Association of simple renal cysts with metabolic syndrome in adults.

Background and aims: Metabolic syndrome is common nowadays and may increase risk of hypertension, type 2 diabetes mellitus, cardiovascular complications and even mortality. Renal cysts are also frequently found during routine examination. However, the relationship between simple renal cysts (SRCs) and metabolic syndrome remains unclear. This study aimed to investigate the association of SRCs with metabolic syndrome. Methods: A total of 16,216 subjects aged ≥18 years were enrolled in this study. SRCs were diagnosed with ultrasonography by finding: sharp, thin posterior walls, a round/oval shape, absence of internal echoes, and posterior enhancement. SRCs were categorized by number (0, 1, and ≥2) and size (<2 and ≥2 cm). Metabolic syndrome was diagnosed according to the consensus statement from the International Diabetes Federation. Results: In multivariate analysis, SRCs were positively related to metabolic syndrome (OR: 1.18, 95% CI: 1.06-1.34). The risk of metabolic syndrome was higher for SRCs with a number ≥2 (OR: 1.35, 95% CI: 1.08-1.68) and size ≥2 cm (OR: 1.33, 95% CI: 1.10-1.61). When considering the SRC number and size concomitantly, SRCs with a number ≥2/size ≥2 cm (OR: 1.42, 95% CI: 1.02-1.98) or <2/size ≥2 cm (OR: 1.30, 95% CI: 1.04-1.62) were positively related to metabolic syndrome. Conclusions: Simple renal cysts were found to be related to a higher risk of metabolic syndrome, and the association is more significant in those with larger (sizes ≥2cm) or plural (numbers ≥2) SRCs.

Application of Noncontact Laparoscopic High Ligation of the Hernia Sac of the Vas Deferens in Children with Indirect Inguinal Hernia.

Objective: This study aims to evaluate the usefulness of vas deferens noncontact laparoscopic high ligation of the hernia sac in children with indirect inguinal hernia (IIH). Materials and Methods: The clinical data of 146 male children with IIH treated in the Anhui Children's Hospital from January 2018 to June 2019 were analyzed retrospectively. There were 82 patients in the observation group in which the inner ring opening was sutured and closed using the vas deferens noncontact suture and 64 patients in the control group in which the peritoneum at the inner ring opening was closed using the intradermal suture. The operation time, surgical complications, postoperative complications, and recurrence rate were compared between the two groups (followed up for 2 years). Results: The operation was successful in all the patients in both groups. In the observation group, there was one case of intraoperative spermatic cord vascular injury and one case of infra-abdominal wall vascular injury, and no intraoperative complications occurred in the control group. The operation time was 12.8 ± 1.4 minutes in the control group and 10.4 ± 2.6 minutes in the observation group (P < .01). The two groups of patients were followed up for 2 years, and no complications and no recurrence occurred. Conclusion: The vas deferens noncontact laparoscopic high ligation of the hernia sac to close the inner ring opening has several advantages: The operation is simple; the operation time is shorter than the traditional method, avoiding the possibility of vas deferens injury; and it is a safe, reliable, and effective surgical method. However, due to the small number of clinical cases in this study, its long-term effect requires further observation.

Cumulative Betel Quid Chewing and the Risk of Significant Liver Fibrosis in Subjects With and Without Metabolic Syndrome.

BACKGROUND: Betel quid chewing is associated with metabolic disorders, oral cancer, cardiovascular disease, and chronic liver diseases. Metabolic syndrome (MetS) is also a factor associated with liver fibrosis, cirrhosis, and hepatocellular carcinoma (HCC). However, studies on the relationship between betel quid and liver fibrosis while also considering MetS are lacking. The aim of this study was thus to investigate the association of betel quid chewing and liver fibrosis with MetS. METHODS: A total of 9,221 subjects were enrolled after excluding subjects <18 years of age, with past history of chronic liver diseases, cancer, significant alcohol consumption, and incomplete data. Betel nut chewing habit was classified into three groups: none, former-chewing, and current-chewing, and cumulative exposure was calculated by multiplying the duration with the quantity. Liver fibrosis was evaluated based on the NAFLD fibrosis score (NFS), which is a composite score of age, hyperglycemia, BMI, platelet count, albumin, and the AST/ALT ratio. Significant liver fibrosis was defined as NFS ≥-1.455. RESULTS: After adjusting for other variables, MetS was positively associated with significant liver fibrosis. Subjects with both MetS and betel quid chewing had a higher associated risk of significant liver fibrosis than those with neither MetS nor betel quid chewing (adjusted OR: 3.03, 95% CI: 2.04-4.50, p < 0.001). Betel quid chewing was associated with significant liver fibrosis (adjusted OR: 2.00, 95% CI: 1.14-3.49, p = 0.015) in subjects with MetS, but not in subjects without. CONCLUSION: Metabolic syndrome increased the associated risk of significant liver fibrosis. Cumulative betel quid exposure increased the associated risk of significant liver fibrosis in subjects with MetS, but not in subjects without.

