1.Retroperitoneal laparoscopic surgery in urology:A report of 87 cases
Jiongming LI ; Xiao LI ; Xiaohua MO
Chinese Journal of Minimally Invasive Surgery 2001;0(02):-
Objective To investigate the clinical effects of retroperitoneal laparoscopic surgery in the management of diseases of adrenal glands, kidneys and ureters. Methods By using a closed puncture into retroperitoneal space to establish a surgical access ,87 patients with diseases of adrenal glands, renal cysts, ureteral calculi and ureteral deformities were operated on by means of retroperitoneal laparoscopic surgery. Results The surgery was successfully accomplished in 83 patients with an excellent therapeutic effect, whereas a conversion to open surgery was required in 4 patients. There were no blood transfusions or serious complications in the study. Conclusions Retroperitoneal laparoscopic operations of adrenalectomy, cyst unroofing, ureterolithotomy, ureterolysis and ureteroplasty has the advantages of minimal invasion, less blood loss and fewer complications, being an effective and practical procedure .
2.The Analysis of Using Modified Clavien Classification of Surgical Complications in Postoperative Complications of Mini-Percutaneous Nephrolithotomy
Pei LI ; Jiongming LI ; Jianhe LIU ; Jian CHEN ; Yongming JIANG ; Jinsong ZHANG
Journal of Kunming Medical University 2016;37(8):123-126
Objeetive To discuss risk factors for postoperative complications after Mini-percutaneous nephrolithotomy (mPNL) using modified Clavien classification of surgical complications.Methods From September 1999 to December 2010,4533 patients having complications after mPNL were analyzed with five related clinical factors using the modified Clavien classification of surgical complications in the Second Affiliated Hospital of Kunming Medical University.Results Among 88 cases having complications (1.94%),69 had hemorrhage (0.24%),5 had colon injury (0.11%),3 had septic shock (0.06%),5 had liquid absorption syndrome (0.11%),6 had pleural effusion (0.13%).According to the modified Clavien classification,11 cases were clustered into Class Ⅰ (0.24%),71 cases into Class Ⅱ (1.56%),6 cases into Class Ⅲa (0.13%) and no cases was classified in Class Ⅲ b,Ⅳ a,Ⅳ b and Ⅴ.For patients having complications of Class Ⅱ and Ⅲ,the average hospital stay was significantly longer than those having either Class Ⅰ or no complications.Multiple logistic regression analysis showed that five factors were associated with postoperative complications,including operation time (OR=1.46),ASA score (0 =2.49),having cardiovascular disease or diabetes at the same time (0R=1.67),stone load (0R=1.34) and positive urine culture (0R=0.97).Conclusion Using modified Clavien classification of surgical complications in the analysis of mPNL was standard,objective,applicable and recommended.
3.The treatments of a long segmental avulsed injury of ureter suffered from ureteroscopy
Yongming JIANG ; Jiongming LI ; Hongyi XU ; Jianhe LIU ; Yongji YAN ; Jinsong ZHANG ; Jian CHEN ; Wanjian JIA
Chinese Journal of Urology 2008;29(6):408-410
Objective To summarise the methods for a long segmental avulsed inj ury of ureter.Methods Ureteroscopies were performed on three male patients with upper ureteral calculi and one female patient with haematuria from upper urinary tract.Ureteral calculi caused small and middle hy-dronephrosis,obstruction wasn't seen on the upper urinary tract with haematuria.The kidney on the affected side showed normal founction on IVP.Four patients were suffered from a long segmental avulsed inj uries of full-thickness of ureter from ureteroscopy in a continuous epidural anesthesia.The injuries took place in UPJ and upper ureter.The length of avutsed ureters is 20-25 cm,mean length is 24 cm. Results The ureteroscopies were altered to open operations which were ileal ureteral substi-tutions on two patients,being anastomosed the avulsed ureter wrapped by caul on one patient and nc-phrectomy on one patient under general anesthesia in an emergercy.Two ileal ureteral substitutions had reached satisfied results that were no damaged renal functions,no metabolic acidosis,no repeatly U-rinary tract infections and no complains about micturition.One patient has maintained normal renal morphology and function after thirteen years followup,the other formed stricture in the anastomosis of the proximal piece of-ileum to the renal pelvis tWO years after operation,and then improved after ante-grade dilation.The patient with being replaced back and anastomosed the avulsed ureter had compli-cated with a renal atrophy on the affected side three months after the double-J was extracted.The kid-ney showed no function on isotop nephrogram and then was ablated.The last one with nephrectomy and the one before were followed up regularly,the renal functions and blood pressures remain normal.Conclusion Ileal ureteral substitution would be a good choice and has a stable curative effect and provide a good prognosis for treating long segmental avulsed injury of ureter suffered from ureterosco PY when no available urinary tract was utilized for reconstruction.
