用Fowler-Stephens法加穿行腹横筋膜治疗高位隐睾

目的 :针对高位隐睾治疗的困难性 ,探讨新的手术方法。方法 :对 13例高位隐睾采用 Fowler-Stephens法加将隐睾直接穿行腹横筋膜进入阴囊的方法进行治疗。结果 :本组术后无特殊并发症出现 ,隐睾复位满意 ,睾丸发育正常。结论 :良好的暴露、精细的解剖和无张力复位是获得良好效果的关键 ,本术式是治疗高位隐睾的一种有效和安全的方法。     

Expression and regulation of orphan receptor TR2 mRNA in germ cells of cryptorchid testis in rat and rhesus monkey

Expression and cellular localization of orphan receptor TR2 mRNA in relation to germ cell apoptosis in cryptorchid testes of rat and rhesus monkey have been studied by usingin situ hybridization andin situ 3′-end labeling of DNA fragments (TUNEL). The results show that: (i) TR2 mRNA is specifically expressed in the germ cells, mainly in the spermatocytes, round and elongated spermatids. The expression level of TR2 mRNA varies with the seminiferous cycle, (ii) In the rat cryptorchid testes on days 3 and 5 after the surgery, the germ cells began to undergo apoptosis with no evident decrease in TR2 mRNA level. On day 7.5, however, most germ cells underwent apoptosis, while the expression level of TR2 mRNA declined markedly, and TR2 mRNA was rarely expressed on day 10 thereafter, (iii) On days 15 and 20 of the cryptorchid testes of rhesus monkey, TR2 mRNA was only expressed in a few of primary spermatocytes and the mRNA was almost undetectable on days 30, 45, 60. These results suggest that TR2 mRNA probably plays an important role in spermatogenesis and germ cell apoptosis.     

隐睾继发恶变15例临床分析

目的回顾性分析15例隐睾继发睾丸癌患者资料,总结隐睾恶变的临床诊治特点.方法分析15例隐睾继发睾丸癌患者资料,年龄21～56岁,平均36.6岁.其中,腹股沟隐睾6例,腹腔隐睾9例;左侧5例,右侧7例,双侧3例.临床分期Ⅰa:4例、Ⅰb:5例、Ⅱb:3例、Ⅱc:2例,Ⅲb:1例.其中,5例已行隐睾牵引复位固定术(双侧1例),复位固定与发现睾丸癌间隔14～26 a,平均22.2 a.结果 6例腹股沟隐睾睾丸癌行根治性切除.9例腹腔隐睾肿瘤中,肿瘤根治性切除6例,根治性切除加腹膜后淋巴结清扫2例,1例因肿瘤严重粘连行姑息切除.病理诊断精原细胞瘤13例,精原细胞瘤合并胚胎癌1例,胚胎癌1例.15例患者中1例行严密监测随访,未行进一步治疗,14例行术后放疗,其中合并胚胎癌者及姑息性肿瘤切除术者同时予以化疗.9例随访6个月～9 a,平均3.7 a,未见复发及远处转移征象.结论隐睾发生肿瘤的概率大于正常睾丸,隐睾应及时治疗并终生随访;隐睾睾丸肿瘤的病理类型多为精原细胞瘤,手术切除加术后放疗疗效较好.