Objective To explore the feasibility of magnetic compression technique (MCR) in the treatment of severe single mid-ureteral stricture in a rabbit model. Methods After 10 female New Zealand rabbits were selected, the distal end of the right ureter was ligated with silk thread. Two weeks after the operation, when the right ureter was dilated, the mid-ureter was ligated again with silk thread to create a severe single mid-ureteral stricture animal model. Longitudinal incisions were made at the upper and lower ends of the ligation site, and cylindrical NdFeB magnets with central holes (sub-magnets and main magnets) were placed to anastomose and recanalize the mid-ureteral stricture. The magnets were adjusted to the appropriate position to automatically align and attract each other. The longitudinal incision sites of the ureter were sutured with 6-0 Prolene thread, and the abdominal cavity was closed layer by layer. The operation time was recorded. X-ray films were taken every two days to confirm the position of the magnets and record the time of magnet detachment. Three weeks after the operation, the anastomotic specimens were obtained, and the formation of the anastomosis was evaluated with gross observation and histological staining. Results Two weeks after ligation, all experimental rabbits showed obvious dilation of the right ureter. The mid-ureteral ligation and placement of the male and female magnets were successfully completed in all 10 experimental rabbits, with an operation time of (24.00±5.15)minutes. The male and female magnets attracted each other well. X-ray examination showed that the magnets detached and entered the distal ureter (14.0±1.9) days after magnetic compression. The recanalization of the severe single mid-ureteral stricture was successfully achieved. The gross specimens and histological examination of the anastomosis showed that the anastomosis remained patent and the mucosal healing was good. All experimental rabbits survived well after the operation without serious complications. Conclusion MCT provides a new idea and novel method for the treatment of mid-ureteral stricture. This study confirmed the feasibility of this technique in treating severe single mid-ureteral stricture in a rabbit model. The operation is relatively simple and has potential for clinical application.

[Objective] To explore the clinical features of IgG4-related urinary diseases so as to provide reference for the diagnosis and treatment of such diseases. [Methods] The clinical data of 4 cases of IgG4-related urinary system diseases diagnosed and treated in Xijing Hospital of Air Force Medical University during Aug.2019 and Dec.2023 were retrospectively collected.Here, we report on the diagnosis and treatment of these patients, analysing their symptoms, serology, imaging and pathology as well as their treatment and outcomes. [Results] The patients included 2 male and 2 female.The lesions were involved with the retroperitoneum and urinary system.Three patients had symptoms of lumbar pain.The imaging manifestations were complex, including retroperitoneal mass involving urinary system organs in 2 cases, tabdense shadow of the right kidney in 1 case, and simple cystic mass of kidney in 1 case.Serum IgG4 value was not detected before surgery.All patients underwent radical surgical treatment.Postoperative pathology showed fibrous tissue hyperplasia with a large number of plasma cells, lymphocytes, a few neutrophil infiltrates, and lymphoid follicles and obliterated vasculitis in some specimens.The number of IgG4⁺ plasma cells was more than 10 in all tissues under high power microscope.After surgery, 3 patients had symptoms improved, and serum IgG4 value was within the normal range; 1 patient (patem 3) had elevated IgG4 value during follow-up, received subsequent hormone therapy, and the serum IgG 4 level remained stable. [Conclusion] The symptoms of IgG4-related diseases involving the urinary system are non-specific, and the imaging findings are various, easily confused with other diseases.Early detection of serum IgG4 and biopsy pathology can help clinicians make correct diagnosis in the early stage.

