Objective:To investigate the feasibility,safety and effectiveness of robot-assisted laparo-scopic buccal mucosa graft ureteroplasty in the treatment of complex long proximal ureteral stricture.Methods:The clinical data of 20 patients with proximal ureteral stricture undergoing robot-assisted lapa-roscopic buccal mucosa graft ureteroplasty admitted to the Department of Urology,Peking University First Hospital and Beijing Jiangong Hospital from July 2022 to January 2023 were prospectively collected and analyzed.Intraoperative conditions,postoperative complications and follow-up data were also recorded and analyzed.Results:The operations under robot-assisted laparoscopy were performed successfully in all the 20 patients without conversion to traditional laparoscopic surgery or open surgery.The study in-cluded 14 males and 6 females with a mean age of(41±11)years(range:19 to 60 years)and a mean body mass index of(24.3±3.6)kg/m2(range:18.2 to 31.8 kg/m2).There were 9 cases on the left side and 11 cases on the right side.The strictures of all the patients were located in the proximal segment of the ureter(including the ureteropelvic junction).The mean preoperative serum creatinine was(92.2±23.3)μmol/L(range:49.2 to 138.9 μmol/L),and the mean length of ureteral stricture was(2.8±0.9)cm(range:1.0 to 4.0 cm).Ten patients had previously undergone unsuccessful reconstructive surgery.During the operation,12 patients received posteriorly augmented anastomosis with ventral onlay.The mean length of the buccal mucosa graft harvested during the operation was(3.1±0.6)cm(range:2.0 to 4.3 cm),and the median width was 1.5 cm(range:1.0 to 2.0 cm).The omentum flap was used to wrap the reconstructed ureteral segment in all the 20 cases.The median operative time was 154 min(range:113 to 300 min),and the median estimated blood loss was 45 mL(range:0 to 100 mL).The median postoperative hospital stay was 4 d(range:4 to 14 d).The mean postoperative follow-up time was(15.0±1.7)months(range:12.5 to 17.9 months),and the surgical success rate was 100.0％in this study.After surgery,11 patients reported mild discomfort at the oral donor site,2 patients deve-loped urinary tract infection,and no postoperative complications were reported in the other 7 patients.The mean serum creatinine was(90.9±23.9)μmol/L(range:60.0 to 153.0 μmol/L)six months after surgery.Conclusion:Robot-assisted laparoscopic buccal mucosa graft ureteroplasty for the treatment of complex long proximal ureteral stricture has satisfactory efficacy without severe complications,which has shown good feasibility,safety and effectiveness.However,large sample studies and long-term follow-up are still needed to evaluate its long-term efficacy.

Ovarian aging is one of the most common reproductive endocrine disorders in women of reproductive age, with an increasing incidence over the years. It is characterized by a decline or depletion of ovarian function, including follicle quantity and/or quality. Depending on the degree of ovarian function decline, it can be classified into diseases including diminished ovarian reserve, premature ovarian insufficiency, premature ovarian failure, etc., which are clinically characterized by ovulatory dysfunction, reproductive endocrine hormone disruption, and ultimately lead to a decline in female fertility. The pathogenesis is complex and varied, and the exact mechanism is unknown to date. Granulosa cells play a key role in ovarian hormone synthesis and disruption development, and many studies have shown that the programmed death of granulosa cells (apoptosis, pyroptosis, autophagy, ferroptosis, cuproptosis, etc.) may be closely related to the occurrence and development of ovarian aging. In this article, we present a systematic review of the relevant literature with the aim of exploring the relationship between programmed cell death in granulosa cells and ovarian aging.

