Modeling the growth of Salmonella in raw ground pork under dynamic conditions of temperature abuse.

Salmonella contamination of pork products is a significant public health concern. Temperature abuse scenarios, such as inadequate refrigeration or prolonged exposure to room temperature, can enhance Salmonella proliferation. This study aimed to develop and validate models for Salmonella growth considering competition with background microbiota in raw ground pork, under isothermal and dynamic conditions of temperature abuse between 10 and 40 °C. The maximum specific growth rate (µmax) and maximum population density (MPD) were estimated to quantitatively describe the growth behavior of Salmonella. To reflect more realistic microbial interactions in Salmonella-contaminated product, our model considered competition with the background microbiota, measured as mesophilic aerobic plate counts (APC). Notably, the µmax of Salmonella in low-fat samples (∼5 %) was significantly higher (p < 0.05) than that in high-fat samples (∼25 %) at 10, 20, and 30 °C. The average doubling time of Salmonella was 26, 4, 2, 1.5, 0.8, and 1.1 h at 10, 15, 20, 25, 30, and 40 °C, respectively. The initial concentration of Salmonella minimally impacted its growth in ground pork at any temperature. The MPD of APC consistently exceeded that of Salmonella, indicating the growth of APC without competition from Salmonella. The competition model exhibited excellent fit with the experimental data, as 95 % (627/660) of residual errors fell within the desired acceptable prediction zone (pAPZ >0.70). The theoretical minimum and optimum growth temperatures for Salmonella ranged from 5 to 6 °C and 35 to 36 °C, respectively. The dynamic model displayed strong predictive performance, with 90 % (57/63) of residual errors falling within the APZ. Dynamic models could be valuable tools for validating and refining simpler static or isothermal models, ultimately improving their predictive capabilities to enhance food safety.

A Biochemical and Biophysical Analysis of the Interaction of nsp9 with nsp12 from SARS-CoV-2-Implications for Future Drug Discovery Efforts.

The ongoing global pandemic of the coronavirus 2019 (COVID-19) disease is caused by the virus SARS-CoV-2, with very few highly effective antiviral treatments currently available. The machinery responsible for the replication and transcription of viral RNA during infection is made up of several important proteins. Two of these are nsp12, the catalytic subunit of the viral polymerase, and nsp9, a cofactor of nsp12 involved in the capping and priming of viral RNA. While several recent studies have determined the structural details of the interaction of nsp9 with nsp12 in the context of RNA capping, very few biochemical or biophysical details are currently available. In this study, we have used a combination of surface plasmon resonance (SPR) experiments, size exclusion chromatography (SEC) experiments, and biochemical assays to identify specific nsp9 residues that are critical for nsp12 binding as well as RNAylation, both of which are essential for the RNA capping process. Our data indicate that nsp9 dimerization is unlikely to play a significant functional role in the virus. We confirm that a set of recently discovered antiviral peptides inhibit nsp9-nsp12 interaction by specifically binding to nsp9; however, we find that these peptides do not impact RNAylation. In summary, our results have important implications for future drug discovery efforts to combat SARS-CoV-2 and any newly emerging coronaviruses.

A Novel Multi-Effect Photosensitizer for Tumor Destruction via Multimodal Imaging Guided Synergistic Cancer Phototherapy.

Background: How to ingeniously design multi-effect photosensitizers (PSs), including multimodal imaging and multi-channel therapy, is of great significance for highly spatiotemporal controllable precise phototherapy of malignant tumors. Methods: Herein, a novel multifunctional zinc(II) phthalocyanine-based planar micromolecule amphiphile (ZnPc 1) was successfully designed and synthesized, in which N atom with photoinduced electron transfer effect was introduced to enhance the near-infrared absorbance and nonradiative heat generation. After simple self-assembling into nanoparticles (NPs), ZnPc 1 NPs would exhibit enhanced multimodal imaging properties including fluorescence (FL) imaging (FLI) /photoacoustic (PA) imaging (PAI) /infrared (IR) thermal imaging, which was further used to guide the combined photodynamic therapy (PDT) and photothermal therapy (PTT). Results: It was that under the self-guidance of the multimodal imaging, ZnPc 1 NPs could precisely pinpoint the tumor from the vertical and horizontal boundaries achieving highly efficient and accurate treatment of cancer. Conclusion: Accordingly, the integration of FL/PA/IR multimodal imaging and PDT/PTT synergistic therapy pathway into one ZnPc 1 could provide a blueprint for the next generation of phototherapy, which offered a new paradigm for the integration of diagnosis and treatment in tumor and a promising prospect for precise cancer therapy.

