The effect of spleen tyrosine kinase inhibitor R406 on diabetic retinopathy in experimental diabetic rats.

PURPOSE: To investigate the effect of spleen tyrosine kinase (Syk) inhibitor R406 on diabetic retinopathy (DR) in diabetic mellitus (DM) rats. METHODS: Rats were randomized into Normal, DM, DM + 5 mg/kg R406 and DM + 10 mg/kg R406 groups. DM rats were established via injection of streptozotocin (STZ). One week after model establishment, rats in treatment groups received 5 mg/kg or 10 mg/kg R406 by gavage administration for 12 weeks consecutively, followed by the detection with hematoxylin-eosin (HE) staining, Evans blue angiography, retinal trypsin digestion assay, Western blotting, immunohistochemistry, TUNEL assay, immunofluorescence assay and quantitative reverse transcriptase real-time polymerase chain reaction (qRT-PCR). RESULTS: The retina of DM rats presented different degree of edema, disordered and loose structure, swollen cells with enlarged intercellular space, and dilated and congested capillaries. Besides, the retinal vessels of DM rats showed high fluorescence leakage. However, R406 alleviated the above-mentioned conditions, which was much better with high concentration of R406 (10 mg/kg). R406 also reversed the down-regulations of occludin, claudin-5, ZO-1 and the up-regulation of and VEGF in retinal tissues of DM rats; inhibited retinal cell apoptosis; strengthened retinal cell proliferation; and reduced expressions of IL-1ß, IL-6, TNF-α and nuclear p65 NF-κB in retinal tissues. The improvement in all these indexes was much more significant in rats of DM + 10 mg/kg R406 group than in rats of DM + 5 mg/kg R406 group. CONCLUSION: Syk inhibitor R406 could attenuate retinal inflammation in DR rats via the repression of NF-κB activation.

Design, Synthesis, DFT Study and Antifungal Activity of Pyrazolecarboxamide Derivatives.

A series of novel pyrazole amide derivatives were designed and synthesized by multi-step reactions from phenylhydrazine and ethyl 3-oxobutanoate as starting materials, and their structures were characterized by NMR, MS and elemental analysis. The antifungal activity of the title compounds was determined. The results indicated that some of title compounds exhibited moderate antifungal activity. Furthermore, DFT calculations were used to study the structure-activity relationships (SAR).

Facile and efficient synthesis and herbicidal activity determination of novel 1,2,4-triazolo[4,3-a]pyridin-3(2H)-one derivatives via microwave irradiation.

A series of novel 1,2,4-triazolo[4,3-a]pyridin-3(2H)-one derivatives were synthesized and identified by (1)H NMR, single crystal X-ray diffraction, elemental analysis or HRMS, and their herbicidal activities were determined at different concentrations. It was found that some of the title compounds possess high herbicidal activity. Furthermore, DFT calculation was used to study the SAR.

Microwave assistant synthesis, antifungal activity and DFT theoretical study of some novel 1,2,4-triazole derivatives containing pyridine moiety.

In order to investigate the biological activity of novel 1,2,4-triazole compounds, seventeen novel 1,2,4-triazole derivatives containing pyridine moiety were synthesized under microwave assistant condition by multi-step reactions. The structures were characterized by 1H NMR, MS and elemental analyses. The target compounds were evaluated for their fungicidal activities against Stemphylium lycopersici (Enjoji) Yamamoto, Fusarium oxysporum. sp. cucumebrium, and Botrytis cinerea in vivo, and the results indicated that some of the title compounds displayed excellent fungicidal activities. Theoretical calculation of the title compound was carried out with B3LYP/6-31G (d,p). The full geometry optimization was carried out using 6-31G (d,p) basis set, and the frontier orbital energy, atomic net charges were discussed, and the structure-activity relationship was also studied.

[Mechanism underlying spatial vision deficit of monocular amblyopia based on the theory of Magnocellular and Parvocellular (M-P) pathways].

