Objective To evaluate the feasibility and outcomes of robotic-assisted laparoscopic pyeloplasty in children .Methods A retrospective study was performed in patients who underwent robotic-assisted laparoscopic pyeloplasty ( Anderson-Hynes ) at our institution between January 2014 to August 2014.Totally 6 boys were diagnosed as left ureteropelvic junction obstruction depending on the symptoms and radiographic studies .The mean age was 9 years ( range 4 -12 years ) .Results The procedure was performed successfully without conversion to open surgery in all of the cases .Mean operative time was 216 min (range 175-269 min), with a mean robotic anastomosis time of 45 min (range 30-60 min).Mean estimated blood loss was less than 15 ml.The mean hospitalization was 4.5 days.Mean follow-up period was 10 months ( range 7 -14 months ) .There were no perioperative complications , and recovery was uncomplicated (without recurrence, pyelonephritis, nephrarctia) in all of the patients.Conclusion Robotic-assisted laparoscopic pyeloplasty can be safely performed in children older than 4-year-old with ureteropelvic junction obstruction .

OBJECTIVE Metastasis-associated in colon cancer-1 (MACC1) is an oncogene that has been newly identified. It promotes tumor proliferation and invasion via the MET pathway. Our study investigated the effects of Saikosaponin-b(SS-b) on the proliferation and apoptosis of HepG2 cells and its regulation on MACC1/c-Met/Akt signaling pathway. METHODS HepG2 cells were treated with SS-b (10-800 g·L-1) for 48 h in vitro. The CCK-8 assay was used to assess cell proliferation, and cell apoptosis was determined by Hoechst33258 staining, AnnexinⅤ/PI staining and caspase 3 assay. RT-PCR was used to examine the expression of MACC1, c- MET and hepatocyte growth factor (HGF) mRNA. MACC1 protein was detected by Western blot and immunohistochemistry. The protein expressions of p-c-MET, c-MET, p-AKT, AKT, p-BAD, BAD were measured by Western blot. RESULTS SS-b inhibited the growth of HepG2 cells in dose-dependent way and induced cell apoptosis significantly. HepG2 cells showed karyopyknosis, fragmentation and fluorescence highlight in SS-b treatment group. FCM results showed that apoptosis rate of HepG2 cells increased with SS- b concentration. The immunofluores?cence results showed that the MACC1 expression decreased significantly in HepG2 cells treated with SS-b. The expression levels of MACC1, c-MET and HGF mRNA in HepG2 cells were significantly inhibited by SS-b. SS-b also significantly decreased the protein expressions of MACC1, p-c-MET and p-AKT while increased the expression of p-BAD and caspase 3 in HepG2 cells(P<0.05). CONCLUSION SS-b inhibited the proliferation and induced the apoptosis of HepG2 cells by targeting the MACC1/c-Met/Akt signaling pathway.

OBJECTIVE Angiogenesis therapy has attracted interest as a potential treatment for hepatocellular carcinoma (HCC). In this study, we investigated the anti-proliferative activities and anti-angiogenesis effects of saikosaponins (SS)-b on hepatocellular carcinoma (HCC) and its regulation on VEGF/ERK/HIF-1α signal pathway. METHODS H22 hepatoma-bearing mice model and HepG-2 cells were used to study the anti-tumor and anti-angiogenesis effects of SS-b in vivo and in vitro. Pathological change of tumor tissue was observed by HE staining, the microvascular changes were detected by immunohistochemical method. The effects of SS-b on angiogenesis were examined by using the chick embryo chorioallantoic membrane (CAM) model. The effects of SS- b on proliferation, migration and invasion were investigated by MTT assay, scratch wound healing assay and transwell assay inhuman umbilical vein endothelial cell (HUVEC) and HepG2 cells in vitro. Vascular endothelial growth factor (VEGF), matrix metalloproteinase-2/9(MMP-2/9), hypoxia-inducible factor-1α (HIF-1α) expression and the phosphorylation of extracellular regulated kinase(ERK) were analyzed using RT-PCR and Western-blot. RESULTS SS-b effectively inhibited the tumor growth of H22 mice in vivo. The inhibitory rate of tumor was 49.1%, 50.7%, 66.1% in SS-b 5, 10 and 20 mg·kg-1 group respectively. HE staining results showed that SS-b induced tumor necrosis and nuclear dissolution in H22 mice. Moreover, SS-b also reduced the number of microvessels of tumor tissue in H22 mice significantly and suppressed the angiogenesis of CAM induced by b-FGF. SS-b had an obvious inhibitory effect on cell proliferation, migration and invasion of HUVEC cells and HepG-2 cells. These effects were associated with down-regulation of the expression of MMP2/9 and suppression of VEGF/ERK/HIF-1α signaling in H22 mice and Hep-G2 cells. CONCLUSION Our findings showed that SS-b exerts anti-tumor effects by inhibit?ing tumor angiogenesis via regulating VEGF/ERK/HIF-1α signal pathway in vivo and in vitro.

