Outcomes of seromuscular bladder augmentation compared with standard bladder augmentation in the treatment of children with neurogenic bladder.

BACKGROUND: Intestinal seromuscular bladder augmentation (SMBA) surgery has produced no mucosal-related complications, but its outcomes need to be studied. AIM: To evaluate the safety and effectiveness of SMBA in the treatment of children with neurogenic bladder. METHODS: A retrospective analysis of the clinical data of children with SMBA was performed from March 2008 to February 2018, and the data were compared with those of children receiving standard cystoplasty (SC). RESULTS: In a cohort of 67 children who underwent bladder augmentation, the 46 children in the SC group had an average age of 10.6 years and a follow-up time of 36 mo, and the 21 children in the SMBA group had an average age of 7.6 years and a follow-up time of 29.7 mo. The preoperative and postoperative bladder volumes in the SMBA group were 151.7 mL and 200.4 mL, respectively, and those in the SC group were 173.9 mL and 387.0 mL, respectively. No significant difference in preoperative urinary dynamic parameters was found between the two groups, but the difference after operation was statistically significant. The main complications after SMBA were residual ureteral reflux and failed bladder augmentation, with incidences of 33.3% and 28.6%, respectively. In all 6 patients with failed augmentation in the SMBA group, ileum seromuscular patches were used for augmentation, and SC was chosen for reaugmentation. During reoperation, patch contracture and fibrosis were observed. CONCLUSION: The improvement of urinary dynamic parameters in the SMBA group was significantly lower than that in the SC group. Children with SMBA had a higher probability of patch contracture and reaugmentation, which might be related to impaired blood supply and urine stimulation, and the sigmoid colon patch should be the priority.

Surgical outcomes of bladder augmentation: A comparison of three different augmentation procedures.

BACKGROUND: Augmentation cystoplasty is indispensable in many pediatric diseases, especially neurogenic bladder. Various methods and materials are used to augment the bladder, and these methods are associated with different shortcomings and complications. AIM: The present study reported the mid-term outcomes of patients undergoing various bladder augmentation procedures in a single institution, and assessed whether seromuscular cystoplasty lined with urothelium (SCLU) provided better urodynamic results than auto-augmentation (AA). METHODS: A retrospective review of 96 patients undergoing various augmentation methods between 2003 and 2018 was performed. The patients were divided into three groups according to the type of augmentation, and their outcomes were compared. All patients developed neurogenic bladder due to myelomeningocele or sacrococcygeal teratoma. The clinical data of all patients were collected. RESULTS: The mean ages at surgery in the three groups (standard cystoplasty [SC], SCLU, AA) were 10.8, 7.5, and 4.8 years, respectively, with mean follow-ups of 36, 61, and 36 mo, respectively. The mean preoperative and postoperative bladder capacities of the SC, SCLU, and AA groups were 174 ± 11.7 vs. 387 ± 13.7 (P < 0.0001), 165 ± 12.2 vs. 240 ± 14.7 (P = 0.0002), and 138 ± 16.7 vs. 181 ± 9.9 (P = 0.0360), respectively. Compared with the AA group, the SCLU procedure did not have better postoperative urodynamic parameters. Incontinence was reduced in most patients. The mean times of clean intermittent catheterization per day in the SC, SCLU, and AA groups were 5.6, 7.8, and 8.2, respectively. The main complications of the SC group were recurrent urinary tract infections (8%) and bladder calculi (6%). Re-augmentation was done in patients in the SCLU (8) and AA (3) groups. CONCLUSION: SC provided sufficient bladder capacity and improved compliance with acceptable complications. After AA and SCLU, the patients acquired limited increases in bladder capacity and compliance with a high rate of re-augmentation. Compared with AA, SCLU did not yield better postoperative urodynamic parameters.

Identification of and solution for false D-dimer results.