PISOX Copolyesters-Bio- and CO2-Based Marine-Degradable High-Performance Polyesters.

Oxalate esters and isosorbide serve as intriguing polymer building blocks, as they can be sourced from renewable resources, such as CO2 and glucose, and the resulting polyesters offer outstanding material properties. However, the low reactivity of the secondary hydroxyl groups makes it difficult to generate high-molecular-weight polymers from isosorbide. Combining diaryl oxalates with isosorbide appears to be a promising approach to produce high-molecular-weight isosorbide-based polyoxalates (PISOX). This strategy seems to be scalable, has a short polymerization time (<5 h), and uniquely, there is no need for a catalyst. PISOX demonstrates outstanding thermal, mechanical, and barrier properties; its barrier to oxygen is 35 times better than PLA, it possesses mechanical properties comparable to high-performance thermoplastics, and the glass transition temperature of 167 °C can be modified by comonomer incorporation. What makes this high-performance material truly exceptional is that it decomposes into CO2 and biomass in just a few months in soil under home-composting conditions and it hydrolyzes without enzymes present in less than a year in 20 °C water. This unique combination of properties has the potential to be utilized in a range of applications, such as biomedical uses, water-resistant coatings, compostable plastic bags for gardening and agriculture, and packaging plastics with diminished environmental impact.

La3+@BC500-S2O82- system for removal of sulfonamide antibiotics in water.

Sulfonamide antibiotics (SAs) widely used have potentially negative effects on human beings and ecosystems. Adsorption and advanced oxidation methods have been extensively applied in SAs wastewater treatment. In this study, compared with Al3+@BC500 and Fe3+@BC500, La3+@BC500 for activating persulfate (S2O82-) had the best effect removal performance of sulfadiazine (SDZ) and sulfamethoxazole (SMX). Morphology, acidity, oxygen-containing functional groups, and loading of La3+@BC500 were analyzed by techniques, including EA, BET, XRD, XPS, FT-IR. XRD results show that with the increase of La3+ loading, the surface characteristics of biochar gradually changed from CaCO3 to LaCO3OH. Through EPR technology, it is proved that LaCO3OH on the surface of La3+@BC500 can not only activate S2O82- to generate SO4-•, but also to produce •OH. In the optimization experiment, the optimal dosage of La3+ is between 0.05 and 0.2 (mol/L)/g. SDZ had a good removal effect at pH (5-9), but SMX had a good removal effect only at pH=3. Zeta potential also proves that the material is more stable under acidic conditions. The removal process of SDZ is more in accord with pseudo-first-order kinetics (R2=0.9869), while SMX is more in line with pseudo-second order kinetics (R2=0.9926).

Flow dynamics and turbulent coherent structures around sediment reduction plates of a sewer system.

