Objective To explore the expression of nitric oxide synthases including neuronal nitric oxide synthases(nNOS), inducible nitric oxide synthases(iNOS), endothelial nitric oxide synthases (eNOS) in neurogenic bladder tissues, and analyze it's producing feature and significance. Methods There were 30 cases with neurogenic bladder(18 males, 12 females). The average age was 6.3±3.1 years. All patients appeared with myelodysplasia, urinary and fecal incontinence in different degree. Twenty-six cases were manifested with hyperreflexia bladders, and all patients were treated with surgical procedures. During operation, collected bladder tissue samples including tissues of apex vesicae and tissues of bladder neck, and all tissues were enveloped with mineral wax. All tissues were detected for nNOS, iNOS, and eNOS respectively in tissues of apex vesicae and tissues of bladder neck,and with normal bladder tissues as control group (bladder tissues of hypospadia, 10 cases), and according to clinical features, to explore the expression of NOS, and to analyze the relationship among them. Results In normal apex vesicae tissues, all cases stained with nNOS, and distributed among bundles of smooth muscles, and surface of smooth muscles and interstitial tissue, histochemica;score (HS) 2.8-4.0 and 1.2-2.7. There were no stained cells in bladder tissues of iNOS, and HS was very low, HS:0-0. 4 and 0-0.1 ;eNOS mainly distributed in interstitial tissues in rarefaction manners, and mainly in vascular endothelial cell (VEC), and smooth muscles had no stainings the most expression among them was nNOS, and mainly distributed in bladder neck tissues. In neurogenic bladder tissues, the main expression of NOS type was iNOS, and nNOS decreased significantly. eNOS mainly expressed in VEC among interstitial tissues, and had no staining in smooth muscle cells and collagenoblast and rarefaction of microvessel in bladder tissues, and microvessel density decreased significantly than normal bladder tissues. Microvessal density(MVD) in bladder tisssus (6. 8± 3.2/100per square) was less than that in normal tissues (16.7±6.3/100 per square). Conclusions In normal bladder tissues, nNOS mainly distributes in bladder neck and urethra, and nitric oxide mainly derives from nNOS. Much more matrix fibers, fewer nitrogenergic nerves, and less nNOS expression are seen in neurogenic bladder interstitial tissue. There are more iNOS expressions in bladder tissues,and NO is mainly derived from iNOS, and it may play an important role in pathological bladder tissues, especially in fibrosis of bladder wall. eNOS may be considered as angiopoietic labeling, and may evaluate the blood supply of bladder.

Purpose To study the MRI manifestations of hippocampus with acute injury in children with epilepsy, and to explore its causes and outcomes for a better understanding of the changes of hippocampal structure with acute injury.Materials and Methods The clinical and imaging data of 8 children with epilepsy whose hippocampus showed hyperintensity in DWI were retrospectively analyzed. The bilateral hippocampal volume and ADC values were measured; changes of hippocampal volume and T2WI signal and ADC value were also analyzed.Results Eight patients were clinically diagnosed as epilepsy, 7 cases had recurrent history of seizures. MRI was performed from 1 to 5 days after the onset of epilepsy. All the 8 patients had increased unilateral hippocampal volume, 6 of whom were on the left side and the other 2 were on the right side. The affected ipsilateral hippocampal volume was significantly higher than that on the contralateral side [(2.096±0.570) cm3 and (1.768±0.447) cm3, respectively,t=-4.763,P<0.01]. The signals increased on T2WI and FLAIR; DWI showed hyperintensity with increase by approximately 25.52%. The affected ipsilateral ADC value was significantly lower than the contralateral one [(0.763±0.049)×10-3 mm2/s and (0.859±0.054)×10-3 mm2/s, respectively, t=9.598,P<0.01]. No abnormalities were found in bilateral hippocampus when 3 patients underwent MRI due to febrile convulsions and seizures before the onset of epilepsy. The affected ipsilateral hippocampal volume reduced in 3 patients after 3 to 5 months;signal was still high on T2WI and FLAIR; ADC values increased by 15.6%, the imaging results indicated hippocampal sclerosis.Conclusion Epilepsy can cause acute injury in hippocampus which demonstrates hippocampus swelling, signal increase on T2WI, and reduced ADC value and may lead to hippocampal sclerosis.