BACKGROUND: Clinically, D-dimer (DD) levels are mainly used to exclude diseases such as deep venous thrombosis (DVT). In clinical testing, DD assays can be subjected to interference that may cause false results, which directly affect the clinical diagnosis. Our hypothesis was that the 95% confidence intervals (CIs) of the fibrin degradation product (FDP)/DD and fibrinogen (Fib)/DD ratios were used to identify these false results and corrected via multiple dilutions. METHODS: In total, 16 776 samples were divided into three groups according to the DD levels detected by Sysmex CS5100 and CA7000: Group A, DD ≥ 2.0 µg/mL fibrinogen equivalent unit (FEU); group B, 0.5 < DD < 2.0 µg/mL FEU; and group C, DD ≤ 0.5 µg/mL FEU. The 95% CIs of the FDP/DD and Fib/DD ratios were calculated. Six abnormal DD results were found according to the 95% CIs. For verification, we performed multiple dilutions, compared the results with those of other instruments, and tested the addition of heterophilic blocking reagent (HBR). RESULTS: The median and 95% CI of the FDP/DD ratio were 3.76 and 2.25-8.15 in group A, 5.63 and 2.86-10.58 in group B, 10.23 and 0.91-47.71 in groups C, respectively. For the Fib/DD ratio, the 95% CIs was 0.02-2.21 in group A, 0.68-8.15 in group B, and 3.82-55.27 in groups C. Six abnormal results were identified after multiple dilutions, by comparison with other detection systems, and after HBR addition. CONCLUSIONS: The FDP/DD ratio is more reliable for identifying false results. If the FDP/DD ratio falls outside the 95% CI, it should be verified by different methods.

Evaluation of Rex Shunt on Cavernous Transformation of the Portal Vein in Children.

BACKGROUND: Children with cavernous transformation of the portal vein (CTPV) develop severe complications from prehepatic portal hypertension, such as recurrent variceal bleeding and thrombocytopenia. In this study, we reported the results of 30 children with symptomatic CTPV that were treated by a Rex shunt. The effectiveness of this surgical approach was evaluated. METHODS: A retrospective review was performed of 30 children aged between 3 and 18 years with CTPV, who underwent a Rex shunt between 2008 and 2015. All children were evaluated based on symptoms, complete blood count, portal system color-flow Doppler ultrasound or computed tomography angiography portography and gastroscopy for gastroesophageal varices pre- and postoperatively. Children were also evaluated during follow-up. Intraoperative evaluations included liver biopsy, portography and portal pressure. RESULTS: Twenty-one patients demonstrated intermittent bleeding from gastroesophageal varices, 3 patients showed hypersplenism with varying degrees of leucopenia, anemia and thrombocytopenia, and in 6 patients both bleeding and hypersplenism were observed. Rex was successful in 28 patients (93.3%). The portal pressure immediately decreased significantly after placing of the shunt (P < 0.01). During the clinical follow-up period within 2-82 months, transaminase levels were maintained in the normal range. Blood flow velocity and diameter of the left portal vein significantly increased after surgery (P < 0.01). In addition, leukocyte and platelet counts increased postoperatively and anemia improved significantly (P < 0.01). Gastroscopy results indicated that the degree of gastroesophageal varices significantly alleviated postoperatively within 3 months and 1 year (P < 0.01). In 2 patients who demonstrated nodular cirrhosis and chronic active hepatitis, success of the Rex shunt was not achieved after operation. We found that for Rex effectiveness hepatic pathology and patient age were major determinants. CONCLUSION: Rex shunt is an effective approach for the treatment of children suffering from CTPV at an early stage that do not show additional liver lesions.

Targeted Photodynamic Killing of Breast Cancer Cells Employing Heptamannosylated ß-Cyclodextrin-Mediated Nanoparticle Formation of an Adamantane-Functionalized BODIPY Photosensitizer.

The targeted delivery of a photosensitizer (PS) into specific cancer cells is an effective way to enhance the efficacy and minimize the side effects of photodynamic therapy. Herein, heptamannosylated ß-cyclodextrin (ß-CD) was used to mediate the formation of an adamantane (Ad)-functionalized BODIPY PS nanoparticle via strong ß-CD/Ad complexation. The mannose-functionalized PS nanoparticles are selectively internalized by mannose-receptor-rich MDA-MB-231 breast cancer cells via receptor-mediated endocytosis, facilitating singlet oxygen generation to trigger apoptosis in cancer cells upon red-light irradiation. These nanoparticles exhibit excellent targeted delivery of the PS, leading to cancer cell death after irradiation both in vitro and in vivo.

AIE-active tetraphenylethene functionalized metal-organic framework for selective detection of nitroaromatic explosives and organic photocatalysis.

