１１月～１９９７年５月采用ＭＲ尿路造影（ＭＲＵ）诊断泌尿外科疾病患者２２例，其中尿路无病变６例，上尿路梗阻６例，输尿管癌２例，肾输尿管结核１例，输尿管结石４例，神经性膀胱所致慢性肾功能衰竭１例，膀胱癌２例。结果：尿路无病变６例ＭＲＵ均能明确显示尿路无梗阻；６例上尿路梗阻可明确病变；４例尿路结石单纯ＭＲＵ无法诊断病变；２例输尿管癌ＭＲＵ不能显示输尿管下段与膀胱重叠部位病变；１例肾输尿管结核ＭＲＵ有典型征象；１例慢性肾功能衰竭，ＭＲＵ清晰显示尿路扩张、积水；２例膀胱癌ＭＲＵ清晰显示膀胱占位及膀胱壁浸润。结果认为：ＭＲＵ是一种新的、无创性、无需造影剂诊断尿路病变的方法     

Spread of tuberculosis from the urinary bladder to the male genital organs an experimental study

Summary In order to study the spread of tuberculous infection from the urinary bladder to the male genital organs, guinea pigs were inoculated with tubercle bacilli (H₃₇Rv) into the bladder wall. Half of the animals were prepared by bilateral resection of the ductus deferens before inoculation. The infection spread to the prostate in most of the animals, and in more than half of them to the epididymis. In only one animal was there spread to a seminal vesicle.-Spread occurred irrespective of whether the ductus deferens was intact, probably mainly by way of the lymphatics.     

Neuroendocrine tumours of the urinary system and male genital organs: clinical significance

Two basic types of neuroendocrine (NE) tumours with diverse clinicopathological features and outcome are identified in the urinary system and male genital organs: carcinoid tumour and neuroendocrine carcinoma. Carcinoid, a rare tumour, occurs in the kidney, bladder, prostate and testis. It is morphologically, histochemically, immunohistochemically and ultrastructurally similar to its counterpart in other organs, such as lung or gastrointestinal tract. Metastases can be detected at the initial evaluation, although they have been reported up to several years after removal, emphasizing the need for a long‐term follow‐up. NE carcinoma occurs in the kidney, bladder and prostate, and includes small cell carcinoma (SCC) and large cell NE carcinoma (LCNEC), the latter being exceedingly rare. Both show the morphology and immunophenotype of NE carcinoma originating in other organs. Although the occurrence is rare, it is highly aggressive.     

数字化图像与原始IVU诊断泌尿系统疾病的比较

目的探索数字化图像诊断泌尿系统疾病的应用及意义。方法将ＩＶＵ胶片通过扫描仪转换为数字化图像，对１００例泌尿系统疾病的诊断作数字化图像与原始ＩＶＵ的比较，其中结石２９例、肿瘤４２例、囊肿５例、结核２例、先天性畸形５例、前列腺增生９例、其它８例。结果数字化图像与原始ＩＶＵ的诊断正确率分别为８８％和９１％，差异无显著性（Ｐ＞０．０５）。诊断可信度分别为４．６分和４．８分，图像质量为４．６分和４．８分，诊断难度为１．７分和１．５分，差异均有非常显著性（Ｐ＜０．０１）。结论数字化图像与原始ＩＶＵ胶片对泌尿系统疾病诊断正确率无明显差别，有益于远程会诊和教育。     

男性不育症患者精浆锌与血清生殖激素测定及意义

目的评价精浆锌及血清生殖激素水平测定在不育症诊断及判定睾丸功能损害程度的意义。方法对200例男性不育症患者进行了精浆锌、血清生殖激素(FSH、LH、T、PRL)检测,并结合精液常规检查、睾丸容积测定以及睾丸病理活检进行分析。结果不育症患者精浆锌含量下降、血清生殖激素异常与睾丸间质细胞功能受损、生精上皮不同程度的破坏有明显的关系。结论精浆锌及血清生殖激素的检测,对判定男性不育症患者睾丸损害程度及鉴别睾丸原发性与梗阻性无精子症具有重要的作用。     

