What are the symptoms of vas deferens obstructive azoospermia

   Vas deferens obstruction is a common disease of male diseases. It brings great mental pain to patients, friends and families, and also endangers men’s health. Vas deferens is also a troublesome place. Vas deferens is the culprit and the cause of male infertility. Diagnosis of obstruction of the vas deferens is essential for the treatment of male infertility. What are the main symptoms of vas deferens obstruction? The main symptoms are:    1. Congenital obstruction of the vas deferens, congenital absence or occlusion of the vas deferens, congenital epididymal dysplasia, epididymis and testis not connected, congenital absence of seminal vesicles or absence of ejaculatory ducts Such as.  2, tumors of the vas deferens    tumors in the spermatic cord, epididymis, seminal vesicle cysts and tumors, when they occur unilaterally, they cause decreased fertility, and bilateral infertility often occurs. 3. The common infectious factors for infection of the vas deferens are tuberculosis, gonorrhea and schistosomiasis. When Mycobacterium tuberculosis invades the wall of the vas deferens, the wall of the vas deferens becomes thicker, and the vas deferens becomes hard and thick, showing a beaded shape. The disease can spread to the epididymis along the vas deferens The tail, and then spread to the entire epididymis and testis. Coccal infections mainly damage the tail of the epididymis, rarely invade the head of the epididymis, and the vas deferens are often affected. When filariasis infection invades the vas deferens and epididymis, it can also cause obstruction. When the infection invades the prostate and seminal vesicles, the symptoms of vas deferens obstruction can manifest as local congestion, edema, and fibrosis of the seminal vesicles, resulting in infertility due to obstruction of the ejaculatory tract.  4. Trauma of the vas deferens    is mainly caused by iatrogenic injury. Including high ligation of varicocele, hernia repair, cryptorchidectomy, hydrocele&#39.&gt. hydrocele and hydrocele inversion.

Is myeloma benign?

Myeloma is generally a malignant tumor, and the probability of a good tumor is extremely low, and it is attributed to multiple myeloma. The patient needs to be treated immediately after diagnosis. Myeloma is tested by blood cell protein electrophoresis, and patients with myeloma will also experience osteoporosis and bone pain. &nbsp.&nbsp.Multiple myeloma belongs to malignant disease, multiple myeloma is the most common type of malignant plasma cell disease, also known as myeloma plasma cell myeloma, multiple myeloma belongs to monoclonal plasma Cells are malignant and multiply, and metabolize many replicating human immunoglobulins. There are various clinical symptoms, generally slow onset, and some patients have no symptoms for a long time, but they will be detected by blood cell protein electrophoresis. &nbsp.&nbsp.Then there is the invasion of bones, usually invading the bones, the patient will have the main manifestations of osteoporosis, bone hyperplasia and destruction, and bone pain. Infiltration of the bone marrow, the patient may have anemia, and the final stage will be The reduction of total red blood cells can also cause invasion to other human organs. It may cause neuralgia, feel abnormalities, or even paralysis, enlargement of the liver, liver, and lymph nodes. In addition, invasion and other human organs will cause relative clinical symptoms. There is the destruction of bone hyperplasia, bone hyperplasia digestion and absorption of a lot of calcium into the blood, which will cause hypercalcemia. &nbsp.&nbsp. Chemotherapy is the most basic treatment method for the treatment of myeloma. Now many new drugs also have a good therapeutic effect on myeloma, such as bortezomib combined with dexamethasone; in addition, lenalidomide is also a better treatment for myeloma. Good medicine; the basic treatment for myeloma is mainly chemotherapy. Hematopoietic stem cell transplantation can be used as heterosexual consolidation therapy, which is helpful to the patient’s condition. Patients who have no chance to receive transplantation also need maintenance treatment. Ranolamide is used more internationally. Used as a maintenance medicine to help the condition of myeloma.

