男性原发绒癌13例临床分析并文献回顾

目的探讨男性原发绒癌的诊断、治疗及预后因素。方法回顾性分析北京协和医院1990年至2012年收治的男性绒癌患者的临床资料,并复习同期文献报道的男性绒癌患者临床资料。结果本院13例患者的中位生存期54个月,包括7个原发部位。所有患者均经手术治疗,12例患者同时加用了联合化疗或放疗。随访至2013年3月,6例患者存活,疾病无复发(随访时间21~138月)。复习文献100例病例,连同我院病例共113例,总的中位生存期10个月,肿瘤最常见的原发部位为睾丸(41/113),大部分伴有转移(80/113)。年龄≤34岁、绒癌合并其他组织成分、联合化疗的患者中位生存期较长。结论男性原发绒癌预后较女性妊娠绒癌明显差,经积极的化疗可延长生存期,年轻(≤34岁)、肿瘤合并其他组织成分者,预后相对偏好。     

睾酮对雄性家兔血管损伤后内皮功能及内膜增生的影响

目的探讨雄激素睾酮对雄性家兔腹主动脉球囊损伤后内皮功能及内膜增生的影响.方法选择健康雄性新西兰白兔24只随机分成三组假去势对照组、低睾酮血症组(去势)及睾酮替代组(去势1周后加用长效十一酸睾酮单次肌注,14mg/kg),每组8只.去势10天后对所有动物行腹主动脉球囊损伤术.损伤后2周采血测血浆睾酮、血脂、一氧化氮(NO)、超氧化物歧化酶(SOD)及丙二醛(MDA)水平,并截取腹主动脉进行图像分析.结果低睾酮血症组的新生内膜面积明显高于假去势对照组和睾酮替代组(P＜0.01),且血浆总胆固醇、甘油三酯、低密度脂蛋白及MDA显著上升,NO和SOD水平明显下降,(P＜0.01或0.05).治疗组和对照组比较各数据无差异.结论生理水平的睾酮(内源或外源补充)抑制雄性家兔动脉损伤后的内膜增生,并保护内皮功能.     

1962名男性新兵人格诊断问卷(PDQ-4~+)结果分析

目的了解部队新兵人格倾向特征。方法采用人格诊断问卷(PDQ-4+)对某部队1 962名男性新兵进行抽样调查,并与大学生样本进行比较。结果 (1)除表演型、反社会型分量表外,新兵其他各分量表及总量表得分均显著低于大学生(P<0.05);新兵人格倾向亚型的阳性检出率在7.25%~36.07%。(2)低年龄组新兵在偏执型、分裂型、自恋型、边缘型、反社会型、依赖型分量表及总量表的得分均高于高年龄组新兵(P<0.05);父母关系和睦的新兵各个人格倾向亚型(除强迫型外)得分均显著低于父母关系不和睦新兵的得分(P<0.05);农村与城市新兵的偏执型、分裂型、表演型、自恋型、边缘型、反社会型和被动攻击型分量表得分,差异有统计学意义(P<0.05),且城市新兵人格障碍得分更高(P<0.05);除分裂样型、自恋型、强迫型分量表外,独生子女新兵其他分量表及总量得分均高于非独生子女新兵(P<0.05)。结论新兵的人格倾向问题好于大学生样本,低龄、父母关系不和睦、居住在城市和独生子女新兵有更多的人格倾向问题。     

Scrotal abnormalities and infertility in west African men: A comparison of fertile and sub-fertile men using scrotal ultrasonography

