Surgical site infection of scrotal and inguinal lesions after urologic surgery

To clarify the incidence of surgical site infection (SSI) after urological scrotal and inguinal surgical procedures and the preventive effect of antimicrobial prophylaxis for SSI, retrospective analysis was performed. The patients who underwent scrotal and inguinal operations from 2001 to 2010 were included in this analysis. A first or second generation cephalosporin was administered as antimicrobial prophylaxis just before the start of surgery and no additional prophylaxis was conducted. The surgery was classified into 76 (38%) cases with testicular sperm extraction (TESE), 72 (36%) with radical orchiectomy, 29 (14.5%) with bilateral orchiectomy (surgical castration) and 23 (11.5%) with other scrotal and inguinal operations. The median age and age range were 36 years and 18–81 years, respectively. SSI occurred in 7 (3.5%) cases. The frequencies of SSI were 6.5% in the patients with urological inguinal surgery and 1.6% in those with scrotal surgery. The frequency of SSI in the patients with urological inguinal surgery was not negligible even though it is considered a clean operation, and further analysis is warranted to prevent SSI.     

经尿道前列腺切除及去势术联合89Sr和药物治疗晚期前列腺癌

目的 评价姑息性经尿道前列腺切除及去势术联合~(89)Sr和药物治疗晚期前列腺癌(PCa)的疗效。方法 对8例晚期PCa患者行姑息性经尿道前列腺电气化切除(TUEVP)及睾丸切除术后,给予~(89)Sr锶(~(89) ~(Sr))和服用缓退瘤或磷酸雌二醇氮芥治疗,随访了2—4年。结果 病人前列腺症状评分(IPSS)平均下降50％,平均最大尿流率(Qmax)由(5.4±2.1)ml/s增加到(15.3±3.0)ml/s。血清PSA由治疗前的平均53.4μg/L降至~(89) ~(Sr)治疗后第3个月末的平均3.6μg/L。随访8例中,生存6例,死亡2例。转移性骨痛缓减率达100％,6例生存者的原发灶和转移灶明显缩小或消失,5例中存已超过3.5年,1例超过3年。结论 该方法可明显提高晚期PCa患者的生活质量并延长生存期,是治疗晚期PCa较有效的方法。     

鸦胆子油乳治疗中、晚期前列腺癌疗效观察(附33例报告)

为探讨治疗中、晚期前列腺癌（PCa）的有效方法，采用中药鸦胆子油乳注射疗法治疗中、晚期PCa33例，其中14例C期PCa采用鸦胆子油乳腺体内注射加卓九切除术（含2例未作睾丸切除术者）治疗，19例D期PCa采用鸦胆子油乳腺体内注射和静脉内滴注加睾丸切除术（含4例未作睾丸切除术者）治疗。结果2年内近期疗效满意，14例C期PCa达到完全缓解，19例D期PCa中有3例达到完全缓解，16例达到部分缓解。3年生存率达78．8％。认为，与既往常用的单纯睾丸切除内分泌治疗和放疗相比，鸦胆子油乳注射治疗中、晚期PCa患者的3年生存率高，且无副作用。     

黄体生成素释放激素-A治疗前列腺癌睾丸切除后复发转移疗效的探讨(附5例报告)

采用黄体生成素释放激素-A（LHRH－A）治疗前列腺癌睾丸切除术后复发或转移的患者5例（其中2例用过氟硝丁酰胺，1例用过磷酸雌二醇氮芥控制一段时期后复发），结果5例皆有效，其中4例已控制2年以上。提示LHRH－A不仅仅具有药物去势作用；若长期使用可起到选择性药物切除垂体，达到全雄性激素阻断的作用；对曾用过其他内分泌或化学药物治疗无效的患者，LHRH－A仍然有效。建议对LHRH－A治疗人类前列腺癌的作用机制作进一步的研究。     

Fertility preservation for men with testicular cancer: Is sperm cryopreservation cost effective in the era of assisted reproductive technology?