How does HIV harm human health

Each different virus will have more or less affinity and adaptability to a specific cell in the human body. Before reaching such cells, they must be able to escape the pursuit of the human immune defense system. This is also like a process of chasing and counter-pursuing. When the virus resists the annihilation of several lines of defense and still survives, it can reach its goal and survive and develop successfully.   Of course, if the human immune defense system has loopholes or declines in function, there will naturally be a great opportunity for virus intrusion. For example, healthy and intact skin can prevent viruses from entering, but after being injured, it opens the gates for the enemy, giving the enemy the best chance of invading. The use of unclean syringes by drug users inadvertently gave the virus a chance to invade. The virus remains in the syringe and then sneaks into the body when drug addicts inject drugs.   The reason why HIV is a frightening virus is that after it invades the human body, it destroys human cells and causes a variety of malignant diseases, such as malignant tumors. If the human body is healthy and has strong resistance, the target cell will destroy the virus after the virus invades. But if the human body is weak, the virus will continue to multiply, destroy cells, and “burn, kill, and snatch.” Those who are seriously ill will die in a short time.   In order to prevent HIV from harming human health, it should be prevented as soon as possible. Sexual intercourse is the main route of transmission of AIDS and the most difficult route of transmission. Judging from the current situation, there is no absolute insurance method that can meet the sex needs of HIV-infected people without causing the spread of infection. However, in trying to reduce the risk of infection, some measures can be taken, such as not having sex with HIV-infected persons and using condoms during sexual intercourse.

Can’t read the pathology report after lung cancer surgery? You can understand with a simple learning, no need to ask a doctor

Pathological diagnosis is the gold standard for diagnosing cancer, as is lung cancer. This is a very critical basis for tumor treatment. How important is the pathology report? It can be said that the pathology report after the operation determines almost everything about the patient. What stage of the disease is, what kind of treatment is needed in the future, the possible development of the disease in the future and the judgment of prognosis, all the information comes from postoperative pathology. How to read the pathology report of lung cancer patients? A complete pathological diagnosis includes 4 aspects of information: 1. The basic information of the patient, such as name, gender, age, and pathology number. Among them, the pathology number is a unique number that each patient has in the hospital where they are examined, which is very important. In addition, depending on the circumstances of each hospital, the patient’s medical record number or ID number is also included in the basic information. 2. The method and location of the source of the specimen for inspection. That is to say, it is necessary to indicate which organ, which part, and the method by which the specimen was obtained, such as puncture, endoscopic or surgical resection. 3. The content of the pathology report The content of the pathology report is the most critical part of the entire pathological diagnosis, including the type, nature, and differentiation of cancer cells found after the detection. The specimens obtained by surgical resection also included the extent of tumor invasion, whether lymph node metastasis occurred, whether there was vascular tumor thrombus, whether there was nerve invasion, whether the resection margin was negative, positive, or proximal. In addition, if the tumor lesions are not typical, the content of differential diagnosis needs to be added to the content of the pathology report, and the differential diagnosis of tumors often requires the use of immunohistochemical methods. 4. Molecular typing For lung cancer, molecular typing is also an important part of pathological diagnosis reports. However, the specific content of the molecular typing report may be a separate report later, or it may be attached to the pathology report to form the fourth part. Specifically, let’s talk about the content of the pathological report in Item 3: The pathological types of lung cancer include adenocarcinoma, squamous cell carcinoma, small cell carcinoma, large cell carcinoma, adenosquamous carcinoma, carcinoid, sarcomatoid carcinoma, lymphoepithelioid carcinoma, etc. The morphology of these different types of cells under the microscope is different, and some of them are difficult to distinguish and need to be judged with the results of immunohistochemistry. Adenocarcinoma is the most common nowadays, and the pathology report will also indicate that the cells are mainly attached to the wall, acinar-based, micropapillary-based, and solid with mucus secretion. In addition, there are relatively rare mucinous adenocarcinomas and colloid carcinomas. , Intestinal adenocarcinoma. Histological differentiation: including well-differentiated, moderately differentiated, poorly differentiated and undifferentiated, some of which are highly-medium differentiated, or moderately-poorly differentiated. Tumor size and scope of invasion: The tumor size in pathology is directly measured. The scope of invasion needs to be observed under microscope. Whether the cancer cell involves the main bronchus, whether it invades the visceral pleura, whether there is regional lymph node invasion (each group of lymph nodes will be specifically marked ), whether it violates the trachea, esophagus, large blood vessels, carina, etc. If there is a tumor thrombus in the vessel, it means that cancer cells may have entered the blood circulation. If the resection margin is positive, it means that there is residual tumor at the surgical site, which is not strictly a radical operation. In general, pathological staging can be carried out based on tumor size and scope of invasion, and pathological TNM staging determines the stage of the patient’s condition and guides subsequent treatment. The results of immunohistochemistry can not only help identification, some indicators can also judge the prognosis, such as Ki-67 (nuclear proliferation antigen). If it is too high, it means that the cells proliferate quickly and the prognosis is not good. In lung cancer immunohistochemistry, sometimes PDL1, Kras, EGFR, ALK and other indicators are used. If the expression is positive, further genetic testing can be done to guide targeted therapy and immunotherapy.