Objective:To examine the ultrasonographic and clinical features of post-menopausal struma ovarii(PMOS).Methods:Clinical presentations and transvaginal sonography(TVS)data of 7 PMOS patients diagnosed during surgery were retrospectively analyzed and compared with histopathological results.Results:The ages of 7 patients ranged from 52 to 77 years(60.1±8.0 years, median age: 59 years, natural menopause age: 49.9±1.8 years). Ultrasound imaging data showed all adnexal masses were unilateral(1 on the left side, 6 on the right side). The focal lesions were irregular, round or elliptic in shape, measuring 2.8-9.5 cm, with either clear or unclear margins.Two PMSO cases were diagnose as teratoma on ultrasound, showing mixed echogenic patterns, with echoless interior regions and poor sound transmission.Color doppler flow imaging found no blood flow signal inside and around the mixed echogenic areas.Five cases were misdiagnosed on ultrasound, with 2 as postmenopausal ovarian endometrial cyst and 3 as ovarian cystadenocarcinoma.All patients recovered well after surgery.By the end of the follow-up, no recurrence of struma ovarii was found in the 7 cases.Conclusions:PMSO is a rare monodermal teratoma, can be easily misdiagnosed and needs to be differentiated from postmenopausal ovarian endometrial cyst, mature teratoma, ovarian cystadenocarcinoma and other types of lesions.A mass >5 cm may exhibit characteristic ultrasonographic manifestations, including protruding thyroid nodules, cyst wall calcification, etc.A solid portion of the cystic mass with blood flow may suggest a diagnosis of struma ovarii.

Objective:To examine the ultrasound images, clinical features, intraoperative conditions, and pathological features of ovarian clear cell carcinoma(OCCC)during perimenopause, in order to improve the early diagnosis of OCCC via ultrasound examination.Methods:A retrospective analysis of 29 patients, aged 42-72(56.8±7.4)years, who were surgically treated and pathologically diagnosed with OCCC at our hospital between 1 September 2015 and 31 December 2022, including 10 in the non-menopausal phase, 3(10.3%)in early menopausal transition, 7(24.1%)in late menopausal transition, and 19(65.5%)in the post-menopausal phase.The number of pregnancies(1.86±1.04)and the number of births(0.97±0.56)were also recorded.Results:In 29 cases, the masses contained solid components, and the ultrasound manifestations were as follows: (1)single-compartment cystic masses(solid components accounted for <50% of the total volume)were found in 11 cases, with clear borders, regular morphology, ground-glass echoes inside the cystic cavity, multiple solid protrusions inside the cystic cavity, and blood flow signals inside the solid components on color Doppler flow imaging(CDFI); (2)multi-compartment cystic masses(solid components accounted for <50% of the total volume)occurred in 8 cases, with largely clear borders, ground-glass echoes inside the cystic cavity, multiple solid protrusions inside the cavity, thick walls where the protrusions were attached, varying thickness of walls separating the cystic cavities, and blood flow signals inside the solid components, walls where there were solid attachments and thicker parts of the separating walls on CDFI; (3)there were 7 cases with predominantly solid cystic masses(the solid components accounted for >50% of the total volume), unclear borders, poor translucency, irregular morphology of the solid components, uneven internal echoes, and blood flow signals in the solid component on CDFI; (4)solid masses(the solid components accounted for >95%of the total volume)were seen in 3 cases with unclear borders, irregular morphology, uneven internal echoes, and a small number of cystic cavities(cystic portion <5%), with poor translucency in the cystic cavities and blood flow signals in the solid components on CDFI.Intraoperative exploration of ascites was performed in 17 cases, and adhesion between the mass and surrounding organs was found in 27 cases.Postoperative pathological results revealed 26 cases with high grade tumors and 3 cases with intermediate grade tumors.There were 3 cases with bilateral OCCC, 13 with left side OCCC and 13 with right side OCCC.According to the FIGO pathological staging system, 12 cases were in stage Ⅰ, 10 in stage Ⅱ, 5 in stage Ⅲ and 2 in stage Ⅳ.Comparison of different pathological stages(early stages Ⅰ and Ⅱ versus late stages Ⅲ and Ⅳ)showed statistically significant differences in the ratio of pathological stages between patients with different ultrasonographic manifestations( χ2=11.163, P<0.05), and the results of two-by-two comparisons showed that OCCC patients with ultrasonographic manifestations of solid masses(solid component accounting for >95%of the total volume)were more often in the late stage at the time of onset, while OCCC patients with a high number of cystic components within the lesions were more likely to be in the early stage at the time of onset.OCCC patients with more cystic components in the lesions tended to have an earlier onset and a better prognosis. Conclusions:When ultrasound imaging shows primarily a single chamber cystic solid mass in a patient in the perimenopausal phase with an endometriosis history, together with signs of specialized examination and pelvic adhesion during transvaginal sonography, a diagnosis of OCCC should be suspected.It is of great significance to pay attention to transvaginal sonography examination, ultrasound image features and clinical symptoms in perimenopausal women for the early diagnosis of OCCC.

