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

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

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

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

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

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

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

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

All-optical synaptic neuron based on add-drop microring resonator with power-tunable auxiliary light.

We propose and demonstrate an all-optical synaptic neuron based on an add-drop microring resonator (ADMRR) with power-tunable auxiliary light. Dual neural dynamics of passive ADMRRs, having spiking response and synaptic plasticity, are numerically investigated. It is demonstrated that, by injecting two beams of power-tunable and opposite-direction continuous light into an ADMRR and maintaining their sum power at a constant value, linear-tunable and single-wavelength neural spikes can be flexibly generated, in virtue of the nonlinear effects triggered by perturbation pulses. Based on this, a weighting operation system based on cascaded ADMRRs is designed; it enables implementation of real-time weighting operations at a number of wavelengths. This work provides a novel, to the best of our knowledge, approach for integrated photonic neuromorphic systems based entirely on optical passive devices.

Multifunctional silica nanocomposites prime tumoricidal immunity for efficient cancer immunotherapy.

The tumor immune microenvironment (TIME) has been demonstrated to be the main cause of cancer immunotherapy failure in various malignant tumors, due to poor immunogenicity and existence of immunosuppressive factors. Thus, establishing effective treatments for hostile TIME remodeling has considerable potential to enhance immune response rates for durable tumor growth retardation. This study aims to develop a novel nanocomposite, polyethyleneimine-modified dendritic mesoporous silica nanoparticles loaded with microRNA-125a (DMSN-PEI@125a) to synergistically enhance immune response and immunosuppression reversion, ultimately generating a tumoricidal environment. Our results showed that DMSN-PEI@125a exhibited excellent ability in cellular uptake by murine macrophages and the cervical cancer cell line TC-1, repolarization of tumor associated macrophages (TAMs) to M1 type in a synergistic manner, and promotion of TC-1 immunogenic death. Intratumor injection of DMSN-PEI@125a facilitated the release of more damage-related molecular patterns and enhanced the infiltration of natural killer and CD8+ T cells. Meanwhile, repolarized TAMs could function as a helper to promote antitumor immunity, thus inhibiting tumor growth in TC-1 mouse models in a collaborative manner. Collectively, this work highlights the multifunctional roles of DMSN-PEI@125a in generating an inflammatory TIME and provoking antitumor immunity, which may serve as a potential agent for cancer immunotherapy.

[Midline urethral-plate incision followed by Mathieu urethroplasty for repair of distal hypospadias].

OBJECTIVE: To compare the effect of midline urethral-plate incision followed by Mathieu urethroplasty (MUPI-MU) with that of tubularized incised-plate (TIP) urethroplasty in the treatment of distal hypospadias. METHODS: We retrospectively analyzed the clinical date on 72 cases of distal hypospadias treated in our hospital from August 2016 to January 2019, of which 21 (including 5 cases with a narrow urethral plate, small flat glans and shallow urethral groove) underwent MUPI-MU and the other 51 received TIP urethroplasty. We followed up the patients postoperatively and compared the shape and position of the urethral meatus and incidences of glanular dehiscence, fistula, stenosis and diverticulum between the two groups. RESULTS: After surgery, the urethral meatus was found vertical, slit-like and in a normal anatomical position in 19 cases (90.5%) in the MUPI-MU and 46 cases (90.2%) in the TIP group, with no statistically significant difference in the shape of the urethral meatus between the two groups (P>0.05). The postoperative incidence of fistula was significantly lower in the MUPI-MU than in the TIP group (1 ï¼»4.8%ï¼½ vs 15 ï¼»29.4%ï¼½, P = 0.048), and so was that of meatal stenosis (0 vs 12 ï¼»23.5%ï¼½, P = 0.037), but no statistically insignificant differences were observed between the MUPI-MU and TIP groups in the incidence of either glanular dehiscence (1 ï¼»4.8%ï¼½ vs 2 ï¼»9.8%ï¼½, P>0.05) or diverticulum (1 ï¼»4.8%ï¼½ vs 6 ï¼»11.8%ï¼½, P>0.05). No postoperative complications occurred in the 5 cases with a narrow urethral plate, small flat glans and shallow urethral groove. CONCLUSIONS: MUPI-MU can achieve a normal-looking, vertical, slit-like urethral meatus with a reasonable urethral diameter and minimized incidence of complications, especially applicable to the distal hypospadias patients with a narrow urethral plate, small flat glans and shallow urethral groove.