Definition of Obstetrics and Gynecology (19) Abnormal Placenta Implantation of Fetal Attachments

Definition: Placental tissue invades myometrium to varying degrees. Classification: According to the depth of the placental villi invading the muscle layer, it is divided into: placental adhesion: placental villi adhere to the surface of the muscle layer; placenta implantation: the placental villi penetrate deep into the muscle wall; penetrating placenta implantation: placental villi reach or exceed the muscle layer Serosa. According to the placenta implantation area, it is divided into: complete placenta implantation; partial placenta implantation. 30 minutes after delivery, the placenta was still unable to peel itself; it was difficult to remove the placenta by hand or found the placenta and the uterine wall were tightly adhered and seamless; when the cesarean section was found, the placenta was implanted or even penetrated the muscle layer. Color Doppler ultrasound is the most common method for judging the placenta position and predicting the placenta implantation. MRI is used to evaluate the implantation of the posterior wall placenta, the depth of the placenta invading the muscular layer, and the involvement of the parauterine and bladder. It is used for those who cannot be confirmed by ultrasound. Treatment: need to be handled in a medical institution with rescue conditions (doctors with blood transfusion conditions, placenta disposal experience, anesthesiologists, doctors with premature infant disposal experience, form a treatment team); Cesarean section incision avoids placenta or placenta mainly Part; remove the uterus if necessary.

Why is my tinea versicolor “difficult”?

In life, there are some patients who have been diagnosed with tinea versicolor: “Doctor, why is my tinea versicolor still bad?” Today, let’s take a little bit of silk and cocoon to explore the truth. Tinea versicolor is a disease that easily recurs, commonly known as “sweat spots”, a superficial mycosis caused by infection of the cuticle of the epidermis with Malassezia. Occurs in areas where oil secretion is strong, and mycological examination is positive. Often manifested as grayish white spots or light brown spots, when grayish white spots appear, they are often confused with vitiligo. (Source: Tencent Medical Code, Invasion) The principle of treatment is usually antifungal treatment, not very serious, you can apply some antifungal ointment (such as: ketoconazole ointment, terbinafine hydrochloride cream, etc.) serious , You can take oral antifungal drugs. Such as: itraconazole, etc. usually cured, hypopigmented spots and pigmented spots will take some time to fade. So, this is why the patient wonders why it is still “bad”. (Picture source network, intrusion and deletion) Prevention is extremely critical, which is helpful to avoid the occurrence of tinea versicolor. The following points need to be noted: 1, daily need to pay attention to personal hygiene, especially in the hot season to avoid sweating. Take a shower and change clothes frequently. 2. The diet is light and healthy, and the mood is pleasant 3. Control blood sugar, exercise in moderation, and improve self-immunity. I am a dermatologist Dr. Li Lili, follow me to learn more about dermatology.

Hu Guisheng: Where are the extramedullary invasions of multiple myeloma?

