Retrograde ureteric stent insertion from percutaneous suprapubic access to the bladder in renal transplant recipients with ureteric stenosis: a novel minimally invasive technique.

BACKGROUND: Ureteric stricture is a common and salvaging complications after renal transplantation. Two treatment methods are usually used, retrograde ureteral stent placement and percutaneous nephrostomy. The former has a higher failure rate, the latter has a great risk. Therefore, a safe and reliable treatment is needed. CASE PRESENTATION: A technique of retrograde insertion of ureteral stent was established, which was applicable in three transplant recipients with post-transplant ureteral stenosis, and the data was retrospectively recorded. The patients are 2 men and 1 woman, ages 44, 27 and 32 years. These patients underwent a total of five times of retrograde insertion of ureteral stent between 2018 and 2019. None of these patients had any postoperative complication, but all patients had complete recovery from oliguric status within two weeks. CONCLUSIONS: The retrograde ureteric stent insertion by percutaneous suprapubic access to the bladder (RUS-PSAB) was demonstrated feasibility and safety in a case series with short-term follow-up. However, larger prospective studies are needed.

Combined usage of Ho:YAG laser with monopolar resectoscope in the treatment of bladder stone and bladder outlet obstruction.

OBJECTIVE: Bladder stones in elderly men are commonly associated with bladder outlet obstruction, and many different treatment modalities have been presented for both these conditions. To evaluate the effectiveness and safety of a novel method concerning spontaneous usage of both monopoplar transurethral resection of the prostate and Holmium Laser cystolithotripsy, we compared the transurethral use of resectoscope and cystoscope lithotripsy approaches retrospectively. METHODS: Patients data of one hundred and nine male patients with benign prostatic hyperplasia (BPH) and bladder stone(s) were analyzed retrospectively. Two groups of patients were compared: Group I was treated with combination of transurethral holmium laser cystolithotripsy (HLC) and transurethral resection of the prostate (TURP) using the 24F resectoscope, and group II used 22F cystoscope and 24F resectoscope for treating both these conditions. RESULT: We reviewed the records of 109 patients undergoing transurethral cystolithotripsy with holmium laser and simultaneous TURP. The mean bladder stone size were 3.6±1.5 cm in Group-I and 3.7±1.1 cm (mean 3.8) in Group-II (p>0.05). The mean operation time of Group-I and Group-II was 49.0±22.5 minutes and 79.0±28.5 minutes, respectively (p<0.05). Stone fragments were removed completely and TURP procedures were done successfully in all of the patients. Mild hematuria was found more frequently in Group-II (22.2%), and four (7.4%) patients had urethral stricture in the same group during the late follow-up. CONCLUSION: Combination of transurethral laser cystolithotripsy and TURP using the same 24F resectooscope is an effective, safe and economical treatment for bladder stones in BPH patients. It is minimally invasive and involves and has lower complication rates and shorter hospital stay. However, this combined approach should be taken in the treatment of calculus within 4 or 5 centimeters.

Carbon peaking prediction scenarios based on different neural network models: A case study of Guizhou Province.

Global warming, caused by greenhouse gas emissions, is a major challenge for all human societies. To ensure that ambitious carbon neutrality and sustainable economic development goals are met, regional human activities and their impacts on carbon emissions must be studied. Guizhou Province is a typical karst area in China that predominantly uses fossil fuels. In this study, a backpropagation (BP) neural network and extreme learning machine (ELM) model, which is advantageous due to its nonlinear processing, were used to predict carbon emissions from 2020 to 2040 in Guizhou Province. The carbon emissions were calculated using conversion and inventory compilation methods with energy consumption data and the results showed an "S" growth trend. Twelve influencing factors were selected, however, five with larger correlations were screened out using a grey correlation analysis method. A prediction model for carbon emissions from Guizhou Province was established. The prediction performance of a whale optimization algorithm (WOA)-ELM model was found to be higher than the BP neural network and ELM models. Baseline, high-speed, and low-carbon scenarios were analyzed and the size and time of peak carbon emissions in Liaoning Province from 2020 to 2040 were predicted using the WOA-ELM model.

Prediction of clear cell renal cell carcinoma ≤ 4cm: visual assessment of ultrasound characteristics versus ultrasonographic radiomics analysis.

