Objective To analyze the incidence of congenital syphilis in four regions of China from 2005 to 2020 and predict its change trend, and to provide a scientific basis for the prevention and control of congenital syphilis. Methods The incidence data of congenital syphilis in eastern, western, central and northeastern China from 2005 to 2020 were collected. The annual change percentage (APC) and average annual change percentage (AAPC) were calculated by Joinpoint software, and the change trend was analyzed. The ARIMA model was established by SPSS26.0 software to predict the incidence from 2021 to 2025. Results From 2005 to 2020, there were 107 504 cases of congenital syphilis, and the incidence reached the peak in 2011, which was 0.90/100 000, and decreased to 0.09/100 000 in 2020. The incidence of congenital syphilis in the eastern, central, western, and northeastern regions of China decreased to 0.07/100 000, 0.06/100 000, 0.12/100 000, and 0.15/100 000 in 2020, respectively. Joinpoint regression analysis found that from 2005 to 2020, the incidence of congenital syphilis showed a downward trend in the whole country (AAPC=-8.68%, t=-5.18, P＜0.05), the eastern region (AAPC=-12.01%, t=-6.81, P＜0.05), the central region (AAPC=-5.45%, t=-2.09, P＜0.05), and the western region (AAPC=-6.05%, t=-3.00, P＜0.05), while the incidence in the northeast region was relatively stable (AAPC=-1.66%, t=-1.18，P＞0.05). The ARIMA (2,2,0) model was constructed to predict that the annual incidence of congenital syphilis from 2021 to 2025 would be 0.06/100,000, 0.03/100,000, 0.02/100,000, 0.01/100,000, and 0.01/100,000, respectively. Conclusion From 2005 to 2020, the incidence of congenital syphilis in China shows an overall downward trend. The western and northeastern regions are the key prevention and control areas, and the work of ^"eliminating mother to child transmission of syphilis^" needs to be continuously promoted.

Objective To explore the application of the"learning by doing"learning theory and methods in the teaching of Obstetrics and Gynecology Nursing for undergraduate nursing students.Method By setting up an experimental group of 151 students and a control group of 152 students in the teaching of Obstetrics and Gynecology Nursing for undergraduate nursing students,practicing"learning by doing"and evaluating the teaching effect.Result The experimental group students held a positive attitude towards the implementation of"learning by doing"in the teaching of Obstetrics and Gynecology Nursing for undergraduate nursing students,with higher scores in both theoretical and skill exams than the control group(P＜0.05),and achieved good practical results.Conclusion By comparing the theoretical and skill exam scores of the experimental group and the control group,the experimental group had a higher average score than the control group(P＜0.05).The application of"learning by doing"in the teaching of Obstetrics and Gynecology Nursing for undergraduate nursing has improved students'self-learning ability and empowered their innovative and collaborative growth.

Purpose: Transcutaneous electrical neural stimulation (TENS), as a non-invasive modality, has been clinically used as an alternative treatment for children with overactive bladder (OAB). We conducted a pooled analysis to explore the effect of TENS on OAB. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-analysis guideline was followed in this study. The MEDLINE, Embase, and Cochrane Central Register of Controlled Trials databases, as well as the reference lists of the retrieved studies, were used to find trials relevant for assessing the use of TENS to treat OAB. Results: Of the 246 records identified, 8 publications were analyzed in our study. Our analysis found that TENS resulted in a greater decrease of wet days/wk, daily voiding frequency, daily incontinence episodes, and daily number of voids than was observed in the control group. Furthermore, TENS-treated patients showed similar visual analogue scale (VAS) scores to patients in the control group, demonstrating that the application of TENS did not increase patients’ discomfort and pain. TENS had a relative advantage in the number of partial responses, but no clear differences were found in frequency of no response or a full response compared to the control group. In urodynamic testing, TENS led to obvious improvements in average voided volume and maximum voided volume in children with OAB. Conclusions TENS had a remarkable effect on the improvement of urodynamic indexes and objective OAB symptoms without a significant increase in VAS scores for children with OAB.

Osteopontin (OPN) is a widely distributed secretory protein and is involved in integrin-mediated cell signal transduction. It also plays an important role in the development, progression, and metastasis of hepatocellular carcinoma (HCC). OPN plays a pivotal role in biomineralization and innate immunity, participates in tumor growth and angiogenesis by interacting with integrin, and induces the recurrence and metastasis of HCC via multiple signal transduction. Combined measurement of OPN and other tumor biomarkers can improve the sensitivity of early diagnosis of HCC. OPN inhibitors may serve as a new target for the treatment of HCC and can improve the sensitivity of chemotherapeutic drugs. This article summarizes the recent studies on OPN and introduces the biological function of OPN and its role in the progression and diagnosis and treatment of HCC.

