Objective:To analyze the prenatal ultrasonographic features and prognosis of fetal perirenal urinoma.Methods:This retrospective study included eight fetuses with perirenal urinoma diagnosed by prenatal ultrasound in the Women and Children's Hospital of Chongqing Medical University from January 2017 to August 2023. Descriptive analysis was performed on their prenatal ultrasonographic features, intrauterine intervention measures, postnatal treatment, and prognosis.Results:Among the eight cases, the prenatal ultrasonographic diagnosis was consistent with the postnatal clinical diagnosis in seven cases, with one misdiagnosis (postnatally confirmed as giant renal cyst with multicystic dysplastic kidney). Prenatal ultrasonographic features of fetal perirenal urinoma included cystic mass adjacent to the renal capsule; obvious compression of the surrounding organs and the affected kidney; increased craniocaudal diameter of the affected kidney with thin parenchyma, increased echogenicity, indistinct corticomedullary differentiation, and pyeletasis; poorly visualized partial renal arteries; normal or mildly enlarged contralateral kidney; adequate bladder filling; normal amniotic fluid volume. Two cases underwent intrauterine cyst aspiration with subsequent cyst size reduction (slight re-enlargement during follow-up). Among the remaining six untreated cases, one case showed stable cyst size, while five cases exhibited initial significant cyst enlargement followed by stabilization or regression trend. All eight cases were born at full term (three delivered vaginally and five by cesarean section). The affected kidney was significantly atrophied within one week after birth by ultrasound observation. Impaired function of the affected kidney was shown in four patients by follow-up after discharge (including two cases of intrauterine treatment),one case abandoned treatment due to other illnesses, two cases were lost to follow-up after discharge.Conclusions:Prenatal ultrasound images of perirenal urinary cysts infetuses exhibit typical features. Intrauterine treatment can reduce the compression of large cysts and hydronephrosis on fetal organs, but there is no significant improvement in the recovery of renal function.

BACKGROUND:Allogeneic hematopoietic stem cell transplantation is an important treatment for malignant hematological diseases,and delayed postoperative platelet implantation is a common complication that seriously affects the quality of patient survival;however,there are no standard protocols to improve platelet implantation rates and prevent platelet implantation delays. OBJECTIVE:To compare the safety and efficacy of oral Herombopag Olamine versus subcutaneous recombinant human thrombopoietin for promoting platelet implantation in patients with malignant hematological diseases undergoing haploid hematopoietic stem cell transplantation. METHODS:Clinical data of 163 patients with malignant hematological diseases who underwent haploidentical hematopoietic stem cell transplantation from January 2016 to October 2022 were retrospectively analyzed.A total of 72 patients who started to subcutaneously inject recombinant human thrombopoietin at+2 days were categorized into the recombinant human thrombopoietin group;a total of 27 patients who started to orally take Herombopag Olamine at+2 days were categorized into the Herombopag Olamine group;and 64 patients who did not apply Herombopag Olamine or recombinant human thrombopoietin were categorized into the blank control group.The implantation status,incidence of acute graft-versus-host disease of degree II-IV within 100 days,1-year survival rate,1-year recurrence rate,and safety were analyzed in the three groups. RESULTS AND CONCLUSION:(1)The average follow-up time was 52(12-87)months.The implantation time of neutrophils in the blank control group,recombinant human thrombopoietin group,and Herombopag Olamine group was(12.95±3.88)days,(14.04±3.71)days,and(13.89±2.74)days,respectively,with no statistically significant difference(P=0.352);the implantation time of platelets was(15.16±6.27)days,(17.67±6.52)days,and(17.00±4.75)days,with no statistically significant difference(P=0.287).(2)The complete platelet implantation rate on day 60 was 64.06%,90.28%,and 92.59%,respectively,and the difference was statistically significant(P<0.001).The subgroup analysis showed that the difference between the blank control group and the recombinant human thrombopoietin group was statistically significant(P<0.001),and the difference between the blank control group and the Herombopag Olamine group was statistically significant(P=0.004).The difference was not statistically significant between the recombinant human thrombopoietin group and Herombopag Olamine group(P=0.535).(3)100-day II-IV degree acute graft-versus-host disease incidence in the blank control group,recombinant human thrombopoietin group,and Herombopag Olamine group were 25.00%,30.56%,and 25.93%,respectively,and the difference was not statistically significant(P=0.752).(4)The incidence of cytomegalovirus anemia,cytomegalovirus pneumonia,and hepatic function injury had no statistical difference among the three groups(P>0.05).(5)During the follow-up period,there was no thrombotic event in any of the three groups of patients.(6)The results showed that recombinant human thrombopoietin and Herombopag Olamine could improve the platelet implantation rate of malignant hematological disease patients after haploidentical hematopoietic stem cell transplantation,with comparable efficacy and good safety.

