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Objective:To compare the efficacy of pneumovesicoscopic Cohen and Politano-Leadbetter procedures in the treatment of vesicoureteral junction obstruction (VUJO) in children.Methods:The data of 48 children with VUJO who underwent operations in the Department of Urology, Anhui Provincial Children′s Hospital from January 2017 to December 2021 were retrospectively analyzed.According to the operation time, the patients were divided into the pneumovesicoscopic Cohen group(group C) (28 cases) and pneumovesicoscopic Politano-Leadbetter group(group P) (20 cases). The operation time, postoperative urinary catheterization duration, hematuria duration, hospitalization time, and the improvement of hydronephrosis, ureteral dilatation, and renal function after surgery were compared between the 2 groups.The enumeration data were compared by the χ2 test or Fisher′ s exact probability method.The measurement data were compared by the t-test. Results:All the 48 children were successfully operated on by the same surgeon, without conversion to open surgery.Six cases in the group C had a megaureter and underwent ureter tailoring.Two cases in the group P had calyceal and ureteral calculi, which were all removed after operation.There was a statistically significant difference in the operation time between group C and group P[(136.5±35.4) min vs.(165.8±33.2) min, t=-3.154, P=0.002]. The patients were followed up for (10.3±2.6) months after operation.There were 8 cases and 6 cases of urinary tract infection in group C and group P within 2 months after the operation, respectively.They all improved after conservative anti-infection treatment, and the infection was well controlled after removal of the D-J tube.Besides, their intravenous pyelography 6 months after operation showed that the ureter was unobstructed.In group C, 6 months after the operation, the anterior and posterior diameters of the renal pelvis [(1.62±0.54) cm vs.(2.55±1.24) cm, t=-5.027, P=0.001] and the largest diameter of the ureter [(0.95±0.27) cm vs.(1.51±0.52) cm, t=-8.495, P<0.001] were significantly decreased, compared with those before operation.However, the renal cortex thickness was increased significantly [(1.47±0.25) cm vs.(0.86±0.46) cm, t=2.028, P=0.004], and the renal function (as indicated by the diuretic nephrogram) was notably improved [(46.27±2.16)% vs.(41.83±3.04)%, t=1.647, P=0.030]. In group P, 6 months after operation, the anterior and posterior diameters of the renal pelvis[(1.48±0.82) cm vs.(2.68±1.41) cm, t=-2.740, P=0.003] and the maximum diameter of the ureter [(1.05±0.46) cm vs.(1.36±0.27) cm, t=-1.635, P=0.040] were significantly smaller than those before operation.However, the renal cortical thickness was increased [(1.38±0.33) cm vs.(0.74±0.39) cm, t=9.073, P<0.001], and the renal function (as indicated by the diuretic nephrogram) was significantly improved [(45.18±3.35)% vs.(39.55±2.49)%, t=1.277, P=0.030]. Politano-Leadbetter surgery outperformed Cohen surgery in promoting the recovery of the anterior and posterior diameters of the renal pelvis [(1.48±0.82) cm vs.(1.62±0.54) cm, t=-1.748, P=0.030]. Conclusions:Pneumovesicoscopic Politano-Leadbetter operation can establish a longer submucosal tunnel without changing the ureteral shape and opening position, having good effects in treating VUJO combined with calyceal and ureteral calculi.Pneumovesicoscopic Politano-Leadbetter operation can also better improve postoperative recovery from hydronephrosis than Cohen operation.However, the pneumovesicoscopic Politano-Leadbetter operation is more difficult and requires longer time.The surgeon should choose a reasonable operation based on his/her own experience.
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ObjectiveTo observe the effect of brain-computer interface (BCI) training based on motor imagery on hand function in hemiplegic patients with subacute stroke. MethodsFrom June, 2020 to December, 2021, 40 patients with hemiplegia in subacute stroke from Department of Rehabilitation Medicine, Fifth Affiliated Hospital of Zhengzhou University were divided into control group (n = 20) and experimental group (n = 20) using random number table. Both groups accepted medication and routine comprehensive rehabilitation, while the control group accepted hand rehabilitation robot training, and the experimental group accepted the robot training using motor imagery-based BCI, for four weeks. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE), modified Barthel Index, modified Ashworth scale, and measured integrated electromyogram of the superficial finger flexors, finger extensors and short thumb extensors of the affected forearm during maximum isometric voluntary contraction with surface electromyography. ResultsTwo patients in the control group and one in the experimental group dropped off. All the indexes improved in both groups after treatment (t > 2.322, Z > 2.631, P < 0.05), and they were better in the experimental group than in the control group (t > 2.227, Z > 2.078, P < 0.05), except the FMA-UE score of wrist. ConclusionMotor imagery-based BCI training is more effective on hand function and activities of daily living in hemiplegic patients with subacute stroke.
