Single-port-plus-one robot-assisted laparoscopic Lich-Gregoir direct nipple ureteral extravesical reimplantation in pediatric primary obstructive megaureter, comparing to laparoscopic cohen.

PURPOSE: To compare the effects of a single-port-plus-one robotic laparoscopic-modified Lich-Gregoir direct nipple approach and traditional laparoscopic Cohen in treating pediatric primary obstructive megaureter. MATERIALS AND METHODS: The clinical data of 24 children with primary obstructive megaureter from January 2021 to November 2021 were analyzed retrospectively. Among them, 12 children (8 boys and 4 girls, the average age were 17.17 ± 6.31 months) treated with the laparoscopic Cohen method were defined as group C. The remaining 12 children (7 boys and 5 girls, the average age was 17.33 ± 6.99 months) underwent single-port-plus-one robotic laparoscopic-modified Lich-Gregoir direct nipple ureteral extravesical reimplantation were defined as group L. The parameters of pre-operation, intraoperative and postoperative were compared. RESULTS: There were no differences in the patient characteristics and average follow-up time between the two groups (P > 0.05).The obstruction resolution rate was 100% in both groups. The total operation time in group L is slightly longer than that in group C(P < 0.001),but the intraperitoneal operation time of the two groups was comparable(P > 0.05). The postoperative parameters included blood loss, gross haematuria time, indwelling catheterization time and hospitalization time in group L is shorter than group C(P < 0.05). One year post-operation, decreasing in ureteral diameter and APRPD, and increasing in DRF were remarkably observed in both two groups(P < 0.05). Ureteral diameter, APRPD, and DRF were not significantly different both in pre-operation and post-operation between Group L and Group C(P > 0.05). CONCLUSION: Single-port-plus-one robot-assisted laparoscopic-modified Lich-Gregoir direct nipple approach and traditional laparoscopic Cohen are both dependable techniques for ureteral reimplantation in the treatment of pediatric primary obstructive megaureter. Since Lich-Gregoir can preserve the physiological direction of the ureter and direct nipple reimplantation enhances the effect of anti-refluxing, this technique is favorable for being promoted and applied in robot surgery.

Revealing the mechanism of post-harvest processing on rose quality based on dynamic changes in water content, enzyme activity, volatile and non-volatile metabolites.

Existing studies on post-harvest processing of edible roses have mainly focused on processing techniques and physicochemical properties of the final dried products, with limited studies on how changes in metabolites during processing affect the quality of these products. This study investigated changes in water content and status, enzyme activity, phenolic compounds, and volatile and non-volatile compounds during processing and revealed the mechanisms by which post-harvest processing (drying without blanching (WBD) and drying with blanching (BD)) affects the quality of dried roses by establishing their correlations. Results showed that the blanching reduced the relative content of free water and water activity, thus reducing the subsequent drying time and enzyme activity. The BD method caused higher levels of phenolic compounds than the WBD method in terms of gallic acid, ellagic acid, epicatechin, and quercetin. The OPLS-DA analysis identified 6 differential volatiles out of 72 detected volatiles, contributing to the unique aroma of dried roses by activating olfactory receptors through hydrogen bonding and hydrophobic interactions. 58 differential metabolites were screened from 964 non-volatile metabolites. KEGG pathway analysis revealed that the changes in volatile and non-volatile metabolites induced by different processing methods were due to the effect of blanching on glutathione and fatty acid metabolism. These findings provide a comprehensive understanding of how post-harvest processing affects the quality of dried roses.

Single-port plus one in pediatric robotic-assisted Lich-Gregoir ureteral reimplantation for vesicoureteral reflux, a comparative analysis with short-term outcomes.