Objective: To investigate the effect of neurite outgrowth inhibitor extracellular peptide residues 1-40 (NEP1-40) combined with poly (lactic-co-glycolic acid) (PLGA) and gelatin electrospun fiber membrane on facial nerve repair in rats. Methods: According to the principle of random grouping, 108 male SD rats were divided into four groups (n = 27 in each group, approved by the ethics committee), namely, the sham group, control group, PLGA group, and NEP1-40 + PLGA group. A facial nerve fracture model was established for all of the groups except for the sham group. The control group received no further treatment, the PLGA group and the NEP1-40+PLGA group were supported by PLGA membrane, and the NEP1-40+PLGA group received one immediate local injection of NEP1-40 (5 μg/μL) at a dose of 10 μL. Facial nerve function analysis, electrophysiological examination, transmission electron microscope observation, HE staining, and immunohistochemical staining of myelin marker S100β and axonal marker β3-tubulin were used to evaluate the recovery of injured facial nerves of rats at 2, 4 and 8 weeks. Results : At 8 weeks, the facial nerve function score of the NEP1-40+PLGA group was better than that of the control group and PLGA group (P < 0.001), and facial nerve function was significantly restored. Electrophysiological examination of nerve action potentials at the injured facial nerve showed that the amplitude in the NEP1-40+PLGA group was higher than that of the control group and PLGA group (P < 0.001), but there was no significant difference in latency and conduction velocity results between the groups (P > 0.05). At 2, 4, and 8 weeks, transmission electron microscopy showed that the number of myelinated nerve fibers and myelin sheath thickness in the cross-section of the injured facial nerve in the NEP1-40+PLGA group were greater than those in the other groups (P < 0.05). At 8 weeks, HE staining showed that the facial nerves in the control group had partially recovered, but the overall cell distribution was uneven and the boundary with surrounding tissues was slightly blurred. In contrast, the NEP1-40+PLGA group had a relatively uniform cell distribution and a clearer boundary with surrounding tissues. At 2, 4, and 8 weeks, the immunohistochemical results showed that in the cross-section of the injuried facial nerve, NEP1-40 increased the expression of neural markers S100 β and β3-tubulin, especially β3-tubulin, which was close to normal levels (P > 0.05) Conclusion NEP1-40 is beneficial for the generation of new myelin sheaths and axons at the site of injury, and it can promote the repair and regeneration of injured facial nerves to a certain extent, thus accelerating the recovery of injured nerve function.

Objective To observe the value of intratumoral and peritumoral radiomics based on dynamic contrast-enhanced MRI(DCE-MRI)combined with clinical indexes for predicting Ki-67 expression of prostate cancer(PCa).Methods Totally 294 PCa patients were retrospectively enrolled and randomly divided into training set(n=205)and test(n=89)set at a ratio of 7∶3,who were stratified into low-expression subgroup(Ki-67≤10%)and high-expression subgroup(Ki-67＞10%)based on pathological findings.ROIintratumoral and ROIperitumoral were delineated on DCE-MRI,and radiomics features were extracted from ROIintratumora,l ROIperitumoral and ROIintratumoral+peritumora,l respectively.Radiomic features significantly associated with Ki-67 expression status were selected to construct radiomics models.A multivariate logistic regression analysis was performed to develop a clinical predicting model,then a combined model was established combined with the optimal radiomics model.Receiver operating characteristic(ROC)curves were plotted,and the area under the curve(AUC)were calculate to evaluate the predictive efficacy of the models and compared between each two models.Decision curve analysis(DCA)was used to assess the clinical net benefit of each model.Results The AUC of modelintratumora,l modelperitumoral and modelintratumoral+peritumoral for predicting Ki-67 expression in training set was 0.905,0.867 and 0.930,and the last one was the best.In clinical model,total prostate-specific antigen(t-PSA)and T stage≥3 were both independent predictors of high Ki-67 expression of PCa(both P＜0.05).The AUC of combined model based on modelintratumoral+peritumoral and clinical model was 0.911 in test set,being not significantly different with that of modelintratumoral+peritumoral(AUC=0.906;Z=0.349,P=0.727)but higher than that of clinical model(AUC=0.684;Z=4.370,P＜0.05).DCA revealed that the combined model provided higher clinical net benefit than clinical model and modelintratumoral+peritumoral across risk thresholds of 0.10-0.70.Conclusion DCE-MRI intratumoral+peritumoral radiomics model could effectively predict Ki-67 expression status of PCa.Combining with clinical indexes could further enhance its clinical net benefit.

