Objective To investigate the effects of lipopolysaccharide(LPS) on the tryptophan-kynurenine(TRP) metabolic pathway in rat brains and provide new evidence for the relationship between inflammation and depression.Methods Rats in LPS group were given a single dose of 3.5 mg/kg LPS.while the rats in control group were given the same dosage of saline.The dialysis in ventro-hippocampus were collected by microdialysis within 8 hours and then the TRP,KYN and KA were detected by LC-MS/MS.And the expression of indoleamine 2,3-dioxygenase was detected by Western-blot.Results The level of TRP((550.15± 107.96) pmol/L) and KYN ((337.95±62.73) pmol/L) showed a time-dependent increase after administration LPS 4 h compared with the control group(TRP (368.38±59.31) pmol/L,KYN (172.80±43.96) pmol/L),while KA level in the circulation exhibited a trend to decrease,especially at 7 h ((3.47±0.62) pmol/L,P＜0.05).The ratio of KYN/TRP significantly increased at about 5 h (0.69±0.11,P＜ 0.05),and an ratio of KA/KYN (0.02±0.00) was dramatically decreased after administering LPS 4 h compared with the control group (0.05±0.01)(P＜0.05).Most of the analytes showed more dramatic changes around 4 h to 8 h.LPS group(1.48±0.37) increased the protein expression of indoleamine 2,3-dioxygenase compared with the control group(1.00±0.24) (P＜0.01).Conclusions LPS may cause tryptophan metabolic abnormalities and accelerate the way of kynurenine metabolism,leading to decreased the kynurenic acid status.

Objective:To investigate the effect of BMSCs transplantation plus hyperbaric oxygen (HBO) on repair of rat SCI. Methods:Seventy five male rats were divided randomly into five groups:sham, vehicle, BMSCs transplantation group, combination group, 15 rats in each group. Every week after the SCI onset, all animals were evaluated for behavior outcome by Basso-Beattle-Bresnahan (BBB) score and inclined plane test. Axon recovery was examined with focal spinal cord tissue by electron microscope at 6 weeks after the SCI onset. HE staining and BrdU staining were performed to examine the BMSCs and lesion post injury. Somatosensory evoked potential (SEP) testing was performed to detect the recovery of neural conduction. Results:Results from the behavior tests from combination group were significant higher than rats which received only transplantation or HBO treatment. Results from histopathology showed favorable recovery from combination group than other treatment groups. The number of BrdU+ in combination group were measureable more than transplantation group (P<0.05). The greatest decrease in TNF-α, IL-1β, IL-6, IFN-αdetermined by Elisa assay in combination group were evident too. Conclusions:BMSCs transplantation can promote the functional recovery of rat hind limbs after SCI, and its combination with HBO has a synergistic effect.

Objective To investigate the expression of miRNA-16 in peripheral blood monouclear cells (PBMC)from systemic lupus erythematosus( SLE)patients. Methods Sixteen SLE patients who meet the diagnostic criteria of SLE revised in 1997 American rheumatology and 12 healthy individuals were selected as our subjects. Their peripheral blood were sampled. Total RNAs were extracted and purified. The level of miRNA-16 was determined by quantitative reverse transcription PCR( qRT-PCR). U6 was used as housekeeping control. The amount of target miRNA was normalized relative to the amount of U6(ΔCt =ΔCt miRNA-ΔCtU6 ). Relative expression levels were expressed as 2-ΔCt . Results The expression level of miRNA-16 in the SLE patients was 919. 87 ± 715. 45,significantly higher than that in the healthy control group(413. 6 3 ± 330. 69;t= -2. 497,P﹤0. 05). And miRNA-16 expression in SLE active group was 1 298. 79 ± 803. 79,significantly higher than that in SLE stable group(540. 95 ± 350. 15;t= -2. 445,P﹤0. 05). The level of miRNA-16 was related with AnuA (r=0. 669,P=0. 005),ESR(r=0. 608,P=0. 012)and SLEDAI(r=0. 530,P=0. 035). Conclusion The expression of miRNA-16 is high in SLE patients and it is related with SLE activity.

