1.Analysis of Alleviating Effect of Calcium Cyanamide on Replanting Problems of Rehmannia glutinosa
Lianghua LIN ; Hengrui ZHANG ; Haoxiang YU ; Fan YANG ; Yufei WANG ; Caixia XIE ; Tao GUO ; Zhongyi ZHANG ; Liuji ZHANG ; Bao ZHANG ; Suiqing CHEN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(22):212-222
ObjectiveTo investigate the alleviating effect of calcium cyanamide (CaCN2) soil fumigation on replanting problems of Rehmannia glutinosa. MethodsNewly soil (NP) was used as the control group, while three treatment groups were established: replanted soil (RP), newly soil treated with CaCN2 (120 g·m², tillage depth 25 cm) (NPCC), and replanted soil treated with CaCN2 (RPCC). R. glutinosa was cultivated in all groups. At harvest, the tuber agronomic traits (number of enlarged roots, maximum root diameter, fresh weight, dry weight) were measured. The content of catalpol and rehmannioside D was quantified by ultra-high-performance liquid chromatography (UPLC) to evaluate medicinal quality. Rhizosphere soil available nutrients and enzyme activities were analyzed by assay kits. The community structure and composition of fungi and bacteria in rhizosphere soil were assessed via internal transcribed spacer 2 (ITS2) sequencing and 16S rDNA sequencing, respectively. ResultsCompared with NP, the RP group showed obviously reduced in tuber agronomic traits and quality indicators (P0.05). However, the RPCC group showed significant improvement in agronomic traits and a notable increase in rehmannioside D content compared to RP (P0.05). The contents of available phosphorus and potassium in RPCC and NP groups were obviously lower than those in RP (P0.05). The polyphenol oxidase soil (S-PPO) activity in RP was obviously lower than in NP (P0.05), while sucrose soil (S-SC), acid phosphatase soil (S-ACP), and S-PPO activities in RPCC were obviously higher than in RP (P0.05). Microbial richness and diversity in RP were obviously higher than in NP (P0.05), whereas no significant differences were observed between the RPCC and NP. The relative abundances of fungal genera Nectria, Myrothecium, Tomentella, and bacterial genus Skermanella were obviousl lower in RPCC and NP than in RP (P0.05). Correlation analysis that S-ACP activity was positively correlated with the content of rehmannioside D (P0.05). Fungal genera Engyodontium and Alternaria, and bacterial genera Pir4 lineage, Pirellula, Methyloversatilis, Brevundimonas, Ralstonia, and Acidibacter were obviously positively correlated with tuber dry weight (P0.05). Conversely, fungal genera Pseudaleuria, Nectria, Haematonectria, Ceratobasidium, and bacterial genera Streptomyces, Skermanella, RB41, Gemmatimonas, and Bacillus were obviously negatively correlated with dry weight (P0.05). The fungal genus Alternaria and bacterial genera Brevundimonas, Ralstonia, Acidibacter, and Dongia showed positive correlations with medicinal quality of R.glutinosa tuber, while fungal genera Pseudaleuria, Nectria, Stachybotrys, Fusarium, Gibberella, Ceratobasidium, and bacterial genera Sphingomonas, Skermanella, RB41, Gemmatimonas, and Bacillus were obviously negatively correlated (P0.05). ConclusionCaCN2 soil fumigation can significantly improve enzyme activities in replanted Rehmannia rhizosphere soil, enhance the utilization of available nutrients, reshape microbial community structure of replanted R.glutinosa at the family and genus level, and notably improve tuber agronomic traits and medicinal quality. This study provides a novel approach to alleviating replanting problems and offers insights for the integrated development of standardized cultivation techniques, including soil disinfection, nutrient-targeted regulation, and microbial inoculant application.