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【Objective】 To compare the clinical efficacy of pneumovesic and open laparoscopic ureteral replantation in the treatment of primary vesicoureteral reflux, and to summarize the characteristics of pneumovesic surgery. 【Methods】 A total of 70 children with vesicoureteral reflux treated at our hospital during 2016 and 2021 were divided into pneumovesic group and open group, with 35 children in either group. The pneumovesic group underwent laparoscopic Cohen’s ureteral replantation, and the open group underwent open Cohen’s ureteral replantation. The operation-related data of the two groups were compared. 【Results】 Compared with the open group, the pneumovesic group had smaller incision size (1.5 cm vs. 4.0 cm), less intraoperative blood loss (2.0 mL vs.10.0 mL), longer operation time [(185.3±54.2)min vs. (150.5±45.5)min], shorter postoperative hematuria time [(4.7±2.1 d) vs. (6.0±1.3 d)], shorter urinary catheter indwelling time [(11.9±4.0) d vs. (14.1±3.8) d], lower FLACC pain score [(d1: 2.5±0.7, d3: 1.5±0.6) vs. (d1: 5.3±0.9, d3: 2.9±0.6)], lower incidence of frequent and urgent urination (3% vs. 17% ), and higher postoperative incision satisfaction (100% vs. 89%). There was no recurrence in either group. 【Conclusion】 The curative effects were significant in both groups. Compared with open surgery, pneumovesic laparoscopic ureteral replantation for the treatment of primary vesicoureteral reflux has the advantages of small trauma, beautiful appearance, quick recovery and little influence on bladder function.
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Objective By analyzing the cases of cryptorchidism owing to dysplasia in children to explore how to apply orchidectomy in the treatment of children with cryptorchidism. Methods Two hundred and seven cryptorchi-dism patients with dysplasia who underwent surgical treatment were collected in the Department of Urology,Anhui Province Children′s Hospital Affiliated to Anhui Medical University from July 2005 to May 2016. All the patients were true cryptorchidism,aged from 0. 6 to 11. 4 years [(4. 7 ± 1. 2)years]. There were 78 cases of left cryptorchidism,104 cases of right cryptorchidism and 25 cases of bilateral cryptorchidism. All cases underwent ultrasound examination be-fore surgery,showing that there were no testis in 53 cases,testicular atrophy or dysplasia in 154 cases. All cases under-went surgical treatment,including 149 cases of inguinal incision alone,groin incision combined with laparoscopic explo-ration in 47 cases and simple laparoscopic surgery in 11 cases. Communication with the parents of all the children was conducted during operation. One hundred and sixty - seven cases of mild and moderate testicular dysplasia underwent testicular descending fixation. Forty cases of severe dysplasia or testicular atrophy,including 16 cases of intrahepatic unilateral cryptorchidism and 22 cases of unilateral cryptorchidism outside the abdomen which underwent testicular resection,while 2 cases of bilateral cryptorchidism with severe dysplasia underwent bilateral testicular descent fixation after communication with the parents of the children during operation. All the specimens were sent for pathological examination after the operation. One hundred eighty - six cases were followed up from 1 to 128 months [(53 ± 8) months],and 21 cases were lost. Ultrasound examination was performed from 3 to 6 months after the operation to observe the development of bilateral testis and whether testicular dysplasia or testicular atrophy existed. Results All the children successfully underwent the operation and discharged from hospital. The group who underwent testicular had confirmed slim blood vessels in spermatic cord and poor testicular development through operation,while another group in postoperative follow up ultrasound showed that there was no obvious testicular - like structure in 6 cases,complete atrophy in 12 cases and partial atrophy in 48 cases and no atrophy in 93 cases. No patients had testicular resection again and no canceration after the operation. The healthy sides of the testicular resection in another group all had normal development. Conclusions Mild and moderate testicular dysplasia in children can choose testicular descending fixation,while severe dysplasia or testicular atrophy should select a reasonable surgical approach after communication with families.
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objective To explore the mechanism of Naotaitong granule on ischemic apoplexy by observing the effect of Naotaitong granule on ischemic apoplexy model. Methods128 rats were randomly divided into sham operation group, console group, experimental group and control group. Ischemic apoplexy model were established in all the animals. Different disposal was given to different group. In the 7 d、 10 d、 14 d、21 d and 28 d after drug administration, immunohistochemistry were used to evaluate the expression of Slit2 and VEGF. In addition, behavior alteration and HE staining were applied to evaluate the variation of brain tissue neuron. ResultsAll the animals revealed hemiplegia and cerebral tissue softened after successfully establishing apoplexy model. The morphology of experimental group and control group was improved after drug administration with softened focus obviously reduced. Longa grade of console group in the 7 d、 10 d、 14 d、 21 d and 28 d was (2.92±0.20)、 (2.58±0.20)、 (2.25±0.27)、 (1.83±0.26) and (1.42±0.20) respectively. Longa grade of Naotaitong group in the 7 d、 10 d、 14 d、 21 d and 28 d was (1.92±0.20)、 (1.50±0.32)、 (1.25±0.27)、(0.83 ±0.26) and (0.50±0.00) respectively. Longa grade of control group in the 7 d、 10 d、 14 d、 21 d and 28 d was (2.33±0.41)、 (2.00±0.45)、 (1.75±0.27)、 (1.33±0.41) and (0.92±0.38) respectively. Longa grade of both control and Naotaitong group had statistics significance compared with the console group (P＜0.01) .Conclusion Naotaitong granule may improve anoxemia in rats brain and protect brain tissue.