Comparison of clinical characteristics of testicular tumor between children and adult population: a retrospective analysis.

OBJECTIVE: Testicular tumor (TT) is a uncommon disease posing serious health problem. There are differences in some aspects between adult and pediatric TT. The study was to compare their differences of clinical and histological characteristics through the analysis of the long-term experiences in TT patients from two institutions. MATERIALS AND METHODS: The clinical data of hospitalized patients was collected and analyzed retrospectively from January 2014 to January 2024 at a pediatric and an adult institution, respectively. The data included composition, gender, age, initial presentation, tumor size, tumor markers, pathological diagnosis. RESULTS: A total of 195 hospitalized patients were included. There were 135 children and 60 adult with TT, respectively. Of these children, patients were aged from 1 month to 14 years, with a mean age of 2.32 years. More cases (37.04%) were diagnosed at age younger than 1 years. 69 cases were left-sided, 65 cases were right-side and only 1 case was bilateral. Pediatric TTs mainly included 82 prepubertal teratomas, 37 had prepubertal yolk sac tumors and 3 mixed malignant germ tumors. Testicular surgeries included testicular-sparing surgery (TSS) (n = 73), radical orchiectomy (n = 60), and testicular biopsy (n = 2). There were 24 patients receiving postoperative chemotherapy. Adult TTs mainly contained 17 seminomas, 10 prepubertal teratomas,7 postpubertal teratomas, 6 stromal tumors and 3 embryonal carcinomas. The average age was 34.08 years. There were 29 right-sided, 27 left-sided and 4 bilateral tumors. TSS (n = 26), radical orchiectomy (n = 33), and testicular biopsy (n = 1) were performed in these TT patients. Only 6 patients received postoperative chemotherapy. The most common symptom was a painless scrotal mass at initial diagnosis in both groups. In addition, we found that significant differences were explored between histological type and age, tumor size (P < 0.05). Yolk sac tumor and seminoma were the most common malignant TT in pediatric and adult population, respectively. After two year follow-up, two children with yolk sac tumor and 4 adults with seminoma died of their diseases. CONCLUSIONS: The majority of pediatric cases were benign compared to adult. The most common type was prepubertal teratoma and yolk sac tumor. Pediatric TTs often occurred under the age of 1 year. Seminomas and prepubertal teratomas were commonly found in adult TTs, especially for young adult. We found that pediatric tumor type was associated with age and tumor size. TSS should be considered for benign TTs based on frozen biopsy findings in children.

Effect of agricultural management practices on rice yield and greenhouse gas emissions in the rice-wheat rotation system in China.

Agricultural management practices (AMPs) have the potential to significantly enhance crop yield, albeit with the possible side effect of escalating greenhouse gas emissions. Few studies have undertaken a comprehensive quantification of the impact of AMPs on crop production and soil GHG, particularly in identifying the optimal AMPs for rice cultivation within rice-wheat rotation system. Here, we combined data analysis and keyword search methods on 1433 individual experimental observations from 172 studies on diverse soil types in the subtropical monsoon climate zone of China to assess the impact of AMPs on rice yield, CH4 and N2O emissions, total greenhouse gas emissions (TGHGE). We focused on four key AMPs: mineral N fertilizer management (including ordinary N fertilizer and slow-/controlled-release fertilizer (SCRF)), organic material management (incorporating organic fertilizer, biochar amendment, and straw return), water-saving irrigation, and no-tillage. Our result showed the rice yield ranged from 2525 to 31,196 kg ha-1, and mineral N fertilizer and organic material management boosted rice yield by 2.84-16.19 % and 2.47-8.52 %, respectively. In terms of N2O emissions, biochar amendment resulted in a decrease of 13.05 %, while ordinary N fertilizer, organic fertilizer, and water-saving irrigation led to increases of 63.16 %, 136.66 %, and 37.41 %, respectively. The implementation of SCRF, water-saving irrigation, and no-tillage significantly curtailed CH4 (6.83 %-35.91 %) and TGHGE (6.22 %-20.59 %). Conversely, organic fertilizer and straw return significantly escalated CH4 emissions by 102.20 % and 33.64 % and TGHGE by 85.03 % and 32.40 %. Rice yield and GHG emissions are mainly influenced by variables such as soil bulk density, pH, soil organic carbon, soil texture, mean annual temperature, and total nitrogen. Our study demonstrates that the application of SCRF, water-saving irrigation, and no-tillage can effectively reduce GHG without compromising yield. These practices are particularly effective under climatic and soil conditions of rice-wheat rotation systems in China, thereby contributing to the sustainable rice farming.

