目的 分析探讨血红蛋白在前列腺癌和前列腺增生患者血清中的水平,探讨其在前列腺癌中的诊断价值.方法 回顾性分析2019年1月—2022年4月本院泌尿外科收治的139例前列腺癌和前列腺增生患者的临床资料,观察不同组别患者之间血红蛋白水平的差异.结果 经Mann-Whitney U非参数检验,前列腺增生患者血红蛋白水平显著高于前列腺癌患者(P<0.001).与前列腺增生组患者相比,前列腺癌骨转移亚组以及前列腺癌病理分级亚组血红蛋白水平更低(P<0.001).Spearman相关性检验显示,前列腺癌患者的病理分级、是否骨转移与血红蛋白水平具有显著负相关(P<0.001).将血红蛋白用于前列腺癌诊断,其曲线下面积为0.632,其取值为137.5g/L时,灵敏度为61.9％,特异性为58.6％.在诊断前列腺癌骨转移时,其曲线下面积为0.736,当血红蛋白取值为128.5g/L时,灵敏度为67.6％,特异性为75.7％.结论 治疗前血红蛋白水平对于前列腺癌有一定诊断价值,可作为其辅助诊断指标之一.

目的 探讨左卡尼汀对男性不育症患者精子活力、DNA完整性及不良反应的影响.方法 选取2019年2月至2020年1月于医院就诊的86例男性不育症患者,按随机数字表法分为两组,各43例.对照组采用五子衍宗丸治疗,试验组采用左卡尼汀治疗,比较两组的精子活力、DNA完整性及不良反应发生情况.结果 治疗3个月后,试验组精子浓度、前向运动精子百分率及精子总活率分别为(31.27±5.42)×106/ml、(35.74±5.72)％、(48.75±5.82)％,均高于对照组的(25.14±5.07)×106/ml、(29.66±5.31)％、(40.39±5.56)％,差异有统计学意义(P<0.05);试验组DNA碎片率为(12.14±2.05)％,低于对照组的(16.94±2.87)％,差异有统计学意义(P<0.05);两组均无严重不良反应.结论 左卡尼汀可增强男性不育症患者的治疗效果,提高精子总活率,增加精子浓度,降低精子DNA碎片率,且安全性较高.

目的 探讨单纯精液液化不全对宫腔内人工授精(IUI)结局的影响.方法 回顾性分析2015年1月至2018年12月在本院生殖中心行IUI治疗的351例不孕不育患者的临床资料.依照WHO第5版推荐的标准对男方精液进行检查,根据男性精液液化情况分为正常对照组(n=295)和精液液化不全组(n=56).比较两组临床妊娠率、早期流产率.结果 351例患者共行796个IUI周期,共妊娠116例,总妊娠率14.6％(116/796),早期流产17例.其中正常对照组共行703个IUI周期,妊娠98例,妊娠率13.9％(98/703),早期流产16例,早期流产率16.3％(16/98);精液液化不全组共行93个IUI周期,妊娠18例,妊娠率19.4％(18/93),早期流产1例,早期流产率5.6％(1/18).两组临床妊娠率比较差异无统计学意义(c2=0.164,P>0.05);两组早期流产率比较差异无统计学意义(c2=0.466,P>0.05).结论 精液液化情况对IUI后临床妊娠率、早期流产率均无明显影响.

目的 研究经尿道前列腺等离子双极电切用于前列腺增生治疗的意义.方法 将2014年1月至2016年2月在本院接受治疗的前列腺增生患者130例作为研究对象,根据随机数字表法将上述前列腺增生患者分为两组,分别为改良组66例和传统组64例.传统组给予经尿道前列腺电切术治疗;改良组采取经尿道前列腺等离子双极电切治疗.观察两组患者手术操作时间、术后膀胱冲洗时间、留置尿管时间、血红蛋白、术前术后生活质量、最大尿流率、前列腺症状评分和尿道狭窄等并发症发生率,并进行分析比较.结果 改良组尿道狭窄等并发症发生率低于传统组(P<0.05);改良组患者留置尿管时间与传统组比较无显著差异(P>0.05);改良组患者手术操作时间、术后膀胱冲洗时间、血红蛋白均优于传统组(P<0.05);两组患者术前生活质量、最大尿流率、前列腺症状评分无显著差异(P>0.05);术后改良组生活质量、最大尿流率、前列腺症状评分明显优于传统组(P<0.05).结论 经尿道前列腺等离子双极电切用于前列腺增生治疗的效果确切,可有效改善患者临床症状,手术操作简单,术后并发症少,恢复快,可有效改善患者生活质量,值得推广.