A transcriptome analysis focusing on splenic immune-related mciroRNAs of rainbow trout upon Aeromonas salmonicida subsp. salmonicida infection.

MicroRNAs (miRNAs) are a class of small non-coding RNAs that can regulate the immune responses during pathogen infection. Aeromonas salmonicida (A. salmonicida) subsp. salmonicida is the causative agent of furunculosis in salmon and trout. To identify the miRNAs and investigate the specific miRNAs in rainbow trout upon A. salmonicida subsp. salmonicida infection, we performed high throughput sequencing using the spleens of rainbow trout infected with and without an A. salmonicida subsp. salmonicida clinical isolate. A total of 381 known miRNAs and 926 novel miRNAs were identified. Eleven known and 16 novel miRNAs were found to be differentially expressed upon infection. The results of Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analyses indicated that the target genes of the differentially expressed miRNAs were closely associated with immune responses and biological regulations. Additionally, over- and suppressed expression of miR-155-5p significantly enhanced and reduced the IL-2 and IL-1ß expressions in RTG-2 cells induced by A. salmonicida, respectively. To our knowledge, this is the first experimental study on the miRNAs of rainbow trout upon A. salmonicida infection. The results here might lay a foundation for the further understanding of the roles of miRNAs in the immune responses during A. salmonicida infection in rainbow trout.

Identification of the optimal insertion site for expression of a foreign gene in an infectious hematopoietic necrosis virus vector.

Infectious hematopoietic necrosis virus (IHNV) was developed as a vector to aid the construction of vaccines against viral diseases such as viral hemorrhagic septicemia virus, spring viremia of carp virus, and influenza virus H1N1. However, the optimal site for foreign gene expression in the IHNV vector has not been determined. In the present study, five recombinant viruses with the green fluorescence protein (GFP) gene inserted into different genomic junction regions of the IHNV genomic sequence were generated using reverse genetics technology. Viral growth was severely delayed when the GFP gene was inserted into the intergenic region between the N and P genes. Real-time fluorescence quantitative PCR assays showed that the closer the GFP gene was inserted towards the 3' end, the higher the GFP mRNA levels. Measurement of the GFP fluorescence intensity, which is the most direct method to determine the GFP protein expression level, showed that the highest GFP protein level was obtained when the gene was inserted into the intergenic region between the P and M genes. The results of this study suggest that the P and M gene junction region is the optimal site within the IHNV vector to express foreign genes, providing valuable information for the future development of live vector vaccines.

Trancriptome profiles of Amur sturgeon spleen in response to Yersinia ruckeri infection.

Yersinia ruckeri (YR) is the causative agent of yersiniosis which has caused significant economic losses in fish culture worldwide, including in Amur sturgeon (Acipenser schrenckii) culture. To better understand the mechanism of the immune responses to YR in Amur sturgeon, the transcriptomic profiles of the spleens from YR-infected and non-infected groups were obtained using RNA-seq techniques. The de novo assemblies yielded totally 145 670 unigenes from the two libraries. The total numbers of transcripts in YR-infected and non-infected groups were from 110 893 to 147 336, with the mean length varying from 560 to 631 (N50: from 882 to 1083). GO analysis revealed that 10 038 unigenes were categorized into 26 biological processes subcategories, 17 cellular components subcategories and 19 molecular functions subcategories. A total of 59 487 unigenes were annotated in the KEGG pathway and 20 pathways were related to the immune system. 1465 differently expressed genes (DEGs) were identified, including 377 up-regulated genes and 1088 down-regulated genes. 125 DEGs were found to be related to immune responses of Amur sturgeon and further divided into 16 immune-related KEGG pathways, including antigen processing and presentation, complement and coagulation cascades, T cell receptor signaling pathway, B cell receptor signaling pathway, NOD-like receptor signaling pathway, chemokine signaling pathway, etc. Eight of the DEGs were further validated by qRT-PCR. Altogether, the results obtained in this study will provide insight into the immune response of Amur sturgeon against Y. ruckeri infection.

