Robot-assisted radical cystectomy(RARC)combined with orthotopic neobladder(ONB)reconstruction represents a key function-preserving surgical approach for the treatment of muscle-invasive bladder cancer(MIBC). This review systematically summarizes current techniques and standardized operative procedures for ONB reconstruction, including the modified Studer, Bordeaux, and conventional Y-shaped methods, with a focus on the innovative totally intracorporeal modified Y-shaped orthotopic neobladder technique developed by our department. Based on perioperative data of 5 bladder cancer patients treated during Jan. and Dec. 2024, the comprehensive impacts of this technique on functional outcomes, oncological efficacy and patients' quality of life were evaluated. The review aims to provide evidence-based support for the standardized adoption of this technique and a three-dimensional anatomical teaching paradigm.

Objective:To investigate the clinical value of high-frequency ultrasound combined with virtual touch tissue imaging and quantification in the assessment of limb muscle tension after stroke in patients.Methods:A total of 31 patients with stroke who received treatment in Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2020 to May 2022 and 41 healthy controls who concurrently underwent physical examination in the same hospital were included in this study. Before rehabilitation treatment, the shear wave velocity of the main muscle groups of the limbs was measured using virtual touch tissue imaging and quantification in all participants. The shear wave velocity of the main muscle groups was compared between the affected and healthy sides of patients between two sides of patients. The patient's muscle tension was evaluated using the modified Ashworth Scale. The shear wave velocity of the affected muscle groups in patients was correlated with the modified Ashworth Scale score.Results:There were no significant differences in the shear wave velocities of the main muscle groups of upper (biceps, flexor digitorum sublimis, flexor digitorum profundus) and lower [medial head of the gastrocnemius muscle, lateral head of the gastrocnemius muscle] limbs between the left [(2.46 ± 0.26) m/s, (2.81 ± 0.50) m/s, (2.96 ± 0.31) m/s, (2.49 ± 0.44) m/s, (2.21 ± 0.20) m/s] and right [(2.42 ± 0.29) m/s, (2.80 ± 0.47) m/s, (3.02 ± 0.36) m/s, (2.54 ± 0.37) m/s, (2.18 ± 0.17) m/s] sides in healthy controls ( t = 0.78, 0.04, 0.83, 0.58, 1.15, P = 0.435, 0.967, 0.405, 0.558, 0.216). The shear wave velocities of the main muscle groups of upper [flexor digitorum sublimis (3.74 ± 0.67) m/s, flexor digitorum profundus (3.64 ± 0.60) m/s), biceps (3.63 ± 0.64) m/s] and lower [medial head of the gastrocnemius muscle (3.28 ± 0.61) m/s, lateral head of the gastrocnemius muscle (2.90 ± 0.37) m/s] limbs on the affected side in patients with stroke were significantly higher than (2.56 ± 0.40) m/s, (2.67 ± 0.38) m/s, (2.78 ± 0.41) m/s, (2.30 ± 0.21) m/s, (2.25 ± 0.23) m/s on the healthy side ( t = 11.81, 8.21, 8.75, 8.91, 10.43, all P < 0.001). The shear wave velocities of the main muscle groups of the upper (flexor digitorum sublimis, flexor digitorum profundus, and biceps) and lower (medial head of the gastrocnemius muscle and lateral head of the gastrocnemius muscle) limbs were positively correlated with the modified Ashworth Scale score ( r = 0.77, 0.70, 0.72, 0.74, 0.78, P = 0.007, 0.029, 0.021, 0.016, 0.001). Conclusion:Monitoring the shear wave velocities of the main muscle groups of the upper and lower limbs using high-frequency ultrasound combined with virtual touch tissue imaging and quantification can effectively reflect the change in limb muscle tension of patients with stroke, which is highly valuable for evaluating rehabilitation efficacy and prognosis in patients with stroke.

OBJECTIVE: To explore the genetic basis for a pedigree affected with hereditary spastic paraplegia type 4 (HSP4). METHODS: Peripheral venous blood samples were taken from members of the four-generation pedigree and 50 healthy controls for the extraction of genomic DNA. Genes associated with peripheral neuropathy and hereditary spastic paraplegia were captured and subjected to targeted capture and next-generation sequencing. The results were confirmed by Sanger sequencing. RESULTS: DNA sequencing suggested that the proband has carried a heterozygous c.1196C>G variant in exon 9 of the SPAST gene, which can cause substitution of serine by threonine at position 399 (p.Ser399Trp) and lead to change in the protein function. The same variant was also detected in other patients from the pedigree but not among unaffected individuals or the 50 healthy controls. Based on the ACMG 2015 guidelines, the variant was predicted to be possibly pathogenic. CONCLUSION The c.1196C>G variant of the SPAST gene probably underlay the HSP4 in this pedigree.
Base Sequence ; Humans ; Mutation ; Paraplegia/genetics* ; Pedigree ; Sequence Analysis, DNA ; Spastic Paraplegia, Hereditary/genetics* ; Spastin/genetics*