目的:分析雄激素受体剪接变异体7(AR-V7)对前列腺癌激素抵抗敏感时间的预测作用.方法:将本院100例经活检穿刺证实为前列腺癌的患者纳入研究,所有患者均接受内分泌治疗,利用免疫组化方法检测前列腺癌组织AR-V7的表达情况,利用Cox模型分析患者各临床因素对前列腺癌激素抵抗敏感时间的影响,采用Kaplan-Meier法分析AR-V7对前列腺癌激素抵抗敏感时间的作用,同时利用Log-rank法对结果进行显著性检验.结果:(1) 100例患者内分泌治疗过程中前列腺特异性抗原(PSA)最低值平均(1.1±0.08) μg·L-1;到达PSA最低值的时间平均(8.2±0.03)个月;PSA半衰期平均(1.2±0.4)个月.至随访结束有88例进展为去势抵抗性前列腺癌(CRPC),其激素敏感时间平均(28.5±1.8)个月.(2) AR-V7表达主要位于细胞核,仅有少数表达于细胞质中,100例前列腺癌患者中有25例患者AR-V7表达呈现阳性,75例患者表现为阴性.(3) Cox多因素分析显示PSA最低值、PSA半衰期及癌组织中AR-V7的表达量是影响激素敏感时间的因素,多因素分析结果显示PSA最低值(r=1.98,P=0.02)及AR-V7的表达量(r=2.93,P=0.003)是晚期前列腺癌患者激素敏感时间的独立预测因子.(4) AR-V7阳性患者的中位生存时间为(32±1.2)个月,AR-V7阴性患者中位生存时间为(46±1.9)个月,差异有统计学意义(P＜0.05).结论:AR-V7是影响前列腺癌激素抵抗敏感时间的预测因子,其可能作为前列腺癌治疗新靶向.

Objective:To evaluate the clinical efficacy of ureteroscopic holmium laser lithotripsy in the treatment of acute renal failure due to ureteral stones obstruction.Method:30 patients with acute renal failure caused by ureteral stones obstruction were treated with transurethral ureteroscopic holmium laser lithotripsy.Result:The obstruction of 30 cases were released completely.Renal function return to normal or near normal after treatment,blood urea nitrogen and creatinine are back to normal or near normal,urine volume of patients return to normal.Successful lithotripsy were made in 28 cases immediately.Few residual stones were founded in the renal pelvis in 2 case.The residual stones were spontaneously expelled after extracorporeal shock wave lithotripsy(ESWL).Conclusion:Ureteroscopic holmium laser lithotripsy is a minimally invasive,safe and effective treatment methods for acute renal failure due to ureteral stones obstruction.

Objective:To analyze the relationship between intravesical protrusion prostate and overactive bladder in patients with benign prostatic hyperplasia.Method:The clinical data of 128 patients with BPH in our hospital from January 2014 to February 2015 were analyzed retrospectively.They were divided into 3 groups according to IPP,analyzed the differences between IPP and age,IPSS,QOL score,prostate volume,Qmax,RUV,the occurrence rate of OAB .The correlation between IPP and OAB were analyzed by the multiple linear regression.Result:The age and QOL score had no statistical differences in different groups(P>0.05).The IPSS,Prostate volume,RUV,PSA,Qmax,the occurrence rate of OAB in different groups had statistical differences(P<0.05).IPP showed a positive correlation with OAB used by the multiple linear regression analysis(P<0.05).Conclusion:There is a significant correlation between IPP which reflects anatomical changes in the prostate and OAB in patients with benign prostatic hyperplasia.

