Minimally invasive ureteroplasty with lingual mucosal graft for complex ureteral stricture: analysis of surgical and patient-reported outcomes.

OBJECTIVE: To evaluate objective treatment efficacy and safety, and subjective patient-reported outcomes in patients with complex ureteral strictures (US) undergoing minimally invasive lingual mucosal graft ureteroplasty (LMGU). MATERIALS AND METHODS: We prospectively enrolled patients underwent robotic or laparoscopic LMGU between May 2020 and July 2022. Clinical success was defined as symptom-free and no radiographic evidence of re-obstruction. Patient-reported outcomes, including health-related quality of life (HRQoL), mental health status and oral health-related quality of life (OHRQoL), were longitudinally evaluated before surgery, 6 and 12 months postoperatively. RESULTS: Overall, 41 consecutive patients were included. All procedures were performed successfully with 32 patients in robotic approach and 9 in laparoscopic. Forty (97.56%) patients achieved clinical success during the median follow-up of 29 (range 15-41) months. Although patients with complex US experienced poor baseline HRQoL, there was a remarkable improvement following LMGU. Specifically, the 6-month and 12-month postoperative scores were significantly improved compared to the baseline (p < 0.05) in most domains. Twenty-eight (68.3%) and 31 (75.6%) patients had anxiety and depression symptoms before surgery, respectively. However, no significant decrease in the incidence of these symptoms was observed postoperatively. Moreover, there was no significant deterioration of OHRQoL at 6 months and 12 months postoperatively when compared to the baseline. CONCLUSIONS: LMGU is a safe and efficient procedure for complex ureteral reconstruction that significantly improves patient-reported HRQoL without compromising OHRQoL. Assessing patients' quality of life enables us to monitor postoperative recovery and progress, which should be considered as one of the criteria for surgical success.

Minimally invasive ureteroplasty with lingual mucosal graft for complex ureteral stricture: analysis of surgical and patient-reported outcomes

ABSTRACT Objective: To evaluate objective treatment efficacy and safety, and subjective patient-reported outcomes in patients with complex ureteral strictures (US) undergoing minimally invasive lingual mucosal graft ureteroplasty (LMGU). Materials and Methods: We prospectively enrolled patients underwent robotic or laparoscopic LMGU between May 2020 and July 2022. Clinical success was defined as symptom-free and no radiographic evidence of re-obstruction. Patient-reported outcomes, including health-related quality of life (HRQoL), mental health status and oral health-related quality of life (OHRQoL), were longitudinally evaluated before surgery, 6 and 12 months postoperatively. Results: Overall, 41 consecutive patients were included. All procedures were performed successfully with 32 patients in robotic approach and 9 in laparoscopic. Forty (97.56%) patients achieved clinical success during the median follow-up of 29 (range 15-41) months. Although patients with complex US experienced poor baseline HRQoL, there was a remarkable improvement following LMGU. Specifically, the 6-month and 12-month postoperative scores were significantly improved compared to the baseline (p < 0.05) in most domains. Twenty-eight (68.3%) and 31 (75.6%) patients had anxiety and depression symptoms before surgery, respectively. However, no significant decrease in the incidence of these symptoms was observed postoperatively. Moreover, there was no significant deterioration of OHRQoL at 6 months and 12 months postoperatively when compared to the baseline. Conclusions: LMGU is a safe and efficient procedure for complex ureteral reconstruction that significantly improves patient-reported HRQoL without compromising OHRQoL. Assessing patients' quality of life enables us to monitor postoperative recovery and progress, which should be considered as one of the criteria for surgical success.

Heterozygosity analysis of spontaneous 2n female gametes and centromere mapping of the diploid Hevea brasiliensis based on full-sib triploid populations.

