This study aims to compare the clinical efficacy of percutaneous laparoscopic-assisted gastrostomy (PLAG) and surgical gastrostomy (SG) for temporary gastrostomy in neonates with long-gap esophageal atresia (LGEA). We conducted a retrospective analysis of 41 neonates diagnosed with LGEA who underwent temporary gastrostomy. Patients were retrospectively divided into two groups based on the year of surgery: the PLAG group (intervention group, n = 23,post-2020) and the SG group (historical control group, n = 18, pre-2020).We compared perioperative parameters, including postoperative fasting duration, gastrostomy closure rates, abdominal scar scores and complication rates between the two groups. No significant differences were found in baseline characteristics, including gender (p = 0.732), gestational age (p = 0.460), birth weight (p = 0.421), operative age (p = 0.165), Gross classification (p = 0.117), esophageal gap length (p = 0.081), or concomitant deformities (p = 0.767). The two groups showed no statistically significant differences in operative time (p = 0.067), intraoperative blood loss (p = 0.189), or postoperative fasting duration (p = 0.378). However, the PLAG group demonstrated clinically meaningful advantages in several outcomes, including significantly lower rates of gastrostomy closure (p < 0.001), improved cosmetic results (assessed by lower abdominal scar scores; p < 0.001), and reduced complication rates for stoma leakage (p < 0.001), peristomal dermatitis (p < 0.001), local infection (p < 0.001), and tube dislodgement (p = 0.003). No significant differences were noted in stomal hemorrhage (p = 0.083) or intra-abdominal fistula rates (p = 0.252). Compared to SG, PLAG offers significant advantages for temporary gastrostomy in LGEA, including lower closure requirements, improved cosmetic outcomes, and fewer overall complications. These findings support the broader clinical adoption of PLAG in this patient population.

This study investigates the diagnostic efficacy of combining ultrasonography, Pediatric Appendicitis Score (PAS), and C-reactive protein (CRP) for appendicitis in children. We retrospectively analyzed 268 children with acute abdominal pain from 2017 to 2020. Compared with those of any single diagnostic method, the sensitivity and negative predictive value of ultrasonography combined with the pediatric appendicitis score and C-reactive protein were higher in diagnosing acute appendicitis (P < .05). In addition, the sensitivity of ultrasonography combined with C-reactive protein was also greater for diagnosing acute complicated appendicitis (P < .05). Ultrasonography correlated closely with pathological examination findings for appendicitis types (Kappa = 0.888; P < .05). The combined use of ultrasonography, the Pediatric Appendicitis Score, and C-reactive protein enhances the diagnostic accuracy for acute appendicitis. Furthermore, the integration of ultrasonography with C-reactive protein levels may assist in determining the pathological subtype of appendicitis in pediatric patients.

PATZ1 (POZ/BTB and AT hook containing zinc finger 1) is an important member of the POZ/BTB (Poxvirus and Zinc finger / Broad-complex, Tramtrack, and Bric-à-brac) family and has been confirmed to be involved in the development and progression of various tumors. Moreover, differential expression of PATZ1 is associated with the prognosis of multiple cancers and systemic metabolic patterns. It participates in the regulation of oncogenes and a range of biological processes, including glucose and lipid metabolism. This review aims to summarize the current understanding of the relationship between the transcription factor PATZ1, tumorigenesis, and metabolism, with the goal of providing a theoretical basis for the development of PATZ1-targeted therapies.

Cuproptosis, a recently identified type of programmed cell death triggered by copper, has mechanisms in Wilms tumor (WT) that are not yet fully understood. This research focuses on examining the link between WT and Cuproptosis-related genes (CRGs), with the goal of developing a predictive model for WT. Four gene expression datasets related to WT were sourced from the GEO database. Subsequently, expression profiles of CRGs were extracted for differential analysis and immune infiltration studies. Utilizing 105 WT samples, clusters related to Cuproptosis were identified. This involved analyzing associated immune cell infiltration and conducting functional enrichment analysis. Disease-characteristic genes were pinpointed using weighted gene co-expression network analysis. Finally, the WT risk prediction model was constructed by four machine learning methods: random forest, support vector machine (SVM), generalized linear and extreme gradient strength model. The best-performing machine learning model was chosen, and a nomogram was created. The effectiveness of this predictive model was validated using methods such as the calibration curve, decision curve analysis, and by appiying it to the TARGET-GTEx dataset. Thirteen differentially expressed Cuproptosis-related genes were identified. The infiltration level of CD8 + T cells in WT children was lower than that in Normal tissue (NT) children, and the level of M0 infiltration of macrophages and T follicular helper cells was higher than that in NT children. In addition, two clusters of cuproptosis-related WT were identified. Enrichment analysis results indicated that genes in cluster 2 were primarily involved in cell division, nuclear division regulation, DNA biosynthesis process, ubiquitin-mediated proteolysis. The SVM model was judged to be the optimal model using 5 genes. Its accuracy was confirmed through a calibration curve and decision curve analysis, demonstrating satisfactory performance on the TARGET-GTEx validation dataset. Additional analysis revealed that these five genes exhibited high expression in both the TARGET-GTEx validation dataset and sequencing data. This research established a link between WT and Cuproptosis. It developed a predictive model for assessing the risk of WT and pinpointed five key genes associated with the disease.

