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1.
Bioact Mater ; 7: 154-166, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34466724

RESUMO

Zinc is generally considered to be one of the most promising materials to be used in biodegradable implants, and many zinc alloys have been optimized to improve implant biocompatibility, degradation, and mechanical properties. However, long-term degradation leads to the prolonged presence of degradation products, which risks foreign body reactions. Herein, we investigated the in vivo biocompatibility and degradation of a biodegradable Zn-Mg-Fe alloy osteosynthesis system in the frontal bone, mandible, and femur in beagles for 1 year. Results of the routine blood, biochemical, trace element, and histological analyses of multiple organs, peripheral blood CD4/CD8a levels, and serum interleukin 2 and 4 levels showed good biocompatibility of the Zn-Mg-Fe alloy. Zinc content analysis revealed zinc accumulation in adjacent bone tissue, but not in the liver, kidney, and spleen, which was related to the degradation of the Zn-Mg-Fe alloy. The alloy demonstrated a uniform slowing degradation rate in vivo. No degradation differences in the frontal bone, mandible, and femur were observed. The degradation products included zinc oxide [ZnO], zinc hydroxide [Zn(OH)2], hydrozincite [Zn5(OH)6(CO3)2], and hopeite [Zn3(PO4)2·4H2O]. The good biocompatibility and degradation properties of the Zn-Mg-Fe alloy render it a very attractive osteosynthesis system for clinical applications.

2.
Sci Total Environ ; 804: 150239, 2022 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-34798750

RESUMO

It is common practice to apply manure onto soil as an effective way to increase soil fertility. However, the impact of different carbon sources on the transformation and fate of manure derived nitrogen (N) remains poorly understood. This study investigated the mineralization and immobilization turnover (MIT) of various manure-N fractions using sequential extractions and 15N tracing techniques combined after soil amendment with biochar, straw and mixtures thereof. Soil N was fractionated into mineral nitrogen (NH4+ and NO3-), microbial biomass nitrogen (MBN), hot water extractable organic nitrogen (HWDON), hydrochloric acid extractable organic nitrogen (HCl-N), and residual nitrogen (RN). Results showed that biochar addition increased the 15NH4+ content by 45% during the early stage. However, the high pH and labile C absence of biochar inhibited the remineralization of microbial immobilization N during the mid-to-late stage. Straw addition enhanced 15NH4+ assimilation by 10% to form HCl-15N. After that, microbial cellular structures and secondary metabolites were remineralized to meet crop N requirements. Adding carbon source mixtures with the organic fertilizer manifested the relationship between biochar and straw. The labile C content of the carbon sources rather than the C/N ratio was the critical factor regulating the N-MIT process. Overall, these findings offer new insights into the N transformation approaches using the co-application technique of organic amendments.


Assuntos
Esterco , Solo , Carvão Vegetal , Fertilizantes , Nitrogênio/análise
3.
Chemosphere ; 287(Pt 1): 132018, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34454221

RESUMO

Chemical oxidation and high-temperature heating have been widely used for the decontamination of soils polluted by hydrocarbons and the removal of soil organic matter. Chemical oxidation and high-temperature heating decreased the stability of soil colloids, but the difference in colloidal stability and aggregation behaviors of soil after chemical oxidation and high-temperature heating is not clear. In this study, taken black soil as an example, we tested the stability profiles of black soil colloids (BC), hydrogen peroxide (H2O2) treated black soil colloids (BC_H2O2), and 350 °C treated black soil colloids (BC_350 °C) in three salt solutions (NaCl, CaCl2, and Na2SO4) with different salt concentrations. The stability of soil colloids in salt solutions was in the order of BC > BC_350 °C > BC_H2O2. The salt concentrations at which three colloids started to be unstable were much lower for CaCl2 solution than those for NaCl and Na2SO4 solution. Salt concentrations that suspension started to be unstable were similar in NaCl and Na2SO4 solution for all the three colloids, but the colloidal stability profile in NaCl solution decreased faster than that in Na2SO4 solution when the suspension was unstable. The stability profiles of three colloids at the fast aggregation stage could be well fitted with the proposed exponential model, and model parameters (t0 and Smax) could reflect the stability behaviors of soil colloids in various salt solutions.


