超声及临床特征对附睾局灶性病变的鉴别价值

目的:评价超声及临床特征在附睾局灶性病变鉴别诊断中的应用价值。方法:回顾性分析附睾局灶性病变48例,包括非特异性附睾炎、附睾结核和附睾精液囊肿。分析附睾局灶性病变大小、形态、位置、回声强度及均一性,鞘膜腔是否有积液;病灶血流的程度以及患者年龄、病程和阴囊压痛程度。结果:附睾结核病灶平均面积比非特异性附睾炎病灶大(P<0.05),并多可见钙化斑。非特异性附睾炎病灶的血流信号比附睾结核(P<0.05)及附睾精液囊肿(P<0.01)丰富;非特异性附睾炎病程比附睾结核(P<0.01)和附睾精液囊肿(P<0.01)短;非特异性附睾炎病灶的压痛比附睾结核(P<0.01)和附睾精液囊肿(P<0.01)明显。附睾局灶性病变发生位置及有无鞘膜积液无明显区别(P>0.05)。结论:超声和临床特征对附睾局灶性病变鉴别诊断具有重要的价值,为临床诊断、治疗附睾疾病及评价疗效提供客观依据。     

恒猴精索内注射长效局麻药后对睾丸和附睾的影响

在13只恒河猴精索内注射长效局麻药后,睾丸发生明显变化;而且给药剂量不同,睾丸曲精小管改变的程度和恢复正常的时间亦不同。睾丸间质细胞无明显变化;睾酮分泌不减少,无毒性反应。对临床男性节育应用及生殖生理研究均具有意义。     

用酶联免疫吸附术观察向附睾注射鱼肝油酸钠后抗精子抗体的变化

本研究用酶联免疫吸附术观察8只家兔在附睾注射鱼肝油酸钠后血清及精浆中的抗精子抗体。血清抗精子抗体阳性率为37.5～50.0%,最早检出率为术后2个月,6～7月达高峰。精浆抗精子抗体阳性率为25%,最早检出率为术后4个月,且此时己达高峰。与输精管结扎资料相比,发现血清抗精子抗体检出率偏低,而精浆相应抗体偏高,表明向附睾注射鱼肝油酸钠引起的免疫反应有别于结扎,以生殖道局部为主。     

高压氧对精索静脉曲张家兔附睾组织学影响的实验研究

目的研究高压氧(HBO)对精索静脉曲张(VC)家兔附睾组织学的影响,探讨精索静脉曲张导致男性不育的发病机制。方法采用HBO干预精索静脉曲张家兔模型,对睾丸、附睾的重量,附睾不同节段精子活力,附睾的组织形态以及精液参数进行研究。结果与未行HBO干预的VC模型比较,HBO 干预后的VC模型精液质量明显改善,睾丸、附睾重量明显增加(P值均<0．01),左侧附睾尾部Ⅱ级以上精子明显增加(Ⅱ级57．43％±6．48％,Ⅲ级2．91％±1．51％)(P<0．01,<0．05)。附睾上皮结构改善,腔内精子密度增加。结论 VC可导致附睾病理损害、精子成熟和获能障碍。慢性缺血、缺氧及其微循环障碍是导致附睾病理损害、精子成熟和获能障碍的主要机制。HBO可有效抑制VC致附睾的病理损害进程。     

低氧对大鼠附睾功能的影响

目的研究低氧对大鼠附睾功能的影响。方法将成年雄性Wistar大鼠随机分为常氧和低氧5d、15d、30d4组。低氧各组置低压舱内模拟5,000m高原低氧。测定附睾尾精子数量、质量,生化法测定各组大鼠附睾液中果糖、肉毒碱的含量及α-葡萄糖苷酶的活性。结果低氧15d组、30d组大鼠附睾尾精子数显著低于常氧组。低氧各组精子活力、活率显著低于常氧组;尾部畸形精子数显著高于常氧组。低氧5d组、15d组大鼠附睾液果糖含量显著高于常氧组(P<0.01)。低氧5d、30d组,大鼠附睾液中性α-葡萄糖苷酶活性显著低于常氧组。结论低氧可抑制附睾尾精子数量和质量,并抑制附睾液中性α-葡萄糖苷酶活性,提示低氧可干扰附睾功能,并抑制精子的成熟。     

