Suprapubis-assisted umbilical laparoendoscopic mini-dual-site surgery for varicocele: a report of 80 cases / 中华男科学杂志

<p><b>OBJECTIVE</b>To study the safety, effectiveness and feasibility of suprapubis-assisted umbilical laparoendoscopic mini-dual-site surgery (SAU-LEMDS) in the treatment of varicocele.</p><p><b>METHODS</b>This study included 80 varicocele patients aged 24 - 44 (mean 28.5 +/- 2.6) years, 25 cases of grade I, 45 cases of grade II and 10 cases of grade III, 58 cases in the left side, 6 in the right and 16 in both sides, and all with asthenospermia. The patients were treated by SAU-LEMDS under subarachnoid anesthesia combined with general anesthesia in a supine position with a head-down-feet-up slope of 15 degrees. Two 5 mm trocars were inserted bilaterally at the umbilical edge, one with a 5 mm 30 degrees laparoscope placed in it, and another into the abdominal cavity below the pubic hairline with a 5 mm laparoendoscopic clipper placed in it. The operation procedure was similar to that of standard laparoscopic ligation of spermatic veins, with reservation of the spermatic artery and double-ligation of spermatic veins. And the procedure was repeated for the contralateral lesion in the bilateral cases. Postoperative follow-up was conducted for the incidences of orchiatrophy and testicular hydrocele and changes of seminal parameters.</p><p><b>RESULTS</b>All the operations were successful, with the mean operation time of (10 +/- 5.0) min (range 8 to 25 min) for the unilateral cases and (18 +/- 6.5) min (range 15 to 30 min) for the bilateral cases, the mean blood loss of (1.5 +/- 0.5) ml (range 1 to 2 ml), and the mean postoperative hospital stay of (2 +/- 0.5) d (range 1.5 to 3 d). The patients were followed up for 6 -24 (12 +/- 2.5) months, which showed significant improvement in sperm motility as compared with the baseline ([28.53 +/- 5.21] vs [19.62 +/- 3.56]%, P < 0.05), with 28 cases (35.0%) restored to normal. Recurrence was found in 4 cases (5.0%). Testicular hydrocele occurred in 7 cases (8.75%), but orchiatrophy in none. The scars in the umbilicus and suprapubis were invisible because of the wrinkles and pubic hair.</p><p><b>CONCLUSION</b>SAU-LEMDS is safe, effective and feasible for the treatment of varicocele. It is superior to umbilical laparoendoscopic single-site surgery (U-LESS) for its less invasiveness, simpler operation, and better cosmetic appearance.</p>

Genetic characterization and protein stability analysis of a Chinese family with Von Hippel-Lindau disease / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Von Hippel-Lindau disease (VHL), a heritable autosomal dominant disease characterized by neoplasia in multiple organ systems, has rarely been reported in Asia. We genetically investigated a unique Chinese family with VHL disease and performed an analysis of the VHL protein stability.</p><p><b>METHODS</b>Genomic deoxyribonucleic acid (DNA) extracted from peripheral blood was amplified by polymerase chain reaction (PCR) to three exons of the VHL gene in 9 members of the Chinese family with VHL disease. PCR products were directly sequenced. We estimated the effects of VHL gene mutation on the stability of pVHL, which is indicated by the free energy difference between the wild-type and the mutant protein (ΔΔG).</p><p><b>RESULTS</b>The Chinese family was classified as VHL type 1. Three family members, including two patients and a carrier, had a T to G heterozygotic missense mutation at nucleotide 515 of the VHL gene exon 1. This missense mutation resulted in the transition from leucine to arginine in amino acid 101 of the VHL protein. There was low stability of the VHL protein (the ΔΔG was 12.71 kcal/mol) caused by this missense mutation.</p><p><b>CONCLUSIONS</b>We first reported a family with this VHL gene mutation in Asia. This missense mutation is predicted to significantly reduce the stability of the VHL protein and contribute to the development of the renal cell carcinoma (RCC) phenotype displayed by this family. The genetic characterization and protein stability analysis of families with VHL disease are important for early diagnosis and prevention of the disease being passed on to their offspring.</p>

Testicular microlithiasis influences seminal profile and testicular blood flow in infertile men / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the testicular blood flow in patients with testicular microlithiasis (TM) and its correlation with the seminal profile in infertile men.</p><p><b>METHODS</b>We selected 88 infertile men and examined them by testicular color Doppler and routine seminal tests.</p><p><b>RESULTS</b>Testicular microlithiasis was found in 19 (19.3%) of the patients, classic testicular microlithiasis (CTM) in 7 (8.0%), and limited testicular microlithiasis (LTM) in 10 (11.3%). No significant differences were observed in the age of onset, bilateral testicular volume, resistance index (RI) of bilateral testicular arteries, semen amount and the rate of teratospermia. The bilateral testicular peak systolic velocity (PSV), sperm count and sperm motility were significantly lower in the CTM than in the LTM group (P < 0.05), but showed no statistically significant difference between the LTM and the non-calcification group.</p><p><b>CONCLUSION</b>TM may be one of the causes of poor sperm function in infertile men.</p>

