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.

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.

Objective:To establish an evaluation index system of home care quality for caregivers of children aged ≤3 years with burns.Methods:The combined approach of qualitative and quantitative research was used, and the fundamental principles of constructing an index system was followed. From January to February 2022, through literature analysis, conducting a semi-structured interview on 6 female nurses aged 31 to 51 years who worked for more than 10 years in the Department of Burns, Plastic Surgery, and Aesthetic Medicine of General Hospital of Ningxia Medical University, as well as 15 caregivers (11 females and 4 males) of hospitalized children with burns aged 28 to 54 years who received professional training from nursing staff, a preliminary evaluation index system of home care quality for caregivers of children ≤3 years old with burns was established using Maslow's hierarchy of needs as theoretical guidance. From March to June 2022, the Delphi method was applied to conduct inquiry by correspondence with 15 experts in relevant fields who met the inclusion criteria and were employed in general hospitals, specialized hospitals, and universities in the Ningxia Hui Autonomous Region (with their general information being recorded), and the evaluation index system was established and the weights of indicators at all levels were determined by the analytic hierarchy process. The effective recovery ratio of the inquiry form was calculated to determine the level of enthusiasm of experts, the average authority coefficient of all indicators was calculated to determine the level of expert authority, the average importance assignment and full score ratio of all indicators were calculated to determine the concentration of expert opinions, and the average Kendall's harmony coefficients and mean coefficient of variation for all indicators were calculated to determine the degree of coordination of expert opinions. The Kendall's harmony coefficients for the first level indicators, the total second level indicators, and the total third level indicators in each round of correspondence inquiry were statistically analyzed with chi-square test.Results:The preliminary evaluation index system of home care quality for caregivers of children ≤3 years old with burns included 5 first level indicators, 13 second level indicators, and 55 third level indicators. The majority of the 15 experts were women, aged 32-56 years, all with a bachelor's degree or above education background, intermediate or above professional titles, and worked for 14-31 years. The effective recovery ratios of the first and second rounds of inquiry forms were 1 (15/15) and 0.93 (14/15), respectively. The average authority coefficients of all indicators in the first and second rounds of correspondence inquiries were 0.87 and 0.90, respectively. The average importance assignment and average full score ratio of all indicators were 4.25 and 0.68 respectively in the first round of inquiry, and 4.39 and 0.70 respectively in the second round of inquiry. In the first and second rounds of inquiries, the average Kendall's harmony coefficients for all indicators were 0.50 and 0.62, respectively, and the average coefficients of variation for all indicators were 0.15 and 0.14, respectively. The Kendall's harmony coefficients of the five first level indicators (physiological needs, safety needs, needs for love and belonging, needs for respect, and needs for self-realization), the total second level indicators, and the total third level indicators in the first and second rounds of correspondence inquiries were statistically significant (with χ2 values of 22.18, 20.36, 23.42, 25.81, 21.44, 124.73, 524.05 and 24.27, 19.85, 22.39, 27.52, 20.83, 102.38, 503.27, respectively, P<0.05). The final evaluation index system of home care quality for caregivers of children ≤3 years old with burns included 5 first level indicators, 13 second level indicators, and 56 third level indicators. The weights of the first level indicators for physiological needs, safety needs, needs for love and belonging, needs for respect, and needs for self-realization were 0.343, 0.371, 0.091, 0.076, and 0.127, respectively. The weights of the second level indicators were 0.024 to 0.192, and the weights of the third level indicators were 0.001 to 0.089. Conclusions:The evaluation index system of home care quality for caregivers of children ≤3 years old with burns established on the basis of Maslow's hierarchy of needs theory is scientific and reliable, and can serve as a reference for home care of children with burns in this age group.

Objective:To introduce the Burnt Hand Outcome Tool (BHOT) into China to conduct sinicization, cross-cultural debugging, and test the reliability and validity, thus provide a reference for the evaluation of treatment effect and making of medical decisions of hand burn patients.Methods:The cross-sectional research was conducted. After obtaining the authorization of the original author, the Brislin translation mode was used to literally translate, synthesize, back-translate, and be checked by experts to form the Chinese version of BHOT (C-BHOT) 2. Ten experts in the field of burn rescue and treatment were invited by purpose sampling method to conduct cross-cultural debugging to form C-BHOT 3. A total of 21 hand burn patients who were treated in General Hospital of Ningxia Medical University from January to March 2020 and conformed to the inclusion criteria were selected by accidental sampling method for pre-testing. Then the final version of C-BHOT 4 was formed. Hospitalized patients who met the selection criteria were recruited using accidental sampling, multi-site and cross-regional survey method from May 2020 to March 2021 in General Hospital of Ningxia Medical University, the First Affiliated Hospital of Air Force Medical University, the First Affiliated Hospital of Army Medical University (the Third Military Medical University), and the First Affiliated Hospital of Nanchang University. The survey was performed with the general information questionnaire and C-BHOT 4. Critical ratio method and correlation coefficient method were used for item analysis, Cronbach's α coefficient test tool was used to test internal consistency, test-retest reliability was used to judge the stability of the tool, content validity index analysis tool was used to analyze the content validity, and exploratory factor analysis was used to test the validity of the structure. Data were statistically analyzed with independent sample t test or Pearson correlation analysis. Results:After the sinicization, cross-cultural debugging, and pre-testing, C-BHOT 4 was formed with a total of 20 items. All items were adjusted to positive scoring, and 7 modifications were made on the basis of the original tool. A total of 353 questionnaires were issued in the formal survey, and 344 valid questionnaires were returned, with an effective response rate of 97.45%. In the 344 patients, there were more male patients (297 patients) than female patients (47 patients), with ages of 23 to 57 years. The critical ratios of each item in the item analysis ranged from 5.48 to 12.59 ( P<0.05). There were statistically significant differences in the scores between patients in high-score group and low-score group ( t=-10.72--2.84, P<0.05 or P<0.01). There was significant positive relationship among the scores of each two items and between scores of each item and the overall tool score ( r=0.68-0.71, 0.47-0.63, P<0.05 or P<0.01). In reliability test, the Cronbach's α coefficient of the whole tool was 0.837, and the test-retest reliability was 0.702-0.793. In validity test, the content validity index of whole tool was 0.923. The exploratory factor analysis extracted 3 common factors, and the cumulative variance contribution rate was 76.162%. The comparative fit index in the confirmatory factor analysis was 0.924. Conclusions:After the BHOT tool being sinicized, cross-culturally debugged, pre-tested, and tested for reliability and validity, it was verified that C-BHOT 4 has good reliability and validity in assessing the outcome of Chinese hand burn patients, and therefore can be used as an effective tool for the evaluation.