Purpose To investigate the prenatal ultrasound features and prognosis of fetal patent urachal.Materials and Methods The prenatal ultrasound characteristics of six cases with patent urachal diagnosed in Women and Children's Hospital of Chongqing Medical University from September 2018 to March 2023 were retrospectively analyzed,their pregnancy and postnatal conditions were followed up.Results In the first and second trimester of pregnancy,the prenatal ultrasonography of six fetuses showed that the epurachus was occluded.Among them,two cases were diagnosed as bladder diverticulum.The ultrasonography showed that the bladder was malformed,the top of the bladder was changed like a beak,and was connected to the umbilical cord entrance of the abdominal wall through an abnormal tube.Four cases were diagnosed as urachal fistula with allantoic cyst.Ultrasound showed that the cyst was at the root of the umbilical cord,and the cyst communicated with the bladder through an abnormal duct.The size of the cyst changed with the filling and emptying of the bladder.Color Doppler showed that the cysts were surrounded by the umbilical artery.None of the six fetuses were abnormal by chromosome examination.Among them,two fetuses with simple urachal fistula and allantoic cyst were born with good prognosis,and the remaining four fetuses were induced by other malformations.One of the six fetuses was female,and five fetuses were male.Conclusion Prenatal ultrasound of patent urachus has typical features and low correlation with chromosomal abnormalities.It is more common in males clinically and has a good prognosis without other structural abnormalities.

Objective:To explore the effectiveness of family-based interventions for adolescent suicide pre-vention using meta-analytic methods.Methods:A meta-analysis was conducted by searching CNKI,VIP,Wanfang,Web of Science,PubMed,APA PsycInfo and The Cochrane Library for randomized controlled trials of family-based interventions for adolescent suicide prevention.Results:A total of 15 RCTs involving 2541 cases were conclu-ded.The results of meta-analysis showed that family-based therapy was effective in preventing adolescent suicide(95％CI:-0.76--0.09,P＜0.05),with a medium effect size for the intervention(g=-0.42),in which there was a significant effect on reducing suicidal ideation(SMD=-0.77,95％CI:-1.31--0.23,P＜0.05),and the effect on reducing suicide attempts was not significant(OR=0.87,95％CI:0.68-1.11,P＞0.05).Family-based therapies were most effective in adolescent suicide prevention when the duration of the intervention was 12 weeks or more,when they were based on attachment-based family therapy(ABFT)or resource support and safety plans,and when they had a reasonably high dropout rate(Ps＜0.05).Conclusion:Family-based therapy has significant inter-vention effects on adolescent suicide prevention,and intervention effects on suicidal ideation are superior to those on suicide attempts.

Purpose To investigate the prenatal ultrasound features and prognosis of fetal patent urachal.Materials and Methods The prenatal ultrasound characteristics of six cases with patent urachal diagnosed in Women and Children's Hospital of Chongqing Medical University from September 2018 to March 2023 were retrospectively analyzed,their pregnancy and postnatal conditions were followed up.Results In the first and second trimester of pregnancy,the prenatal ultrasonography of six fetuses showed that the epurachus was occluded.Among them,two cases were diagnosed as bladder diverticulum.The ultrasonography showed that the bladder was malformed,the top of the bladder was changed like a beak,and was connected to the umbilical cord entrance of the abdominal wall through an abnormal tube.Four cases were diagnosed as urachal fistula with allantoic cyst.Ultrasound showed that the cyst was at the root of the umbilical cord,and the cyst communicated with the bladder through an abnormal duct.The size of the cyst changed with the filling and emptying of the bladder.Color Doppler showed that the cysts were surrounded by the umbilical artery.None of the six fetuses were abnormal by chromosome examination.Among them,two fetuses with simple urachal fistula and allantoic cyst were born with good prognosis,and the remaining four fetuses were induced by other malformations.One of the six fetuses was female,and five fetuses were male.Conclusion Prenatal ultrasound of patent urachus has typical features and low correlation with chromosomal abnormalities.It is more common in males clinically and has a good prognosis without other structural abnormalities.

