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【Objective】 To investigate the efficacy and surgical technique of total laparoscopic radical cystectomy with intracorporeal ileal conduit urinary diversion, so as to provide reference for the selection of surgery for patients with bladder cancer. 【Methods】 Clinical data of 48 patients with bladder cancer who underwent laparoscopic radical cystectomy during Mar.2017 and Aug.2022 in our hospital were retrospectively analyzed, including 23 cases who received traditional laparoscopic radical cystectomy combined with extracorporeal ileal conduit, and 25 who received total laparoscopic radical cystectomy with intracorporeal ileal conduit.The operation time, blood loss, postoperative intestinal function recovery time, drainage tube removal time and hospital stay were compared between the two groups. 【Results】 All procedures were successfully performed, and no Clavien-Dindo>grade 3 complications were observed.The operation time, and amount of estimated blood loss of the traditional group and total laparoscopic radical group were (227.0±46.4) min vs. (253.6±58.9) min, and (131.7±79.8) mL vs. (154.0±93.0) mL, respectively.There were no differences in postoperative intestinal function recovery time and drainage tube removal time (P>0.05).The hospital stay was shorter in the total laparoscopic radical group than in the traditional group (P=0.035). 【Conclusion】 Total laparoscopic radical cystectomy with intracorporeal ileal conduit urinary diversion is safe and feasible.which is comparable to the traditional laparoscopic surgery, while the hospital stay in the total laparoscopic group is shorter, which is conducive to rapid postoperative recovery.
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【Objective】 To evaluate the efficacy and safety of 3-dimensional laparoscopic pyeloplasty and ultrasound-guided flexible ureteroscopy lithotripsy (3DLP-UGFURL) in the treatment of ureteropelvic junction obstruction (UPJO) and renal calculi. 【Methods】 The clinical data of 29 patients of UPJO complicated with renal calculi treated with 3DLP-UGFURL during Dec.2017 and Jul.2022 were retrospectively analyzed. There were 23 males and 6 females with average age of (35.3±13.6) years. The lesions were on the left side in 20 cases, on the right side in 9 cases, and all were unilateral. One case was complicated with horseshoe kidney. The body mass index (BMI) was 23.6±3.9. Multiple calculi of renal pelvis or calyces occurred in 16 cases, and the rest were single calculi. The maximum diameter of calculi was (1.2±0.6)cm. There were 2 cases of mild hydronephrosis, 19 cases of moderate hydronephrosis and 8 cases of severe hydronephrosis. 【Results】 All operations were successful. The operation time of 3DLP was (84.2±15.4)min. Operation time of UGFURL was (42.8±15.7)min. Estimated blood loss was (36.9±13.6)mL. Indwelling time of drainage tube was (3.6±1.6)d. Indwelling time of urinary catheter and postoperative hospital stay was (6.8±1.2)d. One month after operation, the stone removal rate was 97.4%. The retention time of ureteral stent was 2.7 months. During the follow-up of (24.5±10.0)months, there were 45 Clavien Dindo grade 1 complications. 【Conclusion】 3DLP-UGFURL is safe and effective in the treatment of UPJO complicated with renal calculi, but it still needs long-term follow-up data.
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Objective:To evaluate the mid-term complication rates of the Hui-Jing one-stage procedure (lingual mucosa combined with longitudinal preputial island flap onlay urethroplasty + tubularized incised plate glansplasty)versus the classic Bracka staged surgery for children with severe hypospadias.Methods:A retrospective analysis was conducted on clinical data of 75 children with proximal hypospadias who were treated at the Seventh Medical Center of PLA General Hospital from March 2017 to June 2022. Of these patients, 31 cases (15 cases penoscrotal type and 16 cases perineal type) were underwent the Bracka two-stage surgery with a median age of 38 months (24.0, 44.5) and 44 cases underwent the Hui-Jing one-stage procedure (23 cases penoscrotal type and 21 perineal type) with a median age of 40.5 months (20.75, 90.5). The length of urethral plate defect after correction of penile curvature was (4.30±0.84)cm in the Bracka group and (4.56±0.79)cm in the Hui-Jing group, which also showed no significant difference.There was no statistically significant difference of the median age and the position of preoperative urethral opening between the two groups( P=0.47, P=0.74). The first stage of Bracka repair consists of orthoplasty and urethral bed substitution with free preputial graft. After 6 months, the urethral plate created from free graft was tabularized to form neourethra; Hui-Jing procedure group used the free lingual mucosal as urethral plate substitution, then we conducted longitudinal preputial island flap Onlay and Snodgrass phalloplasty. The incidence of postoperative urethral fistula, urethral stricture and urethral diverticulum was compared between the two groups of cases and the difference in efficacy between the two procedures was assessed. Results:Among the 75 patients included in the study, there was no statistically significant difference in age or location of urethral meatus between the Bracka and Hui-Jing groups. In Bracka group, 9 cases of urethral stricture (29.0%), 6 case of urethral fistula (19.4%), and 2 cases of urethral diverticulum (6.5%) occurred after surgery, while 12 cases of urethral fistula (27.3%) and 3 case of urethral fistula (6.8%) occurred in the Hui-Jing group. No urethral stricture occurred in Hui-Jing group. There was no statistically significant difference in overall incidence of complications between the two groups [17/31(54.8%) vs.15/44(34.1%), P=0.12]. The incidence of urethral fistula and urethral diverticulum show no significant differences between two groups(19.4% vs 27.3, P=0.61, 6.5% vs. 6.8%, P=0.13). The number of operation in Bracka group was (2.68±1.03) and the hospitalization cost was (12 984.63±3 808.15) Yuan, while the number of operation in Hui-Jing group was (1.36±0.53) and the hospitalization cost was (8 490.54±3 136.84) Yuan. Conclusions:The Hui-Jing one-stage procedure can be used for the surgical treatment of children with severe hypospadias. There is no urethral stricture happened in Hui-Jing group, while the general complication incidence and incidence of urethral fistula and diverticulum show no differences.