Multiple myeloma refers to a malignant tumor that occurs in plasma cells in the bone marrow. Multiple myeloma mainly involves the bone marrow or the blood system. Multiple myeloma can also cause multiple bone destruction and damage to kidney function, elevated blood calcium, anemia and so on. Multiple myeloma can also appear extramedullary invasion, so what are the locations? 1. Central nervous system invasion CNS invasion probably accounts for 1% of all MM patients. The pia mater is the most frequently invaded part of the CNS, which can be manifested as thickening of the pia mater with enhancement, similar to meningitis. Or a local mass, similar to meningiomas, our case also has similar manifestations, MRI manifests as T, etc. When the signal is high, the diffusion is limited, and it is obviously evenly strengthened. The diffusion limit indicates its high tumor cell density. CT manifestations of intracranial invasion were equal or high density, MRI showed T, wait until high signal, T2 high signal lesions and diffusion limited. There can be perifocal edema, calcification or hemorrhage in the focus, which needs to be differentiated from lymphoma and metastatic cancer. The spinal canal invasion manifests variously, which can be localized or diffuse. MRI showed T and other signals, T2 and other high signal with enhancement. 2. Head and neck invasion of extramedullary plasmacytoma is more likely to occur in the nasopharynx and sinuses, MRI is often T, a slightly higher signal homogeneous nodules or masses, similar to: in polyps. In this study, 1 case occurred in the left temporal and left eye muscle cones. The MRI showed T, equal signal, and T. slightly higher signal homogenously strengthened the nodule. Dispersion is limited. 3. Chest invasion can be manifested as pulmonary nodules or masses, interstitial infiltration of pleura. Several types of pleura are reported in the literature. The pleura is a common site of EM invasion, and our cases are all manifested as pleural invasion. Pleural invasion can be limited or diffuse. Similar to pleural metastasis or mesothelioma. May be accompanied by pleural effusion, MRI showed T, isobaric signal, T. slightly higher signal, obviously uniform enhancement. 4. Abdominal invasion In multiple autopsy studies, EM is most common in the liver, spleen, and kidney. Splenic invasion is usually more diffuse than focal, and may only appear as splenomegaly. Renal invasion can be manifested as homogeneous nodules or lumps in the kidney or the kidney, moderate to obvious enhancement, pancreatic invasion can be symptomatic, if obstructive jaundice occurs in the head of the pancreas, the image can appear as a pancreatic blood supply mass, similar to islets Cell tumors can also be similar to pancreatic cancer or diffuse swelling of the pancreas, with homogeneous or heterogeneous enhancement. The invasion of the gastrointestinal tract can occur in any section, and it is more common in the small intestine. The strengthening method can slightly delay the strengthening to a significant delay. The invasion of peritoneum and omentum is similar to peritoneal metastasis or lymphoma. 5. Subcutaneous soft tissue and muscle invasion Subcutaneous invasion generally manifests as clear and homogeneous soft tissue nodules or masses under the skin boundary, similar to lymphoma or metastasis, which is consistent with the performance of our case. Muscle invasion can manifest as diffuse infiltrating growth and involving surrounding tissues. 6. Lymph node invasion is more common in the trachea, spleen, and supraclavicular region. This difference may be due to the fact that lymph node invasion generally has no obvious symptoms and is easily ignored by the clinic. The image shows a homogeneously enlarged lymph node with enhancement, and T2 may show a low signal.

