长期缺性会得前列腺炎<br>　　前列腺炎常被人们与不洁性生活扯上边。然而，27岁的李先生近期被证实患有功能性前列腺炎时，怎么也想不通：”我还是处男啊，怎么也会得前列腺炎？”徐谊朝指出，这并不奇怪，性生活过频或者过少都有可能诱发慢性前列腺炎。

目的: 评价有生育需求中老年男性精子参数的变化。方法: 42例50～58岁有生育需求男性的精液标本, 按照其既往生育史分组, A组:继发性不育23例, 平均年龄52.9±2.2(50～58)岁;B组:原发性不育19例, 平均年龄52.7±2.7(50～58)岁。按世界卫生组织手册(WHO, 2010)方法, 检测患者的精子活动率、前向运动精子率、精子浓度、精子畸形率、畸形精子指数和精子顶体完整率。结果: A组的畸形精子率显著低于B组(P<0.05), 其它精子参数组间无统计学差异(P>0.05)。与WHO手册(2010)的参考值对照, A、B组的精子活动率均数、前向运动精子率均数和B组的正常形态精子率均数低于参考值下限。A组和B组分别有11例(47.8%)、5例(26.3%)的精子活动率、前向运动精子率、精子浓度和正常形态精子率达到WHO的参考值范围, 但达到WHO参考值的例数比率组间无统计学差异(P>0.05)。结论: 50～58岁有生育需求中老年男性的精子参数低下, 但存在明显的个体差异。

良性前列腺增生(BPH)与前列腺癌有共同患病人群,BPH的有创治疗均可影响血前列腺特异性抗原(PSA)水平,从而影响对前列腺癌的筛选,因此有必要了解这些有创治疗对血PSA水平的精确影响.经尿道前列腺等离子电切(PKRP)是治疗BPH广泛开展的新技术,但其对血PSA浓度的影响仍缺乏了解.本研究初步探讨PKRP术后血PSA浓度的变化.

【Objective】 To explore retrospectively the difference of therapeutic efficacy and side effect between subcapsular orchiectomy and medical castration in prostate cancer Patients-Ⅳ.【Methods】 In the retrospective study,132 consecutive Patients-Ⅳ were evaluated,the operation group(n =70) had primarily been treated by subcapsular bilateral orchiectomy and the medicine group(n =62) had received medical castration from Jan 2005～Oct 2011.Response to therapy,time of tumor remission,overall survival time,psychological disorders due to loss of organ and postoperative surgical complications were recorded.【Results】 The follow up time was 1～59 months.Median time of tumor remission of the operation group and medicine group were 18 and 17 months.The difference was statistically insignificant(χ2=0.166,P =0.682).Median times of overall survival were 33 and 31 months respectively.The difference was statistically insignificant(χ2=0.080,P =0.778).10% of the operation group showed minor postoperative complications.No psychological disease occurred following bilateral orchiectomy.【Conclusion】 Due to an effective and persistent oncological effectiveness,absence of psychological complications and cost-effective,bilateral subcapsular orchiectomy seems to be a practicable and advisable alternative in the first-line therapy of prostate cancer Patients-Ⅳ.

【Objective】 To prepare anti-HER2 immuoliposomes containing mitoxantrone and evaluate its cytotoxicity on PC-3 cells in vitro.【Methods】 Liposomal mitoxantrone(Ls-MIT) was prepared by transmembrane ammonium sulfate gradient.Anti-HER2 scFv F5 was initially coupled to mPEG-DSPE linker,followed by incorporation of the resulting micellar conjugates into drug loaded liposomes(F5-ILs-MIT).F5-ILs-MIT was then evaluated for stability in PBS and human plasma,and the cytotoxicity on PC-3 cells in vitro.【Results】 F5-ILs-MIT was stable in PBS and human plasma after one month and 24h storage,mitoxantrone remained(94.2±0.9)% and(85.6±0.8)%,respectively.F5-ILs-MIT was more cytotoxic than Free-MIT and Ls-MIT on PC-3 cells in vitro,IC50 was 0.035μg/mL,0.25μg/mL and 9.0μg/mL.respectively.【Conclusions】 HER2 targeted immunoliposomes could enhance the cytotoxicity of mitoxantrone on HER2 over-expressing PC-3 cells in vitro.