The SUPER reporting guideline suggested for reporting of surgical technique.

Background: Existing reporting guidelines pay insufficient attention to the detail and comprehensiveness reporting of surgical technique. The Surgical techniqUe rePorting chEcklist and standaRds (SUPER) aims to address this gap by defining reporting standards for surgical technique. The SUPER guideline intends to apply to articles that encompass surgical technique in any study design, surgical discipline, and stage of surgical innovation. Methods: Following the EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Network approach, 16 surgeons, journal editors, and methodologists reviewed existing reporting guidelines relating to surgical technique, reviewed papers from 15 top journals, and brainstormed to draft initial items for the SUPER. The initial items were revised through a three-round Delphi survey from 21 multidisciplinary Delphi panel experts from 13 countries and regions. The final SUPER items were formed after an online consensus meeting to resolve disagreements and a three-round wording refinement by all 16 SUPER working group members and five SUPER consultants. Results: The SUPER reporting guideline includes 22 items that are considered essential for good and informative surgical technique reporting. The items are divided into six sections: background, rationale, and objectives (items 1 to 5); preoperative preparations and requirements (items 6 to 9); surgical technique details (items 10 to 15); postoperative considerations and tasks (items 16 to 19); summary and prospect (items 20 and 21); and other information (item 22). Conclusions: The SUPER reporting guideline has the potential to guide detailed, comprehensive, and transparent surgical technique reporting for surgeons. It may also assist journal editors, peer reviewers, systematic reviewers, and guideline developers in the evaluation of surgical technique papers and help practitioners to better understand and reproduce surgical technique. Trial Registration: https://www.equator-network.org/library/reporting-guidelines-under-development/reporting-guidelines-under-development-for-other-study-designs/#SUPER.

The SUPER reporting guideline suggested for reporting of surgical technique: explanation and elaboration.

Background: Surgical technique plays an essential role in achieving good health outcomes. However, the quality of surgical technique reporting remains heterogeneous. Reporting checklists could help authors to describe the surgical technique more transparently and effectively, as well as to assist reviewers and editors evaluate it more informatively, and promote readers to better understand the technique. We previously developed SUPER (surgical technique reporting checklist and standards) to assist authors in reporting their research that contains surgical technique more transparently. However, further explanation and elaboration of each item are needed for better understanding and reporting practice. Methods: We searched surgical literature in PubMed, Google Scholar and journal websites published up to January 2023 to find multidiscipline examples in various article types for each SUPER item. Results: We explain the 22 items of the SUPER and provide rationales item by item alongside. We provide 69 examples from 53 literature that present optimal reporting of the 22 items. Article types of examples include pure surgical technique, and case reports, observational studies and clinical trials that contain surgical technique. Examples are multidisciplinary, including general surgery, orthopaedical surgery, cardiac surgery, thoracic surgery, gastrointestinal surgery, neurological surgery, oncogenic surgery, and emergency surgery etc. Conclusions: Along with SUPER article, this explanation and elaboration file can promote deeper understanding on the SUPER items. We hope that the article could further guide surgeons and researchers in reporting, and assist editors and peer reviewers in reviewing manuscripts related to surgical technique.

Clinical outcomes and risk factor analysis of early endoscopic puncture decompression for ureterocele associated with duplex kidney in children: a single-center retrospective study.

