Comparative analysis of laparoscopic and open ureteroureterostomy for the treatment of pediatric duplicated kidneys: a clinical efficacy and safety study.

Background: Duplicated kidneys, though rare, are common in pediatric urinary issues. For children with complete kidney duplication and symptoms or complications, surgery is often needed. Ureteroureterostomy (UU) is a common procedure for this condition. This study aims to evaluate and compare the clinical efficacy and safety of laparoscopic ureteroureterostomy (LUU) and open ureteroureterostomy (OUU) in the treatment of pediatric duplicated kidneys. Methods: A retrospective study at Children's Hospital of Anhui Province from February 2017 to January 2023 included pediatric patients who underwent LUU or OUU for completely duplicated kidneys. Comparative measures included operative time, postoperative hospital stay, intraoperative blood loss, pre- and postoperative renal pelvis anteroposterior diameter, pre- and postoperative upper renal parenchymal thickness, pre- and postoperative upper ureteral diameter, and postoperative complications. Results: There are 30 patients, 20 in the LUU group and 10 in the OUU group. All patients underwent surgery successfully, with no conversions to open surgery in the LUU group. Comparison between the LUU group (average age 3.7±3.4 years) and the OUU group (average age 1.6±1.3 years) showed that laparoscopic surgery had a mean duration of 178.8±60.71 min, intraoperative blood loss of 4.3±0.92 mL, drainage tube removal time of 1.8±0.6 days, and postoperative hospital stay of 4.2±2.2 days. In contrast, the OUU group had a mean surgery duration of 181.6±37.8 min, drainage tube removal time of 2.3±0.7 days, intraoperative blood loss of 6.4±4.06 mL, and postoperative hospital stay of 5.8±1.8 days. Although the LUU group had a shorter surgical duration, the difference was not statistically significant. However, intraoperative blood loss, drainage tube removal time, and postoperative hospital stay were significantly reduced in the LUU group, with statistical significance (P<0.05). After surgery, one case of urinary tract infection occurred in each group. Both groups had double-J stents placed postoperatively, which were removed cystoscopically 4-6 weeks later. Preoperative examinations showed no significant differences between the LUU and OUU groups in terms of upper renal pelvis anteroposterior diameter, upper renal ureteral diameter, and upper renal parenchymal thickness. However, in terms of postoperative recovery indicators, the LUU group outperformed the OUU group significantly, including upper renal pelvis anteroposterior diameter, upper renal ureteral diameter, and upper renal parenchymal thickness, with statistical significance (P<0.05). No hydronephrosis or worsening hydronephrosis was observed in the lower kidneys and ureters of the 30 patients postoperatively. Symptoms disappeared in patients with preoperative dribbling, and pain symptoms in the waist and abdomen relieved. No postoperative febrile urinary tract infections were observed. Conclusions: UU is an effective and safe method for treating pediatric completely duplicated kidneys. Compared to open surgery, laparoscopic surgery is associated with less trauma, faster postoperative recovery, and superior postoperative recovery of anatomical parameters (anteroposterior diameter, ureteral diameter, and parenchymal thickness) of the upper kidneys.

Efficacy Analysis of Pneumocystoscopic Cohen Surgery for Lower Ureteral Lesions in Children.

Objective: This study aims to evaluate the clinical effects, safety, and recovery associated with minimally invasive pneumocystoscopic ureterovesical reimplantation (Cohen) compared to open surgery for treating lower ureteral lesions in children. Methods: The data of 60 sick children with lower ureteral lesions were retrospectively analyzed, who underwent ureterovesical reimplantation in our hospital from January 2017 to June 2022. All of them went through a Cohen procedure. Sixty children were divided into two groups according to surgical approaches: open surgery group (n=30) and pneumocystoscopic group (n=30). There were 26 boys and 4 girls in the open surgery group, aged from 3 months and 7 days old to 8 years and 5 months old, with 18 cases of lower ureteral stenosis and 12 cases of ureteral reflux, while there were 20 boys and 10 girls in the pneumocystoscopic group, aged from 7 months and 2 days old to 10 years and 9 months old, with 18 cases of lower ureteral stenosis and 12 cases of ureteral reflux. We retrospectively analyzed data from 60 children, comparing outcomes such as intraoperative complications, postoperative recovery, and long-term efficacy between open surgery and pneumocystoscopic approaches. Results: The pneumocystoscopic group exhibited smaller surgical incisions, reduced intraoperative bleeding, and shorter hospital stays compared to the open surgery group, although the operation duration was longer. Both groups showed similar postoperative ureter diameters and long-term recovery, with minimal occurrences of ureteral reflux relapse. Conclusion: Pneumocystoscopic ureterovesical reimplantation (Cohen) demonstrated safety, efficacy, minimal invasiveness, and faster recovery in treating lower ureteral lesions in children, with aesthetic benefits and fewer complications, making it a promising approach for pediatric urological surgeries.