Assuntos
Peróxido de Hidrogênio , Solo , Coloides , Calefação , Temperatura
4.
Int J Food Microbiol ; 361: 109473, 2022 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-34768041

RESUMO

The epidemiological characteristics of Salmonella spp. in pork have been widely studied in China, but the results remain inconsistent. This study aimed to summarize the epidemiological characteristics of Salmonella spp. isolated from pork, including its prevalence, serovar distribution, and antibiotic resistance rate. We systematically reviewed published studies on Salmonella spp. isolated from pork in China between 2000 and 2020 in two Chinese and three English databases and quantitatively summarized its prevalence, serovar distribution, and antibiotic resistance using meta-analysis methods. Furthermore, we conducted subgroup analysis and meta-regression to explore the source of the heterogeneity from historical changes and regional difference perspectives. Ninety-one eligible studies published between 2000 and 2020 were included. The meta-analysis showed that the pooled prevalence of Salmonella isolated from pork was 0.17 (95% CI: 0.14, 0.20), with a detected growing trend over time. For the proportions of serovars, Derby (0.32, 95% CI: 0.26, 0.38), Typhimurium (0.10, 95% CI: 0.07, 0.15) and London (0.05, 95% CI: 0.03, 0.08) were dominant in these studies. The antibiotic resistance rates were high for tetracycline (0.68, 95% CI: 0.59, 0.77), sulfisoxazole (0.65, 95% CI: 0.45, 0.83), ampicillin (0.43, 95% CI: 0.34, 0.53), streptomycin (0.42, 95% CI: 0.29, 0.56), and sulfamethoxazole (0.42, 95% CI: 0.25, 0.60). The results of this study revealed a high prevalence, the regional characteristics of serovar distribution, and the severe challenges of antibiotic resistance of Salmonella originating from pork in China, suggesting the potential increasing risk and disease burden. Therefore, it is necessary to improve the prevention and control strategies of Salmonella in pork.


Assuntos
Carne de Porco , Carne Vermelha , Animais , China/epidemiologia , Resistência Microbiana a Medicamentos , Testes de Sensibilidade Microbiana , Prevalência , Salmonella , Sorogrupo , Suínos
5.
J Hazard Mater ; 423(Pt A): 127023, 2022 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-34482075

RESUMO

Due to the recent boom in urbanisation, economy, and global population, the amount of waste generated worldwide has increased tremendously. The World Bank estimates that global waste generation is expected to increase 70% by 2050. Disposal of waste is already a major concern as it poses risks to the environment, human health, and economy. To tackle this issue and maximise potential environmental, economic, and social benefits, waste valorisation - a value-adding process for waste materials - has emerged as a sustainable and efficient strategy. The major objective of waste valorisation is to transit to a circular economy and maximally alleviate hazardous impacts of waste. This review conducts bibliometric analysis to construct a co-occurrence network of research themes related to management of five major waste streams (i.e., food, agricultural, textile, plastics, and electronics). Modern valorisation technologies and their efficiencies are highlighted. Moreover, insights into improvement of waste valorisation technologies are presented in terms of sustainable environmental, social, and economic performances. This review summarises highlighting factors that impede widespread adoption of waste valorisation, such as technology lock-in, optimisation for local conditions, unfavourable regulations, and low investments, with the aim of devising solutions that explore practical, feasible, and sustainable means of waste valorisation.