PURPOSE: The aims of this study were to analyze the clinical outcomes of treating duplex system ureteroceles with early endoscopic puncture decompression and to identify the risk factors related to outcomes to help guide future work. MATERIALS AND METHODS: We retrospectively reviewed the clinical records of patients with ureteroceles with duplex kidney that were treated with early endoscopic puncture decompression. Charts were reviewed for demographics, preoperative imaging, surgical indications, and follow-up data. Recurrent febrile urinary tract infections (fUTIs), de novo vesicoureteral reflux (VUR), persistent high-grade VUR, unrelieved hydroureteronephrosis, and the need for further intervention were considered unfavorable outcomes. Gender, age at surgery, BMI, antenatal diagnosis, fUTIs, bladder outlet obstruction (BOO), type of ureterocele, ipsilateral VUR diagnosed before surgery, simultaneously upper-pole moiety (UM) and lower-pole moiety (LM) obstruction, the width of ureter affiliated to UM, and maximum diameter of ureterocele were all considered potential risk factors. A binary logistic regression model was used to identify the risk factors of unfavorable outcomes. RESULTS: A total of 36 patients with ureteroceles related to duplex kidney underwent endoscopic holmium laser puncture from 2015 to 2023 at our institution. After a median follow-up of 21.6 months, unfavorable outcomes developed in 17 patients (47.2%). Three patients underwent ipsilateral common-sheath ureter reimplantation and one patient underwent laparoscopic ipsilateral upper to lower ureteroureterostomy combined with recipient ureter reimplantation. Three patients underwent laparoscopic upper-pole nephrectomy. Fifteen patients suffered from recurrent UTIs were treated with oral antibiotics and eight of them were diagnosed de novo VUR according to voiding cystourethrography (VCUG). In univariate analysis, patients with simultaneously UM and LM obstruction (P = 0.003), fUTIs before surgery (P = 0.044), and ectopic ureterocele (P = 0.031) were more likely to have unfavorable outcomes. Binary logistic regression analysis showed that ectopic ureterocele (OR = 10.793, 95% CI 1.248-93.312, P = 0.031) and simultaneously UM and LM obstruction (OR = 8.304, 95% CI 1.311-52.589, P = 0.025) were identified as independent factors for unfavorable outcomes. CONCLUSIONS: Our study suggested that early endoscopic puncture decompression is not a preferred but an available treatment option to release BOO or to cure refractory UTIs. It was easier to fail if the ureterocele was ectopic or simultaneously UM and LM obstruction existed. Gender, age at surgery, BMI, antenatal diagnosis, fUTIs, bladder outlet obstruction (BOO), ipsilateral VUR diagnosed before surgery, the width of ureter affiliated to UM, and maximum diameter of ureterocele were not significantly related to the success rate of early endoscopic punctures.

A retrospective analysis of the clinical characteristics of 207 hospitalized children with adrenal masses.

Objective: The detection rates of adrenal masses (AMs) have recently increased. The present study aimed to examine the clinical characteristics of these adrenal masses for guiding the clinical diagnosis and treatment among hospitalized children. Methods: The clinical data of AM cases admitted to our hospital from January 2014 to March 2023 were collected and analyzed retrospectively. The data included composition, sex, age, initial presentation, size and site of mass, functional tumor, intervention or surgery, pathological or clinical diagnosis, and imaging data. Results: A total of 207 hospitalized children were included. Among them, adrenal hematoma was the most common finding (53.6%), followed by adrenal neuroblastoma (36.2%). Most masses were larger-sized (51.2%) and non-functional (94.7%). We found that adrenal hematoma commonly occurred in a neonate or child with abdominal trauma. Most adrenal hematoma cases were found in male patients (63.1%), on the right side (71.2%), and with sizes <4 cm (73.9%). Adrenal neuroblastoma was commonly detected in male patients (56.0%), on the right side (66.7%), and with sizes ≥4 cm (85.3%). Moreover, the metastases were frequently explored at the time of diagnosis. In addition, there was no significant difference between ultrasound and computed tomography (CT) scans under suspicion of hematoma (P > 0.05). However, CT showed a priority over ultrasound in the diagnosis of neuroblastoma (P < 0.05). Conclusion: Most masses were non-functional and benign. Of these, adrenal hematoma was the most common type of pediatric AM, followed by adrenal neuroblastoma. They were both commonly found in male patients and on the right side. Neuroblastoma revealed a larger tumor size. Compared to cases of adrenal hematoma, cases of adrenal neuroblastoma required CT scans for further assessment.

Surface modification of ureteral stents: development history, classification, function, and future developments.

INTRODUCTION: Ureteral stents are commonly used in urology but are frequently associated with hematuria, abdominal discomfort, urinary tract infection, stent displacement, and stent encrustation. Surface modification of ureteral stents is beneficial to solve the problem, and these can be divided into coated stents and drug-eluting stents according to the modification method. Coated stents can be divided into hydrophilic coatings, antibacterial coatings, and anti-encrustation coatings. Drug-eluting stents can be divided into antimicrobial drug-eluting, antispasmodic analgesic drug-eluting, anti-ureteral stricture drug-eluting, and anti-tumor drug-eluting. Surface modification of ureteral stents can not only reduce complications related to ureteral stents but also strengthen the treatment of certain urologic diseases, which has a high clinical application value. AREAS COVERED: This review focuses on highlighting and summarizing the latest research progress about surface modification of ureteral stents, ureteral stent development history, classification, functions, and future development prospects. EXPERT OPINION: The purpose of this article is to discuss surface modification of ureteral stents to reduce stent-related complications and potential research directions for the treatment of urinary tract tumors are also briefly discussed, to help guide further innovation in ureteral stent coatings, which contribute to the future progress of ureteral stents surface modification.

