Objective:To evaluate the long-term effectiveness of lingual mucosal graft ureteroplasty (LMGU) for managing long-segment (≥5 cm) ureteral strictures in a multi-institutional cohort of patients.Methods:A multi-center retrospective case series study was conducted on clinical data from 42 patients undergoing LMGU for long-segment ureteral strictures (≥5 cm) across five institutions between February 2017 and June 2024. The cohort comprised 31 males and 11 females, with an age of (43.4±12.0) years (range: 15 to 64 years) and a body mass index of (24.6±2.6) kg/m2 (range: 16.0 to 30.0 kg/m2). Strictures involved the left ureter in 24 cases and right ureter in 18 cases, demonstrating a stricture length of (6.4±1.5) cm (range: 5.0 to 11.5 cm). Surgical interventions included either onlay ureteroplasty or augmented anastomotic ureteroplasty, selected according to intraoperative findings. Intraoperative parameters, postoperative complications, and follow-up outcomes were analyzed.Results:Laparoscopic surgery was performed in 22 cases and robot-assisted surgery in 20 cases. Among the 42 patients, 22 underwent onlay ureteroplasty while 20 received augmented anastomotic ureteroplasty. The graft length was (5.9±1.8) cm (range: 3.0 to 12.0 cm), operative time (191.5±55.6) minutes (range: 105.0 to 350.0 minutes), and intraoperative estimated blood loss (86.7±73.6) ml (range: 10.0 to 400.0 ml). All procedures were successfully completed without conversion to open surgery. The postoperative hospital stay was (7.6±2.0) days (range: 4.0 to 15.0 days), with double-J stent removal at 6 to 8 weeks postoperatively. During a follow-up of (49.1±25.0) months (range: 12.0 to 99.0 months), no stricture recurrence was observed in any patient.Conclusion:LMGU is a safe, feasible, and effective long-term technique for managing long-segment (≥5 cm) ureteral strictures.

Obsessive-compulsive disorder (OCD) is characterized by recurrent episodes of intrusive thinking and/or behavior, persistent and variable symptoms, and chronic recurrence. It is clearly recommended in the OCD treatment guidelines that psychotherapy can effectively improve clinical symptoms and play an important role in maintaining long-term efficacy. However, previous research and clinical practice paid little attention to the application of psychological interventions in OCD.Currently, there is insufficient understanding of psychotherapy for OCD, especially the proven first-line exposure and response prevention therapy (ERP), cognitive-behavioral therapy, and Morita therapy.Due to limited resources, they have not received effective intervention. Therefore, this article reviews the relevant research on psychological therapy intervention for OCD in recent years, summarizes the intervention effects of different psychological therapy methods on OCD and further elaborates on possible therapeutic mechanisms.Based on this, combined with the existing research, this article clarifies the effect of various behavioral psychological interventions and their combined treatment, and explores group and online forms of psychological intervention in order to increase the accessibility of psychotherapy for OCD patients.

Obsessive-compulsive disorder (OCD) is characterized by recurrent episodes of intrusive thinking and/or behavior, persistent and variable symptoms, and chronic recurrence. It is clearly recommended in the OCD treatment guidelines that psychotherapy can effectively improve clinical symptoms and play an important role in maintaining long-term efficacy. However, previous research and clinical practice paid little attention to the application of psychological interventions in OCD.Currently, there is insufficient understanding of psychotherapy for OCD, especially the proven first-line exposure and response prevention therapy (ERP), cognitive-behavioral therapy, and Morita therapy.Due to limited resources, they have not received effective intervention. Therefore, this article reviews the relevant research on psychological therapy intervention for OCD in recent years, summarizes the intervention effects of different psychological therapy methods on OCD and further elaborates on possible therapeutic mechanisms.Based on this, combined with the existing research, this article clarifies the effect of various behavioral psychological interventions and their combined treatment, and explores group and online forms of psychological intervention in order to increase the accessibility of psychotherapy for OCD patients.