PURPOSE: OnabotulinumtoxinA is used widely for the treatment of neurogenic detrusor overactivity. We conducted a systematic review and meta-analysis to assess its efficacy and safety for neurogenic detrusor overactivity treatment. METHODS: A systematic literature review was performed to identify all published randomized double-blind, placebo-controlled trials of onabotulinumtoxinA for neurogenic detrusor overactivity treatment. MEDLINE, Embase, and the CENTRAL were employed. Reference lists of retrieved studies were reviewed carefully. RESULTS: Six publications involving 871 patients, which compared onabotulinumtoxinA with a placebo were analyzed. Efficacy of onabotulinumtoxinA treatment was shown as a reduction of the mean number of urinary incontinence episodes per day (mean difference, -1.41; 95% confidence interval [CI], -1.70 to -1.12; P<0.00001), maximum cystometric capacity (135.48; 95% CI, 118.22–152.75; P<0.00001), and maximum detrusor pressure (-32.98; 95% CI, -37.33 to -28.62; P<0.00001). Assessment of adverse events revealed that complications due to onabotulinumtoxinA injection were localized primarily to the urinary tract. CONCLUSIONS: This meta-analysis suggests that onabotulinumtoxinA is an effective treatment for neurogenic detrusor overactivity with localized advent events.
Humans ; Urinary Incontinence ; Urinary Tract

ObjectiveTo investigate the clinical outcome of laparoscopic nephroureterectomy (LUNT) for native upper tract urothelial carcinoma (UC) in renal transplant (RT) recipients.Methods We conducted a retrospective analysis on 1130 RT recipients,and 9 patients (0.8％,9/1130) with native upper tract UC were identified. UC was confirmed pathologically in the 9 patients,including 3 cases of unilateral ureter tumor (2 on the right,and 1 on the left),4 cases of unilateral renal pelvis tumor (2 on the right,2 on the left),1 case of bilateral ureter tumor and 1 case of tumor in the right ureter and left kidney.Females predominated (8/9) in the 9 patients with upper tract UC.The patients with left upper urinary tract cancer underwent LUNT using a retroperitoneal approach with a technique of transurethral circumcision of the ureteral orifice.The patients with right upper urinary tract cancer were subjected to nephroureterctomy with ureterectomy and bladder cuff excision by complete laparascopy through a transperitoneal approach. Immunosuppressive protocol conversion from calcineurin inhibitors to sirolimus was performed on all cases. Results In the 9 patients,11 LUNTs were performed successfully without conversion to open surgery.The follow-up period was from 6 to 48 months. One patient died of lung metastasis at 8th month after tumor excision,and 1 patient displayed ductal cancer of the left breast at 7th month after LNUT.Another seven patients showed no evidence of disease during the follow-up period with normal renal function.ConclusionOur present clinical experience suggested that LNUT for the native upper tract cancer in renal transplant recipients is feasible,safe,and effective.

Objective To explore the value of MR imaging-guided percutaneous lumbar discectomy and discolysis with oxygen-ozone mixture for treatment of posterolateral lumbar disc herniation via a new puncture approach of facet joint medial route. Methods All 114 lumbar intervertebral discs in 103 patients were diagnosed as posterolateral lumber disc herniation by CT or MRI, which were located at the levels of L3-4 in 5 cases, LA-5 in 87 cases and L5-S1 in 22 cases. The procedure was guided under 0. 23 T open magnetic resonance with iPath 200 optical tracking system. A 14 G MR-compatible needle was punctured into the disc center via a new puncture approach of facet joint medial route. The therapy steps were as follows: firstly, cut nucleus pulposus and inject 6 ml oxygen-ozone mixture of 60 μg/ml in the disc center;secondly, retreat the needle to the local prominence, cut prominent part and inject 6 ml oxygen-ozone mixture of 60 μg/ml. Thirdly, retreat the needle to the periradicular nerve root, inject 15 ml oxygen-ozone mixture of 40 μg/ml and 4 ml pain-block liquid. All patients were followed up at 3 days, 1 month, 3 months and 6 months after operation, evaluated for the effect of treatment with the modified Macnab criteria, and the results were compared with the χ2 test. Results All procedures were successfully performed. Intraoperative dural injury occurred in 5 cases. Postoperative infection of intervertebral space occurred in 2 cases. The clinical effective rate was 96. 1% (99/103), 84.5% (87/103), 94.2% (97/103), 95.1% (98/103)respectively at 3 days, 1 month, 3 months and 6 months after operation, and the differences were signifieant (χ2 = 12. 942, P = 0. 005 ) . Conclusion MR imaging-guided percutaneous lumbar discectomy and discolysis with oxygen-ozone mixture via facet joint medial route is a minimally invasive, safety and effective method for the treatment of posterolateral lumbar disc herniation.