Purpose: This study aimed to analyze the expression and prognosis of SRY-box transcription factor 11 (SOX11) in neuroblastoma (NB), as well as the biological function and potential regulatory mechanism of SOX11 in NB. Methods: Public RNA sequencing was used to detect the expression level of SOX11. The Kaplan -Meier curve and hazard ratios (HR) were used to determine the prognostic value of SOX11 in NB. Functional analyses were performed using CCK8, wound healing assay, and transwell invasion assay. Finally, the potential target genes of SOX11 were predicted by Harmonizonme (Ma'ayan Laboratory) and Cistrome Data Browser (Cistrome Project) database to explore the potential molecular mechanism of SOX11 in NB. Results: Compared with normal adrenal tissue, the expression of SOX11 in NB tissue was significantly upregulated. The Kaplan -Meier curve showed that high expression of SOX11 was associated with poor prognosis in children with NB (HR, 1.719; P = 0.049). SOX11 knockdown suppressed the migration capacity of SK-N-SH cells but did not affect proliferation and invasion capacity. Enhancer of zeste homolog 2 (EZH2) may be a potential downstream target gene for the transcription factor SOX11 to play a role in NB. Conclusion: The transcription factor SOX11 was significantly upregulated in NB. SOX11 knockdown suppressed the migration capacity of NB cell SK-N-SH. SOX11 may promote the progression of NB by targeting EZH2. [Ann Surg Treat Res 2024;106(5):284-295]

BACKGROUND:Laparoscopic splenectomy (LS), a treatment for both benign and malignant splenic diseases, can prove technically challenging in patients with massive splenomegaly. In particular, the optimal surgical modality for treating massive splenomegaly in children remains controversial. METHODS:The clinicopathologic data of 289 pediatric patients undergoing splenectomy for massive splenomegaly were studied in a retrospective analysis. Accordingly, the patients were classified into the LS surgery group and open splenectomy (OS) surgery group. In the laparoscopy cohort, they were separated into two subgroups according to the method of surgery: the multi-incision laparoscopic splenectomy (MILS) and the single-incision laparoscopic splenectomy (SILS) surgery groups, respectively. Patient demographics, clinical data, surgery, complications, and postoperative recovery underwent analysis. Concurrently, we compared the risk of adverse laparoscopic splenectomy outcomes utilizing univariable and multivariable logistic regression. RESULTS:The total operation time proved remarkably shorter in the OS group in contrast to the LS group (149.87 ± 61.44 versus 188.20 ± 52.51 min, P < 0.001). Relative to the OS group, the LS group exhibited lowered postoperative pain scores, bowel recovery time, and postoperative hospitalization time (P < 0.001). No remarkable difference existed in post-operation complications or mortality (P > 0.05). Nevertheless, the operation duration was remarkably longer in the SILS surgery group than in the MILS surgery group (200 ± 46.11 versus 171.39 ± 40.30 min, P = 0.02). Meanwhile, the operative duration of MILS and SILS displayed a remarkable positive association with splenic length. Moreover, the operative duration of SILS displayed a remarkable positive association with the age, weight, and height of the sick children. Splenic length proved an independent risk factor of adverse outcomes (P < 0.001, OR 1.378). CONCLUSIONS:For pediatric patients with massive splenomegaly who can tolerate prolonged anesthesia and operative procedures, LS surgery proves the optimal treatment regimen. SILS remains a novel surgery therapy which may be deemed a substitutional surgery approach for treating massive splenomegaly.

目的 研究后尿道瓣膜症后尿道扩张程度与病情严重程度及预后的相关性.方法 选取2018年1月～2020年12月于我院及广西医科大学第一附属医院收治的后尿道瓣膜症患儿80例,所有患儿均做排泄性膀胱尿道造影测量后尿道的长度及宽度,并行经尿道膀胱镜尿道瓣膜电切术.随访1年后根据预后情况分为预后不良组和预后良好组.比较两组患儿临床资料、排尿情况、尿流率、残余尿、尿路感染、膀胱形态、肾及输尿管积水、膀胱输尿管反流、肾功能等情况.应用多因素Logistic回归分析影响尿道瓣膜症术后预后情况的相关因素.结果 80例患儿中有6例脱落,有29例术后预后不良,仍存在排尿困难等情况,为预后不良组,剩余45例预后良好为预后良好组,预后不良的发生率为39.19％.预后不良组后尿道扩张严重程度、有膀胱壁增厚及小梁增生、合并膀胱功能障碍所占的比例均大于预后良好组,差异有统计学意义(P<0.05).多因素Lo-gistic回归分析显示,后尿道扩张长度(OR=8.880)、后尿道扩张宽度(OR=9.410)和有膀胱壁增厚及小梁增生(OR=5.375)是后尿道瓣膜症病情严重程度及影响术后预后的独立危险因素.结论 后尿道扩张严重程度和有膀胱壁增厚及小梁增生是影响后尿道瓣膜症术后预后的危险因素,早期监测有助于了解病情严重程度及调整治疗方案.

