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.

One-dimensional recoverable ZnFe2O4/C/MnO2/BiOI magnetic composite with enhanced photocatalytic performance for organic dyes degradation.

Excessive discharge of toxic dyes is detrimental to ecological system and human health. Therefore, an effective photocatalyst must be designed and developed to degrade dyes from wastewater. Herein, a novel one-dimensional (1D) flower-like recoverable ZnFe2O4/C/MnO2/BiOI magnetic composite photocatalyst was synthesized via electrospinning technique combined with hydrothermal method. The photocatalytic activities of composite photocatalyst were evaluated by degrading methyl orange (MO) and Rhodamine B (RhB) under simulated light irradiation. The efficiency of ZnFe2O4/C/MnO2/BiOI photocatalyst in visible light for 150 min reached 91% (MO) and 120 min reached 94% (RhB). Moreover, the degradation rate of MO still remained 78% after five cycles. The design of 1D magnetic flower-like composite provided a new strategy for preparing photocatalysts possessing excellent photocatalytic efficiency and cyclic stability.

[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.

[Effect of Water Management on Rice Growth and Rhizosphere Priming Effect in Paddy Soils].

The rhizosphere priming effect (RPE) caused by carbon inputs from crop rhizodeposits plays a key role in regulating the carbon emission flux and carbon balance of farmland soils. Due to frequent alternations between dry and wet conditions, CO2 and CH4 emissions and the RPE in paddy field ecosystems are significantly different to those of other ecosystems. Therefore, it is of great significance to determine the direction and intensity of the rice RPE under alternations of dry and wet to limit greenhouse gas emissions. In this study, using a 13C-CO2 continuous labeling method combined with a pot-based experiment, the response of rice growth and the RPE under alternating dry and wet and continuous flooding conditions was examined. The results showed that, compared with the continuous flooding treatment, the alternating dry and wet treatments significantly increased aboveground and root biomass and the root-to-root ratio, and also increased soil microbial biomass. Under continuous flooding conditions, fluxes of 13CO2 and 13CH4 increased with rice growth from 10.2 µg·(kg·h)-1 and 2.8 µg·(kg·h)-1 (63 d) to 16.0 µg·(kg·h)-1 and 3.2 µg·(kg·h)-1 (75 d), respectively. During the 12-day drying process, the emissions of 13CO2 and 13CH4 derived from rhizosphere deposited C decreased by 57.5% and 88.1%. Under continuous flooding conditions, the RPE for CO2 and CH4 were positive and increased with the growth of rice. Under the alternating dry and wet treatment, after 12 days of drying, the RPE for CO2 and CH4 was reduced from 0.29 mg·(kg·h)-1 and 12.3 µg·(kg·h)-1 (63 d) to -0.39 mg·(kg·h)-1 and 0.07 µg·(kg·h)-1 (75 d). Thus, alternating wet and dry treatment can effectively promote rice growth and reduce the cumulative emissions of CH4. Therefore, adopting appropriate field water management is of great significance for increasing rice yields and mitigating greenhouse gas emissions.

Fabrication of hollow flower-like magnetic Fe3O4/C/MnO2/C3N4 composite with enhanced photocatalytic activity.

The serious problems of environmental pollution and energy shortage have pushed the green economy photocatalysis technology to the forefront of research. Therefore, the development of an efficient and environmentally friendly photocatalyst has become a hotpot. In this work, magnetic Fe3O4/C/MnO2/C3N4 composite as photocatalyst was synthesized by combining in situ coating with low-temperature reassembling of CN precursors. Morphology and structure characterization showed that the composite photocatalyst has a hollow core-shell flower-like structure. In the composite, the magnetic Fe3O4 core was convenient for magnetic separation and recovery. The introduction of conductive C layer could avoid recombining photo-generated electrons and holes effectively. Ultra-thin g-C3N4 layer could fully contact with coupled semiconductor. A Z-type heterojunction between g-C3N4 and flower-like MnO2 was constructed to improve photocatalytic performance. Under the simulated visible light, 15 wt% photocatalyst exhibited 94.11% degradation efficiency in 140 min for degrading methyl orange and good recyclability in the cycle experiment.

