Extramammary Paget's Disease of the scrotal and penile: A case report and review of the literature.

INTRODUCTION: Extramammary Paget's Disease of the scrotum and penis is a relatively rare cutaneous malignant tumor. At present, its pathogenesis, clinical and pathological characteristics are not very clear. There is controversial regarding surgical margin width to decrease the high recurrence rate. This paper aims to report the case and review the literature of Extramammary Paget's Disease of scrotum and penis. CASE PRESENTATION: We presented the case of a 74-year-old male patient with the patchy erythema and pruritus in the perineum who was admitted to our department. Biopsy of the large plaque revealed Paget disease. Under the condition of ensuring negative surgical margins by rapid frozen pathology, a wide local excision of the lesion, bilateral orchiectomy and adnexectomy were performed on the patient. Pathology revealed that many scattered vacuolated Paget cells were observed in the epidermal layer, and the diagnosis was Paget's disease of the scrotum and penis. The 2cm outside the skin lesion was used as the initial surgical margin and free skin flap transplantation was used to repair the surgical wound. The patient recovered well and was discharged one week after surgery. CONCLUSION: Currently, histopathologic biopsy is the most important diagnostic method for EMPD. Once confirmed, for patients eligible for surgical intervention, wide local excision of the lesion and rapid intraoperative frozen pathological examination should be performed as soon as possible. The skin flap transplantation is the first choice for the repair of large-scale wound after surgery.

Machine learning assisted biosensing technology: An emerging powerful tool for improving the intelligence of food safety detection.

Recently, the application of biosensors in food safety assessment has gained considerable research attention. Nevertheless, the evaluation of biosensors' sensitivity, accuracy, and efficiency is still ongoing. The advent of machine learning has enhanced the application of biosensors in food security assessment, yielding improved results. Machine learning has been preliminarily applied in combination with different biosensors in food safety assessment, with positive results. This review offers a comprehensive summary of the diverse machine learning methods employed in biosensors for food safety. Initially, the primary machine learning methods were outlined, and the integrated application of biosensors and machine learning in food safety was thoroughly examined. Lastly, the challenges and limitations of machine learning and biosensors in the realm of food safety were underscored, and potential solutions were explored. The review's findings demonstrated that algorithms grounded in machine learning can aid in the early detection of food safety issues. Furthermore, preliminary research suggests that biosensors could be optimized through machine learning for real-time, multifaceted analyses of food safety variables and their interactions. The potential of machine learning and biosensors in real-time monitoring of food quality has been discussed.

Programmable DNA tweezers-SDA for ultra-sensitive signal amplification fluorescence sensing strategy.

BACKGROUND: DNA tweezers, classified as DNA nanomachines, have gained prominence as multifunctional biosensors due to their advantages, including a straightforward structure, response mechanism, and high programmability. While the DNA tweezers demonstrate simultaneous, rapid, and stable responses to different targets, their detection sensitivity requires enhancement. Some small molecules, such as mycotoxins, often require more sensitive detection due to their extremely high toxicity. Therefore, more effective signal amplification strategies are needed to further enhance the sensitivity of DNA tweezers in biosensing. RESULTS: We designed programmable DNA tweezers that detect small-molecule mycotoxins and miRNAs through simple sequence substitution. While the DNA tweezers demonstrate simultaneous, rapid, and stable responses to different targets, their detection sensitivity requires enhancement. We introduced the Strand Displacement Amplification (SDA) technique to address this limitation, proposing a strategy of novel programmable DNA tweezers-SDA ultrasensitive signal amplification fluorescence sensing. We specifically investigate the effectiveness of this approach concerning signal amplification for two critical mycotoxins: aflatoxin B1 (AFB1) and zearalenone (ZEN). Results indicate that the detection ranges of AFB1 and ZEN via this strategy were 1-10,000 pg mL -1 and 10-100,000 pg mL -1, respectively, with corresponding detection limits of 0.933 pg mL -1 and 1.07 pg mL -1. Compared with the DNA tweezers direct detection method for mycotoxins, the newly constructed programmable DNA tweezers-SDA fluorescence sensing strategy achieved a remarkable 104-fold increase in the detection sensitivity for AFB1 and ZEN. SIGNIFICANCE: The constructed programmable DNA tweezers-SDA ultrasensitive signal-amplified fluorescence sensing strategy exhibits excellent detection performance for mycotoxins. The superb versatility of this strategy allows the developed method to be easily used for detecting other analytes by simply replacing the aptamer and cDNA, which has incredible potential in various fields such as food safety screening, clinical diagnostics, and environmental analysis.

