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1.
Food Chem ; 370: 131276, 2022 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-34662790

RESUMO

This study presented an effective and sensitive SERS substrate for rapid detection of thiabendazole (TBZ) in fruit samples. A core-shell gold/silver nanorod (Au@Ag NRs) has been synthesized as a bimetallic SERS-active substrate. The obtained substrate showed an excellent SERS effect because of the tunable plasmon resonance of Au NRs, the significantly enhanced effect of silver, and the bimetallic synergistic effect of Au@Ag NRs. Under optimal conditions, the substrate was used to detect TBZ in fresh apple juice and peach juice with limits of detection of 0.032 and 0.034 ppm respectively. In addition, the recovery rate was within a satisfactory range of 95-101%, indicating that the Au@Ag NRs substrate could be a SERS detection platform for fruit pesticides residues with great development potential.


Assuntos
Nanopartículas Metálicas , Nanotubos , Sucos de Frutas e Vegetais , Ouro , Análise Espectral Raman , Tiabendazol/análise
2.
Transl Androl Urol ; 10(10): 3705-3713, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34804814

RESUMO

Background: To describe our initial experience with robotic ureteral reimplantation for the management of ureterovaginal fistulas. Methods: Between January 2018 and January 2020, four patients received robotic ureteral reimplantation for ureterovaginal fistulas. All patients were diagnosed based on anterograde urography and computed tomography urography (CTU). Follow-up was performed with magnetic resonance urography and renal ultrasound as well as the clinical assessment of symptoms. Results: The mean age of all patients was 50.3 (range, 37-65) years. The cause of the ureterovaginal fistula in four patients was due to a previous hysterectomy. The mean time from fistula diagnosis to robotic repair surgery was 14.5 (range, 3-36) months. All robotic procedures were successfully performed without intraoperative complications or open conversion. The mean operative time was 137 (range, 116-171) minutes, and the mean estimated blood loss was 25 (range, 10-50) mL. No postoperative complications that were high grade (grade III and IV) occurred within one month of surgery. Patients had the double-J (D-J) stents removed 2 months after surgery and the nephrostomy tubes removed 3 months after the operation. There was a 100% success rate without serious complications, such as the leakage of urine and side progressive hydronephrosis, during the 6 to 24 months of follow-up. Conclusions: Our initial results and experience showed that robotic ureteral reimplantation for the management of ureterovaginal fistula is safe and feasible.

3.
Transl Androl Urol ; 10(10): 3737-3744, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34804817

RESUMO

Background: To analyze the safety and clinical significance of performing ureteroscopy after ureteral reconstruction with autologous onlay/graft. To describe the ureteroscopic appearances of the appendiceal onlay flap and lingual mucosa graft. Methods: Beginning in August 2018, we conducted a prospective cohort study of autologous onlay/graft techniques to repair ureteral strictures. The perioperative data of 42 patients who had undergone surgery more than 6 months prior were collected prospectively. During the postoperative follow-up, ureteroscopy was performed in 27 patients (64.3%) after surgery (group A), and ureteroscopy was not performed in the other 15 patients (35.7%) (group B). We carried out a comparative study of these two groups of patients. Analyses were conducted mainly on complications related to ureteroscopy and the success rate of ureteral reconstruction surgery. Results: There were no significant differences in patient demographic data or the length of ureteral reconstruction between the two groups (P>0.05). For the ureteroscopy group, the median time from repair surgery to ureteroscopy was 3 (range, 2-7) months, there was no poor healing of the anastomosis, and the ureteral lumen of all patients was unobstructed. Some expected observations can be found in the ureteral lumen, such as mucosa edema, stones, follicles and granulation tissue. Among the 27 patients, one patient (3.7%) developed bleeding intraoperatively and 7 patients (25.9%) were found to have low-grade (Clavien-Dindo I and II) postoperative complications, including 5 cases of fever and 2 cases of bleeding. The mean follow-up times of patients in group A and group B were 16.7±6.4 and 19.0±10.1 months, respectively. The objective success (imaging showed hydronephrosis ease) rate of the two groups was 100%. The subjective success (symptom relief) rates of group A and group B were 96.3% and 100%, respectively. Conclusions: Patients after autologous onlay flap/graft ureteroplasty do not need to undergo routine ureteroscopy unless there is aggravation of hydronephrosis or other indications for ureteroscopy, such as stones.