Astragaloside IV induces the protective effect of bone marrow mesenchymal stem cells derived exosomes in acute myocardial infarction by inducing angiogenesis and inhibiting apoptosis.

Bone marrow mesenchymal stem cells (BMECs)-derived exosomes (MSC-Exo) can improve acute myocardial infarction (AMI). Astragaloside IV (AS-IV) has also been reported to have cardioprotective pharmacological effects. However, it is not entirely clear whether AS-IV can improve AMI by inducing MSC-Exo. BMSCs and MSC-Exo were isolated and identified, and we also established the AMI rat model and the OGD/R model with H9c2 cells. After MSC-Exo or AS-IV-mediated MSC-Exo treatment, cell angiogenesis, migration, and apoptosis were evaluated by tube formation, wound healing, and TUNEL staining. The cardiac function of the rats was measured by echocardiography. The pathological changes and collagen deposition in rats were also assessed with Masson and Sirius red staining. The levels of α-SMA, CD31 and inflammatory factors were determined by immunohistochemistry and enzyme-linked immunosorbent assay (ELISA). In vitro, AS-IV-mediated MSC-Exo can significantly enhance the angiogenesis and migration of H9c2 cells induced by OGD/R, and significantly reduce their apoptosis. In vivo, AS-IV-mediated MSC-Exo can improve the cardiac function of rats, and attenuate pathological damage and collagen deposition in AMI model rats. In addition, AS-IV-mediated MSC-Exo can also promote angiogenesis and reduce inflammatory factors in rats with AMI. AS-IV-stimulated MSC-Exo can improve myocardial contractile function, myocardial fibrosis and angiogenesis, reduce inflammatory factors and induce apoptosis in rats after AMI.

Reporting guidelines for surgical technique could be improved: a scoping review and a call for action.

OBJECTIVES: To identify reporting guidelines related to surgical technique and propose recommendations for areas that require improvement. STUDY DESIGN AND SETTING: A protocol-guided scoping review was conducted. A literature search of MEDLINE, the EQUATOR Network Library, Google Scholar, and Networked Digital Library of Theses and Dissertations was conducted to identify surgical technique reporting guidelines published up to December 31, 2021. RESULTS: We finally included 55 surgical technique reporting guidelines, vascular surgery (n = 18, 32.7%) was the most common among the clinical specialties covered. The included guidelines generally showed a low degree of international and multidisciplinary cooperation. Few guidelines provided a detailed development process (n = 14, 25.5%), conducted a systematic literature review (n = 13, 23.6%), used the Delphi method (n = 4, 7.3%), or described post-publication strategy (n = 6, 10.9%). The vast majority guidelines focused on the reporting of intraoperative period (n = 50, 90.9%). However, of the guidelines requiring detailed descriptions of surgical technique methodology (n = 43, 78.2%), most failed to provide guidance on what constitutes an adequate description. CONCLUSION: Our study demonstrates significant deficiencies in the development methodology and practicality of reporting guidelines for surgical technique. A standardized reporting guideline that is developed rigorously and focuses on details of surgical technique may serve as a necessary impetus for change.

Optimum plastic mulching application to reduce greenhouse gas emissions without compromising on crop yield and farmers' income.

