Background: In traditional laparoscopic orchiopexy for inguinal undescended testis (UDT) surgery, the testicles are pulled back into the abdominal cavity by grasping and cephalad retracting the testicle and the cord. If this fails, a subsequent open inguinal incision is made to complete orchiopexy. To improve the orchiolysis and avoid extra open inguinal incision, we describe our early experience with and illustrate the surgical procedure of a novel anatomical laparoscopic orchiopexy (ALO) and hybrid transscrotal orchiopexy as required in high palpable UDT. Methods: From March 2018 to April 2020, ALO was performed in 140 consecutive patients (158 testes) with high inguinal UDT. After blunt and bloodless dissection of the inter-tunica vaginalis-cremasteric fascia plane, tunica vaginalis enveloping the testis was brought into the abdominal cavity as a whole. When the tunica vaginalis was unable to be brought into the abdominal cavity, given that the orchiolysis had already been partially carried out, the testis could be brought out of the external ring and descended when converting to transscrotal surgery. Results: The mean age in this study was 1.88 years (standard deviation ±1.95). The position of the testis assessed at surgery was peeping (58, 36.7%) and canalicular (100, 63.3%). In 128 testes (81.1%), ALO brought the UDT into the abdominal cavity; the remaining 30 testes (18.9%) required a hybrid transscrotal technique. All testes were descended without conversion to open inguinal procedure. The mean operative time was 43.9 ± 9.2 minutes. All patients had follow-up within a median of 17.8 months, with satisfactory results in relation to viability and location of the testis. Conclusions: ALO was shown to be not only safe, feasible, and effective for high inguinal UDT but also facilitated subsequent hybrid transscrotal orchiopexy; when the testis failed to be pulled into the abdominal cavity, the conversion to open inguinal orchiopexy could be obviated.
Abstract Both subclinical hypothyroidism (SCH) and overweight or obesity are prevalent in major depressive disorder (MDD), with inconsistent results due to differences in inclusion criteria in previous studies. Few previous studies have compared the prevalence and influencing factors of SCH in MDD patients accompanied by overweight or obesity between those who are not. The aim of our study was to examine the prevalence of SCH and associated risk factors among young Chinese first-episode drug-naïve (FEND) MDD patients with overweight or obesity and exclude the impact of age and medication. This study recruited a total of 1289 young FEDN MDD outpatients and their demographic data, clinical information, thyroid function and biochemical parameters were collected. They were also assessed on the Hamilton Depression Inventory (HAMD), Hamilton Anxiety Inventory (HAMA), and Positive and Negative Symptom Scales (PANSS). The incidence of SCH in young FEDN MDD patients with overweight or obesity was 65.78%, which was 1.59 times higher than that in patients without high BMI (28.6%). Patients with SCH had longer duration of illness, higher HAMA, HAMD, and PANSS positive symptom scores, stronger suicide attempts, higher blood pressure (BP), higher fasting blood glucose, total cholesterol (TC) levels and low-density lipoprotein (LDL) levels, and lower high-density lipoprotein (HDL) levels than those without SCH. Additionally, logistic regression showed that the HAMD score, fasting blood glucose, TC levels, HDL-C levels, systolic and diastolic BP were significantly associated with SCH. Furthermore, the combination of TC levels and systolicBP could differentiate patients with SCH from those without SCH. Our results suggested a high incidence of SCH in young MDD patients with high BMI. The severity of depression and several metabolic parameters contribute to the incidence of SCH in young MDD patients with high BMI.
Purpose This case report aims to enhance the understanding of clinical physicians regarding splenogonadal fusion (SGF) and to help them consider SGF as a differential diagnosis when testicular tumors are suspected, thus avoiding unnecessary orchiectomies. Methods We report three cases of SGF admitted to our hospital, one of which presented as a suspected testicular tumor. We also searched the literature on scrotal masses from the last 25 years and summarize the characteristics of cases of SGF manifesting as scrotal swelling combined with our cases. Results After conducting a thorough search, we found a total of 24 publications relevant to this case study, which included 25 testes. All lesions were located on the left side, and the average age of those affected was 20.22 years. Seven cases were of the continuous type. Three cases presented with pain, all of which were intratesticular masses. Thirty cases had a definite onset duration, ranging from 3 weeks to 10 years. Nine patients (36%) underwent orchiectomy, and one underwent partial orchiectomy. Conclusion It is crucial to identify SGF in the clinic. When a patient presents with scrotal swelling, diagnosing SGF preoperatively is challenging, and it should be considered when there is a long history of a stable testicular mass. An intraoperative frozen section should be performed if a testicular tumor is suspected to avoid unnecessary orchiectomy.
Objective
To investigate the relationship between interventricular septum thickness(IVS) and renal function in patients with diabetes mellitus.
Methods
Two hundred and sixty-five patients of type 2 diabetes without dialysis were enrolled in a cross-sectional study. According to their IVS, the patients were divided into normal group (IVS≤11 mm) and higher IVS group (IVS>11 mm). All patients according to evaluated glomerular filtration rate (eGFR) level were divided into eGFR≥60 ml·min-1·(1.73 m2)-1 group and eGFR<60 ml·min-1·(1.73 m2)-1 group. The demographic characteristic, biochemical examination, eGFR, and proteinuria of different groups were compared. Pearson or spearman correlation was used to analyze the relationship between eGFR, IVS and other parameters. eGFR<60 ml·min-1·(1.73 m2)-1 and IVS thickening were analyzed by binary logistic regression. Risk factors affect the prognosis of renal function in patients with diabetes mellitus were analyzed by Cox regression analysis.
