[Trends in upper urinary tract reconstruction surgery over a decade based on a multi-center database].

OBJECTIVE: To study the trend of surgical type, surgical procedure and etiological distribution of upper urinary tract repair in recent 10 years. METHODS: The preoperative and perioperative variables and follow-up data of upper urinary tract reconstruction surgery in RECUTTER (Reconstruction of Urinary Tract: Technology, Epidemiology and Result) database from 2010 to 2021 were searched, collected and analyzed. The surgical type, surgical procedure, duration of hospitalization, time of operation, incidence of short-term complications, and proportion of the patients undergoing reoperations were compared between the two groups of 2010-2017 period and 2018-2021 period. RESULTS: A total of 1 072 patients were included in the RECUTTER database. Congenital factors and iatrogenic injuries were the main causes of upper urinary tract repair. Among them, 129 (12.0%) patients had open operation, 403 (37.6%) patients had laparoscopic surgery, 322 (30.0%) patients had robot-assisted laparoscopic surgery and 218 (20.3%) patients had endourological procedure. In the last decade, the total number of surgeries showed a noticeable increasing annual trend and the proportion of robot-assisted laparoscopic surgery in 2018-2021 was significantly higher than that in 2010-2017 (P < 0.001). The 1 072 patients included 124 (11.6%) cases of ileal ureter replacements, 440 (41.1%) cases of pyeloplasty, 229 (21.4%) cases of balloon dilation, 109 (10.2%) cases of ureteral reimplantation, 49 (4.6%) cases of boari flap-Psoas hitch surgery, 60 (5.6%) cases of uretero-ureteral anastomosis, 61 (5.7%) cases of lingual mucosal onlay graft ureteroplasty or appendiceal onlay flap ureteroplasty. Pyeloplasty and balloon dilatation had been the main types of surgery, while the proportion of lingual mucosal onlay graft ureteroplasty plus appendiceal onlay flap ureteroplasty had increased significantly in recent years (P < 0.05). In addition, the time of operation was significantly increased (P < 0.05) after 2018, which was considered to be related to the sharp increase in the proportion of robot-assisted laparoscopic surgery. We found that minimally invasive surgery (endourological procedure and robot-assisted laparoscopic surgery) as an independent risk factor (P=0.050, OR=0.472) could reduce the incidence of short-term post-operative complications. CONCLUSION: We have justified the value of the RECUTTER database, created by the Institute of Urology, Peking University in data support for clinical research work, and provided valuable experience for the construction of other multi-center databases at home and abroad. In recent 10 years, we have observed that, in upper urinary tract reconstruction surgery, the surgery type tends to be minimally invasive and the surgery procedure tends to be complicated, suggesting the superiority of robot-assisted laparoscopic surgery.

[Clinical outcomes following microsurgery and endovascular embolization in the management of spinal dural arteriovenous fistula: A meta-analysis study].

OBJECTIVE: To compare the clinical effect of microsurgery and endovascular embolization in the treatment of spinal dural arteriovenous fistula (SDAVF) by meta-analysis. METHODS: A systematic review was performed to retrieve all relevant literature about surgical treatment or endovascular embolization of SDAVF up to December 2019 through PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials Results, CNKI, Wanfang Data, and SinoMed. The Chinese and English key words included: "SDAVF", "spinal dural arteriovenous fistula", "spinal AVM", "spinal vascular malformation and treatment". The included studies were evaluated using the Newcastle-Ottawa scale. The early failure rate, long-term recurrence, neurological recovery, and complications were evaluated and the clinical effects of the two methods in the treatment of SDAVF were compared by using RevMan 5.3 software. And a further subgroup analysis of the therapeutic effect of endovascular embolization with different embolic agents was conducted. RESULTS: A total of 46 studies involving 1 958 cases of SDAVF were included, in which 935 cases were treated by microsurgery and 1 023 cases were treated by endovascular embolization. The funnel plot demonstrated that there was no publication bias. The results of meta-analysis showed that the incidence of early surgical failure was lower than that of endovascular embolization (OR=0.20, 95%CI: 0.13-0.30, P < 0.05), and the long-term recurrence was also lower than that of endovascular embolization (OR=0.36, 95%CI: 0.22-0.58, P < 0.05). The improvement of neurological function in the surgical patients is significantly higher than that in the patients treated with endovascular embolization (OR=2.86, 95%CI: 1.36-5.99, P < 0.05). There was no significant difference in the occurrence of complications in these two groups (OR=1.52, 95%CI: 0.88-2.64, P=0.14). In the cases of endovascular embolization, the risk of treatment failure or recurrence was higher with Onyx glue than with n-butyl 2-cyanoacrylate (NBCA), and the difference was statistically significant (OR=4.70, 95%CI: 1.55-14.28, P < 0.05). CONCLUSION: Although the treatment of dural arteriovenous fistulas by intravascular embolization has been widely used, the clinical effect of microsurgery is still better than that of endovascular embolization. Large scale and high-quality randomized controlled trials are required to validate the efficacy and safety of endovascular treatment in SDAVF patients.