With the rapid socio-economic development in China, poverty alleviation and the reduction of the environmental footprint in the plastic film mulching (PM) planting system have become key to sustainable agricultural production. Although many studies have evaluated the maize yield, agricultural economic benefits, and greenhouse gas (GHG) emissions associated with PM through small-scale field experiments, identifying suitable PM regions in combination with their demographic characteristics and the future development of such systems has received little attention. This study combines a Denitrification-Decomposition (DNDC) model and demographic characteristics to determine the optimum PM region in rainfed areas of the Loess Plateau in northwest China. The results demonstrated that PM produced a higher maize yield, agricultural net profit (ANP), and cost-benefit ratio compared to a control treatment (CK) without PM. An agricultural income far above the poverty level would assist in meeting the goals of alleviating poverty and building a prosperous society. In addition, the PM system produced more GHG emissions, but had a lower greenhouse gas intensity (GHGI) than CK under both low (200 kg N ha-1) and high (300 kg N ha-1) nitrogen (N) fertilizer rates. This study developed a framework to evaluate maize yield alongside economic and environmental indicators. We concluded that PM should be adopted in areas with precipitation less than 500 mm, and concentrated in the region with rainfall of 200-400 mm. The results provide a theoretical basis for the sustainable development of the PM maize planting system, and will contribute to the desired goal of environmentally sustainable agricultural production.

[Staged Duckett urethroplasty and Byars reconstruction for severe hypospadias with dysplastic glans].

OBJECTIVE: To study the effects of staged Duckett urethroplasty and Byars reconstruction in the treatment of severe hypospadias with dysplastic glans. METHODS: We retrospectively analyzed the clinical data on 57 cases of severe hypospadias with dysplastic glans treated by two-stage Duckett urethroplasty or Byars reconstruction from September 2015 to May 2020. At stage-Ⅰ treatment, the patients were aged from 5 to 47 (mean 21) months, the diameter of the glans less than 1.4 cm, and the interval between the two stages from 6 to 41 (mean 14) months. The patients underwent Duckett urethroplasty, distal in stage Ⅰ and proximal in stage Ⅱ (group A, n = 25) or Byars reconstruction with the urethral plate in stage Ⅰ and Duplay urethroplasty in stage Ⅱ (group B, n = 32). Postoperative follow-up lasted 12－56 (mean 35) months. RESULTS: After stage Ⅱ surgery, penile straightening and smooth appearance of the graft were achieved in all the patients. Six cases of postoperative complications (24%) were observed in group A, including 4 cases of urinary fistula, 1 case of glans dehiscence, 1 case of urethral diverticulum and 1 case of urethral stricture, while 14 cases (43.8%) were observed in group B, including 9 cases of urinary fistula, 9 cases of glans dehiscence and 2 cases of urethral diverticulum, with a remarkably lower incidence rate of glans dehiscence in group A than in B (P = 0.043), but no statistically significant difference in the other observations between the two groups (P > 0.05). CONCLUSION: Both staged strategies of Duckett urethroplasty and Byars reconstruction can be used for the treatment of severe hypospadias with dysplastic glans, but the latter may result in a higher incidence rate of glans dehiscence postoperatively and bring more difficulties to subsequent repair.

Clinical characteristics and identification of risk factors of testicular torsion in children: A retrospective study in a single institution.

Background: Testicular torsion (TT) is a common urological emergency posing serious health problem in children. Prompt diagnosis and treatment of TT are very important for children to protect the affected testis. The aim of this study was to evaluate the historical features, physical examination findings, laboratory tests, and ultrasound examinations in children with TT, as well as to identify the predictors of testicular salvage in children. Materials and methods: We conducted a retrospective record of clinical findings, laboratory data, ultrasound findings, operating results, and the results of follow-up in hospitalized children with TT from November 2004 to December 2021. A multivariable logistic regression model was used to identify predictors of testicular salvage. Results: A total 102 hospitalized children who presented with TT were included. Patients were aged from 1 month to 16 years, with a median age of 7.71 years. TT is significantly more common in the winter. Of these patients, 77 torsions were left-sided, 24 were on the right side, and only 1 was on bilateral sides. Meanwhile, we detected that 88 children suffering from TT had intravaginal torsion of the spermatic cord, and the rest were outside. Anticlockwise torsion was found in 65 cases (63.73%) and clockwise torsion in 37 (36.27%). As a result, 60 underwent orchidectomy, while 42 had a scrotal exploration with fixation of the testis. Multivariate analysis showed that cause of TT, time to intervention, white blood cell (WBC), and mean platelet volume (MPV) were correlated with the risk of a surgical outcome. Conclusion: Only a small proportion of TT children received timely surgical management. Testicular salvage can be predicted by cause of TT, time to intervention, WBC, and MPV. Early scrotal exploration based on careful physical examination decreases the risk of misdiagnosis of spermatic cord torsion. A certain percentage of children with TT presenting with scrotal trauma or epididymo-orchitis should have their testicles checked to make sure that they do not have torsion, especially those who visit in the cold season.

