The efficacy of topical 0.1% mometasone furoate for treating symptomatic severe phimosis: A comparison of two treatment regimens.

Background: Twice daily 0.1% mometasone furoate is an effective treatment for phimosis in children. However, mometasone furoate has an important therapeutic advantage because it is effective in once-daily applications. This study was to compare the efficacy of two different topical 0.1% mometasone furoate regimens for the treatment of symptomatic severe phimosis in pediatric patients. Methods: A total of 1,689 patients with symptomatic severe phimosis classified by the Kikiros system were prospectively enrolled in the study from March 2018 to February 2021. A total of 855 patients received 0.1% mometasone furoate twice-daily (BID group) and 834 patients received 0.1% mometasone furoate once-daily (QD group) for 4 weeks. Results: A total of 1,595 boys completed the treatment (798 and 797 in the BID and QD groups, respectively). The success rate of the BID group was higher than that of the QD group at the end of week 2 (44.8% vs. 33.3%, P < 0.05), while there was no difference in the success rate at 4 weeks and 3 months between the two groups (70.7% vs. 69.7%, and 66.8% vs. 64.9%, respectively) (P > 0.05). In both treatment groups, the success rate of grade 5 phimosis was lower than that of grade 4 at 2 weeks, 4 weeks, and 3 months. A total of 83 patients experienced recurrence of phimosis. Only fifteen patients had local mild adverse drug reactions. Conclusion: Topical application of 0.1% mometasone furoate once-daily or twice-daily for 4 weeks had comparable efficacy in children with symptomatic severe phimosis. A once a day regimen may be more suitable for children. Topical steroid application is more effective in children with low-grade phimosis than those with high-grade phimosis.

[Ultrasound measurement of the testis volume of 0－14 years old Chinese boys].

OBJECTIVE: To obtain the normative values of the testis volume of 0－14 years old Chinese boys by ultrasound measurement. METHODS: We collected the testicular ultrasound data on 1607 Chinese boys with normal testes between January 2016 and June 2019. The boys were aged 0－14 years and divided into 14 age groups, with at least 100 cases in each group. We compared the mean, standard deviation and median of the testis volume among different age groups. RESULTS: The testis grew slowly in volume before 8 years old (0.372－0.678 ml), faster after 9 years old (1.040－4.600 ml), (1.040 ± 0.970) ml at 9－10 years, (1.876 ± 1.631) ml at 10－11 years, (2.831 ± 2.155) ml at 11－12 years, (3.640 ± 2.376) ml at 12－13 years, and (4.600 ± 3.559) ml at 13－14 years, larger in the 0－1 than in the 1－2 years group (ï¼»0.403 ± 0.130ï¼½ vs ï¼»0.372 ± 0.110ï¼½ ml, P = 0.04), negatively correlated in age between the two groups. CONCLUSIONS: Ultrasonography is an effective method for the measurement of the testis volume, which can provide the normative values of the testis volume of the 0－14 years old Chinese boys and some evidence for clinical diagnosis and consultation.

The influence of delay elimination communication on the prevalence of primary nocturnal enuresis-a survey from Mainland China.

AIMS: A pilot survey shows that primary nocturnal enuresis (PNE) prevalence has increased significantly during the past decade in Mainland China. Whether it is related to the delay of elimination communication (EC) is unclear. This study retrospectively investigated the influence of delayed EC on the PNE prevalence in children and adolescents in mainland China. METHODS: A cross-sectional study of PNE prevalence was performed by distributing 19 500 anonymous self-administered questionnaires to parents in five provinces of mainland China from July 2017 to October 2017. The questionnaires included sociodemographic data, family caregivers' information, and details about the disposable diapers (DD) usage, EC commencement date, psychological disorders, lower urinary tract symptoms, and family history of PNE in children and adolescents. The 2017 PNE prevalence was compared with that of 2006 in Mainland China. RESULTS: The total response rate was 97.04% (18 631 of 19 500) and 92.39% (18 016 of 19 500) qualified for statistical analysis. The PNE prevalence in 2017 has increased significantly compared to that of 2006 (7.30% vs 4.07%, P < 0.001). The PNE prevalence in children with EC starting before 6 months of age was significantly lower than those who start after 12 months of age. The longer DD were used and the later the beginning of EC, the higher the PNE prevalence was found. CONCLUSIONS: The PNE prevalence in Mainland China has increased significantly during the past 10 years. A longer use of DD and later onset of EC may be risk factors for PNE.