OBJECTIVE: To investigate the relationship between the characteristics of spatial vision deficit and the degree of amblyopia in monocular amblyopes, and to analyze its mechanism with the theory of Magnocellular and Parvocellular pathways. METHODS: One hundred and eleven patients with monocular amblyopes aged 7-34 were included in this study. Distance best corrected visual acuity (BCVA) in logMAR units and contrast sensitivity function test were performed on both eyes in all patients with ETDRS digital visual chart and functional test system OPTECR 6500. The spatial vision of amblyopic and non-amblyopic eyes was evaluated by the AULCSF, Smax, Frmax and cutSF derived from the curve of contrast sensitivity function. RESULTS: The degree of amblyopia was significantly correlated with the difference of AULCSF between the amblyopic and non-amblyopia eyes (r=-0.83, P<0.01). BCVA of amblyopic eyes was significantly correlated with AULCSF, CutSF, Smax, Frmax(r=-0.68, -0.80, -0.73, -0.56, respectively; P<0.01). In amblyopic eyes, significant difference in BCVA, AULCSF, Smax, Frmax and CutSF was seen among different amblyopic groups (P<0.01), which was defined by the degree of amblyopia. In non-amblyopic eyes,no significant difference in BCVA, AULCSF, Smax, Frmax and CutSF was noted among different amblyopic groups (P>0.05). In mild amblyopes, no significant difference in AULCSF and Frmax was found between the amblyopic eyes and non-amblyopic eyes (P>0.05), while Smax and CutSF were significantly different. However, in moderate and severe amblyopes, significant differences in BCVA, AULCSF, Smax, Frmax and CutSF was seen between the amblyopic and non-amblyopic eyes (P<0.01). In amblyopic eyes, significant difference in contrast sensitivity was noted in all kinds of spatial frequencies among different amblyopic groups (P<0.01), and in non-amblyopic eyes, significant differences in contrast sensitivity was not seen in all kinds of spatial frequencies among different amblyopic groups. CONCLUSIONS: The AULCSF, CutSF, Smax and Frmax are accorded with visual acuity for evaluation of the spatial vision of amblyopia. As the severity of amblyopia increases, the overall function of spatial vision in amblyopic eyes gradually decreases, the resolution ability of high spatial frequency is gradually weaken, the peak of contrast detection function gradually descends, and the optimal spatial frequency for contrast detection offsets toward low level of spatial frequency. Mild monocular amblyopia produces spatial contrast sensitivity loss in high spatial vision, suggesting there may be decreased sensitivity of the Parvocellular pathway, and no significant anomalous processing of Magnocellular Pathway. Whereas, in moderate and severe amblyopes, a generalized loss of sensitivity is observed at each spatial frequency. This result shows that both Magnocellular and Parvocellular pathways are damaged in different degrees, especially in Parvocellular pathway.

Design, synthesis, biological activities and 3D-QSAR of new N,N'-diacylhydrazines containing 2,4-dichlorophenoxy moieties.

A series of new N,N'-diacylhydrazine derivatives were designed and synthesized. Their structures were verified by 1H-NMR, MS and elemental analysis. The herbicidal activities and plant growth regulating activity of these N,N'-diacylhydrazines were evaluated. The herbicidal activity results showed that most of these N,N'-diacyl-hydrazines showed excellent in vivo activities against Echinochloa crus-galli, Digitaria sanguinalis, Brassica napus, Amaranthus retroflerus. Most of them exhibited higher herbicidal activities against dicotyledonous weeds than monocotyledonous weeds. To further investigate the structure-activity relationship, comparative molecular field analysis (CoMFA) was performed on the basis of herbicidal activity data. Both the steric and electronic field distributions of CoMFA are in good agreement in this work.

[Study of the visual deficits pattern in strabismic and anisometropic amblyopia].