Objective: To investigate the diagnostic efficacy of the clinical ultrasound imaging model, ultrasonographic radiomics model, and comprehensive model based on ultrasonographic radiomics for the differentiation of small clear cell Renal Cell Carcinoma (ccRCC) and Renal Angiomyolipoma (RAML). Methods: The clinical, ultrasound, and contrast-enhanced CT(CECT) imaging data of 302 small renal tumors (maximum diameter ≤ 4cm) patients in Tianjin Medical University Cancer Institute and Hospital from June 2018 to June 2022 were retrospectively analyzed, with 182 patients of ccRCC and 120 patients of RAML. The ultrasound images of the largest diameter of renal tumors were manually segmented by ITK-SNAP software, and Pyradiomics (v3.0.1) module in Python 3.8.7 was applied to extract ultrasonographic radiomics features from ROI segmented images. The patients were randomly divided into training and internal validation cohorts in the ratio of 7:3. The Random Forest algorithm of the Sklearn module was applied to construct the clinical ultrasound imaging model, ultrasonographic radiomics model, and comprehensive model. The efficacy of the prediction models was verified in an independent external validation cohort consisting of 69 patients, from 230 small renal tumor patients in two different institutions. The Delong test compared the predictive ability of three models and CECT. Calibration Curve and clinical Decision Curve Analysis were applied to evaluate the model and determine the net benefit to patients. Results: 491 ultrasonographic radiomics features were extracted from 302 small renal tumor patients, and 9 ultrasonographic radiomics features were finally retained for modeling after regression and dimensionality reduction. In the internal validation cohort, the area under the curve (AUC), sensitivity, specificity, and accuracy of the clinical ultrasound imaging model, ultrasonographic radiomics model, comprehensive model, and CECT were 0.75, 76.7%, 60.0%, 70.0%; 0.80, 85.6%, 61.7%, 76.0%; 0.88, 90.6%, 76.7%, 85.0% and 0.90, 92.6%, 88.9%, 91.1%, respectively. In the external validation cohort, AUC, sensitivity, specificity, and accuracy of the three models and CECT were 0.73, 67.5%, 69.1%, 68.3%; 0.89, 86.7%, 80.0%, 83.5%; 0.90, 85.0%, 85.5%, 85.2% and 0.91, 94.6%, 88.3%, 91.3%, respectively. The DeLong test showed no significant difference between the clinical ultrasound imaging model and the ultrasonographic radiomics model (Z=-1.287, P=0.198). The comprehensive model showed superior diagnostic performance than the ultrasonographic radiomics model (Z=4. 394, P<0.001) and the clinical ultrasound imaging model (Z=4. 732, P<0.001). Moreover, there was no significant difference in AUC between the comprehensive model and CECT (Z=-0.252, P=0.801). Both in the internal and external validation cohort, the Calibration Curve and Decision Curve Analysis showed a better performance of the comprehensive model. Conclusion: It is feasible to construct an ultrasonographic radiomics model for distinguishing small ccRCC and RAML based on ultrasound images, and the diagnostic performance of the comprehensive model is superior to the clinical ultrasound imaging model and ultrasonographic radiomics model, similar to that of CECT.

[Surgical management of anti-elevation syndrome following anterior transposition of inferior oblique muscle].

OBJECTIVE: To evaluate the effect of surgery to treat anti-elevation syndrome following anterior transposition of inferior oblique muscle (ATIO). METHODS: We retrospectively studied six cases of anti-elevation syndrome that had surgical history of anteriorization of inferior oblique muscle. We disinserted the inferior oblique from the transposed insertion and simultaneously weakened the contralateral inferior oblique for three cases with severe limited supraduction. We anteriorized the contralateral inferior oblique muscle for other three cases with mild or moderate limitation. The patients were followed up more than 6 months. RESULTS: Six cases we aged from 5 to 22 years. Postoperatively, vertical deviation in primary position improved to less than 6 PD with no more abnormal head position. Three cases with severe limited supraduction showed great improvement. All patients showed no more over reaction of contralateral inferior oblique muscle. Three cases with previously DVD showed improved drift of contralateral eye. All patients were satisfied for the correction and no more surgery were done. The results persisted after six months follow up. CONCLUSIONS: Disinserting the inferior oblique from the transposed insertion is an effective way to treat anti-elevation syndrome with severe limited supraduction. Unilateral anterization of inferior oblique should be avoided.

IgE Epitope Analysis and Hypo-Immunoreactivity Derivative of Arginine Kinase in Mantis Shrimp (Oratosquilla oratoria).

As the main allergenic food, shrimp can trigger allergic reactions in various degrees. In this study, arginine kinase (AK) was identified as an allergen in Oratosquilla oratoria by LC-MS/MS. The open reading frame of AK was obtained, which included 356 amino acids, and recombinant AK (rAK) was expressed in Escherichia coli. The results of immunological analysis and circular dichroism showed that rAK displayed similar IgG-/IgE-binding activity and structure as native AK. Besides, five IgE linear epitopes of AK were verified by serological analysis, on the basis of which an epitope-deleted derivative was obtained and named as mAK-L. It has been shown that mAK-L displayed hypo-immunoreactivity compared to rAK, and the contents of secondary structures were different. In conclusion, these discoveries enrich the overall understanding of crustacean allergens and epitopes and set the foundations for food allergy diagnosis and immunotherapy.