4.
Transl Androl Urol ; 10(10): 3745-3755, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34804818

RESUMO

Background: To develop an original and standardized ureteral stricture disease (USD) score and classification system for quantifying ureter stricture characteristics, assessing complexity of the minimally invasive upper urinary tract reconstructive (UUTR) surgical procedure, formulating preoperative plans, and offering objective comparisons of surgical techniques between different institutions and surgeons. Methods: We retrospectively reviewed a test set of 64 patients and a validation set of 170 patients who underwent minimally invasive UUTR surgery from January 2018 to January 2021. Three factors were selected to be included in the USD score and classification system: (I) stricture etiology (E, 1-2 points); (II) stricture segment (S, 0-3 points); and (III) length of stricture (L, 1-5 points). The UUTR surgery involves low-complex surgeries (cystoscopy with ureteral dilation and stent placement, ureteropyeloplasty, end to end repair, ureteral reimplantation) and high-complex surgeries (onlay repair (buccal mucosae, lingual mucosae, appendix mucosae), Boari flap repair and ileal ureter replacement). Estimated blood loss and operative time were used as surrogate indicators of surgical complexity. Results: The interrater reliability of the USD score and classification system was 0.908. A linear relationship between the USD score and estimated blood loss was observed (rs =0.676, P<0.001). The USD score was also correlated with operative time (rs =0.638, P<0.001). A significant difference in USD scores was found between the high and low complexity surgery groups (4 vs. 7, P<0.001). Variability of UUTR surgery is based on USD classification system, but with regularity to conform to. Conclusions: The USD score and classification system is a concise, easily applicable, and validated scale to delineate the clinically significant features of ureter stricture that correlate with the complexity of the UUTR surgical procedure. The use of this score and classification system can facilitate preoperative plan and comparison of USD treatments in clinical practice and urological literature. Research with large sample is needed to further examine and modify the use of the system.

5.
Transl Androl Urol ; 10(10): 3891-3898, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34804831

RESUMO

Tuberculous bladder contracture with a bilateral duplicated collecting system is rare. According to anatomic variation, the surgical treatment strategy is highly individualized. We illustrate our robotic technique of urinary tract reconstruction. A 19-year-old girl with a history of pulmonary tuberculosis (TB) as a young child presented with a complaint of increasing frequency of micturition, nocturia, urgency, and urge incontinence starting at the age of 17. Clinical and imaging examinations demonstrated tuberculous contracted bladder with a bilateral duplex collecting system. The patient underwent a robot-assisted Institute of Urology Peking University (IUPU) orthotopic ileal neobladder reconstruction. This is a modified urinary tract reconstructive method, including resection of the end of the duplex ureters and diseased contracted bladder with preservation of the proximal urethra and bladder neck, ileal harvesting and IUPU strategy to reconstruct an ileal neobladder, uretero-ileal anastomosis and neobladder-bladder neck anastomosis. The patient remained symptom-free without recurrence of TB and had improved renal function during the one-year follow-up after surgery. Thus, our robot-assisted IUPU orthotopic ileal neobladder reconstruction method is an effective approach for this benign case. It can effectively increase bladder capacity, reduce intravesical pressure, and improve symptoms such as urination frequency and urgency.

6.
Nat Commun ; 12(1): 6322, 2021 11 03.
Artigo em Inglês | MEDLINE | ID: mdl-34732728

RESUMO

Molecular programs that underlie precursor progression in multiple myeloma are incompletely understood. Here, we report a disease spectrum-spanning, single-cell analysis of the Vκ*MYC myeloma mouse model. Using samples obtained from mice with serologically undetectable disease, we identify malignant cells as early as 30 weeks of age and show that these tumours contain subclonal copy number variations that persist throughout progression. We detect intratumoural heterogeneity driven by transcriptional variability during active disease and show that subclonal expression programs are enriched at different times throughout early disease. We then show how one subclonal program related to GCN2 stress response is progressively activated during progression in myeloma patients. Finally, we use chemical and genetic perturbation of GCN2 in vitro to support this pathway as a therapeutic target in myeloma. These findings therefore present a model of precursor progression in Vκ*MYC mice, nominate an adaptive mechanism important for myeloma survival, and highlight the need for single-cell analyses to understand the biological underpinnings of disease progression.