Objective:To explore the effectiveness of family-based interventions for adolescent suicide pre-vention using meta-analytic methods.Methods:A meta-analysis was conducted by searching CNKI,VIP,Wanfang,Web of Science,PubMed,APA PsycInfo and The Cochrane Library for randomized controlled trials of family-based interventions for adolescent suicide prevention.Results:A total of 15 RCTs involving 2541 cases were conclu-ded.The results of meta-analysis showed that family-based therapy was effective in preventing adolescent suicide(95％CI:-0.76--0.09,P＜0.05),with a medium effect size for the intervention(g=-0.42),in which there was a significant effect on reducing suicidal ideation(SMD=-0.77,95％CI:-1.31--0.23,P＜0.05),and the effect on reducing suicide attempts was not significant(OR=0.87,95％CI:0.68-1.11,P＞0.05).Family-based therapies were most effective in adolescent suicide prevention when the duration of the intervention was 12 weeks or more,when they were based on attachment-based family therapy(ABFT)or resource support and safety plans,and when they had a reasonably high dropout rate(Ps＜0.05).Conclusion:Family-based therapy has significant inter-vention effects on adolescent suicide prevention,and intervention effects on suicidal ideation are superior to those on suicide attempts.

Objective To observe the value of intratumoral and peritumoral radiomics based on dynamic contrast-enhanced MRI(DCE-MRI)combined with clinical indexes for predicting Ki-67 expression of prostate cancer(PCa).Methods Totally 294 PCa patients were retrospectively enrolled and randomly divided into training set(n=205)and test(n=89)set at a ratio of 7∶3,who were stratified into low-expression subgroup(Ki-67≤10%)and high-expression subgroup(Ki-67＞10%)based on pathological findings.ROIintratumoral and ROIperitumoral were delineated on DCE-MRI,and radiomics features were extracted from ROIintratumora,l ROIperitumoral and ROIintratumoral+peritumora,l respectively.Radiomic features significantly associated with Ki-67 expression status were selected to construct radiomics models.A multivariate logistic regression analysis was performed to develop a clinical predicting model,then a combined model was established combined with the optimal radiomics model.Receiver operating characteristic(ROC)curves were plotted,and the area under the curve(AUC)were calculate to evaluate the predictive efficacy of the models and compared between each two models.Decision curve analysis(DCA)was used to assess the clinical net benefit of each model.Results The AUC of modelintratumora,l modelperitumoral and modelintratumoral+peritumoral for predicting Ki-67 expression in training set was 0.905,0.867 and 0.930,and the last one was the best.In clinical model,total prostate-specific antigen(t-PSA)and T stage≥3 were both independent predictors of high Ki-67 expression of PCa(both P＜0.05).The AUC of combined model based on modelintratumoral+peritumoral and clinical model was 0.911 in test set,being not significantly different with that of modelintratumoral+peritumoral(AUC=0.906;Z=0.349,P=0.727)but higher than that of clinical model(AUC=0.684;Z=4.370,P＜0.05).DCA revealed that the combined model provided higher clinical net benefit than clinical model and modelintratumoral+peritumoral across risk thresholds of 0.10-0.70.Conclusion DCE-MRI intratumoral+peritumoral radiomics model could effectively predict Ki-67 expression status of PCa.Combining with clinical indexes could further enhance its clinical net benefit.

Objective:To analyze the prenatal ultrasonographic features and prognosis of fetal perirenal urinoma.Methods:This retrospective study included eight fetuses with perirenal urinoma diagnosed by prenatal ultrasound in the Women and Children's Hospital of Chongqing Medical University from January 2017 to August 2023. Descriptive analysis was performed on their prenatal ultrasonographic features, intrauterine intervention measures, postnatal treatment, and prognosis.Results:Among the eight cases, the prenatal ultrasonographic diagnosis was consistent with the postnatal clinical diagnosis in seven cases, with one misdiagnosis (postnatally confirmed as giant renal cyst with multicystic dysplastic kidney). Prenatal ultrasonographic features of fetal perirenal urinoma included cystic mass adjacent to the renal capsule; obvious compression of the surrounding organs and the affected kidney; increased craniocaudal diameter of the affected kidney with thin parenchyma, increased echogenicity, indistinct corticomedullary differentiation, and pyeletasis; poorly visualized partial renal arteries; normal or mildly enlarged contralateral kidney; adequate bladder filling; normal amniotic fluid volume. Two cases underwent intrauterine cyst aspiration with subsequent cyst size reduction (slight re-enlargement during follow-up). Among the remaining six untreated cases, one case showed stable cyst size, while five cases exhibited initial significant cyst enlargement followed by stabilization or regression trend. All eight cases were born at full term (three delivered vaginally and five by cesarean section). The affected kidney was significantly atrophied within one week after birth by ultrasound observation. Impaired function of the affected kidney was shown in four patients by follow-up after discharge (including two cases of intrauterine treatment),one case abandoned treatment due to other illnesses, two cases were lost to follow-up after discharge.Conclusions:Prenatal ultrasound images of perirenal urinary cysts infetuses exhibit typical features. Intrauterine treatment can reduce the compression of large cysts and hydronephrosis on fetal organs, but there is no significant improvement in the recovery of renal function.