[Two different routes for transferring the pedicled preputial island flap for hypospadias in children: A comparative analysis].

OBJECTIVE: To summarize the experience in the surgical treatment of hypospadias by analyzing the operation features and clinical effects of two different routes for transferring the pedicled preputial island flap. METHODS: This retrospective study included 122 cases of hypospadias treated by transferring the pedicled preputial island flap, 80 from one side of the penis (the control group) and the other 42 through the middle orifice of the vascular pedicle (the observation group). We recorded the intra- and postoperative data and compared them between the two groups. RESULTS: The operation time was significantly longer in the observation group than in the control (ï¼»164.43 ± 25.03ï¼½ vs ï¼»134.71 ± 32.37ï¼½ min, P < 0.01), but the catheter-indwelling time was dramatically shorter in the former than in the latter group (ï¼»2.93 ± 0.97ï¼½ vs ï¼»3.68 ± 0.73ï¼½ wk, P < 0.01). There was no statistically significant difference in the length of the reconstructed urethra between the two groups (ï¼»2.86 ± 0.71ï¼½ vs ï¼»2.83 ± 0.82ï¼½ cm, P = 0.863). A 6- to 12-month follow-up showed a significantly lower incidence of postoperative complications in the observation than in the control group (9.52% vs 25.00%, P < 0.05). CONCLUSIONS: Transferring the pedicled preputial island flap through the middle orifice of the vascular pedicle, though taking a longer time than that from one side of the penis, has the advantages of a shorter catheter-indwelling time and a lower incidence rate of postoperative complications, and therefore deserves wide clinical application.

Classification between digs and dust particles on optical surfaces with acquisition and analysis of polarization characteristics.

In the automatic detection for surface defects of optical components, the digs and dust particles exhibit similar features: point-like shape and variable intensity reflectivity. On this condition, these two types with entirely different damages are easily confused so that misjudgments will be induced. To solve this problem, a polarization-characteristics-based classification method of digs and dust particles (PCCDD) is proposed based on the polarimetric imaging technique and dark-field imaging technique. First, a dark-field imaging system equipped with a polarization state generator (PSG) and a polarization state analyzer (PSA) is employed to measure and establish normalized Mueller matrices' datasets of digs and dust particles. And by a nonlinear global search combined with a separability evaluation method, the optimal number of acquisitions and corresponding polarization measurement states of the PSG and the PSA are obtained, as well as the parameters of classification function. Then, multiple polarization images are acquired under the optimal states to extract a multidimensional feature description that relates only to the polarization characteristics of the defect; this subsequently acts as the input vector of the classifier to finally achieve the classification. This method takes full advantage of both the difference in polarization properties between digs and dust particles and the characteristic that the polarization properties of digs are relatively invariant while those of dust particles have a large variability. The classification process involves only simple matrix operations. Compared to the traditional discrimination method based on intensity images, the features obtained by this method have a higher separability. Experiments show that the classification accuracy reaches over 90%. This method can be further applied to the recognition and discrimination of other defects in the field of surface defects' detection.

High-precision calibration method for shear ratio based on the shearing wavefront feature extraction of a phase plate.

A new method based on the shearing wavefront feature extraction (SWFE) of a phase plate is proposed to accurately estimate the shear ratio of the system. The relationship between the shear ratio of a quadriwave lateral shearing interferometer based on a randomly encoded hybrid grating (REHG) and the measurement sensitivity, dynamic range, and wavefront retrieval accuracy is analyzed to provide a theoretical guidance for practical application. The simulation result of the SWFE method shows that the relative error of the shear ratio value is about 1.8×10-3, within the acceptable range of the system. In the experiment, two fused quartz phase plates etched with step change edge grooves were introduced to calibrate the shear ratio of the REHG wavefront diagnosis system. Then, the etching depths of these two phase plates and the figure error of a spherical surface were characterized by the REHG. A comparison with a ZYGO GPI interferometer exhibits that the testing results by the REHG are highly precise, which further confirms the effectiveness of the SWFE method in the shear ratio calibration. This shear ratio calibration method is available for similar kind of shearing interferometric wavefront sensor.