Results
Compared with normal group, patients in the higher IVS group had higher systolic pressure (P=0.002), their level of Scr, BUN, 24 h urinary protein were increased (all P<0.05), while the level of eGFR, albumin (ALB), hemoglobin (Hb) and fasting blood glucose were decreased (all P<0.05). The prevalence of hypertension was increased (81.16% vs 58.67%, χ2=11.273, P=0.001), and there was also a difference in the proportion of patients in each stage of CKD (χ2=34.593, P<0.001). Correlation analysis showed that IVS was positively correlated with BMI, systolic BP, Scr, BUN, 24 h urinary albumin, 24 h urinary protein (all P<0.05), while negative correlation was observed between the thickened degree of IVS and Hb, albumin, eGFR and total calcium (all P<0.05). It's worth noting that IVS also correlated with history of hypertension and degree of renal injury (all P<0.01). Logistic regression analysis showed that longer duration of diabetes, higher systolic pressure and BUN were independent risk factors for eGFR<60 ml·min-1·(1.73 m2)-1 (all P<0.05), while higher Hb and Alb were independent protective factors for eGFR<60 ml·min-1·(1.73 m2)-1 (all P<0.05). Logistic regression analysis also showed that the baseline increased Scr was independent risk factor for interventricular thickening (P<0.05), while the increase of fasting blood-glucose was independent protective factor for interventricular thickening (P<0.05). Cox regression analysis showed that interventricular thickening was an independent risk factor in predicting the progression of type 2 diabetes (HR=1.396, 95% CI=1.098-1.774, P=0.006).
Conclusion
Interventricular septum thickness is closely related to the state of renal function, as well as is an independent risk factor to predict kidney function decline in patients with type 2 diabetes.
Key words:
Diabetes mellitus, type 2; Glomerular filtration rate; Prognosis; Interventricular septum thickness
Objective: To explore potential mechanism about the experience that hypertension is associated with poor outcome in patients with coronavirus disease 2019 (COVID-19). Methods: In this retrospective study, 134 hypertensive patients diagnosed with COVID-19 were included from February 1, 2020 to March 15, 2020. We assessed the associations between renal injury on admission and risks of acute kidney injury (AKI) and in-hospital mortality and analyzed the dynamic changes of serum creatinine and blood urea nitrogen (BUN). Result: Among the 134 COVID-19 patients, 95 (70.9%) were discharged and survived, and 39 (29.1%) died. On admission, BUN and serum creatinine were elevated in 24 (17.9%) and 39 (29.1%) patients, respectively. Estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2 was reported in 18 (13.4%) patients. Multiple regression analysis showed that elevated baseline BUN and eGFR less than 60 ml/min/1.73 m2 on admission were independent risk factors for both AKI and in-hospital death in COVID-19 patients with hypertension. Level of serum creatinine or BUN increased faster in patients with elevated baseline serum creatinine or BUN respectively than those with normal levels. Conclusion: Renal injury of hypertensive patients can result in poor outcomes including AKI and death after they are infected with SARS-CoV-2, and clinicians should be vigilant for these patients with abnormal renal function at admission.
Introduction. Previous studies have shown that TGF-β1/Smad3 signaling promotes renal fibrosis by inhibiting miR-29. To date, only few studies have reportedon circulating microRNAs in IgA nephropathy (IgAN). However, the plasma expression of miR-29a and its role in patients with IgAN remains unclear. In this study, we attempted to elucidate whether plasma miR-29a expression can be used as a biomarker for monitoring disease states. Methods. For this study, 15 healthy subjects, 36 patients with untreated renal biopsy-proven IgAN, and 79 patients with IgAN, who were under treatment for a period of 1 year on an average, all of whom had similar age and gender distributions, were included. The plasma expression of miR-29a in each group was explored by real-time PCR, and the relationship between miR-29a expression and clinical, pathological, and prognostic indicators of IgAN was further evaluated. Results. Relative plasma expression of miR-29a in patients with IgAN was significantly lower than that in healthy controls (P < .001), and these changes in plasma miR-29a could be suppressed by treatment (P < .05). Plasma miR-29a was positively correlated with eGFR and negatively correlated with proteinuria and serum creatinine, irrespective of whether or not the patients with IgAN accepted treatment (P < .05). Plasma miR-29a level was negatively correlated with primary pathological parameters such as crescent formation, Lee’s and Oxford classification (P < .05). Kaplan–Meier analysis revealed that patients with high plasma expression of miR-29a had better renal function and better response to treatment compared to those with low expression (P < .05). Conclusion. Plasma miR-29a could be considered as a biological marker that reflects renal damage and function, to predict the progression of IgAN.
'/%3e%3cuse xlink:href='%23a' transform='rotate(23.036 .093 25.536)'/%3e%3cuse xlink:href='%23a' transform='rotate(45.87 1.273 16.18)'/%3e%3cuse xlink:href='%23a' transform='rotate(69.945 .996 12.078)'/%3e%3cuse xlink:href='%23a' transform='rotate(20.66 -19.689 31.932)'/%3e%3c/svg%3e)