Introduction

Many patients do not cryopreserve sperm before undergoing cancer treatment because of high perceived costs of cryopreservation. We sought to investigate the cost-effectiveness of fertility preservation compared to posttherapeutic fertility treatment in testicular cancer patients.

Management protocol for Fournier’s gangrene in sanitary regime caused by SARS-CoV-2 pandemic: A case report

BACKGROUNDFournier''s gangrene (FG) is a serious, aggressive and often deadly polymicrobial infection of the soft tissues of the perineum, the rectum and the external genital organs. It is an anatomical subcategory of necrotizing fasciitis, which has a similar etiology and treatment strategy.CASE SUMMARYA 60-year-old man was admitted to the hospital during severe acute respiratory syndrome coronavirus 2 pandemic with complaints of fever up to 38.9 °C, abdominal pain, and edema of the scrotum, the penis, the perineum, and the right gluteal region for 2 d. Computed tomography of the abdomen and the pelvis revealed extensive inflammatory infiltrations of the subcutaneous tissue of the hypogastrium, and the penis; along with liquefaction and presence of gas in the subcutaneous tissues of the scrotum, the perineum, and the right gluteal region. The patient was diagnosed with FG, and was urgently qualified to undergo surgery in the Department of Urology. After performing the necessary examinations, a resection of the necrotic tissues with bilateral orchiectomy and excision of the penile and scrotal skin was performed. After surgery, he was transferred to the intensive care unit for further management.CONCLUSIONEarly management prevents the resection of the other organs by inhibiting the contiguous spread of infection.     

腹腔镜诊断和治疗隐睾（附15例报告）

目的探讨腹腔镜在隐睾的诊断与治疗中的价值及其经验总结。方法1999年3月至2003年12月对15例（17侧）隐睾应用腹腔镜进行诊断和治疗。其中5例为成人腹腔型隐睾，4例（5侧）为成人腹股沟高位萎缩隐睾，均在腹腔镜下作切除术，6例（7侧）为腹股沟隐睾，在腹腔镜下作隐睾下降、固定术。结果手术均获得成功。术中出血量少；术后住院时间为1-3d；无术后并发症。结论腹腔镜技术对不同类型的隐睾在诊断和治疗方面均能取得较好的效果，是诊断、治疗这类疾病的微创技术。     

去势对人前列腺癌裸鼠移植瘤miR-301a表达水平的影响

目的 探讨人前列腺癌LNCaP细胞荷瘤裸鼠去势后miR-301a和其宿主基因SKA2的表达变化. 方法 制备LNCaP荷瘤裸鼠模型,待肿瘤长至体积为200mm 3时,将LNCaP荷瘤裸鼠随机分成4组,每组6只,2组行去势手术,另2组作为对照组,绘制肿瘤体积变化曲线图.在去势组裸鼠肿瘤体积缩小过程中选择一时间点,处死去势荷瘤裸鼠和对照裸鼠各1组,取出皮下肿瘤称重,作为第1次取材的肿瘤.继续观察另2组裸鼠肿瘤大小,在肿瘤缩小后又再次增长的过程中选择一时间点,处死l组去势荷瘤裸鼠和对照裸鼠,取出肿块称重,作为第2次取材的肿瘤.2次取材均计算抑瘤率,并抽提肿瘤组织RNA,实时定量PCR检测肿瘤miR-301a和SKA2的表达. 结果 LNCaP荷瘤裸鼠自去势手术的第2天,肿瘤体积逐渐减小,至去势后第13天(第1次取材),肿瘤体积缩小为(62.5±21.5)mm3,肿瘤抑瘤率为59.8％,差异有统计学意义(t=-3.895,P=0.018).去势后的第17天,裸鼠肿瘤体积达到最小值,随后逐渐增大,在去势后的第41天(第2次取材),肿瘤体积增长为(364.5±97.3)mm3,抑瘤率为62.2％,差异有统计学意义(t=-7.017,P=0.002).第1次取材的肿瘤组织中miR-301a和SKA2在去势组的表达水平显著低于对照组,分别是对照组的65％和50％,差异有统计学意义(P＜0.05).在第2次取材的肿瘤组织中,miR-301a和SKA2的表达水平2组基本一致,差异无统计学意义(P＞0.05). 结论 去势能够使前列腺癌荷瘤裸鼠的肿瘤从雄激素依赖性转变为雄激素非依赖性,miR-301a和宿主基因SKA2的表达水平随前列腺癌雄激素依赖性质的转变而发生变化,两者具有密切的相关关系.     