6.
Front Genet ; 12: 698831, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34721518

RESUMO

Glioma is considered one of the most lethal brain tumors, as the aggressive blood vessel formation leads to high morbidity and mortality rates. However, the mechanisms underlying the initiation and progression of glioma remain unclear. Here, we aimed to reveal the role of circTLK1 in glioma development. Our results revealed that circTLK1 is highly expressed in glioma tumor tissues and glioma cell lines. We then conducted a series of experiments that showed that circTLK1 was involved in the progression of gliomas. Mechanistically, investigation of the factors downstream of circTLK1 revealed that circTLK1 activated JAK/STAT signaling in glioma cells. Furthermore, AGO2-RIP, RNA-pull down, and luciferase reporter gene assays led to the identification of the novel circTLK1/miR-452-5p/SSR1 axis. Moreover, we investigated the upstream regulator of circTLK1 and found that circTLK1 expression in glioma cells could be regulated by the transcriptional factor PBX2. Taken together, our findings show that circTLK1 mediated by PBX2 activates JAK/STAT signaling to promote glioma progression through the miR-452-5p/SSR1 pathway. These results provide new insights into glioma diagnosis and therapy.

7.
Foods ; 10(11)2021 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-34829037

RESUMO

Foodborne disease caused by Salmonella is an important public health concern worldwide. Animal-based food, especially poultry meat, is the main source of human salmonellosis. The objective of this study was to evaluate the prevalence and epidemiology of Salmonella contamination in raw poultry meat commercialized in China. Following the principle of systematic review, 98 sets of prevalence data were extracted from 74 publications conducted in 21 Chinese provincial regions. The random-effect model was constructed for subgrouping analysis by meat category, preservation type, and geographical location. The prevalence levels differed from high to low among raw poultry meat, including chicken, 26.4% (95% CI: 22.4-30.8%); pigeon, 22.6% (95% CI: 18.2-27.8%); duck, 10.1% (95% CI: 5.3-18.2%); and other poultry meat, 15.4% (95% CI: 12.0-19.5%). Prevalence data on the preservation type revealed that chilled poultry meat might be more likely to experience cross-contamination than non-chilled poultry meat in China. The distribution map of Salmonella for raw poultry meat showed that a higher prevalence level was found in the Shaanxi, Henan, Sichuan, and Beijing regions. All subgroups possessed high amounts of heterogeneity (I2 > 75%). The scientific data regarding the differences in prevalence levels between meat category, preservation method, and geographical region sources might be useful to improve specific interventions to effectively control the incidence of Salmonella in poultry meat.

8.
Int J Mol Sci ; 22(21)2021 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-34769281

RESUMO

Melatonin has been indicated to ameliorate tau hyperphosphorylation in the pathogenesis of tau diseases, but the role of melatonin-receptor signal transduction has not been clearly discovered. In this study, we found intensive tau hyperphosphorylation in melatonin receptor knockout mice. Bielschowsky silver staining showed ghostlike neurofibrillary tangles in melatonin receptor-2 knockout (MT2KO) as well as melatonin receptors-1 and -2 knockout (DKO) mice, and an argyrophilic substance was deposited in melatonin receptor-1 knockout (MT1KO) mice. Furthermore, we found significantly decreased activity of protein phosphatase 2A (PP2A) by Western blot and enzyme-linked immunosorbent assay (ELISA), which was partly due to the overexpression of protein phosphatase methylesterase-1 (PME-1), but not glycogen synthase kinase-3ß (GSK-3ß), cyclin-dependent kinase 5 (CDK5) or protein kinase B (Akt). Finally, we observed a significant increase in cyclic adenosine monophosphate (cAMP) and a decrease in miR-125b-5p levels in MT1KO, MT2KO and DKO mice. Using a luciferase reporter assay, we discovered that miR-125b-5p largely decreased the expression of firefly luciferase by interfering with the 3'UTR of PME-1. Furthermore, miR-125b-5p mimics significantly decreased the expression of PME-1, while miR-125b-5p inhibitor induced tau hyperphosphorylation. These results show that melatonin-receptor signal transduction plays an important role in tau hyperphosphorylation and tangle formation.