BACKGROUND: The primary limitation to kidney transplantation is organ shortage. Recent progress in gene editing and immunosuppressive regimens has made xenotransplantation with porcine organs a possibility. However, evidence in pig-to-human xenotransplantation remains scarce, and antibody-mediated rejection (AMR) is a major obstacle to clinical applications of xenotransplantation. METHODS: We conducted a kidney xenotransplantation in a brain-dead human recipient using a porcine kidney with five gene edits (5GE) on March 25, 2024 at Xijing Hospital, China. Clinical-grade immunosuppressive regimens were employed, and the observation period lasted 22 days. We collected and analyzed the xenograft function, ultrasound findings, sequential protocol biopsies, and immune surveillance of the recipient during the observation. RESULTS: The combination of 5GE in the porcine kidney and clinical-grade immunosuppressive regimens prevented hyperacute rejection. The xenograft kidney underwent delayed graft function in the first week, but urine output increased later and the single xenograft kidney maintained electrolyte and pH homeostasis from postoperative day (POD) 12 to 19. We observed AMR at 24 h post-transplantation, due to the presence of pre-existing anti-porcine antibodies and cytotoxicity before transplantation; this AMR persisted throughout the observation period. Plasma exchange and intravenous immunoglobulin treatment mitigated the AMR. We observed activation of latent porcine cytomegalovirus toward the end of the study, which might have contributed to coagulation disorder in the recipient. CONCLUSIONS 5GE and clinical-grade immunosuppressive regimens were sufficient to prevent hyperacute rejection during pig-to-human kidney xenotransplantation. Pre-existing anti-porcine antibodies predisposed the xenograft to AMR. Plasma exchange and intravenous immunoglobulin were safe and effective in the treatment of AMR after kidney xenotransplantation.
Transplantation, Heterologous/methods* ; Kidney Transplantation/methods* ; Heterografts/pathology* ; Immunoglobulins, Intravenous/administration & dosage* ; Graft Survival/immunology* ; Humans ; Animals ; Sus scrofa ; Graft Rejection/prevention & control* ; Kidney/pathology* ; Gene Editing ; Species Specificity ; Immunosuppression Therapy/methods* ; Plasma Exchange ; Brain Death ; Biopsy ; Male ; Aged

Objective:To construct a dispatching system based on ultra wide band(UWB)positioning technique,so as to enhance dynamic management capabilities for equipment and clinical response efficiency.Methods:The dispatching system based on UWB positioning technique for emergency equipment included internet of things(IoTs)perception layer of network,network layer,data service layer,and business application layer of intelligently medical equipment,which integrated the positioning technique with UWB centimeter level and the deep Q-network(DQN)algorithm,and it can realize real-time localization and intelligent dispatching decisions for equipment.The used thirty-five emergency equipment in the intensive care unit(ICU)ward of Eastern Branch of Ningbo Medical Center Li Huili Hospital from January 2023 to December 2024 were selected.Based on different management modes,25 equipment using conventional manual dispatching during January and June 2023 were divided into control group,while 25 equipment using the UWB dispatching technique-based dispatching system during July and December 2023(included 15 equipment of the original control group and 10 new equipment at later stage)were used as observation group.The dispatching efficiency,utilization rate,positioning precision,and maintenance efficiency of equipment between two groups were compared.Results:The dispatching time for equipment in the observation group was(7.2±0.8)min,which significantly shorter than(12.2±1.5)min in the control group,and the difference was significant(t=18.34,P<0.05).The distance of movement,and response time for fault in the observation group were significantly lower than those in the control group,and the utilization rate of equipment was significantly higher than that in the control group,and the differences were significant(t=15.67,14.28,6.92,P<0.05).The repair rate for fault in the observation group was significantly higher than that in the control group,and the difference was significant(x2=7.80,P<0.05).The positioning error of the system is(35±10)cm.Conclusion:The UWB-based dispatching system can significantly optimize the dispatching process for resource of emergency equipment,which can improve utilization and management efficiency for equipment.It can provide reliably technical support for rapid response in clinical emergency.

Objective:To construct a dispatching system based on ultra wide band(UWB)positioning technique,so as to enhance dynamic management capabilities for equipment and clinical response efficiency.Methods:The dispatching system based on UWB positioning technique for emergency equipment included internet of things(IoTs)perception layer of network,network layer,data service layer,and business application layer of intelligently medical equipment,which integrated the positioning technique with UWB centimeter level and the deep Q-network(DQN)algorithm,and it can realize real-time localization and intelligent dispatching decisions for equipment.The used thirty-five emergency equipment in the intensive care unit(ICU)ward of Eastern Branch of Ningbo Medical Center Li Huili Hospital from January 2023 to December 2024 were selected.Based on different management modes,25 equipment using conventional manual dispatching during January and June 2023 were divided into control group,while 25 equipment using the UWB dispatching technique-based dispatching system during July and December 2023(included 15 equipment of the original control group and 10 new equipment at later stage)were used as observation group.The dispatching efficiency,utilization rate,positioning precision,and maintenance efficiency of equipment between two groups were compared.Results:The dispatching time for equipment in the observation group was(7.2±0.8)min,which significantly shorter than(12.2±1.5)min in the control group,and the difference was significant(t=18.34,P<0.05).The distance of movement,and response time for fault in the observation group were significantly lower than those in the control group,and the utilization rate of equipment was significantly higher than that in the control group,and the differences were significant(t=15.67,14.28,6.92,P<0.05).The repair rate for fault in the observation group was significantly higher than that in the control group,and the difference was significant(x2=7.80,P<0.05).The positioning error of the system is(35±10)cm.Conclusion:The UWB-based dispatching system can significantly optimize the dispatching process for resource of emergency equipment,which can improve utilization and management efficiency for equipment.It can provide reliably technical support for rapid response in clinical emergency.