7.
Int J Med Robot ; : e2352, 2021 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-34773371

RESUMO

BACKGROUND: To present our experiences with partial nephrectomy (PN) through retroperitoneal approach (RP) with the Kangduo robotic system. METHODS: From December 2020 to February 2021, the perioperative data of 11 patients underwent PN through RP with the Kangduo robotic system were collected prospectively. RESULTS: For the R.E.N.A.L. nephrometry score, 72.7% of patients had a low score (4-6) and 27.3% of patients had a medium score (7-9). Seven tumours were posterior (P), four tumours were on the midline (X). All procedures were completed successfully. The median warm ischemia time was 18.5 (IQR, 13.7-21.0) min. None of the patients had positive surgical margins at definitive histology (all pT1a). No high-grade perioperative complications or device-related adverse events occurred. At a mean follow-up of 8 ± 0.8 months, no complications occurred in all patients. CONCLUSIONS: RPPN using the novel Kangduo robotic system is a safe and effective option for managing posterior and lateral renal tumours with R.E.N.A.L. nephrometry scores ≤9.

8.
Gene ; : 146054, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34737001

RESUMO

BACKGROUND: Activation of oncogenes through promoter hypomethylation and silencing of tumor suppressor genes induced by promoter hypermethylation played essential roles in the progression of lung adenocarcinoma (LUAD). This study aimed to identify the LUAD prognostic CpG sites and the regulated genes which contributed to LUAD progression. METHODS: Methylation profiles from TCGA and GSE60645 were used to screen the differentially methylated CpGs. Then, the Log-rank test was adopted to identify LUAD prognosis-associated CpGs. Differential gene expression and survival analyses were further performed to suggest the roles of methylation-driven genes in LUAD prognosis. Finally, models and nomograms were constructed to predict the prognosis of LUAD. RESULTS: A total of 1891 CpGs at gene promoters were differentially methylated. Among them, 54 CpGs were significantly associated with LUAD prognosis. Nine of them showed significant correlations with the expression of four genes (CCDC181, CFTR, PPP1R16B, MYEOV). CCDC181, CFTR and PPP1R16B were aberrantly down-regulated in LUAD, while MYEOV was up-regulated. All of them were significantly associated with LUAD prognosis. The LASSO regression analysis indicated that tumor stages, cg09181792, cg16998150, cg22779330 and PPP1R16B were promising prognostic factors. The AUC (area under the curve) of the model containing the clinical predictors was 0.643. The combination of CpGs and PPP1R16B with clinical variables significantly improved the predictive efficiency with an AUC of 0.714 (P = 0.036). CONCLUSION: This study identified four pairs of promoter CpGs and genes that were significantly associated with LUAD prognosis. The integration of CpGs methylation and gene expression showed better predictive ability for LUAD prognosis.

9.
Zhonghua Yi Xue Yi Chuan Xue Za Zhi ; 38(11): 1140-1144, 2021 Nov 10.
Artigo em Chinês | MEDLINE | ID: mdl-34729761

RESUMO

The overall prevalence of uniparental disomy (UPD) across all chromosomes was estimated to be around one birth in 2000. To date, more than 4170 UPD cases have been registered. UPD for chromosomes 6, 7, 11, 14, 15, and 20 can result in clinically recognizable imprinting disorders due to abnormal levels of imprinted gene expression. For other chromosomes, the clinical consequences associated with UPD are not apparent, unless when a recessive genetic disorder is unmasked by UPD or regions of homozygosity (ROH). A clinical practice guideline will assist in strengthening the precise analysis and interpretation of the clinical significance of ROH/UPD. This guideline summarizes the conception, mechanism and clinical consequences of ROH/UPD, as well as the principles for data analysis, with an aim to standardize the clinical application and data interpretation.


Assuntos
Impressão Genômica , Dissomia Uniparental , Expressão Gênica , Homozigoto , Humanos , Guias de Prática Clínica como Assunto , Dissomia Uniparental/genética
10.
Artigo em Inglês | MEDLINE | ID: mdl-34753704

RESUMO

In the early stage of P deficiency in cucumbers, the P deficiency symptoms in leaves are similar to the symptoms in control leaves at the early stage of aging and are difficult to identify with naked eyes or computer image processing techniques. In order to realize the quick diagnosis of P deficiency in plants at the early stage, the NIR hyperspectral images of control leaves and P-deficient leaves were collected, and the feature information of the NIR hyperspectral images was extracted by PCA and ICA respectively. Through PCA and HCA verification, the IC1 component diagram of P-deficient leaves NIR hyperspectral image could effectively characterize the features of invisible water-stained plaques caused by early P-deficient leaves. Region of interest from IC1 was selected to extract spectral information for classification, and the diagnostic rate was remarkably improved. Finally, 240 leaves were diagnosed by using the BP-ANN model with a diagnostic rate of 97.5%. In addition, the experiment verified that it was possible to diagnose whether the plant was in the state of P deficiency 21 days in advance, and timely guidance of top dressing was of great significance to increase yield.

