Objective To investigate the clinical efficacy of transurethral plasma electrotomy with rod electrode and end-to-end urethral anastomosis in the treatment of short urethral stricture.Methods 125 male patients with short urethral stricture(＜2 cm)who were admitted to our hospital from January 2014 to December 2020 were retrospectively analyzed.According to different surgical methods,they were divided into transurethral plasma resection with rod electrode(minimally invasive group)and urethral end-to-end anastomosis(open group).According to the length of urethral stricture,the minimally invasive group was divided into minimally invasive group 1(stricture length≤1 cm),minimally invasive group 2(stricture length1-2 cm),open group 1(stricture length ≤1 cm)and open group 2(stricture length 1-2 cm).The four groups were compared with each other,and the surgical success rates were compared between the four groups.Results The success rate of the minimally invasive group 1 and the open group 1 was 88.57％and 93.10％,respectively.There was no significant difference between the two groups(P＞0.05).The surgical success rate of the minimally invasive group 2 and the open group 2 was 67.86％and 90.91％,respectively.The surgical success rate of the minimally invasive group 2 was significantly lower than that of the open group 2.The difference was statistically significant(P＜0.05).The surgical success rate of minimally invasive group 1 and minimally invasive group 2 was 88.57％and 67.86％,respectively,the difference was statistically significant(P＜0.05).The success rate of operation in the open group 1 and the open group 2 was 93.10％and 90.91％,respectively,and there was no significant difference between the two groups(P＞0.05).Conclusion Transurethral plasma resection with rod electrode is preferred for urethral stricture with length≤1 cm,because the success rate of this surgery is the same as that of open surgery,and the surgical trauma is small and the recovery is fast.For 1-2 cm urethral stricture,minimally invasive surgery has less trauma and faster recovery,but open surgery has a higher success rate.The choice of surgical method needs to weigh the advantages and disadvantages and take comprehensive consideration.

Objective To evaluate the long-term efficacy of transjugular intrahepatic portosystemic shunt(TIPS)with bare stents and Fluency covered stents in the treatment of portal hypertension,and to discuss its clinical value.Methods The clinical data of 29 patients with intractable ascites or esophagogastric fundus varices rupture and hemorrhage caused by cirrhotic portal hypertension,who received TIPS with bare stents and covered stents at the First Affiliated Hospital of Xinjiang Medical University of China(25 patients)and the Lishui Municipal Central Hospital of China(4 patients)between August 2012 and December 2017,were retrospectively analyzed.The patients were regularly followed up to check the survival status.The postoperative cumulative shunt patency rate and cumulative survival rate of the patients were analyzed by Kaplan-Meier method.Results The technical success rate of TIPS was 100％.The mean portal vein pressure was decreased from preoperative(40.21±3.24)cmH2O to postoperative(24.55±3.55)cmH2O(P＜0.05).The patients were followed up for 5.1-10.5 years.The postoperative 1-,3-,5-,7-year primary cumulative patency rates of the shunt were 89.7％,75.9％,75.9％ and 52.5％,respectively.The postoperative 5-,7-,9-and 10-year cumulative survival rates were 100％,66.9％,66.9％ and 33.4％,respectively.The incidence of hepatic encephalopathy was 13.8％(4/29).Conclusion Using bare stents combined with Fluency covered stents for TIPS is clinically safe and effective in the treatment of portal hypertension.This technique carries higher long-term shunt patency rate and low incidence of hepatic encephalopathy.Therefore,it can be used as a substitute for Viatorr stent when necessary.(J Intervent Radiol,2024,33:295-299)

Objective To evaluate the clinical application value of medical tissue glue in the treatment of acute hemoptysis by bronchial arterial embolization(BAE).Methods The clinical data of 78 patients who underwent emergency BAE for hemoptysis were retrospectively collected.Among them,18 patients who underwent embolization with medical tissue glue were selected as a study group,and other 18 patients who underwent embolization with absorbent gelatin sponge particles and spring coil were selected as a control group.The technical success rates,average surgical operation time,average surgical cost,postoperative hemoptysis recur-rence rate,and incidence of adverse reactions of the two groups were compared and analyzed.Results The technical success rates of the two groups were both 100％.There were no statistically significant differences in recurrence rate of postoperative hemoptysis and incidence of adverse reactions between the two groups(P＞0.05).The average surgical operation time of study group and control group were 53.4 min[(53.4±2.2)min]and 65.4 min[(65.4±2.8)min],and the average surgical cost were 3 651 yuan[(3 651±102.7)yuan]and 5 094 yuan[(5 094±136.3)yuan],respectively.Compared with the control group,the average surgical operation time and aver-age surgical cost of the study group were shorter,and the differences were statistically significant(P＜0.05).Conclusion Compared with absorbent gelatin sponge particles combined with spring coil embolization,the use of medical tissue glue for embolization is also safe and effective in the treatment of acute hemoptysis patients by BAE.The average surgical operation time is shorter,and the surgical cost for patients is lower.It is worth promoting in clinical practice.