AIE-active luminogen tetraphenylethene (TPE) was incorporated into a UiO-isoreticular zirconium metal-organic framework via the strategy of mixed dicarboxylate struts, and the resulting functionalized MOF shows a strong blue-green emission and selective sensing of nitroaromatic explosives 2,4,6-trinitrophenol (TNP) and 2,4-dinitrophenol (DNP) through fluorescence quenching. Moreover, the luminescent MOF exhibits efficient photocatalytic activity for aerobic cross-dehydrogenative coupling reactions mediated by visible light.

A novel nanoscale organic-inorganic hybrid system with significantly enhanced AIE in aqueous media.

We report the design and fluorescence properties of a novel aggregation-induced emission (AIE) system obtained by grafting carboxyl group conjugated AIE molecules onto monodispersed colloidal GaOOH nanocubes. Compared with nanoaggregates formed in mixed solvents, as-formed nanohybrids avoid contact with a "good" solvent, restrict the molecular motions more efficiently and show a significantly enhanced AIE.

[Rapid Measurement of Carbon Dioxide with Laser-Induced Breakdown Spectroscopy Based on Atomic and Molecular Spectrum].

With the rapid development of economy and industrialization, global warming is becoming the most serious sensitive global climate issues, which causes the rising of sea level and many other negative effects. The cause of global warming is the emission of greenhouse gases and carbon dioxide is the main component of greenhouse gases. The control of CO2 emssion is beneficial to addressing gobal climate change and environmental degradation. Therefore, it's important to develop a rapid detection of CO2 for accurate control. There are amounts of methods to detect CO2 at present, including titration, electrochemical method, gas chromatography, infrared absorption spectroscopy and so on, however, t they still have the deficiency for online monitoring in industrial field. laser induced breakdown spectroscopy (LIBS), which is developing rapidly in recent few decades, is a detecting technology with characteristics of time-saving and synchronous measuring of multicomponent. What's more, there is no need for sample pretreating. To develop the online monitoring technique of CO2 emission in the industrial field, LIBS was employed to measure CO2 in this study. The mass flow controller was used to adjust the flow of high purity CO2 and N2 to obtain mixed gas with different CO2 concentrations. The mixed gas was firstly mixed in an air mixing chamber for thorough mixing and then sent to the sample cell for LIBS measurement. The evolution of C atomic spectral line and CN molecular band with different delay times were being studied, which demonstrated parts of CO2 react with air ambient to form CN molecular during the plasma generation, the CN molecular band should be taken into consideration for quantitative analysis, and the parameters were optimized for synchronous measurement of C line and CN band: 800 ns was the optimal delay time. During the plasma generation, many factors in the plasma may interact with others, the analysis index had close relationship wih serval measuring parameters. With the consideration of the effect of C, CN and the self-absorption in high concentration, multivariate calibration method was employed to establish calibration models of CO2. The results showed that the correlation coefficients R2 and the slope were 0.978 and 0.981, respectively. Compared with calibrated with single factor, the multivariate method improved the reliability of the model. What's more, the feasibility of the application of LIBS to measure CO2 rapidly was proved.

Association of the macrophage migration inhibitory factor gene--173G/C polymorphism with inflammatory bowel disease: a meta-analysis of 4296 subjects.

A variety of epidemiologic studies have focused on the association between macrophage migration inhibitory factor (MIF) gene--173G/C polymorphism and inflammatory bowel disease (IBD). However, results in different studies have been inconsistent. In order to derive a more precise estimation of the associations, we performed this meta-analysis and systematic searches of electronic databases PubMed and Web of Science (up to April 30, 2013). Based on our search criteria, a total of seven eligible studies concerning the MIF--173G/C polymorphism and IBD risk were included in the final meta-analysis, comprising 2162 IBD cases and 2134 controls. Significant association was found between MIF--173G/C polymorphism and the risk of IBD when all studies were pooled into the meta-analysis (for C allele vs. G allele: OR=1.25, 95% CI=1.12-1.41, p=0.000; for C/C vs. G/G: OR=1.71, 95% CI=1.23-2.39, p=0.002; for C/C+G/C vs. G/G: OR=1.24, 95% CI=1.09-1.42, p=0.002; for C/C vs. G/C+G/G: OR=1.67, 95% CI=1.20-2.33, p=0.002). Heterogeneity and publication bias did not exist in the overall comparisons. The present meta-analysis suggests an association between the MIF--173G/C polymorphism and IBD risk. However, due to few studies and the selection bias existed in some studies, the results should be interpreted with caution.