Objective To investigate the role and potential mechanism of glutathione peroxidase 3 (GPX3) in ischemia-reperfusion injury (IRI) during kidney transplantation. Methods C57BL/6 mice were divided into four groups according to different interventions: sham operation group (Sham group), kidney transplantation group (KT group), kidney transplantation + GPX3 overexpression group (KT+GPX3 group) and kidney transplantation + GPX3 overexpression + reactive oxygen species (ROS) agonist group (KT+GPX3+CADD522 group). Twenty-four hours after model establishment, inferior vena cava blood was collected to detect blood urea nitrogen (BUN) and serum creatinine (Scr). Left renal tissues were harvested for immunofluorescence staining to detect ROS and NADPH oxidase 2 (NOX2). Enzyme-linked immunosorbent assay (ELISA) was performed to measure neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), tumor necrosis factor (TNF) -α and interleukin (IL)-1β. Western blotting was used to detect myeloperoxidase (MPO) and citrullinated histone H3 (CitH3). Results Compared with the Sham group, the expression level of GPX3 was decreased in the KT group; compared with the KT group, GPX3 expression was increased in the KT+GPX3 group; compared with the KT+GPX3 group, GPX3 expression was reduced in the KT+GPX3+CADD522 group (all P<0.05). Compared with the Sham group, the levels of Scr, BUN, NGAL and KIM-1 were elevated in the KT group; compared with the KT group, the above indicators were decreased in the KT+GPX3 group; compared with the KT+GPX3 group, the levels of Scr, BUN, NGAL and KIM-1 were increased in the KT+GPX3+CADD522 group (all P<0.05). Compared with the Sham group, the expression levels of NOX2 and ROS were increased in the KT group; compared with the KT group, NOX2 and ROS levels were decreased in the KT+GPX3 group; compared with the KT+GPX3 group, NOX2 and ROS levels were upregulated in the KT+GPX3+CADD522 group (all P<0.05). Compared with the Sham group, the expression levels of MPO and CitH3 were increased in the KT group; compared with the KT group, MPO and CitH3 levels were decreased in the KT+GPX3 group; compared with the KT+GPX3 group, MPO and CitH3 levels were increased in the KT+GPX3+CADD522 group (all P<0.05). Compared with the Sham group, the expression levels of TNF-α and IL-1β were increased in the KT group; compared with the KT group, TNF-α and IL-1β levels were decreased in the KT+GPX3 group; compared with the KT+GPX3 group, TNF-α and IL-1β levels were increased in the KT+GPX3+CADD522 group (all P<0.05). Conclusions GPX3 may alleviate renal tissue inflammation by inhibiting ROS-mediated neutrophil extracellular trap (NET) formation, thereby attenuating IRI in renal transplantation.

Objective To explore the potential functional targets of ischemia-reperfusion injury (IRI) in renal allografts derived from different donor sources. Methods Based on the transcriptome sequencing dataset GSE43974 of kidney transplantation IRI from different donor sources, weighted gene co-expression network analysis (WGCNA) and protein-protein interaction (PPI) network analysis were performed to screen Hub genes and characterize their expression profiles. A nomogram model was established to evaluate the diagnostic efficacy of these Hub genes, which was further validated using the dataset GSE30718. Immune infiltration analysis was conducted to clarify the correlations between Hub genes and immune cell infiltration. A mouse kidney transplantation IRI model was adopted to verify the expression levels of Hub genes in vivo. Results A total of five Hub genes were finally identified, namely PPP1CC, GART, BIRC6, PMSD11 and TMEM192. Nomogram analysis confirmed that these Hub genes possessed favorable diagnostic performance for kidney transplantation IRI in kidneys from different donors. Immune infiltration analysis revealed distinct infiltration patterns of various immune cells in IRI kidneys from different donors, and Hub genes were closely correlated with the regulation of multiple immune cell infiltration. A total of 390 differentially expressed genes were screened between renal tissues of mice in the kidney transplantation group and sham operation group. Gene Ontology (GO) enrichment analysis indicated that these differentially expressed genes were mainly enriched in biological processes including oxidative stress, inflammation and pyroptosis. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis showed significant enrichment in glutathione metabolism, neutrophil extracellular trap formation and other signaling pathways. Transcriptome sequencing verified that the expression levels of the five Hub genes were significantly different between the two groups (all P < 0.05). Conclusions Five Hub genes are identified in kidney transplantation IRI using donor kidneys from different sources. Glutathione metabolism and neutrophil extracellular trap formation may participate in the pathogenesis of kidney transplantation IRI.

