Outcome analysis of immediate and delayed laparoscopic pyeloplasty in infants with severe ureteropelvic junction obstruction.

Objective: The treatment timing of ureteropelvic junction obstruction (UPJO) in infants remains controversial. This study aimed to compare the recovery effect of renal morphology of immediate and delayed laparoscopic pyeloplasty in infants with severe UPJO. Methods: The infants with severe UPJO-induced hydronephrosis who underwent laparoscopic pyeloplasty according to their age at the time of surgery [the immediate treatment (IT) group: ≤1 month of birth, the delayed treatment (LT) group: 3-6 months of birth] in our center between 2010 and 2019 were enrolled in this study. Ultrasonography was used to assess renal morphology, including anteroposterior diameter (APD) of a pelvic, parenchymal thickness (PT), polar length (PL), and Society of Fetal Urology (SFU) grade. Preoperative and postoperative renal morphological outcomes at 6, 12, and 24 months were measured and compared. Results: During this period, a total of 135 patients were assigned to receive either IT (n = 73) or LT (n = 62) and were included for analysis. There were no significant differences in renal morphology indices at baseline between groups of IT and LT. The APD, PT, and PL in both groups all recovered to certain degrees compared with those at baseline, however, the IT group recovered more significantly than the LT group. Despite there being no significant difference in SFU grade between the two groups before and after surgery, the reduction of SFU grade in the IT group was more significant than that in the LT group during the 6-, 12- and 24-month follow-up periods. The PL, SFU, and APD were greater in the IT group than in the LT group at 6, 12, and 24 months of follow-up. At 6 months PL was not significantly higher between the two groups, while the outcome was significantly different at 12 months and 24 months. Conclusion: Immediate laparoscopic pyeloplasty for the infant with severe ureteropelvic junction obstruction is effective, and it can accelerate the recovery of renal morphological indices in infants with severe UPJO-induced hydronephrosis.

One-stage tubularized urethroplasty using the free inner plate of the foreskin in the treatment of proximal hypospadias.

OBJECTIVE: This study summarizes the short-term efficacy of the one-stage tubularized urethroplasty using the free inner in proximal hypospadias. METHODS: A retrospective analysis was conducted on 42 patients with proximal hypospadias. All cases were treated with one-stage tubularized urethroplasty from January 2020 to June 2021. The postoperative complications like urethral fistula, urethral stricture, diverticulum, and split penis head were recorded. RESULTS: Patients were followed up for 3 to 15 months (an average of 8.5 months). A total of 26 cases (62%) were repaired without any complication. Five patients (11.9%) developed urinary fistulas and underwent secondary repair: three cases with anastomotic fistulas and two cases of coronal fistulas. Nine patients (21.4%) had stenosis of the head segment of the penis, six (14.3%) had stenosis that was relieved by urethral dilatation combined with topical mometasone furoate 1 month after urethral catheter removal. Two patients (4.8%) had severe stenosis with secondary surgical stenosis incision, and one (2.4%) had combined urethral diverticulum in which urethral stenosis incision and diverticulectomy were performed. CONCLUSIONS: Tubularized urethroplasty using the free inner bears the advantages of easy access, reduced short-term complications, low incidence of diverticula.

Feasibility and Safety of a Simple Non-cystoscopic Double-J Tube Removal Technique in Children.

Objective: Double-J tube placement is an important procedure during upper urinary tract surgery. A primary drawback is the requirement of a second double-J tube removal under a cystoscope. Therefore, a simple and feasible alternative is required to remove the double-J tube without cystoscopy. The present study reported the feasibility and safety of a simple non-cystoscopic double-J tube removal technique. Method: We retrospectively analysed children who underwent pyeloplasty and ureterovesical reimplantation between June 2015 and August 2021. A simple device (a catheter with a suture) was used to pull out the double-J tube. Patient characteristics, detailed surgical procedures, success and complication rates and reasons for failure were evaluated. Result: A total of 613 children were included. The mean age of patients was 6.2 months (3 months-14 years). Non-endoscopic methods were used to remove the double-J tube in all except 6 patients (0.9%). Of the 6 patients who required ureteroscopy or cystoscopy, 4 had retraction of the double-J tube into the ureter, and 2 (0.6%) had bladder stones. Of the 613 patients, 479 (76.0%) required one attempt, 127 (20.1%) required two attempts and 19 (3.0%) required several attempts. No serious postoperative complications occurred in all patients. The most common complications were gross haematuria (22.5%), pain urinating (17.9%), difficulty in urinating (3.6%), foreskin injury (1.7%), and penile oedema (1.3%). No urethral strictures developed during the follow-up period. Conclusion: The study results demonstrated that the modified and simple non-cystoscopic double-J tube removal technique is a safe and an effective alternative to cystoscopy in clinical practise.