In the management of urban drainage networks, great interest has been generated in the removal of sediments from sewer systems. The unsteady three-dimensional (3D) flow and turbulent coherent structures surrounding sediment reduction plates in a sewer system are investigated by means of the detached-eddy simulation (DES). Particular emphasis is given to detailing the instantaneous velocity and vorticity fields within the grooves, along with an examination of the three-dimensional, long-term, average flow structure at a Reynolds number of approximately 105. Velocity vectors demonstrate continuous flapping of the flow on the groove wall, periodically interacting with ejections of positive and negative vorticity originating from the grooves. The interaction between the three-dimensional groove flow and the shear flow leads to the downstream transport of patches of positive and negative vorticity, which significantly influence sediment transport. The high-velocity shear flows and strong vortices generated in undulating topography, as identified by the Q-criteria, are the key factors contributing to the efficient sediment reduction capabilities of the sediment reduction plates. The sediment reduction plates with partially enclosed structures exhibit low sedimentation rates in grooves on the plate, a broader acceleration region, and a lesser impact on the flow capacity. The results improve the understanding of the hydrodynamics and turbulent coherent structures surrounding the sediment reduction plates while elucidating the driving factors behind the enhancement of sediment scouring and suspension capacities. These results indicate that the redesign of the plates as partially enclosed structures contributes to further improving their sediment reduction performance.

The effect of combined head and tail approach during laparoscopic D3 lymph node dissection on pain severity and complications in patients with right colon cancer.

OBJECTIVE: To examine the impact of a combined craniocaudal approach on pain and complications during laparoscopic D3 lymph node dissection in clients diagnosed with right colon cancer (RCC). METHODS: 100 RCC patients were divided into Group A and Group B. Both groups underwent laparoscopic D3 lymph node dissection, with Group A undergoing an intermediate approach and Group B undergoing a combined head and tail approach. Two groups of patients' perioperative (surgical time, intraoperative blood loss, number of lymph node dissection) indicators, postoperative recovery (postoperative exhaust time, postoperative hospital stay, drainage tube removal time) indicators, perioperative pain level (VAS scores 1, 3, and 5 days following surgery), and incidence of complications (vascular injury, intestinal obstruction, anastomotic bleeding, incision infection), and the therapeutic efficacy [CEA, CA19-9] indicators were compared. RESULTS: Clients in the B team had substantially shorter operating times and considerably fewer intraoperative hemorrhage than those in the A team. The VAS grades of clients in the B team were considerably lower than those in the A team the day following surgery. Clients in the B team experienced vascular injury at a substantially lower rate than those in the A team. The overall incidence rate of problems did not differ statistically significantly between the A team and the B team. Following therapy, teams A and B's CEA and CA19-9 levels were considerably lower than those of the same team prior to therapy. CONCLUSION: Combined craniocaudal technique can significantly reduce intraoperative bleeding, postoperative pain, and the risk of sequelae from vascular injuries.

Effects of Sjogren's Syndrome on essential hypertension: a two-sample mendelian randomization study.

BACKGROUND: Sjogren's Syndrome (SS) plays important roles in the development of essential hypertension. Nevertheless, with the limitation of reverse causality and confounder in observational studies, such a relationship remains unclear. We aimed to assess the causal relationship of SS and hypertension by the Mendelian randomization (MR) approach. METHODS: We used MR to investigate a causal association between SS and essential hypertension. Inverse variance weighted (IVW), MR Egger regression, Maximum likelihood, Weighted median, and MR pleiotropy residual sum and outlier test (MR-PRESSO) were used in this MR analysis. RESULTS: In this study, we found that the ratio of IVW is 1.00024 (95% CI: 1.00013- 1.00036, P=0.0387), This result was also confirmed by sensitivity analysis methods such as Maximum likelihood is 1.00025 (95% CI: 1.00013-1.00037, P=0.036), MR Egger is 1.00071 (95% CI: 1.00047-1.00095, P=0.0045), and Weighted median is 1.00040 (95% CI: 1.00021- 1.00059, P=0.0322). And MR-Egger intercept method revealed the absence of horizontal pleiotropy in this investigation (P>0.05). The Cochran's Q Test indicated an absence of heterogeneity among them (P>0.05). Heterogeneity and horizontal pleiotropy tests further demonstrate that the results of MR are relatively stable. The above results all suggest that pSS may promote the risk of hypertension. CONCLUSIONS: Our study provides evidence of a causal relationship of SS and hypertension. It is suggested to pay attention to early screening for hypertension, reduce disability and mortality rates, and improve patient prognosis in patients with SS.