11.
Transl Pediatr ; 10(10): 2432-2438, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34765466

RESUMO

Background: Neonatal arrhythmia is a common complication that might be life-threatening or serious, but the genetic causes are unclear in most cases. The aim of this study is to investigate the genetic causes of neonatal arrhythmia in a NICU in China. Methods: Newborns who were diagnosed with arrhythmia during the neonatal period were enrolled from Children's Hospital of Fudan University between January 1st 2016, and December 31st, 2019. A neonatal gene panel was performed for each infant. Results: In total, 98 neonatal infants with arrhythmia were enrolled. Fourteen genes and a copy number change were identified and classified as pathogenic/likely pathogenic in 22 patients (22.4%), including 4 genes related to syndrome, 4 related to conduction, 2 related to metabolism, 2 related to structure, 2 related to respiration and immunity, respectively, and trisomy 21. Altogether, 6 genes (6/14, 42.9%) caused original heart structure or conduction abnormalities, leading to arrhythmia. Infants with ventricular tachycardia or fibrillation, atrioventricular block and long-QT syndrome all had positive gene results. The gene positive rate among arrhythmic infants with congenital heart disease or severe heart failure was higher than that of infants without congenital heart disease or severe heart failure. Conclusions: The genetic disorders associated with neonatal arrhythmia could be syndrome-, conduction-, metabolism-, and structure-related. Infants with non-benign arrhythmia, especially ventricular tachycardia or fibrillation, long-QT syndrome, or high-grade atrioventricular block, have a higher rate of genetic abnormalities and should undergo genetic sequencing. Neonates with hereditary arrhythmias may have a higher risk of congenital heart disease or heart failure.

12.
Micromachines (Basel) ; 12(11)2021 Nov 14.
Artigo em Inglês | MEDLINE | ID: mdl-34832811

RESUMO

The radiation fluence of high luminosity LHC (HL-LHC) is predicted up to 1 × 1016 1 MeV neq/cm2 in the ATLAS and CMS experiments for the pixel detectors at the innermost layers. The increased radiation leads to the degradation of the detector properties, such as increased leakage current and full depletion voltage, and reduced signals and charge collection efficiency, which means it is necessary to develop the radiation hard semiconductor devices for very high luminosity colliders. In our previous study about ultra-fast 3D-trench electrode silicon detectors, through induced transient current simulation with different minimum ionizing particle (MIP) hitting positions, the ultra-fast response times ranging from 30 ps to 140 ps were verified. In this work, the full depletion voltage, breakdown voltage, leakage current, capacitance, weighting field and MIP induced transient current (signal) of the detector after radiation at different fluences will be simulated and calculated with professional software, namely the finite-element Technology Computer-Aided Design (TCAD) software frameworks. From analysis of the simulation results, one can predict the performance of the detector in heavy radiation environment. The fabrication of pixel detectors will be carried out in CMOS process platform of IMECAS based on ultra-pure high resistivity (up to 104 ohm·cm) silicon material.

13.
Cancer Lett ; 2021 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-34838826

RESUMO

Tumor-associated macrophages (TAMs) are the major components of the tumor microenvironment that contribute to metastasis in lung adenocarcinoma (LUAD). The potential of TAM-derived exosomes for biomarker discovery in tumor initiation and progression has been recently reported. However, studies on macrophage-derived exosomes in LUAD remain limited. We investigated the role of M2 macrophage-derived exosomes in LUAD both in vivo and in vitro and its underlying mechanism. We showed that the infiltration of M2 macrophages was positively correlated with LUAD metastasis. M2 macrophage-derived exosomes could be taken up by LUAD cells to promote cell migration, invasion, and angiogenesis. Furthermore, miR-942 could be packaged into exosomes secreted by M2 macrophages. Mechanistically, exosomal miR-942 regulates FOXO1 protein expression by binding to the 3'-UTR region of FOXO1 and further alleviates ß-catenin inhibition in LUAD cells. Collectively, we demonstrated that M2 macrophage-derived miRNA-containing exosomes promote LUAD cell invasion and migration and facilitate angiogenesis, thereby providing a new therapeutic target for metastatic LUAD.