KEY MESSAGE: Unreduced megagametophytes via second-division restitution were confirmed through heterozygosity analysis, and four candidate physical centromeres of rubber were located for the first time. The evaluation of maternal heterozygosity restitution (MHR) is vital in identifying the mechanism of 2n gametogenesis and assessing the utilization value of 2n gametes. In this study, three full-sib triploid populations were employed to evaluate the MHR of 2n female gametes of rubber tree clone GT1 and to confirm their genetic derivation. The 2n female gametes of GT1 were derived from second-division restitution (SDR) and transmitted more than half of the parental heterozygosity. In addition, low recombination frequency markers were developed, and four candidate physical centromeres of rubber tree were located for the first time. The confirmation that 2n female gametes of rubber tree clone GT1 are derived from SDR provides insights into the molecular mechanisms of 2n gametogenesis. In addition, the identified centromere location will aid in the development of centromeric markers for the rapid identification of the 2n gametogenesis mechanism.

Development and internal validation of a clinical prediction model for spontaneous abortion risk in early pregnancy

Abstract Objective: This study aimed to develop and internally validate a prediction model for estimating the risk of spontaneous abortion in early pregnancy. Methods: This prospective cohort study included 9,895 pregnant women who received prenatal care at a maternal health facility in China from January 2021 to December 2022. Data on demographics, medical history, lifestyle factors, and mental health were collected. A multivariable logistic regression analysis was performed to develop the prediction model with spontaneous abortion as the outcome. The model was internally validated using bootstrapping techniques, and its discrimination and calibration were assessed. Results: The spontaneous abortion rate was 5.95% (589/9,895) 1. The final prediction model included nine variables: maternal age, history of embryonic arrest, thyroid dysfunction, polycystic ovary syndrome, assisted reproduction, exposure to pollution, recent home renovation, depression score, and stress score 1. The model showed good discrimination with a C-statistic of 0.88 (95% CI 0.87‒0.90) 1, and its calibration was adequate based on the Hosmer-Lemeshow test (p = 0.27). Conclusions: The prediction model demonstrated good performance in estimating spontaneous abortion risk in early pregnancy based on demographic, clinical, and psychosocial factors. Further external validation is recommended before clinical application.

Development and internal validation of a clinical prediction model for spontaneous abortion risk in early pregnancy.

OBJECTIVE: This study aimed to develop and internally validate a prediction model for estimating the risk of spontaneous abortion in early pregnancy. METHODS: This prospective cohort study included 9,895 pregnant women who received prenatal care at a maternal health facility in China from January 2021 to December 2022. Data on demographics, medical history, lifestyle factors, and mental health were collected. A multivariable logistic regression analysis was performed to develop the prediction model with spontaneous abortion as the outcome. The model was internally validated using bootstrapping techniques, and its discrimination and calibration were assessed. RESULTS: The spontaneous abortion rate was 5.95% (589/9,895) 1. The final prediction model included nine variables: maternal age, history of embryonic arrest, thyroid dysfunction, polycystic ovary syndrome, assisted reproduction, exposure to pollution, recent home renovation, depression score, and stress score 1. The model showed good discrimination with a C-statistic of 0.88 (95% CI 0.87‒0.90) 1, and its calibration was adequate based on the Hosmer-Lemeshow test (p = 0.27). CONCLUSIONS: The prediction model demonstrated good performance in estimating spontaneous abortion risk in early pregnancy based on demographic, clinical, and psychosocial factors. Further external validation is recommended before clinical application.

Clinical features and risk factors of COVID-19-associated liver injury and function: A retrospective analysis of 830 cases.