Objective:To evaluate the long-term effectiveness of lingual mucosal graft ureteroplasty (LMGU) for managing long-segment (≥5 cm) ureteral strictures in a multi-institutional cohort of patients.Methods:A multi-center retrospective case series study was conducted on clinical data from 42 patients undergoing LMGU for long-segment ureteral strictures (≥5 cm) across five institutions between February 2017 and June 2024. The cohort comprised 31 males and 11 females, with an age of (43.4±12.0) years (range: 15 to 64 years) and a body mass index of (24.6±2.6) kg/m2 (range: 16.0 to 30.0 kg/m2). Strictures involved the left ureter in 24 cases and right ureter in 18 cases, demonstrating a stricture length of (6.4±1.5) cm (range: 5.0 to 11.5 cm). Surgical interventions included either onlay ureteroplasty or augmented anastomotic ureteroplasty, selected according to intraoperative findings. Intraoperative parameters, postoperative complications, and follow-up outcomes were analyzed.Results:Laparoscopic surgery was performed in 22 cases and robot-assisted surgery in 20 cases. Among the 42 patients, 22 underwent onlay ureteroplasty while 20 received augmented anastomotic ureteroplasty. The graft length was (5.9±1.8) cm (range: 3.0 to 12.0 cm), operative time (191.5±55.6) minutes (range: 105.0 to 350.0 minutes), and intraoperative estimated blood loss (86.7±73.6) ml (range: 10.0 to 400.0 ml). All procedures were successfully completed without conversion to open surgery. The postoperative hospital stay was (7.6±2.0) days (range: 4.0 to 15.0 days), with double-J stent removal at 6 to 8 weeks postoperatively. During a follow-up of (49.1±25.0) months (range: 12.0 to 99.0 months), no stricture recurrence was observed in any patient.Conclusion:LMGU is a safe, feasible, and effective long-term technique for managing long-segment (≥5 cm) ureteral strictures.

Developmental dysplasia of the hip (DDH) is a developmental disease with abnormal position and morphology of the acetabulum and femoral head. DDH ranges from mild dysplasia to complete dislocation, including simple acetabular dysplasia, subluxation, and total dislocation. DDH is one of the most common hip diseases in children, and its onset begins in infancy. The anatomical structure of the hip joint is complex, and there are some practical problems in the large -scale clinical diagnosis and screening work, such as heavy workload, high misdiagnosis rate and missed diagnosis rate, and a long learning period of surgery. Artificial intelligence (AI) is an emerging technology science used to research and develop theories, methods, technologies and application systems that can simulate human intelligence. The main goal is to enable machines to complete complex tasks that require human intelligence. At present, artificial intelligence is mainly used in the diagnosis and treatment of DDH. Artificial intelligence combined with X-ray or ultrasound is used to diagnose and screen DDH, which avoids subjectivity to a certain extent and improves the accuracy of diagnosis and screening. In the preoperative planning of periacetabular osteotomy and total hip arthroplasty, it can more accurately track the position of the bone block and design the size of the prosthesis, which makes the surgical planning more accurate to a certain extent. Artificial intelligence technologies such as 3D navigation system, surgical robot and robotic arm are helpful to improve the accuracy and safety of surgery. Artificial intelligence has the characteristics of simplicity, speed, high repeatability and deep learning ability, which to a certain extent saves manpower, material resources and time costs for DDH diagnosis and treatment, facilitates medical workers to share DDH diagnosis and treatment experience and reduces the burden of patients, families, society and the country. The application of artificial intelligence in DDH diagnosis and treatment is becoming more and more extensive, but at present, artificial intelligence in DDH screening is still in its preliminary stage. There are few reports on artificial intelligence technology in DDH hip preservation treatment and other surgical methods, and there is insufficient research on artificial intelligence in DDH conservative treatment, postoperative complications and prognosis prediction. It is worth exploring new ideas by researchers. At present, the application of artificial intelligence in DDH still has certain limitations, including problems such as difficult to control the quality of image data, difficult to develop and promote technology, and lack of laws and regulations. Based on the literature database and relevant data sharing network, this paper reviews the application of artificial intelligence in the diagnosis and treatment of DDH at home and abroad in recent years, summarizes the current application status of artificial intelligence in the diagnosis and treatment of DDH, and provides new ideas for the future application of artificial intelligence in the diagnosis and treatment of DDH.