Developing the surgical technique reporting checklist and standards: a study protocol.

BACKGROUND: Standardized and transparent reporting of surgical technique is the cornerstone of effective dissemination, implementation and improvement. However, current reporting of surgical techniques is inadequate. The existing guidelines potentially applied to guide surgical technique reporting are with a minimal highlight of the surgical technique, lack requirements explaining what extent and dimensions need to be described in detail, or are unlikely to extrapolate to a wide range of surgical techniques. This study aims to formulate a rigorous protocol to develop a surgical technique reporting checklist and standards (SUPER) that defines what a clear, comprehensive and detailed surgical technique report should be contained. METHODS: This protocol is designed following the classic guidance for developing reporting guidelines recommended by the EQUATOR network. RESULTS: The development team will consist of surgeons (~80%), methodologists, and journal editors. The draft checklist sources will include a scoping review of existing reporting guidelines related to surgical technique, surgical technique articles from 15 top journals published in the last year, and brainstorming by the multidisciplinary development team. The final SUPER checklist will be formed after three rounds of Delphi surveys, one round of face-to-face meeting, and a month-long pilot test. The SUPER checklist will be published as open-access and be used in combination with existing reporting guidelines related to surgical techniques (e.g., IDEAL). This protocol will steer the SUPER checklist's development, allowing us to further elaborate surgical technique reporting for all surgical specialties, and enabling a more favorable experience for surgeons, nurses, medical students, residents, editors, and reviewers. TRIAL REGISTRATION: This trial is registered at the EQUATOR network on December 18th, 2020. Available at: https://www.equator-network.org/library/reporting-guidelines-under-development/reporting-guidelines-under-development-for-other-study-designs/.

The prognosis of cancer patients undergoing liposomal doxorubicin-based chemotherapy: A systematic review and meta-analysis.

BACKGROUND: It is well known that liposome-based delivery of cytotoxic chemotherapeutics has been proposed as a putative strategy to enhance drug tolerability and efficacy compared to the conventional chemotherapy. However, its potential effect on improving prognosis remains largely unknown. The current meta-analysis is to explore the prognosis of cancer patients undergoing liposomal doxorubicin-based chemotherapy. METHODS: A detailed review of English and Chinese literature was conducted up to March 21, 2020. We evaluate its possible correlations using hazard ratios (HRs) with 95% confidence intervals (CIs). The pooled data were calculated by STATA software and Review Manager 5.3 software. RESULTS: Consequently, 26 studies including 7943 patients were satisfied in current analysis. There were no significant differences between liposomal and conventional chemotherapy in OS (HR = 0.98, 95%CI: 0.93-1.04, P = .544) and PFS (HR = 1.00, 95%CI: 0.92-1.10, P = .945). Likewise, subgroup-analysis regarding country, cancer type, and sample sizes also showed the similar results of the 2 paired groups. CONCLUSION: Taken together, our finding has demonstrated that there was no association of undergoing liposomal doxorubicin-based chemotherapy with cancer prognosis. However, detailed and further studies are needed to confirm our conclusion.

Using Buck's Fascia as an Integral Covering in Urethroplasty to Restore the Anatomical Structure of the Penis in One-Stage Hypospadias Repair: A Multicenter Chinese Study Comprising 1,386 Surgeries.