目的：分析后腹腔镜手术治疗肾上腺肿瘤的临床疗效。方法收集我院2012年8月-2013年8月期间诊治的肾上腺肿瘤患者86例作为研究对象，以抛硬币的方式分为试验组与对照组，每组患者各43例。对照组患者采用开放手术治疗，试验组采用后腹腔镜手术治疗，对两组患者的手术时间、术中出血量、术后进食时间以及住院时间以及并发症发生率进行分析对比。结果研究结果显示，试验组患者手术时间、术后进食时间以及住院时间明显短于对照组(P<0.05)，术中出血量明显少于对照组(P<0.05)，试验组中有3例患者发生并发症，包括1例低容量休克、1例皮下气肿，1例感染，未出现肾上腺危象，并发症发生率为6.98%；对照组中有12例患者发生并发症，包括3例低容量休克、2例皮下气肿，4例感染，3例肾上腺危象，并发症发生率为27.91%，试验组并发症发生率明显低于对照组(P<0.05)。结论后腹腔镜手术治疗肾上腺肿瘤具有良好的临床疗效，能有效缩短手术时间、术后进食时间以及住院时间，减少术中出血量，降低并发症发生率，值得在临床应用上推广。

目的：探讨后腹腔镜对肾上腺肿瘤治疗的临床疗效。方法选择该院2010年9月-2013年7月收治的70例肾上腺肿瘤患者为研究对象，随机分为对照组35例，观察组35例，对照组行传统开放性手术治疗，观察组行后腹腔镜手术治疗，对两组患者的治疗效果进行对比分析。将良性肿瘤和恶性肿瘤分为两组，对手术切除的瘤体进行用Western Blot法方法检测，比较两组TGF-β1蛋白水平的差异。结果观察组治疗总有效率为91.43%，对照组为68.57%，差异有统计学意义(P<0.05)；观察组患者的住院时间、术中出血量、术后下床活动时间、术中出血量与手术时间均优于对照组，差异有统计学意义(P<0.05)。结论对肾上腺肿瘤患者实施后腹腔镜治疗，是一种安全、有效的治疗方式，可提高治疗效果，缩短住院时间、手术时间、术后下床活动时间，值得临床推广使用。

Objectives To probe into the experience of diagnosis and treatment of ureterpelvic junction obstruetion.Methods Seventy-six cases with ureterpelvic junction obstruction were reviewed,66 were treated by Anderson-Hynes pyeloplasty.2 Y-V pyeloplasty and 8 loosen operation.Results Seventy-four cases gained success by one operation.60 cases were followed up for 6 month～12 years.1 case had ureteropelvic junction stenosis after operation 1 month.which was cured by a double-J tube placement 3 months.1 case was treated by loosen operation,which was no improvement in hydronephrosis after operation.Conclusions Anderson-Hynos pyeloplasty is the first choice of treatment for ureterpelvic junction obstruction.

Objective To evluate the treatment of ureteral stones by the using of ureteoscope and pnernatic lithotripter. To analysis the canses of diffcult aceess during rigid transurethral ureteroscory and their management. Methods Retrospectively analyzing the data of 216 cases of ureteroscope pneumatie lithotriptor for ureteral culculi. Results The success rate of the one stage for all patients was 90. 5 % (219/242). The successful rates for upper, middle and lower ureteral stone were 66. 67% (14/21) ,90. 9% (80/88) ,94% (125/133).Conclusion Treatment of ureteral stone with this method has been safe and effective. This method should be the first choice of treatment for the middle and lower ureteral stone.

目的 探讨输尿管镜在治疗顽固性肾绞痛的治疗效果.方法 对65例顽固性肾绞痛患者施行检查及治疗.结果 65例患者中有60例为输尿管结石,左侧25例,右侧33例,2例为双侧,均进行输尿管镜下气压弹道碎石取石术及套石治疗,1例输尿管上段结石移位至肾盂,行双J管内引流及二期行ESWL治疗;1例为输尿管癌,给予取活检后限期行输尿管癌根治术,3例为输尿管炎性狭窄,其中2例输尿管狭窄扩张后置双J管内引流术,1例输尿管狭窄扩张失败,行开放手术.结论 经尿道输尿管镜是顽固性肾绞痛的诊断及治疗安全、有效的优选方法.

Objectives To evaluate the clinical effects of tubularized incised plate urethroplasty(Snodgrass procedure)for hypospadias.Methods Thirty one caseswith hypospadias were trebled by tubulsrized incised plate urethroptiaty.The 31 cases aged from 1 to 14 years old with hypospadias were included 5 cases of the glans type,14cases penis type.4 cases peno-scrotal type and 8 cases were second stage uethral reconstruction.Results The 26 patients were cured.Urethral fistula occurred in 2 patients had been corrected by operation.Meatus stricture was noted in 3 patients had been corrected with urethral dilatation.Conclusions Tubularized incised plate urethroplasty can be used in most type of hypospadias.Tubularized incised plate urethroplasty is a simplified method and its success rate is high.