Quantitative phosphoproteomic profiling of mouse sperm maturation in epididymis revealed kinases important for sperm motility.

Transcriptionally and translationally silent sperm undergo functional maturation during epididymis traverse, which provides sperm ability to move and is crucial for successful fertilization. However, the molecular mechanisms governing sperm maturation remain poorly understood, especially at protein post-translational modification level. In this study, we conducted a comprehensive quantitative phosphoproteomic analysis of mouse epididymal sperm from different regions (caput, corpus, and cauda) to unveil the dynamics of protein phosphorylation during sperm maturation. We identified 6,447 phosphorylation sites in 1,407 phosphoproteins, and 345 phosphoproteins were differentially phosphorylated between caput and cauda sperm. Gene ontology and KEGG pathway analyses showed enrichment of differentially phosphorylated proteins in energy metabolism, sperm motility and fertilization. Kinase substrate network analysis followed by inhibition assay and quantitative phosphoproteomics analysis showed that TSSK2 kinase is important for sperm motility and progressive motility. This study systemically characterized the intricate phosphorylation regulation during sperm maturation in the mouse epididymis, which can be a basis to elucidate sperm motility acquisition, and to offer potential targets for male contraception and the treatment of male infertility.

High freeze-thaw stability of Pickering emulsion stabilized by SPI-maltose particles and its effect on frozen dough.

Pickering emulsions with good freeze-thaw stability are essential in frozen food applications. This study developed a high freeze-thaw stabilized soy protein isolate (SPI)-maltose (M) Pickering emulsion and applied it to frozen doughs to investigate and reveal its impacts on the processing properties of the frozen dough. The results showed that after the freeze-thaw cycle, with a volume ratio of 1:2 of SPI to M, the appropriate amount of M changed the structure of SPI. This resulted in the Pickering emulsion prepared by the SPI exhibiting the least droplet coalescence and the best freeze-thaw stability. The results of dough rheological properties, textural properties, and binding capacity with water demonstrated that Pickering emulsions effectively inhibited the loss of gluten protein network structure in the dough after freeze treatment and increased the binding capacity of gluten proteins with starch and water in the dough. The best results were obtained with the incorporation of 3 % SPI-M high freeze-thaw stability, where the amount of bound water following three freeze-thaw cycles was 4.27 times higher than in doughs without Pickering emulsion. Overall, this study is significant for enhancing the freeze-thaw stability of Pickering emulsions stabilized by proteins and providing a new application route for Pickering emulsions.

Biomechanical evaluation of different medial column fixation patterns for valgus pilon fractures.

BACKGROUND: The purpose of this study was to perform a biomechanical analysis to compare different medial column fixation patterns for valgus pilon fractures in a case-based model. METHODS: Based on the fracture mapping, 48 valgus pilon fracture models were produced and assigned into four groups with different medial column fixation patterns: no fixation (NF), K-wires (KW), intramedullary screws (IS), and locking compression plate (LCP). Each group contained wedge-in and wedge-out subgroups. After fixing each specimen on the machine, gradually increased axial compressive loads were applied with a load speed of one millimeter per minute. The maximum peak force was set at 1500 N. Load-displacement curves were generated and the axial stiffness was calculated. Five different loads of 200 N, 400 N, 600 N, 800 N, 1000 N were selected for analysis. The specimen failure was defined as resultant loading displacement over 3 mm. RESULTS: For the wedge-out models, Group-IS showed less displacement (p < 0.001), higher axial stiffness (p < 0.01), and higher load to failure (p < 0.001) than Group-NF. Group-KW showed comparable displacement under loads of 200 N, 400 N and 600 N with both Group-IS and Group-LCP. For the wedge-in models, no statistical differences in displacement, axial stiffness, or load to failure were observed among the four groups. Overall, wedge-out models exhibited less axial stiffness than wedge-in models (all p < 0.01). CONCLUSIONS: Functional reduction with stable fixation of the medial column is essential for the biomechanical stability of valgus pilon fractures and medial column fixation provides the enough biomechanical stability for this kind of fracture in the combination of anterolateral fixation. In detail, the K-wires can provide a provisional stability at an early stage. Intramedullary screws are strong enough to provide the medial column stability as a definitive fixation. In future, this technique can be recommended for medial column fixation as a complement for holistic stability in high-energy valgus pilon fractures.