2.Regulation of skin pigmentation by miR-25-5p via targeting RAB11B: a mechanistic study
Wenzhu WANG ; Hedan YANG ; Yunyao LIU ; Xiaojie SUN ; Xiaoli ZHANG ; Xiuzhen LI ; Siqi TAN ; Haoxiang XU ; Yin YANG ; Tong LIN
Chinese Journal of Dermatology 2025;58(9):816-824
Objective:To investigate the role of microRNA-25-5p (miR-25-5p) in melanogenesis, and to explore its underlying mechanisms.Methods:Target genes of miR-25-5p were predicted using the TargetScan database. The interaction between miR-25-5p and the 3' untranslated region (3' UTR) of the RAB11B gene (a member of RAS oncogene family) was validated through a dual-luciferase reporter assay. Post-inflammatory hyperpigmentation (PIH) models were established in female C57BL/6J mice (6 - 8 weeks old) and female brown guinea pigs (4 - 6 weeks old) through daily broadband ultraviolet B (UVB) irradiation on the dorsal skin of the mouse ear or shaved dorsal skin of guinea pigs, while untreated mice and untreated dorsal skin areas of guinea pigs served as control groups. During modeling, these experimental animals received intradermal injections of a miR-25-5p agomir or a miR control agomir. Changes in skin pigmentation were observed, and skin tissue samples were harvested for further analysis after modeling. Melanin content in skin tissues was evaluated using Masson-Fontana staining. Expression of RAB11B and tyrosinase (TYR) in skin tissues was determined using immunohistochemical staining and quantitative real-time PCR (qPCR). Primary human melanocytes were isolated from discarded normal foreskin tissues of healthy males after circumcision. Both primary human melanocytes and human MNT1 melanoma cells were transfected with miR-25-5p mimics or miR control mimics. Relative expression levels of miR-25-5p and RAB11B mRNA were quantified by qPCR using the 2 -ΔΔCt calculation method. In MNT1 cells, miR-25-5p and RAB11B were co-overexpressed to assess their effect on the mRNA expression of RAB11B and TYR. Statistical analysis was conducted using t test or one-way analysis of variance followed by Tukey's post hoc test for multiple comparisons. Results:The bioinformatic prediction and dual-luciferase reporter assay confirmed a binding site for miR-25-5p in the 3′ UTR of the RAB11B gene. In both animal models, the treatment with the miR-25-5p agomir significantly reduced local skin pigmentation compared to the control groups; Masson-Fontana staining showed a marked decrease in the density of melanin granules in the epidermis and dermis in the miR-25-5p agomir groups compared with the miR control agomir groups (mice: 0.050 ± 0.005 vs. 0.087 ± 0.008; guinea pigs: 0.067 ± 0.015 vs. 0.110 ± 0.013; both P < 0.05). Immunohistochemical staining revealed significantly lower expression of RAB11B in mouse skin tissues in the miR-25-5p agomir group than in those in the miR control agomir group (both P < 0.05). qPCR revealed significantly lower mRNA expression of RAB11B and TYR in skin tissues of guinea pigs in the miR-25-5p agomir group than in those in the miR control agomir group (both P < 0.05). Similarly, RAB11B mRNA expression significantly decreased in the miR-25-5p mimics group compared with the miR control mimics group in primary human melanocytes and MNT1 cells (both P < 0.05). In human MNT1 melanoma cells, miR-25-5p overexpression could suppress TYR mRNA expression, whereas co-overexpression of miR-25-5p and RAB11B could reverse this suppression. Conclusion:Overexpression of miR-25-5p could alleviate UVB-induced post-inflammatory hyperpigmentation and inhibit melanogenesis, likely by targeted suppression of RAB11B expression.
3.Research progress on the fibrinogen-like protein 1 in the pathogenesis of chronic metabolic diseases
Xiangjie WU ; Xia DENG ; Haoxiang LI ; Ling YANG
Chinese Journal of Diabetes 2025;33(3):237-240
Fibrinogen-like protein 1(FGL1)is a novel hepatic factor and a member of the fibrinogen family.FGL1 has diverse and complex functions and is involved in the regulation of multiple biological processes.FGL1 has an important role in the study of metabolic diseases,but further studies are needed to reveal its underlying mechanisms and the feasibility of clinical applications.This review is to summarize the role of FGL1 in the development and progression of DM,obesity,metabolic associated fatty liver disease and polycystic ovarian syndrome.