A novel multi-site damage localization method based on near-field signal subspace fitting using uniform linear sensor array.

Damage diagnose imaging methods based on guided waves have been widely developed to depict the position and area of damage in structural health monitoring (SHM). Among them, compact sensor array based imaging methods have been gradually applied with high accuracy, such as phased array imaging, spatial filter imaging, multiple signal classification imaging and so on. However, when the multi-site damage appears nearly, the performance of these methods usually degrades. On one hand, limited to the array aperture, traditional methods cannot distinguish adjacent damage sites. On another hand, some subspace decomposition based methods also fail, suffering from the correlation between scattered array signals from different damage sites. To realize localization of multi-site damage, a novel near-field signal subspace fitting based multi-site damage localization method is proposed in this paper. This method constructs the cost function, which describe the equivalence relation between the signal subspace and array manifold matrix. Then localization of multi-site damage could be realized through multidimensional search for the optimization of cost function. The proposed method is verified on the aluminum panel with 3 damage sites. Experimental results show that the proposed method can realize multi-site damage localization with the angle errors less than 4° and the distance errors less than 35 mm.

Copper-Catalyzed Radical Aryl Migration Approach for the Preparation of Cyanoalkylsulfonylated Oxindoles/Cyanoalkyl Amides.

A copper-catalyzed radical cross-coupling of oxime esters and activated alkenes is accomplished for the synthesis of cyanoalkylsulfonylated oxindoles and cyanoalkyl amides via an aryl migration strategy. Specifically, the subsequent mechanism research indicates that the unique desulfonylation and sulfone addition processes were involved in the transformation. This transformation is identified as having good functional group applicability with two different quaternary stereocenter in a regioselective manner, which is controlled by the substituent group of the nitrogen.

Visible-Light-Mediated Decarboxylative Radical Addition Bifunctionalization Cascade for the Production of 1,4-Amino Alcohols.

A photocatalytic decarboxylative radical addition bifunctionalization cascade for the synthesis of functionalized alcohols is described. The catalytic cycle is completed through single-electron transfer. The advantages of this reaction are the commercially available materials, wide functional group compatibility, and mild conditions. Notably, some amino acids and bioactive carboxylic acids can provide corresponding products in moderate to good yields, reflecting the potential value in drug development.

Open transumbilical intussusception reduction in children: A prospective study.

PURPOSE: Manual intussusception reduction can sometimes be accomplished through the existing umbilical incision after a laparoscopic attempt has failed. We compared the safety and efficacy of open transumbilical intussusception reduction (OTIR) and laparoscopic reduction (LAP). METHODS: We prospectively enrolled children diagnosed with intussusception at our hospital from June 2014 to December 2018. Clinically stable patients who failed pneumatic intussusception reduction were randomly assigned to the OTIR or LAP group. We compared reduction rates, complications, operative times, and surgery costs between the two groups. RESULTS: Fifty-one of 451 patients with an intussusception met the study criteria. In the OTIR group (n = 27), 22 intussusceptions were successfully reduced, and 5 required incision extension. The mean operative time was 47.7 ±â€¯10.5 min, and mean surgery cost was 1259.74 ±â€¯46.24 US dollars. In the LAP group (n = 24), 5 patients required conversion to open surgery. Three of the 5 cases were resolved by OTIR, while the other 2 needed incision extension. The mean operative time was 68.63 ±â€¯17.13 min, and mean surgery cost was 1750.63 ±â€¯106.98 US dollars. Severe complications did not occur in either group. CONCLUSIONS: OTIR was as safe and effective as LAP and had a shorter operative time and lower surgery cost. OTIR is a good option for intussusception reduction in children. TYPE OF STUDY: Treatment study. LEVELS OF EVIDENCE: Level I.