Objective To observe the effect of biofeedback therapy combined with electrical stimulation in patients with traumatic faecal incontinence.Methods Eishty-two patients with traumatic faecal incontinence were treated once daily with electric stimulation delivered via an intra-anal electrode.They also followed a biofeedback regimen including strengthening,sensory and coordination biofeedback.The whole progrtun consisted of 3 sessions of supervised treatment in hospital followed by 3 sessions of home therapy(10 days per session with an interval of 7days between the sessions).Clinical scores and anorectal function were assessed before and after the program.Results Before treatment,there were 9 patients with good clinical scores,and the general rate of fair and poor clinical scores Was 89%.After therapy,61 patients had good scores,and the general rate of fair and poor Was 26%.Anorectal squeeze pressure and sphincter electromyographic amplitude had improved significantly,the rectal sensory threshold Was decreased significantly,and 76%of the patients who had no external anal sphincter reflex recovered.At the two years follow-up,68% of the patients had maintained the clinical outcomes.Conclusion Biofeedback therapy in conjunction with electrical stimulation has significant therapeutic effects on patients with traumatic faecal incontinence.

Purpose To investigate the correlation between the brain white matter changes of MR diffusion tensor imaging (DTI) and cognitive function in the patients with mild cognitive impairment. Materials and Methods The patients (40 cases) were classified into two groups:group A (20 patients with ischemic foci in the deep white matter ) and group B (20 patients without ischemic foci in the deep white matter), and 20 normal controls was enrolled. Conventional MRI, DTI, mini-mental state examination (MMSE) and montreal cognitive assessment (MoCA) were applied, then fractional anisotropy (FA) value and apparent diffusion coefficient (ADC) value were compared among three groups. The scores of MoCA was analyzed between the patient groups. Results The decreased FA value, increased ADC value and decreased MoCA scores was demonstrate in group A, and showed significant difference compared with group B (t=-4.229,-3.251,-7.533,-2.702,-2.660;P<0.05). The increased ADC value and decreased FA value in the frontal and hippocampus region were detected in group B compared with normal controls (t=-7.790,-2.785,-4.415,-5.164;P<0.05). Conclusion The early and special structural changes can be detected using DTI compared with conventional MRI. The severe white matter lesions can be demonstrated in the patients with ischemic foci in the deep white matter, who is prone to dementia.

Objective To evaluate the effects of assisted reproduction technology ( ART) on gestational weight gain ( GWG) and glucose metabolism .Methods The study was performed in ART women with single-ton and full-term delivery .Age-and pre-pregnancy body mass index matched healthy women with spontaneous pregnancy, singleton, and full-term delivery were recruited as controls .Maternal characteristics (height, age, education level , pre-pregnancy body mass , pre-delivery body mass , medical history , history of abortion , fasting plasma glucose , triglyceride , total cholesterol , and glucose tolerance ) and fetal data ( delivery mode , gender , birth body mass , birth body length ) were collected by a trained nutritionist .Results A total of 200 women were recruited into this study (53 ART women and 147 controls).There was no significant difference in number of previous abortion ( the ratio between the women who had ≥3 abortions to those who had <3 abortions was 6∶47 in the ART group , and 10∶137 in the control group , χ2 =1.080 , P=0.299 ) .Compared with the control group, the ART group had higher education level (33 in the ART and 85 in the control group with un-dergraduate or higher education , 20 in the ART group and 62 in the control group with a college degree or lower education ,χ2 =6.303 , P=0.012 ) .There were no statistically significantly differences between the ART and the control groups in pre-pregnancy body mass index [ (22.00 ±3.05 ) kg/m2 vs.(21.81 ±2.62 ) kg/m2 , P=0.661] and average GWG [ (13.89 ±5.33) kg vs.(14.78 ±4.60) kg, P=0.247].GWG was appro-priate in 22 ART women, excess in 18, and inadequate in 13;in the control group, GWG was appropriate in 66 women, excess in 54, and inadequate in 27.The distribution of GWG showed no significant difference be-tween the two groups (χ2 =1.162 , P=0.247 ) .Oral glucose tolerance test in 24-28 gestational weeks showed no significant difference in fasting blood glucose between the ART and the control groups [ (4.66 ±0.39) mmol/L vs.(4.66 ±0.52) mmol/L, P=0.996], but 1-hour and 2-hour blood glucose levels were significantly in-creased in the ART women [ ( 7.87 ±1.83 ) mmol/L vs.( 7.31 ±1.51 ) mmol/L, P=0.034; ( 7.49 ± 1.29) mmol/L vs.(6.69 ±1.30) mmol/L, P=0.029].The overall prevalence of gestational diabetes melli-tus was 13.5%(27/200), with no significant difference between the ART and the control groups (18.9%vs. 11.6%, P=0.182 ) .Conclusion ART may not affect GWG , but it may cause changes of glucose metabo-lism during pregnancy .