9.
ArXiv ; 2021 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-34815983

RESUMO

Artificial intelligence (AI) provides a promising substitution for streamlining COVID-19 diagnoses. However, concerns surrounding security and trustworthiness impede the collection of large-scale representative medical data, posing a considerable challenge for training a well-generalised model in clinical practices. To address this, we launch the Unified CT-COVID AI Diagnostic Initiative (UCADI), where the AI model can be distributedly trained and independently executed at each host institution under a federated learning framework (FL) without data sharing. Here we show that our FL model outperformed all the local models by a large yield (test sensitivity /specificity in China: 0.973/0.951, in the UK: 0.730/0.942), achieving comparable performance with a panel of professional radiologists. We further evaluated the model on the hold-out (collected from another two hospitals leaving out the FL) and heterogeneous (acquired with contrast materials) data, provided visual explanations for decisions made by the model, and analysed the trade-offs between the model performance and the communication costs in the federated training process. Our study is based on 9,573 chest computed tomography scans (CTs) from 3,336 patients collected from 23 hospitals located in China and the UK. Collectively, our work advanced the prospects of utilising federated learning for privacy-preserving AI in digital health.

10.
Br J Cancer ; 2021 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-34824449

RESUMO

BACKGROUND: Traditional histopathology performed by pathologists through naked eyes is insufficient for accurate survival prediction of clear cell renal cell carcinoma (ccRCC). METHODS: A total of 483 whole slide images (WSIs) data from three patient cohorts were retrospectively analyzed. We performed machine learning algorithm to identify optimal digital pathological features and constructed machine learning-based pathomics signature (MLPS) for ccRCC patients. Prognostic performance of the prognostic model was also verified in two independent validation cohorts. RESULTS: MLPS could significantly distinguish ccRCC patients with high survival risk, with hazard ratio of 15.05, 4.49 and 1.65 in three independent cohorts, respectively. Cox regression analysis revealed that the MLPS could act as an independent prognostic factor for ccRCC patients. Integration nomogram based on MLPS, tumour stage system and tumour grade system improved the current survival prediction accuracy for ccRCC patients, with area under curve value of 89.5%, 90.0%, 88.5% and 85.9% for 1-, 3-, 5- and 10-year disease-free survival prediction. DISCUSSION: The machine learning-based pathomics signature could act as a novel prognostic marker for patients with ccRCC. Nevertheless, prospective studies with multicentric patient cohorts are still needed for further verifications.

11.
Front Genet ; 12: 720013, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34777461

RESUMO

Background: Emerging scientific evidence has shown that long non-coding RNAs (lncRNAs) exert critical roles in genomic instability (GI), which is considered a hallmark of cancer. To date, the prognostic value of GI-associated lncRNAs (GI-lncRNAs) remains largely unexplored in lung adenocarcinoma (LUAC). The aims of this study were to identify GI-lncRNAs associated with the survival of LUAC patients, and to develop a novel GI-lncRNA-based prognostic model (GI-lncRNA model) for LUAC. Methods: Clinicopathological data of LUAC patients, and their expression profiles of lncRNAs and somatic mutations were obtained from The Cancer Genome Atlas database. Pearson correlation analysis was conducted to identify the co-expressed mRNAs of GI-lncRNAs. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses were conducted to determine the main biological function and molecular pathways of the differentially expressed GI-lncRNAs. Univariate and multivariate Cox proportional hazard regression analyses were performed to identify GI-lncRNAs significantly related to overall survival (OS) for construction of the GI-lncRNA model. Kaplan-Meier survival analysis and receiver operating characteristic curve analysis were performed to evaluate the predictive accuracy. The performance of the newly developed GI-lncRNA model was compared with the recently published lncRNA-based prognostic index models. Results: A total of 19 GI-lncRNAs were found to be significantly associated with OS, of which 9 were identified by multivariate analysis to construct the GI-lncRNA model. Notably, the GI-lncRNA model showed a prognostic value independent of key clinical characteristics. Further performance evaluation indicated that the area under the curve (AUC) of the GI-lncRNA model was 0.771, which was greater than that of the TP53 mutation status and three existing lncRNA-based models in predicting the prognosis of patients with LUAC. In addition, the GI-lncRNA model was highly correlated with programed death ligand 1 (PD-L1) expression and tumor mutational burden in immunotherapy for LUAC. Conclusion: The GI-lncRNA model was established and its performance was found to be superior to existing lncRNA-based models. As such, the GI-lncRNA model holds promise as a more accurate prognostic tool for the prediction of prognosis and response to immunotherapy in patients with LUAC.

