Objective:To investigate the efficacy and safety of intravesical injections of botulinum toxin A (BTX-A) for the treatment of pediatric refractory urinary frequency and incontinence (UFI), and to analyze the factors predicting the therapeutic effect of BTX-A injections.Methods:A retrospective case series study was made on 35 children with UFI [(12.3±4.2) years old], including 13 males (37.1%) and 22 females (62.9%), treated in the First Affiliated Hospital of Zhengzhou University from January 2021 to March 2024.Urotherapy and drug treatments were ineffective in all children, who then received intravesical injections of BTX-A.The urodynamic study (UDS) was performed 1 week before treatment and 3 months after treatment, and the Overactive Bladder Symptom Score (OABSS) and Incontinence Quality of Life (I-QOL) were collected.Perioperative and postoperative adverse events were also recorded.A global response assessment (GRA) score of ≥2 at 3 months postoperatively was defined as effective treatment.According to the postoperative GRA score, the patients were divided into effective and ineffective groups to explore the predictive factors affecting the outcome of BTX-A treatment, such as age, gender, preoperative urodynamic parameters, and the types of urinary incontinence. t-test was used to compare quantitative data such as age, UDS parameters, OABSS, and I-QOL scores.The comparison of count data such as gender and urinary incontinence types was conducted using Fisher′s exact test. Results:The bladder compliance, bladder capacity ratio, OABSS and I-QOL scores of patients significantly improved after BTX-A injection (all P<0.05).The 77.1% (27/35) of the patients were satisfied with BTX-A treatment effects.The main adverse event during the follow-up was a temporary increase in postvoid residual urine after injecting BTX-A (7 cases), which was alleviated by the Creade action or clean intermittent catheterization.There was significant difference in age [(13.00±4.32) years vs.(10.00±2.67) years] and preoperative bladder compliance [(11.21±5.74) mL/cmH 2O vs.(5.13±2.42) mL/cmH 2O] between effective (27 cases) and ineffective groups (8 cases) ( t=2.383, 2.899, all P<0.05).The differences in preoperative bladder capacity ratio, maximum filling detrusor pressure, postvoid residual urine, voiding efficiency, gender, and the types of urinary incontinence were not statistically significant between the two groups (all P>0.05). Conclusions:Intravesical injection of BTX-A is a safe and effective treatment for children with refractory UFI.A young age and poor bladder compliance at treatment are associated with poor prognosis of BTX-A treatment.

[Objective]To investigate the restorative effects of She ethnic minority medicine Primpinellae diversifoliae DC.extracts(PEs),on skin photodamage through animal models of skin photodamage and in vitro experiments with human immortalized keratinocytes(HaCaT)cells,providing a scientific basis for clinical applications.[Methods]Ultraviolet(UV)radiation-induced skin photodamage model in female ICR mice was established,and the effects of topical application of PEs on histopathological changes in mouse skin tissue were observed using hematoxylin-eosin(HE)staining.In the photodamage model of HaCaT cells induced by H2O2,cell viability was assessed through 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide(MTT)assay,the levels of reactive oxygen species(ROS)were measured with ROS assay kit.And the expression levels of inflammatory targets interleukin-6(IL-6),interleukin-1β(IL-1β)and tumor necrosis factor-α(TNF-α)in skin tissue of photodamaged mice model and HaCaT cells were detected with quantitative real-time polymerase chain reaction(qPCR).[Results]PEs significantly alleviated the thickening of the epidermis and dermis induced by UV in mice(P<0.001),and significantly inhibited the mRNA expression levels of TNF-α,IL-1β and IL-6 in the skin(P<0.05,P<0.01,P<0.001).In vitro,PEs significantly reduced the ROS levels in HaCaT cells induced by H2O2(P<0.001),and significantly inhibited the mRNA expression of IL-1β,TNF-α and IL-6(P<0.01,P<0.01,P<0.001).[Conclusion]PEs significantly alleviate UV-induced skin damage and H2O2-induced cellular damage by inhibiting oxidative stress and inflammatory responses,demonstrating great potential for repairing photodamage and warranting further development and application..