OBJECTIVE: To elucidate the difference in the pathogenesis between strabismic and anisometropic amblyopia. METHODS: It was a case-control study.We used psychophysical methods, including grating acuity, edge contrast sensitivity, contrast sensitivity function tests, and examined the visual functions of 150 cases from 8 to 40-year-old. Then we applied the Origin 8.0 software for statistical analysis of experimental data, we did the correlation analysis between the grating acuity, edge contrast sensitivity and optotype acuity, and the similarity comparison of the contrast sensitivity function curve between the strabismic and anisometropic amblyopia. RESULTS: The grating acuity had a strong correlation with optotype acuity, the correlation value was 0.81. The grating acuity of the strabismic group was roughly 15% lower than the whole abnormal population, for any given level of optotype acuity; the edge contrast threshold had a weak correlation with optotype acuity, the correlation value was 0.24. Anisometropia, for a given level of optotype acuity, had edge contrast thresholds that were 15% higher (worse) than the whole population, while strabismic and strabismic-anisometropia had edge contrast thresholds that are 17% lower (better) than the whole population. The CSF of all amblyopic eyes were reduced in comparison with the non-amblyopic eye of the same person, the peak sensitivity shifted toward to the low spatial frequency region, the CS curve was depressed especially in the middle and high spatial frequencies, there were no significant difference, but at low frequency area(1.0 c/d) there were statistically significant between the two types of amblyopia(t = 2.239, P < 0.05). CONCLUSION: There were differences in the patterns of visual loss between strabismic and anisometropic amblyopic patients.

Folate receptor-positive circulating tumor cells in predicting ground-glass nodules malignancy.

OBJECTIVE: To study the clinical significance of folate receptor-positive circulating tumor cells (FR+CTCs) in determining malignancy of ground-glass nodules (GGNs) and assess the added value of FR+CTC in the classic GGN evaluation model (Mayo Model). METHODS: Sixty-five patients with single indeterminate GGN were recruited. Twenty-two participants had benign/pre-malignant diseases, and forty-three had lung cancers, as confirmed by histopathology examination. FR+CTC was enumerated by CytoploRare® Kit. A CTC model was drawn based on the multivariate logistic analysis. The area under the receiver operating characteristic curve (AUC) was analyzed to evaluate the diagnostic performance of FR+CTC, CTC model and Mayo model. RESULTS: In the cohort, the mean age of 13 males and 9 females with benign/pre-malignant diseases was 57.7 ± 10.2 years. The mean age of 13 males and 30 females with lung cancers was 53.8 ± 11.7 years. There was no significant difference between the age and the smoking history (P=0.196 and P=0.847, respectively). FR+CTC can effectively differentiate lung cancer from benign/pre-malignant diseases [sensitivity: 88.4%, specificity: 81.8%, the AUCs was 0.8975, 95% confidence interval (CI): 0.8174-0.9775] in patients with GGN. Multivariate analysis revealed that FR+CTC level, tumor size, and tumor location were independent predictors of GGN malignancy (P<0.05). The prediction model based on these factors showed better diagnostic efficiency than the Mayo model (AUC: 0.9345 vs. 0.6823), yielding superior sensitivity (81.4% vs. 53.5%) and specificity (95.5% vs. 86.4%). CONCLUSION: The FR+CTC exhibited a promising potential in determining the malignancy of indeterminate GGNs, and the CTC model's diagnostic efficiency was superior to the Mayo model.

MRCG: A MRI Retrieval Framework With Convolutional and Graph Neural Networks for Secure and Private IoMT.