Ovarian aging is one of the most common reproductive endocrine disorders in women of reproductive age, with an increasing incidence over the years. It is characterized by a decline or depletion of ovarian function, including follicle quantity and/or quality. Depending on the degree of ovarian function decline, it can be classified into diseases including diminished ovarian reserve, premature ovarian insufficiency, premature ovarian failure, etc., which are clinically characterized by ovulatory dysfunction, reproductive endocrine hormone disruption, and ultimately lead to a decline in female fertility. The pathogenesis is complex and varied, and the exact mechanism is unknown to date. Granulosa cells play a key role in ovarian hormone synthesis and disruption development, and many studies have shown that the programmed death of granulosa cells (apoptosis, pyroptosis, autophagy, ferroptosis, cuproptosis, etc.) may be closely related to the occurrence and development of ovarian aging. In this article, we present a systematic review of the relevant literature with the aim of exploring the relationship between programmed cell death in granulosa cells and ovarian aging.

Objective To explore the effect of yiqi yangyin tongluo regime on hematuria,proteinuria and renal tissue's pathological changes in rats with IgA nephropathy (IgAN).Methods Sixty clean male SD rats were randomized into blank group,model group,huangkui group and high,medium and low-dose TCM (yiqi yangyin tongluo regime) group.After modeling for 0 week,4 weeks,8 weeks,12 weeks and 16 weeks,the levels of urine red blood cell count and 24 h urine protein were detected.Meanwhile,after feeding for 8 weeks,the pathological changes of remnant renal tissues and expression of TNF-α were detected by HE staining and immunohistochemical staining.Results After feeding for 8 weeks,compared with blank group,the level of urine red blood cell count,24h urine protein and TNF-α expression in model group,huangkui group,high,medium and low-dose TCM group were significantly higher (P ＜ 0.05).Compared with the model group,the level of urine red blood cell count,24h urine protein and TNF-α expression in huangkui group,high,medium and low-dose TCM group were significantly lower (P ＜ 0.05).The above indexes in TCM group were significantly lower than huangkui group (P ＜ 0.05).Light microscopy showed that the renal tissues were normal in blank group.In the model group,most of glomerular mesangial cells and matrix appeared moderate and severe hyperplasia,inflammatory ceils and focal fibrosis were seed in renal interstitium.Proliferation of mesangial cells and matrix were relieved in huangkui group and TCM group.Conclusion Yiqi yangyin tongluo regime can effectively ameliorate the levels of urine red blood cell count,24 h urine protein and renal pathological changes.The mechanism may be related to the decrease of urine red blood cell count and 24 h urinary protein,and inhibition of TNF-α expression.

Objective To explore the effect of yiqi yangyin tongluo regime on hematuria,proteinuria and renal tissue's pathological changes in rats with IgA nephropathy (IgAN).Methods Sixty clean male SD rats were randomized into blank group,model group,huangkui group and high,medium and low-dose TCM (yiqi yangyin tongluo regime) group.After modeling for 0 week,4 weeks,8 weeks,12 weeks and 16 weeks,the levels of urine red blood cell count and 24 h urine protein were detected.Meanwhile,after feeding for 8 weeks,the pathological changes of remnant renal tissues and expression of TNF-α were detected by HE staining and immunohistochemical staining.Results After feeding for 8 weeks,compared with blank group,the level of urine red blood cell count,24h urine protein and TNF-α expression in model group,huangkui group,high,medium and low-dose TCM group were significantly higher (P ＜ 0.05).Compared with the model group,the level of urine red blood cell count,24h urine protein and TNF-α expression in huangkui group,high,medium and low-dose TCM group were significantly lower (P ＜ 0.05).The above indexes in TCM group were significantly lower than huangkui group (P ＜ 0.05).Light microscopy showed that the renal tissues were normal in blank group.In the model group,most of glomerular mesangial cells and matrix appeared moderate and severe hyperplasia,inflammatory ceils and focal fibrosis were seed in renal interstitium.Proliferation of mesangial cells and matrix were relieved in huangkui group and TCM group.Conclusion Yiqi yangyin tongluo regime can effectively ameliorate the levels of urine red blood cell count,24 h urine protein and renal pathological changes.The mechanism may be related to the decrease of urine red blood cell count and 24 h urinary protein,and inhibition of TNF-α expression.