Orchiectomy upregulates free soluble RANKL in bone marrow of aged rats

The osteoprotegerin (OPG)/receptor activator of NF-κB ligand (RANKL) axis is thought to be involved in the upregulation of bone turnover following sex steroid deficiency. Here, we investigated the effects of orchiectomy (ORX) on bone turnover and free soluble RANKL (sRANKL) in aged rats. Free, bioactive sRANKL is a critical determinant and key mediator for survival and activity of mature osteoclasts. Thirty-three 9-month-old male Fischer-344 rats were either ORX or sham-operated (SHAM). Following in vivo fluorochrome labeling, vehicle (ricinus oil/benzyl benzoate)-treated SHAM and vehicle- or testosterone undecanoate (T, 6 mg/kg s.c. once weekly)-treated ORX rats (n = 8–9 each) were killed 2 months after surgery. Vehicle-treated ORX rats showed lower seminal vesicle weight, loss of proximal tibial trabecular bone mineral density, and reduced cortical thickness at the tibial shaft as measured by peripheral quantitative computed tomography relative to SHAM controls. Bone loss in vehicle-treated ORX rats was associated with enhanced bone turnover as evidenced by increases in tibial cancellous bone formation rate, osteoclast numbers, urinary excretion of calcium and deoxypyridinoline, and serum osteocalcin. T treatment of ORX rats restored seminal vesicle weight to SHAM control levels, and completely protected against post-ORX bone loss by suppressing bone turnover. Free sRANKL concentrations in bone marrow supernatants harvested from the proximal femur were about 3-fold higher in vehicle-treated ORX relative to SHAM rats, and returned to SHAM control levels in T-treated ORX rats. mRNA abundance of matrix metalloproteinase-14 (MMP-14) in bone marrow was 4-fold higher in vehicle-treated ORX rats relative to SHAM rats. T treatment of ORX rats suppressed MMP-14 mRNA expression to SHAM control levels. We conclude that orchiectomy increases the concentration of free sRANKL in bone marrow of aged rats. In addition, increased shedding of membrane-bound RANKL by MMP-14 may be a pivotal mechanism resulting in augmented free sRANKL concentrations in the bone marrow environment after androgen withdrawal.     

Diagnostic and therapeutic laparoscopy for nonpalpable testis

Background: We evaluated the use of laparoscopy in the management of impalpable testis to determine what advantages it might offer over the open approach.Methods: Over a 5.5-year period, a total of 46 patients with 53 nonpalpable testes underwent a laparoscopic procedure at our hospital. There were 28 cases of intraabdominal testis (52.83%), 18 cases of the vas and vessels entering the internal ring (33.96%), and seven cases of intraabdominally absent testis (13.20%). We performed a laparoscopic orchiopexy for 24 testes (scrotal in 21 cases and partial to the inguinal canal in three cases) and an orchiectomy for three testes. We encountered inguinal hernia in 14 cases (26.41%). Results: At follow-up, all testes were the same size as at the time of operation and were well positioned in the scrotum, except for four testes that required reoperation due to partial migration at the superficial inguinal ring. The operating time was <1 h in unilateral cases and <2 h for the bilateral cases. All procedures were completed successfully without conversion or complications. Conclusions: Laparoscopy is the only exploratory procedure that is accurate enough to enable the diagnosis of nonpalpable testis and also allow the surgical treatment to be done in the same setting.     

康士得联合睾丸切除治疗晚期前列腺癌

目的 :观察康士得治疗晚期前列腺癌 (PCa)的疗效。方法 :应用康士得联合睾丸切除治疗晚期PCa和缓退瘤抵抗患者。结果 :① 10例原发PCa治疗 3个月 ,血清前列腺特异抗原 (PSA)降至 (4 .6 7± 2 .5 8) μg/L ,与治疗前比较差异有极显著性意义 (P <0 .0 1)。其中 8例完全降至正常 ,2例下降 >90 %。患者临床症状均改善 ,前列腺体积明显缩小 (P <0 .0 1)。治疗 12～ 18个月 ,无一例出现PSA反跳。② 2例缓退瘤抵抗患者 ,改服康士得后 ,PSA最大降幅分别为 76 %和 81% ,显示对继续阻断雄激素依然有效。结论 :康士得联合睾丸切除治疗晚期PCa有较好疗效。     