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Objective:To compare the efficacy between percutaneous vertebroplasty (PVP) with unilateral double-target puncture approach plus side opening propeller and traditional PVP in the treatment of Kümmell disease.Methods:A retrospective cohort study was conducted to analyze the clinical data of 40 patients with Kümmell disease admitted to Zhengzhou Orthopedic Hospital from January 2020 to June 2022, including 11 males and 29 females; aged 61-95 years [(74.3±9.5)years]. Twenty patients received the PVP with unilateral double-target puncture approach plus side opening propeller (observation group), and 20 patients were treated with traditional PVP (control group). The operation time, volume of cement injection and distribution levels of bone cement were compared between the two groups, as well as the visual analogue score (VAS), Oswestry dysfunction index (ODI), Cobb angle, anterior height of the vertebral body before operation and at 1 day and 6 months after operation. The incidence of complications was also compared between the two groups.Results:All patients were followed up for 6-12 months [(9.1±2.8)months]. The operation time was (40.3±4.5)minutes in the observation group and (38.6±3.5)minutes in the control group ( P>0.05). The volume of cement injection was (6.5±1.3)ml in the observation group, significantly more than that in the control group [(5.4±1.0)ml] ( P<0.01). The distribution levels of bone cement in the observation group (0 patient in Grade 1, 3 in Grade 2, and 17 in Grade 3) were better than those in the control group (1 patient in Grade 1, 15 in Grade 2, and 4 in Grade 3) ( P<0.01). There were no significant differences in the VAS, ODI, Cobb angle or anterior height of the vertebral body between the two groups before operation (all P>0.05). One day after operation, the VAS in the observation group and control group was (1.6±0.7)points and (2.5±0.8)points, with the ODI of 16.1±3.3 and 21.3±4.1, Cobb angle of (18.4±2.9)° and (21.4±2.0)° and anterior height of the vertebral body of (23.7±1.8)mm and (20.1±1.7)mm. Six months after operation, the VAS in the observation group and control group was (1.3±0.5)points and (2.3±0.9)points, with the ODI of 15.0±3.8 and 20.8±3.9, Cobb angle of (19.3±2.9)° and (22.4±1.7)°, and anterior height of the vertebral body of (23.4±1.8)mm and (19.8±1.6)mm. The VAS, ODI, Cobb angle and anterior height of the vertebral body in the observation group were better than those in the control group at 1 day and 6 months after operation (all P<0.01). The VAS, ODI, Cobb angle and anterior height of the vertebral body were significantly improved in the two groups at 1 day and 6 months after operation compared with those before operation (all P<0.01), but there were no significant differences between 1 day and 6 months after operation (all P>0.05). The incidence of complications was not significantly different between the two groups ( P>0.05). Conclusion:The PVP with unilateral double-target puncture approach plus lateral opening propeller not only allows for adequate and evenly distributed injection of bone cement, but also effectively reduces the pain, improves the quality of life, corrects the kyphosis and restores the height of the vertebral body in treating Kümmell disease compared with the traditional PVP.
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Pulmonary surfactant(PS)is a kind of phospholipid-protein complex, whose main function is to reduce the surface tension of alveoli.Exogenous PS replacement therapy has been widely used in the clinical treatment of respiratory distress syndrome(RDS)and other diseases.The clinical application methods include preventive or rescue treatment, invasive or minimally invasive treatment, intubation-surfactant-extubation(INSURE)technology and atomization treatment, etc.Nowadays, INSURE technology has been widely accepted in clinical application, and new non-invasive drug administration methods such as thin catheter, laryngeal mask airway and atomization are being studied or adopted.In this article, the progress of methodological research on clinical application of PS in newborns in recent years is reviewed.
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Telocyte(TC)is a novel type of interstitial cell, which has been identified in various organs and tissues of both humans and animals.Recent studies have confirmed that TC plays crucial roles in regulating tissue and organ development, maintaining tissue homeostasis, participating in tissue repair and regeneration, and modulating the immune response.This article provides a comprehensive review of the current research progress on the distribution, immunophenotype, and cellular functions of TC in the respiratory, circulatory, digestive, urinary, reproductive, locomotor systems, and other organs and tissues during fetal and neonatal development.This review aims to serve as a valuable reference for future investigations into the structure and functions of TC.