Stress might exaggerate the compulsion and impair the working memory of patients with obsessive-compulsive disorder (OCD). This study evaluated the effect of stress on the cognitive neural processing of working memory in OCD and its clinical significance using a “number calculation working memory” task. Thirty-eight patients and 55 gender- and education-matched healthy controls were examined. Stress impaired the performance of the manipulation task in patients. Healthy controls showed less engagement of the medial prefrontal cortex and striatum during the task under stress versus less stress, which was absent in the patients with OCD. The diagnosis × stress interaction effect was significant in the right fusiform, supplementary motor area, precentral cortex and caudate. The failure of suppression of the medial prefrontal cortex and striatum and stress-related hyperactivation in the right fusiform, supplementary motor area, precentral cortex, and caudate might be an OCD-related psychopathological and neural response to stress.

Objective:To compare the cognitive functions in patients with depressive disorder,hyperlipidemia disorder,and comorbid both of the disorders.Methods:A cross-sectional study was performed in age,gender and education year matched patients with depressive disorder (n =51)(according to the ICD-10),hypedipidemia(n =38) (according to the Chinese adult lipid guideline),comorbid both of the disorders(n =40) and normal controls (n =56) were recruited in this study.All subjects received a battery of neuropsychological tests to access the anxiety and depression symptoms and cognitive function.Results:The scores of MoCA were lower in the patients with comorbid both disorders and patients with depression than patients with hypedipidemia [(24 ± 3),(24 ± 4)vs.(26 ± 3),Ps ＜0.05],and were lower in patients with depression than in normal controls(25 ±3),P ＜0.05.Stroop color test amends numbers were higher in patients with comorbid disorder than in the other three groups (Ps ＜0.05).The scores of immediate and delayed logical memory were higher in patients with hyperlipidemia than in other three groups (Ps ＜0.05).The total number of words in verbal fluency test were lower in patients with comorbid disorders and patients with depression than in patients with hyperlipidemia (Ps ＜0.05).Wisconsin card sorting test category completes were lower in patients with comorbid disorders and patients with depression than in patients with hyperlipidemia and normal controls (Ps ＜ 0.05).The scores of persistent errors were higher in patients with comorbid disorders and patients with depression than in patients with hyperlipidemia and normal controls (Ps ＜0.05).Conclusion:In this study,patients with depressive disorder have impairment of cognitive function,while hyperlipidemia may probably do not impair cognitive function.

Objeetive To explore the clinical application value of new modified paracalculous ureteral catheter in ureteroscopic holmium laser lithotripsy for the treatment of large middle and lower ureteral stone.Methods From January 2014 to January 2017,86 patients with unilateral middle and lower ureteral large stone were treated in Jingzhou Central Hospital.By adopted to random digital table,86 patients were randomly separated into two groups,all of whom were treated with ureteroscopic holmium laser lithotripsy.Forty-three cases were underwent new modified laser lithotripsy with ureteral catheter inserted beneath the stone.Normal saline was injected continuously through the catheter during lithotripsy procedure (modified lithotripsy group).Forty-three cases were underwent direct ureteroscopic holmium laser lithotripsy (direct lithotripsy group).The outcome data were compared between the two groups,such as the operation time,stone clearance rate,ureteral perforation,transit to open surgery,postoperative urinary sepsis,perirenal hematoma,ureterostenosis and other complications.Measurement data were expressed as ((x) ± s),and t test was used for comparison between groups.Results All the patients in the modified lithotripsy group were completed successfully without ureteral perforation,rupture,loss of lithotripsy channel,transit to open surgery,perirenal hematoma,and urinary sepsis and so on.In the direct lithotripsy group,there were 5 cases of ureteral perforation,4 cases of lithotripsy channel loss,6 cases of transit to open surgery,2 cases of perirenal hematoma,1 case of urinary sepsis.The operation time of the two groups was (39.5 ± 7.2) min and (47.2 ± 11.6) min,respectively,t =-4.975,P =0.001.Stone clearance rate was 100％,91.1％.The patients in both groups received an average of 1 year out-patient follow-up.There were 3 cases of mild ureterostenosis in the modified lithotripsy group,which were not re-operated.In the direct lithotripsy group,there were 5 cases of mild ureterostenosis,and 2 cases of severe ureterostenosis,which were re-operated.Conclusion It is safe and effective to use the new modified paracalculous uteteral catheter in the ureteroscopic holmium laser lithotripsy of large middle and lower ureteral stone,which can shorten the total operation time and reduce the occurrence of complications.It has a higher clinical value.