4.Regulation of skin pigmentation by miR-25-5p via targeting RAB11B: a mechanistic study
Wenzhu WANG ; Hedan YANG ; Yunyao LIU ; Xiaojie SUN ; Xiaoli ZHANG ; Xiuzhen LI ; Siqi TAN ; Haoxiang XU ; Yin YANG ; Tong LIN
Chinese Journal of Dermatology 2025;58(9):816-824
Objective:To investigate the role of microRNA-25-5p (miR-25-5p) in melanogenesis, and to explore its underlying mechanisms.Methods:Target genes of miR-25-5p were predicted using the TargetScan database. The interaction between miR-25-5p and the 3' untranslated region (3' UTR) of the RAB11B gene (a member of RAS oncogene family) was validated through a dual-luciferase reporter assay. Post-inflammatory hyperpigmentation (PIH) models were established in female C57BL/6J mice (6 - 8 weeks old) and female brown guinea pigs (4 - 6 weeks old) through daily broadband ultraviolet B (UVB) irradiation on the dorsal skin of the mouse ear or shaved dorsal skin of guinea pigs, while untreated mice and untreated dorsal skin areas of guinea pigs served as control groups. During modeling, these experimental animals received intradermal injections of a miR-25-5p agomir or a miR control agomir. Changes in skin pigmentation were observed, and skin tissue samples were harvested for further analysis after modeling. Melanin content in skin tissues was evaluated using Masson-Fontana staining. Expression of RAB11B and tyrosinase (TYR) in skin tissues was determined using immunohistochemical staining and quantitative real-time PCR (qPCR). Primary human melanocytes were isolated from discarded normal foreskin tissues of healthy males after circumcision. Both primary human melanocytes and human MNT1 melanoma cells were transfected with miR-25-5p mimics or miR control mimics. Relative expression levels of miR-25-5p and RAB11B mRNA were quantified by qPCR using the 2 -ΔΔCt calculation method. In MNT1 cells, miR-25-5p and RAB11B were co-overexpressed to assess their effect on the mRNA expression of RAB11B and TYR. Statistical analysis was conducted using t test or one-way analysis of variance followed by Tukey's post hoc test for multiple comparisons. Results:The bioinformatic prediction and dual-luciferase reporter assay confirmed a binding site for miR-25-5p in the 3′ UTR of the RAB11B gene. In both animal models, the treatment with the miR-25-5p agomir significantly reduced local skin pigmentation compared to the control groups; Masson-Fontana staining showed a marked decrease in the density of melanin granules in the epidermis and dermis in the miR-25-5p agomir groups compared with the miR control agomir groups (mice: 0.050 ± 0.005 vs. 0.087 ± 0.008; guinea pigs: 0.067 ± 0.015 vs. 0.110 ± 0.013; both P < 0.05). Immunohistochemical staining revealed significantly lower expression of RAB11B in mouse skin tissues in the miR-25-5p agomir group than in those in the miR control agomir group (both P < 0.05). qPCR revealed significantly lower mRNA expression of RAB11B and TYR in skin tissues of guinea pigs in the miR-25-5p agomir group than in those in the miR control agomir group (both P < 0.05). Similarly, RAB11B mRNA expression significantly decreased in the miR-25-5p mimics group compared with the miR control mimics group in primary human melanocytes and MNT1 cells (both P < 0.05). In human MNT1 melanoma cells, miR-25-5p overexpression could suppress TYR mRNA expression, whereas co-overexpression of miR-25-5p and RAB11B could reverse this suppression. Conclusion:Overexpression of miR-25-5p could alleviate UVB-induced post-inflammatory hyperpigmentation and inhibit melanogenesis, likely by targeted suppression of RAB11B expression.
5.Research progress on the fibrinogen-like protein 1 in the pathogenesis of chronic metabolic diseases
Xiangjie WU ; Xia DENG ; Haoxiang LI ; Ling YANG
Chinese Journal of Diabetes 2025;33(3):237-240
Fibrinogen-like protein 1(FGL1)is a novel hepatic factor and a member of the fibrinogen family.FGL1 has diverse and complex functions and is involved in the regulation of multiple biological processes.FGL1 has an important role in the study of metabolic diseases,but further studies are needed to reveal its underlying mechanisms and the feasibility of clinical applications.This review is to summarize the role of FGL1 in the development and progression of DM,obesity,metabolic associated fatty liver disease and polycystic ovarian syndrome.