In the context of Industry 4.0, the medical industry is horizontally integrating the medical resources of the entire industry through the Internet of Things (IoT) and digital interconnection technologies. Speeding up the establishment of the public retrieval database of diagnosis-related historical data is a common call for the entire industry. Among them, the Magnetic Resonance Imaging (MRI) retrieval system, which is one of the key tools for secure and private the Internet of Medical Things (IoMT), is significant for patients to check their conditions and doctors to make clinical diagnoses securely and privately. Hence, this paper proposes a framework named MRCG that integrates Convolutional Neural Network (CNN) and Graph Neural Network (GNN) by incorporating the relationship between multiple gallery images in the graph structure. First, we adopt a Vgg16-based triplet network jointly trained for similarity learning and classification task. Next, a graph is constructed from the extracted features of triplet CNN where each node feature encodes a query-gallery image pair. The edge weight between nodes represents the similarity between two gallery images. Finally, a GNN with skip connections is adopted to learn on the constructed graph and predict the similarity score of each query-gallery image pair. Besides, Focal loss is also adopted while training GNN to tackle the class imbalance of the nodes. Experimental results on some benchmark datasets, including the CE-MRI dataset and a public MRI dataset from the Kaggle platform, show that the proposed MRCG can achieve 88.64% mAP and 86.59% mAP, respectively. Compared with some other state-of-the-art models, the MRCG can also outperform all the baseline models.

Semi-Supervised 3D Medical Image Segmentation Based on Dual-Task Consistent Joint Learning and Task-Level Regularization.

Semi-supervised learning has attracted wide attention from many researchers since its ability to utilize a few data with labels and relatively more data without labels to learn information. Some existing semi-supervised methods for medical image segmentation enforce the regularization of training by implicitly perturbing data or networks to perform the consistency. Most consistency regularization methods focus on data level or network structure level, and rarely of them focus on the task level. It may not directly lead to an improvement in task accuracy. To overcome the problem, this work proposes a semi-supervised dual-task consistent joint learning framework with task-level regularization for 3D medical image segmentation. Two branches are utilized to simultaneously predict the segmented and signed distance maps, and they can learn useful information from each other by constructing a consistency loss function between the two tasks. The segmentation branch learns rich information from both labeled and unlabeled data to strengthen the constraints on the geometric structure of the target. Experimental results on two benchmark datasets show that the proposed method can achieve better performance compared with other state-of-the-art works. It illustrates our method improves segmentation performance by utilizing unlabeled data and consistent regularization.

Cystic Fibrosis Transmembrane Conductance Regulator Attenuates Oxidative Stress-Induced Injury in Diabetic Retinopathy Rats.

PURPOSE: To investigate the effects of cystic fibrosis transmembrane conductance regulator (CFTR) on oxidative stress-induced injury of diabetic retinopathy (DR) rats. METHODS: DR rat model was constructed treated with Ad-CFTR. Hematoxylin and Eosin (HE) staining was applied for testing the thickness of each layer of retinal tissues. Enzyme-linked immunosorbent assay (ELISA) was used to determine levels of serum inflammatory cytokines and contents of oxidative stress related genes in rats. Terminal deoxynucleotidyl transferase (TdT)-mediated dUTP nick-end labeling (TUNEL) staining was used to detect retinal cell apoptosis, and western blotting to measure the expression of MAPK/NF-κB pathway-related proteins in retinal tissues. RESULTS: Our experiment revealed the remarkable decrease of CFTR protein in retinal tissues of DR rats. DR rats had decreased body weight and increased blood glucose level, with decreased thickness of total retinal thickness (TRT), outer nuclear layer and outer plexiform layer (ONL + OPL), inner nuclear layer (INL), and inner plexiform layer (IPL). Besides, DR rats were apparently up-regulated in the expression of pro-inflammatory cytokines, with increased malondial dehyde (MDA), p-ERK1/2/ERK1/2 and p-JNK1/2/JNK1/2 expressions, decreased superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) activity in retinal tissues, as well as up-regulated p65 protein in nucleus and down-regulated p65 protein in cytoplasm. DR rats treated with Ad-CFTR were effectively improved regarding the above parameters except body weight and blood glucose. CONCLUSIONS: CFTR can inhibit MAPK/NF-κB signaling pathway to ameliorate inflammatory response and oxidative stress-induced injury of DR rats, thereby reducing retinal cell apoptosis and playing a protective role in retina.

