Single-Port Laparoscopic Assisted Transcrotal Orchidopexy for Palpable Inguinal Canalicular Cryptorchidism Accompany With Indirect Inguinal Hernia

Purpose: To assess the outcomes of a novel laparoscopic assisted transcrotal orchidopexy (LATO) combined with percutaneous extraperitoneal closure (PEC) for palpable inguinal canalicular cryptorchidism accompany with indirect inguinal hernia, and evaluate its safety and efficiency.Materials and Methods: A retrospective cohort study for single-port LATO-PEC and traditional inguinal orchidopexy (TIO) was performed between 2011 and 2014. Totally 53 children with both palpable inguinal canalicular testes and indirect inguinal hernia were included. Median patient age was 15month (range, 6 months to 4 years). Of them, 35 patients underwent LATO-PEC procedure, utilizing an umbilical trocar for laparoscope, transcrotal dissection for orchidopexy, and an inner two-hooked cannula for ligation of the patent processus at the level of the internal ring. Three of them were bilateral, 12 on the left side and 20 on the right. Eighteen patients received TIO, seven of them on the left side and 11 on the right. Patient demographics, surgical technique, complications, and clinical outcomes were reviewed. Follow-up visits were performed to reassess position and size of the testes.Results: All 56 undescended testes were delivered into the scrotum successfully. In the LATO-PEC group, nine contralateral herniorrhaphy were accomplished simultaneously. Fifteen contralateral patent processus vaginalis (PPVs) in 32 unilateral undescended testis (UDT) were newly confirmed during the laparoscopy, while 6 of them received percutaneous extra-peritoneal herniorrhaphy for visible inguinal bubble in pneumoperitoneum condition. No additional port placement or conversion to open procedure was needed. Mean operative time for unilateral and bilateral LATO-PEC in this study was (37.81 ± 5.23) min and (53.33 ± 2.98) min, respectively. In TIO group, mean operative time was (41.11 ± 8.67) min. There was no statistical difference in operative time between the two approaches for unilateral UDTs (p = 0.098). Median follow-up interval was 24 months (range, 12–84 months). No operative complications were found in either group to date.Conclusions: Singe-port LATO-PEC is a safe, effective, and cosmetic choice for inguinal canalicular cryptorchidism accompany with indirect inguinal hernia, minimizing injuries to the vas deferens and testicular vessels. Laparoscopy can provide a diagnostic and therapeutic solution of contralateral PPV

MiR-155 protects against sepsis-induced cardiomyocyte apoptosis via activation of NO/cGMP signaling pathway by eNOS

Purpose: To examine the impact of miR-155 on sepsis-induced myocardial apoptosis and heart failure, and to explore its molecular mechanism. Methods: Mice were divided into four groups and septic myocardial dysfunction was induced by intraperitoneal injection of lipopolysaccharide (LPS, 5 mg/kg). The LPS stimulation expression of miR-155 levels was determined by real time-polymerase chain reaction (RT-PCR). In vivo, echocardiography and TUNEL staining were used to investigate the effects of miR-155 in inhibiting cardiac function and myocardial apoptosis. Changes in the expression of eNOS when miR-155 was overexpressed or inhibited were determined by RT-PCR, while double luciferase gene assay assessed the relationship between eNOS and miR-155, eNOS, expression of iNOS, SGC alpha 1, and PKG protein. Results: MiR-155 was significantly increased after LPS stimulation (p < 0.01). In vitro, the inhibition of miR-155 by antagomiR significantly down-regulated the apoptosis of cardiomyocytes (p < 0.05), while overexpression of miR-155 by agomiR significantly up-regulated the apoptosis of cardiomyocytes (p < 0.05). In vivo, ejection fraction, fractional shortening and heart weight were significantly increased (p < 0.05), while apoptosis was significantly decreased (p < 0.05). MiR-155 negatively regulated the expression of eNOS (p < 0.01), and targeted the expression of eNOS mRNA (p < 0.001). In addition, the expression of eNOS, sGCα1 and PKA were significantly up-regulated (p < 0.05), while the expression of iNOS was significantly down-regulated (p < 0.05) after the inhibition of miR-155 in LPS mouse model. Conclusion: MiR-155 regulates sepsis-induced cardiomyocyte apoptosis and heart failure through eNOS /NO/cGMP signaling pathway. Thus, these findings can potentially facilitate the development of an effective strategy for management of heart failure

Prophylactic Consecutive Administration of Haloperidol Can Reduce the Occurrence of Postoperative Delirium in Gastrointestinal Surgery