INTRODUCTION AND OBJECTIVES: The incidence of liver injury (LI) in hospitalized COVID-19 patients ranged from 14% to 53% based on sole or multiple elevated indexes for LI. The aims of our study were to investigate the changes of parameters (ALT, AST) in LI and determine the risk factors for LI in a cohort of 830 COVID-19 patients. METHODS: Demographic information, clinical features, and laboratory testing outcomes on admission were compared between patients with and without liver biochemistry abnormality (LBA). The same comparisons were performed between the LBA and LI groups. The updated RUCAM was used to determine the causality between drugs application and LI. Univariable and multivariable logistic regression analyses were used to explore the potential risk factors associated with LBA and LI. RESULTS: A total of 227 (27.3%) patients exhibited LBA and 32 (3.9%) patients were categorized as having LI based on the diagnostic criteria. 32.6% (74/227) of the LBA patients had RUCAM score >3, whereas the non-LBA patients had a slight lower at rate of 24.2% (146/603) (P?=?0.047). Multivariable regression showed that a higher incidence of LBA was associated with hepatic hypoattenuation on computed tomography (CT) (odds ratio: 2.243, 95% confidence interval: 1.410-3.592, p?=?0.001), lymphocyte proportion <20% (2.088, 1.476-2.954, p?1?mg/dL (2.650, 1.845-3.806, p?1 (2.558, 1.820-3.596, p?1.0?mg/dL, lymphocyte proportion <20%, AST/ALT ratio <1, and triglyceride levels >1.7?mol/L are potential risk factors for LI.

Aspiration with or without lavage in the treatment of acute suppurative thyroiditis secondary to pyriform sinus fistula.

Objective There is currently no consensus regarding the optimal management of acute suppurative thyroiditis (AST) secondary to pyriform sinus fistula (PSF). To investigate the benefits and adverse events of aspiration with or without lavage for the treatment of AST secondary to PSF. Subjects and methods This was a retrospective analysis of consecutive patients with AST secondary to PSF who were admitted at the Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University between August 2012 and December 2018. Clinical information, procedural data, and imaging data were analyzed. Results Seven patients (five women; mean age, 16.9 ± 6.3 years; range, 8-26 years) were included. The patients most presented with anterior neck pain and swelling (n = 7), fever (n = 7), or odynophagia (n = 5). Six cases of AST occurred on the left side of the thyroid and 1 on the right. All patients had thyroid abscess. AST was diagnosed by ultrasound-guided needle aspiration cytology in all cases. PSF was diagnosed during the inflammatory stage in five patients and during the quiescent stage in two. All patients were treated with empiric antibiotics. Needle aspiration without lavage was performed in three cases. Needle aspiration with lavage was performed in four cases. Repeat aspiration was performed in three cases. All patients recovered completely, with no procedure-related complications. During 18.3 ± 7.8 months of follow-up, AST recurred in one case. Excision of the PSF was performed in another case. Conclusion Ultrasound-guided aspiration with or without lavage had a good treatment effect and without adverse events for the management of AST secondary to PSF.

Rosemary supplementation (Rosmarinus oficinallis L.) attenuates cardiac remodeling after myocardial infarction in rats.

BACKGROUND: Myocardial infarction (MI) is one of the leading causes of morbidity and mortality worldwide. Dietary intervention on adverse cardiac remodeling after MI has significant clinical relevance. Rosemary leaves are a natural product with antioxidant/anti-inflammatory properties, but its effect on morphology and ventricular function after MI is unknown. METHODS AND RESULTS: To determine the effect of the dietary supplementation of rosemary leaves on cardiac remodeling after MI, male Wistar rats were divided into 6 groups after sham procedure or experimental induced MI: 1) Sham group fed standard chow (SR0, n = 23); 2) Sham group fed standard chow supplemented with 0.02% rosemary (R002) (SR002, n = 23); 3) Sham group fed standard chow supplemented with 0.2% rosemary (R02) (SR02, n = 22); 4) group submitted to MI and fed standard chow (IR0, n = 13); 5) group submitted to MI and fed standard chow supplemented with R002 (IR002, n = 8); and 6) group submitted to MI and fed standard chow supplemented with R02 (IR02, n = 9). After 3 months of the treatment, systolic pressure evaluation, echocardiography and euthanasia were performed. Left ventricular samples were evaluated for: fibrosis, cytokine levels, apoptosis, energy metabolism enzymes, and oxidative stress. Rosemary dietary supplementation attenuated cardiac remodeling by improving energy metabolism and decreasing oxidative stress. Rosemary supplementation of 0.02% improved diastolic function and reduced hypertrophy after MI. Regarding rosemary dose, 0.02% and 0.2% for rats are equivalent to 11 mg and 110 mg for humans, respectively. CONCLUSION: Our findings support further investigations of the rosemary use as adjuvant therapy in adverse cardiac remodeling.