Objective:To investigate the correlation between brain gray matter volume (GMV) and interactive effects of smoking addiction and overweight.Methods:We retrospectively analyzed the clinical data and resting-state functional magnetic resonance imaging data of 99 subjects recruited from January 2019 to December 2021 through online platforms such as WeChat, including the following four groups: overweight smoking addiction group ( n=24), normal-weight smoking addiction group ( n=28), overweight non-smoking group ( n=19), and normal-weight non-smoking group ( n=28). All subjects underwent 3.0T MRI. We used voxel-based morphometry (VBM) to compare gray matter volume (GMV) among the four groups. A two-way analysis of variance was conducted with age, years of education, and head motion as covariates to explore the interaction effects between smoking addiction and weight status on GMV, the main effect of smoking addiction and main effect of overweight, which were then correlated with clinical data. Results:Significant interactive effects of smoking addiction and overweight were observed in the left dorsolateral prefrontal cortex (DLPFC) (GRF corrected, voxel-level P<0.001, cluster-level P<0.05). Correlation analysis showed a quadratic effect between body mass index and left DLPFC GMV (β=-3.846, t=-2.134, P=0.036). Additionally, the main effect of smoking addiction was primarily manifested in the bilateral orbitofrontal cortex (OFC)(GRF corrected, P voxel<0.001, P cluster<0.05). Left OFC GMV was negatively associated with the FTND (Fagerstrom Test of Nicotine Dependence) scores ( r=-0.391, P=0.006). And right OFC GMV was negatively correlated with the smoking index ( r=-0.335, P=0.019). No statistically significant main effect of overweight was found at the aforementioned threshold. Conclusion:Smoking addiction and overweight have antagonistic effects on left DLPFC GMV.

Objective:This study aims to investigate the dynamic patterns of intrinsic neural activity and their relationships with Internet Addiction Test (IAT) scores in individuals with internet gaming disorder (IGD).Methods:Resting state functional magnetic resonance imaging (fMRI) scanning was performed on 33 individuals with IGD (IGD group) who were admitted to the psychiatric department of First Affiliated Hospital of Zhengzhou University and 40 healthy volunteers (control group) recruited through the online platform. The dynamic regional homogeneity (dReHo) values were calculated. The two-sample t test was used to analyze the differences of dReHo values between two groups (Gaussian random field corrected, voxel level P<0.001, cluster level P<0.05). Spearman correlation analyses were used to analyze the correlations between IAT scores and dReHo values of brain regions with statistically significant differences between IGD group and control group. Results:Compared with the control group, the IGD group showed increased dReHo values in the right thalamus, right caudate nucleus, left putamen, bilateral medial superior frontal gyrus, bilateral supplementary motor area, and bilateral superior frontal gyrus ( t=3.84-4.94, Gaussian random field corrected, voxel level P<0.001, cluster level P<0.05). The dReHo value in the right medial superior frontal gyrus was positively correlated with IAT scores ( r=0.395, P=0.023) in IGD group. Conclusion:Individuals with IGD exhibited a wide range of abnormal dynamic patterns of intrinsic neural activity in pivotal regions associated with reward processing and cognitive control functions (the fronto-striato-thalamic circuit), providing new insights into the underlying neural mechanisms of IGD.