Objective To explore the efficacy and safety of doxycycline in the treatment of Mycoplasmal pneumoniae pneumonia(MPP)in children under 8 years old.Methods A retrospective selection was made of 258 children with MPP under 8 years old who were admitted to Women and Children's Hospital of Ningbo University from July 2023 to June 2024 as the research subjects.The children were divided into the azithromycin group(n=156)and the doxycycline group(n=102)according to the different drugs used.The clinical indicators,inflammation-related indicators,liver function indicators before and after treatment and adverse reactions of two groups of children were compared.Results After treatment,the defervescence time,cough relief time,pneumonia image absorption time and hospital stay in doxycycline group were shorter than those in azithromycin group(P＜0.05),the number of patients who needed to use steroids and bronchoscope intervention,and the number of patients with total hospitalization costs more than 10 000 yuan were less than those in azithromycin group(P＜0.05).The C-reactive protein(CRP),D-dimer(DD),serum ferritin(SF)and lactate dehydrogenase(LDH)in both groups of children were significantly lower than those before treatment in this group(P＜0.05),and the reduction amplitzes of CRP,DD,SF and LDH in doxycycline group were significantly greater than those in azithromycin group(P＜0.05).There were no significant changes in alanine aminotransferase,aspartate aminotransferase and prealbumin between two groups of children before and after treatment(P＞0.05).The adverse reactions of two groups of children were mainly gastrointestinal reactions,and there was no statistically significant difference in the incidence rate(x2=0.254,P=0.204).Conclusion Doxycycline in treatment of MPP in children under 8 years old can effectively relieve clinical symptoms,reduce inflammatory responses,decrease hormone and bronchoscopy interventions,shorten hospital stays and reduce hospitalization costs,and has good safety.

[Objective]To investigate the restorative effects of She ethnic minority medicine Primpinellae diversifoliae DC.extracts(PEs),on skin photodamage through animal models of skin photodamage and in vitro experiments with human immortalized keratinocytes(HaCaT)cells,providing a scientific basis for clinical applications.[Methods]Ultraviolet(UV)radiation-induced skin photodamage model in female ICR mice was established,and the effects of topical application of PEs on histopathological changes in mouse skin tissue were observed using hematoxylin-eosin(HE)staining.In the photodamage model of HaCaT cells induced by H2O2,cell viability was assessed through 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide(MTT)assay,the levels of reactive oxygen species(ROS)were measured with ROS assay kit.And the expression levels of inflammatory targets interleukin-6(IL-6),interleukin-1β(IL-1β)and tumor necrosis factor-α(TNF-α)in skin tissue of photodamaged mice model and HaCaT cells were detected with quantitative real-time polymerase chain reaction(qPCR).[Results]PEs significantly alleviated the thickening of the epidermis and dermis induced by UV in mice(P<0.001),and significantly inhibited the mRNA expression levels of TNF-α,IL-1β and IL-6 in the skin(P<0.05,P<0.01,P<0.001).In vitro,PEs significantly reduced the ROS levels in HaCaT cells induced by H2O2(P<0.001),and significantly inhibited the mRNA expression of IL-1β,TNF-α and IL-6(P<0.01,P<0.01,P<0.001).[Conclusion]PEs significantly alleviate UV-induced skin damage and H2O2-induced cellular damage by inhibiting oxidative stress and inflammatory responses,demonstrating great potential for repairing photodamage and warranting further development and application..

Objective:To investigate the efficacy and safety of intravesical injections of botulinum toxin A (BTX-A) for the treatment of pediatric refractory urinary frequency and incontinence (UFI), and to analyze the factors predicting the therapeutic effect of BTX-A injections.Methods:A retrospective case series study was made on 35 children with UFI [(12.3±4.2) years old], including 13 males (37.1%) and 22 females (62.9%), treated in the First Affiliated Hospital of Zhengzhou University from January 2021 to March 2024.Urotherapy and drug treatments were ineffective in all children, who then received intravesical injections of BTX-A.The urodynamic study (UDS) was performed 1 week before treatment and 3 months after treatment, and the Overactive Bladder Symptom Score (OABSS) and Incontinence Quality of Life (I-QOL) were collected.Perioperative and postoperative adverse events were also recorded.A global response assessment (GRA) score of ≥2 at 3 months postoperatively was defined as effective treatment.According to the postoperative GRA score, the patients were divided into effective and ineffective groups to explore the predictive factors affecting the outcome of BTX-A treatment, such as age, gender, preoperative urodynamic parameters, and the types of urinary incontinence. t-test was used to compare quantitative data such as age, UDS parameters, OABSS, and I-QOL scores.The comparison of count data such as gender and urinary incontinence types was conducted using Fisher′s exact test. Results:The bladder compliance, bladder capacity ratio, OABSS and I-QOL scores of patients significantly improved after BTX-A injection (all P<0.05).The 77.1% (27/35) of the patients were satisfied with BTX-A treatment effects.The main adverse event during the follow-up was a temporary increase in postvoid residual urine after injecting BTX-A (7 cases), which was alleviated by the Creade action or clean intermittent catheterization.There was significant difference in age [(13.00±4.32) years vs.(10.00±2.67) years] and preoperative bladder compliance [(11.21±5.74) mL/cmH 2O vs.(5.13±2.42) mL/cmH 2O] between effective (27 cases) and ineffective groups (8 cases) ( t=2.383, 2.899, all P<0.05).The differences in preoperative bladder capacity ratio, maximum filling detrusor pressure, postvoid residual urine, voiding efficiency, gender, and the types of urinary incontinence were not statistically significant between the two groups (all P>0.05). Conclusions:Intravesical injection of BTX-A is a safe and effective treatment for children with refractory UFI.A young age and poor bladder compliance at treatment are associated with poor prognosis of BTX-A treatment.