Visible-Light-Mediated Trifluoromethylation/Benzylation of Styrenes Catalyzed by 4-CzIPN.

Difunctionalization of alkenes is a valuable tool for the synthesis of complicated compounds from simple precursors. Herein, a feasible method for the construction of ß-trifluoromethyl-α-substituted alcohols under visible-light-induced metal-free conditions is described. This catalytic system exhibits mild reaction conditions and good compatibility of functional groups. Trifluoromethyl and alcohols are valuable structural motifs due to their unique biological properties, and this work shows the potential application in the realm of pharmacy and organic synthesis.

Visible-Light-Induced Pd-Catalyzed Radical Strategy for Constructing C-Vinyl Glycosides.

A novel visible-light-induced palladium-catalyzed Heck reaction for bromine sugars and aryl olefins with high regio- and stereochemistry selectivity for the preparation of C-glycosyl styrene is described. This reaction takes place in one step at room temperature by using a simple and readily available starting material. This protocol can be scaled up to a wide range of glycosyl bromide donors and aryl olefin substrates. Mechanistic studies indicate that a radical addition pathway is involved.

Ligand-controlled regiodivergent π-allyl palladium catalysis enables a switch between [3+2] and [3+3] cycloadditions.

Reported herein is the use of ligands to tune the regioselectivity and reactivity of palladium-catalyzed [3+2] and [3+3] cycloadditions. Diverse synthesis with vinylethylene carbonates (VECs) as well as free naphthols has been explored to construct four different valuable polycyclic frameworks in a broad substrate scope.

Analysis of Main Components in Asarum heterotropoides var. mandshuricum Seedling at Different Growth Periods and Maturation Period / 中国实验方剂学杂志

Objective: To analyze the change rule of main chemical components in Asarum heterotropoidesvar.mandshuricum seedling during the growing process.Method:Whole seedling samples (one week and two weeks) and the mature plant (three months) of A.heterotropoidesvar.mandshuricum were collected and every sample was divided to aerial part (stems and leaves) and underground part (roots).The secondary metabolites were qualitatively identified by HPLC-TOF-MS and the quantitative identification was carried out at the same time with asarinin as index component.Result: A total of 6 known compounds were identified from the underground part of A.heterotropoidesvar.mandshuricum as α-asarone (1),N-isobutyl-2,4,8,10-dodecatetraenamide (2),9-methoxyaristolactam Ⅳ(3),asarinin (4),caulesnarinside (6) and chalcononaringenin 2',4'-di-O-β-D-glucopyranoside (7),respectively,the peak area values showed that the contents of these compounds increased gradually with the growth time.A total of 4 known compounds were identified from the aerial part of this herb as N-isobutyl-2,4,8,10-dodecatetraenamide (2),caulesauroneside (5),caulesnarinside (6) or chalcononaringenin 2',4'-di-O-β-D-glucopyranoside (7) and peonidin 3-caffeoylgentiobioside (8).Asarinin was identified only in the underground part of mature plant,its content was 155.4 μg·g-1.Conclusion: The species and contents of secondary metabolites are quite different in the aerial and underground parts of A.heterotropoidesvar.mandshuricum.At different growth stages of A.heterotropoides var.mandshuricum seedling,the types and contents of secondary metabolites in the same site are also different,while the contents of main components show an increasing trend with the growth time.

Delayed diagnosis of spontaneous bladder rupture: a rare case report.

BACKGROUND: Bladder rupture caused by trauma or pelvic fracture is very common, and can be easily diagnosed. However, Spontaneous rupture of the bladder is rare. Reported by Peters PC. (Peters, Urol Clin N Am 16:279-82, 1989): The incidence of spontaneous bladder rupture is 1: 126000. During childbirth, the occurrence rate of this disease is lower than that of the former. It is very difficult to make an early diagnosis of the spontaneous rupture of the bladder during childbirth, which eventually results in high maternal mortality. Due to peritoneal reabsorption, the patient may show high levels of serum creatinine and potassium, and this would easily be misdiagnosed as acute renal failure. However, these patients have normal renal function, hence the diagnosis of renal failure is incorrect. CASE PRESENTATION: A 23 year-old female patient had her first pregnancy and delivered a full-term healthy baby girl. After delivery, the patient developed fever, oliguria, massive ascites, high serum creatinine and high serum potassium. The patient was initially diagnosed with acute renal failure, however treatment for her condition was ineffective. After further examination, the patient was diagnosed with intraperitoneal bladder rupture. The patient was treated for bladder rupture, made a full recovery and was discharged. CONCLUSIONS: Sudden onset of massive ascites and renal failure due to abnormal serum biochemical characteristics after delivery should be first diagnosed as spontaneous bladder rupture. However, bladder radiography may suggest a false negative result, hence cystoscopy should be performed to confirm the diagnosis. The ratio between ascites creatinine and serum creatinine would be helpful for early diagnosis and to determine the time of rupture. Conservative management or surgical repair should be used to treat bladder rupture.

