Clinical Characteristics of Testicular Torsion and Identification of Predictors of Testicular Salvage in Children: A Retrospective Study in a Single Institution.

PURPOSE: Testicular torsion (TT) is a serious surgical emergency. Prompt diagnosis and treatment of TT are essential to improve the incidence of salvaged testes. 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 retrospectively reviewed the records of 136 males who presented with TT to our institution. Clinical findings, physical examinations, laboratory data, color Doppler ultrasound findings, operating results, and the results of follow-up were collected and analyzed. Patients with neonatal torsion, negative scrotal exploration, or testicular appendix torsion were excluded. A multivariable logistic regression model was used to identify predictors of testicular salvage. Receiver operator characteristics analyses were performed to determine the probability of a non-salvageable torsed testis based on time and degree of twisting. RESULTS: A total of 136 children with TT were identified. Patients were aged from 1 to 16 years, with a mean age of 9.7 years (median, 12; range, 1-16 years). The peak incidences of TT were found between ages of 12 and 14 years. Acute TT is significantly more common in the winter. Testicular salvage occurred in 49 (36%) cases. Of the 49 cases of testicular salvage, 5 patients developed subsequent testicular atrophy. Cutoff values of 13.5 h and 530 degrees of torsion would provide sensitivities of 96 and 61%, with specificity of 80 and 70%, respectively. Multivariate analysis showed that time to surgery and degree of testicular twist were correlated with the risk of a non-salvageable testis. CONCLUSIONS: Testicular salvage can be predicted by the duration of symptoms along with degree of twisting. 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 lower abdominal pain should have their testicles checked to make sure that they do not have torsion, especially those visitors in cold season.

Adsorption performance of antimony by modified iron powder.

Antimony pollution resulting from industrial production is a great threat to the environment, ecology and the human body. Zero-valent iron powder is low-cost and easy to obtain. Nevertheless, the lower adsorption capacity limits its application when it is used as an adsorbent. In the present study, ball-milling and acid modification were developed to change its surface characteristics and γ-Fe2O3, γ-FeOOH and Fe3O4 were obtained after treatment, which promoted its adsorption capacity. Compared with the raw iron powder, the adsorption capacities for Sb(iii) and Sb(v) using the modified material were increased from 12.93 mg g-1 and 5.47 mg g-1 to 17.96 mg g-1 and 10.58 mg g-1, respectively. The study showed that the experimental data fitted the Langmuir model and the pseudo-first-order kinetic model better; the adsorption process was monolayer and chemically controlled at pH 5.0 ± 0.2. XPS and FT-IR analysis showed that Fe-O-Sb bonds arose during the adsorption process. The effect of pH on the adsorption capacity was also studied and the pH affected the adsorption of Sb(v) more than the adsorption of Sb(iii). In addition, the modified iron powder presented better efficiency when applied to the removal of low levels of antimony in drinking water. Based on the increase of adsorption capacity and low cost, iron powder should be a promising adsorbent for aqueous antimony removal.

Granular tri-metal oxide adsorbent for fluoride uptake: Adsorption kinetic and equilibrium studies.

A novel adsorbent embedding Mg-Al-Zr mixed oxides with millimetre-sized calcium alginate beads (SA-CMAZ) was synthesized, characterized, and applied for the secondary removal of fluoride from wastewater. Key factors affecting the fluoride adsorption, including initial fluoride concentration, contact time, initial pH and coexisting anions, were investigated. The results showed that fluoride could be removed by SA-CMAZ over a wide pH range, from 4 to 10. The presence of coexisting anions weakened the adsorption of fluoride, and the decreasing order of the removal towards fluoride was PO43->CO32->SO42->NO3-. The adsorption follows a pseudo second order kinetic with theoretical adsorption capacity (Qe,cal) and experimental adsorption capacity (Qe,exp) close to each other at the temperatures of 303K, 308K, and 313K. The equilibrium data could be fitted by the Freundlich isotherm model as the SA-CMAZ is a heterogeneous. The value of the thermodynamic parameter indicated an endothermic adsorption process. A negative value shows the feasibility and spontaneity of the material-anion interaction.