Objective: To investigate transport mechanism of cyperotundone in Caco-2 cell model and provide experimental basis for clinical application of Cyperi Rhizoma. Method: The toxicity of cyperotundone with different concentrations to Caco-2 cells was investigated by methyl thiazolyl tetrazolium (MTT) colorimetry, in order to determine the concentration of administration in transport test. The content of cyperotundone was determined by liquid chromatography-mass spectrometry (LC-MS) with apparent permeability coefficient (P_app) and cumulative transport capacity as indexes. The chromatographic conditions were as following:mobile phase of acetonitrile (A)-water (B) for gradient elution (0-1.5 min, 35%A; 1.5-2 min, 35%-90%A; 2-4 min, 90%A; 4-4.1, 90%-35%A; 4.1-8 min, 35%A), the flow rate at 0.3 mL · min^-1, injection volume of 1 μL, and temperature of column at 30℃. The mass spectrometric conditions was electrospray ionization (ESI) and positive ion mode, the detection ions of cyperotundone and osthole (internal standard substance) were m/z 219.2-110.9 and m/z 245.0-189.0, respectively. Effect of concentration of cyperotundone, administration time, ethylenediamine tetraacetic acid (EDTA) and P-glycoprotein (P-gp) inhibitor on the transmembrane transport of cyperotundone on in vitro cell model were investigated. Result: Cyperotundone didn't have significant toxicity to Caco-2 cells at 3-90 mg · L^-1 after incubation for 4 h. The transportion of cyperotundone in Caco-2 cell model was related to the concentration and time to a certain extent, its P_app was higher than 1×10^-6 cm · s^-1, which indicated that absorption of cyperotundone was good, the efflux rate (ER) of cyperotundone was 0.5-1.5.There was no significant difference in bidirectional P_app of cyperotundone after the addition of cell bypass transport inhibitor (EDTA) and P-gp transport inhibitor (verapamil). Conclusion: The transport mechanism of cyperotundone in Caco-2 cell model is mainly passive diffusion, and cell bypass transport and P-gp are not involved in its transport.

Background: Reverse intertrochanteric fractures are usually initially treated with closed reduction. However, sometimes these fractures are not amenable to closed reduction and require open reduction. To date, few studies have been conducted on predictors of and reduction techniques for irreducible reverse intertrochanteric fractures. Therefore, this study aimed to summarize the displacement patterns of irreducible reverse intertrochanteric fractures and corresponding reduction techniques, and explore predictors of irreducibility. Methods: We reviewed 1174 cases of trochanteric fractures treated in our hospital from January 2006 to October 2018, 113 of which were reverse intertrochanteric fractures. An irreducible fracture was determined according to intra-operative fluoroscopy imaging after closed manipulation. Fractures were assessed for displacement patterns, radiographic features of irreducibility, and reduction techniques. Logistic regression analysis was performed on potential predictors for irreducibility, including gender, age, body mass index, AO Foundation/Orthopaedic Trauma Association (AO/OTA) classification, and radiographic features. Results: Seventy-six irreducible fractures were identified, accounting for 67% of reverse intertrochanteric fractures. Six patterns of fracture displacement after closed manipulation were identified; the most common pattern was medial displacement and posterior sagging of the femoral shaft relative to the head-neck fragment. Multivariate logistic regression analysis identified three predictors of irreducibility: a medially displaced femoral shaft relative to the head-neck fragment on the anteroposterior (AP) view (odds ratio [OR], 8.00; 95% confidence interval [CI], 3.04-21.04; P < 0.001), a displaced lesser trochanter (OR, 3.61; 95% CI, 1.35-9.61; P = 0.010), and a displaced lateral femoral wall (OR, 2.92; 95% CI, 1.02-8.34; P = 0.046). Conclusions A high proportion of reverse intertrochanteric fractures are not amenable to closed reduction. Six patterns of fracture displacement after closed manipulation were identified. Different reduction techniques are required for different displacement patterns. Predictors of irreducibility include a medially displaced femoral shaft relative to the head-neck fragment on the AP view, a displaced lesser trochanter, and a displaced lateral femoral wall. These patients warrant special consideration in terms of recognition and management.