6.Development and validation of a predictive model for postoperative blood pressure outcomes in primary aldosteronism based on CYP11B2 gene polymorphism
Qiangfeng FU ; Yongjia CHEN ; Shengtao ZENG ; Haoxiang XU ; Chenglin YANG ; Yue YANG ; Zhi CAO ; Wei WANG
Chinese Journal of Urology 2025;46(7):529-536
Objective:To construct and validate a clinical model combining CYP11B2 gene polymorphisms with clinical parameters to predict complete postoperative hypertension remission in primary aldosteronism patients.Methods:The clinical data of a total of 116 patients with primary aldosteronism who underwent unilateral adrenalectomy from April 2018 to August 2024 were retrospectively included. There were 63 males and 53 females,with a body mass index(BMI)of(25.50 ± 2.03)kg/m 2. Genomic DNA was extracted from venous blood leukocytes before surgery,and polymerase chain reaction-restriction fragment length polymorphisms(PCR-RFLP)were used to detect CYP11B2(rs1799998)promoter region 344(C > T)base substitution. The follow-up duration was more than 6 months,with the following parameters recorded at the last follow-up:plasma aldosterone,renin,serum potassium,and sodium levels. Blood pressure progression and antihypertensive medication usage were also assessed. The postoperative outcome was determined according to the Primary Aldosteronism Surgical Outcome score(PASO)for primary aldosteronism,and the specific criteria were as follows. ① Clinical complete remission:the patient's blood pressure returned to normal(< 140/90 mmHg,1 mmHg = 0.133 kPa)and all antihypertensive drugs were discontinued;②Partial clinical remission:blood pressure returns to normal,and the number or dose of antihypertensive drugs is reduced compared with before;③Clinical non-remission:blood pressure does not drop and antihypertensive drugs do not change or increase compared with before surgery. Patients were divided into complete and incomplete remission groups. The chi-square test was used for univariate analysis,followed by binary logistic forward conditional regression for multivariate analysis,and a variety of machine learning algorithms such as random forest,logistic regression,support vector machine and gradient lifter were integrated,and the results of multivariate analysis were included to construct a postoperative blood pressure outcome model,and the predictive performance of the model was evaluated by using receiver operating characteristic(ROC)curve,calibration curve and clinical decision curve. Results:The PCR-RFLP detection results of 116 cases showed the genotype distribution of CYP11B2(344C > T)(rs1799998)as follows:CC type in 50 cases(43.1%),CT type in 46 cases(39.7%),and TT type in 20 cases(17.3%). There were 74 cases in the complete remission group and 42 cases in the incomplete remission group,and the rate of complete remission with hypertension at the end of the operation was 63.8%. Univariate analysis showed that the the differences between complete remission group and incomplete remission group in body mass index[(24.27 ± 2.90)kg/m 2 vs.(26.98 ± 3.17)kg/m 2, P<0.001],preoperative hypertension grade(grade 1/2/3:29/29/16 cases vs. 9/13/20 cases, P = 0.012),preoperative antihypertensive drugs(0/1/≥ 2:25/32/17 cases vs. 7/15/20 cases, P = 0.016),and CYP11B2(344C > T)(CC/TT + CT:39/35 cases vs. 11/31 cases, P = 0.006)were statistically significant. Multivariate analysis showed that the type of preoperative antihypertensive drugs[≥ 2: OR = 5.26(95% CI 1.12?24.61, P = 0.016;1: OR = 4.55(95% CI 1.23?22.47), P = 0.025]was the strongest independent predictor,followed by CYP11B2(344C > T)[ OR = 4.02(95% CI 1.16?13.82), P = 0.028]and BMI[ OR = 3.96(95% CI 2.26?6.92), P < 0.001]. Comparing the receiver operating feature(ROC)curves of the four types of machine learning models,the best model was the support vector machine model with an area under the curve(AUC)of 0.88(95% CI 0.82?0.95),followed by the gradient elevator model of 0.83(95% CI 0.76?0.91),the logistic regression