[Gamma event-related synchronization analysis: a new method for cortical function mapping].

OBJECTIVE: To localize the sensory motor cortex of human brain by analyzing the power change in Gamma band (> 60 Hz) of electrocorticography (ECoG) data. METHODS: Eight patients with intractable epilepsy underwent temporary placement of subdural electrodes. After surgery, sensory evoked potential (SEP), electrocortical stimulation (CES) and event-related synchronization analysis of Gamma band (Gamma ERS analysis) were performed to reduce the risk of complications. The results of Gamma ERS analysis were compared with those of SEP and CES. RESULTS: The results of Gamma ERS analysis had 80.7% electrodes fitting perfectly those of CES and SEP. And the percentage reached 92.3% if electrodes were superimposed or added adjacently. CONCLUSION: The Gamma ERS analysis is a new sensitive and precise method for cortical function mapping.

[Identification of released population of Japanese flounder based on stable isotopes analysis]. / åŸºäºŽç¨³å®šåŒä½ç´ æŠ€æœ¯çš„å¢žæ®–æ”¾æµç‰™é²†ç¾¤ä½“é‰´åˆ«.

Japanese flounder (Paralichthys olivaceus) is an important releasing fish in the Yellow and Bohai Seas of China. The identification of wild and releasing population is the premise to evaluate the enhancement effects. In order to study the application of stable isotope in the identification of released P. olivaceus population, captured juveniles in the offshore releasing area of Qinhuangdao were distinguished into wild and released population using previous method (combination of morphology and molecular). Then, the contents of carbon and nitrogen stable isotope in muscle and otoliths (including the whole and the core region) were measured. The cultured population was set as control. The results showed that δ13C values (wild population: -17.19‰±0.73‰; released population: -17.10‰±0.61‰; cultured population: -20.75‰±0.07‰) and δ15N values (wild population: 11.81‰±0.38‰; released population: 11.62‰±0.48‰; cultured population: 8.64‰±0.60‰) of muscle and δ13C value (wild popu-lation: -4.47‰±0.35‰; released population: -4.63‰±0.29‰; cultured population: -6.59‰±0.58‰) of the whole otolith could be used to identify the cultured population, but could not be used to distinguish the wild from the released population. The δ13C value (wild population: -4.66‰±0.30‰; released population: -5.41‰±0.21‰; cultured population: -5.37‰±0.19‰) of the core region of otolith could be used to identify the wild popu-lation. The δ18O values of the whole and the core region of otolith from these three groups were overlapped and could not be used to distinguish different populations. Our results indicated that the δ13C value of the core area of otolith could be used to identify wild and released population, with application prospect in the identification of broodstocks participating in spawning migration. This study provided basic data and technical methods for evaluating early resources replenishment and the effects of Japanese flounder enhancement.

Anti-CXCL10 monoclonal antibody therapy protects against the diabetic retinopathy in the mouse model induced by streptozotocin.

OBJECTIVE: To explore the effect of CXC chemokine CXCL10 in the mice with diabetic retinopathy (DR). METHODS: DR models were constructed on mice via injection of streptozotocin (STZ). At 3 weeks of STZ, mice were treated with anti-CXCL10 monoclonal antibodies (mAb)/control mAb, and a series of experiments were then conducted at 6 weeks of STZ, including HE staining, western blotting, retinal trypsin digestion, real-time qPCR and enzyme-linked immuno sorbent assay (ELISA). The corresponding kits were used to detect the activity of oxidative stress markers. RESULTS: Compared with nondiabetic eyes, DR mice both at 3 and 6 weeks presented the decreases in the total retinal thickness, the retinal outer nuclear layer (ONL) thickness, and the cells of ganglion cell layer (GCL), with the upregulated CXCL10, pro-inflammatory cytokines and malondialdehyde (MDA), as well as the downregulated levels of superoxide dismutase (SOD), glutathione peroxidase (GPx) and CAT, especially in those at 6 weeks, which were attenuated by the anti-CXCL10 mAb treatment. Moreover, in comparison with the DR mice, mice in the DR + anti-CXCL10 mAb group gained the significant decrease in the number of acellular capillaries of retina, with up-regulations of Claudin-5 and ZO-1 and down-regulations of VEGF and FGF-2. The DR mice injected with anti-CXCL10 mAb demonstrated alleviated retinal pathology as compared to mice at 3 weeks of STZ. CONCLUSION: Anti-CXCL10 mAb could mitigate the retinal pathology of DR mice, with the decreased inflammation and oxidative stress, thus mediating a delay in the development or disease improvement in patients of DR.