Clinical analysis of renal cell carcinoma: report of 271 cases / 中华外科杂志

<p><b>OBJECTIVE</b>To study the diagnosis and treatment of renal cell carcinoma.</p><p><b>METHOD</b>From January 1993 to December 2000 the data of 271 cases of renal cell carcinoma were reviewed.</p><p><b>RESULTS</b>Ultrasonography and CT scanning were still the main diagnostic methods. Surgical operation was performed on 234 patients. Radical nephrectomy was performed on 197 patients (72.6%); Nephron sparing surgery was performed on 19 patients; Metastatic tumor resection was performed on 6 patients and other procedures for 12. The pathological results showed that 137 cases (61.4%) were clear cell carcinoma, 18 cases (8. 1%) of granular cell carcinoma, 32 cases (14. 3%) being combination of the above two varieties, 23 cases (10.3%) of renal papillary adenocarcinoma, 13 cases being renal cell of other types. And 210 cases (77.5%) had been successfully followed up. The 1, 3, 5 and 10 year survival rates were 95.3% (182/191), 88.7% (107/122), 74.7% (56/75) and 32.1% (10/31) respectively.</p><p><b>CONCLUSIONS</b>Ultrasonography is the first select examination method of detecting of renal cell carcinoma, and CT scanning is the most valuable diagnostic mean. Early diagnosis and prompt radical nephrectomy or nephron sparing nephrectomy are the critical points for achieving long-term survivals of patients with renal cell carcinoma.</p>

An experimental study of the culture, isolation and biological characteristics of rat adipose tissue-derived stromal cells in vitro / 中华男科学杂志

<p><b>OBJECTIVE</b>To establish a method for the isolation and culture of rat adipose tissue-derived stromal cells (ADSCs) and explore some biological characteristics of the acquired ADSCs.</p><p><b>METHODS</b>Adipose tissues were isolated from the inguinal fat of SD rats. Primary ADSCs were obtained by the method of collagenase I digestion, inoculated, cultured in the Dulbecco modified Eagle medium with 10% fetal bovine serum, and subcultured at the right moment. The morphology and proliferation characteristics of the cells were observed under the inverted phase contrast microscope every day. Their growth curves were detected and experiments of freezing and resuscitation performed. The third passage ADSCs were induced into osteoblasts by osteogenic inducing fluid and into adipocytes by adipogenic inducing fluid. The osteogenic phenotypes were examined by Von Kossa staining and the adipocytes by Oil Red O staining.</p><p><b>RESULTS</b>ADSCs were successfully obtained and cultured from the rat adipose tissue. They appeared fibroblast-like and could proliferate rapidly in vitro, the third passage having the most active proliferative ability. Calcium nodes characteristic of osteoblasts were observed in the ADSCs on Von Kossa staining after induction with dexamethasone, ascorbic acid and beta-sodium glycerophosphate, and red-stained fats characteristic of adipocytes were noted in the cytoplasm on Oil Red O staining after induction with IBMX, indomethacin and insulin. The ADSCs showed no significant decrease in their proliferation activity and capability of differentiating into diverse cell types after cryopreserved in liquid nitrogen for a month.</p><p><b>CONCLUSION</b>A simple and effective method for the isolation and culture of rat ADSCs was successfully established. The ADSCs obtained could grow and proliferate rapidly in vitro, capable of differentiating into diverse cell types, easy to be preserved and promising to be seed cells for cell therapy and tissue engineering. The procedure of schizolysising erythrocytes with NH4Cl could be omitted in the isolation of the rat ADSCs and dexamethasone is not indispensable in the induction of ADSCs into adipocytes.</p>

Value of transrectal ultrasonography in the diagnosis of midline prostatic cysts / 中华男科学杂志

<p><b>OBJECTIVE</b>To assess the value of transrectal ultrasonography (TRUS) in the diagnosis of midline prostatic cysts.</p><p><b>METHODS</b>We retrospectively analyzed the TRUS manifestations of 87 cases of midline prostatic cysts.</p><p><b>RESULTS</b>Of the total number, 33 cases were diagnosed as Müllerian duct cysts, 21 cases ejaculatory duct cysts and the other 33 cases undifferentiated midline prostatic cysts; 19 cases had dilated seminal vesicles, 19 seminal vesicle agenesis, 9 seminal vesiculitis and 5 dilation of the ejaculatory duct.</p><p><b>CONCLUSION</b>TRUS, convenient, sensitive, safe and non-invasive, is a desirable method for the diagnosis of midline prostatic cysts.</p>

Diagnosis and treatment of primitive neuroectodermal tumor of the penis: a case report and review of the literature / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the clinical and pathological characteristics, treatment and prognosis of peripheral primitive neuroectodermal tumor (PNET) of the urinary tract and reproductive system.</p><p><b>METHODS</b>The clinical data and pathological characteristics of a PNET patient was analyzed and relevant literature reviewed.</p><p><b>RESULTS</b>The diagnosis was established by pathological and immunohistochemical method. The patient underwent radical surgery, followed by chemotherapy.</p><p><b>CONCLUSION</b>Pathology and immunohistochemistry help the diagnosis of PNET. For the treatment of the tumors in the early stage, surgery is the best choice, and for that in the late stage, it can be followed by chemotherapy. The PNET of the penis is a rare disease and evidence still lacks for the evaluation of its prognosis.</p>