Objective:To investigate the correlation between brain gray matter volume (GMV) and interactive effects of smoking addiction and overweight.Methods:We retrospectively analyzed the clinical data and resting-state functional magnetic resonance imaging data of 99 subjects recruited from January 2019 to December 2021 through online platforms such as WeChat, including the following four groups: overweight smoking addiction group ( n=24), normal-weight smoking addiction group ( n=28), overweight non-smoking group ( n=19), and normal-weight non-smoking group ( n=28). All subjects underwent 3.0T MRI. We used voxel-based morphometry (VBM) to compare gray matter volume (GMV) among the four groups. A two-way analysis of variance was conducted with age, years of education, and head motion as covariates to explore the interaction effects between smoking addiction and weight status on GMV, the main effect of smoking addiction and main effect of overweight, which were then correlated with clinical data. Results:Significant interactive effects of smoking addiction and overweight were observed in the left dorsolateral prefrontal cortex (DLPFC) (GRF corrected, voxel-level P<0.001, cluster-level P<0.05). Correlation analysis showed a quadratic effect between body mass index and left DLPFC GMV (β=-3.846, t=-2.134, P=0.036). Additionally, the main effect of smoking addiction was primarily manifested in the bilateral orbitofrontal cortex (OFC)(GRF corrected, P voxel<0.001, P cluster<0.05). Left OFC GMV was negatively associated with the FTND (Fagerstrom Test of Nicotine Dependence) scores ( r=-0.391, P=0.006). And right OFC GMV was negatively correlated with the smoking index ( r=-0.335, P=0.019). No statistically significant main effect of overweight was found at the aforementioned threshold. Conclusion:Smoking addiction and overweight have antagonistic effects on left DLPFC GMV.

Objective:This study aims to investigate the dynamic patterns of intrinsic neural activity and their relationships with Internet Addiction Test (IAT) scores in individuals with internet gaming disorder (IGD).Methods:Resting state functional magnetic resonance imaging (fMRI) scanning was performed on 33 individuals with IGD (IGD group) who were admitted to the psychiatric department of First Affiliated Hospital of Zhengzhou University and 40 healthy volunteers (control group) recruited through the online platform. The dynamic regional homogeneity (dReHo) values were calculated. The two-sample t test was used to analyze the differences of dReHo values between two groups (Gaussian random field corrected, voxel level P<0.001, cluster level P<0.05). Spearman correlation analyses were used to analyze the correlations between IAT scores and dReHo values of brain regions with statistically significant differences between IGD group and control group. Results:Compared with the control group, the IGD group showed increased dReHo values in the right thalamus, right caudate nucleus, left putamen, bilateral medial superior frontal gyrus, bilateral supplementary motor area, and bilateral superior frontal gyrus ( t=3.84-4.94, Gaussian random field corrected, voxel level P<0.001, cluster level P<0.05). The dReHo value in the right medial superior frontal gyrus was positively correlated with IAT scores ( r=0.395, P=0.023) in IGD group. Conclusion:Individuals with IGD exhibited a wide range of abnormal dynamic patterns of intrinsic neural activity in pivotal regions associated with reward processing and cognitive control functions (the fronto-striato-thalamic circuit), providing new insights into the underlying neural mechanisms of IGD.

Objective:To explore the dynamic temporal variability of brain functional networks in individuals with internet gaming disorder(IGD)using dynamic functional connectivity density(dFCD).Methods:From January 2019 to December 2021, resting-state functional magnetic resonance imaging data were recruited from 55 patients with IGD and demographically matched 50 healthy controls.Data analysis was performed by IBM SPSS 21.0 software. The functional connectivity density(FCD) combined with sliding window analysis was employed to calculate the temporal variability of global functional connectivity.FCD in whole brain was further devided into ipsilateral and cotralateral parts.The temporal variability of dFCD was further quantified utilizing the standard deviations of whole brain, intra-, and inter-hemispheric FCD. Finally, Pearson correlation analysis was performed between dFCD variance in differential brain regions and clinical behaviors.Results:The inter-hemispheric dFCD in the left posterior cingulate cortex(-0.16±0.24) and the left precuneus(-0.08±0.23) in patients with IGD were lower that those in healthy controls(0.002±0.260, 0.12±0.36)( t=-3.502, -4.160, both P<0.05).And the intra-hemispheric dFCD in the left calcarine, the left precuneus, and the left posterior cingulate cortex in patients with IGD were lower that those in healthy controls( t=-3.809, -4.360, -3.561, all P<0.05).Moreover, abnormal global dFCD variability of the calcarine and ipsilateral dFCD variability of the PCC negatively correlated with the severity of IGD( r=-0.380, -0.413, both P<0.05). Conclusion:Patients with IGD show intra-and inter-hemispheric dFCD differences in the visual attention network and default mode network, which may respond to the underlying neurobiological basis for the presence of cognitive dysfunction and impaired concentration.