[High-frequency ultrasonographic characteristics and clinical features of primary testicular lymphoma in children].

OBJECTIVE: To investigate the high-frequency ultrasonographic characteristics and clinical features of primary testicular lymphoma (PTL) in children. METHODS: We retrospectively analyzed the high-frequency ultrasonographic manifestations and clinical characteristics of 11 cases of PTL in children, all confirmed by postoperative pathology. RESULTS: Most of the PTL patients were school-age children, with painless testicular enlargement as the initial symptom. Preoperative grey-scale ultrasonography showed involvement of the unilateral testis in 8, bilateral testes in 3, and both the testis and epididymis in 2 of in the 11 children with PTL. Nine of the cases were displayed as diffuse lesion and the other 2 as nodular lesion, all with extremely low echogenicity. Color Doppler flow imaging (CDFI) revealed abundant blood flow signals but no liquefaction or calcification echo in the lesions. Follow-up ultrasonography after immunochemotherapy showed complete disappearance of the lesion in 3 cases, reduction in another 3, no significant change in 1, and enlargement in the other 4. CONCLUSIONS: PTL in children has some specific ultrasonographic characteristics. A deeper insight into the ultrasonographic characteristics and clinical features of PTL may help improve ultrasonographic diagnosis of the disease.

Reconstruction of bladder function and prevention of renal deterioration by means of end-to-side neurorrhaphy in rats with neurogenic bladder.

AIMS: To investigate the feasibility of restoring bladder function and prevention of renal deterioration by neurorrhaphy in rats with neurogenic bladder (NB). METHODS: Forty-two rats were assigned to the end-to-side nerve coaptation group (ECG, n = 16), no nerve coaptation group (NCG, n = 16), and control group (CG, n = 10). In the ECG, the left ventral root (VR) and dorsal root (DR) of L6 and S1 were transected, and the distal stump of L6VR was sutured to the lateral face of L4VR. In the NCG, the left VR and DR of L6 and S1 were transected, but coaptation was not performed. In the CG, no operation was performed. Nerve regeneration, bladder function, and renal function were evaluated by FluoroGold (FG) retrograde tract tracing, cystometry, electrical stimulation, MRI, histology and biochemical assays. RESULTS: In the ECG, FG-labeled neurons were observed in the left ventral horn of L4 spinal cord. There was a significant increase in intravesical pressure upon stimulation of the left L4VR proximal to the coaptation. Maximum cystometric capacity, post-void residual urine, bladder compliance and weight, serum creatinine, blood urea nitrogen, and fibrotic area of bladder and kidney were lower in the ECG than in the NCG, but higher than the CG. Hydronephrosis was noticed in ECG and NCG rats. Maximum detrusor voiding pressure was higher in the ECG and CG than in the NCG. CONCLUSIONS: End-to-side neurorrhaphy is a useful method for restoring bladder function and preventing renal injury in rats with NB.

Stromal cell-derived factor-1α as a novel biomarker for hyperlipidemia.

Stromal cell-derived factor-1 (SDF-1) is expressed in a wide variety of organs, such as heart, and plays a pivotal role in the mobilization of hematopoietic stem and progenitor cells in bone marrow. SDF-1α, a common subtype of SDF-1, may control hematopoiesis and angiogenesis, but its role in the pathogenesis of hyperlipidemia is unknown. The aim of this study was to determine the role of SDF-1α in the pathogenesis of hyperlipidemia. First, log-transformed SDF-1α serum levels (logSDF-1α) were significantly higher in male patients with borderline high lipid profile (BHLP; n=28; 2.15±0.08 ng/ml) compared to control subjects (n=37; 1.94±0.06 ng/ml; P<0.01). The logSDF-1α in male patients with high lipid profile (HLP; n=33; 1.95±0.08 ng/ml) were lower than BHLP patients (P<0.01). The logSDF-1α was positively associated with HDL-C only in female patients (n=125; r=0.379, P=0.016). These results suggest the different pathophysiology in male and female patients with hyperlipidemia. Moreover, flow cytometry analysis showed that expression of the SDF-1α receptor, CXC-chemokine receptor 4, was lower in peripheral blood mononuclear cells of patients with BHLP (n=10) and HLP (n=10), compared to control subjects (n=10; P<0.001). Lastly, peripheral blood leukocyte, neutrophil and lymphocyte counts were higher in BHLP patients (n=62; P<0.05). Taken together, we suggest SDF-1α as a biomarker of hyperlipidemia that may be helpful to uncover the pathogenesis of hyperlipidemia.