Objectives: The objective of the study is to investigate the feasibility and efficacy of urethroplasty with a Buck's fascia integral-covering technique (BFIC) to wrap and restore the normal anatomical structure of the penis in one-stage hypospadias surgery. Methods: One-stage surgeries for hypospadias management were performed using BFIC from January 2016 to September 2020 at four high-volume medical centers in China. The technique integrates Buck's fascia with glans wings to mobilize and wrap the urethra and restore penile anatomical relationships. The clinical data, postoperative follow-up data, and complications were recorded, and the results were analyzed. Results: A total of 1,386 patients were included in the study: 1,260 cases of primary hypospadias and 126 cases of re-operations; distal in 382 cases (27.6%), mid-shaft in 639 (46.1%), proximal in 365 (26.3%); tubularized incised plate (TIP) in 748 cases, inlay-graft in 124, onlay-graft in 49, Mathieu in 28, free-tube graft urethroplasty in 406, and 31 of hybrid procedures. One thousand one hundred forty-two patients (82.4%) were found to have penile curvature (>10°) after artificial erection and all corrected by dorsal plication/s or transection of the urethra plate (UP) simultaneously. The median followed-up time was 27 months (6-62). A total of 143 (10.3%) complications were recorded: 114 (9.0%) in the primary operations and 29 (23%) in the re-operations, 15 (3.9%) in distal hypospadias, 61 (9.5%) in mid-shaft, and 67 (18.4%) in proximal. The complication rate in UP preservation and transection was 10.1 and 10.8%, respectively. Of all case complications, there were 73 (5.2%) of fistula, 10 (0.6%) of dehiscence, 22 (1.6%) of meatal stenosis, 21 (1.5%) of stricture, 6 (0.7%) of diverticulum, and resident curvature in 11 cases (1.2%). The overall complication rate in TIP and free-tube procedure was 9.8 and 9.9%, respectively, and fistula occurred in primary TIP of 33 cases (4.9%). Conclusions: Buck's fascia with the glans can be used as an integral covering technique in one-stage distal to proximal hypospadias and primary or re-operative hypospadias repair. It is safe, feasible, and effective for the repair of hypospadias.

Evidence on reporting guidelines for surgical technique in clinical disciplines: a scoping review protocol.

BACKGROUND: The reporting of surgical techniques is of mixed quality, with most at a very minimal level. Reporting guidelines that could be applied to guide surgical technique reporting vary in methodology for development, discipline coverage, dimension coverage and detail requested. However, a scoping review that could indicate the gaps and efforts needed in surgical technique reporting guidelines is lacking and warranted. This study aims to design a methodological rigour protocol to guide the development of a scoping review of surgical technique reporting guidelines. METHODS: This protocol is designed following the 2020 manual proposed by the Joanna Briggs Institute. To further ensure the soundness of the protocol, we also included multidisciplinary professionals (including methodologists, clinicians, and journal editors) to refine the protocol. DISCUSSION: Seven key steps for developing the scoping review are identified and presented in detail, including (I) identifying the research questions; (II) inclusion criteria; (III) search strategy; (IV) source of evidence selection; (V) data extraction; (VI) analysis of the evidence; and (VII) presentation of the results. Guided by this protocol, the subsequent scoping review will inform us the overview of surgical technique reporting guidelines and precisely guide our direction and next steps in improving surgical technique reporting guidelines. TRIAL REGISTRATION: This protocol is not registered as the PROSPERO database only accepts registration of systematic review protocols while does not accept registration of scoping review protocols.

Potential factors of specialists' willingness to write editorial and commentary: a retrospective study based on 5,091 invitations.

BACKGROUND: Editorials and commentaries (E/C) are common article categories and usually solicited by editors in many journals. However, not all experts accept invitation for an E/C essay for a variety of reasons. We conducted this study to explore the potential influence factors contributing whether an invitation to write E/C is accepted by a specialist. METHODS: Data of invited E/C from all journals of AME Publishing Company between January 1st, 2018 and December 31st, 2018 were retrospectively identified and consecutively collected. Acceptance of writing E/C from experts was recorded as "positive", while acceptance without submission, refusal, or no response, were all recorded as "negative". Factors that could potentially affect invitation acceptance were generally categorized as being related to three areas: original studies, inviting journals, and experts. RESULTS: A total of 5,091 invitations were sent to 4,788 experts from 79 different countries or areas to write E/C on 695 research papers from 43 journals, with a total positive acceptance rate of 18.88%. Greece (40.54%), India (36.8%), and Brazil (35.42%) were the top three countries for acceptance rate. Surgeons (surgeons 23.80% vs. non-surgeons 17.05%; P<0.001) and oncologists (oncologists 22.57% vs. non-oncologists 17.58%; P=0.029) were more likely to accept the E/C invitations. The acceptance rate decreased with the increasing number of published articles of an expert (P=0.005). The acceptance rate was the highest (28.03%) when an inviting journal was indexed in both SCIE and PubMed. ABS, VATS and JTD ranked as the top three journals with the highest invitation acceptance rate. The impact factor of journals on which original papers were published had a negative correlation with the invitation acceptance rate (P=0.015). Database-related studies had the highest acceptance rate (21.66%), while translational (16.49%) and basic studies (16.56%) had a significantly lower acceptance rate among all study types. CONCLUSION: Original studies, inviting journals, and expert-related factors were all influence factors on the acceptance rate/willingness to write of E/C from invitations.