目的 通过检测人睾丸生殖细胞肿瘤中的Skp2蛋白质异常表达,探讨相关意义。 方法 应用S-P免疫组织化学法检测睾丸生殖细胞肿瘤，正常睾丸组织和慢性睾丸炎组织中Skp2的表达。 结果 睾丸生殖细胞肿瘤中Skp2阳性表达率为74.5%，正常睾丸组织中Skp2阳性表达率为20.0%，在慢性睾丸炎组织中Skp2阳性表达率为40.0%，在3种不同睾丸组织中表达差异有统计学意义（P＜0.05）；Skp2表达与不同组织学类型的睾丸生殖细胞肿瘤无相关性（P＞0.05）；随着临床分期的增高，睾丸生殖细胞肿瘤中的Skp2表达增多，差异无统计学意义（P＞0.05）。 结论 在人睾丸生殖细胞肿瘤中的Skp2高表达，提示细胞周期的异常调控在睾丸生殖细胞肿瘤的发生、分化中起着重要的作用。
目的 研究完全腹膜外腹腔镜腹股沟疝修补术对睾丸血流灌注及体积的影响。 方法 2009年7月－2011年5月，对62例行完全腹膜外腹腔镜单侧腹股沟疝修补术男性患者进行自身前后对照研究，比较术前、术后患侧睾丸的睾丸动脉（TA）、睾丸包膜动脉（CA）、睾丸内动脉（ITA）血流参数[收缩期峰值血流速度（PSV）、舒张未期血流速度（EDV）及血管阻力指数（RI）]、睾丸体积（TV）及血清睾酮的变化情况。 结果 患者获随访7～24个月，平均15.6个月，无复发患者。术前及术后3、6个月时患侧TV分别为（9.91 ± 3.72）、（10.23 ± 4.18）和（10.16 ± 3.94）cm3，同期血浆睾酮水平分别为（544.25 ± 123.72）、（532.89 ± 145.66）和（565.65 ± 138.13）μg/L，手术前后比较患侧TV（F=1.350，P=0.263）、血浆睾酮水平（F=1.673，P=0.192）无统计学意义，血浆睾酮水平均在正常范围内。术后3、6个月患侧TA、CA和ITA的EDV明显高于术前，RI较术前明显降低，差异均有统计学意义（P＜0.05）；PSV与术前比较差异无统计学意义（P＞0.05）。术后3个月患侧睾丸各动脉PSV、EDV、RI与术后6个月比较差异无统计学意义（P＞0.05）。 结论 完全腹膜外腹腔镜腹股沟疝修补术后患侧睾丸血流灌注情况可能会有所改善，不影响TV及血清睾酮水平。
To explore the effect of burying testis in inguinal pocket on spermatogenesis. Methods Sixty New Zealand rabbits of 6-8 months old included 36 males and 24 females, weighing 2.5-2.7 kg. The male rabbits were randomly divided into the experimental group (n=18)and the control group (n=18). The model of repairing skin defect of scrotum were establ ished by burying testes in inguinal region subcutaneously in the experimental group. The rabbits were not treated in the control group. The sperms were collected and the surface temperature of testis was measured in both groups after 8 weeks. Testes biopsies were harvested from 6 rabbits of 2 groups randomly respectively. The apoptosis of spermatogeniccells was detected with TUNEL. The other 12 male rabbits in two groups were fed respectively with female rabbits to observe the fertil ity. Results The semen density and the spermid activity ratio were (237.3 ± 39.7) × 109/L and 76.9% ± 3.8% in the control group, and were (4.7 ± 2.7) × 109/L and 0 in the experimental group respectively; showing statistically significant difference between two groups (P lt; 0.05). The average superficial temperature of testes was (38.02 ± 0.36)℃ in the experimental group and (36.15 ± 0.64) in the control group (P lt; 0.05). TUNEL results showed: The spermatogenic epithel ium became thin and obvious apoptotic spermatogenic cells were found in experimental group; the spermatogenic epithel ium was normal and few apoptotic spermatogenic cells were found in the control group. The apoptotic index (AI) was 89.69% ± 3.76% in the experimental group and 7.73% ± 4.95% in the control group (P lt; 0.05). The Pairing results showed that the female rabbits pairing with male rabbits of the experimental group were all not pregnant, and those of the control group were all pregnant (P lt; 0.05). Conclusion As the same as the scrotum was reconstructed with skin flaps, it will induce the rabbit infertil ity that the testes were buried in inguinal region subcutaneously to repair defect of scrotum skin. The main reason is the excessive apoptosis of spermatogenic cell by the high testes environmental temperature.