model of 0.78(95% CI 0.68?0.88),and the random forest model of 0.77(95% CI 0.68?0.86). The optimal threshold of the Yoden index of the support vector machine model was 0.588,with a sensitivity of 78.5% and a specificity of 86.5%. The clinical decision curve and calibration curve show that the support vector machine model has a higher net benefit and acceptable stability and reliability. Conclusions:The support vector machine model incorporating CYP11B2 gene polymorphisms,BMI,and types of preoperative antihypertensive medications could effectively predict postoperative hypertension remission in primary aldosteronism patients,providing new evidence for personalized treatment strategies
7.Development and validation of a predictive model for postoperative blood pressure outcomes in primary aldosteronism based on CYP11B2 gene polymorphism
Qiangfeng FU ; Yongjia CHEN ; Shengtao ZENG ; Haoxiang XU ; Chenglin YANG ; Yue YANG ; Zhi CAO ; Wei WANG
Chinese Journal of Urology 2025;46(7):529-536
Objective:To construct and validate a clinical model combining CYP11B2 gene polymorphisms with clinical parameters to predict complete postoperative hypertension remission in primary aldosteronism patients.Methods:The clinical data of a total of 116 patients with primary aldosteronism who underwent unilateral adrenalectomy from April 2018 to August 2024 were retrospectively included. There were 63 males and 53 females,with a body mass index(BMI)of(25.50 ± 2.03)kg/m 2. Genomic DNA was extracted from venous blood leukocytes before surgery,and polymerase chain reaction-restriction fragment length polymorphisms(PCR-RFLP)were used to detect CYP11B2(rs1799998)promoter region 344(C > T)base substitution. The follow-up duration was more than 6 months,with the following parameters recorded at the last follow-up:plasma aldosterone,renin,serum potassium,and sodium levels. Blood pressure progression and antihypertensive medication usage were also assessed. The postoperative outcome was determined according to the Primary Aldosteronism Surgical Outcome score(PASO)for primary aldosteronism,and the specific criteria were as follows. ① Clinical complete remission:the patient's blood pressure returned to normal(< 140/90 mmHg,1 mmHg = 0.133 kPa)and all antihypertensive drugs were discontinued;②Partial clinical remission:blood pressure returns to normal,and the number or dose of antihypertensive drugs is reduced compared with before;③Clinical non-remission:blood pressure does not drop and antihypertensive drugs do not change or increase compared with before surgery. Patients were divided into complete and incomplete remission groups. The chi-square test was used for univariate analysis,followed by binary logistic forward conditional regression for multivariate analysis,and a variety of machine learning algorithms such as random forest,logistic regression,support vector machine and gradient lifter were integrated,and the results of multivariate analysis were included to construct a postoperative blood pressure outcome model,and the predictive performance of the model was evaluated by using receiver operating characteristic(ROC)curve,calibration curve and clinical decision curve. Results:The PCR-RFLP detection results of 116 cases showed the genotype distribution of CYP11B2(344C > T)(rs1799998)as follows:CC type in 50 cases(43.1%),CT type in 46 cases(39.7%),and TT type in 20 cases(17.3%). There were 74 cases in the complete remission group and 42 cases in the incomplete remission group,and the rate of complete remission with hypertension at the end of the operation was 63.8%. Univariate analysis showed that the the differences between complete remission group and incomplete remission group in body mass index[(24.27 ± 2.90)kg/m 2 vs.