On-Line Multi-Damage Scanning Spatial-Wavenumber Filter Based Imaging Method for Aircraft Composite Structure.

Structural health monitoring (SHM) of aircraft composite structure is helpful to increase reliability and reduce maintenance costs. Due to the great effectiveness in distinguishing particular guided wave modes and identifying the propagation direction, the spatial-wavenumber filter technique has emerged as an interesting SHM topic. In this paper, a new scanning spatial-wavenumber filter (SSWF) based imaging method for multiple damages is proposed to conduct on-line monitoring of aircraft composite structures. Firstly, an on-line multi-damage SSWF is established, including the fundamental principle of SSWF for multiple damages based on a linear piezoelectric (PZT) sensor array, and a corresponding wavenumber-time imaging mechanism by using the multi-damage scattering signal. Secondly, through combining the on-line multi-damage SSWF and a PZT 2D cross-shaped array, an image-mapping method is proposed to conduct wavenumber synthesis and convert the two wavenumber-time images obtained by the PZT 2D cross-shaped array to an angle-distance image, from which the multiple damages can be directly recognized and located. In the experimental validation, both simulated multi-damage and real multi-damage introduced by repeated impacts are performed on a composite plate structure. The maximum localization error is less than 2 cm, which shows good performance of the multi-damage imaging method. Compared with the existing spatial-wavenumber filter based damage evaluation methods, the proposed method requires no more than the multi-damage scattering signal and can be performed without depending on any wavenumber modeling or measuring. Besides, this method locates multiple damages by imaging instead of the geometric method, which helps to improve the signal-to-noise ratio. Thus, it can be easily applied to on-line multi-damage monitoring of aircraft composite structures.

Two-dimensional optical waveguiding and luminescence vapochromic properties of 8-hydroxyquinoline zinc (Znq2) hexagonal microsheets.

Two-dimensional (2D) hexagonal microsheets of 8-hydroxyquinoline zinc (Znq2) were synthesized readily via a mixed solvent induced self-assembly method. The 2D optical waveguiding properties of the microsheets have been clearly revealed by both fluorescence microscopy and confocal microscopy. In addition, the reversible vapochromic properties of the microsheets have also been demonstrated when the Znq2 is exposed to HCl and NH3 vapors.

Covalently linked DNA/protein multilayered film for controlled DNA release.

A stable, biocompatible single strand DNA (ssDNA)/bovine serum albumin (BSA) multilayered film for control release of DNA was fabricated on PEI-coated quartz slides, gold-evaporated plates and silicon wafers, respectively through a formaldehyde-induced, covalently linked layer-by-layer (LBL) assembly technique. The constructed film structure was well characterized by using UV-vis spectrometry, surface plasmon resonance (SPR) and atomic force microscopy (AFM). The results showed that the DNA incorporated LBL film was fabricated successfully and the amount of ssDNA and BSA in the film could be tailored simply by controlling the number of the bilayers. The control release of DNA from the film was also monitored in this study. UV-vis spectrometry, SPR and AFM measurements indicated that the release of ssDNA and amino acid was adjustable by changing the proteinase K incubation time. This biocompatible covalently assembled film demonstrates an innovative approach to engineer a DNA/protein based nanostructure for controlled DNA release, which could provide stability, controllability and flexibility superior to that of LBL film assembled by electrostatic attraction. Since the film in this work can be assembled on different substrates, it is very feasible to fabricate nanoparticle-based gene therapy systems with this new approach and to have great potential in biomedical applications.