Objective lo explore the application value of medial caudal approach combined with middle page-turning lymphadenectomy in laparoscopic radical right hemicolectomy.Methods Eighty-six patients with right hemicolon cancer admitted to our hospital from May 2019 to May 2020 were selected as the research objects,and they were divided into an observation group of 43 cases and a control group of 43 cases by random drawing.The control group adopts the intermediate approach,and the observation group adopts the medial caudal approach combined with middle page-turning lymphadenectomy.The surgical recovery index,complication rate,serum tumor markers and survival index were compared between the two groups to evaluate the clinical efficacy and safety.Results There were no significant differences between the two groups in the number of lymph nodes removed,the length of the intestinal tube removed,extubation,fluid feeding and hospitalization time,the incidence of postoperative complications(P＞0.05),but the operation time and intraoperative bleeding in the observation group were significantly lower,and the postoperative exhaust time was shorter(P＜0.05).The serum CA19-9 and CEA levels of the two groups after one year decreased,and the serum CA19-9 and CEA levels of the observation group were lower than those of the control group(P＜0.05).The disease-free progression period was prolonged in the observation group(P＜0.05),but there was no difference in survival time.Conclusion The medial caudal approach combined with the middle page-turning lymphadenectomy has higher clinical application value in the laparoscopic radical right hemicolectomy,which is conducive to shortening the operation time and postoperative exhaust time,reducing the amount of intraoperative bleeding and postoperative serum CA19-9 and CEA levels,and improving the disease-free progression period with high safety.

Objective    To explore whether surgery combined with adjuvant chemotherapy can bring survival benefits to patients with cervical and upper thoracic esophageal squamous cell carcinoma (ESCC). Methods    The clinical data of patients with cervical and upper thoracic ESCC who underwent R0 resection and neck anastomosis in our department from 2006 to 2010 were retrospectively analyzed. Patients received neoadjuvant therapy or adjuvant radiotherapy were excluded. The adjuvant chemotherapy group was given a combination of taxanes and platinum based chemotherapy after surgery; the surgery alone group did not receive adjuvant chemotherapy. The Kaplan-Meier method was used to analyze the survival difference between the adjuvant chemotherapy group and the surgery alone group. Results    A total of 181 patients were enrolled, including 141 (77.9%) males and 40 (22.1%) females, with an average age of 61.0±8.2 years (80 patients aged≤61 years, 101 patients aged>61 years). There were 70 (38.7%) patients of cervical ESCC, and 111 (61.3%) patients of upper thoracic ESCC. Eighty-seven (48.1%) patients underwent postoperative adjuvant chemotherapy, and 94 (51.9%) patients underwent surgery alone, and the basic clinical characteristics were well balanced between the two groups (P>0.05). The median survival time of patients in the adjuvant chemotherapy group and the surgery alone group was 31.93 months and 26.07 months, and the 5-year survival rate was 35.0% and 32.0%, respectively (P=0.227). There was no statistical difference in median survival time between the cervical ESCC and upper thoracic ESCC group (31.83 months vs. 29.76 months, P=0.763). For cervical ESCC patients, the median survival time was 45.07 months in the adjuvant chemotherapy group and 14.70 months in the surgery alone group (P=0.074). Further analysis showed that the median survival time of lymph node negative group was 32.53 months, and the lymph node positive group was 24.57 months (P=0.356). The median survival time was 30.43 months in the lymph-node positive group with adjuvant chemotherapy and 17.77 months in the lymph-node positive group with surgery alone. The survival curve showed a trend of difference, but the difference was not statistically significant (P=0.557). Conclusion    There is no statistical difference in the long-term survival of cervical and upper thoracic ESCC patients after R0 resection. Postoperative adjuvant chemotherapy may have survival benefits for patients with cervical ESCC and upper ESCC with postoperative positive lymph nodes, but the differences are not statistically significant in this setting.

The low-frequency oscillation of electroencephalography can reflect the process of brain neuron remodeling. This article reviews the basic principles of neurobiology, measurement and analysis methods of delta (0.5-4 Hz) and theta (4-8 Hz) low-frequency oscillatory activities and their clinical applications in post-stroke motor, cognitive and language functions, and discusses the possibility of their clinical research and conversion application in the field of stroke rehabilitation.