Objective To investigate the correlation between NRAMP1 gene polymorphisms and susceptibility to tuberculosis ( TB) in Tibetan people in Qinghai. Methods A case-control study was con-ducted in this study, involving 99 Tibetan patients with TB and 89 healthy Tibetans. The single nucleotide polymorphisms of NRAMP1 gene at rs17235409 and rs3731865 sites were detected by using TaqMan probe method. Gene cloning and sequencing typing were performed to analyze the single nucleotide polymorphisms of NRAMP1 gene at the rs17235416 site. SPASS20. 0 software was used to statistically analyze the correla-tion between NRAMP1 gene polymorphisms and susceptibility to TB in Tibetan people. Results No signifi-cant difference in the genotype frequencies of rs3731865 and rs17235409 was found between the two groups (χ2=0. 852, P=0. 356;χ2=0. 279, P=0. 597). The genotype frequencies of TGTG/TGTG and TGTG/del+del/del at the rs17235416 site were 70. 7% ( 70/99 ) and 29. 3% ( 29/99 ) in patients with TB and 86. 5% (77/89) and 13. 5% (12/89) in healthy subjects. There were significant differences in the geno-type frequencies of TGTG/TGTG and TGTG/del+del/del between the two groups (χ2=6. 870, P=0. 009). The genotypes of TGTG/del and del/del at rs17235416 were risk factors for TB ( OR=0. 376; 95%CI:0. 178-1. 794 as compared with the TGTG/TGTG genotype in Tibetan people in Qinghai. Conclusion This study suggested that the NRAMP1 gene polymorphisms at rs3731865 and rs1723409 sites had no correlation with the susceptibility to TB in Tibetans in Qinghai. However, the NRAMP1 gene polymorphisms at rs17235416 site were correlated with the susceptibility to TB. The TGTG/del alleles at the rs17235416 site might be the risk factors for tuberculosis in Tibetans in Qinghai.