Hemangiomas in this area may affect fertility

Hemangioma is a congenital benign tumor, and the majority of patients are infants and young children. One of the most worrying is nothing more than a private hemangioma. If the scrotum of a boy has a hemangioma, parents need to pay attention as soon as possible. The scrotum, as an important male reproductive organ, is very harmful if it is violated by a hemangioma, so the opportunity for treatment is very important. The treatment of hemangioma requires not only good treatment but also patient patience and cooperation. What are the hazards of scrotal hemangioma? 1 Prone to rupture. Scrotal hemangioma is special. It is often stimulated by urine and feces and rubbed back and forth. Therefore, if it is not treated in time or the parental care is not in place, it is easy to cause rupture. , Bleeding, infection and other complications occur. Once these complications occur, even if treatment measures are taken at a later stage, there will be scars due to ulceration. 2Causes tendon sheath effusions Clinical comorbidity of some children in clinical practice, want to have more swollen scrotum than normal children. Generally, after puberty, because the scrotum is too long, it may affect the normal life of the child. Many patients will also have testicular enlargement and precocious puberty. When they should be mature, they will not have normal sexual function or blood discharge. Therefore, parents When children are young, they must pay attention to them and treat them in time. 3Affects growth and development The surface of a large area of ​​scrotal capillary hemangioma, from the femur to the epidermis, will be ruptured due to congestion and expansion, and repeated circulation damage will cause the formation of cavernous hemangioma in the affected area. In the later stage, the legs will be different in thickness and walk limping. 4 The scrotum and anus are invaded near the surrounding normal tissues, so if the scrotal hemangioma is not treated in time, then the anus will be further violated, and then the tumor will invade the rectum again. Once the anal contraction and congestion function is damaged due to the hemangioma, then Stool can be unconsciously discharged after exhaustion, enteritis, or diarrhea. Finally, the expert reminded everyone that patients with hemangiomas entering the rectum have many sinuses similar to hemorrhoids growing on the rectal wall, which are prone to hemorrhage or hemorrhage at the time of stool, so they are easily mistaken for hemorrhoids. Hemangiomas growing on the scrotum are often rubbed by diapers and impregnated with urine and feces. If the care is not good, it will easily rupture and cause bleeding. It will even affect the child’s reproductive function in the future. ,The consequences could be disastrous. Therefore, the care of infants and young children with this hemangioma must be particularly careful and treated as soon as possible.

【Disease Science】 Removal of acoustic neuroma through the middle cranial fossa approach

The clinical manifestations of acoustic neuroma are more complicated, and their symptoms are not completely consistent, but can be severe or severe. This is mainly related to many factors such as the tumor’s initial site, growth rate, development direction, tumor size, blood supply, and whether it is cystic. The typical first symptoms of acoustic neuroma are unilateral deafness and tinnitus. In most cases, the ear tinnitus is a high frequency sound. The tinnitus is described as “whistle sound”, “whistle sound”, “cicada sound”, “roar sound” “Wait. The sound of tinnitus sometimes changes often, and sometimes disappears after a while. Tinnitus can be intermittent or persistent. Atypical symptoms include headache, ear bloating, dizziness, and unstable walking. Later tumor enlargement can compress the brain stem or cause intracranial hypertension. Failure to carry out surgical intervention in time may threaten the patient’s life. Therefore, when patients with tinnitus and hearing loss as the main complaint come to the clinic, if the drug treatment effect is not good, further imaging examination is needed to rule out the possibility of acoustic neuroma. Transcranial fossa approach for the removal of acoustic neuromas. The main indications (MCF) for resection of the cranial fossa approach include the removal of small vestibular schwannomas mainly located in the internal auditory canal, exposed decompression of the facial nerve labyrinth and upper tympanum, and vestibular neurotomy , And the repair of cracks in the upper semicircular canal. From the past, the hearing retention rate of the middle cranial fossa approach is the highest, but it also places the facial nerve between the surgeon and the tumor, potentially leading to an increased risk of postoperative facial paralysis. In some cases, this situation necessitates blind removal. This approach also requires proper stretching of the temporal lobe. Although it provides a limited view of the cerebellopontine angle area, it is accompanied by the potential risk of postoperative epilepsy and language disorders. The approach of the middle cranial fossa is not suitable for the elderly, because the elderly have tight adhesion to the epidural and it is difficult to separate the epidural. This approach is recommended for young patients with small internal auditory canal tumors, which mainly grow in the internal auditory canal. In particular, the tumor involves the bottom of the internal auditory canal. During the posterior approach of the sigmoid sinus, access to and exposure of the internal auditory canal is limited. The approach of the middle cranial fossa is a good alternative approach. In general, the middle cranial fossa approach provides a limited working window for entering the posterior cranial fossa. This limitation is manifested by the fact that the appearance of facial nerves in the surgeon’s field of view adds complexity and limits the surgeon’s ability to remove large tumors. On the other hand, the posterior sigmoid sinus approach revealed a better relationship between pontine cerebellar angle tumors and peripheral neurovascular structures.