Characterization and bioactivities of a novel polysaccharide obtained from Gracilariopsis lemaneiformis.

Gracilariopsis lemaneiformis is a type of red alga that contains seaweed polysaccharide agar. In this study, a novel non-agar seaweed polysaccharide fraction named GCP (short of crude polysaccharide obtained from Gracilariopsis lemaneiformis) was isolated from Gracilariopsis lemaneiformis. Structural analysis showed that GCP shows triple helical chain conformation when dissolved in water and has many branches and long side chains. Also, 1→3 linkage is the major linkage and the sugar structures are galactopyranose configurations linked by ß-type glycosidic linkages. Two macromolecular substance fractions (GCP-1 and GCP-2) were purified by DEAE Sepharose Fast Flow column chromatography. Moreover, a splenocyte damage assay and splenocyte proliferation assay were used to analyse the bioactivities of GCP, GCP-1 and GCP-2. It was demonstrated that polysaccharides could protect splenocyte damaged by H2O2; GCP-2 shows a greatest protection rate, that is, 92.8%, which significantly enhanced the splenocyte proliferation, and GCP showed the highest proliferation rate, 9.30%. The results suggested that this type of novel non-agar polysaccharide displayed remarkable antioxidant and immunomodulatory activities and early alkali treatment could decrease the activities. It may represent a potential material for health food and clinical medicines.

Characterization and bioactivities of a novel polysaccharide obtained from Gracilariopsis lemaneiformis

ABSTRACT Gracilariopsis lemaneiformis is a type of red alga that contains seaweed polysaccharide agar. In this study, a novel non-agar seaweed polysaccharide fraction named GCP (short of crude polysaccharide obtained from Gracilariopsis lemaneiformis) was isolated from Gracilariopsis lemaneiformis. Structural analysis showed that GCP shows triple helical chain conformation when dissolved in water and has many branches and long side chains. Also, 1→3 linkage is the major linkage and the sugar structures are galactopyranose configurations linked by β-type glycosidic linkages. Two macromolecular substance fractions (GCP-1 and GCP-2) were purified by DEAE Sepharose Fast Flow column chromatography. Moreover, a splenocyte damage assay and splenocyte proliferation assay were used to analyse the bioactivities of GCP, GCP-1 and GCP-2. It was demonstrated that polysaccharides could protect splenocyte damaged by H2O2; GCP-2 shows a greatest protection rate, that is, 92.8%, which significantly enhanced the splenocyte proliferation, and GCP showed the highest proliferation rate, 9.30%. The results suggested that this type of novel non-agar polysaccharide displayed remarkable antioxidant and immunomodulatory activities and early alkali treatment could decrease the activities. It may represent a potential material for health food and clinical medicines.

Adult-plant resistance to Septoria tritici blotch in hexaploid spring wheat.

KEY MESSAGE: New QTL for Septoria tritici blotch detected in hexapoid spring wheat under field conditions across diverse environments. Septoria tritici blotch caused by the ascomycete fungus Zymoseptoria tritici presents a serious and consistent challenge to global wheat production. In particular the augmented use of soil management practices that leave large amounts of wheat stubble on the soil surface and global warming increases the chance of Septoria tritici blotch epidemics to emerge more frequently including in developing countries. Two recombinant inbred line populations developed from a cross between the susceptible Moroccan spring bread wheat variety 'NASMA' and the CIMMYT resistant lines, 'IAS20*5/H567.71' and 'RPB709.71/COC' were used to study the genetics and map adult-plant resistance to Septoria tritici blotch under field conditions in different environments. Resistance to Septoria tritici blotch in both populations was quantitative and overall, five across environment consistent resistance loci on chromosomes 1BS, 3AL, 5AL and 7AS were detected in the two populations. The QTL on chromosome 1BS and 7AS are likely to be allelic with the known Septoria tritici blotch genes Stb3 and Stb11. All identified QTL were additive and explained between 4 and 27 % of the phenotypic variation. Epistatic interaction was not observed. Low cost KASP assays were developed as flanking markers for all five QTL that will facilitate molecular breeding. Our study represents the first mapping effort under field conditions utilizing two spring bread wheat resistant sources evaluated over multiple environments.