3-氯丙二醇及2,3-氧丙醇合并给药对大鼠附睾、肝、肾超微结构的影响

以每日5mg/kg的3-氯丙二醇及75mg/kg的2,3-氧丙醇同时给大鼠灌胃,连续给药2天后停药8天,共10天为一疗程。观察了3,6,9疗程结束时,附睾起始部主细胞的超微结构改变,及附睾管起始部的精子和肝脏、肾脏的超微结构。发现在3、6疗程末,附睾主细胞的高尔基复合体扁平囊变窄,大泡皱缩。在6疗程末,细胞表面的吞饮小泡和静纤毛减少。仅在3疗程见到粗面内质网扩张。9疗程的超微结构与对照比较无明显区别。结果提示,每一疗程药物引起的附睾主细胞超微结构的改变,在多数动物是可恢复的。但由于个体差异,部分动物于疗程之末,尚未完全恢复。在第6疗程末的肝脏,有部分肝细胞滑面内质网扩张,线粒体体积缩小,基质电子密度增高。这些变化可能是一种轻度的细胞损伤,这种损伤在3,9疗程均未发现,说明它与疗程长短不呈平行关系。肾尿细管上皮细胞及附睾起始部精子的超微结构,无可见改变。这一结果为阐明3-氯丙二醇及2,3-氧丙醇合并用药的抗生育作用,及对有关内脏的毒性作用,提供了形态学的依据。     

Absence of group II phospholipase A2, a Paneth cell marker, from the epididymis

Paneth cell-like metaplasia has been reported in the epithelium of the epididymis and prostatic adenocarcinomas. We studied the expression of group II phospholipase A2 (PLA2), a marker of Paneth cell differentiation, in six orchiectomy specimens with Paneth cell-like metaplasia. Both immunohistochemistry for group II PLA2 protein and in situ hybridization for the mRNA of group II PLA2 gave negative results in all six cases but positive reaction for lysozyme. The results show that the cells of the Paneth cell-like metaplasia are not true Paneth cells.     

青春期糖尿病雄鼠血清和性腺血管紧张素转换酶活性变化

４０日龄雄性Ｗｉｓｔａｒ大鼠２１只，分为对照（Ｃ）组，腹腔内注射赋形剂和糖尿病（Ｄ）组，腹腔内注射链脲菌素（ｓｔｒｅｐｔｏｚｏｔｏｃｉｎ，ＳＴＺ），５５ｍｇ／ｋｇ体重，观察６０天。结果表明，Ｄ组大鼠的睾丸、附睾、附睾尾重量显著低于Ｃ组（Ｐ＜０．０１）；Ｄ组附睾尾精子计数显著少于Ｃ组（Ｐ＜０．００１）。ＡＣＥ活性测定结果表明，Ｄ组睾丸和附睾尾组织ＡＣＥ活性显著低于Ｃ组（Ｐ＜０．０５），而血清ＡＣＥ显著高于Ｃ组（Ｐ＜０．０１），相关检验显示，附睾重量，附睾尾精子计数与附睾尾ＡＣＥ水平呈显著正相关（Ｐ＜０．０１），与血清ＡＣＥ呈显著负相关（Ｐ＜０．０５，Ｐ＜０．０１）。     

Review article: Structure and function of the epididymis

Summary Testicular spermatozoa are functionally immature in that they cannot fertilize ova. It was first demonstrated by Young [171, 172] that spermatozoa undergo certain changes as they migrate through the epididymis. He proposed that spermatozoa ripen during epididymal transit. It is now known that specific maturational changes occur in spermatozoa during epididymal transit which result in their developing the ability to fertilize ova. Concomitant with this functional maturity are changes in spermatozoal morphology, motility, chemistry, permeability, density and metabolism. It is apparent that in some way not understood these changes are necessary for sperm to achieve the ability to complete the fertilization process. When these mechanisms are understood, we may be able to effectively treat conditions such as necrospermia or abnormally low sperm motility. Furthermore, with the development of the hamster-egg penetration test a new type of male infertility has become evident in recent years; the inability of otherwise normal sperm to penetrate an ovum. It is during epididymal transit that this ability is normally acquired. Thus, any insight into how sperm attain the capacity to penetrate an ovum could lead to an effective treatment of patients whose sperm do not have this ability. In addition, the epididymis holds significant promise as the site of action for a male contraceptive. Thus, it is the purpose of this review to describe the structure and function of the mammalian epididymis with particular emphasis on the factors regulating sperm maturation.