Objective:To investigate the clinical characteristics and therapeutic laparoscopy treatment for superior mesenteric artery syndrome(SMAS) in children.Methods:A retrospective study on 5 children with SMAS who failed to respond to the conservative treatment in the Second Hospital of Shandong University from March 2017 to March 2022 was carried out.All the patients underwent the laparoscopic lysis of the ligament of Treitz and duodenal lowering procedure.The clinical data were analyzed and literature retrieved from Wanfang and PubMed databases were reviewed.Results:There were 3 boys and 2 girls in the 5 cases with SMAS.The average age was (12.4±1.4) years, and the preoperative body mass index was (15.2±0.8) kg/m 2.The patients were admitted to the hospital with vomiting, abdominal pain and emaciation symptoms, and the duration of symptoms was (8.4±7.8) months.Gastroscopy, laparoscopic lysis of the ligament of Treitz and duodenal lowering procedure were performed successfully in all the patients, without conversions to open surgery.The average operation duration was (66.0±10.7) min.Food intake was allowed 1 day after surgery.Chylous fistula occurred 4 days after operation in one patient, whose symptom relieved after 11 days of conservative treatment.One patient still had nausea and vomiting symptoms 10 days after operation and was healed by knee-chest posture treatment.No other short-term complications were observed.The median postoperative duration of stay in the hospital was 7 (6-22) days.The patients were followed up for 9-56 (median: 21) months.All of them recovered well and gained weight.One patient had mild recurrent symptoms, and was cured after conservative treatment.A total of 15 literature on the treatment of SMAS by laparoscopic lysis of the ligament of Treitz was retrieved, and the cure rate was 40%-100%.Only one group of these cases had a cure rate below 75%. Conclusions:The laparoscopic lysis of the ligament of Treitz and duodenal lowering procedure is safe, effective, simple and minimally invasive treatment for children with SMAS.It can be used as the first choice for most pediatric patients.

Background Macrophages are essential components of the natural immune system. They play a significant role in resisting foreign bodies in the respiratory tract and maintaining the homeostasis of the internal environment of lung tissue. Objective To investigate the mechanism of macrophage pyroptosis induced by silica dust with different particle sizes. Methods The modified murine macrophage cell line, RAW-ASC cells, was cultured and divided into a blank control group, a lipopolysaccharide (LPS) group (1 μg·mL⁻¹ LPS), a nano-SiO₂ group (1 μg·mL⁻¹ LPS+100 μg·mL⁻¹ nano-SiO₂), a micro-SiO₂ group (1 μg·mL⁻¹ LPS+750 μg·mL⁻¹ micro-SiO₂), and a positive control group [1 μg·mL⁻¹ LPS+3 mmol·L⁻¹ adenosine triphosphate (ATP)]. Apart from the blank control group, cells in other groups were pretreated with LPS for 6 h, and then exposed to SiO₂ or ATP for 4 h. According to the molecular target NOD-like receptor pyrin domain-containing protein 3 (NLRP3) and reactive oxygen species (ROS), we applied MCC950 (NLRP3 inhibitor) and N-acetyl cysteine (NAC, ROS scavenger) to macrophages. CCK-8 assay was used to detect cell viability; 5-ethynyl-2'-deoxyuridine (EdU) staining was used to detect cell proliferation; lactate dehydrogenase (LDH) assay kit was used to detect LDH in supernatant; calcein AM/PI fluorescent double-staining was applied to evaluate cell rupture; 2',7'-dichlorofluorescin diacetate (DCFH-DA) fluorescent probe was used to measure the content of ROS; Western blotting was used to measure the expressions of NLRP3, apoptosis-associated speck-like protein containing CARD (ASC), Caspase-1, gasdermin D (GSDMD), and interleukin-1β (IL-1β). Results Compared with the blank group, 100 μg·mL^-1nano-SiO₂ and 750 μg·mL^-1micro-SiO₂ dust exposure reduced the cell viability to 40% and 68% (P<0.05), and the cell proliferation rate to 30% and 33% (P<0.01), respectively; they also induced cell lysis and ROS release, upregulated NLRP3, ASC, Caspase-1, GSDMD, and IL-1β at protein level (P<0.05), and induced macrophage pyroptosis. After intervening with MCC950 (10 μmol·L^-1) and NAC (10 mmol·L^-1), the expressions of NLRP3, ASC, Caspase-1, and IL-1β decreased (P<0.05), and, specifically, NAC effectively reduced ROS levels (P<0.05). Conclusion Both nano- and micro-SiO₂ dust have cytotoxicity, can upregulate ROS level, activate NLRP3 inflammasome, and promote the release of cytokines, leading to pyroptosis. These results are helpful to reveal the molecular mechanism of macrophage pyroptosis induced by SiO₂ dust.