4.Long term follow up of patients with the ileal orthotopic neobladder
Xuede QIU ; Hongyi XU ; Yongfu SHI ; Zehui LI ; Jiongming LI ; Jiansong WANG ; Zhipeng LI ; Kewei FANG ; Guihua CAO ; Haidan LI ; Jin HE ; Shuchen HE
Chinese Journal of Urology 2009;30(10):677-680
Objective To discuss the long term clinical effect of ileal orthotropic neobladder.Methods From 1991 to 1998,79 patients,mean age 55(41~75)years,male 74,female 6,were followed up.The serum creatinine and urea,electrolytes,blood routine,B ultrasonic scan of the neobladder residual urine and IVU or MRU of the patients were followed up.The max transverse diameter of renal pelvis and the max verticaI/level diameter of neobladder were measured in 5,10 to 14,15 years of postoperative when IVU or MRU.All results of different time were compared by the multiple comparisons.The local or distant cancer recurrence and the complications of the operation Were evaluated. Results Sixty-four cases,58 male,6 famle,were long term followed up:mean time was 167 (range,121~216)months.Seven cases died of other diseases.Seven cases had pelvic recarrence.Two cases had urethral recurrence.Three cases died of tumor metastasis.One case had ureter recurrence.Forty-eight patients were alive more than 10 years.The value of the serum creatinine,urea,electrolytes and bloods routine of the patients were normal after 5,10 to 14 and 15 vears postoperative (P>0.05).The max transverse diameter of the renal pelvis in 5,10 to 14 and 15 years Dostoperative were 14.0 mm,14.1 mm and 13.7 mm,respectively,P>0.05.The max vertical/level diameter of the neobladder in 5,10 to 14,15 years of postoperative were 110.4 mm/90.4 mm,111.5 mm/95.3mm and 127.0 mm/97.0 mm,respectively,P>0.05.The residual urine of 5 cases was more than 50 ml and had not increased during follow up.Eight cases with neobladder stone were cured by the intracavitary lithothrypsis.Two cases with uretheral stricture were cured by the intracavitary therapy.Twelve cases of 14 cases with inguinal hernia were cured by reoperation,2 cases accepted conservative treatment.Only 17 cases had no complication involve of the cancer and the operation. Conclusion The upper urinary tract and neobladder of the ileal orthotopic neobladder could be stable for long time,the cure rate of tumor is satisfactory and the lifetime follow up is necessary.
