Objective To observe the therapeutic effect of discontinuation pyeloplasty in children with hydronephrosis.Analyze the factors that affect the recovery of postoperative renal function.Methods A retrospective analysis was performed on 125 children with hydronephrosis caused by unilateral ureteropelvic junction obstruction from January 2014 to December 2015 in Hunan Children's Hospital.Preoperative and postoperative renal pelvis anteroposterior diameter,renal parenchymal thickness,segmental artery resistance index,glomerular filtration rate (GFR),blood urea nitrogen,serum creatinine and other indicators were observed.The measurement data were expressed as mean ± standard deviation (Mean ± SD),and paired t-test was used for inter-group comparison,and Chi-square test was used for inter-group comparison of counting data.Logistic regression analysis was performed on the factors such as sex,age,hydronephrosis location and hydronephrosis degree before operation,and the important factors affecting postoperative renal function recovery were screened out.Results Postoperative renal pelvis anteroposterior diameter (1.87 ± 1.02) cm,renal parenchyma thickness (6.34 ± 1.41) mm,segmental arterial resistance index (0.68 ± 0.05),GFR (40.54 ± 3.25) ml/min,blood urea nitrogen (2.18 ± 1.24) mmol/L and serum creatinine (27.54 ± 6.21) μg/ml and other indicators were better than preoperative,the difference were statistically significant (P ＜ 0.05).Multivariate logistic regression analysis showed that the degree of hydronephrosis,age and level of renal function were the influencing factors of renal function recovery (P ＜ 0.05).The postoperative recoveryof renal function was not related to gender,location of hydronephrosis,surgical methods and other factors (P ＞ 0.05).Conclusions Pyeloplasty is good for children with hydronephrosis,it can improve the degree of patients with hydronephrosis,improve renal function recovery.Preoperative patients with age,degree of hydronephrosis and sub-renal function levels affect postoperative renal function recovery.

Objective: To analyze the relationship between the expression of homeobox A13 (HOXA13), epidermal growth factor (EGF) and epidermal growth factor receptor (EGFR) gene in prepuce tissue of children with congenital hypospadias, discuss the relationship and significance of HOXA13, EGF and EGFR genes in congenital hypospadias and to understand their role in the pathogenesis of hypospadias. Methods: 65 cases of hypospadias were selected as the experimental group and 42 cases of phimosis as the control group. Hematoxylin-eosin (HE) staining was used to observe the pathological characteristics of prepuce tissues in the two groups. Immunohistochemistry, real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) and Western blot were used to detect the expression of HOXA13, EGF and EGFR in the two groups. Results: ⑴ HE staining showed that the epidermis of hypospadias was composed of keratinized stratified flat epithelium and epidermis of penile skin. The prepuce of phimosis children showed only infiltration of inflammatory cells in the superficial layer of the inner prepuce, blood vessel congestion, no obvious appendage structure, mostly fibroblasts. ⑵ Immunohistochemistry: The positive expressions of HOXA13, EGF and EGFR in the control group were significantly higher than those in the experimental group (P<0.01). ⑶ qRT-PCR: The expression levels of HOXA13, EGF and EGFR in the control group were 53.447±33.471, 80.012±20.430, 75.012±14.339, and the expression levels of HOXA13, EGF and EGFR in the experimental group were 9.128±5.996, 45.521±18.242, 32.043±10.215, respectively. The expression of HOXA13, EGF and EGFR in the control group was significantly higher than that in the experimental group (P<0.01). ⑷ Western blot: The expression levels of HOXA13, EGF and EGFR in the experimental group were lower than those in the control group. Conclusions The expression of HO-XA13, EGF and EGFR in prepuce tissue of children with hypospadias is low, which may be related to hypospadias.

Objective:To investigate the association between preterm birth, low birth weight and the risk of hypospadias.Methods:According to the search strategy of Cochrance Collaborative Network, the China National Knowledge Internet (CNKI), VIP, Wanfang, Pubmed, Cochrance and Embase were searched from the establishment of the database to April 2022. The literature on the relationship between preterm birth, low birth weight and the risk of hypospadias was included. Meta analysis was conducted on the relationship between preterm birth, low birth weight and the risk of hypospadias.Results:A total of 13 articles were included, including cases from Asia, Europe, Australia and America. Newcastle-ottawa Scale was used for evaluation, and the scores were all above 6. There were 10 articles on the relationship between preterm birth and the risk of hypospadias, all of which were case-control studies. Heterogeneity test I2=46%, P=0.05. There were 3 521 cases in the case group and 95 816 cases in the control group. Compared with the control group, preterm birth was a risk factor for hypospadias ( OR: 2.13, 95% CI: 1.89-2.41), and the difference was statistically significant ( Z=12.21, P<0.01). There were 11 articles on the association between low birth weight and the risk of hypospadias, all of which were case-control studies. Heterogeneity test I2=47%, P=0.04. There were 2 460 cases in the case group and 94 260 cases in the control group. Compared with the control group, low birth weight was a risk factor for hypospadias ( OR: 3.29, 95% CI: 2.57-4.22), and the difference was statistically significant ( Z=9.40, P<0.01). Conclusions:Based on meta-analysis of published literature, preterm birth and low birth weight increase the risk of hypospadias.