(26.98 ± 3.17)kg/m 2, P<0.001],preoperative hypertension grade(grade 1/2/3:29/29/16 cases vs. 9/13/20 cases, P = 0.012),preoperative antihypertensive drugs(0/1/≥ 2:25/32/17 cases vs. 7/15/20 cases, P = 0.016),and CYP11B2(344C > T)(CC/TT + CT:39/35 cases vs. 11/31 cases, P = 0.006)were statistically significant. Multivariate analysis showed that the type of preoperative antihypertensive drugs[≥ 2: OR = 5.26(95% CI 1.12?24.61, P = 0.016;1: OR = 4.55(95% CI 1.23?22.47), P = 0.025]was the strongest independent predictor,followed by CYP11B2(344C > T)[ OR = 4.02(95% CI 1.16?13.82), P = 0.028]and BMI[ OR = 3.96(95% CI 2.26?6.92), P < 0.001]. Comparing the receiver operating feature(ROC)curves of the four types of machine learning models,the best model was the support vector machine model with an area under the curve(AUC)of 0.88(95% CI 0.82?0.95),followed by the gradient elevator model of 0.83(95% CI 0.76?0.91),the logistic regression model of 0.78(95% CI 0.68?0.88),and the random forest model of 0.77(95% CI 0.68?0.86). The optimal threshold of the Yoden index of the support vector machine model was 0.588,with a sensitivity of 78.5% and a specificity of 86.5%. The clinical decision curve and calibration curve show that the support vector machine model has a higher net benefit and acceptable stability and reliability. Conclusions:The support vector machine model incorporating CYP11B2 gene polymorphisms,BMI,and types of preoperative antihypertensive medications could effectively predict postoperative hypertension remission in primary aldosteronism patients,providing new evidence for personalized treatment strategies
8.Effect of buccal acupuncture on analgesia after tonsilloadenoidectomy in pediatric patients
Yaying HUANG ; Jiayi YANG ; Jiehui FANG ; Haoxiang KE ; Yingyi XU ; Bilian LI ; Junxiang HUANG ; Xingrong SONG ; Tingting YU
Chinese Journal of Anesthesiology 2024;44(10):1235-1238
Objective:To evaluate the effect of buccal acupuncture on analgesia after tonsilloadenoidectomy in pediatric patients.Methods:This was a randomized controlled study. One hundred and twenty-six American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ pediatric patients, aged 3-12 yr, weighing 12-34 kg, with body mass index <30 kg/m 2, undergoing elective tonsilloadenoidectomy with general anesthesia, were divided into 2 groups ( n=63 each) by the random number table method: buccal acupuncture group (group B) and control group (group C). All pediatric patients received the same anesthesia induction and intraoperative anesthesia maintenance. The concentration of sevoflurane was adjusted to keep the fluctuation amplitude of vital sign parameters within 20% of the baseline value. After surgery, the drug was immediately stopped and the children were transferred to the postanesthesia care unit for resuscitation under general anesthesia. In group B, the bilateral neck points, upper neck points, hologram points on the head and Zhongjiao points were selected before removal of the tracheal catheter, and disposable acupuncture needles were inserted directly into the acupoints and remained for 20-30 min. Group C received no buccal acupuncture. The pain Assessment Scale (FLACC) was used to assess the severity of postoperative pain. The postoperative agitation score was evaluated by Aono four-point rating method to evaluate the occurrence of agitation. The effective pressing times of patient-controlled analgesia, rescue analgesia and occurrence of nausea and vomiting within 48 h after operation were recorded. The occurrence of bleeding, infection and broken needle at acupuncture sites was recorded. Results:Compared with group C, the effective pressing times of patient-controlled analgesia and incidence of nausea and vomiting were significantly decreased in group B ( P<0.05). There was no significant difference in the rate of rescue analgesia and incidence of postoperative agitation between the two groups ( P>0.05). No infection or broken needle was found at acupuncture sites after buccal acupuncture, only 2 cases had slight bleeding at the puncture site, and there was no abnormality after pressing in group B. Conclusions:Buccal acupuncture can enhance the analgesic effect after tonsilloadenoidectomy in pediatric patients.