OBJECTIVE: To observe the safety and short-term outcomes of a new way of laparoscopic trocar placement in pediatric robotic-assisted Lich-Gregoir ureteral reimplantation for vesicoureteral reflux. METHODS: The retrospective study included 32 patients under 14 years diagnosed with primary vesicoureteral reflux (VUR). All these patients underwent robotic-assisted Lich-Gregoir ureteral reimplantation in our department from December 2020 to August 2022. These patients were divided into the following groups according to the different ways of trocar placement: 13 patients in group single-port plus one (SR) and 19 patients in group multiple-port (MR). Patients' characteristics as well as their perioperative and follow-up data were collected and evaluated. RESULTS: There was no significant difference in the data regarding patients' characteristics and preoperative data. These data included the grade of vesicoureteral reflux according to the voiding cystourethrogram (VCUG), and the differential degree of renal function (DRF) at the following time points: preoperative, postoperative, and comparison of preoperative and postoperative. There was no difference between the two groups. During surgery, the time of artificial pneumoperitoneum establishment, ureteral reimplantation time, and total operative time in the SR group were longer than those in the MR group. Yet only the time of artificial pneumoperitoneum establishment shows a statistical difference (P < 0.0001). Also, the peri-operative data, including the volume of blood loss, fasting time, hospitalization, and length of time that a ureteral catheter remained in place, and the number of postoperative complications demonstrate no difference. In addition, the SFU grade and VCUG grade at the following time point also show no difference between the two groups. CONCLUSION: The study demonstrates that SR in robotic-assisted Lich-Gregoir ureteral reimplantation has reached the same surgical effects as MR. In addition, the single-port plus one trocar placement receives a higher cosmetic satisfaction score from parents and did not increase the surgical time and complexity.

Modulation of the properties of starch gels by a one-step extrusion modification method based on Ca2+-citric acid synergistic crosslinking.

Citric acid (CA) is a green and safe food-grade crosslinking agent for starch, but its high crosslinking temperature limits its application. In this study, a "one-step" extrusion modification method based on Ca2+-esterification synergistic crosslinking was proposed for the preparation of high gel performance crosslinked starch at low temperatures (90 °C). The linear and nonlinear rheological properties of crosslinked starch were comprehensively characterized, and the enhancement effect of synergistic crosslinking reactions on starch gel properties was quantitatively studied. The results show that the elastic modulus of the synergistically crosslinked starch (SC-0.5Ca2+, G' = 3116 ± 36) was significantly increased by 879 % compared to the elastic modulus of starch without synergistically crosslinked modification (SC, G' = 318 ± 9). The elastic modulus of starch gels can be adjusted by changing the ion concentration. Nonlinear rheological Lissajous curve analysis results show that the synergistic crosslinked gel system has a stronger anti-deformation ability. In addition, the honeycomb porous structure and smaller pore size distribution of the synergistic crosslinked gels were characterized using scanning SEM. The XPS, FTIR and XRD results suggest that the synergistic crosslinking enhancement effect may involve various molecular forces such as electrostatic attraction, hydrogen bonding and ester bonding.

Single-port-plus-one robot-assisted laparoscopic modified Lich-Gregoir direct nipple ureteral extravesical reimplantation in children with a primary obstructive megaureter.

Purpose: To introduce a new technique of single-port-plus-one robotic laparoscopic-modified Lich-Gregoir direct nipple ureteral extravesical reimplantation and ascertain its validity in the treatment of pediatric primary obstructive megaureter. Methods: Between January 2021 and November 2021, we retrospectively analyzed the clinical data of 12 children with primary obstructive megaureter who were admitted to the Department of Pediatric Surgery of Fujian Provincial Hospital. All 12 children were treated with single-port-plus-one robotic laparoscopic Lich-Gregoir direct nipple ureteral extravesical reimplantation. Five of them were female and seven were male, including nine cases were simple obstructive type, while the remaining three cases were obstructive with reflux type. The mean age of the children was 17.33 ± 6.99 (10-36) months and the mean follow-up time was 14.16 ± 1.75 (12-17) months. Changes in preoperative and first-year postoperative parameters were compared. Results: The mean operative time for all 12 children was 123.58 ± 10.85 (110-145) min, with a mean internal operative time of 101.42 ± 0.85 (90-120) min, a mean operative bleeding time of 2.42 ± 0.67 (2-4) ml, and a mean hematuria duration of 16.08 ± 1.44 (14-19) h. The mean indwelling catheterization time was 2.25 ± 0.45 (2-3) days and the mean hospitalization time was 3.83 ± 0.39 (3-4) days. At the postoperative first year, the ureteral diameter, calyceal diameter, and anterior-posterior renal pelvic diameter were found to be significantly smaller than at the preoperative period (18.83 ± 3.21 mm vs. 6.83 ± 1.27 mm, 13.99 ± 3.58 mm vs. 3.5 ± 2.90 mm, and 34.92 ± 4.25 mm vs. 10.08 ± 1.88 mm, P < 0.001). There was a significant increase in renal cortical thickness and the percentage of differential renal function (3.63 ± 1.66 mm vs. 5.67 ± 1.88 mm, 33.75 ± 2.77 mm vs. 37.50 ± 1.31 mm, P < 0.001). The resolution rate of obstruction was 100% and no child developed DeNovo vesicoureteral reflux. Conclusion: The technique of modified Lich-Gregoir direct nipple ureteral extravesical reimplantation can help maintain the physiological direction of the ureter and at the same time enhance the effectiveness of antirefluxing in robotic surgery. The design of a single-port-plus-one wound can produce a cosmetic appearance by concentrating and hiding the wound around the umbilicus. This modified reimplantation procedure has the potential to become a promising technique in the robot-assisted treatment of primary obstructive megaureter.

