Objective: To explore the efficacy of transcystoscopic holmium laser sieve-shaped fenestration in the treatment of ureteral cysts in children. Methods: The clinical data of 41 children with ureteral cysts treated in our hospital during Jan.2019 and Dec.2023 were retrospectively analyzed.All children received this surgery.The perioperative indicators and postoperative outcomes were recorded. Results: All operations were successful, the average operation time being (32.20±11.49) min.During the 12-month follow-up, the cysts were reduced or the obstructive symptoms were relieved in 31 cases, and the cysts completely disappeared in 6 cases.Vesicoureteral reflux (VUR) developed in 4 cases, 1 of which had grade Ⅱ VUR with no obvious symptoms and received conservative treatment.Repeated urinary tract infections developed in 2 cases; obstructive symptoms remained unchanged in 1 case; these 3 cases received vesicoureteral replantation.Two days before operation and 3 months after operation, the ureter diameter was (9.95±2.38) mm and (7.41±3.39) mm (t=3.16, P＜0.05), the anteroposterior diameter of the renal pelvis was (13.32±2.63) mm and (9.07±3.02) mm (t=6.86, P＜0.01). Conclusion: Transcystoscopic holmium laser sieve-shaped fenestration for children with ureteral cysts has good efficacy, little trauma and few complications.It can quickly relieve obstructive symptoms and can be used as the initial treatment of ureteral cysts.

Objective To evaluate the effect of photo-activated disinfection(PAD)as a kind of adjuvant treatment on moderate to severe chronic periodontitis.Methods 21 patients with the chronic periodontitis(totally 218 selected sites)were randomly enrolled and divided into group A(minocycline hydrochloride),group B(PAD),group C(PAD + minocycline hydrochloride),and group D(no adjunctive therapy)for the adjunctive treatment after receiving the scaling and root planing(SRP).Periodontal indexs as probing depth(PD),bleeding on probing(BOP)and clinical attachment loss(CAL)were examined at the baseline,6 and 12 weeks after the treatment.Meanwhile,periodontal pathogens as Porphyromonas gingivalis(Pg)and Tannerella forsythia(Tf)from subgingival plaque of group A,B and C were detected by Real-time PCR.Results Compared with the baseline,the periodontal inflammations of all groups were improved signiffcantly at 6 and 12 weeks after the treatment(P<0.001),and group A,group B and group C were better than group D(P<0.001),group C was better than group A(P<0.001);Furthermore,the concentration of Pg and Tf was decreased significantly(P<0.001),and there was no difference among the three groups with adjunctive therapy.Conclussion As the adjunctive treatment of SRP,PAD could achieve the same and even better effect than minocycline hydrochloride ointment.

Radiotherapy serves as an effective means in the clinical treatment of renal cell carcinoma (RCC). Radiation resistance, denoting the decreased sensitivity of cancer cells to ionizing radiation during radiotherapy, is a common problem in tumor radiotherapy that is closely associated with the occurrence of adverse outcomes like tumor metastasis and recurrence. Focusing on RCC′s radiotherapy resistance, this study elucidated the radiation resistance mechanisms of RCC cells in terms of DNA damage repair, cell cycle arrest, activation of the anti-apoptotic pathway, autophagy, and cancer stem cells. Moreover, it summarized the radiosensitizers currently used in RCC radiotherapy. This study aims to provide a novel approach for the mechanism study of RCC radiotherapy resistance, the improvement of radiotherapy strategies, and the innovative research and development of drugs.

Objective:To explore the clinicopathological and genetic characteristics of sporadic medullary thyroid carcinoma (MTC) and new therapeutic targets for sporadic MTC.Methods:Based on family and personal disease history, we identified 32 sporadic MTC who underwent surgical resection from Jan 2010 to Dec 2022. Clinicopathological and immunohistochemical features were analyzed in all patients, while 6 of them were subject to the whole exome sequencing (WES).Results:Compared with those of low-grade sporadic MTC, patients with high-grade tumors were more likely to have lymph node metastasis at presentation ( χ2=4.428, P=0.040); less likely to be cured by biochemical treatment ( χ2=4.072, P=0.044). Pathological grading scheme, biochemical cure, and TNM stage were independent risk factors of disease free survival. WES was performed on 6 pairs of normal tissues. We screened RET and RAS as driver mutations, and the mutation ratio was 3/6 respectively. Patients with RET or RAS mutations had no recurrence. In addition, we detected PDGFRA somatic mutation, with a mutation ratio of 1/6. Conclusions:For sporadic MTC cases, the pathological grading system has important prognostic value, and RET and RAS somatic mutations are the main driver mutations. PDGFRA are potential therapeutic targets for sporadic MTC.