Molecular basis for cA6 synthesis by a type III-A CRISPR-Cas enzyme and its conversion to cA4 production.

The type III-A (Csm) CRISPR-Cas systems are multi-subunit and multipronged prokaryotic enzymes in guarding the hosts against viral invaders. Beyond cleaving activator RNA transcripts, Csm confers two additional activities: shredding single-stranded DNA and synthesizing cyclic oligoadenylates (cOAs) by the Cas10 subunit. Known Cas10 enzymes exhibit a fascinating diversity in cOA production. Three major forms-cA3, cA4 and cA6have been identified, each with the potential to trigger unique downstream effects. Whereas the mechanism for cOA-dependent activation is well characterized, the molecular basis for synthesizing different cOA isoforms remains unclear. Here, we present structural characterization of a cA6-producing Csm complex during its activation by an activator RNA. Analysis of the captured intermediates of cA6 synthesis suggests a 3'-to-5' nucleotidyl transferring process. Three primary adenine binding sites can be identified along the chain elongation path, including a unique tyrosine-threonine dyad found only in the cA6-producing Cas10. Consistently, disrupting the tyrosine-threonine dyad specifically impaired cA6 production while promoting cA4 production. These findings suggest that Cas10 utilizes a unique enzymatic mechanism for forming the phosphodiester bond and has evolved distinct strategies to regulate the cOA chain length.

Research Progress of Vagal Nerve Regulation Mechanism in Acupuncture Treatment of Atrial Fibrillation.

Atrial fibrillation (AF) is the most common arrhythmia in clinical practice. It has a high prevalence and poor prognosis. The application of antiarrhythmic drugs and even surgery cannot completely treat the disease, and there are many sequelae. AF can be classified into the category of "palpitation" in Chinese medicine according to its symptoms. Acupuncture has a significant effect on AF. The authors find that an important mechanism of acupuncture in AF treatment is to regulate the cardiac vagus nerve. Therefore, this article intends to review the distribution and function of vagus nerve in the heart, the application and the regulatroy effect for the treatment of AF.

Design, synthesis, and evaluation of benzodioxolane compounds for antitumor activity.

This study reports the design, synthesis, and comprehensive biological evaluation of 13 benzodioxolane derivatives, derived from the core structure of piperine, a natural product with established antitumor properties. Piperine, primarily found in black pepper, has been noted for its diverse pharmacological activities, including anti-inflammatory, antioxidant, and anticancer effects. Leveraging piperine's antitumor potential, we aimed to enhance its efficacy through structural modifications. Among the synthesized compounds, HJ1 emerged as the most potent, exhibiting a 4-fold and 10-fold increase in inhibitory effects on HeLa and MDA-MB-231 cell lines, respectively, compared to piperine. Furthermore, HJ1 demonstrated a favorable safety profile, characterized by significantly lower cytotoxicity towards the human normal cell line 293T. Mechanistic investigations revealed that HJ1 markedly inhibited clonogenicity, migration, and adhesion of HeLa cells. In vivo studies utilizing the chick embryo chorioallantoic membrane (CAM) model substantiated the robust antitumor activity of HJ1, evidenced by its ability to suppress tumor angiogenesis and reduce tumor weight. These results suggest that HJ1 holds significant promise as a lead compound for the development of novel antitumor therapies.

Copper-catalyzed asymmetric 1,2-arylboration of enamines: access to chiral borate-containing 3,3'-disubstituted isoindolinones.