Chicken gasdermins mediate pyroptosis after the cleavage by caspases.

Gasdermin (GSDM) proteins are executioners of pyroptosis in many species. Gasdermin proteins can be cleaved at their linker region between the amino domain (NT) and carboxyl domain (CT) by enzymes. The released GSDM-NTs bind cell membrane and form pores, thereby leading to the release of cellular components and lytic cell death. GSDM-mediated pyroptosis is considered to play important role in immune responses. However, little is known about the GSDM proteins and GSDM-mediated pyroptosis in birds. In the current study, genes encoding chicken gasdermin A (chGSDMA) and chGSDME were cloned. The cleavage of chGSDMA and chGSDME by chicken caspase-1 (chCASP1), chCASP3 and chCASP7 and the cleavage sites were determined. The chGSDMA-NT obtained form chCASP1-mediated cleavage and chGSDME-NT obtained from chCASP3/chCASP7-mediated cleavage could bind and damage cell membrane and lead to cell death of HEK293 cells. chGSDMA-NT also strongly localized to and formed puncta in nucleus. Besides, both chGSDMA-NT and chGSDME-NT showed growth inhibition and bactericidal activity to bacteria. In chickens challenged with Pasteurella multocida and Salmonella typhimurium, the expression of chGSDMA and chGSDME was upregulated and the activation of chCASP3 and the cleavage of chGSDME were observed. The work provides essential information for expanding our knowledge on pyroptosis in birds.

Host miR-146a-3p Facilitates Replication of Infectious Hematopoietic Necrosis Virus by Targeting WNT3a and CCND1.

Infectious hematopoietic necrosis virus (IHNV) is a serious pathogen that causes great economic loss to the salmon and trout industry. Previous studies showed that IHNV alters the expression patterns of splenic microRNAs (miRNAs) in rainbow trout. Among the differentially expressed miRNAs, miRNA146a-3p was upregulated by IHNV. However, it is unclear how IHNV utilizes miRNA146a-3p to escape the immune response or promote viral replication. The present study suggested that one multiplicity of infection (MOI) of IHNV induced the most significant miR-146a-3p expression at 1 day post infection (dpi). The upregulation of miR-146a-3p by IHNV was due to viral N, P, M, and G proteins and relied on the interferon (IFN) signaling pathway. Further investigation revealed that Wingless-type MMTV integration site family 3a (WNT3a) and G1/S-specific cyclin-D1-like (CCND1) are the target genes of miRNA-146a-3p. The regulation of IHNV infection by miRNA-146a-3p is dependent on WNT3a and CCND1. MiRNA-146a-3p was required for the downregulation of WNT3a and CCND1 by IHNV. Moreover, we also found that WNT3a and CCND1 are novel proteins that induce the type-I IFN response in RTG-2 cells, and both of them could inhibit the replication of IHNV. Therefore, IHNV-induced upregulation of miRNA-146a-3p promotes early viral replication by suppressing the type-I IFN response by targeting WNT3a and CCND1. This work not only reveals the molecular mechanism of miRNA-146a-3p during IHNV infection but also provides new antiviral targets for IHNV.

Microwave pretreatment effects on the aroma precursors, sensory characteristics and flavor profiles of fragrant rapeseed oil.