Objective:To explore the effects and mechanism of zedoary turmeric oil and its active components on the vascular endothelial growth factor A （VEGFA）， signal transducer and activator of transcription 3 （STAT3）， and mechanistic target of rapamycin （mTOR） in the ovarian cancer （OC）. Method:Network pharmacology technology was employed to analyze the mechanism of Curcumae Rhizoma on OC. Bioinformatics was used to analyze the expression of VEGFA， STAT3， and mTOR in OC and the effect on the prognosis of OC to explore the feasibility of zedoary turmeric oil in regulating VEGFA， STAT3， and mTOR in OC.The xenograft tumor model of nude mice was established， and the effects of zedoary turmeric oil and its active components on VEGFA， STAT3， and mTOR in OC were observed by hematoxylin-eosin （HE） staining， real-time fluorescence-based quantitative polymerase chain reaction （Real-time PCR）， Western blot， and immunohistochemistry （IHC）. Result:Bioinformatics analysis and literature research showed that VEGFA， STAT3， and mTOR played a special regulatory role in the occurrence and development of OC， and were potential key targets for the proliferation of OC. Network pharmacology analysis revealed that Curcumae Rhizoma could regulate multiple disease targets of OC， and mediate VEGFA， STAT3， and mTOR in OC through these multiple targets. As demonstrated by HE staining， the tumor cells in the model group were densely arranged， with no erosion on the edge and no vesicles inside. Compared with the model group， the cell density in other treatment groups was reduced， and strip-shaped erosion on the edge and small empty vesicles were observed in the tumor tissue， especially in the zedoary turmeric oil group. According to the results of Real-time PCR and IHC， zedoary turmeric oil and its active components could inhibit the mRNA and protein expression of VEGFA， STAT3， and mTOR in the OC tissue （P<0.05）. Conclusion:Zedoary turmeric oil and its active components could reduce the expression of VEGFA， STAT3， and mTOR in tumor tissue of nude mice， and inhibited the proliferation of OC through VEGFA， STAT3， and mTOR.

Objective: To explore the epidemiological characteristic of a COVID-19 outbreak caused by 2019-nCoV Omicron variant BF.7 and other provinces imported in Shenzhen and analyze transmission chains and characteristics. Methods: Field epidemiological survey was conducted to identify the transmission chain, analyze the generation relationship among the cases. The 2019-nCoV nucleic acid positive samples were used for gene sequencing. Results: From 8 to 23 October, 2022, a total of 196 cases of COVID-19 were reported in Shenzhen, all the cases had epidemiological links. In the cases, 100 were men and 96 were women, with a median of age, M (Q₁, Q₃) was 33(25, 46) years. The outbreak was caused by traverlers initial cases infected with 2019-nCoV who returned to Shenzhen after traveling outside of Guangdong Province.There were four transmission chains, including the transmission in place of residence and neighbourhood, affecting 8 persons, transmission in social activity in the evening on 7 October, affecting 65 persons, transmission in work place on 8 October, affecting 48 persons, and transmission in a building near the work place, affecting 74 persons. The median of the incubation period of the infection, M (Q₁, Q₃) was 1.44 (1.11, 2.17) days. The incubation period of indoor exposure less than that of the outdoor exposure, M (Q₁, Q₃) was 1.38 (1.06, 1.84) and 1.95 (1.22, 2.99) days, respcetively (Wald χ²=10.27, P=0.001). With the increase of case generation, the number and probability of gene mutation increased. In the same transmission chain, the proportion of having 1-3 mutation sites was high in the cases in the first generation. Conclusions: The transmission chains were clear in this epidemic. The incubation period of Omicron variant BF.7 infection was shorter, the transmission speed was faster, and the gene mutation rate was higher. It is necessary to conduct prompt response and strict disease control when epidemic occurs.
Male ; Humans ; Female ; SARS-CoV-2 ; COVID-19/epidemiology* ; Disease Outbreaks ; Epidemics ; China/epidemiology*

OBJECTIVE: To observe the analgesic effect of manipulation loading on chronic low back pain (CLBP) model rats and the expression of inflammatory factors in psoas major muscle tissue, and to explore the improvement of manipulation on local inflammatory microenvironment. METHODS: Thirty two SPF male SD rats weighing 340-360g were randomly divided into blank group, sham operation group, chronic low back pain model group and treatment group, with 8 rats in each group. In the model group, L RESULTS: There was no significant difference in PWT and PWL between the blank group and the sham operation group after modeling ( CONCLUSION Local massage loading has analgesic effect on CLBP rats, at the same time, it can inhibit the content of CGRP and NGF in psoas muscle tissue of CLBP rats, and improve the local inflammatory microenvironment.
Animals ; Calcitonin ; Calcitonin Gene-Related Peptide ; Low Back Pain/therapy* ; Male ; Nerve Growth Factor/genetics* ; Rats ; Rats, Sprague-Dawley