[Traversing the vertical pedicle flap for the treatment of severely buried penis in children].

OBJECTIVE: To assess the effect of traversing the vertical pedicle flap (TVPF) for the treatment of severely buried penis in children. METHODS: Totally 43 children with severely buried penis underwentTVPF (n = 21)or modifiedShiraki surgery (control, n = 22) in our hospitalfrom February to December 2014. Wecompared the operation time, intra-operation blood loss, foreskin swelling time, and parents' satisfaction with penile appearance between the two groups. RESULTS: No statistically significant differences were observed between the TVPFand control groups in the operation time (ï¼»45.0 ±6.8ï¼½ vs ï¼»42.0 ±5.3ï¼½ min, P>0.05) or intra-operation blood loss(ï¼»5.0 ±1.2ï¼½ vs ï¼»6.0 ±0.8ï¼½ ml, P>0.05). The average foreskin swelling time was markedly shorter in the TVPFgroup than in the control (ï¼»9.0 ±2.3ï¼½ vs ï¼»15.0 ±4.8ï¼½ d, P<0.05)and the parents' satisfaction with penile appearancewas higher in the former than in the latter (95.23vs31.81 %, P<0.05). The elastic bandages were removedfor all the patientsat 3 days postoperatively, and 3 to 6-month follow-up revealed no penile retraction or relapse. CONCLUSIONS: The method of traversing the vertical pedicle flap is a feasible surgical option for the treatment of severely buried penis in children, which can make a rational use of the foreskin,remove the tight ring, and achieve a satisfactory appearance of the penis.

Basal vein in the posterior incisural space: An anatomical comparison based on autopsy, digital subtraction angiography and computed tomographic venography.

BACKGROUND: During surgical procedures, the basal vein in the posterior incisural space is susceptible to obstruction. In such circumstances, venous infarction can occur along with venous damage. OBJECTIVE: The aim of this study was to correlate the microanatomy of the basal vein in the posterior incisural space with the digital subtraction angiography (DSA) and computed tomographic venography (CTV). METHODS: Twenty cadavers and 42 patients were examined in this study. The head of each cadaver was injected with blue-colored gelatin via the internal jugular veins. Venograms for each patient were obtained from the venous phases of DSA or CTV. RESULTS: Compared to the cadavers, in the patients, DSA and CTV revealed 90% and 95% of the basal vein, respectively. According to difference of entrance, three types of basal veins were identified. No statistical difference of typing was found among the cadavers, DSA images and CTV images. On three sides of the cadavers and one side of the CTV images, the basal vein entered the straight sinus through the meningeal vein in the tentorium cerebelli. CONCLUSIONS: Preoperative DSA and CTV are useful in the design of individualized surgical approaches and the preservation of the basal vein in the posterior incisural space.

Epitope mapping of the infectious hematopoietic necrosis virus glycoprotein by flow cytometry.

The glycoprotein of infectious hematopoietic necrosis virus was truncated to ten overlapping fragments. All fragments were displayed on the inner membrane of the Escherichia coli periplasm. After disruption of the outer membrane, spheroplasts that had anchored with the glycoprotein fragment were incubated with an anti-glycoprotein polyclonal antibody. Prey pairs were detected and quantitated by flow cytometry with all fragments but one, G2, reacting with the polyclonal antibody. The antigenicity of all ten fragments was analyzed using conventional methods, and epitopes were localized in all fragments, except for G2 and were consistent with FCM analysis. Antigenicity of purified glycoprotein fusion proteins was confirmed by western blotting and ELISA. This method provides a rapid, quantitative and simple strategy for identifying linear B cell epitopes of a given protein.