[Correlation between the expression profile of cytokeratin 19/glypican 3 and recurrence of hepatocellular carcinoma after interventional therapy].

Objective: To observe the correlation between the expressions profile of cytokeratin 19/glypican 3 (CK19/GPC3) and recurrence of hepatocellular carcinoma after interventional therapy. Methods: Clinical and pathological information of 251 eligible cases with hepatocellular carcinoma who underwent interventional therapy in You'an Hospital from November 2007 to May 2016 were retrospectively collected. Univariate and multivariate Cox regression analysis was used to analyze the relevant risk factors that may affect their prognosis. Kaplan-Meier survival analysis was used to draw the survival curve. Log-rank test was used to compare the difference in survival rates between the groups. Results: Kaplan-Meier univariate analysis showed that histological grade, CK19/GPC3 expression profile, alpha-fetoprotein level and Hep Parl were closely related to tumor recurrence. Multivariate Cox regression analysis showed CK19/GPC3 expression profile (HR = 1.634, 95%CI: 1.041 ~ 2.564, P = 0.033), histological grade (HR = 1.445, 95%CI: 1.037 ~ 2.014, P = 0.030), alpha-fetoprotein level (HR = 1.410, 95%CI: 1.042 ~ 1.908, P = 0.026), Hep Parl (HR = 0.570, 95%CI: 0.349 ~ 0.930, P = 0.025) were the four independent factors for prediction of recurrence after interventional therapy. Conclusion: Hepatocellular carcinoma patients with CK19(+)/GPC3(+) and CK19(-)/GPC3(+) phenotypes who meet the Milan criteria have a higher risk of recurrence after interventional therapy than CK19(-)/GPC3(-) phenotypes.

[Exploration on endovascular treatment for symptomatic occlusion of the intracranial vertebral arteries in early non-acute stage].

Objective: To examine the clinical efficacy of endovascular treatment on symptomatic occlusion of intracranial vertebral artery (ICVA) in early non-acute stage. Methods: Nine consecutive patients who presented with aggressive ischemic events in the early non-acute stage of ICVA occlusion from January 2014 to December 2019 and received endovascular treatment at Department of Neurosurgery, Peking University First Hospital were retrospectively reviewed.There were 7 males and 2 females, aged 63.4 years old(range: 52 to 72 years).The average preoperative modified Rankin scale(mRS) was 4.3(range: 4 to 5), the National Institute of Health stroke scale(NIHSS) was 12.3(range: 8 to 18). Among them, 2 patients received a single stage endovascular treatment, and the other 7 patients received staged endovascular treatment.The strategy of staged treatment was as follows: firstly, the occlusion part was passed through by a micro-guidewire and dilated with balloons to maintain the blood flow above Thrombolysis In Cerebral Infarction grade 2b. Then, the intravascular large load thrombus was eliminated by the fibrinolytic system and strengthened antiplatelet drugs. After that, a second stage of angioplasty with stenting was performed on the severe residual stenosis part.The complications and the recanalization rate were collected, and the National NIHSS and mRS after endovascular treatment and in follow-up period were recorded. Results: In the 2 cases received single stage endovascular treatment, although revascularization was achieved lastly, one patient suffered embolus translocation and the other suffered re-occlusion after mechanical thrombectomy during the operation, respectively.Technical success was achieved in 6 of the 7 patients received staged endovascular treatment.On discharge, the average NIHSS scores was 5.7(range: 3 to 4) of the patients. Three months after operation,the average mRS was 1.6(range:0 to 3) and it was 0.9(range: 0 to 2) at the latest follow-up, which were better than preoperative status. Conclusions: Staged endovascular treatment might be a safe, efficient, viable option in carefully selected patients with symptomatic ICVA occlusion in early non-acute stage. It needs to be confirmed by further investigation, preferably in a large controlled setting.