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Epilepsy is a common neurological disease, which is caused by transient brain dysfunction due to sudden abnormal discharges of neurons.Repetitive transcranial magnetic stimulation (rTMS) is a neuroelectrophysiological technique developed based on transcranial magnetic stimulation that regulates the excitability of the cerebral cortex, presenting the advantages of painless, non-invasiveness, good safety and less adverse events.In addition, rTMS is widely used in experimental research and clinical treatment, which has a high efficacy on the treatment of central nervous system diseases, and important value for the detection and treatment of pediatric epilepsy.This paper reviews the principle, mechanism, application and safety of rTMS in the treatment of pediatric epilepsy.
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Methods:Cultured human alveolar epithelial A549 cells were assigned into LPS group and blank control group. LPS group was stimulated with LPS and adenosine triphosphate to induce pyroptosis and inflammation. A549 cells were divided into 4 groups: miR-20a mimics group, mimics-negative control (NC) group, inhibitor group and inhibitor-NC group. MiRNA-20a mimics, mimics-NC, inhibitor, and inhibitor-NC were transfected respectively into A549 cells, and after 24 h, the cells were collected to verify transfection efficiency by qPCR. MiRNA-20a mimics and the constructed TLR4-3'UTR double luciferase reporter plasmid were co-transfected into A549 cells, and luciferase activity was analyzed. MiRNA-20a mimics/inhibitors were transfected into A549 cells, and then the cells were stimulated by LPS for 8 h followed by adenosine triphosphate for 30 min. QPCR, Western Blot and ELISA were used to detect the expression of GSDMD, inflammatory factors (ASC, NLRP3, Caspase-1, IL-1β) and Signaling molecules (TLR4、NF-κB) in A549 cells at mRNA level and protein level. Immunofluorescence was used to detect the expression of TLR4 in the A549 cells and NF-κB in the nucleus of A549 cells after transfecting with miRNA-20a mimics/inhibitor.Results:The mRNA and protein expression of pyroptosis marker molecule (GSDMD) and inflammatory factors (ASC, NLRP3, Caspase-1, IL-1β) in A549 cells stimulated with LPS were significantly higher than those in the blank control group, and the differences were statistically significant ( P<0.05). The expression of miRNA-20 in the mimics group was significantly higher than that in the mimic-NC group ( P<0.05), while the expression of miRNA-20a in the inhibitor group was lower than that in the inhibitor-NC group ( P<0.01). The double luciferase reporter gene experiment showed that the relative fluorescence value of the co-transfection group for TLR4-3'UTR-WT and miRNA-20a mimics was significantly lower than the co-transfection group for TLR4-3'UTR-WT and miRNA-20a mimics-NC ( P<0.05). The mRNA and protein levels of pyroptosis marker molecule (GSDMD) , inflammatory factors (ASC, NLRP3, Caspase-1, IL-1β) and signaling molecules (TLR4, NF-κB) were decreased in the mimics group compared to the mimics-NC group, and increased in inhibitor group compared to inhibitor-NC group. Conclusions:miRNA-20a may inhibit LPS-induced pyroptosis and inflammation of A549 cells via TLR4/NF-κB signal pathway.Objetive:To explore the potential role of miRNA-20a in lipopolysaccharide (LPS) induced pyroptosis and inflamation of human alveolar epithelial A549 cells and its regulation mechanisim.
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Objective:To establish a matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) method for the direct detection of serum M protein without antibody enrichment, and to assess its detection performance.Methods:Method establishment. A total of 712 waste serum samples were collected from patients who applied for the M protein identification test in Beijing Chaoyang Hospital affiliated to Capital Medical University. The immunoglobulin light chain was obtained by reduction of IgG and IgA by TCEP, and the detection method was preliminarily determined. The waste serum samples from 20 healthy people were collected to determine the range of mass-to-charge ratios of κ and λ light chain ions. 8 parallel tubes and 8 batches were set up for intra-and inter-batch reproducibility evaluation. 10-fold, 100-fold and 200-fold diluted M protein from 23 positive samples were detected by established MALDI-TOF MS method, and its sensitivity was evaluated. 3 methods of IFE, SPE and MALDI-TOF MS were used to detect M protein simultaneously, and the coincidence rate between MALDI-TOF MS and IFE and SPE was calculated.Results:The repeatability within and between batches was 100%, respectively. The original, 10-, 100-and 200-fold dilutions of 23 M protein-positive samples were determined, and the detection limit of MALDI-TOF MS for M protein was 0.06-0.18 g/L. IFE as the gold standard, the overall coincidence rates of SPE and MALDI-TOF MS were 85.9% and 92.3%, respectively, and the positive coincidence rates of SPE and MALDI-TOF MS were 72.8% and 99.7%, respectively, of the 712 samples. Among the different types of M-proteins, MALDI-TOF-MS agreed 100% with IFE M-protein results for IgA, IgD, IgM, free light chain type and biclonal group, while the agreements of SPE for IgM, IgA and free light chain samples were only 66.7%, 58% and 19.5%, respectively. One positive sample in the IgG group was not detected by MALDI-TOF MS. 23 M-proteins positive samples were diluted by original, 10, 100 and 200 times to access the sensitivity of MALDI-TOF MS method. The coincidence rate of MALDI-TOF MS was 100% and IFE was 96% at 10-fold dilution. The coincidence rate of IFE was 28% and 23% of MALDI-TOF MS at 100-fold and 200-fold dilution, respectively.Conclusions:A MALDI-TOF MS method for the detection of serum M-proteins was successfully established. This method has the advantages of high detection throughput, fast speed, good sensitivity, specificity and coincidence rate.