目的 探讨阴茎折断的诊断和治疗.方法 对11例阴茎折断伤患者的诊断和治疗进行回顾性分析.结果 11例均行手术治疗,术后随访时间2个月～7.5年,无阴茎勃起功能障碍、尿道狭窄等并发症.结论 早期手术是治疗阴茎折断的首选治疗.

Objectives To investigate the therapeutic effect of super-selective bladder arterial infusion chemotherapy and embolization on treating of middle and advanced stage of bladder cancer.Methods Eighteen cases were treated by trans-arterial infusion, and then followed by lipiodol 5-Fu and gelfoam embolization. Results CR+ PR 15 cases (15/18), NC for the three cases (3/ 18), and the total efficiency of 83.3%.Conclusions Super-selective bladder arterial chemo-embolization is the treatment of middle and advanced bladder cancer an effective palliative method can significantly increase the survival rate of patients.

Objective To study the diagnosis and therapy of cireumeaval ureter.Methods The diag-nosis of this disease depends on imaging examtions,such as mtravenous urograpny(IVU),retrogradure terophy(RU)or MRurograpy(MRU),showed risht hydronephosis with reveised"J shaped"or"S shaped"ureter.Surgicaloperation was used to treat this disease.The eomtpressed retrocaval portion of ureter was reseeted and end-endamastomosis Was performed antenor to the vena cava.Results 15 cases have been followed uD by IVU and ul-～asonography,and nO nephrohydrosis or stenosis of the amastomosis site has been noted.Conclusion IVU andRU ale the eardinal means for the diagnosis op eircumcaval ureter,segmental resestion of the ureter with end-to-end stomosis is the ideal procedure for the treatment of this disease.

Objectives To present an experience of diagnosis and treatment of renal trauma in 150 patients.Methods One hundred and fifty cases of renal trauma were retrospectively analyzed.Results The positive rate of renal injury detected by B-ultra sonography and CT were 95.7% and 100% respectively. One hundred and twenty-one cases were managed conservatively and 29 cases were treated by operation.Conclusions B-ultra sonography which was simple, reliable and harmless to the patients, is the first choice in detecting renal trauma. Accurate diagnosis rate is high with CT scanning. Surgical management is indicated in cases of severe injured kidney and open renal injury, and increase the opportunities for retaining kidney.

[Objective] To investigate the effects on the management of ureterolith street with ureteroscopic lithotripsy. [Methods] 5 cases of ureterolith street with complicating acute renal failure were treated by emergency ureteroscopic lithotripsy and double-J tubes indwelling. [Results] All cases were cured. [Conclusion] Ureteroscopic lithotripsy manipulation is believed to be a safe and effective method for the treatment of ureterolith street with complicating acute renal failure.

Objective: To investigate the expression of inhibitor of apoptosis protein survivin in the bladder transitional cell carcinoma(BTCC) and its clinical significance.Methods: Survivin was detected by SP immunohistochemistry technique in 47 cases of BTCC and 8 cases of normal bladder tissue.The correlations between the expression of survivin and tumor grade,stage and survival rates of the patients were closely studied.Results: The abnormal expression of survivin was in BTCC and no expression in the normal bladder tissue.The expression of survivin increased following the augment of tumor stage and grade.High expression of survivin was associated with poor prognosis of BTCC.Conclusion: The abnormal expression of survivin is common in BTCC.The expression of survivin may play an important role in BTCC invasion and metastasis and prognosis.

目的:提高肾上腺偶发瘤早期诊断水平,指导临床治疗。方法:19例肾上腺偶发瘤患者均行手术治疗。结果:19例患者中,术后病理诊断为:髓质脂肪瘤3例,腺瘤3例,皮质癌2例,囊肿5例,假性囊肿2例,节神经细胞瘤1例,肉瘤1例,转移癌1例,神经鞘瘤1例。19例患者术后均获随访,随访5个月~10年,4例恶性肿瘤者死亡,15例良性病变者未见肿瘤复发。结论:肾上腺偶发瘤术前定性诊断困难,应积极手术治疗。