14.
Zhonghua Yi Xue Yi Chuan Xue Za Zhi ; 38(11): 1140-1144, 2021 Nov 10.
Artigo em Chinês | MEDLINE | ID: mdl-34839523

RESUMO

The overall prevalence of uniparental disomy (UPD) across all chromosomes was estimated to be around one birth in 2000. To date, more than 4170 UPD cases have been registered. UPD for chromosomes 6, 7, 11, 14, 15, and 20 can result in clinically recognizable imprinting disorders due to abnormal levels of imprinted gene expression. For other chromosomes, the clinical consequences associated with UPD are not apparent, unless when a recessive genetic disorder is unmasked by UPD or regions of homozygosity (ROH). A clinical practice guideline will assist in strengthening the precise analysis and interpretation of the clinical significance of ROH/UPD. This guideline summarizes the conception, mechanism and clinical consequences of ROH/UPD, as well as the principles for data analysis, with an aim to standardize the clinical application and data interpretation.

15.
Hum Exp Toxicol ; : 9603271211045959, 2021 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-34632857

RESUMO

OBJECTIVE: How to reduce the neurodevelopmental toxicity of decabromodiphenyl ether (PBDE-209) remains unclear. This study investigated neurodevelopmental toxicity of PBDE-209 and the protective effects of insulin-like growth factor-1 (IGF-1). METHODS: Pregnant Sprague-Dawley rats were treated with PBDE-209 and IGF-1, and the offspring were subjected to the Morris Water Maze test. Hippocampal neurons were cultured with PBDE-209 and IGF-1 or the PI3K inhibitor or MEK inhibitor for cell viability, apoptosis, immunofluorescence, and Western blot assays. RESULTS: Prenatal PBDE-209 exposure impaired the learning and memory ability of rats by delaying the mean latency to the platform compared, whereas prenatal treatment with IGF-1 treatment improved the learning and memory ability. In vitro, treatment of primary cultured hippocampal neural stem cells (H-NSCs) with PBDE-209 reduced cell proliferation and differentiation, but induced apoptosis. In contrast, IGF-1 treatment antagonized the cytotoxic effects of PBDE-209 in H-NSCs in vitro. At the gene level, IGF-1 inhibition of PBDE-209-induced cell cytotoxicity was through the activation of the PI3K/AKT and MEK/ERK signaling pathways in vitro because the effect of IGF-1 was blocked by the AKT inhibitor LY294002 and the ERK1/2 inhibitor PD98059. CONCLUSION: Prenatal PBDE-209 exposure impaired the learning and memory ability of rats, whereas IGF-1 treatment was able to inhibit the neurodevelopmental toxicity of PBDE-209 by activation of the PI3K/AKT and ERK1/2 cell pathways.

16.
Front Psychol ; 12: 709320, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34690866

RESUMO

This longitudinal study investigated the role of psychological difficulties and self-efficacy in the relationship between family cumulative risk and hope among children from low-income families. The participants were 392 Chinese children from low-income families; the study extended for 2 years, and participants completed data that were collected with the following questionnaires: the Family Cumulative Risk Index, Children's Hope Scale, Strengths and Difficulties Questionnaire-Difficulties subscale, and General Self-efficacy Scale. The results demonstrated that psychological difficulties played a mediating role in the relationship between family cumulative risk and hope; specifically, family cumulative risk predicted hope of children via psychological difficulties. Self-efficacy moderated the relationship between psychological difficulties and hope. This moderation supported "a drop in the ocean effect"; the protective effect of high self-efficacy worked only when psychological difficulties were at low levels. When psychological difficulties were at high levels, the buffering effect of self-efficacy on family cumulative risk was gradually weakened and eventually lost.