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Objective:To evaluate the safety and efficacy of laparoscopic nipple-inserted ureteral bladder reimplantation in the treatment of ureteral stricture in kidney recipients.Methods:Two patients with ureteral stenosis after kidney transplantation who underwent laparoscopic nipple-inserted ureteral bladder reimplantation in our hospital in November 2020 and May 2021 were retrospectively analyzed. Case 1, Female, 54 years old, the patient found mild hydronephrosis in the transplanted kidney 2 years before the operation. Ultrasound showed aggravated hydronephrosis 1 week before the operation, and the width of the renal pelvis was 2.9 cm. Nephrostomy was performed before the operation, and antegrade radiography showed that the ureteral anastomosis was narrow, about 2 cm in length, and the grade of ureteral stenosis in the transplanted kidney was grade 3. Case 2, Male, 56 years old, the patient was previously diagnosed with transplanted kidney hydronephrosis, ureterolithiasis and ureteral stricture, and had undergone percutaneous nephrolithotripsy for transplanted kidney and balloon dilatation for ureteral stricture. However, the hydronephrosis and calculus of the transplanted kidney recurred. One month before the operation, due to sudden anuria, a nephrostomy was performed in our hospital. Ultrasound indicated that the transplanted renal pelvis was dilated, and the width of the renal pelvis was 3.1 cm. The grade of ureteral stricture of the transplanted kidney was grade 3. Both patients underwent transabdominal laparoscopy to dissociate and disconnect the ureter, and performed ureteral papillaplasty outside the abdominal cavity to complete ureteral reimplantation. Data on operation time, intraoperative blood loss, intraoperative and postoperative complications, and postoperative follow-up data were collected.Results:Both operations were successfully completed. The operation time was 145 and 180 minutes respectively. The intraoperative blood loss was 30 ml and 50 ml, respectively. The patient had no postoperative complications, and the renal function recovered compared with before. The double J tube was removed 12 weeks after the operation, and ultrasound showed that the width of the renal pelvis recovered to 0.8 cm and 1.1 cm respectively. The two patients were followed up for 18 and 12 months, respectively, and no recurrence of hydronephrosis was found.Conclusions:Laparoscopic nipple-inserted ureteral bladder reimplantation is a safe and effective method for the treatment of allograft ureteral stenosis, which has the advantages of minimally invasive, faster recovery, and fewer complications.
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Objective:To analyze the learning effect of laparoscopic radical cystectomy(LRC)+ modified ileal conduit(MIC).Methods:From 2014 to 2019, 42 patients underwent MIC and their clinical data was retrospectively analyzed. 34 operations were performed by surgeon 1 and 8 operations by surgeon 2. We divided the 34 patients of surgeon 1 into three groups according to their surgical sequence (group A, 1st to 12th; group B, 13th to 23th; group C, 24 th to 34 th), the 8 cases of surgeon 2 was regarded as group D. The history of abdomen surgery in the 4 groups were 0, 1, 4, 3 cases, respectively ( P<0.05). There was no significant difference of the other baseline characteristics, such as age, BMI, American Society of Anesthesiologists. Then we compared several variables between the 4 groups like operation time, time of ileal conduit construction, blood loss, complication rate, lymph node yield, surgical margin, etc. The key steps of the MIC included isolating terminal ileum when the mesentery was transilluminated, performing end-to-end reflux ureterointestinal anastomosis after the efferent loop was fixed, closing the rent of the retroperitoneum. Results:All operations were performed intracorporeally with no transition to open surgery. The operative time for group A, B, C were 330.0(320.0, 360.0)min, 300.0(250.0, 308.0)min, 270.0(216.0, 324.0)min, respectively ( P =0.010). The time of ileal conduit construction of the 3 groups were 136.5(131.3, 147.5)min, 92.0(79.0, 119.0)min, 79.0(72.0, 115.0)min, respectively ( P <0.001). In addition, the difference of the two variables above between A and B, A and C groups separately reached statistical significance ( P<0.05), while the difference between B and C groups did not ( P>0.05). Other variables, such as blood loss, complication rate, lymph node yield, surgical margin, between the 3 groups reached no statistical significance ( P>0.05). The operative time of group D was 420.0(350.0, 450.0)min, and it reached statistical significance ( P<0.05) when compared with group A. There were no significant differences in other variables, such as blood loss, complication rate, lymph node yield, surgical margin, among the 2 groups ( P>0.05). Conclusions:The learning effect of LRC+ MIC was obvious. When surgeon volume increased, the operative time decreased significantly. Variables like estimated blood loss and complication rate of the 2 surgeons did not reached significant difference, which indicated reproductivity and safety of this procedure.