MOF-on-MOF heterostructure boosting AIE sensing and triggered structural collapse for histamine detection.

We explored a novel preparation method for MOF-on-MOF heterostructured material (Zn-BTEC@ZIF-8). This prepared heterostructured material acts as a container, capable of adsorbing tetracycline hydrochloride molecules into its backbone through hydrogen bonding and π-π interactions. This phenomenon triggers an aggregation induced emission (AIE) effect, leading to the formation of luminescent bodies. The coordination between histamine and MOF was found to collapse the originally stabilized MOF-on-MOF structure. This collapse causes the splitting of the initially stabilized MOF-on-MOF structure from the aggregated state into fragments, resulting in the quenching of fluorescence in the fluorophore. Remarkably, the fluorescence quenching efficiency of this composite surpasses that of single-layer metal-organic framework (MOF) zeolitic imidazolate framework-8 (ZIF-8) or zinc-based MOF of pyromellitic acid (Zn-BTEC), enabling more sensitive detection of histamine. In this investigation, we constructed a label-free fluorescent sensor specifically designed for the detection of histamine, capitalizing on the AIE effect inherent in MOF-on-MOF architecture and the presence of tetracycline hydrochloride (Tet). The sensor demonstrates a rapid, straightforward, and stable response, allowing for histamine detection within 20 min. Notably, the sensor covers a detection range of 2-400 mg L-1, achieving a low detection limit of 1.458 mg L-1 The practical application of this sensor for quantitative detection of histamine in river water and various fish species exhibited robust performance, ensuring reliability and accuracy in real samples. Its potential application in food safety and environmental monitoring is evident, making it a valuable tool for addressing histamine-related challenges in these domains.

Transvaginal prolapsed submucosal leiomyoma after cesarean section misdiagnosed as bladder prolapse: A case report with literature review.

Uterine leiomyomas, also known as uterine fibroids, are the most common benign tumors found in the female reproductive system. Transvaginal prolapsed submucosal leiomyomas are a rare complication of uterine fibroids during the postpartum period. Due to the lack of sufficient published evidence on these rare complications and their uncommon appearance, they often result in diagnostic and treatment difficulties for clinicians. This case report presents a primigravida with no special prenatal examination developed recurrent high fever and bacteremia following an emergency cesarean section. On the 20th day after delivery, a vaginal prolapsed mass was observed, which was initially misdiagnosed as bladder prolapse before being corrected to a diagnosis of vaginal prolapse of submucosal uterine leiomyoma. This patient was able to retain fertility by prompt use of powerful antibiotics and transvaginal myomectomy rather than undergoing a hysterectomy. For parturient women with hysteromyoma and recurrent fever after delivery where the source of infection cannot be found, the infection of the submucous leiomyoma of the uterus should be highly suspected. It can be helpful to perform an imaging examination to diagnose a disease, and transvaginal myomectomy should be the first choice for treating prolapsed leiomyoma in cases with no obvious blood supply or if pedicle can be achieved.

Clinical efficacy of flap transfer coverage in the treatment of vesicovaginal fistula.

INTRODUCTION AND HYPOTHESIS: Vesicovaginal fistula (VVF) brings severe psychological, physiological, and social stress to patients, which seriously affects the quality of their sexual life. Traditional transvaginal repair surgery can cause vaginal shortening. Transferring the lateral free flap can maintain vaginal length. This study was carried out to investigate the clinical efficacy of the surgery of flap transfer coverage for treating VVF. METHODS: A retrospective analysis was performed on 37 patients diagnosed with VVF and repaired by flap transfer coverage in the Urogynecology department of the First Affiliated Hospital of Kunming Medical University from January 2018 to June 2021. All patients took a prone split leg position to repair VVF with the flap transfer covering method and a chart review was performed. RESULTS: Among the 37 patients, there were 34 cases of primary complete healing, and the success rate reached 91.89% without recurrence and complications. Three cases recurred with leakage of urine; cystoscopy showed that the fistula was significantly reduced, and all patients were cured after secondary repair by the same surgical method without complications. CONCLUSIONS: Flap transfer coverage is a safe and effective surgical method for repairing VVF. The prone split leg position can better increase exposure. The fistula being away from the incision suture is the key to the success of the operation. Transferring the fistula can effectively improve the cure rate of VVF. Transferring the lateral free flap can maintain vaginal length.