Development of thermoultrasound assisted blanching to improve enzyme inactivation efficiency, drying characteristics, energy consumption, and physiochemical properties of sweet potatoes.

Thermoultrasound (USB) as a promising alternative to traditional hot water (HWB) blanching was employed to blanch sweet potatoes and its influence on enzyme activity, drying behavior, energy consumption and physiochemical properties of sweet potatoes were investigated. Results showed that successive increases in blanching temperature and time resulted in significant (p < 0.05) decreases in PPO and POD activities. Compared to HWB, USB led to more effective drying by promoting texture softening, moisture diffusion, microstructure alterations, and microchannels formation, which significantly reduced energy consumption and improved the overall quality of the dried sample. Specifically, USB at 65 °C for 15 min improved water holding capacity and ABTS, while USB at 65 °C for 30 min improved color (more red and yellow), total phenolic content, total carotenoid content, and DPPH. Unfortunately, blanching process showed detrimental effects on the amino acid composition of dried samples. Overall, the development of thermoultrasound assisted blanching for sweet potatoes has the potential to revolutionize the processing and production of high-quality sweet potato products, while also improving the sustainability of food processing operations.

Robot-assisted pyeloplasty and laparoscopic pyeloplasty in children: A comparison of single-port-plus-one and multiport surgery.

Objective: This study aimed to compare the effects of various trocar placements in robot-assisted and laparoscopic pyeloplasty involving children diagnosed with obstruction of the ureteropelvic junction (OUPJ). Methods: We retrospectively collected the data on 74 patients under 14 years of age who had been diagnosed with OUPJ; these patients underwent either robot-assisted or laparoscopic pyeloplasty in our hospital between January 2015 and November 2021. There were four groups, as follows: •Laparoscopic multiport pyeloplasty (LMPY),•Laparoscopic single-port pyeloplasty (LSPY),•Robotic-assisted multiport pyeloplasty (RMPY),•Robotic-assisted single-port-plus-one pyeloplasty (RSPY).Patients' characteristics as well as their perioperative and follow-up data were collected and evaluated. Results: There was no significant difference in the data regarding patients' characteristics. These data included the grade of hydronephrosis according to the Society of Fetal Urology (SFU grade), anterior and posterior diameter of the renal pelvis and ureter (APDRPU), and the differential degree of renal function (DRF) at following time points: preoperative, postoperative, and comparison of preoperative and postoperative. There was no difference among these groups. During surgery, the time of trocar placement, urethroplasty time, and total operative time in the robotic groups (RMPY and RSPY) were longer than those in the laparoscopic groups (LMPY and LSPY). However, the ratio of the urethroplasty time and full operative time (UT/WT) in the robotic groups (RMPY and RSPY) was lower than that in the laparoscopic groups (LMPY and LSPY) (P = 0.0075). Also, the volume of blood loss was lower in the robotic groups (RMPY and RSPY) than that in the laparoscopic groups (LMPY and LSPY), although there was no statistical difference (P = 0.11). There were, however, significant differences in hospitalization days (P < 0.0001) and parents' cosmetic satisfaction scores (P < 0.001). There were no differences in fasting time, the length of time that a ureteral catheter remained in place, or the number of postoperative complications. Conclusion: Our study shows that both robotic multiple-port and single-port-plus-one approaches are comparable, with laparoscopic multiple-port and single-port approaches equally effective in resolving OUPJ in children. Robotic and single-port-plus-one approaches may be associated with some advantages in hospitalization time and cosmetic outcomes; therefore, these approaches may be useful in urologic surgery that requires precise suturing, especially in pediatric patients.