Objective:To explore the ultrasonography and classification management strategy for adult atrial septal aneurysm (ASA).Methods:Of 138 patients diagnosed with ASA by the transthoracic echocardiography (TTE), in No.83 Army Hospital and No.988 Hospital of Joint Logistic Support Force from January 2015 to October 2019, 103 underwent the transesophageal echocardiography (TEE), and all were examined by the right heart contrast transthoracic echocardiography (cTTE). According to the semi-quantitative method, the shunt was graded, classified, and managed through follow-up or surgical treatment.Results:In the resting state, among 138 patients, 26 cases were detected by TTE as ASA with patent foramen ovale (PFO), showing left-to-right shunt. Among 112 patients with no shunt detected by TTE, 103 cases underwent TEE, of whom 44 cases had PFO and left-to-right shunt. The detection rate of PFO shunt by TEE was significantly higher than that of TTE (42.72% vs 18.84%, P<0.001). Out of the 138 patients who underwent cTTE, 96 cases had different degrees of right-to-left shunt. According to the semi-quantitative standard, there were 15 cases of grade Ⅰ, 28 cases of grade Ⅱ, and 53 cases of grade Ⅲ. The detection rate of cTTE was significantly higher than that of TTE and TEE (69.56% vs 18.84% and 42.72%, both P<0.001). Among these 96 patients with right-to-left shunt detected by cTTE, 52 cases (54.17%) were clinically diagnosed as cryptogenic stroke, with right-to-left shunt in 6 cases of grade Ⅰ, 12 cases of grade Ⅱ, and 34 cases of grade Ⅲ. The number of new infarcts in patients with grade Ⅱ or Ⅲ shunts who received PFO closure via catheter was significantly lower than that of patients who did not receive closure therapy (0 vs 27.27%, P=0.011). Conclusion:ASA combined with PFO and right-to-left shunts were detected more frequently by ultrasonography combined with cTTE in adults, this helps to formulate a reasonable management strategy.

OBJECTIVETo detect mutations of the retinitis pigmentosa GTPase regulator (RPGR) gene in two Chinese X-linked retinitis pigmentosa families.

METHODSFragments of exons 1-19 of the RPGR gene were amplified with intronic primers, using genomic DNA as template. The polymerase chain reaction (PCR) products were analysed by single-strand conformation polymorphism (SSCP) and direct sequencing. Mutations were identified by comparing DNA sequences of the patients with those of the normal controls.

RESULTSTwo novel mutations, c1536delC and E332X, were identified in exons 12 and 9 of the RPGR gene in both families. Each mutation was the first mutation found in their respective exons. Both mutations were predicted to cause premature termination, which resulted in truncated proteins without normal functions of the RPGR products.

CONCLUSIONSBoth mutations are the genetic basis of the pathogenesis in the respective families. Our data might be helpful in analysing the function of the RPGR protein.

Carrier Proteins ; genetics ; Eye Proteins ; Female ; Genetic Linkage ; Humans ; Male ; Mutation ; Polymerase Chain Reaction ; Polymorphism, Single-Stranded Conformational ; Retinitis Pigmentosa ; genetics ; Sequence Analysis, DNA ; X Chromosome

Objective To study the effects of Wenshen Kechuan Tablets in relieving cough and asthma, and to make a preliminary investigation of its therapeutic mechanism. Methods The actions of relieving cough and asthma were studied with the cough model induced by ammonia water, asthma model induced by histamine- acetylcholine, asthma model induced by ovalbumin. In addition, the phenolsulfonphthalein excretion and lung overfall were measured. The therapeutic mechanism of Wenshen Kechuan Tablets was studied with the kidney- yang- insufficiency model induced by cortisol and the model of emasculated male mice. Results Wenshen Kechuan Tablets could significantly prolong the cough latent period and cough times within 3 min and increase phenol red secretion from trachea in cough model induced by ammonia water. Wenshen Kechuan Tablets could significantly prolong the asthma latent period and relieve spasm in guinea pigs with histamine- acetylcholine- induced asthma, prolong spasm latent period and reduce shock attack and lung overfall volume in guinea pigs with ovalbumin- induced asthma. Wenshen Kechuan Tablets had a protective effect on whole behavior and body weight increase in model mouse of insufficiency of kidney- yang, and show some androgen- like biological activity in emasculated male mice. Conclusion Wenshen Kechuan Tablets have obvious actions of relieving cough and asthma, the effects may be achieved by warming kidney- yang or by androgen- like biological activity.