去势对戊四氮点燃癫痫大鼠海马细胞凋亡、ANT_1及GABA表达的影响

目的:探讨SD雄鼠去势后的细胞凋亡及γ-氨基丁酸(GABA的表达改变,以此来推测雄激素及去势对雄鼠的致痫的影响。方法:取健康SD雄性大鼠44只,随机分为4组:空白对照和生理盐水对照各10只;正常致痫组和去势致痫组各12只。采用戊四氮亚惊厥剂量(35mg/kg)腹腔注射造模,观察记录大鼠潜伏期及发作时间等。点燃后采用心内灌注固定取脑,对脑组织标本行HE染色及GABA、腺嘌呤核苷酸移位酶-1(ANT1)免疫组化染色,整理数据进行统计学分析。结果:①HE染色显示:空白对照及盐水对照组大鼠海马各区细胞排列整齐,边缘清晰,染色均匀,核仁清晰可见,形态正常。②致痫组海马区域神经细胞排列紊乱,胞浆嗜依红染色,体积缩小,核固缩,核膜皱缩,呈现为三角形或不规则性,部分空泡变,去势组受损神经元数目较非去势组略轻。③海马区GABA免疫组化结果显示:空白对照与生理盐水组各区阳性细胞数无显著性差异,致痫组GABA阳性细胞数明显增多,且去势组增加较非去势组相比明显减轻(P<0.05)。④致痫大鼠海马区ANT1阴性表达。结论:致痫大鼠海马区ANT1阴性表达,癫痫细胞凋亡与ANT1无明确相关性。非去势SD大鼠海马区GABA表达较去势大鼠表达增多,与行为学表现一致。     

双睾丸切除和药物治疗后前列腺切除治疗晚期前列腺癌(附7例报告)

目的：探讨双睾丸切除和内分泌药物治疗后行根治性或姑息性前列腺切除术治疗晚期前列腺癌的临床效果。方法：对７例晚期前列腺癌患者行双睾丸切除术后服用缓退瘤和乙烯雌酚３￣６个月再行根治性（２例）或姑息性（５例）前列腺切除术。结果：解除了患者下尿道梗阻,提高了生存质量,延长了生存期,４例患者生存超过３．５年,３例超过３年。结论：该方法是治疗晚期前列腺癌的有效方法。     

以腹痛为首发症状的围青春期男性睾丸扭转

目的:提高对以腹痛为首发症状的睾丸扭转的诊治水平.方法:回顾分析26例围青春期男性睾丸扭转病例,按首发症状分为腹痛(A组)和阴囊痛(B组)两组,比较其诊治特点.结果:A组7例(27％),平均年龄18(12～25)岁,其中5例(72％)因缺血坏死行睾丸切除术,1例(14％)睾丸萎缩,1例(14％)局部睾丸坏死;B组19例(73％),平均年龄17(13～22)岁,其中9例(47％)因缺血坏死行睾丸切除术、1例(5％)睾丸萎缩.结论:以腹痛为首发症状的睾丸扭转更容易延误诊治而导致睾丸切除.对腹痛的围青春期男性,应将睾丸扭转列为鉴别诊断疾病之一,并常规检查阴囊.     

保留睾丸的肿瘤剜除术治疗儿童良性睾丸肿瘤

目的评价保留睾丸的肿瘤剜除术治疗儿童良性睾丸肿瘤的临床疗效。方法回顾性分析1998年10月到2009年3月收治的29例保留睾丸的肿瘤剜除术患儿临床资料。患儿平均发病年龄为42．6个月（4个月至12岁）,临床表现均为无痛性阴囊肿块,除1例术前AFP升高外,其余术前AFP均在正常范围。结果均行保留睾丸的肿瘤剜除术,术后病理诊断：21例为成熟性畸胎瘤,2例为表皮囊肿,4例为皮样囊肿,1例为囊肿性病变伴肉芽肿形成,1例为未成熟畸胎瘤（后行睾丸切除术）。25例冰冻切片均诊断为良性病变。21例B超下计算肿瘤体积为（1．25±2．05）mL,患侧睾丸体积（含肿瘤）为（4．56±5．07）mL,肿瘤占睾丸体积比例为（54．3±30．11）％（6．04％～100％）。7例最近1次门诊随访术侧平均睾丸体积为（0．78±0．31）mL,与健侧比较无统计学意义。20例平均获随访34个月（4～72个月）,无一例复发,患侧睾丸发育良好。结论保留睾丸的肿瘤剜除术可作为小儿睾丸良性肿瘤的首选治疗方法。     

硫酸糖基化蛋白2在去势大鼠前列腺中的表达

目的 探讨硫酸糖基化蛋白2（SGP－2）在去势大腹叶前列腺表达的规律及其与前列腺凋亡的相关性。方法 将90只大鼠随机分为9组，每组10只，分别于去势后0、1、2、3、5、7、10、14、21d处死，取前列腺包埋切片后行免疫组织化学检测SGP－2和增殖细胞核抗原（PCNA),缺口末端标记术（TUNEL）和电镜检测前列腺细胞凋亡，计算阳性率，并作连续切片，行计算机图像重叠技术比较SGP－2表达与凋亡的相关性，及与PCNA表达的关系。结果 正常大鼠前列腺SGP－2表达较少，去势后则显著增加，与凋亡的变化及分布规律相似，其表达的阳性率与凋亡阳性率呈正相关（r＝0．8075，P＜0．01）。SGP－2的表达和PCNA呈负相关（r=－0．8061，P＜0．01）。结论 SGP－2在去势大鼠腹叶前列腺表达增高，与凋亡呈正相关，与PCNA呈负相关，提示可能有促凋亡和抑制增殖的作用。