Effect of Combined Infrared and Hot Air Drying Strategies on the Quality of Chrysanthemum (Chrysanthemum morifolium Ramat.) Cakes: Drying Behavior, Aroma Profiles and Phenolic Compounds.

Chrysanthemum (Chrysanthemum morifolium Ramat.) is a seasonal plant with high medicinal and aesthetic value, and drying is an effective practice to enhance its storability after harvesting. The effects of hot air drying (HAD), combined infrared and hot air drying (IR-HAD), and sequential IR-HAD and HAD (IR-HAD + HAD) on the drying behavior, color, shrinkage, aroma profiles, phenolic compounds, and microstructure of chrysanthemum cakes were studied. Results showed that the increasing temperature resulted in a decrease in drying time and an increase in drying rate and moisture diffusivity. The Logarithmic and Page models exhibited superior fit in describing the dehydration process. Among the three drying strategies, IR-HAD was more effective in reducing energy consumption, improving shrinkage, water holding capacity, water binding capacity and cellular microstructure, while IR-HAD + HAD showed better inhibitory effect on color deterioration. Furthermore, gas chromatography-mass spectrometry (GC-MS) analysis revealed that different drying strategies dramatically influenced the aroma profiles in samples, and IR-HAD obtained the highest concentration of volatiles. The results of ultra-performance liquid chromatography (UPLC) indicated that the introduction of infrared radiation contributed to increasing the contents of chlorogenic acid, luteolin, total phenolic and flavonoid. These suggested that IR-HAD was a promising technique for drying medicinal chrysanthemum.

Ureteral reimplantation for pediatric vesicoureteral reflux and primary obstructive megaureter: Transvesicoscopic cohen vs. Politano-Leadbetter approaches.

BACKGROUND: Transvesicoscopic approaches for ureteral reimplantation (UR) are effective surgical techniques with which to resolve vesicoureteral reflux (VUR) or primary obstructive megaureter (POM) in pediatric patients. However, the effectiveness of different UR surgical methods for these two diseases is still unclear. PURPOSE: To compare the effects of Cohen's cross-trigonal and Politano-Leadbetter techniques in children in need of UR. METHODS: A retrospective chart review was performed for consecutive patients who underwent UR at our institution between May 2018 and November 2019, including those treated for vesicoureteral reflux (VUR) or primary obstructive megaureter (POM). Patients who underwent Cohen's technique included in Group C, and those who underwent the Politano-Leadbetter technique were included in Group P. Patient characteristics, perioperative parameters, and short-term postoperative outcomes were compared. RESULTS: Forty-six patients who underwent unilateral UR were included in the analysis. At presentation, those in Group P (N = 22, 12 diagnosed with VUR and 10 with POM) did not differ from those in Group C (N = 24, 12 diagnosed with VUR and 12 with POM) with respect to age, sex, disease type or severity. For VUR patients, reflux was clinically resolved for all patients in both groups; however, only a 75% resolution rate was observed in Group C, with 3 patients experiencing persistent low-grade, clinically insignificant reflux, while a 100% resolution rate was found in Group P (P > 0.05). Among POM patients, the obstruction was resolved for all those in Group P and for 90% of those in Group C; this difference was also not statistically significant (P > 0.05). At the 1-year follow-up, the ureteral diameter (P < 0.05) and anterior-posterior renal pelvic diameter (APRPD) (P < 0.05) of Group P were significantly reduced, and differential renal function (DRF) (P < 0.05) was slightly improved compared with that in Group C in both VUR and POM patients. CONCLUSIONS: Politano-Leadbetter and Cohen are both reliable techniques for UR in children with VUR or POM, and the short-term outcomes of these methods in solving reflux and obstruction are comparable. Besides traditional Cohen's technique, Politano-Leadbetter's technique maybe a potential choice for ureteral reimplantation in children.