A Comparative Study on the Clinical Efficacy of Simple Transobturator Midurethal Sling and Posterior Pelvic Floor Reconstruction.

Background and Objectives: The purpose of this study was to compare the complications, success rate and satisfaction of pelvic floor reconstruction after transobturator midurethral sling (TOT) and TOT combined with pelvic floor reconstruction in the treatment of female stress urinary incontinence. To explore the pathogenesis of stress urinary incontinence after pelvic floor stress injury and improve the surgical treatment strategy. Materials and Methods: From 15 August 2018 to 24 February 2022, patients diagnosed with stress urinary incontinence (SUI) and secondary prolapse of the anterior pelvis were selected to receive surgically. Participants were followed up and evaluated at 2 months, 6 months and 1 year after treatment. According to the patient's chief complaint, the patient can urinate automatically without incontinence. The number of urinary incontinence and urine leakage was significantly reduced compared with those before operation. Urinary incontinence symptoms did not improve or worsen as ineffective, observing the efficacy and complications. Results: We included 191 patients in the TOT group and 151 patients in the pelvic floor reconstruction group after TOT was combined. The operation time and hospital stay in the TOT group were short, but the TOT group needed a second operation to treat recurrent SUI. Perioperative complications were mostly dysuria, and the incidence of postoperative complications in the group of TOT combined with pelvic floor reconstruction was low. The complete success rate and effective rate of pelvic floor reconstruction after TOT in the merger group were significantly higher than those in the TOT group, and the patient satisfaction and complete success rate were also higher. Conclusions: TOT combined with posterior pelvic floor reconstruction has a definite short-term effect on patients with SUI and anterior pelvic secondary prolapse. The operation design should pay attention to the support of the posterior wall of the perineum to the bladder neck and the middle and proximal end of the urethra.

Comparison of the Axes and Positions of the Uterus and Vagina Between Women With and Without Pelvic Floor Organ Prolapse.

PURPOSE: To analyze the role of the axial positions of the uterus and vagina in providing pelvic floor support, encourage evaluations of pelvic floor function, and improve the understanding of the pathogenesis of pelvic organ prolapse. METHODS: The lengths and angles of the upper, middle, and lower axes of the vagina, uterine body, and cervix of 81 women with prolapse (prolapse group) and 57 women without prolapse (non-prolapse group) were measured and compared using magnetic resonance images. The pelvic inclination correction system (PICS) line was also compared between the groups. The coordinate parameters of the anatomical points of the uterus and vagina were measured, and their positions were analyzed. RESULTS: In the prolapse group, the uterine body-cervical angle, cervical-upper vaginal angle, uterine body-PICS line angle, cervical-PICS line angle, and lower vaginal-PICS line angle were smaller (p < 0.05) and the middle-lower vaginal angle, upper vaginal-PICS line angle, and middle vaginal-PICS line angles were larger (p < 0.05) than those in the non-prolapse group. The cervical length was longer (p < 0.05) and the middle and lower vaginal lengths were shorter (p < 0.05) in the prolapse group. The coordinate system revealed that the uterine and vaginal axes were shifted backward and downward in the prolapse group. CONCLUSION: Patients in the prolapse group were more likely to have retroversion and retroflexion of the uterus than those in the non-prolapse group. The vagina was shortened, turned forward, and straightened, and the uterus and vagina were shifted backward and downward in the prolapse group. Changes in the axial position of the uterus and vagina are important mechanisms of pelvic floor organ prolapse.

The Anatomical Pathogenesis of Stress Urinary Incontinence in Women.

Stress urinary incontinence is a common disease in middle-aged and elderly women, which seriously affects the physical and mental health of the patients. For this reason, researchers have carried out a large number of studies on stress urinary incontinence. At present, it is believed that the pathogenesis of the disease is mainly due to changes related to age, childbirth, obesity, constipation and other risk factors that induce changes in the urinary control anatomy, including the anatomical factors of the urethra itself, the anatomical factors around the urethra and the anatomical factors of the pelvic nerve. The combined actions of a variety of factors lead to the occurrence of stress urinary incontinence. This review aims to summarize the anatomical pathogenesis of stress urinary incontinence from the above three perspectives.