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Objective:To discuss the efficacy of robotic-assisted laparoscopic hemi-nephrectomy for the treatment of complete duplex kidney.Methods:We retrospectively reviewed the clinical data of the 20 patients who had robotic-assisted laparoscopic hemi-nephrectomy surgery from March 2017 to November 2019. Four of these patients were male, while the others were female.The average age of these patients was 28.6 months, ranged from 1-2 months.The duplex kidneys were on the upper pole, 9 on the left side, and l1 on the right side. All the patients had a history of gradual exacerbations of hydronephrosis before surgery. The most commonly seen symptoms were lumbar/abdominal pain(2 cases), dysuresia(1 case) and leakage of urine(1 case). Twelve patients had a history of repeated urinary tract infections. One patient expressed the cystic mass of the urethra protruded from the external orifice. Preoperative diagnosis was confirmed by magnetic resonance urinary water imaging (MRU), diuretic renal dynamic imaging(ECT), intravenous pyelography(IVP), and voiding cystoureterography(VCUG). Two cases were of ectopic urete, 4 of ureterocele and 4 of vesieoureteral reflux(VUR). All the patients underwent hemi-nephrectomy for the treatment of complete duplex kidney. Then we observed the intraoperative and postoperative complications and follow-ups.Results:A11 the cases performed by robotic-assisted laparoscopic surgery transperitoneally were completed successfully.There was no significant complication during the surgery with quick recovery after the surgery.The mean operative time was 109.5min(range 82-150 min). The mean estimated blood loss was about 9 ml (range 5-22 ml). Routinely placing a peripelvic catheter drainage was recommended. The mean hospital stay was 5.9 days(range 4-8 days). One patient was lost to follow-up.Mean follow-up was 13.6 months (range 3 -30 months). The results of the re-examination of ECT did not indicate loss or atrophy of lower renal function 3 months after operation. Primary symptoms improved.Conclusions:Robotic-assisted laparoscopic hemi-nephrectomy for hydronephrosis with duplex kidney could be minimal invasive and effective, and has achieved similar results with cosmetic scar .
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Objective:To evaluate the safety and feasibility of robotic-assisted laparoscopic resection of bladder rhabdomyosarcoma.Methods:A retrospective study was performed in 4 children underwent robotic-assisted surgery for bladder rhabdomyosarcoma from July 2018 to September 2019 in our hospital. The perioperative information and short time outcomes were collected. All the four patients were male. The average age of these patients was 68 months (from 11 to 122 months). After cystoscopy biopsy was conducted, preoperative chemotherapy was carried out. Preoperative radiotherapy was also added depends on the tumor response, then robotic-assisted surgery was performed. Radical cystectomy and orthotopic neobladder reconstruction with bilateral ureter reimplanataion were carried out for the bladder was widely occupied case. Bladder preserving surgery was performed for the other three localized cases.Results:All of the four operations have been conducted successfully without conservation to open surgery. The mean operative time was 189(104-316) min while the mean estimated blood loss was 32.5(20-50) ml. The mean tumor diameter was 4.48(2.7-6.0)cm. According to the pathological results, all of the four cases were diagnosed as embryonal rhabdomyosarcoma. One case had positive margin while other three cases had negative margins. No complication more than Clavien-Dindo grade Ⅲ was observed. The mean length of hospital stay was 18(14-24)days and the mean follow-up time was 14.7(7-21) months. Postoperative chemotherapy was carried out according to the protocol of IRS low risk group for all cases (VAC, eight cycles). Postoperative radiotherapy was conducted for the case with positive margin. No recurrence was recorded during the follow-up period.Conclusions:Robotic-assisted laparoscopic technique for the treatment of bladder rhabdomyosarcoma in children is safe and feasible.
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Objective:Differentially expressed circ_Dock6 was screened in vivo by applying circRNA high-throughput sequencing technology in lung tissue of newborn rats suffering from acute respiratory distress syndrome (ARDS). The corresponding target genes of microRNAs were predicted by bioinformatics, and their biological processes and signal pathways were analyzed as well. Methods:Real-time quantitative PCR was utilized to detect the expression of circ_Dock6 in the lung tissue of newborn rats in ARDS group (12 cases) and normal control group (12 cases). TargetScan, RNAhybrid and miRanda databases were adopted to predict the possible recruitment of miRNAs and their corresponding target genes by circ_Dock6.Functional enrichment analysis and signal pathway enrichment analysis were carried out on the target genes of each miRNA.Results:The expression of circ_Dock6 (0.44±0.29) in the lung tissue of ARDS group was significantly down-regulated ( t=2.060, P<0.05) compared with normal control group(1.63±1.33). The target gene intersections of miRNAs (miR-24-3p, miR-667-3p, miR-711, miR-203b-5p, miR-5132-5p, etc.) may be recruited by circ_Dock6 and were obtained from three databases.Its target gene aggregation function was enriched in various biological processes, including protein metabolism, protein amino acid phosphorylation, DNA-dependent transcriptional regulation, biological regulation, tissue and organ development, cell differentiation, signal regulation, gene expression, response to stimuli, almost all cellular components such as intracellular, organelle, cytoplasm, and nucleus, as well as molecular functions such as transferase activity, transcription factor activity, and phosphotransferase activity.The involved signaling pathways, including enrichment in mitogen-activated protein kinase(MAPK) signaling pathway, phosphatidylinositol-3-kinase-protein kinase B(PI3K-Akt)signaling pathway, and mammalian rapamycin target protein(mTOR)signaling pathway, were closely related to ARDS.Circ_Dock6 may play a significant role in the pathogenesis of ARDS. Conclusions:Circ_Dock6 may be closely correlated with the pathogenesis of neonatal ARDS.Through bioinformatics analysis, the prediction of its target genes and related signaling pathways laid the foundation for further explorations of its mechanism of action.