天津地区性病门诊男性生殖器疱疹流行病学分析

目的:了解天津地区性病门诊2006～2010年男性生殖器疱疹流行趋势和特征。方法:对天津医科大学总医院性病门诊2006～2010年男性生殖器疱疹患者的资料进行统计分析。结果:辖区内2006～2010年共有男性生殖器疱疹患者130例,年龄18～76岁,其中30～39岁年龄组占31.54%。主要集中在工人40例(30.77%),干部职员39例(30.00%)。文化程度以中学文化比例最高,性伴职业以服务员为主。结论:天津地区生殖器疱疹仍未得到有效控制,应根据流行出现的新变化,制定相应的防治措施。     

低强度脉冲超声在泌尿系统疾病治疗中的研究进展

低强度脉冲超声(LIPUS)是一种强度远低于传统超声能量(<3 w/cm^2)并通过脉冲形式输出的超声波。由于LIPUS的低强度和脉冲输出模式,其热效应很小,而其非热效应通常被认为可以引起受体阻滞的改变,这吸引了大多数研究者的注意。LIPUS已被用于治疗慢性前列腺炎/慢性盆腔疼痛综合征(chronic prostatitis/chronic pelvic pain syndrome,CP/CPPS)、压力性尿失禁(stress urinary incontinence,SUI)、勃起功能障碍(erectile dysfunction,ED)等泌尿外科疾病,并有可能成为一种有效的治疗手段。对于基础科学和临床研究者来说,探索微能量在生物医学中的应用仍然需要付出巨大的努力。     

AMS量表在上海市社区人群中的适用性研究

目的:评价在上海社区人群中应用AMS量表(the aging males'symptoms scale)的信度和效度。方法:以上海市某社区40岁及以上的973例中老年男性为研究对象,采用AMS量表进行调查,计算分半信度系数、Cronbach'sα系数考察量表内在一致性;通过验证性因子分析考察结构效度,t检验、方差分析和相关分析考察区分效度、校标效度和内容效度。结果:AMS量表及各领域的分半信度系数均大于0.78(P<0.01),Cronbach'sα均大于0.82(P<0.01);验证性因子分析结果表明AMS量表可分为3个领域,各条目与其所属领域的相关系数均大于0.49(P<0.01);血清总睾酮水平为校标时的Pearson相关系数为-0.04(P>0.05)。除心理领域得分在不同年龄组间差别无统计学意义外,不同年龄组、有无慢性病组间AMS量表及各领域得分均存在统计学差异。结论:AMS量表应用于上海社区人群时具有较好的信度和效度,是一份较好的老年男性症状评分量表。但其作为迟发性性腺功能减退症(LOH)的筛选工具仍需深入评估。     

Methods for the detection of male genital tract inflammation

Summary. Male genital tract inflammation is reflected by increased numbers of white blood cells (WBC) in semen. An ejaculate containing more than 10⁶ WBC ml⁻¹ semen is termed leukocytospermic. Among male infertility patients, the frequency of leukocytospermia is between 10% and 20%. By conventional light microscopy or sperm staining techniques, it is not possible to reliably differentiate WBC from immature germ cells in semen. In contrast, the cytochemical peroxidase method reliably identifies granulocytes, the most prevalent WBC type in semen. The method is cheap, fast and easy to perform. The gold standard for the detection of all WBC populations in semen is immunocytology using monoclonal antibodies. However, it is expensive and time-consuming, thus remaining a research tool at present. The measurement of granulocyte elastase in semen provides information on the number of granulocytes and their inflammatory activation. However, commercial granulocyte elastase enzyme immunoassays are expensive and due to logistical reasons often delay the results for more than 1 week. Leukocyte esterase dipstick tests lack both sensitivity and specificity for the detection of inflammatory changes in semen. For clinical purposes, the peroxidase method is ideally suited to detect inflammatory changes in semen.