Microwave technology offers a rapid and uniform heating method. This study investigated how microwave pretreatment affects the aroma precursors and flavor of fragrant rapeseed oils (FROs). Microwave pretreatment led to decreased levels of polyunsaturated fatty acids, sugars, protein-bound amino acids, and glucosinolates. Using gas chromatography-mass spectrometry, we identified 66 volatile compounds in the oil samples. Among these, based on odor activity values (OAV ≥ 1), we found 9 aldehydes, 1 ketone, 6 pyrazines, 1 isothiocyanate, and 7 nitriles as the key aroma-active compounds, contributing fatty-like, nutty-like, and pungent-like odors, respectively. The electronic nose results highlighted W5S and W1W as primary sensors for determining the flavor profiles of FROs. Notably, aroma-active pyrazines exhibited strong negative correlations with sucrose, cysteine, lysine, and isoleucine. This research provides essential insights for enhancing the aroma of FROs.

All-optical neuromorphic XOR and XNOR operation utilizing a photonic spiking neuron based on a passive add-drop microring resonator.

We propose a concise hardware architecture supporting efficient exclusive OR (XOR) and exclusive NOR (XNOR) operations, by employing a single photonic spiking neuron based on a passive add-drop microring resonator (ADMRR). The threshold mechanism and inhibitory dynamics of the ADMRR-based spiking neuron are numerically discussed on the basis of the coupled mode theory. It is shown that a precise XOR operation in the ADMRR-based spiking neuron can be implemented by adjusting temporal differences within the inhibitory window. Additionally, within the same framework, the XNOR function can also be carried out by accumulating the input power over time to trigger an excitatory behavior. This work presents a novel, to the best of our knowledge, and pragmatic technique for optical neuromorphic computing and information processing utilizing passive devices.

Management of pediatric vanishing testes syndrome based on pathological diagnosis: a single-center retrospective study.

This study aims to explore the optimal management strategy for pediatric vanishing testes syndrome (VTS) based on pathological characteristics. We retrospectively analyzed clinical data and pathological results of children with unilateral VTS who underwent surgical treatment at our center from July 2012 to July 2023. The children were categorized into the testicular excision group and testicular preservation group based on the surgical approach. Clinical characteristics and outcomes were compared between the two groups. Pathological examination results of excised testicular tissues were collected and analyzed, and long-term follow-up was conducted. A total of 368 children were included in this study. The age of the children at the time of surgery was 27 months (range, 6-156). Among them, 267 cases (72.6%) had VTS on the left side, and 101 cases (27.4%) on the right side. There were no statistically significant differences (P > 0.05) in age, affected side, contralateral testicular hypertrophy (CTH), testicular location, and preferred surgical incision between the testicular excision group (n = 336) and the testicular preservation group (n = 32). In the preservation group, two children experienced scrotal incision infections, showing a statistically significant difference compared to the excision group (P < 0.05). Pathological examination of excised tissues revealed fibrosis as the most common finding (79.5%), followed by vas deferens involvement (67%), epididymis involvement (40.5%), calcification (38.4%), and hemosiderin deposition (17.9%). Seminiferous tubules (SNT) was present in 24 cases (7.1%), germ cells (GC)in 15 cases (4.5%), and ectopic adrenal cortical tissue(EACT) in 1 case (0.3%). VTS belongs to a type of non-palpable testes (NPT) and requires surgical exploration. Considering the risk of scrotal incision infection after preserving atrophic testicular remnants and the unpredictable malignant potential, we recommend excision.

Diagnosis and treatment strategies for pediatric urogenital tract foreign bodies: A retrospective study.