12.
Br J Haematol ; 2021 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-34787307

RESUMO

Natural killer (NK) cells exert anti-viral effects after haematopoietic stem cell transplantation (HSCT). The balance between inhibition and activation of NK cells determined by the inherited repertoire of killer cell immunoglobulin-like receptors (KIR) genes may influence Epstein-Barr virus (EBV) reactivation after transplantation. To evaluate the relative contributions of KIR genotypes to EBV reactivation, we prospectively enrolled 300 patients with malignant haematological disease who were suitable for haploidentical HSCT. Univariate analysis showed that donors with KIR2DS1, KIR2DS3 or KIR3DS1 genes were associated with an increased risk of EBV reactivation [hazard ratio (HR) 1·86, 95% confidence interval (CI) 1·19-2·9, P = 0·0067; HR 1·78, 95% CI 1·07-2·97, P = 0·027; HR 1·86, 95% CI 1·19-2·91, P = 0·0065 respectively]. Multivariate analysis revealed that the presence of KIR2DS1, KIR2DS3 or KIR3DS1 genes was associated with increased EBV reactivation after HSCT. This effect was more evident in the absence of the cognate ligands for the corresponding activating receptors. Our present data firstly showed that donors with activating KIR genes, specifically activating KIR2DS1, KIR2DS3 and KIR3DS1, had an increased risk of EBV reactivation. Precaution for patients whose donors carry activating genes will help prevent EBV reactivation and improve patient prognosis after HSCT.

13.
Opt Express ; 29(24): 39125-39136, 2021 Nov 22.
Artigo em Inglês | MEDLINE | ID: mdl-34809282

RESUMO

A linearly-polarized radiation can be considered as the superposition of two circularly-polarized components with the same propagating direction and opposite spins. We investigated the splitting between the two spin-components in the reflective beam off the antiferromagnetic surface. The gyromagnetism and surface impedance mismatch cause the difference between the spatial shifts of the two spin-components, i.e., the spin-splitting. We analytically achieved the in- and out-plane shift-expressions of either spin-component for two typical linearly-polarized incident beams (i.e., the p- and s-incidences). In the case of no gyromagnetism, we obtained very simple shift-expressions, which indicate a key role played by the gyromagnetism or the surface impedance-mismatch in spin-splitting. Based on a FeF2 crystal, the spin-splitting distance was calculated. The spin-splitting distance is much longer for the p-incidence than the s-incidence, and meanwhile the in-plane splitting distance is much larger than the out-plane one. The gyromagnetism plays a key role for the in-plane spin-splitting and the surface impedance-mismatch is a crucial factor for the out-plane spin-splitting distance. The results are useful for the manipulation of infrared radiations and infrared optical detection.

14.
Int Immunopharmacol ; : 108376, 2021 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-34815191

RESUMO

High incidence of recurrency had been a significant threat among glioma patients. Moreover, the performance of traditional therapies among recurrent gliomas was far from satisfying. Advances in the tumor microenvironment (TME) and immune responses on the brain inspired immunotherapy researches. Nevertheless, verification of classic PD-1/PD-L1 inhibitors failed in phase III clinical trials. Additional gene targets were required for future studies among glioma patients. Immune cell infiltration (ICI) scores, defined based on multiple prognostic genes, were proved as the marker for the sensitivity of immunotherapies in many tumors. However, relevant results were not reported in gliomas. In the study, a retrospective cohort of 495 patients was classified into two ICI score subgroups. High ICI scores were closely related to high tumor mutation burden (TMB) values, indicating a high instability of genes. Furthermore, ICI scores were proved as reliable prognostic predictors. And a predictive model was built based on the ICI scores and multiple clinical features. The model showed its superiority through both internal validation and external validation. The ICI scores and the predictive model showed significant clinical values through decision curve analysis (DCA) since high ICI scores were related to high sensitivity for treatment. The prognostic immune-related gene list provided targets for immunotherapy researches.

