目的 观察S100A8、E-cadherin在膀胱癌组织中的表达变化,分析其与膀胱癌侵袭与迁移的相关性.方法 采用免疫组织化学方法检测90例膀胱肿瘤组织及其癌旁组织中的S100A8、E-cadherin表达,图像分析技术分析二者在膀胱癌中的阳性表达率,并分析其与肿瘤病理等级、临床分期的关系.结果 S100A8在膀胱癌组织中的表达增高,与癌旁正常组织相比,癌组织中S100A8的阳性率、光密度扫描值均随着肿瘤分级的升高而显著增高;E-cadherin在膀胱癌组织中的表达量下降,与癌旁正常组织相比,不同分级的膀胱癌组织中E-cadherin的阳性率、光密度扫描值均显著下降.结论 S100A8、E-cadherin在膀胱癌组织中的异常表达与膀胱恶性肿瘤的侵袭及迁移的病理特征高度相关;检测S100A8、E-cadherin的表达水平可用于膀胱癌的诊断及预后评估.

Objective:To evaluate the effect on patients with upper urinary urothelial carcinoma treated by tran-surethral resection of the ureteral orifice combined with retroperitoneal laparoscopy. Methods:Group A and B consis-ted of 15 cases with upper urinary urothelial carcinoma respectively. The former was treated by transurethral resection of the ureteral orifice combined with retroperitoneal laparoscopy,the latter by open operation. The clinic data was com-pared. Results:The surgeries were all completed successfully. The time of operation,postoperative recovery and inpa-tient procedure in group A were all shorter than that of group B,and the blood loss in group A was less,with statistical differences(P < 0. 05 or P < 0. 01). The infection in slit was found in two cases of group B,while not found in group A(P < 0. 01). There was no distant metastasis in the two groups,while having one case respectively recurrence in bladder without irrigation. Conclusion:Transurethral resection of the ureteral orifice combined with retroperitoneal laparoscopy for upper urinary urothelial carcinoma is a safe and effective procedure worthy of extending.

Objective:To evaluate the change of immune function in postoperative patients with renal cell carcino-ma treated with interferon.Methods:Fifty patients with renal cell carcinoma treated with interferon after operation consisted of the treatment group.The control group included 45 patients without any treatment after operation.Immune parameters,including CD3 +,CD4 +,CD8 +,CD4 +/CD8 +,CD19 + and CD16 +56 + were determined before and at the 1th,2nd,3th month after therapy.Results:The levels of detected immune parameters had no statistic difference before operation(P >0.05)between the two groups.In control group,the levels of immune parameters had no statistic differ-ence at the 1th,2nd,3th month after operation(P >0.05).However,statistic difference was found in treatment group at the 2nd and 3th month after operation(P <0.05,P <0.01).Conclusion:Interferon can increase the immune level of patients with renal cell carcinoma after operation,and its influence on the long -term survival needs further study.

Objective Talks under the abdominal wall to move the veins and orpe arteriovenous anastamosis the young child top figure cryptorchis clinical significance.Methods Under the abdominal wall use the special anatomic structure of vein blood vessels.The blood vessel cend finally a rope arterievenous anastamosis. Extension of suo xueguan bleeding.improve the operation of treatment to 19 cases of young children cryptorchises top figure.Results The 16 cases of rope testicular serves blood is good.the color Doppler Doppler and check the rope blood vessel blood flow to be smooth.testicular elas-tic.Olly yean later,testicular volume,touch the fiexibility is good,the color of inspection Doppler rope is smooth,3 cases of testicular nature are slightly,The rope of blood flow is off and on the determination of testosterone rotation,on average higher value.Conclusion Under the adbominal wall the intravenous therapy top figure cryptorchis ,extend the length of the rope, The tensity testicular and blood flow of rope blood vessels.prevention is short because of the blood vessel rope,testicular ap-peared because of the insufficient supple to shrink.The surgery makes testicular for one time,two times and surgeries testicu-lar excisions.The retention of this method to young children top fryptorchis testicular the clinical course.