BACKGROUND: Foreign bodies in the pediatric urogenital tract are rare but urgent clinical conditions that can cause severe symptoms and complications. The current management remains challenging. OBJECTIVE: This study aims to provide an in-depth understanding of the clinical characteristics, diagnostic challenges, and treatment strategies for pediatric urogenital tract foreign bodies. Through a retrospective analysis of patient data, valuable insights into the management of this condition are offered to facilitate the development of more effective management strategies. METHODS: A single-center retrospective study design was employed, reviewing clinical data of 30 pediatric patients with urogenital tract foreign bodies admitted to Anhui Children's Hospital from October 2016 to May 2023. This included 16 cases of urethral and bladder foreign bodies and 14 cases of vaginal foreign bodies. Among them, there were 14 males and 16 females, with a median age of 6.3 years. Treatment methods included transvaginal endoscopic removal, cystoscopic removal, pneumovesicum laparoscopy removal, and perineal incisional foreign body removal. Surgical time, blood loss, hospitalization days, and postoperative follow-up results were recorded. RESULTS: Key clinical presentations included vaginal bleeding, abnormal vaginal discharge, hematuria, dysuria, urinary retention, and perineal pain. Preoperative routine examinations included ultrasound, abdominal radiography, and, in some cases, CT scans. All 30 patients underwent successful surgery, with a median surgical time of 30.5 min (IQR 16.8-50.8), minimal intraoperative bleeding, and a median postoperative hospital stay of 2 days (IQR 2-3). Follow-up from 3 months to 1 year revealed no abnormalities in the urogenital system, no residual foreign bodies, and no occurrence of severe complications. No cases of recurrent foreign body insertion were observed. CONCLUSION: Early diagnosis and treatment of pediatric urogenital tract foreign bodies are crucial to reduce patient suffering and the risk of complications. The choice of surgical method depends on the type, size, and location of the foreign body, with endoscopy being the preferred option. Laparoscopic cystoscopy and open surgery are also effective treatment modalities.

Analysis of the Therapeutic Efficacy of Laparoscopic Treatment for Fibroepithelial Polyps of the Ureter in Children.

Objective: The aim of this study is to assess the efficacy and safety of laparoscopic surgery in the treatment of pediatric ureteral fibroepithelial polyp (FEP) patients. Our hypothesis is that laparoscopic surgery can effectively treat FEPs while minimizing patient discomfort and complications. Our research aims to evaluate the clinical outcomes of the surgery, including postoperative symptom relief, improvement in kidney function, and risk of postoperative complications. Methods: The clinical records of 34 patients who underwent ureteral polyp surgery at the Department of Urology at Anhui Provincial Children's Hospital between May 2014 and February 2023 were retrospectively analyzed. All patients underwent laparoscopic surgery. Among the 34 pediatric patients, there were 31 males and 3 females, with 2 on the right side and 32 on the left side. Of these cases, 24 polyps were located at the ureteropelvic junction, while seven were found in the upper segment of the ureter and three in its middle segment. Patients' ages ranged from 4 years and 3 months to 15 years, with a median age of 8 years and 6 months. All children presented with varying degrees of hydronephrosis, and preoperative clinical symptoms included ipsilateral flank or abdominal pain, hematuria, and other discomfort. Preoperative examinations mainly comprised ultrasound, intravenous pyelography, CT, or magnetic resonance urography imaging studies, as well as diuretic renography. All pediatric patients underwent laparoscopic excision of the polyp segment of the ureter, followed by renal pelvis ureteroplasty or ureter-to-ureter anastomosis. Results: All patients underwent surgery without conversion to open surgery. The surgical duration ranged from 72 to 313 minutes, with an average of 179.5 minutes. The average intraoperative blood loss was 14 mL. Postoperatively, one patient experienced leakage at the anastomotic site; however, no other significant complications occurred during or after the procedure. Postoperative histopathology confirmed the presence of FEPs in the ureter for all cases. All patients experienced a favorable postoperative recovery, with hospitalization periods ranging from 3 to 16 days and an average stay of 8.6 days. A Double-J stent was inserted in all patients for a duration of 1 to 2 months after surgery, and upon removal, follow-up color Doppler ultrasound revealed reduced hydronephrosis within 1 to 3 months. Follow-up examinations were conducted at intervals ranging from 3 to 108 months postsurgery, with an average follow-up time of 42.2 months, during which no recurrence of ureteral polyps or symptoms such as pain and hematuria was observed. Conclusions: The findings of this study demonstrate that laparoscopic excision of the polyp segment of the ureter, renal pelvis ureteroplasty, and ureter-to-ureter anastomosis represent safe and effective treatment modalities for pediatric FEPs in the ureters. This technique offers several advantages, including minimal invasiveness, rapid recovery, and definitive therapeutic efficacy, which effectively alleviate clinical symptoms and improve hydronephrosis.

Laparoscopic-Assisted Scrotal Approach for the Treatment of Inguinal Cryptorchidism with Patent Processus Vaginalis: Clinical Efficacy Analysis.

