Bile Duct Neoplasms ; diagnosis ; Bile Ducts, Intrahepatic ; pathology ; Cholangiocarcinoma ; diagnosis ; Humans ; In Situ Hybridization, Fluorescence

Objective To explore the effects of health education on the behavior therapy for community senile patients with urinary incontinence which is guided by the transtheoretical model. Methods Totals of 80 community senile patients with urinary incontinence were selected by convenience sampling method, and then randomized into control group and observation group, 40 patients per group. The control group were given conventional community health education,and the observation group were interfered with health education guided by the transtheoretical model on the basis of conventional community health education. Six months after intervention, compared the differences of urinary incontinence symptoms, self-efficacy, and quality of life between two groups.Results After six months′ intervention, the urinary incontinence symptoms, self-efficacy, and quality of life for patients in two groups were all improved. Moreover, the patients in the observation group were improved more significantly compared with those in the control group, and the differences were statistically significant (P<0.05).Conclusions The intervention of health education guided by transtheoretical model can enhance the compliance of behavioral therapy for community senile patients with urinary incontinence, and improve their urinary incontinence symptoms, self-efficacy and quality of life.

Recent epidemiological studies have increasingly found that pregnant women who are exposed to air pollutants (for example airborne particulate matter, nitrogen oxides, ozone, and sulfur dioxide) increase the risk of various birth defects in their offspring, such as congenital heart disease, neural tube defects, cleft lip and palate, and hypospadias. Hypospadias not only impairs the sexual function of infants but also causes major social and psychological problems during their growth period, therefore, the prevention and treatment of hypospadias infant carry substantial public health importance. However, the association between prenatal exposure to air pollution and hypospadias remains controversial. The study reviews the epidemiological research progress and potential biological mechanisms of prenatal maternal exposure to air pollutants such as particulate matter, nitrogen oxides, ozone, sulfur dioxide, and the risk of hypospadias in offspring. The study also summarizes the limitations of previous research and looks forward to future research directions, to provide scientific evidence for creating a healthy living environment for pregnant women, and reducing the risk of hypospadias in offspring.

Recent epidemiological studies have increasingly found that pregnant women who are exposed to air pollutants (for example airborne particulate matter, nitrogen oxides, ozone, and sulfur dioxide) increase the risk of various birth defects in their offspring, such as congenital heart disease, neural tube defects, cleft lip and palate, and hypospadias. Hypospadias not only impairs the sexual function of infants but also causes major social and psychological problems during their growth period, therefore, the prevention and treatment of hypospadias infant carry substantial public health importance. However, the association between prenatal exposure to air pollution and hypospadias remains controversial. The study reviews the epidemiological research progress and potential biological mechanisms of prenatal maternal exposure to air pollutants such as particulate matter, nitrogen oxides, ozone, sulfur dioxide, and the risk of hypospadias in offspring. The study also summarizes the limitations of previous research and looks forward to future research directions, to provide scientific evidence for creating a healthy living environment for pregnant women, and reducing the risk of hypospadias in offspring.

Objective: To summarize the diagnosis and prognosis of adrenocortical carcinoma in children. Methods: Medical records of 10 pediatric patients with adrenocortical cancer treated in Children's Hospital of Nanjing Medical University from September 2010 to March 2018 were retrospectively reviewed, and their clinical manifestation, laboratory, auxiliary, and pathological examination results, and prognosis were analyzed. Results: The average age of all patients (5 male and 5 female pediatric patients) was (53.3+48.4) months. Clinical mani-festations included abdominal mass, hypertension, cortisol level, and peripheral precocious puberty. Laboratory tests showed that lactate dehydrogenase, neuroenolase, and cortisol levels were high in some patients, and sex hormones were abnormal. Auxiliary examination using the abdominal computed tomography enhancement showed irregular an adrenal gland, uneven density, necrosis, mass calcification, and some infiltration into the surrounding tissue. Pathological examination suggests tumor cell pleomorphism, more frequent pathological division, high mitotic index, abundant interstitial sinusoid, necrosis, tumor infiltration, vascular invasion, and Weiss score of≥3 points. Lactate acid dehydrogenase and cortisol levels; Weiss score; and tumor size, staging, and resection rate were not statistically different among prognostic factors. Conclusions: For pediatric patients with adrenal masses, the survival rate should be improved by combining the clinical manifestation, laboratory examination, and auxiliary examination for the early diagnosis of adrenocortical carcinoma and to select the appropriate treatment. Combined with pathological results, adrenocortical carcinoma can be well differentiated from other adrenal masses.