[A long-term follow-up of the correlation between obstructive sleep apnea hypopnea syndrome and multiple organ diseases].

OBJECTIVE: To explore the correlation between obstructive sleep apnea hypopnea syndrome (OSAHS) and multiple organ diseases. METHODS: Home-visit questionnaires were performed in 1 868 subjects (956 male, 912 female) with an average age of (79 ± 5) years, and a prospective follow-up was performed for a period of 20 years with annual medical examinations. Multiple organ diseases included hypertension, coronary heart disease, stroke, diabetes, pulmonary heart disease, renal insufficiency and erythrocytosis. The subjects were grouped by the diagnosis of OSAHS. RESULTS: Among the 1 868 subjects, 598 (32.0%) were diagnosed with OSAHS, and 1 270 (68.0%) of non-OSAHS as the control group. By the end of follow-up, in the OSAHS group there were 477 (79.8%) cases with hypertension, 337 (56.4%) cases with coronary heart disease, 167 (27.9%) cases with stroke, 76 (12.7%) cases with diabetes, 37 (6.2%) cases with pulmonary heart disease, 73 (12.2%) cases with renal insufficiency and 211(35.3%) cases with erythrocytosis, all of which were significantly higher than those of the control group [323(25.4%), 315 (24.8%), 95 (7.5%), 69 (5.4%), 40 (3.2%), 58 (4.6%), 30 (2.4%), P < 0.01]. The number of diseases in the OSAHS group was also higher than that in the control group (P < 0.05) . CONCLUSION: The incidence of multiple organ diseases was remarkably higher in the OSAHS group than that in the control group, which indicated that OSAHS was a risk factor for multiple organ diseases. These diseases in OSAHS patients may be related to hypoxia caused by OSAHS, endocrine and metabolic disorders, unhealthy lifestyles and arteriosclerosis.

Laparoscopic Ureteral Reconstruction in Children with Retrocaval Ureter: A Modern Single Center Retrospective Study.

PURPOSE: This study aims to report our experience in the treatment of children with retrocaval ureter(RCU) using laparoscopic ureteral reconstruction surgery. PATIENTS AND METHODS: We retrospectively collected clinical data from 10 pediatric patients with RCU who underwent laparoscopic surgery at our hospital from April 2010 to April 2022. All patients underwent comprehensive preoperative radiological assessment and were diagnosed with RCU, subsequently undergoing laparoscopic ureteral reconstruction. Patient demographics, surgical data, and postoperative outcomes were recorded. Regular follow-ups were conducted postoperatively, evaluating clinical symptoms and radiological results. RESULTS: The median age of the 10 patients was 8.8 years (range, 6-14 years). All surgeries were successfully performed laparoscopically without the need for open conversion, with an average surgical time of 153.3 minutes (range, 120-243 minutes). Intraoperative bleeding was minimal, and no blood transfusions were required. No intraoperative complications were observed. The average hospital stay for the patients was 5.3 days (range, 4-7 days), and the Double-J(D-J)stent was removed six weeks postoperatively. Follow-up ultrasound results at 3 and 6 months postoperatively showed a reduction in renal pelvic dilatation, and all patients experienced significant relief of clinical symptoms related to flank and abdominal discomfort. CONCLUSION: Laparoscopic reconstruction for RCU demonstrates good feasibility and effectiveness in pediatric patients, offering a minimally invasive treatment option for the management of RCU in children.

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

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

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

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

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

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

Efficacy comparison between Mathieu combined urethral plate incision and onlay island flap urethroplasty for distal hypospadias in patients with urethral plate stenosis.