Prognostic value of high-expression of miR-17-92 cluster in various tumors: evidence from a meta-analysis.

The prognostic value of miR-17-92 cluster high-expression in various tumors remains controversial. Therefore, we conducted this meta-analysis by searching literatures in PubMed, Embase, Cochrane Library, China Biology Medicine disc, China National Knowledge Infrastructure to identify eligible studies. Eventually, we analyzed 36 articles that examined 17 tumor types from 4965 patients. Consequently, high-expression of miR-17-92 cluster in various tumors was associated with unfavorable overall survival in both univariate (HR = 2.05, 95%CI: 1.58-2.65, P<0.001) and multivariate (HR = 2.14, 95%CI: 1.75-2.61, P<0.001) analyses. Likewise, similar results were found in different subgroups of country, test method, miR-17-92 cluster component, sample source and size. Additionally, high-expression of miR-17-92 cluster was linked with poor disease-free survival (Univariate: HR = 1.96, 95%CI: 1.55-2.48, P<0.001; Multivariate: HR = 2.18, 95%CI: 1.63-2.91, P<0.001), favorable progression-free survival (Univariate: HR = 0.36, 95%CI: 0.16-0.80, P = 0.012; Multivariate: HR = 1.55, 95%CI: 0.79-3.05, P = 0.201) and poor cancer specific survival in univariate rather than multivariate analyses (Univariate: HR = 1.77, 95%CI: 1.21-2.60, P = 0.004; Multivariate: HR = 1.77, 95%CI: 0.80-3.92, P = 0.160). However, no association of miR-17-92 cluster high-expression was detected with recurrence or relapse-free survival. In summary, this meta-analysis towards high-expression of miR-17-92 cluster has indicated poor prognosis of various cancers. Notably, future studies comprising large cohort size from multicenter are required to confirm our conclusions.

Quadriwave lateral shearing interferometric microscopy with wideband sensitivity enhancement for quantitative phase imaging in real time.

Real-time quantitative phase imaging has tremendous potential in investigating live biological specimens in vitro. Here we report on a wideband sensitivity-enhanced interferometric microscopy for quantitative phase imaging in real time by employing two quadriwave lateral shearing interferometers based on randomly encoded hybrid gratings with different lateral shears. Theoretical framework to analyze the measurement sensitivity is firstly proposed, from which the optimal lateral shear pair for sensitivity enhancement is also derived. To accelerate the phase retrieval algorithm for real-time visualization, we develop a fully vectorized path-independent differential leveling phase unwrapping algorithm ready for parallel computing, and the framerate for retrieving the phase from each pair of two 4 mega pixel interferograms is able to reach 47.85 frames per second. Experiment results demonstrate that the wideband sensitivity-enhanced interferometric microscopy is capable of eliminating all the periodical error caused by spectral leaking problem and reducing the temporal standard deviation to the half level compared with phase directly retrieved by the interferogram. Due to its high adaptability, the wideband sensitivity-enhanced interferometric microscopy is promising in retrofitting existing microscopes to quantitative phase microscopes with high measurement precision and real-time visualization.

General measurement of optical system aberrations with a continuously variable lateral shear ratio by a randomly encoded hybrid grating.

A general lateral shearing interferometry method to measure the wavefront aberrations with a continuously variable shear ratio by the randomly encoded hybrid grating (REHG) is proposed. The REHG consists of a randomly encoded binary amplitude grating and a phase chessboard. Its Fraunhofer diffractions contain only four orders which are the ±1 orders in two orthogonal directions due to the combined modulation of the amplitude and phase. As a result, no orders selection mask is needed for the REHG and the shear ratio is continuously variable, which is beneficial to the variation of sensitivity and testing range for different requirements. To determine the fabrication tolerance of this hybrid grating, the analysis of the effects of different errors on the diffraction intensity distributions is carried out. Experiments have shown that the testing method can achieve a continuously variable shear ratio with the same REHG, and the comparison with a ZYGO GPI interferometer exhibits that the aberration testing method by the REHG is highly precise and also has a good repeatability. This testing method by the REHG is available for general use in testing the aberrations of different optical systems in situ.