The cDNA fragment of JEV prME gene was cloned into the baculovirus shuttle vector (bacmid) to construct a recombinant baculovirus vector, defined as AcBac-prME. Then the recombinant baculovirus Ac-prME was obtained by transfecting Sf9 cells with AcBac-prME. Western blot analysis and immunofluorescence results indicated that both prM and E proteins were efficiently expressed in Sf9 cells. Electron microscopy suggested that prME was assembled into JEV-VLPs. To further evaluate the potential of JEV-VLPs as vaccine, the mice were immunized with JEV-VLPs and then challenged with lethal JEV. The results of mice survival and pathological changes demonstrated that the JEV-VLPs performed complete protection against JEV-P3 strain and relieved pathological changes in the mice brain significant. This study suggest that JEV-VLPs would be a potential vaccine for Japanese encephalitis virus.
Animals ; Antibodies, Viral ; immunology ; Encephalitis Virus, Japanese ; genetics ; immunology ; Encephalitis, Japanese ; immunology ; prevention & control ; virology ; Humans ; Japanese Encephalitis Vaccines ; administration & dosage ; genetics ; immunology ; Mice ; Mice, Inbred BALB C ; Sf9 Cells ; Vaccination ; Vaccines, Virus-Like Particle ; administration & dosage ; genetics ; immunology ; Viral Envelope Proteins ; administration & dosage ; genetics ; immunology

Objective To investigate the etilolgy of failed pyeloplasty in children and to study the feasibility of redo laparoscopic surgery for recurrent nreterupelvic junction obstruction.Methods The clinical data of 39 patients with recurrent ureteropelvic junction obstruction after the primary pyeloplasty underwent redo laparoscopic surgery were analyzed retrospectively between September 2009 and June 2016 in our institution.There were 31 males and 8 females with a mean age of 66 months,ranged from 4 to 204 months.28 patients had left obstructions and 11 had fight obstructions,who were diagnosed by ultrasonography,MRU,and MAG3 renal scan et a1.Under general anesthesia,we identified that two patients (5.1％) had renal calices strictures,four patients (10.3％) had unsolved disease ureter and anastomotic strictures,two patients (5.1％) had adhesion band and anastomotic strictures,one patient had adhesion band,high ureteropelvic anastomosis and ureter torsion,and 30 (76.9％) patients had anastomotic strictures.Thirty-three patients underwent cdismembered pyeloplasty,five patients underwent onlay appendiculoureteroplasty and one patient underwent ureterocalicostomy.Results All surgeries were successfully completed without conversion.No intraoperative complication was encountered.One patient had persistent,frequent and intolerable flank pain with severe hydronephrosis after surgery,he subsequently underwent nephrectomy.One patient had persistent severe hydronephrosis which was repaired with on-lay appendiculoureteroplasty.One patient had anastomotic adhesion and balloon dilatation was performed with no further obstruction in follow up imaging.The rest of the patients got complete clinical or radiologic resolution.The successive rate was 36 of 39 (92.3％) at a mean follow up of 25 months (ranging 3-60 months).Conclusions Unsolved ureteric pathologies,anastomotic stricture,renal calices stricture,adhesion band,torsion of ureter and high ureteropelvic anastomosis all contribute to recurrent obstruction after the primary pyeloplasty.Laparoscopic redo pyeloplasty is safe and feasible for skilled surgeons.

Objective To summarize the experience of patient positing,port placements setting and robot cart docking in pediatric robot-assisted laparoscopic upper urinary tract operations.Methods From March 2017 to December 2017,140 robot-assisted laparoscopic upper urinary tract procedures were performed in our institution,including 110 cases of pyeloplasty,15 upper pole heminephroureterectomy,12 simple nephrectomy and 3 adrenalectomy.There were 103 males and 37 females with a range age from 1 month to 18 years.The assistant surgeon was adjacent to the instrument nurse,and patients were placed in a supine position with 60°-80° inclination and keep the legs low to the body.Room setup and patient positioning were similar to the traditional laparoscopic surgery.Semi-hidden incision technique was used in 140 patients:the camera port was placed umbilicus,two additional arm ports (one 5 mm and one 8 mm) were placed under direct vision,the 8 mm arm port was placed on the line of a Pfannenstiel incision and the 5 mm arm port was placed below the Xiphoid along the midline.Finally,a 3 or 5 mm assistant port was placed approximately 3 cm lateral to the inferior arm port,the line of a Pfannenstiel incision.Results The average time was (11.5 ± 3.2) min (10.5-16.5 min) from skin incision to robot cart docking completed.All surgeries were successfully completed without open conversion.One patient required an additional assist port for severe adhesion after the previously open surgery,there was no injury to other viscera.Average operative time was (146.9 ± 48.7)min (78-259 min) and average post-operative hospitalization time was (5.7 ± 1.4) d(4-10 d),respectively.There was no visual scar on abdominal 6 weeks postoperatively,and all parents made comments about their satisfaction with the cosmetic appearance.All operations got complete success at a mean follow up of 6 (1-9) months.Conclusions A good room setup,patient positioning and the semi-hidden incision technique port placements are maintaining the safety of the patient,avoiding compression injuries,allowing maximum mobility of the robotic arms,and facilitating a smooth and efficient surgery,and improving post-operative recovery.