Paratesticular liposarcoma: Two case reports.

BACKGROUND: Paratesticular liposarcoma accounts for approximately 7% of scrotal tumors. They are rare lesions of the reproductive system with approximately 90% of the lesions originating from the spermatic cord. Surgery, with the goal of complete resection, is the mainstay for treatment of this disease. However, treatment consisting of extended resection to decrease local recurrence remains controversial. CASE SUMMARY: We report the cases of two patients with paratesticular liposarcomas who were treated with radical testicular tumor resection without adjuvant therapy. Follow-up investigations at 9 mo showed no sign of recurrence. CONCLUSION: Surgery is the first-line treatment, regardless of whether it is a recurrent or primary tumor. Extended resection carries a higher risk of complications and should not be performed routinely. Preoperative radiotherapy can reduce the local recurrence rate without affecting the overall survival.

Uretero-lumbar artery fistula: A case report.

BACKGROUND: Uretero-arterial fistula (UAF) is a disease that usually involves the aorta, common iliac artery, external iliac artery, hypogastric artery, and lumbar artery. Among them, uretero-lumbar artery fistula (ULAF) is the most unusual type. So, both in China and around the world, the diagnosis and treatment of ULAF is a big challenge. CASE SUMMARY: A 55-year-old female patient with a history of pelvic radiotherapy developed unexplained massive hemorrhage during replacement of the right Resonance metallic ureteral double-J tubes due to a long-standing indwelling ureteral stent for ureteral stricture. Later, we found contrast extravasation from the patient's right L4 artery into the ureter under digital subtraction angiography (DSA) and administered polyvinyl alcohol particle embolic agent and coil embolization; hematuria was controlled. Follow-up investigations at 18 mo showed no sign of recurrence. CONCLUSION: DSA is very important in the diagnosis and treatment of UAF, and DSA should be preferred when UAF is suspected. In addition, the use of softer ureteral stents in patients with primary disease and risk factors for UAF should be considered to avoid increasing the risk of the development of the disease; endovascular treatment should be preferred in patients who have developed UAF.

Neuroprotective effect of piperine on primarily cultured hippocampal neurons.

It was previously reported that piperine (PIP) significantly blocks convulsions induced by intracerebroventricular injection of threshold doses of kainate, but had no or only slight effects on convulsions induced by L-glutamate, N-methyl-D-aspartate and guanidinosuccinate. In traditional Chinese medicine, black pepper has been used for epileptic treatment; however, the exact mechanism is still unclear. We reported here in that appropriate concentration of PIP effectively inhibites the synchronized oscillation of intracellular calcium in rat hippocampal neuronal networks and represses spontaneous synaptic activities in terms of spontaneous synaptic currents (SSC) and spontaneous excitatory postsynaptic currents (sEPSC). Moreover, pretreatment with PIP expects protective effect on glutamate-induced decrease of cell viability and apoptosis of hippocampal neurons. These data suggest that the neuroprotective effects of PIP might be associated with suppression of synchronization of neuronal networks, presynaptic glutamic acid release, and Ca(2+) overloading.

Gadd45α affects retinal ganglion cell injury in chronic ocular hypertension rats by regulating p38MAPK pathway.