目的观察RECK和MMP-9蛋白在肾细胞癌组织中的表达,探讨两者在肾细胞癌侵袭和转移中的关系。方法采用免疫组化SP法检测57例肾细胞癌手术切除标本中RECK、MMP-9蛋白表达情况。结果 RECK在肾细胞癌组织中的阳性表达率为47.4%,明显低于癌旁正常组织(P<0.01);而MMP-9在肾细胞癌组织中的阳性表达率为80.7%,明显高于癌旁正常组织(P<0.01)。RECK和MMP-9蛋白表达与肿瘤的组织学分级、临床病理分期和淋巴结转移密切相关。两者表达水平呈负相关(r=-0.614,P<0.05)。结论 RECK和MMP-9蛋白表达与肾细胞癌的侵袭和转移密切相关,可作为评价肾细胞癌预后的生物学指标。

Aim:To investigate the clinical safety and efficacy of the treatment for leukoplakia of the bladder by transurethral resection.Methods: All patients(34 females) were treated by transurethral eletrovparization resection.The range of resection was extended 1 cm outside the involved area.The depth reached the surface of the muscle.All cases was injected Mitomycin-C(MMC)into the bladder postoperatively.The average age was 38.2±4.08 years(range 28 to 46 years).Results: The procedures were successful in all 35 cases,no blood transfusion.The operative time ranged from 6 to 15 min,average time was 9.18±2.05 min.No surgical complications occurred.The mean hospitalization time was 4.06±0.78 days(range 3-5 days).The patients had been followed up for 6～15 months(mean 11.12±2.32 months).The symptoms of these cases disappeared postoperatively.There was no evidence of recurrence.Conclusion:The transurethral eletrovaprization of leukoplakia and intravesical instillation of MMC is safe and effective for treatment of leukoplakia of the bladder,it has the advantage of less damage and rapid recovery.

目的 探讨微创经皮肾穿刺取石治疗孤立肾肾结石的疗效和安全性.方法 35例孤立肾肾结石患者行MPCNL.结果 该组35例均经1次穿刺即成功建立通道,31例行单通道取石,4例鹿角形结石行多通道碎石.一期行MPCNL治疗29例,二期MPCNL治疗6例.手术时间90～140 min,平均94.1 min,术中出血40～90mL,平均(62.6±14.2) mL.结石清除率87.8％( 29/35),二期碎石后总清除率为94.3％( 33/35).1例下盏结石残留,1例上盏结石残留,残留直径＜7 mm.无气胸、腹腔脏器损伤及大出血等严重并发症.术后住院时间5～9d,平均5.4 d.术后发热2例.术后随访6～22个月,平均11个月,结石无复发.结论 MPCNL治疗孤立肾肾结石是有效、安全治疗方案,具有创伤小,恢复快,出血少等优点.

目的 探讨微创经皮肾镜取石术治疗多囊肾合并上尿路结石的临床疗效.方法 17例多囊肾合并肾结石患者均采用B超定位经皮肾镜气压弹道碎石系统治疗,并观察结石清除情况.结果 均一期成功建立皮肾通道,6例同时行双侧碎石.手术时间70～140 min,平均(95.1±19.5)min,术中出血(60±13.4)mL.术中无气胸、腹腔脏器损伤等严重并发症,术后无大出血、发热、造瘘管周围漏尿等并发症.术后肠道功能恢复时间12～24 h,下床活动时间24～48 h,结石清除率为88.2%(15/17).2例有较大结石残留辅以ESWL治疗,术前肾功能不全7例患者血肌酐均有不同程度下降,术后住院时间4～9 d,平均(5.6±1.5) d.术后随访3～18个月,结石无复发.结论 微创经皮肾穿刺取石术是治疗多囊肾合并上尿路结石的有效、安全治疗方法.