Cross-sectional and longitudinal studies have identified widespread and progressive grey matter volume (GMV) reductions in schizophrenia, especially in the frontal lobe. In this study, we found a progressive GMV decrease in the rostral medial frontal cortex (rMFC, including the anterior cingulate cortex) in the patient group during a 6-week follow-up of 40 patients with schizophrenia and 31 healthy controls well-matched for age, gender, and education. The higher baseline GMV in the rMFC predicted better improvement in the positive score on the Positive and Negative Syndrome Scale (PANSS), and this might be related to the improved reality-monitoring. Besides, a higher baseline GMV in the posterior rMFC predicted better remission of general symptoms, and a lesser GMV reduction in this region was correlated with better remission of negative symptoms, probably associated with ameliorated self-referential processing and social cognition. Besides, a shorter disease course and higher educational level contributed to better improvement in the general psychopathological PANSS score, and a family history was negatively associated with improvement of the negative and total PANSS scores. These phenomena might be important for understanding the neuropathological mechanisms underlying the symptoms of schizophrenia and for making clinical decisions.
Adult ; Antipsychotic Agents ; therapeutic use ; Female ; Frontal Lobe ; diagnostic imaging ; drug effects ; pathology ; Genetic Predisposition to Disease ; Gray Matter ; diagnostic imaging ; drug effects ; pathology ; Humans ; Image Processing, Computer-Assisted ; Longitudinal Studies ; Magnetic Resonance Imaging ; Male ; Organ Size ; Psychiatric Status Rating Scales ; Regression Analysis ; Schizophrenia ; diagnostic imaging ; drug therapy ; genetics ; pathology ; Time Factors ; Treatment Outcome

The ZNF804A variant rs1344706 has consistently been associated with schizophrenia and plays a role in hippocampal-prefrontal functional connectivity during working memory. Whether the effect exists in the resting state and in patients with schizophrenia remains unclear. In this study, we investigated the ZNF804A polymorphism at rs1344706 in 92 schizophrenic patients and 99 healthy controls of Han Chinese descent, and used resting-state functional magnetic resonance imaging to explore the functional connectivity in the participants. We found a significant main effect of genotype on the resting-state functional connectivity (RSFC) between the hippocampus and the dorsolateral prefrontal cortex (DLPFC) in both schizophrenic patients and healthy controls. The homozygous ZNF804A rs1344706 genotype (AA) conferred a high risk of schizophrenia, and also exhibited significantly decreased resting functional coupling between the left hippocampus and right DLPFC (F(2,165) = 13.43, P < 0.001). The RSFC strength was also correlated with cognitive performance and the severity of psychosis in schizophrenia. The current findings identified the neural impact of the ZNF804A rs1344706 on hippocampal-prefrontal RSFC associated with schizophrenia.
Adult ; Analysis of Variance ; Female ; Functional Laterality ; genetics ; Genotype ; Hippocampus ; diagnostic imaging ; Humans ; Image Processing, Computer-Assisted ; Kruppel-Like Transcription Factors ; genetics ; Magnetic Resonance Imaging ; Male ; Neural Pathways ; diagnostic imaging ; Neuropsychological Tests ; Oxygen ; blood ; Polymorphism, Single Nucleotide ; genetics ; Prefrontal Cortex ; diagnostic imaging ; Psychiatric Status Rating Scales ; Schizophrenia ; diagnostic imaging ; genetics ; physiopathology ; Severity of Illness Index ; Young Adult