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Objective@#To evaluate the clinical efficacy of robot-assisted laparoscopic ureteral reimplantation (RAUR) for primary obstructive megaureter (POM) in children.@*Methods@#Twenty-one patients who underwent RAUR for POM in Bayi Children’s Hospital between 2017 April and 2018 April were retrospectively analyzed. The study population consisted of 15 boys and 6 girls aged between 2 months and 11 years. Ten patients had left POMs, 9 had right POMs and two had bilateral POMs. All patients were preoperatively diagnosed with a POM based on urinary system ultrasonography, magnetic resonance urography, and diuretic renal dynamic imaging. Our main technique key steps include: Under general anesthesia, the patients were placed in a Trendelenburg position approximately 40 degrees from the horizon. An 8.5-mm camera port was placed at the level of the umbilicus. Followed by two 5-mm robotic Trocars placed under direct vision 6 cm to the camera port separately, a 5-mm assistant port was placed on the right upper abdominal quadrants which was located 3 cm from the camera and robotic port. The ureter was identified at the pelvic brim. The peritoneum covering the ureter was incised and the ureter was mobilized to the level of the vesico-ureteric junction. The bladder was filled with 60 ml saline and a 5 cm length and 1.5 cm wide submucosal detrusor tunnel was created. The ureter was transected at the bladder mucosa and the narrowed ureteral segment was discarded. The ureteroneocystostomy was performed using 6-0 absorbable suture. Dissecting the perivesical fascia appropriately and using down-top suturing approach, use of an apical stay stitch, and incorporation of the ureteral adventitia during detrusorraphy. Postoperative complications were analysed using the Clavien-Dindo classification. Success was defined as symptomatic relief, decreased hydronephrosis on ultrasound and no evidence of vesicoureteral reflux on voiding cystourethrography.@*Results@#All surgeries were successfully completed without conversion and no intra-operative complication was encountered. The mean operative time was 117.6±18.1(89-165)min, the mean estimated blood loss was 11.9±4.3(5-25)ml, the abdominal drainage tubes were removed after a mean of 4.9±1.1(3-8)days, and the mean postoperative hospital stay was 6.3±1.3(4-10) days. Postoperative complications (Clavien Ⅰ-Ⅱ) occurred in 9.5% (two patients had recurrent urinary tract infections postoperatively) children, no grade Ⅲ-Ⅳ complication was observed. The pre-operative symptoms in all patients disappeared. One patient had grade Ⅱ VUR on VCUG, who were followed conservatively. Ultrasound at postoperative follow-up showed that the hydronephrosis was disappeared in 20 ureters and significantly decreased in 3 ureters. The success rate was 95.7% at a mean follow-up of 16.3±4.0(10-23)months.@*Conclusion@#RAUR is a safe and feasible option for the treatment of POM in children with higher success rate and lower complication rate.
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Objective@#To explore urinary NAG, Cr, MA, α1-MG andβ2-MG as the early renal damage index in children hydronephrosis.@*Methods@#The clinical data of 206 patients in the Bayi Children′s Hospital Affiliated to the Seventh Medical Center of Chinese PLA General Hospital from May 2018 to January 2019 were analyzed retrospectively. Among them, 152 children with hydronephrosis were set as observation group, 54 children without hydronephrosis were set as control group. In the observation group, the age ranged from 1 month to 18 years old, and the median age was 2 years old. There were 123 cases of hydronephrosis caused by ureteropelvic junction obstruction (UPJO) and 29 cases of posterior urethral valve complicated with hydronephrosis. In the control group, the age ranged from 1 month to 15 years old, with a median age of 5 years. There were 18 hypospadias cases, 15 occult penis cases and 21 phimosis. All children with hydronephrosis underwent nuclear medicine renal dynamic imaging. Urine specimens were tested for urinary NAG, Cr, MA, α1-MG, and β2-MG. According to renal dynamic results, the observed components were the renal function injury group and the normal renal function group. The above indicators analyzed to judge the clinical value to find the early renal damage.@*Results@#The expression levels of urinary NAG, MA, α1-MG and β2-MG in the observation group were higher than those in the control group, and the difference was statistically significant. The expression of urinary Cr and the abnormal rate were no significant difference between any two groups(P=0.647, P=0.572). The expression levels of urinary NAG, MA, α1-MG and β2-MG were not significantly different between the normal renal hydronephrosis group and the renal function impairment group (P=0.365, P=0.448, P=0.379, P=0.338). The abnormal expression rate of Urine MA and β2-MG was not statistically significant in the patients with normal renal hydronephrosis and the renal function impairment group (P=0.436, P=0.478). MA got the highest sensitivity of (58.8%), and NAG had the highest specificity of 89.3% to detect early renal demage. Four indexes combined analysis, sensitivity, negative predictive rate, diagnostic coincidence rate improved obviously. Joint analysis of posterior urethral valves combined with hydronephrosis, the abnormal rate was 89.7%(26/29). The renal dysfunction of the posterior urethral valve showed that the renal dynamics dysfunction rate was only 37.9%(11/29).@*Conclusions@#The combined analysis of urinary NAG, MA, α1-MG and β2-MG can accurately predict early renal injury. The index of early renal loss may be the early evidence to judge whether the posterior urethral valve is complicated with upper urinary tract function injury.