<正>先天性尿道下裂成形术术后并发症较高,尿瘘是其最常见的并发症之一,有报道其发生率在15%～30%[1]。其因瘘口的大小、部位不同,有不同修补术式。笔者回顾分析2002～2009年收治54例术后尿瘘患儿的临床资料,总结尿瘘修补的经验,探讨

Aim: The aim of this study was to assess the clinical efficacy and safety of alcohol sclerotherapy and laparoscopic surgery for symptomatic simple renal cysts.Methods: Of 25 patients with symptomatic simple renal cyst,15 patients underwent percutaneous aspiration followed by injection of 99% ethanol and 10 performed retroperitoneal laparoscopic marsupialization.All patients were followed up over a period of 6 months.In both groups,we evaluated operating time,hospital stay,cost,success rate and complication rate.Results: Comparing alcohol sclerotherapy group with retroperitoneal laparoscopic renal cystectomy group,there was no statistical significance in success rate and complication rate(P0.05) even though success rates were 87% and 100%,complication rates were 13% and 20%,respectively.However,the operating time [(57.0±8.4) min,(94.0±19.0) min],hospital stay [(1.0±0.0) day,(2.5±0.5) day] and cost [(5017.08±90.62) yuan,(14 698.35±985.76) yuan] were significantly deceased in the alcohol sclerotherapy group(P0.01).Conclusion:Alcohol sclerotherapy is considered as a primary treatment for symptomatic simple renal cyst because it is simple,noninvasive and highly cost-effective.However,laparoscopic ablation of renal cysts may be indicated as an alterative treatment of patients who have failed alcohol sclerotherapy or expected technical difficulty.

目的探讨输尿管镜微创治疗上尿路结石致肾功能不全的疗效和手术方法。方法回顾性分析53例接受输尿管镜取石、经皮肾微造瘘取石治疗患者的临床资料,通过比较手术前、后血肌酐浓度,观察肾功能改善情况。结果本组53例术前血肌酐平均(445.4±22.7)μmol/L,血肌酐于术后2周开始下降,平均(180.8±10.0)μmol/L,与术前比较差异有显著性(P=0.000)。50例患者术后4周内肌酐降至正常,3例血肌酐分别稳定于135~273μmol/L。于术后1个月复查,结石排尽者39例(73.6%);术后3个月复查,结石排尽者47例(88.7%)。结论上尿路结石引起的肾功能不全是泌尿外科的危重疾病,应早期诊断和及时处理,输尿管镜取石、经皮肾微造瘘取石治疗,是一种适宜的、具有创伤小、出血少、恢复快、效果明显、安全有效等优点的治疗方法。

目的评价输尿管镜治疗输尿管下段结石术后是否有必要放置输尿管支架管。方法回顾性分析97例用输尿管镜治疗输尿管下段结石的病例,根据术后是否放置输尿管支架管将其分成放置支架组(55例)和不放置支架组(42例)。输尿管镜取石采用德国Wolf(F8/9.8)硬性输尿管镜。统计和记录每组病例的手术时间、结石体积、成功率和手术后不适症状。不适症状的记录时间为患者术后第7天。结果两组的结石体积、成功率和手术时间差异无显著性。放置支架组患者在耻骨上不适(P=0.001)、膀胱刺激症状(P=0.019)和总体不适症状发生率(P<0.05)三方面均比不放置支架组患者明显,两组间差异有显著性。结论放置输尿管支架管可增加患者膀胱刺激症状和疼痛不适的发生率。因此,输尿管下段结石患者输尿管镜取石术后不必常规放置输尿管支架管。

目的:探讨精索静脉高位结扎术在亚临床型精索静脉曲张(SVC)伴少精子症,弱精子症患者中的意义。方法:14例SVC伴少精子症,弱精子症患者行经腹股沟途径精索静脉高位结扎术,并对术前和术后精液进行分析。结果:术后精子密度较术前明显提高,而精液量、形态、存活率、活力等无显著变化。4例(28.6%)患者手术7～10个月后受孕,另有4例(28%)患者手术10～30个月后体外授精妊娠成功。结论:SVC患者精索静脉高位结扎术后精子的质量及受孕情况有一定的改善。