Abstract Background: As one of the most common diseases of acute abdomen, early diagnosis of acute appendicitis remains a vital issue. This study aims to explore the value of combined ultrasonography, Pediatric Appendicitis Score and C-reactive protein in the diagnosis and pathological types of appendicitis in children. Method: A total of 268 children with acute abdominal pain admitted to our center between January 2017 and January 2020 were retrospectively analyzed and divided into group acute appendicitis and group non-acute appendicitis based on the surgical findings and pathological findings. Group acute appendicitis was further divided into three groups based on the types of pathology, group simple appendicitis, group suppurative appendicitis and group gangrenous appendicitis. Results: Pediatric Appendicitis Score and level of C-reactive protein in group acute appendicitis were higher than group non-acute appendicitis (P < 0.05). The areas under the receiver operating characteristic curve of Pediatric Appendicitis Score, C-reactive protein and ultrasonography for acute appendicitis were 0.871, 0.777 and 0.897, respectively (P < 0.001). The sensitivity and negative predictive value of ultrasonography combined with Pediatric Appendicitis Score and C-reactive protein in diagnosing acute appendicitis were higher than ultrasonography and CRP, while the specificity and positive predictive value were lower (P＜0.05). The C-reactive protein in the acute complicated appendicitis was significantly higher than simple appendicitis, and the areas under the ROC curve of C-reactive protein and ultrasonography in diagnosing acute complicated appendicitis were 0.814(0.762-0.867) and 0.861(0.812-0.909). The sensitivity of ultrasonography combined with C-reactive protein in diagnosing acute complicated appendicitis was 98.21%, which was significantly higher than that of ultrasonography and CRP alone (P＜0.05). The sensibilities of ultrasonography for different pathological types of appendicitis were 78.95% for acute simple appendicitis, 81.97% for acute suppurative appendicitis and 92.16% for acute gangrenous appendicitis. The diagnostic results of ultrasonography for different pathological types of appendicitis in children were consistent with those of pathological examination (Kappa=0.888; P < 0.001). Conclusion: The combination of ultrasonography, Pediatric Appendicitis Score and C-reactive protein detection is helpful to the accurate diagnosis of acute appendicitis, and ultrasonography combined with CRP may contribute to diagnosing pathological type of appendicitis in children, providing important evidence for clinical diagnosis.

Objective:To explore the correlation between preoperative inflammation parameters and severity of acute appendicitis (AA) in children.Methods:From January 2017 to April 2021, 149 hospitalized AA children undergoing laparoscopic appendectomy were recruited as research subjects.According to the postoperative pathological results, they were assigned into two groups of uncomplicated appendicitis ( n=28) and complicated appendicitis ( n=121). The latter group included 85 cases of purulent appendicitis and 36 cases of gangrene appendicitis.Univariate analysis was performed for comparing the inter-group differences of baseline profiles and preoperative inflammatory parameters.Binary Logistic regression analysis was performed for determining the independent risk factors of complicated appendicitis.Finally receiver operating characteristic (ROC) curve was plotted for evaluating the diagnostic value of inflammatory parameters for complicated appendicitis. Results:In the preoperative uncomplicated appendicitis group and complicated appendicitis group, The number and proportion of fever cases or not was respectively[8 cases (28.6%) and 20 cases (71.4%)] vs.[66 cases (54.5%) and 55 cases (45.5%)], white blood cell count (WBC) (10.95±5.50) vs.(15.81±5.12)×10 9/L, neutrophil count percentage (NEUT%) (67.49±16.97) vs.(82.84±7.99)%, C-reactive protein (CRP) was (17.77±26.06) vs.(83.84±68.47)mg/L, CRP/ALB (albumin, ALB) were (0.61±1.13) vs.(1.97±1.78), prealbumin (PAB) (189.61±50.91) vs.(152.93±57.92)mg/L, and all above these difference was significant statistical ( P<0.05). Preoperative NEUT% ( OR=1.096, 95% CI: 1.027~1.170) and CRP( OR=1.045, 95% CI: 1.006~1.085) were independent risk factors for complicated appendicitis ( P<0.05). The areas under the curve of NRUT% and CRP were 0.801 and 0.839, respectively ( P<0.05). The critical preoperative NEUT% and CRP values for complex appendicitis were 77.75% and 28.27 mg/L respectively.The critical CRP value of 28.27mg/L was converted into a binary variable, and the calculated relative risk was 1.659 (95% CI: 1.321-2.083). Conclusion:Preoperative levels of NEUT% and CRP are valuable for predicting complicated appendicitis in children.When NEUT%≥77.75% or CRP≥28.27 mg/L occurs preoperatively, preoperative diagnosis of complicated appendicitis is more likely in AA children.Surgery should be promptly performed.