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Objective To evaluate the clinical efficacy of robot-assisted laparoscopic ureteral reimplantation (RAUR) for primary obstructive megaureter (POM) in children.Methods Twenty-one patients who underwent RAUR for POM in Bayi Children's Hospital between 2017 April and 2018 April were retrospectively analyzed.The study population consisted of 15 boys and 6 girls aged between 2 months and 11 years.Ten patients had left POMs,9 had right POMs and two had bilateral POMs.All patients were preoperatively diagnosed with a POM based on urinary system ultrasonography,magnetic resonance urography,and diuretic renal dynamic imaging.Our main technique key steps include:Under general anesthesia,the patients were placed in a Trendelenburg position approximately 40 degrees from the horizon.An 8.5-mm camera port was placed at the level of the umbilicus.Followed by two 5-mm robotic Trocars placed under direct vision 6 cm to the camera port separately,a 5-mm assistant port was placed on the right upper abdominal quadrants which was located 3 cm from the camera and robotic port.The ureter was identified at the pelvic brim.The peritoneum covering the ureter was incised and the ureter was mobilized to the level of the vesico-ureteric junction.The bladder was filled with 60 ml saline and a 5 cm length and 1.5 cm wide submucosal detrusor tunnel was created.The ureter was transected at the bladder mucosa and the narrowed ureteral segment was discarded.The ureteroneocystostomy was performed using 6-0 absorbable suture.Dissecting the perivesical fascia appropriately and using down-top suturing approach,use of an apical stay stitch,and incorporation of the ureteral adventitia during detrusorraphy.Postoperative complications were analysed using the Clavien-Dindo classification.Success was defined as symptomatic relief,decreased hydronephrosis on ultrasound and no evidence of vesicoureteral reflux on voiding cystourethrography.Results All surgeries were successfully completed without conversion and no intra-operative complication was encountered.The mean operative time was 117.6 ± 18.1 (89-165)min,the mean estimated blood loss was 11.9 ± 4.3 (5-25) ml,the abdominal drainage tubes were removed after a mean of 4.9 ± 1.1 (3-8) days,and the mean postoperative hospital stay was 6.3 ± 1.3(4-10) days.Postoperative complications (Clavien Ⅰ-Ⅱ) occurred in 9.5％ (two patients had recurrent urinary tract infections postoperatively) children,no grade Ⅲ-Ⅳ complication was observed.The pre-operative symptoms in all patients disappeared.One patient had grade Ⅱ VUR on VCUG,who were followed conservatively.Ultrasound at postoperative follow-up showed that the hydronephrosis was disappeared in 20 ureters and significantly decreased in 3 ureters.The success rate was 95.7％ at a mean follow-up of 16.3 ± 4.0 (10-23) months.Conclusion RAUR is a safe and feasible option for the treatment of POM in children with higher success rate and lower complication rate.