Postoperative delirium has in recent years been a common complication which can interfere with the recovery of patients after surgery. Unfortunately there is still no medical procedure available which can completely prevent the occurrence of postoperative delirium. Haloperidol is a psychopharmacological agent that has been used to treat the delirium and agitation, especially in geriatric patients. To assess the effectiveness and safety of the use of haloperidiol for the reduction of postoperative delirium, we performed a randomized, comparative clinical study in which 78 patients who underwent gastrointestinal surgery received either 5 mg of haloperidol intravenously postoperatively at 21:00 for 5 consecutive days, or normal saline with the same schedule. Postsurgical evaluation revealed the incidence of postoperative delirium to be only 10.5% (4 of 38 patients) in the group receiving haloperidol treatment, compared to 32.5% (13 of 40 patients) in the saline treatment group. No significant neuroleptic side effects were seen in any of the patients. These results suggest that daily postoperative administration of haloperidol can reduce the occurrence of postoperative delirium safely

Genome-wide gene expression analyses reveal unique cellular characteristics related to the amenability of HPC/HSCs into high-quality induced pluripotent stem cells

is Table S2 presenting characteristics of the SF-iPSCs and TTF-iPSCs. (DOC 28 kb

Improving Text Matching in E-Commerce Search with A Rationalizable, Intervenable and Fast Entity-Based Relevance Model

Discovering the intended items of user queries from a massive repository of items is one of the main goals of an e-commerce search system. Relevance prediction is essential to the search system since it helps improve performance. When online serving a relevance model, the model is required to perform fast and accurate inference. Currently, the widely used models such as Bi-encoder and Cross-encoder have their limitations in accuracy or inference speed respectively. In this work, we propose a novel model called the Entity-Based Relevance Model (EBRM). We identify the entities contained in an item and decompose the QI (query-item) relevance problem into multiple QE (query-entity) relevance problems; we then aggregate their results to form the QI prediction using a soft logic formulation. The decomposition allows us to use a Cross-encoder QE relevance module for high accuracy as well as cache QE predictions for fast online inference. Utilizing soft logic makes the prediction procedure interpretable and intervenable. We also show that pretraining the QE module with auto-generated QE data from user logs can further improve the overall performance. The proposed method is evaluated on labeled data from e-commerce websites. Empirical results show that it achieves promising improvements with computation efficiency

Cytokeratin-Positive Cells in Lymph Nodes in Which Metastases Are Undetectable by Conventional Histological Staining in Advanced Gastric Cancer

Detection of occult metastases in lymph nodes by immunostaining is becoming of increasing interest as a way to improve the accuracy of predicting the prognosis for patients with gastric cancer. Immunohistochemical detection of cytokeratin (CK) is recognized as the most sensitive method for identification of cancerous epithelial cells. In this study, lymph nodes were stained for CK in an effort to detect micrometastases and the clinical implications of the results were examined. We immunostained sections from a total of 1,198 lymph nodes from 25 totally gastrectomized patients with T3 or T4 gastric cancer who had been diagnosed as having no nodal involvement by conventional hematoxylin-eosin (HE) staining. Eighty (6.7%) of 1,198 lymph nodes from 15 (60%) of the 25 patients were immunostained with a CK-specific monoclonal antibody. CK-positive cells were more frequent in patients with macroscopic types of 3,4 and 5 gastric cancer. Patients with nodes that were both HE-negative and CK-negative had the best postoperative survival, followed by patients with HE-negative and CK-positive nodes and, finally, by patiof micrometastases in lymph nodes is a reliable indicator of the prognosis of patients with advanced gastric cancer

SCRaMbLE generates designed combinatorial stochastic diversity in synthetic chromosomes

Synthetic chromosome rearrangement and modification by loxP-mediated evolution (SCRaMbLE) generates combinatorial genomic diversity through rearrangements at designed recombinase sites. We applied SCRaMbLE to yeast synthetic chromosome arm synIXR (43 recombinase sites) and then used a computational pipeline to infer or unscramble the sequence of recombinations that created the observed genomes. Deep sequencing of 64 synIXR SCRaMbLE strains revealed 156 deletions, 89 inversions, 94 duplications, and 55 additional complex rearrangements; several duplications are consistent with a double rolling circle mechanism. Every SCRaMbLE strain was unique, validating the capability of SCRaMbLE to explore a diverse space of genomes. Rearrangements occurred exclusively at designed loxPsym sites, with no significant evidence for ectopic rearrangements or mutations involving synthetic regions, the 99% nonsynthetic nuclear genome, or the mitochondrial genome. Deletion frequencies identified genes required for viability or fast growth. Replacement of 3′ UTR by non-UTR sequence had surprisingly little effect on fitness. SCRaMbLE generates genome diversity in designated regions, reveals fitness constraints, and should scale to simultaneous evolution of multiple synthetic chromosomes.</jats:p