An enantioselective copper-catalyzed 1,2-arylboration reaction of enamines has been developed by employing (R)-xyl-BINAP as a chiral ligand. A number of chiral borate-containing 3,3'-disubstituted isoindolinones were obtained in moderate to good yields and good to excellent enantioselectivities from the reactions of N-(o-iodobenzoyl)enamines and bis(pinacolato)diboron (B2pin2) under mild reaction conditions. Synthetic transformations of the products were conducted to demonstrate the practicality of this reaction.

Chinese Health Insurance in the Digital Era: Bibliometric Study.

BACKGROUND: China has entered the era of digital health care after years of reforms in the health care system. The use of digital technologies in healthcare services is rapidly increasing, indicating the onset of a new period. The reform of health insurance has also entered a new phase. OBJECTIVE: This study aims to investigate the evolution of health care insurance within the context of telemedicine and Internet Plus Healthcare (IPHC) during the digital health care era by using scientometric methods to analyze publication patterns, influential keywords, and research hot spots. It seeks to understand how health care insurance has adapted to the growing integration of IPHC and telemedicine in health care services and the implications for policy and practice. METHODS: A total of 411 high-quality studies were curated from the China National Knowledge Infrastructure (CNKI) database in the Chinese language, scientometric analysis was conducted, and VOSviewer software was used to conduct a visualized analysis of keywords and hot spots in the literature. RESULTS: The number of articles in this field has increased notably from 2000 to 2022 and has increased annually based on a curve of y=0.332exp (0.4002x) with R2=0.6788. In total, 62 institutions and 811 authors have published research articles in the Chinese language in this field. This study included 290 keywords and formulated a total of 5 hot-topic clusters of "telemedicine," "IPHC," "internet hospital," "health insurance payments," and "health insurance system." CONCLUSIONS: Studies on the application of digital technologies in health care insurance has evolved from foundational studies to a broader scope. The emergence of internet hospitals has showcased the potential for integrating IPHC services into insurance payment systems. However, this development also highlights the necessity for enhanced interregional coordination mechanisms. The reform of health insurance payment is contingent upon ongoing advancements in digital technology and increased investment in electronic medical records and primary health care services. Future efforts should focus on integrating technology with administrative systems, advancing mobile health care solutions, and ensuring interoperability among various payment systems to improve efficiency and standardize health care services.

Ceramic-added lime and cement mortars: A review of applications in building products.

Ceramic-added air lime mortars have been used since ancient times owing to the pozzolanic effect provided by crushed ceramic particles that impart hydraulic properties. This work reviews the historical use, composition, reaction mechanisms, characterization techniques, and performance properties of ceramic-added air lime mortars. The fine ceramic powder composed of silica and alumina phases reacts with calcium hydroxide released during lime hydration to form calcium silicate hydrates (CSH) and calcium aluminate hydrates (CAH) via pozzolanic reaction. This provides hydraulicity and reduces setting time compared to pure air lime mortars. The coarser ceramic particles also serve as aggregate and refine the microstructure as filler. The reactivity depends on the ceramic composition, amorphous phase content, particle size distribution, and firing temperature. Optimal proportioning of the fine ceramic powder and coarse ceramic aggregate is necessary to achieve desired properties. Ceramic addition enhances the durability of air lime mortars against weathering while maintaining compatibility with lime-based masonry structures. Key novelties of this review include: (i) in-depth analysis of the influence of ceramic characteristics (mineralogy, particle size, pozzolanicity) and processing on reaction kinetics and phase evolution; (ii) systematic assessment of mechanical, physical and durability properties in comparison to conventional air lime mortars and cement-based grouts; (iii) elucidation of microstructural mechanisms governing performance using advanced characterization techniques; (iv) critical appraisal of test methods and standards for evaluation; and (v) rigorous discussion on potential applications in construction, conservation and repair, with case studies.

[Robot-assisted laparoscopic ureteroplasty with buccal mucosa graft for complex ureteral stricture].