At present, the negative impact caused by white pollution has spread to all aspects of human society economy, ecosystem, and health, which causes severe challenges for developing the circular bioeconomy. As the largest plastic production and consumption country in the world, China has shouldered an important responsibility in plastic pollution control. In this context, this paper analyzed the relevant strategies of plastic degradation and recycling in the United States, Europe, Japan and China, measured the literature and patents in this field, analyzed the status quo of technology from the perspective of research and development trends, major countries, major institutions, and discussed the opportunities and challenges faced by the development of plastic degradation and recycling in China. Finally, we put forward future development suggestions which include the integration of policy system, technology path, industry development and public cognition.
Humans ; Plastics ; Ecosystem ; Environmental Pollution ; Recycling ; Policy

Objective To discuss the efficacy of laparoscopic ureteroureterostomy for upper pole hydronephro-sis and ureteral dilatation in children with complete duplex kidney.Methods The clinical data of 14 patients (15 units in total)who underwent laparoscopic ureteroureterostomy from April 2016 to October 2017 were retrospectively analyzed. Nine out of 14 cases had repeated urinary tract infections(UTI)and other symptoms[6 cases in group A:patients without vesicoureteral reflux(VUR)but presenting urinary tract infection (UTI)symptoms,3 cases in group C:patients diagnosed with VUR];5 cases of asymptomatic patients were selected as group B.All the 14 cases had upper pole hydronephrosis and ureteral dilatation.Preoperative examinations included ultrosonograpy,urinary magnetic resonance urography(MRU), intravenous pyelography (IVP),voiding cystourethrogram(VCUG),and nuclear renal scanning.It was found that 4 cases had ureterocele;3 cases had recurrent cystoureteral reflux (group C)before operation,and 1 case had cystoureteral re-fluxed after replantation.Results Laparoscopic surgery was successful in all of 14 children.None of them were shifted to open surgery because of abdominal viscera injury bleeding.The operation duration was 85－140 min.The average posto-perative hospital stay was 5.58 days.There was neither urinary anastomotic leakage nor UTI.Fourteen cases were followed up and the postoperative follow－up period was 7－23 months.No cases developed urinary tract infection except 2 cases with vescioureteral reflux.Ultrasound examination showed that the upper renal parenchyma of 5 children was thicker,ul-trasonography showed that upper pole hydronephrosis was better and ureteroceles were smaller.There was no complication such as lower pole hydronephrosis.The symptoms of urinary tract infection disappeared after operation.Conclusions Laparoscopic ureteroureterostomy can treat renal duplication with less trauma,and it is safe and effective.It can be one of therapeutic regimen to treat low－functional upper pole hydronephrosis and ureteral dilatation in renal duplication.Howe-ver,this procedure cannot be used for vescoureteral reflux cases because of high rate of stump infection.

Minimally invasive surgery experienced a rapid development in the past thirty years, of which the laparoscopy has been widely used in gastrointestinal surgery. Lymph node dissection is one of the difficulties of laparoscopic radical resection of gastric cancer. The lymph node dissection along the left gastroepiploic vessels is a difficult part, which usually causes bleeding and splenic injury. This article mainly introduce the indications, contraindications, surgical preparations, the difficulties and techniques during the lymph nodes dissection when the operator stood on the left side of the patients, and perioperative complications of lymph nodes dissection along the left gastroepiploic vessels.

