目的 总结分析新生儿睾丸扭转（neonatal testicular torsion，NTT）的临床特点及治疗措施。 方法 回顾性分析2009年1月至2014年12月中国医科大学附属盛京医院收治的13例NTT病例。通过医院的医疗信息管理系统，收集这些病例的临床资料和随访情况等，对这些NTT患儿的临床特点和治疗情况进行描述性分析。 结果 （1）13例日龄为1~28 d，平均8.2 d；左侧8例，右侧4例，双侧1例；急症型7例，非急症型6例。（2）急症型7例存在阴囊急症表现，彩超显示患侧睾丸血运异常，术前均诊断为NTT；5例手术（探查6睾，切除5睾，其中1例为双侧），2例拒绝手术。4例单侧睾丸扭转证实已发生睾丸坏死，切除后，对侧睾丸行预防性固定；1例为双侧睾丸扭转，但扭转程度不同，保留相对病变较轻侧睾丸。所有切除睾丸术后病理检查显示睾丸组织结构基本消失，大部分呈现出血伴坏死改变，其间可见少量残存的生精小管和输精管。（3）非急症型6例，无阴囊急症表现，彩超显示患侧阴囊内异常包块，3例MRI可见混杂信号包块。术前3例诊断为睾丸肿瘤，3例诊断为NTT。6例均行手术治疗。术中见患侧阴囊内无正常睾丸组织，为质硬、均一的肿物，与周围组织可有粘连，扭转方向及程度已分辨不清，术后病理检查可见大部分出血坏死及钙化灶，睾丸结构基本不见，术后均诊断为NTT。（4）术后随访3~12个月。所有手术病例患侧阴囊切口均愈合良好，阴囊无出血肿胀，2例保守治疗的患儿及１例双侧NTT的患儿分别在出院2和3个月复查时发现患病睾丸明显萎缩，查体可触及小而硬的包块，术后6个月随访超声显示病变睾丸演变为无血流信号的瘢痕结构。所有单侧NTT患儿随访超声检查，均未发现对侧睾丸异常改变。 结论 彩超结合临床表现可准确诊断急症型NTT，但非急症型NTT的超声影像需与睾丸畸胎瘤鉴别。对于急症型NTT，及时手术干预对挽救病变睾丸仍有意义。

Primary vesical varices are rare. We report a case of a 4-year-old girl who presented with recurrent gross hematuria secondary to primary vesical varices. Ultrasonography, enhanced computed tomography, and voiding cystourethrogram revealed a solid mass in the right wall of the bladder. Cystoscopy revealed a group of dilated submucosal veins and a red mass. The mass was ablated, and the histopathologic examination demonstrated varices of the bladder. Observation of the patient for 6 months postoperatively showed no recurrence of the hematuria. UROLOGY 79: 902-905, 2012. (C) 2012 Elsevier Inc.

Objective To assess apoptosis in congenital hydronephrosis and discuss its clinical significance.Methods Apoptosis was detected in 15 kidneys from children with congenital hydronephrosis (5 mild hydronephrosis, 5 moderate hydronephrosis and 5 severe hydronephrosis) using the electronmicroscope, in situ gap labeling of fragmented nuclear DNA and DNA fragmentation analysis.Results Apoptosis was seen in kidneys from children with congenital hydronephrosis. Margination of nuclear chromatin was identified and rounded apoptotic bodies were seen. The mean apoptotic index was 0.0941 +/- 0.017 in severe hydronephrosis, 0.0325 +/- 0.0169 in moderate hydronephrosis, and 0.0021 +/- 0.0031 in mild hydronephrosis, There was a significant difference between severe and moderate hydronephrosis (P = 0.0005), as well as between moderate and mild hydronephrosis (P = 0.0154). Moreover, with an increasing degree of hydronephrosis, the number of apoptotic cells also increased. Five kidneys with severe hydronephrosis and one kidney with moderate hydronephrosis showed typical apoptotic bands.Conclusion Apoptosis might participate in damaging kidneys in children with congenital hydronephrosis.