Objective To investigate the feasibility and safety of robotic-assisted laparoscopic pyeloplasty (RALP) in infant ureteropelvic junction obstruction.Methods Of 31 infants who underwent RALP between March 2017 and August 2017 were reviewed,including 25 boys and 6 girls.22 infants were found that the hydronephrosis was in the left kidney and 9 in the right kidney.The average age of the infants was (3.5 ± 0.7) months,ranged from 8 days to 6 months,including 7 infants less than 2 months.The average weight of the infants was (6.7 ± 1.2) kg,with a minimum weight of 3.3 kg.The diagnosis and outcomes of ureteropelvic junction obstruction (UPJO) were reviewed on clinical and imaging data.The ultrasound showed that the mean anteroposterior diameter of hydronephrotic kidney was (4.01 ±0.56)cm.The split renal function was (37.1 ± 3.2) ％ in infants who were more than 2 months.Patients with proximal defect were positioned in the lateral flank position with 50°-70° inclination and as close as possible to the edge of operating table.The trocars of robotic lens and No.1 robotic arm were placed on the middle of the umbilicus and the Pfannenstiel line respectively,and the trocar of No.2 robotic arm was placed on the supraumbilical symmetry point of the trocar No.1 robotic arm,and the auxiliary trocar was placed on the Pfannenstiel line outside the 3-4 cm of healthy side of the trocar of No.1 robotic arm.During operation,the ureteropelvic junction was dissected and tailored.Then the ureter was open longitudinally at the posterior lateral side and was anastomosed at the lowest part the renal pelvis.We assessed preoperative clinical data and outcomes,and analyzed the transition experience.Data are expressed as medians for continuous variables.Results All operations were successful with no serious intraoperative complication and traditional laparoscopic or open surgical conversion.The average operative time was 108 min,the average intraoperative blood loss was 9.5 ml.The average drain removal was 1.2 days,the average start oral of feeding was 3.2 hours days and the average postoperative hospital stay was 6.2 days.Postoperative pathological results showed smooth muscle hyperplasia,hypertrophy and fibrous tissue in the urothelium,accompanied by chronic inflammation of urothelial mucosa.Patients with Clavien Ⅰ and Ⅱ complications 22.6％ (7/31) postoperatively were managed conservatively.Among them,there were 1 cases of flank pain,1 cases of hematuria,2 cases of urinary leakage,and 3 cases of urinary tract infection.Patients' symptoms disappeared by conservative treatment.No patient suffered Clavien Ⅲ and Ⅳ complication postoperatively.The renal pelvis anteroposterior diameter was 1.58 cm at three months postoperatively,which was significantly smaller than that of peroperation (P ＜ 0.05).A diuretic T1/2 showed the improvement of split renal function without urinary obstruction in all patients at three months postoperatively.The postoperative split renal function was (39.2 ± 3.5) ％,which was slightly higher than that of preoperation (P ＞ 0.05).Conclusions Severe hydronephrosis in neonates can be acted as an indication for exploratory surgery when the surgeon's ability,anesthesia,monitoring and management conditions are available.Robotic-assisted laparoscopic pyeloplasty is a safe and feasible option for the treatment of UPJO in infant with less trauma,rapid recovery and good cosmetic result.We suggest that RALP is potentially a recommended feasible treatment option for infant with UPJO.

Objective:To discuss the efficacy of robotic-assisted laparoscopic hemi-nephrectomy for the treatment of complete duplex kidney.Methods:We retrospectively reviewed the clinical data of the 20 patients who had robotic-assisted laparoscopic hemi-nephrectomy surgery from March 2017 to November 2019. Four of these patients were male, while the others were female.The average age of these patients was 28.6 months, ranged from 1-2 months.The duplex kidneys were on the upper pole, 9 on the left side, and l1 on the right side. All the patients had a history of gradual exacerbations of hydronephrosis before surgery. The most commonly seen symptoms were lumbar/abdominal pain(2 cases), dysuresia(1 case) and leakage of urine(1 case). Twelve patients had a history of repeated urinary tract infections. One patient expressed the cystic mass of the urethra protruded from the external orifice. Preoperative diagnosis was confirmed by magnetic resonance urinary water imaging (MRU), diuretic renal dynamic imaging(ECT), intravenous pyelography(IVP), and voiding cystoureterography(VCUG). Two cases were of ectopic urete, 4 of ureterocele and 4 of vesieoureteral reflux(VUR). All the patients underwent hemi-nephrectomy for the treatment of complete duplex kidney. Then we observed the intraoperative and postoperative complications and follow-ups.Results:A11 the cases performed by robotic-assisted laparoscopic surgery transperitoneally were completed successfully.There was no significant complication during the surgery with quick recovery after the surgery.The mean operative time was 109.5min(range 82-150 min). The mean estimated blood loss was about 9 ml (range 5-22 ml). Routinely placing a peripelvic catheter drainage was recommended. The mean hospital stay was 5.9 days(range 4-8 days). One patient was lost to follow-up.Mean follow-up was 13.6 months (range 3 -30 months). The results of the re-examination of ECT did not indicate loss or atrophy of lower renal function 3 months after operation. Primary symptoms improved.Conclusions:Robotic-assisted laparoscopic hemi-nephrectomy for hydronephrosis with duplex kidney could be minimal invasive and effective, and has achieved similar results with cosmetic scar .