OBJECTIVE: To investigate the impact and the mechanism of Gadd45α mediating p38MAPK pathway on the retinal ganglion cells (RGCs) injury in chronic ocular hypertension (COH) rats. METHODS: COH model in rats were established and intraocular pressure (IOP) was tested. Retrograde labeling was used for counting RGCs and TUNEL staining was performed for RGCs apoptosis. Western Blotting was conducted to examine the expression of Gadd45α and p38MAPK pathway. Besides, RGC-5 cells cultured in vitro were treated with H2O2. Cell viability was detected by CCK-8, ROS level tested by DCFH-DA assay, and cell apoptosis examined by flow cytometry. RESULTS: COH rats had increased expression of Gadd45α and p-p38/p38 protein 1-4 weeks after surgery. Rats in COH group enhanced obviously in IOP, RGC apoptosis rate and the protein expression of Gadd45α, p-p38/p38, Bax/Bcl-2 and cleaved caspase-3, but declined appreciably in RGC counting. However, the above indicators of COH rats were effectively improved by Gadd45α shRNA treatment. Additionally, RGC-5 cells in H2O2 group reduced in cell viability and went up in ROS level and apoptosis rate. The H2O2-induced RGC-5 cells treated with Gadd45α shRNA were improved apparently in those indicators, and cells treated with pcDNA Gadd45α showed an opposite trend. Moreover, p38 MAPK inhibitor SB203580 can effectively reverse the damage of pcDNA Gadd45α from H2O2-induced RGC-5 cells. CONCLUSION: Silencing Gadd45α can reduce the RGC damage in COH rats by inhibiting p38MAPK pathway and such a protective role may be associated with the suppression of RGC apoptosis and the mitigation of oxidative stress.

Laparoscopic management of type I choledochal cyst in adults: cyst resection, assisted Roux-en-Y reconstruction and hepaticojejunostomy.

Due to improvement of instrumentation and surgeons' skills, the correction of congenital biliary tract anomalies has been performed by the laparoscopic approach. Because of the high rate of associated malignancy of the biliary system in middle-aged adults, treatment for choledochal cyst is necessary, especially in adult patients. We report on the laparoscopic excision and hepaticoduodenostomy of type I choledochal cysts in five adult patients. To facilitate the procedure, the creation of a Roux-en-Y reconstruction was performed with a minimal abdominal incision. All patients had an uneventful recovery with no major complications. Most were discharged on day 8 after the procedure. At a follow-up of two years, they were still asymptomatic, showing no cholangitis or anicteric. Laparoscopic management for choledochal cyst is an advantageous approach, so it is feasible and will probably become an accepted method in further clinical application.

Urachal remnant with heterotopic sinus in an adult male: A case report.

INTRODUCTION: Urachal remnant with heterotopic sinus is an extremely rare congenital anomaly, and usually coexists with other congenital anomalies. We report the case of a 32-year-old adult male with urachal remnant with heterotopic sinus. PATIENT CONCERNS: A 32-year-old adult male presented with purulent secretion in the heterotopic sinus on the dorsal side of the normal external urethral orifice and pain in the balanus since 5 months. DIAGNOSIS: The computed tomography scan demonstrated a 4 cm cystic mass next to the anterior wall of the urinary bladder. Retrograde urethrography was performed, which demonstrated that this mass communicated with the heterotopic sinus on the dorsal side of the normal external urethral orifice. Cystoscopy showed that there was no communication between the mass and the bladder. Pathology results confirmed that this mass was urachal tissue. INTERVENTIONS: The patient underwent a laparoscopy surgery to undertake the cystic mass, part of the anterior wall of urinary bladder and the epithelium of channel which communicated with the cystic mass. OUTCOMES: The patient was discharged without any complications after 6 months and follow-up was continued in the clinic. CONCLUSIONS: Urachal remnant with heterotopic sinus is rare, and we recommend that urachal remnant should be considered when a patient presents with a mass in the retropubic space.