ObjectiveTo determine and compare the spectrum of scrotal abnormalities in fertile and sub-fertile west African men using scrotal US.Subjects and methodsThe study examined 249 subjects over a period of 13 months. The subjects comprised 149 patients with diagnosis of male infertility, as well as 100 healthy individuals for comparison. The relevant clinical history of each patient was extracted from their case notes. All the subjects had their testes examined using a high frequency (7.5 MHz) linear transducer of an ultrasound scanner. Images in B-mode ultrasound scan and color Doppler were acquired in the supine and upright position. The results were expressed as percentages and tests of significance were done using the chi-square and Fisher's t-test. A P-value < 0.05 was considered statistically significant.ResultsThe prevalence of abnormal scrotal findings in the sub-fertile and fertile men was 65.1% and 23% respectively (P < 0.01). Varicocele was the commonest and was found in 55% and 12% of the fertile and sub-fertile men respectively (P < 0.01). Hydrocele and epididymal abnormalities were the next common with higher prevalence in the sub-fertile men (P > 0.05), while testicular tumor was confirmed in one sub-fertile patient. With the exclusion of varicocele, there was no statistically significant difference in the prevalence of the other abnormalities between the sub-fertile and fertile groups.ConclusionMale sub-fertility was associated with a higher prevalence of scrotal abnormalities. Apart from the diagnoses of the possible causes of the sub-fertility, routine scrotal US was able to diagnose other abnormalities of clinical relevance in the sub-fertile male. Scrotal US is a valuable tool in the evaluation of the sub-fertile west African man and should be considered in the routine evaluation of the sub-fertile west African man.     

线粒体介导的细胞凋亡与男性不育的研究进展

随着世界工业化进程的加快,环境污染逐渐加重,男性不育的发病率呈全球性的增高趋势。疾病、毒物接触、电磁辐射、环境雌激素都可能是造成生育能力下降的诱因,但造成男性不育的机制尚不明确。精子质量低下是男性不育的根本原因,主要包括精子DNA损伤、精子活动力下降、精子密度降低等。线粒体损伤与精子细胞凋亡率升高常伴随以上原因出现。该文对线粒体介导的细胞凋亡与男性不育之间的关系进行简要综述。     

本科男护生实习后期思想现状调查及分析

目的调查男性护理本科生实习后期思想现状,探讨男护生实习培养存在问题及解决方向。方法采用自制调查问卷,对进入临床实习后期45名本科男护生进行调查。结果男护生实习前后对护理工作思想认识、择业态度有较大差异,实习后仍愿从事护理人数比例由实习前56.25%下降到43.75%。结论实习后期男护生思想认识、择业态度比实习前有较大差异,部分学生思想动摇,考虑改行,教育工作者应考虑男护生培养存在问题,思考应对方法。     

悬吊术治疗男性获得性尿失禁的研究进展

男性获得性尿失禁是指男性因外伤或手术导致括约肌受损或后天性神经源性疾病造成机体失去控制尿液的能力。相对于治疗金标准人工尿道括约肌植入术,悬吊术操作简单,费用低廉,疗效可靠,并发症少,在近年逐渐被医患所接受。该文就悬吊术治疗男性获得性尿失禁的研究进展予以综述。     

Assessment of testicular volume: A comparison of fertile and sub-fertile West African men

BackgroundWhile the semen analysis appears to be the cornerstone in the evaluation of testicular function, the testicular volume has long been associated with testicular function. However, racial variations in testicular volume do exist. Neither the critical minimum testicular volume that guarantees adequate function, nor the optimal testicular volume that indicates peak testicular function are also known.ObjectiveTo evaluate the relationship between testicular volume and function using scrotal ultrasound scan in black West African men.Patients and methodsThe study examined 236 subjects over a period of one year. The subjects comprised of 136 patients with diagnosis of male infertility, as well as 100 healthy individuals as control. The relevant clinical history of each patient was extracted from their case notes. All the subjects had their testes examined using a high frequency (7.5 mHz) linear transducer of an ultrasound scanner. The results were expressed as percentages and tests of significance were done using the chi-square and Student's t-test. A P-value < 0.05 was considered statistically significant.ResultsThe mean testicular volume for the sub-fertile patients was 15.32 ml while it was 19.89 ml in the control group. There was a statistically significant difference between the testicular volumes in fertile and infertile men at different age groups, while there was an inverse relationship between testicular volume and severity of oligospermia. This was, however, not directly linear as a mean testicular volume of 18–20 ml was associated with highest semen density. Volumes higher than 20 ml and lower than 18 ml were associated with reduced sperm density. There was also a sharp decline in sperm density when the mean testicular volume reduced from 14 ml to 13 ml. Severe oligospermia (<5 million/ml) was associated with mean testicular volume less than 12 ml.ConclusionTesticular volume on scrotal ultrasound correlates well with severity of oligospermia in men with sub-fertility. While the critical mean testicular volume necessary for adequate spermatogenesis has not been determined, it appears there is an optimal testicular volume of 18–20 ml at which spermatogenesis is at its peak in sub-fertile Nigerian men.