Prevalence of pathogenicity island ETT2 in Escherichia coli isolated from piglets with diarrhea in northeast of China.

Our aim was to investigate the prevalence of the pathogenicity island ETT2 and to examine the relationship between the ETT2 locus and other virulence factors in Escherichia coli (E. coli) isolated from piglets with diarrhea. A total of 354 E. coli strains isolated from scouring piglets were tested using PCR for the presence of the ETT2 locus. The E. coli strains were also analyzed for enterotoxins, fimbriae, non-fimbrial adhesin, Shiga toxins, pathogenicity islands, α-haemolysin (hlyA), afa8 gene cluster and autotransporter protease (sepA) genes. The results showed that 215 (60.7%) of the isolates possessed the ETT2 island. In 215 ETT2-positive E. coli strains, the virulence genes found were EAST1 (27.0%), irp2 (18.6%), paa (15.4%), STb (7.9%), LT (6.5%), ler (4.7%), hlyA (3.7%), AIDA-I (3.7%), K88 (3.7%), eae (3.3%), STa (2.8%), afaD (1.4%), afaE (1.4%), K99 (0.9%) and sepA (0.47%), respectively, and the isolates could be assigned into 25 different virulence factor patterns. In 139 ETT2-negative E. coli strains, the virulence genes detected were EAST1 (38.9%), paa (14.4%), STb (11.5%), AIDA-I (10.1%), irp2 (7.9%), sepA (2.16%), LT (0.7%), STa (0.7%), eae (0.7%), ler (0.7%), hlyA (0.7%) and K88 (0.7%), respectively, and the isolates could be classified into 13 different virulence factor patterns. Moreover, the occurrence of LT gene of ETT2-positive E. coli strains was far more than that of ETT2-negative E. coli strains.

[Efficacy evaluation and exploration of TACE combined with CT-guided precision microwave ablation treatment for primary liver cancer].

OBJECTIVE: To analyze the clinical therapeutic efficacy of transcatheter arterial chemoembolization combined with CT-guided percutaneous precision microwave ablation for the treatment of primary liver cancer and its influencing factors. METHODS: A total of 126 patients with primary liver cancer were treated by transcatheter arterial chemoembolization combined with CT-guided percutaneous precision microwave ablation from Mar 2010 to Oct 2014 in our center. The treatment effect, postoperative complications and recurrence rates were observed, and the factors related to recurrence and survival time were analyzed. RESULTS: All 126 primary liver cancer patients with 201 tumors were ablated for 177 times, and 113 cases with 185 tumors were completed ablated, the complete ablation rate was 92.0%. In all patients, 4 cases had serious complications, the incidence rate was 3.2%. 37 cases had recurrence, with a recurrence rate of 29.4%. All patients were followed up for 10 to 65 months, 17 patients died, and the 1-, 2-, and 3-year cumulative survival rates were 95.2%, 88.1%, and 84.1%, respectively, and the 1-, 2-, and 3-year progression-free-survival rates were 81.5%, 62.7% and 49.2%, respectively .Univariate analysis showed that preoperative AFP level, Child-Pugh score, BCLC stage and the largest tumor size were associated with the survival of patients who received TACE combined with CT-guided precision MWA, and the preoperative AFP level, internal medicine therapy, tumor number and the largest tumor size were associated with the progression-free-survival after the treatment (P<0.05). Multivariate analysis showed that Child-Pugh score and BCLC stage were independent factors affecting the survival of patients with primary liver cancer patients treated with TACE combined with CT guided percutaneous MWA, and the tumor number and the maximum tumor size were independent factors affecting the progression-free-survival of the patients (P<0.05). CONCLUSION: TACE combined with CT-guided percutaneous precision microwave ablation therapy for primary liver cancer has reliable safety and efficacy.

Embedded binary eutectic alloy nanostructures: a new class of phase change materials.

