目的探究超声检查对隐睾、隐睾合并先天性肾脏和尿路畸形(Congenital Anomalies of the Kidney and the Urinary Tract,CAKUT)患儿病情诊断的作用以及评估隐睾手术效果的价值。方法选取2019年7月至2021年5月于我院就诊的101例疑似隐睾...目的探究超声检查对隐睾、隐睾合并先天性肾脏和尿路畸形(Congenital Anomalies of the Kidney and the Urinary Tract,CAKUT)患儿病情诊断的作用以及评估隐睾手术效果的价值。方法选取2019年7月至2021年5月于我院就诊的101例疑似隐睾患儿为研究对象,对其行体格、实验室检查与彩色多普勒超声、腹腔镜探查。以腹腔镜探查结果为金标准,分析彩色多普勒超声对小儿隐睾诊断的准确性(准确度、敏感度、特异度、误诊率)。以体格、实验室检查与其他影像学检查结果为标准,分析彩色多普勒超声对隐睾合并CAKUT诊断的准确性。对确诊隐睾患儿行腹腔镜睾丸下固定术,于术后5 d、术后3个月、术后6个月实施彩色多普勒超声检查。比较术前超声诊断隐睾类型、体积与术中所见一致性,探究超声在评估手术成功率与术后3个月、术后6个月睾丸恢复情况(睾丸体积、形态、血运、精索)中的作用。结果101例患儿中83例确诊隐睾,超声诊断隐睾的准确度97.03%、敏感度98.80%、特异度88.89%、误诊率11.11%。83例隐睾患儿中9例确诊隐睾合并CAKUT,超声诊断隐睾合并CAKUT的准确度95.18%、敏感度90.00%、特异度95.89%、误诊率4.11%。超声诊断睾丸位置、体积与术中所见比较差异无统计学意义(P>0.05)。83例患儿进行手术后,其中80例患儿的睾丸位于阴囊内,无回缩,成功率为96.39%;3例患儿的睾丸回缩至阴囊上方,需进行再次手术,失败率为3.61%。与术后6个月恢复情况比较,术后3个月隐睾患儿血运良好情况、精索情况比较无统计学差异(P>0.05),睾丸体积及睾丸形态正常率明显更低,差异有统计学意(P<0.05)。结论超声诊断隐睾的方式简单,准确性高,且其对隐睾合并CAKUT的早期诊断有一定价值,超声能够详细观察患儿的睾丸位置及发育情况,可作为隐睾术后评估的有效工具。展开更多
Objective： It has been shown in our previous study that cimetidine （CIM） can boost the hosts＇ cellular immunity in patients with gastrointestinal cancer. This study was conducted to evaluate CIM＇s effects on tumo...Objective： It has been shown in our previous study that cimetidine （CIM） can boost the hosts＇ cellular immunity in patients with gastrointestinal cancer. This study was conducted to evaluate CIM＇s effects on tumor infiltrating lymphocytes （TIL） and HLA-DR expression in tumor stroma in colorectal cancer （CRC）, so as to investigate its role in local immune response at the tumor site in CRC. Methods： Forty-nine CRC patients were randomized into treatment group of 25 patients who took CIM 7 days before curative surgery till the operation day, and control group of 24 patients who received similar treatment except for CIM intervention. TIL responses and HLA-DR expression were studied on tumor tissues taken before and after surgical resection. Results： The percentage of significant TIL response was increased from 32% （8/25） to 76% （19/25） （P〈0.005） in the CIM treatment group, whereas there were no significant changes in TIL response in the control group [25% （6/24） at recruitment vs. 33% （8/24） at operation, P〉0.50]. Moreover, the percentages of HLA-DR expression were increased from 36% （9/25） to 72% （18/25） in the CIM treatment group, but there were no significant differences in HLA-DR expression in the control group [41.7% （10/24） before resection vs 45.8% （11/24） after resection, P〉0.50]. Conclusion： CIM used before surgery might promote TIL responses and increase the HLA-DR expression in stroma cells in CRC patients, leading to enhanced host immunity against tumor.展开更多
文摘目的探究超声检查对隐睾、隐睾合并先天性肾脏和尿路畸形(Congenital Anomalies of the Kidney and the Urinary Tract,CAKUT)患儿病情诊断的作用以及评估隐睾手术效果的价值。方法选取2019年7月至2021年5月于我院就诊的101例疑似隐睾患儿为研究对象,对其行体格、实验室检查与彩色多普勒超声、腹腔镜探查。以腹腔镜探查结果为金标准,分析彩色多普勒超声对小儿隐睾诊断的准确性(准确度、敏感度、特异度、误诊率)。以体格、实验室检查与其他影像学检查结果为标准,分析彩色多普勒超声对隐睾合并CAKUT诊断的准确性。对确诊隐睾患儿行腹腔镜睾丸下固定术,于术后5 d、术后3个月、术后6个月实施彩色多普勒超声检查。比较术前超声诊断隐睾类型、体积与术中所见一致性,探究超声在评估手术成功率与术后3个月、术后6个月睾丸恢复情况(睾丸体积、形态、血运、精索)中的作用。结果101例患儿中83例确诊隐睾,超声诊断隐睾的准确度97.03%、敏感度98.80%、特异度88.89%、误诊率11.11%。83例隐睾患儿中9例确诊隐睾合并CAKUT,超声诊断隐睾合并CAKUT的准确度95.18%、敏感度90.00%、特异度95.89%、误诊率4.11%。超声诊断睾丸位置、体积与术中所见比较差异无统计学意义(P>0.05)。83例患儿进行手术后,其中80例患儿的睾丸位于阴囊内,无回缩,成功率为96.39%;3例患儿的睾丸回缩至阴囊上方,需进行再次手术,失败率为3.61%。与术后6个月恢复情况比较,术后3个月隐睾患儿血运良好情况、精索情况比较无统计学差异(P>0.05),睾丸体积及睾丸形态正常率明显更低,差异有统计学意(P<0.05)。结论超声诊断隐睾的方式简单,准确性高,且其对隐睾合并CAKUT的早期诊断有一定价值,超声能够详细观察患儿的睾丸位置及发育情况,可作为隐睾术后评估的有效工具。
基金This project was supported by New-Century Excellent Talents Supporting Program of the Ministry of Education (NCET-04-0669).
文摘Objective： It has been shown in our previous study that cimetidine （CIM） can boost the hosts＇ cellular immunity in patients with gastrointestinal cancer. This study was conducted to evaluate CIM＇s effects on tumor infiltrating lymphocytes （TIL） and HLA-DR expression in tumor stroma in colorectal cancer （CRC）, so as to investigate its role in local immune response at the tumor site in CRC. Methods： Forty-nine CRC patients were randomized into treatment group of 25 patients who took CIM 7 days before curative surgery till the operation day, and control group of 24 patients who received similar treatment except for CIM intervention. TIL responses and HLA-DR expression were studied on tumor tissues taken before and after surgical resection. Results： The percentage of significant TIL response was increased from 32% （8/25） to 76% （19/25） （P〈0.005） in the CIM treatment group, whereas there were no significant changes in TIL response in the control group [25% （6/24） at recruitment vs. 33% （8/24） at operation, P〉0.50]. Moreover, the percentages of HLA-DR expression were increased from 36% （9/25） to 72% （18/25） in the CIM treatment group, but there were no significant differences in HLA-DR expression in the control group [41.7% （10/24） before resection vs 45.8% （11/24） after resection, P〉0.50]. Conclusion： CIM used before surgery might promote TIL responses and increase the HLA-DR expression in stroma cells in CRC patients, leading to enhanced host immunity against tumor.