目的：探讨婴儿肥厚性幽门狭窄(HPS)幽门肌切开黏膜膨出术后呕吐原因,经胃管注入液体,彩超影像动态观察幽门梗阻解除后形态学改变。方法术后3~4天,选用8号小儿胃管,经胃管注入50ml 5%的糖盐水,对31例婴儿先天肥厚幽门狭窄幽门肌切开黏膜膨出术后在彩超下影像动态观察幽门管术后病理形态学改变。结果本组31例术后3~4天全部经胃管液体注入行彩超影像动态观察,18例术后幽门管动态影像观察为正常改变。11例为功能性未完全恢复,影像表现为幽门中央处液体通过回声区是增宽的约2.5mm,液体通过时收缩与排空功能不协调,有逆流现象。2例为幽门肌切开不完全,表现幽门与十二指肠交接处幽门肌增厚,约2mm,液体通过回声区较细宽度约1.5mm 流向缓慢,呈断断续续状态。结论 HPS黏膜膨出术后呕吐,经胃管液体注入彩超下通过动态影像观察,进一步了解引起呕吐的发生因素。明确了HPS 手术后呕吐原因仍受各种因素影响,此方法对手术中和手术后的效果有明确的评估并提供了依据。

Objective To investigate the children with congenital hypospadias using scrotal skin flap in the repair of pediatric metastatic urethral fistula operation and its curative effect. Methods A retrospective review of scrotal flap coverage technology operation treatment of 16 cases of high pediatric penile urethral fistula during 10 years in our hospital was performed. Results The operations for 16 cases were all successful.There were 2 cases of postoperative urethral mild stenosis and became smooth after transurethral dilatation.1 cases of fistula in penile ventral side and treated by double flap overlapping coverage method. Conclusion The operation of scrotal flap transfer operation in repairing high urinary fistula is feasible.Fistula size,location,use of the tissue materials and operation skills are related to the successful rate of operation.

<正>尿道瘘是尿道下裂行尿道成形术后一种较复杂难处理的并发症,发生率可达30%,特别是严重阴茎下屈伸直后需尿道成形皮肤组织不足,及不成熟的术式和方法均可使尿瘘发生,因为在修复尿瘘手术上存在的不利的相关因素很多,使修复尿瘘的失败率也很高。多层次的组织皮瓣覆盖新尿道可减少尿瘘,为了提高尿瘘修补的成功率,我院近年来在手术方式作了改进,采用阴茎带蒂双层皮瓣交叉重迭覆盖治疗13例14个瘘,除1例为二次手术外均一次性成功,在尿道下裂术后尿瘘的治疗上收到效果满意,现就治疗相关的问题进行讨论。

目的:探讨高选择性α-肾上腺素能受体阻断剂盐酸坦洛新缓释片结合行为疗法在早泄治疗中的疗效。方法:对符合诊断标准的90例早泄患者随机分为单纯行为疗法组、单纯药物组和盐酸坦洛新缓释片+行为疗法组,每组30例,给予相应治疗,观察疗效及药物副作用。结果:治疗后结合组与单纯行为疗法组阴道内射精潜伏期均较治疗前比较差异有统计学意义(P<0.01),单纯药物组则无统计学意义(P>0.05)。治疗后各组阴道内射精潜伏期比较,结合组>单纯行为疗法组>单纯药物组,且各组间均有统计学意义(P<0.01)。从夫妻双方对性生活满意率来看,结合组高于单纯行为疗法组及单纯药物组,但各组间无统计学意义(P>0.05)。各组均未出现严重不良反应。结论:盐酸坦洛新缓释片结合行为疗法可明显增加阴道内射精潜伏期,且疗效优于单纯的药物治疗和行为疗法,该疗法对提高夫妻生活满意率也有一定帮助。