Objective: This study aimed to compare the clinical outcomes of two surgical approaches, laparoscopic-assisted scrotal incision and conventional inguinal-scrotal incision, for treating cryptorchidism with unobliterated processus vaginalis. Methods: Clinical data from 60 pediatric patients with inguinal cryptorchidism who were admitted to our institution between January 2018 and January 2022 were retrospectively analyzed. Depending on the surgical technique used, the patients were split into two groups: the laparoscopic group (n = 30) underwent a laparoscopic-assisted scrotal incision, whereas the conventional group (n = 30) underwent a conventional inguinal-scrotal incision for testicular descent and fixation. The length of the procedure, intraoperative blood loss, and the typical hospital stay following the procedure were compared between the two groups. Also assessed was the frequency of postoperative complications including wound infection and hematoma development. Results: The laparoscopic group demonstrated a notably shortened average surgical duration compared with the traditional group, and this discrepancy held statistical significance (P = .017). Moreover, the laparoscopic approach resulted in a reduced volume of intraoperative blood loss, with a statistically significant distinction (P = .002), along with a decreased average length of hospital stay after surgery, also statistically significant (P = .009). Testicular retraction, atrophy, inguinal hernias, or hydrocele were not present in any group. Although the difference between the laparoscopic and open groups was not statistically significant (P > .05), the laparoscopic group saw a reduced frequency of scrotal hematoma. The frequency of wound infection was also decreased in the laparoscopic group compared with the open group, although there was no statistically significant difference (P > .05). Conclusion: The laparoscopic-assisted scrotal incision approach for testicular descent and fixation offers precise localization of cryptorchidism, reduced surgical trauma, shorter postoperative recovery time, and results in smaller scars with minimal tissue damage. The procedure showcases enhanced overall clinical effectiveness, fewer postoperative complications, heightened safety, and superior cosmetic outcomes.

NRTPredictor: identifying rice root cell state in single-cell RNA-seq via ensemble learning.

BACKGROUND: Single-cell RNA sequencing (scRNA-seq) measurements of gene expression show great promise for studying the cellular heterogeneity of rice roots. How precisely annotating cell identity is a major unresolved problem in plant scRNA-seq analysis due to the inherent high dimensionality and sparsity. RESULTS: To address this challenge, we present NRTPredictor, an ensemble-learning system, to predict rice root cell stage and mine biomarkers through complete model interpretability. The performance of NRTPredictor was evaluated using a test dataset, with 98.01% accuracy and 95.45% recall. With the power of interpretability provided by NRTPredictor, our model recognizes 110 marker genes partially involved in phenylpropanoid biosynthesis. Expression patterns of rice root could be mapped by the above-mentioned candidate genes, showing the superiority of NRTPredictor. Integrated analysis of scRNA and bulk RNA-seq data revealed aberrant expression of Epidermis cell subpopulations in flooding, Pi, and salt stresses. CONCLUSION: Taken together, our results demonstrate that NRTPredictor is a useful tool for automated prediction of rice root cell stage and provides a valuable resource for deciphering the rice root cellular heterogeneity and the molecular mechanisms of flooding, Pi, and salt stresses. Based on the proposed model, a free webserver has been established, which is available at https://www.cgris.net/nrtp .

Performance-enhanced time-delayed photonic reservoir computing system using a reflective semiconductor optical amplifier.

We propose a time-delayed photonic reservoir computing (RC) architecture utilizing a reflective semiconductor optical amplifier (RSOA) as an active mirror. The performance of the proposed RC structure is investigated by two benchmark tasks, namely the Santa Fe time-series prediction task and the nonlinear channel equalization task. The simulation results show that both the prediction and equalization performance of the proposed system are significantly improved with the contribution of RSOA, with respect to the traditional RC system using a mirror. By increasing the drive current of the RSOA, the greater nonlinearity of the RSOA gain saturation is achieved, as such the prediction and equalization performance are enhanced. It is also shown that the proposed RC architecture shows a wider consistency interval and superior robustness than the traditional RC structure for most of the measured parameters such as coupling strength, injection strength, and frequency detuning. This work provides a performance-enhanced time-delayed RC structure by making use of the nonlinear transformation of the RSOA feedback.