Objective To evaluate the operative techniques and the methods of the renal function protection in laparoscopic nephron sparing surgery for the treatment of renal tumors.Methods Thirty-six renal tumor patients accepted transperitoneal laparoscopic partial nephrectomy at the 70 degree lateral decubitus position.There were 17 tumors in the upper pole,13 in the lower pole and 6 in the center of kindey.The mean tumor diameter was 2.6 cm(from 0.8 to 4.0 cm).Peke forceps were used to clamp the renal artery and achieve warm ischemia.Cold scissors was used to resect tumors and Hem-o-lok was used to clamp and control the artery bleeding in surgical bed instead of ligature when suturing the kidney parenchyma.Ulinastatin was used to prevent and relieve the ischemical reperfusion injury.The operative time,estimated blood loss,warm ischemia time,intraoperative and postoperative complications and the operative efficacy were recorded.Results All operations were completed successfully,no case was converted to open surgery.The mean operative time was 128 min(95 to 186 min),mean estimated blood loss was 130 ml (40 to 600 ml),mean warm ischemia time was 21 min(16to 28 min).There was no hemorrhage and urinary leakage after surgery.The post-operative renal function was normal in all the cases.The histopathological examination showed that 36 cases were renal cell carcinoma including 31 pT1a,cases and 5 pT1b cases.There was no positive surgical margin.The mean follow-up time was 16 months (from 6 to 30 months).There was no recurrence and metastasis found and renal function was normal in all cases during the follow-up.Conclusions Laparoscopic nephron sparing surgery for renal tumors is a safe and feasible treatment option.This procedure can resect tumor safely and preserve renal function efficiently.The use of Hem-o-lok instead of ligature can significantly reduce the operative time.Ulinastatin can help reducing the ischemical reperfusion injury and thus preserve renal function.

Objective To evaluate the feasibility, accuracy and its clinical value of MRI-guided needle biopsy of lung lesions. Methods A total of 137 patients with pulmonary nodules or masses underwent lung biopsy in low-field open MRI equipped with iPath 200 optical tracking systems. Among them, 103 cases had solitary pulmonary lesion; the other 34 cases had multiple foci. The maximum diameter of the lesion was not smaller than 3.5 cm ( ≥ 3.5 cm) in 57 patients, between 1.5 cm and 3.4 cm( 1.5-3.4 cm) in 71 patients, not greater than 1.4 cm ( ≤ 1.4 cm) in 9 patients. Results The puncture success rate was 100.0% (57/57) for lesions ≥3.5 cm, 98.6% (70/71) for lesions 1.5-3.4 cm,77.8% (7/9) for lesions ≤1.4 cm and 97. 8% (134/137) for total cases, respectively. According to the pathological results, pulmonary lesions were malignant in 98 cases and benign in 39 cases. The sensitivity,specificity, accuracy, positive predictive value and negative predictive value of MRI-guided lung biopsy were 94.2%(98/104), 100.0% (33/33), 95.6% (131/137), 100.0% (98/98) and 84.6% (33/39),respectively. Conclusion MRI-guided needle biopsy of lung lesion can be performed precisely in a lowfield open MRI with a low risk of complications. As a supplement to US or CT-guided biopsy, it is worth further promotion and application.

Objective To investigate expression of extracelluar signal regulated protein kinase(ERK)and phosphorylation ERK(p-ERK)in the temporal lobe from patients with DR-TLE so as to explore the possible roles of ERK in the pathogenesis of DR-TLE.Methods Expression of ERK was detected with Western blot and immunohistochemistry in 32 patients with DR-TLE(24 temporal lobe,8 hippocampi),as compared with 12 controls(9 temporal lobe,3 hippocampi).Results ERK and p-ERK expression in DR-TLE was significantly higher(0.2266?0.0613,0.2097?0.0183 and 0.1924?0.0054,respectively)than those of controls(0.1840?0.0023,0.1974?0.0056 and 0.1825?0.0063,respectively,all P