Construction of Esophagogastric Anastomosis in Rabbits with Magnetic Compression Technique.

PURPOSE: The magnetic compression technique (MCT) is a new surgical method that has been used for gastrointestinal anastomosis, choledochojejunostomy, and intestinal anastomosis, but there are no reports on its use for esophagogastric anastomosis. This study aimed to investigate the feasibility of using MCT to fashion esophagogastric anastomoses in rabbits. METHODS: Twenty rabbits were randomized into an MCT group (study group, n = 10) and a hand-sewn group (control group, n = 10). The magnetic compression anastomosis device used in this study was made of neodymium iron boron (NdFeB) and possessed parent (PMR) and daughter (DMR) magnetic rings. To fashion the anastomosis, the PMR and DMR were inserted into the lower esophagus and gastric fundus, respectively. The coupled magnets automatically compressed the sandwiched tissues and were expelled once the anastomosis was installed. The two groups were further compared in terms of the anastomosis construction time, survival rate, and postoperative complications. One month after the anastomosis was installed, the burst pressure and gross appearance of the anastomoses were evaluated. RESULTS: The anastomosis construction time in the study group was significantly shorter than that in the control group (10.50 ± 1.58 min vs. 18.60 ± 2.22 min; P < 0.05), and the magnetic rings were defecated out in 10.70 ± 3.49 days. The incidence of anastomotic blockage in both the study and control groups did not differ significantly (0%, 0/10 vs. 20%, 2/10; P > 0.05). Anastomotic leakage was not found in either of the groups, and the anastomoses burst pressures were similar in the two groups. However, the magnetically compressed anastomoses in the study group had a relatively smoother gross appearance than the hand-sewn anastomoses. CONCLUSION: The magnetic compression anastomosis device is a safe and feasible tool for fashioning esophagogastric anastomoses in this animal model.

A Positive Relationship between Betel Nut Chewing and Significant Liver Fibrosis in NAFLD Subjects, but Not in Non-NAFLD Ones.

BACKGROUND: Betel nut chewing is associated with oral cancer, cardiovascular disease, liver cirrhosis, and hepatocellular carcinoma (HCC). The aim of this study was to explore the association of betel nut chewing with liver fibrosis in subjects with and without nonalcoholic fatty liver disease (NAFLD). METHOD: A total of 5967 subjects were enrolled. NAFLD was diagnosed with ultrasonography. Betel nut chewing was classified into non-chewing, ex-chewing, and current chewing, and cumulative dosages were calculated. The aspartate aminotransferase (AST)/platelet ratio index and NAFLD fibrosis scores (NFS) were calculated for evaluation of liver fibrosis. RESULTS: NAFLD increased the associated risk of liver fibrosis in those with (odds ratio (OR): 5.51, 95% confidence interval (CI): 3.09-9.80) and without betel nut chewing (OR: 2.33, 95% CI: 1.64-3.29). In subjects without NAFLD, betel nut chewing was not associated with liver fibrosis (OR: 1.12, 95% CI: 0.44-2.86). In subjects with NAFLD, cumulative betel nut chewing and ex- and current chewing were positively associated with NFS and significant liver fibrosis. CONCLUSIONS: In subjects with NAFLD, betel nut chewing, even ex-chewing, was associated with a higher risk of liver fibrosis, where higher cumulative levels were found to increase the risk of significant liver fibrosis. However, the associated risk of liver fibrosis due to betel nut chewing was insignificant in subjects without NAFLD.

Association of sleep quality and sleep duration with serum uric acid levels in adults.

OBJECTIVE: To date, the association between sleep duration or sleep quality and hyperuricemia has remained unclear. In addition, sleep duration and quality were not considered concomitantly in previous studies. Thus, this study was aimed toward an examination of the association of sleep duration and quality with uric acid level in a Taiwanese population. METHODS: A total of 4,555 patients aged ≥18 years were enrolled in this study. The sleep duration was classified into three groups: short (<7 h), normal (7-9 h), and long (≥9 h). The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality, and poor sleep quality was defined as a global PSQI score of >5. RESULTS: Poor sleepers were younger and had lower body mass index, blood pressure, uric acid, blood sugar, cholesterol, creatinine level, shorter sleep duration, and engaged in less exercise but had a higher white blood cell count and prevalence of smoking as compared to good sleepers. There were also differences in body mass index, blood pressure, uric acid, blood sugar, lipid profiles, and sleep quality among subjects with different sleep durations. After adjusting for other variables, poor sleep quality was associated with lower uric acid levels. In addition, short sleep duration was positively associated with higher uric acid levels. CONCLUSIONS: Poor sleep quality was related to lower uric acid levels, whereas short sleep duration was associated with higher uric acid levels.