9.Differences in the Elderly Care Service Demand,Preference,and Tendency Between Urban and Rural Areas in the Pearl River Delta
Huajie YANG ; Xiang HUANG ; Jiabin LIANG ; Zhihui JIA ; Qingguo WEI ; Haoxiang WANG
Acta Academiae Medicinae Sinicae 2024;46(2):193-203
Objective To understand the differences in the demand,preference,and tendency for elderly care services between urban and rural areas in the Pearl River Delta(PRD),and to provide reference for the planning and balanced allocation of elderly care resources in urban and rural areas.Methods Using the multi-stage stratified random sampling method,we selected 7 community health service centers in 2 prefecture-level cities in the PRD and conducted a questionnaire survey on the elderly care service demand,preference,and tendency among 1919 regular residents aged 60 years and above who attended the centers.Results A total of 641 urban elderly residents(33.4%)and 1278 rural elderly residents(66.6%)were surveyed in the PRD.The urban and rural elderly residents showed differences in the child number(χ2 =43.379,P<0.001),willingness to purchase socialized elderly care services(χ2 =104.141,P<0.001),and attitudes to the concept of raising child to avoid elderly hardship(χ2 =65.632,P<0.001).The proportion(71.8%)of rural elderly residents who prefer family-based elderly care was higher than that(57.1%)of urban elderly residents(χ2 =41.373,P<0.001).The proportion(62.2%)of urban elderly residents clearly expressing their willingness to choose institutions for elderly care was higher than that(44.0%)of rural elderly residents(χ2 =57.007,P<0.001).Compared with family-based elderly care,the willingness to choose institutional or community-based in-house elderly care was low among the urban elderly residents with surplus monthly household income or balanced income and expenditure;urban males,those with college education background or above,and those who purchased so-cialized elderly care services tended to prefer community-based in-house elderly care.In rural areas,the elderly residents who had local household registry were prone to choose institutional or community-based in-house elderly care,while those who had more than one child and those who were satisfied with the current living conditions were less willing to choose community-based in-house elderly care.Conclusions It is suggested that the urban-rural differences in the elderly care service demand,preference and tendency should be fully considered in the planning and allocation of urban and rural elderly care resources.Efforts remain to be made to develop diversified social elderly care services tailored to the characteristics of urban and rural areas.
10.Robotic-assisted laparoscopic modified ventral onlay lingual mucosal graft in complex ureteral stricture construction: experience of eight cases
Haoxiang XU ; Chenglin YANG ; Wei WANG ; Zhi CAO ; Zhengfei HU ; Xiaoming ZHANG ; Yuansong XIAO
Chinese Journal of Surgery 2023;61(11):1012-1017
Objective:To examine the efficacy of robot-assisted laparoscopic modified ventral onlay lingual mucosal graft for complex ureteral stricture.Methods:The clinical data of 8 patients with ureteral stricture admitted to the Department of Urology, General Hospital of Southern Theater Command from May to October 2022 were retrospectively analyzed. There were 6 males and 2 females, aged (45.1±10.2) years (range: 34 to 64 years), body mass index (24.6±2.0) kg/m 2 (range: 20.7 to 26.6 kg/m 2). Five cases on the left side, 3 cases on the right side, the length of the ureteral structure was (3.1±0.7) cm (range: 2.2 to 4.5 cm). The value of preoperative serum creatinine was (113.8±22.3) μmol/L (range: 96 to 15 μmol/L). Before excising the structure segment, the titched anastomosed part of the dorsal wall of the ureter, and then the posteriorly augmented anastomotic, the remaining ventral side was augmented with a onlay lingual mucosa graft, then the omentum flap was used to wrap the reconstructed ureteral segment. The lingual mucosa graft with a length of 2.5 to 5.0 cm and a width of 1.0 to 1.5 cm was cut according to the actual structure. The surgery information of the patient, complications, and recent follow-up were recorded. Results:The operation under robot-assisted laparoscopy was performed successfully in the 8 patients without conversion to open surgery. The duration of the operation was (226.9±22.8) minutes (range: 210 to 255 minutes), estimated blood loss was (93.8±25.9) ml (range: 75 to 150 ml), the retention time of the postoperative drainage tube was (4.8±1.3) days (range: 3 to 7 days), and the duration of postoperative hospitalization was (11.1±3.6) days (range: 9 to 14 days). One week after the operation, the patient could pronounce correctly, enunciate clearly, and eat normally. Double J tubes were removed 4 to 8 weeks after the operation. The follow-up time in this group was 3 to 9 months, the follow-up patients underwent imaging and other examinations, which showed a significant improvement in hydronephrosis on the affected side, and the value of renal pelvic separation on the affected side was (1.4±0.8) cm (range: 0 to 2.3 cm). The serum creatinine value was (100.1±24.9) μmol/L (range: 76 to 155 μmol/L). Three months after the operation, the ureteroscopy showed that the ureter was smooth and the mucosa was normal.Conclusions:Robot-assisted laparoscopic ureteroplasty with a lingual mucosal graft is a safe and feasible operation for complex ureteral stricture without serious complications, which provides a surgical option for repairing ureteral stricture.

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