ABSTRACT
Objective To explore urinary NAG,Cr,MA,α1-MG andβ2-MG as the early renal damage index in children hydronephrosis.Methods The clinical data of 206 patients in the Bayi Children's Hospital Affiliated to the Seventh Medical Center of Chinese PLA General Hospital from May 2018 to January 2019 were analyzed retrospectively.Among them,152 children with hydronephrosis were set as observation group,54 children without hydronephrosis were set as control group.In the observation group,the age ranged from 1 month to 18 years old,and the median age was 2 years old.There were 123 cases of hydronephrosis caused by ureteropelvic junction obstruction (UPJO) and 29 cases of posterior urethral valve complicated with hydronephrosis.In the control group,the age ranged from 1 month to 15 years old,with a median age of 5 years.There were 18 hypospadias cases,15 occult penis cases and 21 phimosis.All children with hydronephrosis underwent nuclear medicine renal dynamic imaging.Urine specimens were tested for urinary NAG,Cr,MA,α1-MG,and β2-MG.According to renal dynamic results,the observed components were the renal function injury group and the normal renal function group.The above indicators analyzed to judge the clinical value to find the early renal damage.Results The expression levels of urinary NAG,MA,α1-MG and β2-MG in the observation group were higher than those in the control group,and the difference was statistically significant.The expression of urinary Cr and the abnormal rate were no significant difference between any two groups(P =0.647,P =0.572).The expression levels of urinary NAG,MA,α1-MG and β2-MG were not significantly different between the normal renal hydronephrosis group and the renal function impairment group (P =0.365,P =0.448,P =0.379,P =0.338).The abnormal expression rate of Urine MA and β2-MG was not statistically significant in the patients with normal renal hydronephrosis and the renal function impairment group (P =0.436,P =0.478).MA got the highest sensitivity of (58.8％),and NAG had the highest specificity of 89.3％ to detect early renal demage.Four indexes combined analysis,sensitivity,negative predictive rate,diagnostic coincidence rate improved obviously.Joint analysis of posterior urethral valves combined with hydronephrosis,the abnormal rate was 89.7％ (26/29).The renal dysfunction of the posterior urethral valve showed that the renal dynamics dysfunction rate was only 37.9％ (11/29).Conclusions The combined analysis of urinary NAG,MA,α1-MG and β2-MG can accurately predict early renal injury.The index of early renal loss may be the early evidence to judge whether the posterior urethral valve is complicated with upper urinary tract function injury.
ABSTRACT
Objective To study the effect of small interfering ribonucleic acid (siRNA) silencing apoptosis signal-regulating kinase 1 (ASK1) on inflammatory response of lipopolysaccharide-induced alveolar epithelial A549 cells and its mechanism.Method Cell inflammation model of A549 cells was induced by lipopolysaccharide.The expression of ASK 1 in A549 cells was silenced by liposome transfection of siRNA.The mRNA and expression levels of ASK1,interleukin 6 (IL-6),interleukin 8 (IL-8) and tumor necrosis factor alpha (TNF-α) in A549 cells were detected by immunoblotting,real-time fluorescence quantitative polymerase chain reaction and enzyme-linked immunosorbent assay.Result The expression of IL-6,IL-8 and TNF-α in the experimental group was significantly higher than that in the control group (P＜0.001),which indicated that the inflammatory model of A549 cells was successfully constructed.The mRNA level and expression of ASK1 in the interference group was significantly lower than that in the negative control group and the blank control group (P＜0.01),indicating that silencing ASK1 was also successful.The expressions of IL-6,IL-8 and TNF-α in the interference group (0.37±0.04,0.32±0.04,0.48 ±0.13) were significantly lower than those in the negative control group (1.04±0.11,1.22±0.19,0.93±0.14) and the blank control group (1.01±0.14,1.01 ±0.23,1.02±0.25).The expression of IL-6,IL-8 and TNF-α protein in the interference group (pg/ml) (122.6± 11.0,537.2±42.4,159.2± 19.6) were also significantly lower than those in the negative control group (267.4±20.4,1 289.8±55.3,327.0±26.3) and blank control group (246.6±18.7,1 300.3±35.6,325.2± 18.3),with significant difference (P＜0.05).There was no significant difference in each value between negative control group and blank control group (P＞0.05).Conclusion Silencing ASK1 by siRNA can down-regulate the expression of IL-6,IL-8 and TNF-α in A549 cells,suggesting that ASK 1 may be involved in the regulation of lipopolysaccharide-induced inflammation in A549 cells.
ABSTRACT
Objective To study the clinical value of video-electroencephalogram (VEEG) on the diagnosis and prognosis of neonatal seizure.Method From January 2016 to December 2017,the medical records of 118 neonates who had seizure and received VEEG in our hospital were collected.The results of VEEG and medical records were analyzed using x2 test,Fisher's exact test or rank sum test.Result Among the 118 neonates,94 cases(79.6％) had abnormal VEEG results,including 59 mildly abnormal cases,21 moderately abnormal cases,and 14 severely abnormal cases.The characteristics of mildly abnormal VEEG was delayed mature,and moderately and severely abnormal VEEG were paroxysmal abnormal activities.All of the severely abnormal VEEGs showed abnormal background activities.The incidence of abnormal background activities of severely abnormal group was higher than mildly and moderately abnormal group,the difference was significant (P＜0.001).Neonates with abnormal background activities had higher rates of epileptic seizure and delayed maturation than those with normal background,and the differences were significant (P＜0.001).Among 32 neonates with paroxysmal events,17 cases had non-epileptic events including subtle seizures,myoclonus seizures,and symmnetrical tonic seizures;15 cases had epileptic electrographic seizures and electro-clinical seizures,12 cases had focal seizures.The degree of abnormal VEEG had positive correlations with the incidences of epileptic seizures and delayed maturation (P＜0.001).Conclusion Neonates with seizure has higher rate of abnormal VEEG.Non-epileptic events presents as subtle seizures and myoclonus seizures,and epileptic seizures as focal seizures.The background activities of neonatal VEEG has important predictive value for prognosis.The worse the VEEG is,the higher the possibility of epileptic seizure and delayed maturation.