ObjectiveTo observe the effect of Qinggan Jianpi Huoxue prescription（QGJPHXP） on the polarization of M1/M2 macrophages in rats with hepatic fibrosis induced by carbon tetrachloride（CCl₄）. MethodA rat hepatic fibrosis model was established by intraperitoneal injection of 40% CCl₄-olive oil suspension twice a week at the dosage of 2.0 mL·kg^-1 for 8 weeks. After the model was successfully established， these rats were randomly divided into the model group， QGJPHXP group（32.084 g·kg^-1） and Biejiajian pills（BJJP） group（0.925 5 g·kg^-1）， with 12 rats in each group. The blank group was injected intraperitoneally with the same amount of olive oil. The rats in the administration groups were given the corresponding solution according to the dose， and the blank and model groups were given the same dose of purified water， once a day. After 4 weeks of continuous administration， the liver tissues of rats were taken and stained with hematoxylin-eosin（HE） and Masson to observe the pathological changes. The serums were collected to detect the alanine aminotransferase（ALT） and aspartate aminotransferase（AST） levels. Interleukin（IL）-6， IL-12， IL-10， IL-1β， transforming growth factor-β₁（TGF-β₁） and tumor necrosis factor-α（TNF-α） levels in liver tissues were measured by enzyme-linked immunosorbent assay（ELISA）. The expression levels of CD86 and CD206 were detected by immunohistochemistry（IHC）. Western blot and real-time fluorescence quantitative polymerase chain reaction（Real-time PCR） were used to detect the protein and mRNA expression levels of inducible nitric oxide synthase（iNOS）， arginase-1（Arg-1）， phosphorylated p38 mitogen-activated protein kinase（p-p38 MAPK）， nuclear transcription factor-κB p65（NF-κB p65） in liver tissues of rats. ResultCompared with the blank group， the hepatic cell plate was irregularly arranged, and local inflammatory cell infiltration and fibrous hyperplasia were observed， while the serum levels of ALT and AST were significantly increased in the model group（P<0.01）， and IL-1β， IL-6， IL-12， TGF-β₁， TNF-α， CD86， CD206， iNOS， p-p38 MAPK，p38 MAPK and NF-κB p65 levels in liver tissues were obviously increased（P<0.05， P<0.01）， while the levels of IL-10 and Arg-1 were obviously decreased（P<0.05， P<0.01）. Compared with the model group， QGJPHXP group reduced the degree of liver cell fibrosis，and serum levels of ALT and AST（P<0.01）， and IL-1β， IL-6， IL-12， TGF-β₁， TNF-α， CD86， iNOS， p-p38 MAPK， p38 MAPK， and NF-κB p65 levels in liver tissues were obviously decreased（P<0.05， P<0.01）， the levels of IL-10， CD206 and Arg-1 were obviously increased in the QGJPHXP group（P<0.05， P<0.01）. ConclusionQGJPHXP has ability to inhibit the activation of pro-inflammatory M1 macrophages， induce the secretion of anti-inflammatory cytokines by M2 macrophages， reduce the release of pro-fibrogenic cytokines， and promote the macrophage polarization of M1 to M2 in liver for tissue repair， thereby serving as an anti-inflammatory and anti-hepatic fibrosis drug.

【Objective】 To compare the clinical efficacy of pneumovesic and open laparoscopic ureteral replantation in the treatment of primary vesicoureteral reflux, and to summarize the characteristics of pneumovesic surgery. 【Methods】 A total of 70 children with vesicoureteral reflux treated at our hospital during 2016 and 2021 were divided into pneumovesic group and open group, with 35 children in either group. The pneumovesic group underwent laparoscopic Cohen’s ureteral replantation, and the open group underwent open Cohen’s ureteral replantation. The operation-related data of the two groups were compared. 【Results】 Compared with the open group, the pneumovesic group had smaller incision size (1.5 cm vs. 4.0 cm), less intraoperative blood loss (2.0 mL vs.10.0 mL), longer operation time [(185.3±54.2)min vs. (150.5±45.5)min], shorter postoperative hematuria time [(4.7±2.1 d) vs. (6.0±1.3 d)], shorter urinary catheter indwelling time [(11.9±4.0) d vs. (14.1±3.8) d], lower FLACC pain score [(d1: 2.5±0.7, d3: 1.5±0.6) vs. (d1: 5.3±0.9, d3: 2.9±0.6)], lower incidence of frequent and urgent urination (3% vs. 17% ), and higher postoperative incision satisfaction (100% vs. 89%). There was no recurrence in either group. 【Conclusion】 The curative effects were significant in both groups. Compared with open surgery, pneumovesic laparoscopic ureteral replantation for the treatment of primary vesicoureteral reflux has the advantages of small trauma, beautiful appearance, quick recovery and little influence on bladder function.