前列腺癌患者联合雄激素阻断治疗中的肝功能异常与处理

目的　探讨前列腺癌联合雄激素阻断治疗中出现的肝功能异常和治疗。　方法　 2 3例病理确诊的前列腺癌患者 ,年龄 6 3～ 80岁 ,平均 73岁。均行双侧睾丸切除加氟他胺 2 5 0mg每日 3次 ,治疗后平均 6 .2个月出现肝功能异常。治疗前丙氨酸氨基转移酶 (ALT)为 (37± 7.2 )U/L ,17例ALT升至(6 3.5± 7.5 3)U/L ,无黄疸 ;垂盆草冲剂 1包每日 3次 ,VitC 0 .2g及VitBco 2片每日 2次治疗 ;6例ALT(87.2± 7.34)U/L伴黄疸者 ,停用氟他胺 ,5 %GS 2 5 0ml加肝泰乐 1.2g和 (或 ) 5 %GNS 2 5 0ml加泰特0 .6～ 1.2g静脉点滴每日 1次 ,持续 4周。每周随访肝功能。　结果　 17例肝功能轻度损害者经上述治疗 1～ 2个月后 ,肝功能恢复正常 ;6例重症者中 4例ALT和总胆红素均恢复正常 ,2例ALT和黄疸出现好转 ,但未正常。 4例转移性肝癌伴骨转移患者平均生存 2 .1年后死亡。　结论　双侧睾丸切除加氟他胺治疗中应密切监测肝功能 ,可预先保肝治疗。     

Intermittently administered parathyroid hormone 1–34 reverses bone loss and structural impairment in orchiectomized adult rats

Male osteoporosis is emerging as a central theme in bone research. As in females, hypogonadism appears as a principal risk factor in men that leads to bone loss and increased fracture incidence. Intermittently administered parathyroid hormone (PTH) reverses bone loss in sex hormone-deprived women and female animals and increases bone mass in elderly men and normal male animals. This study was carried out to assess whether the PTH anabolic activity is also effective in adult castrated males and to gain insight into the underlying tissue processes. Bilateral orchiectomy (ORX) or sham-ORX was performed in 13-week old rats. Five weeks later, the ORX rats were treated intermittently with human PTH(1–34), 80 g/kg/day or vehicle for 6 weeks. Femora were evaluated by quantitative micro-computed tomography followed by dynamic histomorphometry. The trabecular bone volume density showed 40% and 56% ORX-induced loss in the distal metaphysis at 6 weeks and 12 weeks post-ORX, respectively. PTH(1–34) induced supraphysiologic recovery of this bone loss (155% recovery) consequent to a vast increase in trabecular thickness (174% over sham-ORX controls) and a partial reversal (62%) of the decrease in trabecular number. As compared with the results in 12-week, orchiectomized vehicle-administered rats, the PTH(1–34) treatment induced a significant decrease in osteoclast number (20%) and twofold increase in bone formation rate. While ORX did not affect the femoral diaphysis, PTH(1–34) induced marked cortical thickening via the stimulation of endosteal mineral appositional rate (154% over ORX rats). These data portray PTH(1–34) as a highly potent bone anabolic agent in adult ORX rats, mainly by increasing both the trabecular and cortical thicknesses through its effect on osteoblasts and osteoclasts. The adult ORX rat is useful for investigating the processes involved in bone anabolic activity in castrated osteoporotic males and for the development of bone anabolic agents for treating this condition.