Objective:To investigate the impact of ginseng alcohol extract(GEE)on improving sleep quality in the aged Drosophila model by regulating the redox balance,and to elucidate its associated mechanism.Methods:Thirty-two male drosophila melanogaster(7-days-old)were randomly selected as young group,while 64 male Drosophila melanogaster flies(35-days-old)were randomly assigned to aged model group(n=32)and GEE group(n=32).The sleep parameters,including total sleep duration,daytime sleep duration,night sleep duration,0-4 h of sleep duration after lights off(ZT0-4 sleep duration),deep sleep duration,sleep episodetimes,sleep fragmentation,and the activity parameters such as the total number of locomotor activity daytime locomotor activity amount and nighttime locomotor activity amount were analyzed using the DAM2 Drosophila behavioral analysis system 7 d after administration.The grouping of the drosophila was as above,and there were 100 drosophila ineach group.The differentially expressed proteins in drosophila brain tissue were screened,identified,and functionally analyzed using two-dimensional fluorescence difference gel electrophoresis(2D-DIGE)and matrix-assisted laser desorption/ionization time of flight mass spectrometry(MALDI-TOF/TOF-MS)proteomic methods.The grouping of the drosophila was as above,and there were 100 drosophila in each group.The activities of superoxide dismutase(SOD),catalase(CAT),and glutathione peroxidase(GSH-Px)and the levels of lipid peroxidation product(MDA)in brain tissue of the drosophila were determined using assay kits.Results:Compared with young group,the total sleep duration daytime sleep duration and night sleep cluration of the drosophila in agaed group were decreased(P<0.05 or P<0.01);and the sleep rhythm amplitude was shortened.Compared with aged group,the total sleep duration and daytime and nighttime sleep durations of the drosphila in GEE group were lengthened(P<0.01).Compared with young group,the ZT0-4 sleep duration deep sleep duration and sleep fragment of the drosophila in aged group were decreased(P<0.05 or P<0.01),and the sleep rhythm amplitude was shortened.Compared with young group,the ZT0-4 sleep duration,deep sleep duration,and single sleep fragment of the drosphila in GEE group were significantly prolonged(P<0.01),and the sleep amplitude was increased.Compared with young group,there was no significant difference in diurnal spontaneous activity or total spontaneous activity of the drosophila in aged group(P>0.05),while the nocturnal spontaneous activity was significantly increased(P<0.05).Compared with aged group,the diurnal spontaneous activity,nocturnal spontaneous activity,and total spontaneous activity of the drosophila in GEE group were significantly decreased(P<0.05 or P<0.01).A total of 47 differentially expressed proteins were selected in the 2D-DIGE electrophoretic mapping.Compared with young group,the expressions of 47 differentially expressed protein sites in aged group were down-regulated mainly including glutathione S-transferase,peroxiredoxin 1 and dihydrolipoic dehydrogenase,which were related to redox balance.Compared with young group,the activities of SOD,CAT and GSH-Px in brain tissue of the drosophila in aged group were decreased(P<0.05 or P<0.01),and the level of MDA was increased(P<0.01);compared with aged group,the activities of SOD,CAT and GSH-Px in brain tissue of the drosphila in GEE group were increased(P<0.05 or P<0.01),and the MDA level was decreased(P<0.05).Conclusion:GEE has improvement effect on the sleep quality of aged drosophila,and its possible mechanism may be related to upregulating the activities of antioxidant enzymes,inhibiting the accumulation of lipid peroxidation products,and maintaining redox balance.

Intentional tooth replantation (ITR) is an advanced treatment modality and the procedure of last resort for preserving teeth with inaccessible endodontic or resorptive lesions. ITR is defined as the deliberate extraction of a tooth; evaluation of the root surface, endodontic manipulation, and repair; and placement of the tooth back into its original socket. Case reports, case series, cohort studies, and randomized controlled trials have demonstrated the efficacy of ITR in the retention of natural teeth that are untreatable or difficult to manage with root canal treatment or endodontic microsurgery. However, variations in clinical protocols for ITR exist due to the empirical nature of the original protocols and rapid advancements in the field of oral biology and dental materials. This heterogeneity in protocols may cause confusion among dental practitioners; therefore, guidelines and considerations for ITR should be explicated. This expert consensus discusses the biological foundation of ITR, the available clinical protocols and current status of ITR in treating teeth with refractory apical periodontitis or anatomical aberration, and the main complications of this treatment, aiming to refine the clinical management of ITR in accordance with the progress of basic research and clinical studies; the findings suggest that ITR may become a more consistent evidence-based option in dental treatment.
Humans ; Tooth Replantation/methods* ; Consensus ; Periapical Periodontitis/surgery*