Objective To explore the efficacy and safety of doxycycline in the treatment of Mycoplasmal pneumoniae pneumonia(MPP)in children under 8 years old.Methods A retrospective selection was made of 258 children with MPP under 8 years old who were admitted to Women and Children's Hospital of Ningbo University from July 2023 to June 2024 as the research subjects.The children were divided into the azithromycin group(n=156)and the doxycycline group(n=102)according to the different drugs used.The clinical indicators,inflammation-related indicators,liver function indicators before and after treatment and adverse reactions of two groups of children were compared.Results After treatment,the defervescence time,cough relief time,pneumonia image absorption time and hospital stay in doxycycline group were shorter than those in azithromycin group(P＜0.05),the number of patients who needed to use steroids and bronchoscope intervention,and the number of patients with total hospitalization costs more than 10 000 yuan were less than those in azithromycin group(P＜0.05).The C-reactive protein(CRP),D-dimer(DD),serum ferritin(SF)and lactate dehydrogenase(LDH)in both groups of children were significantly lower than those before treatment in this group(P＜0.05),and the reduction amplitzes of CRP,DD,SF and LDH in doxycycline group were significantly greater than those in azithromycin group(P＜0.05).There were no significant changes in alanine aminotransferase,aspartate aminotransferase and prealbumin between two groups of children before and after treatment(P＞0.05).The adverse reactions of two groups of children were mainly gastrointestinal reactions,and there was no statistically significant difference in the incidence rate(x2=0.254,P=0.204).Conclusion Doxycycline in treatment of MPP in children under 8 years old can effectively relieve clinical symptoms,reduce inflammatory responses,decrease hormone and bronchoscopy interventions,shorten hospital stays and reduce hospitalization costs,and has good safety.

The clinical data, laboratory testing, genetic testing results, diagnosis and treatment process of a child with PERCHING syndrome diagnosed and treated in the Department of Neonatology, the Third Affiliated Hospital of Zhengzhou University in June 2022 were retrospectively analyzed, and the relevant literatures were reviewed.The proband mainly presented with dyspnea and feeding difficulties after delivery, facial nevus flammeus, protrusion of eyes, small fissure of eyes, wide nasal root, limited opening of mouth, slightly high palatal arch, special posture, cryptorchid, hypospadias, and high muscle tone of limbs.Magnetic resonance imaging of the brain suggested possible agenesis of corpus callosum.Genetic testing showed complex heterozygous variations in the KLHL7 gene, and the two mutation sites have not been previously reported.A case of PERCHING syndrome caused by the KLHL7 gene mutation in China was reported for the first time, which provided new ideas for the diagnosis and treatment of children with PERCHING syndrome and reliable genetic evidence for family reproduction.

Objective To evaluate the feasibility and effectiveness of the application of IQQA (Intelligent/interactive Qualitative and Quantitative Analysis) three-dimensional reconstruction technique in precise laparoscopic or robot-assisted laparoscopic partial nephrectomy (LPN or RAPN) for renal hilar tumors.Methods The study retrospectively reviewed 11patients with hilar tunors from February 2016 to February 2017.Of the 11 patients,4 were women and 7 were men,with an average age of 51 years (range 38 to 70 years).The average tumor size was 3.1 cm (range 1.7 to 4.3 cm).For tumor stage,9 patients were in T1a stage and 2 patients were in T1b stage.Tbe average R.E.N.A.L score was 8.7 (range 7 to 10).The mean preoperative GFR was 40.6 ml/min (range 32 to 45 ml/min).IQQA three-dimensional reconstruction technique was applied for the purpose of precise navigation and resection of the tumors.Multivariate analysis was used to identify predictors of warm ischemia time,estimated blood loss,major perioperative complications,and postoperative renal function.Results All 11 laparoscopic or robot-assisted laparoscopic hilar partial nephrectomies were successfully completed without conversion to a hand-assisted or an open approach.Under the navigation of IQQA,all tumors were found precisely at the first time during surgeries.The final pathologic examination revealed that all the 11 patients were clear cell renal cell carcinomas.The mean operative time was 142 minutes (range 90 to 230 minutes),with a mean warm ischemia time of 24 minutes (range 17 to 33 minutes).The estinated blood loss was 146 ml (range 50 to 400 ml).No intraoperative complications occurred.Two patients suffered from postoperative complications.One patient with gross hematuria was recovered by consistent bladder irrigation.The other patient with postoperative hemorrhage needed transfusion.All patients had negative margins on the final pathologic examination.At a mean follow-up period of 3 months,the mean GRR is 22.5 ml/min (range 13 to 34 ml/min) without any disease recurrence.Conclusions With peculiar features,such as accurate location,complete resection and fewer perioperative complications,the application of IQQA three-dimensional reconstruction technique in precise partial nephrectomy represents a safe and effective procedure for hilar tumors.