OBJECTIVE: To investigate the feasibility, safety and effectiveness of robot-assisted laparoscopic buccal mucosa graft ureteroplasty in the treatment of complex long proximal ureteral stricture. METHODS: The clinical data of 20 patients with proximal ureteral stricture undergoing robot-assisted laparoscopic buccal mucosa graft ureteroplasty admitted to the Department of Urology, Peking University First Hospital and Beijing Jiangong Hospital from July 2022 to January 2023 were prospectively collected and analyzed. Intraoperative conditions, postoperative complications and follow-up data were also recorded and analyzed. RESULTS: The operations under robot-assisted laparoscopy were performed successfully in all the 20 patients without conversion to traditional laparoscopic surgery or open surgery. The study included 14 males and 6 females with a mean age of (41±11) years (range: 19 to 60 years) and a mean body mass index of (24.3±3.6) kg/m2 (range: 18.2 to 31.8 kg/m2). There were 9 cases on the left side and 11 cases on the right side. The strictures of all the patients were located in the proximal segment of the ureter (including the ureteropelvic junction). The mean preoperative serum creatinine was (92.2±23.3) µmol/L (range: 49.2 to 138.9 µmol/L), and the mean length of ureteral stricture was (2.8±0.9) cm (range: 1.0 to 4.0 cm). Ten patients had previously undergone unsuccessful reconstructive surgery. During the operation, 12 patients received posteriorly augmented anastomosis with ventral onlay. The mean length of the buccal mucosa graft harvested during the operation was (3.1±0.6) cm (range: 2.0 to 4.3 cm), and the median width was 1.5 cm (range: 1.0 to 2.0 cm). The omentum flap was used to wrap the reconstructed ureteral segment in all the 20 cases. The median operative time was 154 min (range: 113 to 300 min), and the median estimated blood loss was 45 mL (range: 0 to 100 mL). The median postoperative hospital stay was 4 d (range: 4 to 14 d). The mean postoperative follow-up time was (15.0±1.7) months (range: 12.5 to 17.9 months), and the surgical success rate was 100.0% in this study. After surgery, 11 patients reported mild discomfort at the oral donor site, 2 patients deve-loped urinary tract infection, and no postoperative complications were reported in the other 7 patients. The mean serum creatinine was (90.9±23.9) µmol/L (range: 60.0 to 153.0 µmol/L) six months after surgery. CONCLUSION: Robot-assisted laparoscopic buccal mucosa graft ureteroplasty for the treatment of complex long proximal ureteral stricture has satisfactory efficacy without severe complications, which has shown good feasibility, safety and effectiveness. However, large sample studies and long-term follow-up are still needed to evaluate its long-term efficacy.

Vaccine effectiveness and impact of meningococcal vaccines against gonococcal infections: A systematic review and meta-analysis.

OBJECTIVES: To systematically review and synthesis the evidence of vaccine effectiveness (VE) and impact (VI) of meningococcal vaccines in preventing gonorrhoea. METHODS: We systematically evaluated studies. Literature searches were conducted in PubMed, Embase, Cochrane Library, CINAHL, Google Scholar, clinical trial registries, and major health and immunisation conferences. Meta-analysis was performed with the DerSimonian-Laird random-effects model to estimate the pooled VE. RESULTS: Twelve studies met the criteria for inclusion. VE of meningococcal B (MenB) outer membrane vesicle (OMV) vaccines was evaluated in nine studies, with one study evaluating a non-OMV vaccine, MenB-FHbp. The majority of studies targeted individuals aged 15-30 years. Adjusted VE for OMV vaccines against gonorrhoea ranged from 22% to 46%. MenB-FHbp did not show protection against gonorrhoea. The pooled VE estimates of OMV vaccines against any gonorrhoea infection following the full vaccine series were 33-34%. VI was assessed for 4CMenB in Canada and Australia, for VA-MENGOC-BC in Cuba; and for MenBvac in Norway. VI ranged from a 30% to 59% reduction in gonorrhoea incidence. CONCLUSIONS: 4CMenB and other MenB-OMV vaccines show moderate effectiveness against gonorrhoea. Further research is required to explore the factors associated with vaccine protection, informing more effective vaccination strategies for the management of gonococcal infections.