Objective To establish dog model of testicular autotransplantation with a modified technique.Methods Testicular autotransplantations were performed on the right side of 30 male dogs, whose ages ranged from 1.5 to 2.0 years old and weights ranged from 14 to 17 kg. After the spermatic artery with a cuff of abdominal aorta and spermatic vein and with a cuff of inferior vena cava were detached, the testis was perfused and kept at icing temperature. An end-to-side anastomosis of the spermatic vessels to the external iliac vessels was conducted subsequently. The survival conditions of the auografts were assessed by digital subtraction arteriography (DSA). Histological examination and detection on the serum levels of follicle stimulating hormone (FSH), luteotrophic hormone (LH), and testosterone (T) were made at two weeks intervals. Results Of the 30 testicular autotransplantations performed, 27 cases were successful. The success rate was 90%. The time of heat ischemia, cold ischemia, anastomosis of spermatic vessels, and total operation was 4.5±0.9 minutes, 50.0±10.0 minutes, 35.5±5.5 minutes, and 3.5±0.5 hours respectively. DSA proved that the testis survived well. No morphological abnormality was found at different stages of the spermatogenic cells. The LH level was higherthan that before operation, being statistically different (Plt;0.05);however, the levels of FSH and T did not changed significantly (Pgt;0.05). Conclusion A stable and feasible model of testicular autotransplantation is established and it provides a reliable experimental platform for human testicular transplantation.
Objective To discuss the diagnostic and differential diagnostic value of ultrasonography for primary testicular lymphoma (PTL) by studying the ultrasonographical image characteristics. Methods Thirty-one patients with PTL confirmed by postoperative histopathology between 2005 and 2015 were chosen to be the study subjects. We retrospectively analyzed their ultrasonographical features and clinical data. Results Most PTL patients were elderly men, and the initial symptom was mainly painless testis enlargement. Thirty-nine testicles were involved in the primary testicular lymphoma, including 23 unilateral and 8 bilateral. In the 31 patients, 22 had diffuse lesions and 9 nodal. Ultrasonography showed that most tumors were hypoechoic lesions, and part of them were hyperechoic linearly. The lesions had abundant blood flow signals with a low resistance index. Conclusions In elderly patients with painless testicular enlargement, the possibility of primary testicular lymphoma must be fist considered. Manifestations of primary testicular lymphoma have some distinctive characteristics, and combined with clinical history, they are helpful for the diagnosis and differential diagnosis of PTL.
OBJECTIVE: To investigate the injury on isolated testes induced by ischemia/reperfusion(I/R), and the protective effect of Yisheng injection on the injury. METHODS: Twenty-six isolated cadaver testes contributed by 13 persons were preserved with 4 degrees C 250 ml hypertonic citrate alloxuric (HCA) solution and then reperfused with 37 degrees C 500 ml HCA. Solution of experimental group contained 500 micrograms/ml Yisheng injection. In simple cold preservation test, involving in 8 experimental and 8 control testes, a series of time points (6, 12, 18, 24, 36, 48, 60, 72 hours) were set to harvest. 10 testes (1 testis respectively on 6, 12, 18, 24 and 36 hours in experimental and control groups) were reperfused with 37 degrees C HCA for 6 and 12 hours. Histological and histochemical changes were observed. RESULTS: In the experimental testes, 4 degrees C cold preservation in 24 hours could not induce obvious pathologic changes. After 24 hours, changes such as swelling, vacuolar degeneration or detachment of endothelial cells (ECs), separation between basement membrane and seminiferous epithelium, mal-alignment of spermatogenous cell and edema of mesenchyme could be observed. In the testes preserved for 12 hours, the activity of lactic dehydrogenase(LDH) and succinic dehydrogenase (SDH) increased, then fallen after 24 hours. The activity of Nitric oxide synthetase(NOS) decreased after 18 hours. All changes were more obvious after following 37 degrees C reperfusion. In the control testes, swelling and vacuolar degeneration of ECs occurred on 12 hours cold preservation, and injury was worse along with the prolongation of cold preservation time. Pathologic changes of ECs, seminiferous epithelium and mesenchyme were serious after 37 degrees C reperfusion. CONCLUSION: 4 degrees C cold preservation in 24 hours can only cause mild ECs’ injury, and obvious abnormal testes’ histological profile can be observed beyond 24 hours. 37 degrees C reperfusion will make injury worse. Yisheng injection can keep isolated testes histologic structure well in 24 hours cold preservation, and it has protective effect on I/R injury.