15.
Nat Commun ; 12(1): 6771, 2021 Nov 19.
Artigo em Inglês | MEDLINE | ID: mdl-34799572

RESUMO

Just like in living organisms, if precise coherent operation of tiny movable components is possible, one may generate a macroscopic mechanical motion. Here we report that ~1010 pieces of colloidally dispersed nanosheets in aqueous media can be made to operate coherently to generate a propagating macroscopic wave under a non-equilibrium state. The nanosheets are initially forced to adopt a monodomain cofacial geometry with a large and uniform plane-to-plane distance of ~420 nm, where they are strongly correlated by competitive electrostatic repulsion and van der Waals attraction. When the electrostatic repulsion is progressively attenuated by the addition of ionic species, the nanosheets sequentially undergo coherent motions, generating a propagating wave. This elaborate wave in time and space can transport microparticles over a long distance in uniform direction and velocity. The present discovery may provide a general principle for the design of macroscopically movable devices from huge numbers of tiny components.

16.
Dalton Trans ; 50(45): 16473-16477, 2021 Nov 23.
Artigo em Inglês | MEDLINE | ID: mdl-34730579

RESUMO

Reported here is an attractive pillar-layered metal chalcogenide open framework, in which [Sb2S5] building units act as pillars between [Mn5S12(N2H4)6]n layers. The obtained compound exhibits high stability in both acid and base media and good performance in the electrocatalytic oxygen reduction reaction (ORR).

17.
J Hazard Mater ; : 127659, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34774354

RESUMO

Phytic acid (myo-inositol hexaphosphate, IHP) is a dominant form of organic phosphate (OP) in organic carbon-rich surface soil. The IHP impact on Fe (oxyhydr)oxide transport is critical for iron and phosphorus (bio)geochemical processes in iron and phosphorus rich soil and subsurface systems. Three typical Fe (oxyhydr)oxides (ferrihydrite, hematite, and goethite) were studied in this research. The effects of IHP and morphology on Fe (oxyhydr)oxide transport and IHP cotransport had been investigated using saturated sand columns. The results showed that IHP significantly enhanced the mobility of Fe (oxyhydr)oxide by 30-90% due to the stronger electrostatic repulsion. At low IHP concentration (< 50 µM IHP), the rod-like goethite and goethite-facilitated IHP showed high mobility due to their orientation and motion along the water flow, which is 70% faster than ferrihydrite and hematite at pH 5 and 90% faster at pH 10. The mobility of amorphous ferrihydrite was slowest among three selected iron oxides (< 37% at pH 5 and < 72% at pH 10). At high IHP concentration (> 50 µM IHP), the surface precipitation might have occurred on ferrihydrite because of its poorly ordered crystallinity, contributing to its less negatively charged surface and weak transport. The new insight provided in this study is essential for evaluating the fate and transport behavior of iron and iron-facilitate OP in soil rich in iron and OP.

18.
J Proteomics ; 251: 104422, 2021 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-34775099

RESUMO

Extracellular vesicles (EVs) are involved in a wide range of pathological processes and recognized as potential and novel biomarkers for oral squamous cell carcinoma (OSCC). Here, we describe the plasma EV proteome of rats with 4-nitroquinoline-1-oxide (4NQO)-induced OSCC or moderate dysplasia (MD), which can progress to OSCC, by tandem mass tag (TMT)-labeled mass spectrometry. The proteomic profiles suggest the differential expression of various proteins in MD and OSCC, some well-recognized pathological changes (e.g., translation, ATP metabolism, and mesenchymal transition), and some novel pathological changes (e.g., podosome, focal adhesion, and S100 binding). We re-examined the presence of traditional exosomal markers and the reported novel pan-EV markers. In summary, these results suggest potential EV biomarkers and underlying pathological changes in early OSCC as well as the presence of oral-derived EVs in plasma and the need for pan-EV markers. SIGNIFICANCE: This research suggests potential EV biomarkers and underlying pathological changes in early OSCC as well as the presence of oral-derived EVs in plasma and the need for pan-EV markers.

19.
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.

20.
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.

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