Objective:Exploring the efficacy of indocyanine green（ICG）near-infrared fluorescence（NIRF）imaging technology in robotic-assisted laparoscopic partial nephrectomy for children with duplicated kidneys.Methods:A retrospective analysis was conducted on the medical records of 7 children with duplicated kidneys admitted to Guizhou Provincial People's Hospital from December 2023 to September 2024，including 3 males and 4 females. The patients with a median age of 36（2，132）months. All cases of duplicated kidneys were located at the renal pole，with 5 on the left side and 2 on the right side. All 7 patients had a history of worsening hydronephrosis，with 4 having a history of urinary tract infection and 1 accompanied by urinary incontinence（urine leakage outside the normal voiding period）. Preoperative diagnosis was confirmed via enhanced CT of the urinary tract，diuretic renal dynamic imaging（SPECT），and voiding cystourethrography. One case had an ectopic ureteral opening. One case had recurrent urinary tract infections following ureteral cyst fenestration surgery，and five cases had terminal ureteral obstruction. All seven cases showed that the functional capacity of the duplicated upper kidney was <10%. All 7 cases underwent robot-assisted laparoscopic repeated nephrectomy of the upper kidney using ICG-NIRF technology. Intraoperative ICG fluorescence imaging was performed in three stages：a catheter was inserted through the lower kidney ureter，and after the first injection of ICG，green fluorescence was observed in the lower kidney ureter. Under fluorescence guidance，the upper and lower ureters were anatomically dissected；The second ICG injection via intravenous administration revealed the vessels supplying the upper kidney，and the blood supply to the upper kidney was blocked；After the third ICG injection via intravenous administration，the normal lower kidney showed fluorescence imaging，while the ischemic upper kidney did not. The upper kidney was resected along the anatomical boundary between the upper and lower kidneys.Results:All 7 surgeries were successfully completed，with an average surgical time of（155.1 ± 22.7）min；Intraoperative blood loss was（12.5 ± 8.7）ml；postoperative hospital stay was（5.2 ± 1.7）days. Postoperative follow-up duration was（9.2 ± 3.5）months，with preoperative concomitant urinary tract infection and post-micturition dribbling symptoms resolved. No cases of ureteral stump effusion or urinary leakage were observed postoperatively. At the 3-month postoperative follow-up SPECT examination，no loss of lower kidney function was detected.Conclusions:The application of ICG-NIRF imaging technology in robotic-assisted laparoscopic heminephrectomy for children with duplicated kidneys is easy to perform and safe. Its main advantage is the ability to clearly identify normal ureters，blood vessels of non-functional kidneys，and the boundary between the upper and lower halves of the kidney，thereby guiding the optimization of surgical strategies.

Objective:Exploring the efficacy of indocyanine green（ICG）near-infrared fluorescence（NIRF）imaging technology in robotic-assisted laparoscopic partial nephrectomy for children with duplicated kidneys.Methods:A retrospective analysis was conducted on the medical records of 7 children with duplicated kidneys admitted to Guizhou Provincial People's Hospital from December 2023 to September 2024，including 3 males and 4 females. The patients with a median age of 36（2，132）months. All cases of duplicated kidneys were located at the renal pole，with 5 on the left side and 2 on the right side. All 7 patients had a history of worsening hydronephrosis，with 4 having a history of urinary tract infection and 1 accompanied by urinary incontinence（urine leakage outside the normal voiding period）. Preoperative diagnosis was confirmed via enhanced CT of the urinary tract，diuretic renal dynamic imaging（SPECT），and voiding cystourethrography. One case had an ectopic ureteral opening. One case had recurrent urinary tract infections following ureteral cyst fenestration surgery，and five cases had terminal ureteral obstruction. All seven cases showed that the functional capacity of the duplicated upper kidney was <10%. All 7 cases underwent robot-assisted laparoscopic repeated nephrectomy of the upper kidney using ICG-NIRF technology. Intraoperative ICG fluorescence imaging was performed in three stages：a catheter was inserted through the lower kidney ureter，and after the first injection of ICG，green fluorescence was observed in the lower kidney ureter. Under fluorescence guidance，the upper and lower ureters were anatomically dissected；The second ICG injection via intravenous administration revealed the vessels supplying the upper kidney，and the blood supply to the upper kidney was blocked；After the third ICG injection via intravenous administration，the normal lower kidney showed fluorescence imaging，while the ischemic upper kidney did not. The upper kidney was resected along the anatomical boundary between the upper and lower kidneys.Results:All 7 surgeries were successfully completed，with an average surgical time of（155.1 ± 22.7）min；Intraoperative blood loss was（12.5 ± 8.7）ml；postoperative hospital stay was（5.2 ± 1.7）days. Postoperative follow-up duration was（9.2 ± 3.5）months，with preoperative concomitant urinary tract infection and post-micturition dribbling symptoms resolved. No cases of ureteral stump effusion or urinary leakage were observed postoperatively. At the 3-month postoperative follow-up SPECT examination，no loss of lower kidney function was detected.Conclusions:The application of ICG-NIRF imaging technology in robotic-assisted laparoscopic heminephrectomy for children with duplicated kidneys is easy to perform and safe. Its main advantage is the ability to clearly identify normal ureters，blood vessels of non-functional kidneys，and the boundary between the upper and lower halves of the kidney，thereby guiding the optimization of surgical strategies.