Objective To establish a new model on isolated human cadaver testes with ischemiareperfusion (I/R). MethodsThirteen isolated cadaver testes contributed by 13 persons were preserved under 0℃-4℃ hypothermia and then reperfused under 37℃. Histological and histochemical changes were observed. Results4℃ cold ischemia in 12 hours induced only trivial swelling and vascular degeneration of endothelial cells (ECs), obvious pathologic changes occurred after 24 hours, including detachment of ECs, separation between basement membrane and seminiferous epithelium, degeneration and detachment of spermatogenous cell and edema of mesenchyme. Injury was worse along with the prolongation of cold preservation time. Changes of LDH and SDH activities were found by histochemical staining. Reperfusion following 6 hours ischemia induced tissue injury and unusual enzyme activity. All changes were more obvious after reperfusion following 12,18,24 or 36 hours cold ischemia.Conclusion This new model on isolated cadaver testes with ischemiareperfusion is successful, it can substitute other solid organs of human beings for I/R injury study.
【摘要】 目的 探讨超声动态观察流行性腮腺炎合并睾丸炎的诊断和预后价值。 方法 回顾性分析2008年10月-2010年12月53例流行性腮腺炎合并睾丸炎治疗前后的声像图特征和临床治疗效果。 结果 全部患者均有腮腺、颌下腺、睾丸、附睾不同程度长大，而腮腺、颌下腺以单侧长大为主，睾丸及附睾长大多以单侧为主；53例腮腺炎合并睾丸炎经临床治疗15~20 d后，腮腺、睾丸肿痛及自觉症状消失，声像图恢复正常40例，声像图基本恢复正常13例。治疗出院后全部患者均获得远期超声观察随访，分别于出院后3~4个月及4~6个月观察声像图均为正常。 结论 超声动态观察流行性腮腺炎合并睾丸炎在治疗前后声像图的改变对其诊断和预后有重要的价值。【Abstract】 Objective To investigate the diagnostic and prognostic value of ultrasonic inspection on epidemic parotitis accompanied by orchitis through observing ultrasonic image changes of the disease before and after treatment. Methods We retrospectively analyzed the ultrasonographic features before and after treatment, and the clinical treatment results of 53 patients with epidemic parotitis accompanied by orchitis between October 2008 and December 2010. Results All patients had different level of increment in their parotid gland, submaxillay gland, testicle or epididymis. Most cases of the increment occurred to unilateral parotid gland and submaxillay gland on the same side, as well as unilateral testicle and unilateral epididymis. After clinical treatment for 15 to 20 days, parotid and testicular swelling and pain, and self-conscious symptoms disappeared. Forty patients returned to normal ultrasonic image, and the ultrasonic images of 13 other patients resumed normal basically. After being discharged, all patients were followed up and ultrasound observation was carried out which showed that 3 to 4 months or 4 to 6 months later, all ultrasonic images were normal. Conclusion Ultrasound dynamic observations before and after treatment have important values to the diagnosis and prognosis of epidemic parotitis accompanied by orchitis.