Effect of competing ions and causticization on the ammonia adsorption by a novel poly ligand exchanger (PLE) ammonia adsorption reagent.

In this paper, a poly ligand exchanger, Cu(II)-loaded chelating resin named ammonia adsorption reagent (AMAR), bearing the functional group of weak iminodiacetate acid, was prepared to efficiently remove ammonia from solutions. Batch adsorption equilibrium experiments were conducted under a range of conditions. The effects of pH on the removal of ammonia by AMAR were investigated at 25 °C. The copper loaded on the resin forms a complex with NH3 in solution under alkaline condition. The effect of alkaline dosage (AD) on the ammonia adsorption was investigated. The maximum breakthrough bed volumes were obtained when the AD was set as 0.75 mmol OH-/mL. The higher AD did not guarantee the better ammonia removal efficiency due to the forming of Cu(OH)2 precipitate between OH- in solutions and Cu(II) on the resin. The effect of competing ions on the adsorption breakthrough curve of virgin AMAR and causticized AMAR was also investigated. The results demonstrated that the existence of competing ions had a negative impact on the adsorption capacity for both virgin AMAR and causticized AMAR. After causticization, the AMAR was more resistant to the competing ions comparing with virgin AMAR. The bivalent Ca2+ affects the ammonia adsorption more than does the monovalent Na+.

A novel poly ligand exchanger - Cu(II)-loaded chelating resin for the removal of ammonia-nitrogen in aqueous solutions.

In this paper, a poly ligand exchanger, Cu(II)-loaded chelating resin bearing the functional group of weak iminodiacetate acid was prepared to efficiently remove ammonia from solutions. Batch adsorption equilibrium experiments were conducted under a range of conditions to determine the optimum adsorption conditions. The effects of contact time, pH, resin dosage and temperature on the removal of ammonia by a Cu(II)-loaded resin were determined. The maximum removal efficiency was reached at pH 9.5 at room temperature, 25°C, in 300 min. The maximum ammonia adsorption capacity was found to be 45.66 mg/L. The maximum adsorption capacities decreased with the increasing of solution temperature. Langmuir, Freundlich and Temkin isotherm models were used for fitting the adsorption experimental data without competing ions and the Langmuir isotherm model was proved to be the best-fitting model by comparing the corresponding correlation coefficients (R2) of the listed models. The effect of competing ions Na+ and Ca2+ on the adsorption of the Cu(II)-loaded resin for ammonia was investigated. The results showed that the existing of competing ions had a negative effect on the ammonia removal. The adsorption capacities decreased with the increasing concentration of competing ions. The Langmuir isotherm model was used to fit the experimental data and proved efficient. The existing of competing ions in solutions was unfavorable for ammonia adsorption and the weakening effect of bivalent Ca2+ was stronger than the monovalent Na+. The ammonia adsorption capacity was relatively high compared with other ammonia adsorbents and the Cu(II)-loaded resin was an economically feasible and promising technology for ammonia removal.

Single scrotal incision orchiopexy versus the inguinal approach in children with palpable undescended testis: a systematic review and meta-analysis.

PURPOSE: We performed a systematic review and meta-analysis to compare the efficacy and safety between single-incision, transscrotal orchidopexy, and the traditional inguinal orchidopexy in children. METHODS: A systematic search of the electronic databases was conducted to identify studies compared the transscrotal orchidopexy (SO) and inguinal orchidopexy (IO) for children. Parameters, such as operative time, the incidence of patent processus vaginalis, and postoperative complications, including wound infection, testicular atrophy, testicular reascent, hernia, or hydrocele, were pooled and compared by meta-analysis. RESULTS: Among the 1376 children with palpable undescended testes (UDTs) included in the eight studies, 697 had received SO and 679 IO. There were shorter operative times with the SO approach compared with IO. However, no significant difference was found between SO and IO in the incidence of patent processus vaginalis and postoperative complications, including wound infection, testicular atrophy, testicular reascent, and hernia. CONCLUSION: SO is a safe and effective surgical approach alternative to IO for pediatric UDTs. Compared with IO, SO has the advantage of shorter operative times. Besides, the incidence of postoperative wound infection may be slightly lower in SO. We suggest that SO should be considered as an acceptable option for children with UDTs.