5.Clinical and electrophysiological study of lower limb split signs in amyotrophic lateral sclerosis
Jiao WANG ; Mao LI ; Hongfen WANG ; Jiongming BAI ; Yahui ZHU ; Zhengqing HE ; Zhaohui CHEN ; Hongmei CHENG ; Li LING ; Xusheng HUANG
Chinese Journal of Neurology 2023;56(8):856-863
Objective:To investigate the association between split foot and electrophysiology in patients with amyotrophic lateral sclerosis (ALS).Methods:The clinically definite or clinically probable ALS patients hospitalized in the Department of Neurology, the First Medical Center of Chinese People′s Liberation Army General Hospital from April 2021 to December 2022 were prospectively collected. From April 2021 to December 2022, patients who visited the Chinese People′s Liberation Army General Hospital for other reasons without abnormal electrophysiological examination were collected as the control group. The incidence of split leg [the limb whose modified Medical Research Council Muscle Strength Scale (mMRC) score of ankle dorsiflexors was lower than that of ankle plantarflexors] in ALS patients was calculated, and the incidence of split foot (the limb whose mMRC score of hallux dorsiflexors was lower than that of hallux plantarflexors) in ALS patients was calculated. The amplitude of compound muscle action potential (CMAP) of common peroneal nerve and tibial nerve was detected to observe the involvement of motor neurons innervating ankle dorsiflexors and ankle plantarflexors. The characteristics of split leg and split foot in ALS patients were analyzed from the perspective of muscle strength, and the characteristics of split foot in ALS patients were analyzed from the perspective of electrophysiology. Receiver operating characteristic (ROC) curve was used to analyze the sensitivity and specificity of peroneal nerve/tibial nerve CMAP amplitude ratio in distinguishing ALS patients from controls.Results:A total of 101 ALS patients with lower limb involvement and 110 controls with normal lower limb muscle strength were collected. Among the 101 ALS patients with lower limb involvement, strength of ankle plantarflexors was greater than that of ankle dorsiflexors in 35.64% (36/101) patients, strength of ankle dorsiflexors was greater than that of ankle plantarflexors in 5.94% (6/101) patients, and strength of ankle plantarflexors and ankle dorsiflexors was equal in 58.42% (59/101) patients. Strength of hallux dorsiflexors was lower than that of hallux plantarflexors in 53.47% (54/101) patients, strength of hallux dorsiflexors was greater than that of hallux plantarflexors in 1.98% (2/101) patients, and the strength of hallux dorsiflexors and hallux plantarflexors was equal in 44.55% (45/101) patients. The incidence of split leg was negatively correlated with age ( OR=0.25, 95% CI 0.16-0.40, P<0.05), course of disease ( OR=0.52, 95% CI 0.38-0.80 P<0.05) and ALS functional revised scores ( OR=0.29, 95% CI 0.12-0.67, P<0.05). The incidence of split foot was negatively correlated with the onset time of lower limb symptoms ( OR=0.96, 95% CI 0.93-0.99, P<0.05). Compared with the control group, the differences of the decrease of CMAP amplitude in the common peroneal nerve and tibial nerve [the common peroneal nerve (6.45±2.56) mV vs (3.63±1.83) mV, tibial nerve (12.87±4.72) mV vs (9.18±6.22) mV] were statistically significant ( t=-4.65, t=-3.44, both P<0.001) and the differences of the peroneal nerve/tibial nerve CMAP amplitude ratio (0.54±0.24 vs 0.36±0.18) decrease was statistically significant ( t=-4.31, P<0.001) in patients with split foot. ROC curve analysis showed that the area under the ROC curve of CMAP amplitude ratio of common peroneal nerve/tibial nerve in ALS patients with split foot was 0.70, indicating that the accuracy of CMAP amplitude of common peroneal nerve/tibial nerve in distinguishing ALS patients from controls was low. Conclusions:In ALS patients with lower limb involvement, strength of ankle dorsiflexors is weaker than that of ankle plantarflexors, and strength of hallux dorsiflexors is weaker than that of hallux plantarflexors. At the diagnostic level, the CMAP amplitude ratio of common peroneal nerve/tibial nerve in ALS patients with split foot has a lower accuracy in the diagnosis of ALS.
6.Breeding of peanut variety Yuhua 4 by in vitro mutagenesis.
Guan LI ; Xia WANG ; Xiubo YIN ; Xiaohui HU ; Jing CHEN ; Lixian QIAO ; Jiongming SUI ; Jingshan WANG
Chinese Journal of Biotechnology 2017;33(5):766-774
The embryonic leaflets of peanut (Arachis hypogaea) variety Huayu 20 were used as explants and pingyangmycin as a mutagen to induce somatic embryos. Four weeks after the inoculation, the survived explants were transferred to somatic embryo germination medium containing screening reagent hydroxyproline, and finally 15 regenerated plants were obtained. Pedigree breeding method was used during the following selection breeding, and three lines with significantly increased yield and 23 lines with high oil content were obtained from these mutant offsprings. The line with both high yield and high oil content has passed peanut variety multi-location in Anhui province and was named "Yuhua 4". Its yield was 16.63% higher than that of the control variety Baisha 1016, ranking the first in all the testing varieties. Yuhua 4 showed the characteristics of early maturity, small pod and high oil content. The oil content of kernels was 56.10%, higher than that of original parent Huayu 20 with 49.50% oil content, tested by the Ministry of Agriculture of Oil and Products Quality Supervision, Inspection and Test Center (Wuhan), and the yield was 15% higher than that of Huayu 20. It was concluded that in vitro mutagenesis and target screening was an effective way on creating new germplasm and breeding new variety in peanut.