The aim of the study was to compare the efficacy of Mathieu combined urethral plate incision (Mathieu-IP) versus onlay island flap urethroplasty in patients with distal hypospadias complicated by urethral stenosis. The clinical data of 70 patients with distal hypospadias complicated by urethral plate stenosis treated in the Department of Urology, Anhui Provincial Children's Hospital (Hefei, China), from May 2019 to May 2022, were retrospectively analyzed. Thirty-eight patients underwent Mathieu-IP (Mathieu-IP group) and 32 underwent onlay island flap urethroplasty (Onlay group). Follow-ups at 1 month, 6 months, and 12 months postoperatively assessed operative time, complications, urethral meatus morphology, and family satisfaction. The Mathieu-IP group had significantly shorter operative time (mean ± standard deviation [s.d.]: 81.58 ± 5.18 min) versus the Onlay group (mean ± s.d.: 110.75 ± 6.05 min; P < 0.05). Surgical success rates were 78.9% (Mathieu-IP group) and 75.0% (Onlay group), with no significant difference ( P > 0.05). Complications were comparable between the groups. The Mathieu-IP group resulted in a vertical slit-shaped urethral meatus in 89.5% versus 13.8% in the Onlay group ( P < 0.05). Family satisfaction with general penile appearance and skin shape showed no significant differences, but the Mathieu-IP group had higher satisfaction with meatal position ( P < 0.05). Mathieu-IP offers simplicity, safety, and shorter operative time compared to Onlay. Both the techniques effectively treat urethral plate stenosis in distal hypospadias, with reduced postoperative complications compared to tubularized incised plate urethroplasty. Mathieu-IP results in a vertical slit-shaped urethral meatus which enhances urinary stream, indicating its potential for broader adoption.

Does the presence of blind-ended vas deferens and spermatic vessels in laparoscopic exploration of non-palpable testes conclusively indicate testicular absence?

Objective: The purpose of this study was to determine whether the presence of blind-ended vas deferens and spermatic vessels (VDSV) during laparoscopic exploration of non-palpable testes (NPT) indicates testicular absence or atrophy. Materials and methods: A retrospective analysis was conducted on clinical data of patients diagnosed with NPT and treated with surgical intervention at our center from April 2013-April 2023. The dataset encompassed information such as the children's age, affected side, size of the contralateral testis, surgical procedures employed, outcomes, and histopathological examination results. All patients underwent physical examination and ultrasonography preoperatively, followed by a combination of laparoscopic exploration and exploration through inguinal or scrotal incisions during surgery. Long-term follow-up was conducted postoperatively. Results: A total of 476 cases comprising 504 NPT were included in this study: 302 cases on the left side, 146 cases on the right side, and 28 cases bilaterally. All patients underwent surgical treatment within 6-126 months (median 13 months). During laparoscopic exploration, blind-ended VDSV were found in 90 testes (72 on the left side, 18 on the right side), while exploration through inguinal or scrotal incisions revealed 52 (57.8%) testicular nodules with atrophy, which were excised, leaving 38 (42.2%) without any findings. Histopathological examination of atrophic nodules revealed fibrosis as the most common finding in 41 cases (78.8%), followed by involvement of the vas deferens in 33 cases (63.5%), calcification in 24 cases (46.2%), epididymis in 23 cases (44.2%), and hemosiderin deposition in 7 cases (13.6%). Fibrosis, calcification, hemosiderin deposition, involvement of the vas deferens, and epididymis were found in combination in 47 specimens (90.4%). Seminiferous tubules (SNT) were found in 3 specimens (5.7%), and germ cells (GC) were found in 1 specimen (1.9%). Conclusion: The presence of blind-ended VDSV during laparoscopic exploration of NPT does not necessarily indicate testicular absence or disappearance. It is possible that atrophic testicular nodules are located within the inguinal canal or scrotum. This understanding contributes to the management of non-palpable testes. Considering their unpredictable malignant potential, we recommend excision.