[Preparation of Mg-Al-Me(Me=La, Ce, Zr) Composite Oxides for Efficient Fluoride Uptake].

The Mg-Al-Me(Me=La, Ce, Zr) composites were prepared by co-precipitation method of Mg, Al, Me(Me=La, Ce, Zr) salt solutions with a molar ratio of 20:1:4. The sample were calcined at 500℃ for 5h as the adsorbents for removal of fluoride. The adsorbents were characterized by scanning electron microscopy (SEM) and X-ray diffraction (XRD). The patterns of SEM indicated that three calcined sorbents were somewhat agglomerated particles to form a sheet structure after adsorption. The patterns of XRD showed that the three adsorbents fored a metal composite oxide. The effects of adsorption time, initial concentration of fluorine and coexisting ions (Cl-, NO3-, SO42-, CO32-, HCO3-, PO43-) fluorine adsorption properties on three adsorbents were tested by batch adsorption experiments. The results showed that the kinetics of fluorine on three adsorbents were well fitted by pseudo-second-order model. And the adsorption rate of fluoride on three adsorbents decreased in the order of Mg-Al-Zr > Mg-Al-La > Mg-Al-Ce. Regression results of adsorption rate controlling step test by moving boundary model indicated that intra-particle diffusion rate was not the only rate-limiting step in the adsorption of fluoride on the three materials. The equilibrium isotherm showed that the adsorption capacity of fluoride uptake by three adsorbents decreased in the order of Mg-Al-La > Mg-Al-Ce > Mg-Al-Zr. The adsorption isotherm of three adsorbents was very well described by the Langmuir models, and their linear correlations were 0.9958, 0.9790, 0.9975, respectively. The maximum adsorption capacities of fluoride on Mg-Al-La, Mg-Al-Ce, Mg-Al-Zr calculated by Langmuir model were as high as 54.22, 51.65, 50.89 mg·g-1, respectively. The results showed that the co-existing anions such as CO32-, HCO3-, PO43- had an inhibitory effect on the Mg-Al-La, Mg-Al-Ce, Mg-Al-Zr adsorption of fluoride. The effect of coexisting anions on fluoride adsorption increased in the order of Cl- < NO3- < SO42- < CO32-≈HCO3-

Laparoscopic versus open splenectomy in children: a systematic review and meta-analysis.

PURPOSE: We conducted a systematic review and meta-analysis to compare the clinical outcomes between laparoscopic splenectomy and the traditional open splenectomy in children. METHODS: Literature searches were conducted to identify studies having compared the laparoscopic splenectomy (LS) and open splenectomy (OS) for children. Parameters such as operative time, blood loss, length of postoperative stay, the removal of accessory spleens and postoperative complications including postoperative high fever, acute chest syndrome (ACS), and ileus were pooled and compared by meta-analysis. RESULTS: Among the 922 pediatric participants included in the 10 studies, 508 had received LS and 414 OS. There were shorter length of hospital stays, less blood loss, and longer operative times with the LS approach compared with OS. However, no significant difference was found between LS and OS in the secondary outcome, such as the removal of accessory spleens or postoperative complications including postoperative high fever, ACS, and ileus. CONCLUSION: LS is a feasible, safe, and effective surgical procedure alternative to OS for pediatric patients. Compared with OS, LS has the advantage of shorter hospital stay and less blood loss. Besides, total postoperative complications may be slightly lower in LS. We conclude that LS should be considered an acceptable option for children.