<正>前列腺增生是引起中老年男性排尿障碍原因中最为常见的一种良性疾病[1]。本院泌尿外科门诊从2004年10月~2006年10月使用前列欣胶囊用于改善前列腺

<正>本组67例中单侧60例,双侧7例;年龄19-56岁。均有明确的外伤史,如骑跨伤、跌打伤等。临床表现为发热,患侧阴囊红、肿、疼痛,阴囊皮肤有淤血斑,精索及输精管增粗、肿胀、触痛明显。血常规:白细胞总数及中性粒细胞增高。治疗方法如下:剃净阴毛,局部常规消毒后在皮下环下方找到精索并用左手固定,将注射针头刺入精索鞘膜内,回抽无血后注入1%利多卡因5 ml加庆大霉

目的探讨腹壁下动脉在小儿隐睾手术复位中的临床意义.方法利用腹壁下动脉与精索静脉血转流术方式,对7例小儿高位隐睾睾丸行精索内静脉与腹壁下动脉终末支吻合术.结果术后6例精索睾丸供血良好,1年后睾丸形态观察,体积增大,触摸有弹性,1例睾丸质硬.T-RIA测定均值升高.结论血流改变后对精索睾丸供血营养起到了一定的支持作用,对隐睾睾丸供血不足引起的睾丸萎缩有预防作用,对防止保留睾丸恶变有一定的临床应用价值.

1一般资料 患儿,女,5岁.因会阴部被汽车碾压6h入院.入院后查体:神志清楚,血压90/60mmHg,急性痛苦面容,平卧不能翻动,口唇略苍白.上腹部轻度胀满,有压痛,无移动性浊音,肠鸣音亢进.下腹部皮肤有碾挫伤,皮下有淤血.截石位见会阴部撕裂,肛门、直肠与阴道全部贯通,组织破碎外翻.

目的探讨吞入巨噬细胞内的梅毒螺旋体(trepoema pallidum,TP)结构变化过程和杀伤机制.方法采用图像分析系统对巨噬细胞和细胞外基质内TP超微结构进行形态计量学研究.结果吞入巨噬细胞内的TP经多种蛋白水解酶作用后,TP外周壳膜膨胀,间隙变大,透明区域增宽,TP结构消失,体积肿胀,与细胞外基质中的TP比,横轴宽度明显增大,差异显著(P＜0.01).结论梅毒皮损内浸润的巨噬细胞对感染TP可有效地吞入、溶解、杀灭.

目的探讨尿道下裂术后并发尿道瘘的发生因素和预防办法.方法分析7年来应用阴茎带蒂皮瓣重迭交叉覆盖术治疗尿道瘘临床疗效.结果 8例尿道瘘直径最大0.5cm,最小1mm,采用皮瓣交叉重迭覆盖修补尿瘘方法全部成功.结论应用此方法可降低尿瘘的发生率,选用可吸收线皮瓣重迭间断缝合能收到良好的效果.

目的探讨胃管液体注入B超动态影像诊断小儿幽门狭窄意义.方法分析1988～1999年对27例小儿先天性幽门狭窄(CPS)不行碘油造影,经胃管液体注入B超引导下进行影像动态观察方法诊断治疗小儿幽门狭窄临床特点.结果幽门狭窄症状不典型,14例右上腹包块触及不明显,单独B超检查不满意,应用此方法作出了明确诊断.影像表现出胃内涡流出现的逆蠕动和狭窄的线性病理改变等现象和胃内不规律的动态活动及幽门肌与十二指肠连接的肠壁厚度组织比邻关系.结论方法简便易行,可做为本病的一种诊疗手段,对指导手术,防止穿孔等并发症发生有一定的临床意义.

尿道尖锐湿疣,因生长在狭窄的特殊解剖部位,用常规的物理及化学方法治疗,不易使感染病毒的组织完全被清除而复发,造成久治不愈.我们采用尿道疣体内注射干扰素治疗17例,临床上取得了满意的疗效.现报告如下.