Objective To improve the level of diagnosis and treatment through analyzing the clinical characteristics,treatment and prognosis with testicular torsion in children.Methods We conducted a retrospective analysis of 221 boys with testicular torsion,who received trearment from May 2003 to May 2023 at the Children's Hospital of Chongqing Medical University and Guizhou Provincial People's Hospital.Data analysed included:clinical characteristics,treatment progress and outcome.Results The peak onset age of testicular torsion in children was infancy and prepuberty(71％).The incidence of left side(77％)was higher than that of right side(23％).The first symptoms were mainly scrotal pain and swelling(62％),but some cases mainly manifested lower abdominal pain and inguinal pain(11％).The rate of misdiagnosis and mistreatment of patients in basic hospitals was high.Scrotal color Doppler ultrasonography is the first choice for assistant examination,and mainly showed none or dramatically decrease of blood supply in testis,and abnormal axial direction.The golden time for testicular torsion diagnosis was within 8 hours.The chief pathological manifestation were interstitial hyperemia,edema and seminiferous tubules degeneration within 8 hours,and hemorrhagic necrosis or infarction over 8 hours.Conclusions Children Testicular torsion occurs more frequently in infancy and prepuberty,torsion position in the left side is more than that in right side.The main symptoms are scrotal pain and swelling,as well as lower abdominal or inguinal pain.Testicular pathological lesion is closely associated with the diagnosis time and degree of torsion.

Lichen sclerosus in children often leads to serious complications due to lack of early understanding and management of the disease. This paper reports a case of Lichen sclerosus in children with severe malformation of the urethral meatus of the penis. The patient was treated at a local hospital for preputial stenosis and dysuria, and cicatricial phimosis was considered. During the operation, due to the rigid inner plate of the foreskin, the penile head of the foreskin was severely adherent and could not be separated, and the circumcising operation failed. Only the narrow ring of the foreskin on the back of the penis was cut to solve the difficulty of urination, resulting in serious malformations of the meatus of the penile head. Subsequently, the patient was treated in our hospital for cicatricial adhesion release, circumcision and external urethral ostium plastic surgery. The postoperative pathology showed sclerosing lichenoid degeneration. After 1 year follow-up, the appearance was satisfactory and urination was smooth.

Lichen sclerosus in children often leads to serious complications due to lack of early understanding and management of the disease. This paper reports a case of Lichen sclerosus in children with severe malformation of the urethral meatus of the penis. The patient was treated at a local hospital for preputial stenosis and dysuria, and cicatricial phimosis was considered. During the operation, due to the rigid inner plate of the foreskin, the penile head of the foreskin was severely adherent and could not be separated, and the circumcising operation failed. Only the narrow ring of the foreskin on the back of the penis was cut to solve the difficulty of urination, resulting in serious malformations of the meatus of the penile head. Subsequently, the patient was treated in our hospital for cicatricial adhesion release, circumcision and external urethral ostium plastic surgery. The postoperative pathology showed sclerosing lichenoid degeneration. After 1 year follow-up, the appearance was satisfactory and urination was smooth.

Objective : To investigate the effect of miR-135a-5p on the expression levels of insulin-like factor 3 (INSL3) and testosterone in the testicular tissues of flutamide-induced cryptorchidism mouse． Methods : A model of flutamide-induced cryptorchidism in mouse was constructed，and the experiment was divided into normal control group，flutamide group，flutamide + miR-135a-5p knockdown group and flutamide + miR-135a-5p overexpression group. RT-qPCR was used to detect the expression levels of miR-135a-5p and INSL3 mRNA．Western blot was em- ployed to assess the protein expression level of INSL3．ELISA was performed to measure the expression level of tes- tosterone. Results : The expression levels of miR-135a-5p，INSL3 mRNA and protein and testosterone were significantly down-regulated in the testis of cryptorchid mice by flutamide (P＜0. 05) ．Knockdown of miR-135a-5p could downregulate the expression of INSL3 mRNA，INSL3 protein and testosterone (P ＜0. 01 ) ，while overexpression of miR-135a-5p had the opposite result． Conclusion miR-135a-5p decreased in flutamide-induced cryptorchidism mouse testicular tissues，and overexpression of miR-135a-5p could restore the expression levels of INSL3 and testosterone.