Objective: To investigate the joint effect of abdominal obesity in childhood and adulthood on adult hypertension. Methods: Based on the data from the China Health and Nutrition Survey (CHNS, 1993-2011), a total of 1 431 subjects who were investigated in both childhood (6 to17 years old) and young adulthood (18 to 35 years old) were selected for the analysis. According to waist circumference (WC) status (normal WC or abdominal obesity) in childhood and adulthood, all subjects were categorized into 4 groups. The multinomial logistic regression model was used to analyze the joint effect of abdominal obesity in childhood and adulthood on adult hypertension and pre-hypertension. Results: Compared to the subjects (n=1 057) who had normal WC in both childhood and adulthood, subjects with abdominal obesity in childhood but with normal WC (n=45) in adulthood didn′t have significantly increased risk of hypertension (OR=1.52, 95%CI: 0.19-12.06). In contrast, those who had normal WC in childhood and abdominal obesity in adulthood (n=289) had increased risk of hypertension (OR=6.48, 95%CI: 3.60-11.66). In addition, subjects with persistent abdominal obesity from childhood to adulthood (n=40) had the highest risk of hypertension (OR=15.98, 95%CI: 5.39-47.35). There was a similar trend for the association of abdominal obesity in childhood and adulthood with adult pre-hypertension, with the corresponding OR (95%CI) of 1.28 (0.66-2.49), 2.90 (2.17-3.89) and 3.49 (1.65-7.40), respectively. Conclusion The joint effect of abdominal obesity in childhood and adulthood increased the risk of adult hypertension and pre-hypertension. There was no statistical significance for subjects who had abdominal obesity in childhood but had normal WC in adulthood when compared to those with normal WC in both childhood and adulthood.

Objective To investigate the joint effect of abdominal obesity in childhood and adulthood on adult hypertension. Methods Based on the data from the China Health and Nutrition Survey (CHNS, 1993-2011), a total of 1 431 subjects who were investigated in both childhood (6 to17 years old) and young adulthood (18 to 35 years old) were selected for the analysis. According to waist circumference (WC) status (normal WC or abdominal obesity) in childhood and adulthood, all subjects were categorized into 4 groups. The multinomial logistic regression model was used to analyze the joint effect of abdominal obesity in childhood and adulthood on adult hypertension and pre?hypertension. Results Compared to the subjects (n=1 057) who had normal WC in both childhood and adulthood, subjects with abdominal obesity in childhood but with normal WC (n=45) in adulthood didn′t have significantly increased risk of hypertension (OR=1.52, 95%CI: 0.19-12.06). In contrast, those who had normal WC in childhood and abdominal obesity in adulthood (n=289) had increased risk of hypertension (OR=6.48, 95%CI: 3.60-11.66). In addition, subjects with persistent abdominal obesity from childhood to adulthood (n=40) had the highest risk of hypertension ( OR=15.98, 95%CI : 5.39-47.35). There was a similar trend for the association of abdominal obesity in childhood and adulthood with adult pre?hypertension, with the corresponding OR (95%CI) of 1.28 (0.66-2.49), 2.90 (2.17-3.89) and 3.49 (1.65-7.40), respectively. Conclusion The joint effect of abdominal obesity in childhood and adulthood increased the risk of adult hypertension and pre?hypertension. There was no statistical significance for subjects who had abdominal obesity in childhood but had normal WC in adulthood when compared to those with normal WC in both childhood and adulthood.

Objective To investigate the joint effect of abdominal obesity in childhood and adulthood on adult hypertension. Methods Based on the data from the China Health and Nutrition Survey (CHNS, 1993-2011), a total of 1 431 subjects who were investigated in both childhood (6 to17 years old) and young adulthood (18 to 35 years old) were selected for the analysis. According to waist circumference (WC) status (normal WC or abdominal obesity) in childhood and adulthood, all subjects were categorized into 4 groups. The multinomial logistic regression model was used to analyze the joint effect of abdominal obesity in childhood and adulthood on adult hypertension and pre?hypertension. Results Compared to the subjects (n=1 057) who had normal WC in both childhood and adulthood, subjects with abdominal obesity in childhood but with normal WC (n=45) in adulthood didn′t have significantly increased risk of hypertension (OR=1.52, 95%CI: 0.19-12.06). In contrast, those who had normal WC in childhood and abdominal obesity in adulthood (n=289) had increased risk of hypertension (OR=6.48, 95%CI: 3.60-11.66). In addition, subjects with persistent abdominal obesity from childhood to adulthood (n=40) had the highest risk of hypertension ( OR=15.98, 95%CI : 5.39-47.35). There was a similar trend for the association of abdominal obesity in childhood and adulthood with adult pre?hypertension, with the corresponding OR (95%CI) of 1.28 (0.66-2.49), 2.90 (2.17-3.89) and 3.49 (1.65-7.40), respectively. Conclusion The joint effect of abdominal obesity in childhood and adulthood increased the risk of adult hypertension and pre?hypertension. There was no statistical significance for subjects who had abdominal obesity in childhood but had normal WC in adulthood when compared to those with normal WC in both childhood and adulthood.