[Objective]To evaluate the efficacy of ureteral dilation versus ureteral reimplantation in treating pediatric primary obstructive megaureter(POM).[Methods]A retrospective analysis was conducted on clinical data of 53 pediatric patients with POM treated in the Department of Urology,Anhui Provincial Children's Hospital from April 2019 to September 2023.The cohort included 37 boys and 16 girls with 5 bilateral and 48 unilateral cases.The age ranged from 1 to 157 months,with a median age of 17.00(5.50-48.00)months.Patients were assigned to 3 groups based on the management of the ureteral stricture segment:dilation group(18 cases,19 sides),Cohen group(20 cases,24 sides),and Lich-Gregoir group(15 cases,15 sides).The duration of the operations,postoperative hospital stays,postoperative indwelling catheters,postoperative D-J stents;changes in renal pelvis anteroposterior diameter and ureteral diameter;and postoperative complications were compared to evaluate the therapeutic effects.[Results]All 53 patients successfully underwent surgery.The dilation group showed significantly shorter operative time,postoperative hospital stay,and postoperative catheterization duration compared to the Cohen and Lich-Gregoir groups(P＜0.05).However,the postoperative D-J stent time was longer in the dilation group than in the other 2 groups(P＜0.05).Upon follow-ups for 6-12 months after stent removal,all groups demonstrated statistically significant reductions in renal pelvis anteroposterior diameter and ureteral diameter compared to preoperative values(P＜0.05).No significant differences were observed among the 3 groups in hydronephrosis resolution rates(P＞0.05).Additionally,the incidence of postoperative complications(urinary tract infection,vesicoureteral reflux,and reoperation for restenosis)did not differ significantly among the groups(P＞0.05).[Conclusions]Ureteral dilation demonstrated non-inferior short-term clinical efficacy compared to ureteral reimplantation in managing POM in pediatric patients.With reduced operative time,minimal invasiveness,and technical simplicity,ureteral dilation may be considered a preferential treatment option for children with POM.

[Objective]To evaluate the efficacy of ureteral dilation versus ureteral reimplantation in treating pediatric primary obstructive megaureter(POM).[Methods]A retrospective analysis was conducted on clinical data of 53 pediatric patients with POM treated in the Department of Urology,Anhui Provincial Children's Hospital from April 2019 to September 2023.The cohort included 37 boys and 16 girls with 5 bilateral and 48 unilateral cases.The age ranged from 1 to 157 months,with a median age of 17.00(5.50-48.00)months.Patients were assigned to 3 groups based on the management of the ureteral stricture segment:dilation group(18 cases,19 sides),Cohen group(20 cases,24 sides),and Lich-Gregoir group(15 cases,15 sides).The duration of the operations,postoperative hospital stays,postoperative indwelling catheters,postoperative D-J stents;changes in renal pelvis anteroposterior diameter and ureteral diameter;and postoperative complications were compared to evaluate the therapeutic effects.[Results]All 53 patients successfully underwent surgery.The dilation group showed significantly shorter operative time,postoperative hospital stay,and postoperative catheterization duration compared to the Cohen and Lich-Gregoir groups(P＜0.05).However,the postoperative D-J stent time was longer in the dilation group than in the other 2 groups(P＜0.05).Upon follow-ups for 6-12 months after stent removal,all groups demonstrated statistically significant reductions in renal pelvis anteroposterior diameter and ureteral diameter compared to preoperative values(P＜0.05).No significant differences were observed among the 3 groups in hydronephrosis resolution rates(P＞0.05).Additionally,the incidence of postoperative complications(urinary tract infection,vesicoureteral reflux,and reoperation for restenosis)did not differ significantly among the groups(P＞0.05).[Conclusions]Ureteral dilation demonstrated non-inferior short-term clinical efficacy compared to ureteral reimplantation in managing POM in pediatric patients.With reduced operative time,minimal invasiveness,and technical simplicity,ureteral dilation may be considered a preferential treatment option for children with POM.

Objective:To investigate the value of serum progranulin (PGRN)in the clinical diagnosis of adult sepsis patients.Methods:One hundred and eighty-seveninfection patients admitted to the intensive care unit(ICU) of Affiliated Dongfeng Hospital, Hubei University of Medicinewere divided into non-sepsis group(94 patients) and sepsis group (93 patients)according to the third international consensus definitions for sepsis and septic shock. Patients in the sepsis group were divided into two subgroups according to the degrees of infection: septic shock group (46 patients) and non-septic shock group (47 patients). The levels of serum PGRN, procalcitonin (PCT), C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α(TNF-α) and lactic acid (Lac) were compared between the two groups and subgroups within 1 h into the ICU, as well as the acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) and sequential organ failure assessment (SOFA) scores within 24 h into the ICU. Logistic regression model was used to analyze the relationship between PGRN and sepsis. The receiver operating characteristic (ROC) curve of the subject was drawn. The diagnostic value of PGRN in sepsis was evaluated and compared with PCT, CRP, IL-6, TNF-α and Lac.Results:The levels of PGRN, PCT, CRP, IL-6, TNF-α, Lac and APACHEⅡ, SOFA scores in the sepsis group were higher than those in the non-sepsis group: (129.25 ± 17.81) μg/L vs. (43.17 ± 7.68) μg/L, (5.92 ± 0.82) μg/L vs. (1.34 ± 0.17) μg/L, (64.07 ± 10.51) mg/L vs. (37.18 ± 5.44) mg/L, (111.68 ± 13.17) ng/L vs. (32.41 ± 5.61) ng/L, (86.06 ± 12.19) ng/L vs. (46.44 ± 7.63) ng/L, (2.96 ± 0.45) mmol/L vs. (1.47 ± 0.22) mmol/L, (23.62 ± 4.24) scores vs. (11.74 ± 2.07) scores, (14.84 ± 2.42) scores vs. (1.36 ± 0.23) scores, and the differences were statistically significant ( P<0.05). The levels of PGRN, PCT, CRP, IL-6, TNF-α, Lac in the septic shock group were higher than those in non-septic shock group:(143.29 ± 13.54) μg/L vs. (116.59 ± 10.73) μg/L, (7.64 ± 1.17) μg/L vs. (4.24 ± 0.59) μg/L, (74.49 ± 10.46) mg/L vs. (53.89 ± 8.41) mg/L, (124.48 ± 14.37) ng/L vs.(99.16 ± 13.61) ng/L, (95.91 ± 14.75) ng/L vs. (76.42 ± 11.24) ng/L, (3.52 ± 0.46) mmol/L vs. (2.45 ± 0.39) mmol/L, and the differences were statistically significant ( P<0.05). Logistic regression analysis showed that SODA scores and serum PGRN, PCT, CRP, IL-6, Lac levels were independent risk factors for sepsis ( P<0.05). The ROC curve analysis showed that the area under the curve (AUC) of PGRN was higher than that of CRP, IL-6, TNF-α and Lac for predicting the occurrence of sepsis in infection patients ( P<0.05). The AUC of PGRN was higher than that of CRP, IL-6, TNF-α and Lac for predicting the occurrence of septic shock in infection patients ( P<0.05). Conclusions:The levels of serum PGRN is a good biomarker for the diagnosis of sepsis and could reflect the severity. It has certain clinical value.