Evaluation of ER-α, ER-Β1 and ER-Β2 expression and correlation with clinicopathologic factors in invasive luminal subtype breast cancers.

PURPOSE: Luminal subtype breast cancer is defined as oestrogen receptor (ER)- and/or progesterone receptor (PR)- positive breast cancer. We detected the expression of ER-α, ER-Β1 and ER-Β2 in the tissue samples of invasive luminal subtype breast cancer patients, evaluated the correlations between these ER statuses and prognosis, and tried to clarify whether the status of ER-α isoforms provides clinically useful information further to what is already provided by the traditional ER-α/PR assay. METHODS: The expression of ER-α, ER-Β1 and ER-Β2 in the paraffin-embedded sections of 162 invasive luminal subtype breast cancer patients was detected with an immunohistochemical staining method. With mid-long-term follow-up, the features of ER-α, ER-Β1 and ER-Β2 status and the correlations between clinical characteristics and the prognosis were analysed. RESULTS: ER-Β1-positive status was correlated with PR (rs=0.217, p<0.01). The median follow-up time was 92 months (range, 4-98 months). Univariate analysis suggested that ER-Β1 status was significantly correlated to diseasefree survival (DFS) time (log rank=3.98, p=0.046), especially in patients with positive lymph nodes (log rank=6.20, p=0.013). In patients with smaller tumour size (=20 mm), negative ER-Β2 status was significantly correlated to overall survival time (log rank=3.87, p=0.049). CONCLUSIONS: In invasive luminal subtype breast cancers, ER-Β1 is correlated with good prognosis and could be regarded as one of the factors for evaluating DFS time, especially in lymph node-positive patients. There may be some interactions between ER-Β1 and PR. In clinical practice, besides routine detection of ER-α and PR in invasive luminal subtype breast cancers, immunohistochemical staining of ER-Β1 and ER-Β2 should be considered in order to achieve more useful information. Further studies are needed to confirm our findings.

Long-term high-fat diet-induced obesity decreases the cardiac leptin receptor without apparent lipotoxicity.

AIMS: Leptin resistance has been associated with cardiac lipotoxicity; however, whether leptin resistance is a risk factor associated with cardiac lipotoxicity at different time points in diet-induced obesity is unclear. The objective of this study was to evaluate this relationship. MAIN METHODS: Male Wistar rats were fed a normal chow diet (12% from fat) or a high-fat diet (49% from fat) for 15 and 45 weeks, respectively. The adiposity index, body weight and co-morbidities were evaluated. Heart lipotoxicity was assessed by analyzing cardiac function and morphological changes as well as cardiac triglyceride, ceramide and lipid hydroperoxide accumulations. Cardiac apoptosis was examined using the TUNEL method. Leptin function was determined by examining plasma leptin levels, cardiac leptin receptors (OB-R) and related phosphorylations of AMP-activated kinase protein (AMPK) and Acetyl CoA carboxylase (ACC). KEY FINDINGS: The diet-induced obesity was characterized by an elevated adiposity index, body weight and leptin levels at both 15 and 45 weeks. There was no difference between groups in the cardiac triglyceride or lipid hydroperoxide levels. Interestingly, ceramide levels decreased in obese animals in both experimental periods. The cardiac morphological and functional parameters were not altered. Although down-regulation of OB-R has occurred in chronic obesity, it did not adversely affect AMPK or ACC phosphorylation. SIGNIFICANCE: The development of obesity via long-term feeding of a high-fat diet to rats does not result in cardiac lipotoxicity but promotes the down-regulation of OB-R. However, this does not result in altered levels of AMPK or ACC phosphorylations in this animal model.