[Comparison between photographic analysis and orthopedic goniometer of measurement of compensatory head posture].

OBJECTIVE: To evaluate the application of relative reference point photographic analysis method and goniometer method for head posture measurement, and compare the characteristics of the two methods. METHODS: Thirty patients from March 2011 to April 2011 and August to September with AHP in our hospital were recruited. The AHP were measured by photographic analysis and goniometer method respectively. The data were analyzed by SPSS software. RESULTS: The mean AHP was 15.62° ± 7.48° by photographic analysis measurement, 15.50° ± 6.99° by goniometer measurement. The Pearson's correlation coefficient (r = 0.955, P < 0.001, t = 0.286, P = 0.777). CONCLUSIONS: Relative reference point photographic analysis is a simple and effective way to measure AHP. The results measured by the two methods are highly consistent.

[Management of large exotropia with medial rectus muscle transection following endoscopic sinus surgery].

OBJECTIVE: To evaluate and compare the effect of surgeries in large exotropic patients who underwent a medial rectus muscle (MR) transection after endoscopic sinus surgery (ESS). METHODS: In 5 patients with exotropia (XT) and a lack of adduction after ESS, orbital CT revealed a complete transection of the midportion of the MR. 3 patients was treated within 3 months after injury. Foster procedure in 2 patients, augmented Hümmelsheim procedure in 1 other patients. Two patients were treated over 6 months after ESS with lateral rectus contraction. Surgery was divided into two stages. The adduction deficits were divided into -1 through to -8. The patients were followed up for more than than 6 months. RESULTS: Postoperatively, 5 patients showed orthophoria or small exophoria within -5°among which 4 had no diplopia in the primary position, another one avoid diplopia by prism lens. The adduction deficits improved to -2 to -5. CONCLUSIONS: Surgical management (vertical rectus muscle transposition) is effective in correcting a large exotropia secondary to a medial rectus transection after ESS. The best time for surgery is 3 months after injury.

MAN1B1 is associated with poor prognosis and modulates proliferation and apoptosis in bladder cancer.

Bladder cancer (BC) has been regarded as the most common malignancy of the urinary system worldwide. With lack of investigations for molecular pathogenesis underlying that develop BC, the therapeutic efficacy of several therapeutic approaches existing is still unsatisfactory. Here, our study aimed to explore the potentially biological function of MAN1B1 on BC. In this study, MAN1B1 expression level in BC tissues and normal tissues was analyzed based on The Cancer Genome Atlas (TCGA) data and correlation between its expression and prognosis was determined using Kaplan-Meier analysis. Knockout of MAN1B1 was performed using silencing RNA and the efficacy of MAN1B1 knockout was identified using quantitative reverse transcription polymerase chain reaction (qRT-PCR) analysis. The BC cells proliferation was assessed by Cell Counting Kit-8 (CCK8) assay, and then the cells apoptosis was detected by Annexin V-fluorescein isothiocyanate (Annexin V-FITC)/propidium iodide (PI) staining and flow cytometry following MAN1B1 knocked down by small interfering RNA. Protein kinase B (AKT) signaling was evaluated by detecting related markers, namely AKT, p-AKT, 4E-BP-1 and Bax using western blot assay. As a result, the MAN1B1 expression was higher in BC tissues than those in normal tissues, besides, its overexpression was associated with poor prognosis. Moreover, MAN1B1 reduction by silencing RNA approach resulted in BC cells proliferation suppression and BC cells apoptosis promotion. Finally, AKT signaling activity was inhibited by MAN1B1 silencing. Taken together, these results unraveled that MAN1B1 may act on an oncogenic action in BC, which improved the likelihood of MAN1B1 taking on a promising prognostic biomarker and a potential target for treating BC.

[Analysis of sterile male semen of occupational drivers].

OBJECTIVE: To explore the possible correlation between the driver's occupation and male semen quality. METHODS: Semen samples were collected from 1,223 infertile men (78 drivers and 1,145 non-drivers) and 100 normal men, and their liquefaction, sperm density, sperm vitality, sperm motility and sperm shape were analysed. RESULTS: The abnormal rates of semen quality in sterile male drivers were significantly higher than in non-drivers(P < 0.05) and in normal men(P < 0.01). The semen abnormal rates in drivers with more than 8 years' driving experience were higher than in those with less than 8 years' driving experience(P < 0.05). CONCLUSION: Driving occupation can result in abnormal semen quality.