Phase change materials are essential to a number of technologies ranging from optical data storage to energy storage and transport applications. This widespread interest has given rise to a substantial effort to develop bulk phase change materials well suited for desired applications. Here, we suggest a novel and complementary approach, the use of binary eutectic alloy nanoparticles embedded within a matrix. Using GeSn nanoparticles embedded in silica as an example, we establish that the presence of a nanoparticle/matrix interface enables one to stabilize both nanobicrystal and homogeneous alloy morphologies. Further, the kinetics of switching between the two morphologies can be tuned simply by altering the composition.

Theory of nanocluster size distributions from ion beam synthesis.

Ion beam synthesis of nanoclusters is studied via both kinetic Monte Carlo simulations and the self-consistent mean-field solution to a set of coupled rate equations. Both approaches predict the existence of a steady-state shape for the cluster-size distribution that depends only on a characteristic length determined by the effective diffusion coefficient, the ion solubility, and the volumetric ion flux. The average cluster size in the steady-state regime is determined by the implanted species or matrix interface energy.

Large melting-point hysteresis of Ge nanocrystals embedded in SiO2.

The melting behavior of Ge nanocrystals embedded within SiO2 is evaluated using in situ transmission electron microscopy. The observed melting-point hysteresis is large (+/-17%) and nearly symmetric about the bulk melting point. This hysteresis is modeled successfully using classical nucleation theory without the need to invoke epitaxy.

[Investigation on the stimulation effect of polypyrrole film on rat hepatic cells].

Poypyrrole(PPy) films were prepared at 1 x 10(-3) mA/cm2 electropolymerization current density on indium-tin oxide(ITO)substrate. The PPy films were well-distributed, translucent, stable and insoluble. Moreover, they can be sterilized by steam disinfection. Rat hepatic cells were cultured on these films. The results show that PPy films have good biocompatibility and they can accelerate cell growth under electrical stimulation. The cells on PPy films reach the largest cell density earlier than the cells on tissue culture polystyrene(TCPS). Furthermore, rat hepatic cells can generate on PPy films. The cells on PPy films grow faster and enter logarithmic growth phase earlier than those on TCPS.

Optical properties of Langmuir-Blodgett films investigated by a photoacoustic technique.

A photoacoustic (PA) technique based on a four-layer prism configuration has been developed for nondestructive determination of the optical properties of Langmuir-Blodgett (LB) films, in which the PA signal amplitudes are measured as functions of the incident angle of light. With this technique the experimental PA angular spectra of manganese stearate and cadmium stearate LB films were obtained. Based on the electromagnetic theory and taking into account the anisotropic properties of LB films, as well as use of the numerical optimization method, we have simultaneously determined the optical constants and thicknesses of films based on experimental PA angular spectra.

[Purification and isolation of different stages of Plasmodium vivax, P. falciparum and P. berghei].

The present paper reported the results of purification and isolation of different stages of P. vivax, P. falciparum and P. berghei by Percoll gradient centrifugation after removal of leukocytes (WBCs) by passing the blood suspension through CF-11 cellulose columns. 94.7% and 75.4% of WBCs from the patients' blood of vivax malaria and the mice blood infected with P. berghei respectively were removed with no alteration of the parasite density and the malaria stage ratio after the cellulose filtration. The densities of the uninfected and the infected erythrocytes with different stages of 3 species of malaria parasites were determined by isopycnic centrifugation on multi continuous gradients of Percoll. The mean densities (kg/L) of schizonts, trophozoites, ring form and uninfected cells were approximately 1.059, 1.072, 1.096 and 1.099 in P. vivax; 1.070, 1.079, 1.10 and 1.10, gametocytes 1.085 in P. falciparum; 1.059, 1.062, 1.103 and 1.104 in P. berghei, respectively. Based on these values, 3 different density gradients of Percoll were devised to separate erythrocytes infected with the more mature stages (trophozoites and schizonts) from ring forms and uninfected cells. By these method, it is possible to obtain high purified parasites of 93.5% from blood with starting parasitaemias of 0.8% in P. vivax, 100% from 2.3% in P. falciparum and 93.0% from 30.6% in P. berghei, being raised by 113.8, 43.4 and 2.0 times respectively.