Objective:To investigate the effects of ultra-high dose rate radiation (FLASH-RT) and conventional radiation (CONV-RT) on plasma metabolites in glioma mice.Methods:Tocally 21 male C57BL/6J mice bearing intracranial glioma xenograft were randomly divided into healthy control group ( n=3), CONV-RT group ( n=9) and FLASH-RT group ( n=9). The CONV-RT group was administered a single dose of 24 Gy radiation on the head of mice at a dose rate of 0.4 Gy/s, and the FLASH-RT group was administered a single dose of 24 Gy radiation on the head of mice at a dose rate of 60 Gy/s, and the healthy control group was given 0 Gy pseudoradiation under the same condition. Mice blood was collected through the inner canthus vein for plasma separation at 1, 3 and 7 d after radiation in the two radiation groups, and the blood plasma of healthy control group was collected at 7 days after sham radiation. The changes in plasma metabolites were detected by the non-targeted metabolomics based on liquid chromatography mass spectrometry tandem platform. Results:After irradiation, the metabolites in plasma of two irradiation groups had significant difference. Compared with the healthy control group, 12 and 5 differential metabolites were screened out in the FLASH-RT group and CONV-RT group at three time points, respectively. The difference of plasma metabolites had the largest value at 1 day and decreased at 3 and 7 d after radiation. The arachidonic acid and isovaleric acid, involving arachidonic acid metabolism, biosynthesis of unsaturated fatty acids, and tyrosine metabolism pathways were screened in both FLASH-RT group and CONV-RT group, and the 10 differential metabolites, mainly involving energy metabolism and redox reactions, only existed in the FLASH-RT group.Conclusions:Arachidonic acid and isovaleric acid may be the common sensitive biomarkers to different radiation patterns, which provides ideas for further exploring the molecular mechanism of FLASH-RT in the treatment of glioma.

Renal cell carcinoma (RCC) is one of the most aggressive malignancies in the genitourinary system with a poor prognosis, especially in patients with RCC who have metastases. RCC is conventionally considered not sensitive to radiotherapy. Compared with conventional radiotherapy, stereotactic body radiotherapy (SBRT) has the characteristics of higher precision, higher irradiation dose, and less damage to the surrounding tissue. In recent years, SBRT has shown definite efficacy in the treatment of primary and advanced metastatic RCC. SBRT combined with targeted therapy and immunotherapy can improve the local tumor control rate and cause fewer adverse reactions in patients with primary and advanced metastatic RCC. This article reviews the literature on the strategy and progress of SBRT in combination with targeted therapy and immunotherapy.

Objective:To investigate the characteristics of regional brain functional centrality(DC)in patients with levodopa-induced dyskinesia(LID)and to explore the pathogenesis of LID.Methods:A total of 33 PD patients with LID(PD-LID), 41 PD patients without LID(PD-nLID)and 37 healthy controls from the First Affiliated Hospital of Nanjing Medical University were enrolled in this study.Differences in DC among the three groups were compared and the correlation between Z-DC values of the brain regions with differences and the scores of the involuntary movement scale(items 1-7)was analyzed.Results:Compared with Controls, PD-LID patients showed increased DC in the right amygdala(extending to the right globus pallidus)(MNI: x=30, y=-3, z=-18, t=4.00, P<0.05 after AlphaSim correction)and in the right postcentral gyrus(MNI: x=57, y=-9, z=39, t=-3.59; MNI: x=42, y=-33, z=57, t=-4.23, P<0.05 after AlphaSim correction)and reduced DC in the right superior parietal lobule(MNI: x=24, y=-51, z=72, t=-3.95, P<0.05 after AlphaSim correction).Compared with the PD-nLID group, the PD-LID group showed increased DC in the right globus pallidus(MNI: x=30, y=-12, z=-3, t=3.09, P<0.05 after AlphaSim correction).DC changes in the right globus pallidus were positively correlated with AIMS score( r=0.482, P=0.004). Conclusions:The enhancement of DC function in the right globus pallidus may be closely related to the onset and severity of LID.