1.Lingual mucosal graft ureteroplasty for long (≥5 cm) proximal ureteral stricture: a multi-institutional 8-year experience
Xingyuan XIAO ; Shuaishuai CHAI ; Jinmin ZENG ; Xincheng GAO ; Kangxiang XU ; Yuancheng ZHOU ; Jianjun FANG ; Qiuxuan YU ; Wang WANG ; Manshun DONG ; Ruoyu LI ; Mingzhe TANG ; Junwei HU ; Gong CHENG ; Yujie XU ; Dongyang ZENG ; Chaoqi LIANG ; Xuejun ZHANG ; Yixiang LIAO ; Bing LI
Chinese Journal of Surgery 2025;63(12):1104-1110
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.
2.Lingual mucosal graft ureteroplasty for long (≥5 cm) proximal ureteral stricture: a multi-institutional 8-year experience
Xingyuan XIAO ; Shuaishuai CHAI ; Jinmin ZENG ; Xincheng GAO ; Kangxiang XU ; Yuancheng ZHOU ; Jianjun FANG ; Qiuxuan YU ; Wang WANG ; Manshun DONG ; Ruoyu LI ; Mingzhe TANG ; Junwei HU ; Gong CHENG ; Yujie XU ; Dongyang ZENG ; Chaoqi LIANG ; Xuejun ZHANG ; Yixiang LIAO ; Bing LI
Chinese Journal of Surgery 2025;63(12):1104-1110
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.
3.Methods and Challenges for Identifying and Controlling Confounding Factors in Traditional Chinese Medicine Observational Studies
Guozhen ZHAO ; Ziheng GAO ; Chen ZHAO ; Huizhen LI ; Ning LIANG ; Bin LIU ; Qianzi CHE ; Haili ZHANG ; Yixiang LI ; Feng ZHOU ; He LI ; Bo LI ; Nannan SHI
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(22):120-126
As a supplement to randomized controlled trials, observational studies can provide evidence for the effectiveness of traditional Chinese medicine (TCM) treatment measures. They can also study influencing factors of diseases, etiology, and prognosis. However, there is a confounding effect due to the lack of randomization, which seriously affects the causal inference between the study factors and the outcome, resulting in confounding bias. Therefore, identifying and controlling confounding factors are key issues to be addressed in TCM observational studies. According to the causal network and the characteristics of TCM theory, confounding factors can be categorized into measured and unmeasured confounding factors. In addition, attention must be paid to identifying confounding factors and intermediate variables, as well as the interaction between confounding factors and study factors. For methods of controlling confounding factors, measured confounding factors can be controlled by stratification, multifactor analysis, propensity scores, and disease risk scores. Unmeasured and unknown confounding factors can be corrected using instrumental variable methods, difference-in-difference methods, and correction for underlying event rate ratios. Correcting and controlling confounding factors can ensure a balance between groups, and confounding bias can be reduced. In addition, methods such as sensitivity analysis and determination of interactions make the control of confounding factors more comprehensive. Due to the unique characteristics of TCM, observational studies of TCM face unique challenges in identifying and controlling confounding factors, including the ever-changing TCM treatment measures received by patients, the often-overlooked confounding effects in the four diagnostic information of TCM, and the lack of objective criteria for TCM evidence-based diagnosis. Some scholars have already conducted innovative explorations to address these issues, providing a methodological basis for conducting higher-quality TCM observational studies, so as to obtain more rigorous real-world evidence of TCM and gradually develop quality evaluation criteria for OS that are consistent with the characteristics of TCM.
4.Relationship between distribution of infected snails and transmission of acute schistosomiasis in hilly regions
Yixiang XU ; Chengzhong CHU ; Yunlong WU ; Shengjun CHENG ; Fenghua GAO ; Gonghua ZHANG ; Jin CHENG ; Siwu WANG
Chinese Journal of Schistosomiasis Control 2010;22(1):72-73
Objective To explore the relationship between the distribution of infected snails and transmission of acute schistosomiasis in hilly regions.Methods The data concerning the distribution of the infected snails and acute schistosomiasis in Shitai County,Anhui Province from 1999 to 2008 were collected and analyzed.Results The sehistosome infection rate of human increased as the distance between the settings with infected snails and activity sites of humans shortened.Conclusions Acute infection of schistosome of human is associated with the distance between the settings with infected snails and activity sites of them.Strengthening the measures of snail control in key regions,protecting key populations and carrying out health education for schistosomiasis control are important approaches to control the transmission of acute schistosomiasis in hilly regions.
5.Cloning and expression of new genotype of CYP2C9 from Chinese Han in Escherichia coli.
Pinghu ZHANG ; Juan ZHANG ; Yixiang GAO ; Jing SHANG ; Zhenzhou JIANG ; Luyong ZHANG
Journal of Biomedical Engineering 2010;27(2):365-368
In this study, we successfully expanded a full length gene encoding the monooxygenase eytochrome P450 2C9 gene from human liver of Chinese Han by RT-PCR. Our findings indicated that except G-->T mutation at the 190th nucleotide site, the other nucleotide sequences are completely consistent with CYP2C9 (NM017460) in GenBank. The SDS-PAGE and Western-Blot analysis showed that the CYP 2C9 gene was successfully expressed in the host cell E. coli BL21 (DE3). Our current study lays the foundation for the evaluation of pre-clinical drug metabolism and safety in the future.
Aryl Hydrocarbon Hydroxylases
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biosynthesis
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genetics
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China
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ethnology
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Cloning, Molecular
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Cytochrome P-450 CYP2C9
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Escherichia coli
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genetics
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metabolism
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Genetic Vectors
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genetics
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Humans
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Point Mutation
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Polymorphism, Genetic
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Recombinant Proteins
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biosynthesis
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genetics
6.Tracing Algorithms of ECG Tracks from Scanned Image
Fan CHENG ; Rong GAO ; Yixiang WEI
Journal of Biomedical Engineering 2001;18(2):306-308,325
This paper presents a discussion on the tracing algorithms of the extraction of Electrocardiogram(ECG) data from scanned image of hardcopy ECG. We have advanced a new algorithm integrated by seek-and-predict method and polygon model method, which can tolerate crossing of two leads, fault-line and disturbing of grid lines. Two practical situations that may be encountered while processing hardcopy ECG are discussed in detail. Furthermore, the after-treatment of extraction-filtering is considered and an SVD-based filter designed to smooth ECG signal is analyzed.

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