RNF20, an E3 ligase critical for monoubiquitination of histone H2B at lysine 120 (H2Bub), has been implicated in the regulation of various cellar processes; however, its physiological roles in adipocytes remain poorly characterized. Here, we report that the adipocyte-specific knockout of Rnf20 (ASKO) in mice led to progressive fat loss, organomegaly and hyperinsulinemia. Despite signs of hyperinsulinemia, normal insulin sensitivity and improved glucose tolerance were observed in the young and aged CD-fed ASKO mice. In addition, high-fat diet-fed ASKO mice developed severe liver steatosis. Moreover, we observed that the ASKO mice were extremely sensitive to a cold environment due to decreased expression levels of brown adipose tissue (BAT) selective genes, including uncoupling protein 1 (Ucp1), and impaired mitochondrial functions. Significantly decreased levels of peroxisome proliferator-activated receptor gamma (Pparγ) were observed in the gonadal white adipose tissues (gWAT) from the ASKO mice, suggesting that Rnf20 regulates adipogenesis, at least in part, through Pparγ. Rosiglitazone-treated ASKO mice exhibited increased fat mass compared to that of the non-treated ASKO mice. Collectively, our results illustrate the critical role of RNF20 in control of white and brown adipose tissue development and physiological function.

A novel coronavirus (SARS-CoV-2) that broke out at the end of 2019 is a newly discovered highly pathogenic human coronavirus and has some similarities with severe acute respiratory syndrome coronavirus (SARS-CoV). Angiotensin-converting enzyme 2 (ACE2) is the receptor for infected cells by SARS-CoV. SARS-CoV can invade cells by binding to ACE2 through the spike protein and SARS-CoV-2 may also infect cells through ACE2. Meanwhile, ACE2 also plays an important role in the course of pneumonia. Therefore the possible role of ACE2 in SARS and coronavirus disease 2019 (COVID-19) is worth discussing. This paper briefly summarized the role of ACE2 in SARS, and discussed the possible function of ACE2 in COVID-19 and potential risk of infection with other organs. At last, the function of ACE2 was explored for possible treatment strategies for SARS. It is hoped to provide ideas and theoretical support for clinical treatment of COVID-19.

Objective To calculate Z-score for mitral and tricuspid color blood flow widths in normal fetuses and fetuses with dilated coronary sinuses ( CS ) using fetal echocardiography ,and explore the application value of Z-score of the color flow widths of atrioventricular valves in normal fetuses and fetuses with dilated CS . Methods Two hundred and thirty-eight normal fetuses (control group) with a gestational age of 16 to 38 weeks were studied by color Doppler echocardiography . Gestational age ( GA ) ,biparietal diameter (BPD) ,femoral length (FL) ,aortic inner diameter (AOd) ,pulmonary artery diameter (PAd) ,and heart area ( HA) were measured as independent variables ,and mitral and tricuspid valve color flow widths were measured as the dependent variables . Z-score models were established by regression analysis . Thirty fetuses with dilated CS (dilated CS group) from 22 to 33 weeks'gestation were involved . The Z-score of the CS fetus was calculated based on the established Z-score models and were compared with those of the normal fetuses . Results The independent sample t-test showed that there were no significant differences in the Z-scores of the blood flow width of the fetal mitral and tricuspid valves between dilated CS group and control group ( P >0 .05) . Conclusions The simple dilated CS does not affect the mitral valve diastolic blood flow ,so there is no significant effect on the filling of left ventricular blood flow .

Objective To analyze the clinical efficacy of gamma-ray fractionated stereotactic radiotherapy (FSRT) in the treatment of intracranial metastatic polycystic tumors.Methods Forty cases with 61 metastatic polycystic tumors were selected from 189 patients with 373 intracranial metastatic tumors admitted to our hospital from 2013 to 2015.All cases received gamma-ray FSRT.The isodose line at 50％ was defined as the prescription dose.The prescription dose was ranged from 40 to 48 Gy/10-12f.The survival rate was calculated by Kaplan-Meier method.The single factor analysis was performed by Log-rank method.Results The median follow-up time was 21months (range:6-39 months).The median survival time was 15.3 months.The 6-month,1-and 2-year local control rate was 93％,82％ and 79％,respectively.The 1-and 2-year survival rate was 63％ and 30％.Single factor analysis demonstrated that the volume of cysts and the volume of lesions were not significantly correlated with local control rate (P=0.17 and 0.48).Conclusion Gamma-ray FSRT can be adopted to treat intracranial metastatic polycystic tumors,which yields similar clinical efficacy to metastatic solid tumors.It deserves wide application in clinical practice due to high local control rate and safety.