7.Effect of ACC oxidase gene AhACOs on salt tolerance of peanut.
Jianbin HUANG ; Wenjie ZHOU ; Lei FANG ; Mingming SUN ; Xin LI ; Jingjing LI ; Xiaoting LI ; Yanyan TANG ; Defeng JIANG ; Hong ZHU ; Jiongming SUI ; Lixian QIAO
Chinese Journal of Biotechnology 2023;39(2):603-613
ACC oxidase (ACO) is one of the key enzymes that catalyze the synthesis of ethylene. Ethylene is involved in salt stress response in plants, and salt stress seriously affects the yield of peanut. In this study, AhACO genes were cloned and their functions were investigated with the aim to explore the biological function of AhACOs in salt stress response, and to provide genetic resources for the breeding of salt-tolerant varieties of peanut. AhACO1 and AhACO2 were amplified from the cDNA of salt-tolerant peanut mutant M29, respectively, and cloned into the plant expression vector pCAMBIA super1300. The recombinant plasmid was transformed into Huayu22 by pollen tube injection mediated by Agrobacterium tumefaciens. After harvest, the small slice cotyledon was separated from the kernel, and the positive seeds were screened by PCR. The expression of AhACO genes was analyzed by qRT-PCR, and the ethylene release was detected by capillary column gas chromatography. Transgenic seeds were sowed and then irrigated with NaCl solution, and the phenotypic changes of 21-day-seedings were recorded. The results showed that the growth of transgenic plants were better than that of the control group Huayu 22 upon salt stress, and the relative content of chlorophyll SPAD value and net photosynthetic rate (Pn) of transgenic peanuts were higher than those of the control group. In addition, the ethylene production of AhACO1 and AhACO2 transgenic plants were 2.79 and 1.87 times higher than that of control peanut, respectively. These results showed that AhACO1 and AhACO2 could significantly improve the salt stress tolerance of transgenic peanut.
Salt Tolerance/genetics*
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Arachis/genetics*
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Plant Breeding
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Ethylenes/metabolism*
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Plants, Genetically Modified/genetics*
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Gene Expression Regulation, Plant
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Plant Proteins/genetics*
8.Breeding peanut variety Yuhua 7 by fast neutron irradiation and tissue culture.
Xia WANG ; Luxiang LIU ; Lixian QIAO ; Jiongming SUI ; Defeng JIANG ; Guan LI ; Linshu ZHAO ; Jingshan WANG
Chinese Journal of Biotechnology 2019;35(2):270-280
Creating new germplasms and breeding new cultivars in peanut by radiation mutagenesis and tissue culture were conducted in this study, aiming to develop new breeding method of peanut. Mature seeds from Luhua 11, the most commonly grown peanut cultivar in Northern China, were treated by fast neutron irradiation. Then the embryo leaflets were separated from the irradiated seeds and inoculated on the media, and the regenerated seedlings were obtained through somatic embryogenesis pathway. The regenerated seedlings were grafted, acclimated and then transplanted into field and the selfed pods were harvested from 83 regenerated plants. The progenies were selected by the pedigree method, and 107 mutants were obtained from the progenies of the 83 regenerated plants. Different mutants showed obvious variation in many agronomic traits, including main stem height, branch number, pod shape and size, seed coat color, inner seed coat color, oil content and protein content etc. Yuhua 7, a new peanut variety with low oil content, early maturity and waterlogging tolerance was obtained. The yield of Yuhua 7 was over 14% higher than that of the mutagenic parent Luhua 11, and the oil content of kernels was 47.0%, lower than that of parent Luhua 11 with 52.1% oil content. Yuhua 7 had passed peanut variety regional multi-location trials in Liaoning Province in 2016 and its average yield was 13.8% higher than that of the control variety Baisha 1017. It had also passed national peanut variety registration, and the registration ID is "GPD peanut (2018) 370105". The results show that irradiation mutagenesis combined with tissue culture is an effective method for creating new germplasm and breeding new varieties of peanut.
Arachis
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Breeding
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China
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Fast Neutrons
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Plant Breeding
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Seeds