Objective:To investigate the clinical efficacy of labial mucosa graft coupled preputial island flap urethroplasty for recurrent penile curvature after hypospadias repair.Methods:The data of 35 patients with recurrent penile curvature after hypospadias repair who underwent labial mucosa graft coupled preputial island flap urethroplasty in four hospitals from January 2021 to March 2023 were retrospectively reviewed. The median age of the patients was 15(13, 18)years old, five of them had penile dehiscence, and four had urethrocutaneous fistula. All patients received labial mucosa graft coupled preputial island flap urethroplasty, the penile flexion was confirmed by artificial erection test, and the urethra is obliquely cut at the most obvious curvature of the penis. By removing the ventral fibrotic scar tissue, the length of the urethral defect was measured. The urethral plate was reconstructed with the same length of labial mucosa graft and an adjacent preputial island flap was transplanted to cover the reconstructed urethra plate to form a new urethral lumen. The inner urethral stent tube was extracted three days after the operation, and the outer urethral stent tube was removed three weeks after the surgery. Diagnostic urethral exploration was performed 5 weeks post-operation, uroflowmetry examination was performed seven weeks after the procedure, and the perioperative and postoperative follow-up data were analyzed.Results:All patients underwent a successful surgery, with the average duration of the procedure being (114.7±20.1)minutes. After mean follow-up of (15.5±5.9)months, no penile curvature occurred, and 32 patients were successfully repaired. Uroflowmetry examination was achieved in 21 patients at the seventh week after surgery showed their mean maximum flow rate was (18.4±3.7)ml/s. Three cases (8.6%, 3/35) developed urethrocutaneous fistula, who were repaired successfully 6 months after surgery.Conclusions:Utilizing the combination of labial mucosa grafts and preputial island flaps for urethroplasty has been proven to be a reliable and safe option for individuals with recurrent penile curvature following hypospadias repair, with a high success rate and few complications.

Objective:To evaluate the safety and feasibility of robotic-assisted laparoscopic resection of bladder rhabdomyosarcoma.Methods:A retrospective study was performed in 4 children underwent robotic-assisted surgery for bladder rhabdomyosarcoma from July 2018 to September 2019 in our hospital. The perioperative information and short time outcomes were collected. All the four patients were male. The average age of these patients was 68 months (from 11 to 122 months). After cystoscopy biopsy was conducted, preoperative chemotherapy was carried out. Preoperative radiotherapy was also added depends on the tumor response, then robotic-assisted surgery was performed. Radical cystectomy and orthotopic neobladder reconstruction with bilateral ureter reimplanataion were carried out for the bladder was widely occupied case. Bladder preserving surgery was performed for the other three localized cases.Results:All of the four operations have been conducted successfully without conservation to open surgery. The mean operative time was 189(104-316) min while the mean estimated blood loss was 32.5(20-50) ml. The mean tumor diameter was 4.48(2.7-6.0)cm. According to the pathological results, all of the four cases were diagnosed as embryonal rhabdomyosarcoma. One case had positive margin while other three cases had negative margins. No complication more than Clavien-Dindo grade Ⅲ was observed. The mean length of hospital stay was 18(14-24)days and the mean follow-up time was 14.7(7-21) months. Postoperative chemotherapy was carried out according to the protocol of IRS low risk group for all cases (VAC, eight cycles). Postoperative radiotherapy was conducted for the case with positive margin. No recurrence was recorded during the follow-up period.Conclusions:Robotic-assisted laparoscopic technique for the treatment of bladder rhabdomyosarcoma in children is safe and feasible.