17.
J Cardiothorac Surg ; 16(1): 306, 2021 Oct 18.
Artigo em Inglês | MEDLINE | ID: mdl-34663402

RESUMO

BACKGROUND: For thoracic surgeons, three-dimensional computed tomography bronchography and angiography (3-DCTBA) is a convenient way to analyze pulmonary variations before segmentectomy. Mediastinal lingular artery (MLA) is one of the representative variations. METHODS: The 3-DCTBA data of left upper lobe (LUL) were collected from patients who underwent pulmonary surgery from January 2018 to December 2019. We reviewed the patterns of bronchi and pulmonary vessels and grouped them according to different classifications. RESULTS: Among all the 404 cases of 3-DCTBA, mediastinal lingular artery (MLA) was found in 107 cases (26.49%). The patterns of B3 and the vein in left upper division (LUD) are distinct between mediastinal (M-type) group and interlobar (IL-type) group. The patterns of bronchi and veins in lingular division, as well as the pattern of pulmonary artery in LUD, have no differences between M-type and IL-type groups. CONCLUSIONS: Mediastinal lingular artery is speculated to originate from the variation of B3, and the MLA independently influences the venous pattern in LUD in turn.


Assuntos
Pulmão , Artéria Pulmonar , Brônquios/diagnóstico por imagem , Humanos , Mediastino/diagnóstico por imagem , Artéria Pulmonar/diagnóstico por imagem , Artéria Pulmonar/cirurgia , Tomografia Computadorizada por Raios X
18.
Early Hum Dev ; 163: 105484, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34655917

RESUMO

AIM: To explore whether the General Movement Optimality Score (GMOS) could help to identify asymmetric movement in infants with neonatal arterial ischemic stroke (NAIS) in the early stage. METHOD: Twenty-seven infants with NAIS (16 males, 11 females) were enrolled. The general movement video was recorded approximately one month after birth. The GMOS focused separately on the neck and trunk and the upper and lower extremities. The differences between the ipsilesional and contralesional limbs were analyzed. RESULTS: Eight infants who developed cerebral palsy (CP) had middle cerebral artery (MCA) infarction involving the main branch. By GMOS evaluation, the scores of the contralesional upper and/or lower limbs were lower than those of the ipsilesional side (p < 0.05). In the contralesional limbs, the CP group had a lower GMOS than the non-CP group. Distal rotatory components of the contralesional upper limbs and tremulous movement of the lower limbs showed significant differences. INTERPRETATION: The GMOS could help to quantitatively find and assess the asymmetric movement of global and contralesional limbs. Distal rotatory movement of the upper limbs could be an early sign of abnormal motor function in infants with NAIS.

19.
Polymers (Basel) ; 13(18)2021 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-34577972

RESUMO

The diameter of fibers is a critical factor in determining their final applications. When the diameter of aramid fibers changes from microns to nanoscale, its range of applications will be greatly extended. In this short review, the preparation of aramid nanofibers (ANFs) with diameters from ten nanometers to more than one hundred nanometers is introduced. Due to their excellent mechanical properties and their chemical and thermal stability, ANFs have been widely used as novel nanomaterials and composited with other materials, mainly for use in reinforced composites, energy storage, filtration and adsorption, biomedicine and electromagnetic fields. In this short review, the application of ANFs and their composites during the last 10 years is concisely summarized and a brief perspective on ANFs and their composites is also presented.

20.
Transl Androl Urol ; 10(8): 3226-3238, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34532248

RESUMO

Background: The selection of treatment for bilateral ureteral strictures caused by radiotherapy in patients with gynecological tumors often brings great challenges to urologists. This study was designed to analyze the characteristics of radiation-induced ureteral strictures and summarize the surgical experience of bilateral ileal ureter substitution. Methods: We retrospectively collected the medical records of 18 patients between June 2010 and June 2019 who had a radiation-induced bilateral ureteral strictures. Time interval from radiotherapy to the discovery of ureteral stricture was categorized into short-term (less than 12 months) and long-term (over 12 months) groups. All patients received reverse "7" bilateral ileal ureteral substitution. Surgical success was defined as no restenosis, relief of symptoms, and improved/stabilized hydronephrosis. Results: The patients had been suffered from ureteral stricture for a median of 12 [2-106] months. The mean length of the left and right ureteral stricture was 9.6±2.6 and 8.8±3.2 cm, respectively. The mean length of the ileal graft was 29.1±7.4 cm. The mean operative time was 308.4±70.2 min, and the mean estimated blood loss was 254.7±166.2 mL. The postoperative hospital stays in the short-term group was significantly shorter than that in the long-term group (14.0 vs. 20.6 days, P=0.049). During a median follow-up time of 24.1 (4.5-71.9) months, the success rate was 94.4%. Eight minor complications and two major complications occurred in 7 patients. Conclusions: Bilateral ileal ureter substitution can be an effective strategy for radiation-induced ureteral stricture in patients with gynecological tumors.

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