Objective The cystoscopy has been one of initial diagnostic modalities in the evaluation of microscopic hematuria along with intravenous pyelography and urine cytology, but questions have been raised about its efficacy in the evaluation of asymptomatic microscopic hematuria. For the patients who visit outpatient clinics, the cystoscopy has been looked upon as rather invasive compared to other diagnostic methods. We tried to elucidate the actual diagnostic value of the cystoscopy in the evaluation of asymptomatic microscopic hematuria. Method We reviewed the results of cystoscopic exams of 213 patients(mean age: 49.7) who visited our hospital due to asymptomatic microscopic hematuria. For all of the 213 patients, no definite lesion that could explain the microscopic hematuria was detected by means of IVP, urine cytology, and other nephrologic evaluations. Results There were abnormal cystoscopic findings in 55 of the 213 patients who underwent cystoscopic exams. The lesions that are suspected to be directly related to microscopic hematuria were classified as 'the significant lesions' (31 patients, 17.6%): The lesions that cannot account for microscopic hematuria were classified as 'the insignificant lesions' (24 patients, 9.84%). 27 of the 31 patients with the significant lesions(85.2%) were over 50 years old, and further more, 3 patients who were diagnosed as bladder tumor by cystoscopy were over 60. Conclusions The cystoscopy should be utilized as initial diagnostic modality for asymptomatic microscopic hematuria to rule out any possibility of bladder tumor occurrence, and for the patients over 50 in age, its diagnostic value could be emphasized even more.

目的:探讨经尿道输尿管镜气压弹道碎石术治疗输尿管结石的临床疗效.方法:经尿道在输尿管镜窥视下采用气压弹道碎石机对116例输尿管结石进行碎石治疗.结果:109例原位碎石成功,成功率为94.0%,平均碎石时间(4.6±2.3)min,术后1～3个月结石排净率100%,并发症发生率6.0%,分别为输尿管黏膜下损伤2例,穿孔1例,肾绞痛2例,感染2例.结论:经尿道输尿管镜气压弹道碎石术治疗输尿管结石安全、有效、容易操作,是治疗输尿管中下段结石的首选方法.

目的：评价B超定位电磁式体外冲击波碎石(ESWL)治疗泌尿系结石的效果。方法：利用B超定位电磁式体外碎石机对3521例泌尿系结石患者进行冲击波碎石治疗。结果：肾结石912例，结石粉碎率为100%，3个月排净率为91%；输尿管上段结石564例，治疗成功率为97%；输尿管下段结石1942例，治疗成功率为98.6%；膀胱及后尿道结石103例，治疗成功率98%。碎石时无明显疼痛，个别病人皮肤表面出现红斑，96%耐受良好。结论：B超定位电磁式体外碎石机治疗泌尿系结石安全、疗效满意。

目的对常用的4种精索静脉曲张症诊断方法进行评价.方法①临床体检;②彩色多普勒超声血流图检查;③精索内静脉造影;④阴囊血池扫描.结果临床体检初诊为精索静脉曲张症的582例患者,492例进行了彩色多普勒超声血流图检查,单纯左侧精索静脉曲张占12.8%(63例/492例),双侧精索静脉曲张为87.2%(429例/492例).40例进行了精索内静脉造影术,均发现左侧精索静脉血液返流,右侧精索静脉插管困难,未能进行造影检查.38例进行了阴囊血池扫描,均发现左侧同位素显像较右侧强.结论初诊时应以临床体检作出初步诊断.进一步确诊时推荐使用彩色多普勒超声血流图检查,其结果可靠.精索内静脉造影术是创伤性方法,且无法对右侧精索静脉曲张作出诊断;同位素阴囊血池扫描无法对双侧精索静脉曲张进行诊断,均无应用价值.

Aim: RCC-925 is a cell line of human renal cell carcinoma, effect of α-interferon (α-IFN) and verapamil(VRP) on adrianmycin(ADM) in RCC-925 cells. Methords: (1) RCC-925 cells were culture in vitro with different concentration of α-IFN or VRP or α-IFN+VRP and 1 mg/L ADM, or with the different concentration of ADM and 2.5 mg/L VRP or 500 pg/mL α-IFN or 2.5mg/L VRP + 500 pg/mL α-IFN, living cells were detected by MTT colorimetric assay. (2) The expression of PgP RCC-925 cells was conducted by immunohischemical techniques was used for α-IFN and VRP. Results: The cytotoxicity studies showed that sole use of α-interferon didn't show its reversal function while verapamil combinated with α-interferon was significantly more effective than the sole use of verapamil in overcoming drug resistance (P＜0.05). The expression of P - glycoprotein studies demonstrated the low-level expression in culturing with 500 pg/mL α-interferion and 2.5 mg/L verapamil. Conclusion: The results have indicated that multidrug resistance could be significant reversed by verapamil combinating with α-interferon, would provide a novel therapy in the treatment of cancer patients.