1.Diagnosis and treatment of 138 hermaphroditism cases
Dazhen PENG ; Gensheng LU ; Kaichang ZHU ; Wenhao SHEN ; Yi ZHI
Journal of Third Military Medical University 2003;0(19):-
Objective To improve the diagnosis and treatment of hermaphroditism.Methods The data of 138 cases of hermaphroditism who were hospitalized in our department between March 2005 and April 2008 were reviewed and and analyzed to summarize our experience in the diagnosis and treatment.Results Among the 138 cases with a age ranging from 2 to 36(mean 17 years old),42 were socially male and 96 were socially female.With the help of medical examination,,laboratory examination,ultrasonic examination,radiological examination and pathologic diagnosis,54 patients were diagnosed as female pseudohermaphroditism,66 as male pseudohermaphroditism,10 patients as true hermaphroditism,2 patients as pure gonadal dysgenesis,2 as testicle degeneration,and the left 4 patients as Klinefelter syndrome.Among the 138 patients,132 patients were received surgery operation,including 76 of them receiving laparoscopy.After operation,121 patients were maintained female sex,11 patients were maintained male sex.Female pseudohermaphroditism were all maintained female sex.Fifty-nine patients of male pseudohermaphroditism were maintained female sex.There were 4 patients being maintained male sex,and 3 patients having not received operation.Of the cases of the true hermaphroditism,8 patients were maintained female sex and 2 patients were maintained male sex.Conclusion Early accurate diagnosis is very important to the treatment of hermaphroditism.Etiologic diagnosis is useful in the course.Although it is good for the hermaphroditism to maintain female sex,the decision of the patients and the family should be considered.
2.Preventing superficial bladder cancer from recurrence by intravesical instillation with Brucea Javanica oil emulsion after TUR-Bt operation
Feng TIAN ; He WANG ; Weijun QIN ; Kaichang ZHU ; Yue LIU
Chinese Journal of Rehabilitation Theory and Practice 2005;11(6):475-476
ObjectiveTo observe the effect of intravesical instillation of Brucea Javanica oil emulsion on recurrence of bladder cancer after transurethral resection of bladder tumor (TUR-Bt) operation.Methods187 patients with superficial bladder carcinoma after TUR-Bt operation were randomly divided into the group A (85 cases) and group B (102 cases). Patients of the group A were treated with instillation of Brucea Javanica oil emulsion; those of the group B were treated with mitomycin. A three-years following up was performed to observe the recurrence and side effects.ResultsAfter a 3-years following up, the recurrence rate of group A was 12.94%, lower than that of group B (34.31%). The side effects were seldom seen in the group A.ConclusionThe effect of intravesical instillation of Brucea Javanica oil emulsion to prevent the recurrence of bladder cancer after TUR-Bt operation is favorable.
3.Analysis of factors influencing the disease-free survival after radical prostatectomy for prostate adenocarcinoma
Xiaoxiong WANG ; Liang HUANG ; Baofa HONG ; Zailv WEN ; Yue LIU ; Kaichang ZHU
Chinese Journal of Urology 2001;0(06):-
Objective To analyze the factors that influence the disease-free survival time after radical prostatectomy for prostate adenocarcinoma and to study the expression and significance of Bcl-2,C-erbB-2,Ki-67 in prostate adenocarcinoma. Methods A total of 51 cases of prostate adenocarcinoma undergoing radical prostatectomy were reviewed.Cox proportional hazard model was used to investigate the impact and co-impacts of the factors,which included age, preoperative PSA level,Gleason scores of biopsies and operative specimens,EPE,MR,SVI,LN,PAT,PRT and having testes or not during follow-up.Immunohistochemical staining was used in biopsies and resected specimens to evaluate the positivity of Bcl-2,C-erbB-2,Ki-67 in 15 of the 51 cases. Results In stepwise Cox proportional hazards model, the prognostic factors for recurrence were age(P=0.011),maximal androgen blockade(P=0.017), positive margin of resection(P=0.000),postoperative Gleason score(P=0.002),having testes or not after operation(P=0.040).The expressions of 3 types of proteins showed negative correlation with the prognosis of prostate carcinoma. Conclusions Among clinicopathologic factors,positive resected margin is the most powerful prognostic factor.Patients will benefit from maximal androgen blockage before radical prostatectomy.Disease-free survival after radical prostatectomy is not influenced by not having pelvic lymphadenectomy after finding no enlarged lymph nodes intraoperatively.Not preserving testes after prostatectomy is a favorable factor.The prognosis of prostate carcinoma can be predicted with the expressions of Bcl-2,C-erbB-2 and Ki-67 in biopsies or resected specimens.