Objective:To explore the role of Grx2 in the pathogenesis of cataract by establishing Grx2 knockout (KO) and knockin (KI) mouse models. Methods:Ten black C57BL/6J mice were selected to make Grx2 KO model ( n=5) and Grx2 KI model ( n=5) using CRISPR/Cas9 system.The offspring mice were sequenced by tail clipping and included in the corresponding experimental group according to the genotype.The general condition and lens opacity was recorded.After the mice were sacrificed, the pathological changes of lens were observed by hematoxylin-eosin staining.The contents of reactive oxygen species (ROS) and 8-hydroxy-desoxyguanosine (8-OHdG) were analyzed by enzyme-linked immunosorbent assay (ELISA).The relative expression levels of Grx2, glutathione (GSH), B-cell lymphoma-2 (Bcl-2) , glutathione disulfide (GSSG) and Bcl-2-associated X protein (Bax) in mice lens were assayed.The use and feeding of experimental animals were in accordance with the Regulations on the Management of Experimental Animals issued by the State Science and Technology Commission.The study protocol was approved by the Ethics Committee of the Second Affiliated Hospital of Chongqing Medical University (No.2020-125). Results:The offspring of Grx2 KO and Grx2 KI homozygous and heterozygous mice were confirmed by tail cutting nested PCR and gene sequencing.Compared with the wild type (WT) mice of same age, the lens opacity of Grx2 KO heterozygous mice occurred earlier, while the lens of Grx2 KI homozygous mice remained transparent all the time.A large number of gaps and vacuoles were found in the lens fibers of 5-month-old Grx2 KO mice.The 8-OHdG content and ROS fluorescence intensity in the lens of 5-month-old Grx2 KO mice were (3.886±0.326)ng/ml and 1 594±132, which were significantly higher than (3.531±0.250)ng/ml and 1 157±123 in WT mice ( t=2.711, P=0.033; t=3.384, P=0.028).The relative expression levels of Grx2, GSH and Bcl-2 in the lens of 5-month-old Grx2 KO mice were 0.23±0.01, 0.70±0.06 and 0.32±0.03, which were significantly lower than 0.52±0.02, 1.04±0.08 and 0.49±0.04 of WT mice ( t=2.815, P=0.020; t=2.457, P=0.033; t=2.279, P=0.041). Conclusions:Grx2 KO and Grx2 KI mouse models are successfully established in this study.The occurrence and development of age-related cataract are accelerated in Grx2 KO mice.

Objective:To investigate the short-term outcomes of totally robotic surgical system and robotic surgical system assisted radical gastrectomy for gastric cancer.Methods:The retrospective cohort study was conducted. The clinicopathological data of 290 patients who under-went robotic surgical system radical gastrectomy for gastric cancer in the First Affiliated Hospital of Army Medical University from January 2018 to November 2021 were collected. There were 208 males and 82 females, aged 58 (range, 24?84)years. Of the 290 patients, 125 patients undergoing totally robotic surgical system radical gastrectomy combined with reconstruction of digestive tract were divided into the totally robot group, and 165 patients undergoing robotic surgical system radical gastrectomy combined with a small midline incision-assisted reconstruction of digestive tract were divided into the robotic-assisted group. Observation indicators: (1) surgical and postoperative situations; (2) postoperative complications. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were represented as M(range), and comparison between groups was conducted using the Mann-Whitney U test. Comparison of ordinal data was conducted using the non-parameter rank sum test. Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test or Fisher exact probability. Results:(1) Surgical and postoperative situations. The operation time, volume of intraoperative blood loss, length of incision, duration of postoperative analgesic using, time to postoperative gastric tube removal, time to postoperative initial water intake, time to postoperative first anal flatus, duration of post-operative hospital stay were (246±43)minutes, (104±51)mL, 4(range, 3?6)cm, (2.2±0.5)days, 36(range, 10?112)hours, 62(range, 32?205)hours, 63(range, 18?138)hours, 8(range, 6?50)days in patients of the totally robot group, versus (296±59)minutes, (143±87)mL, 6(range, 3?13)cm, (3.6±0.7)days, 42(range, 12?262)hours, 90(range, 18?262)hours, 80(range, 16?295)hours, 9(range, 6?63)days in patients of the robotic-assisted group, showing significant differences in the above indicators between the two groups ( t=8.04, 4.42, Z=?13.98, t=18.46, Z=?5.47, ?5.87, ?6.14, ?4.04, P<0.05). (2) Post-operative complications. Cases with systemic related complications and cases with pulmonary infection were 7 and 4 in patients of the totally robot group, versus 31 and 16 in patients of the robotic-assisted group, showing significant differences in the above indicators between the two groups ( χ2=10.86, 4.68, P<0.05). Further analysis showed that there were significant differences in age ≥60 years, body mass index ≥25 kg/m 2, tumor diameter ≥3 cm, TNM staging as stage Ⅲ of cases with postoperative complications between the totally robot group and the robotic-assisted group ( odds ratio=0.44, 0.17, 0.40, 0.31, 95 confidence interval as 0.20?1.00, 0.03?0.88, 0.18?0.89, 0.11?0.84, P<0.05). Conclusion:Totally robotic surgical system radical gastrectomy for gastric cancer is safe and feasible with advantages of minimal trauma and quick recovery, especially for patients as age ≥60 years, body mass index ≥25 kg/cm 2, tumor diameter ≥3 cm and TNM stage Ⅲ in complication controlling.