Background: There are many reports on the application of minimally invasive technology in correction of children's vesicoureteral junction obstruction (VUJO), but there is no report on the treatment of children's VUJO with the transumbilical laparoendoscopic single-site surgery (TU-LESS) Lich-Gregoir method. We aimed to comparatively analyze the therapeutic outcomes of transvesicoscopic ureteral reimplantation Cohen (TUR-C) procedure and TU-LESS Lich-Gregoir (TU-LESS-LG) procedure in pediatric VUJO. Materials and Methods: The data of 49 children with VUJO, admitted from January 2016 to January 2020, were retrospectively analyzed. Based on different surgical methods, they were divided into the TUR-C group (23 cases) and the TU-LESS-LG group (26 cases). Demographic characteristics, perioperative characteristics, postoperative complications, recovery of renal function, and improvement of hydronephrosis were compared between the two groups. Results: There were no statistical differences in demographic characteristics and preoperative data between the two groups. The TU-LESS-LG group was superior to the TUR-C group in terms of average operation time and postoperative hospital stay. There was no statistical difference between the two groups in terms of postoperative complications, postoperative recovery of renal function, and improvement of hydronephrosis. Conclusions: The two surgical methods can achieve a similar curative effect in the treatment of VUJO. The TU-LESS-LG procedure has more advantages of operation time, postoperative hospital stay, wider age range for selection of cases, megaureter tapering, and cosmetic incision, but the operation is more difficult. Clinical Trial Registration number: 2021(KY-E-048).

Background:Hirschsprung's disease (HD) is a commonly digestive malformation in children that usually requires surgery. This study aims to evaluate the short-term efficacy of conventional laparoscopic surgery (CLS), transumbilical single-hole laparoscopic surgery (TU-LESS), and robotic surgery (RS) in the treatment of Hirschsprung's disease. Methods:90 patients with Hirschsprung's disease undergone laparoscopic surgery at our center between 2015 and 2019, divided into three groups (group CLS, TU-LESS and RS), were retrospectively analysed. Results:CLS and TU-LESS group showed no significant difference in operation duration (P > 0.05) but shorter operation duration than the RS group (P < 0.05). RS group had highest overall SCAR scores, while TU-LESS group had the lowest one (P < 0.05). Other parameters such as operative blood loss, hospital stays, recovery time of digestive function, postoperative complications had no significant difference among the three groups (P > 0.05). Conclusion:The three surgical methods for HD revealed similar efficacy, where TU-LESS and CLS spent less time than RS; TU-LESS led to the most aesthetic effect, followed by CLS and RS.

Vesicoureteral reflux (VUR) is a common malformation of urinary system in children. Endoscopic injection has been a first choice for primary low-level VUR in Europe and North America. It is gaining popularity in China. Dextranomer/hyaluronic acid copolymer (Dx/HA) is widely known as a safe and effective filler. Hydrodistention implantation technique (HIT) and Double HIT injection are commonly applied. With the curative properties of preventing and controlling urinary tract infections, minimizing renal scarring and avoiding renal function damage, endoscopic injection treatment is safe, effective and mini-invasive. Its overall success rate is similar to that of surgery.

Background: Wilms tumour is the most common childhood renal cancer that requires development of better treatments. Nitidine chloride, a Chinese traditional medicine, could have therapeutic potential for Wilms tumour, however there have been no studies to date. Methods: In-house RNA-seq was performed and public RNA-seq plus microarrays datasets were incorporated for identifying the landscape of differentially expressed genes (DEGs) in Wilms tumour. Meanwhile, the potential targets of nitidine chloride in Wilms tumour were acquired through combined analysis of computational prediction and DEG, which was further validated by molecular docking. The molecular mechanism of nitidine chloride-putative targets was investigated through transcription factors and gene set enrichment analysis. Findings: As a result, a total of 1819 upregulated DEGs and 1942 downregulated DEGs were identified in Wilms tumour. Twenty-three putative targets of nitidine chloride in Wilms tumour were determined and nine showed strong binding force with nitidine chloride in molecular docking. IMPDH2 and MAP4K4 exhibited significant value of prognostic signification. The upregulation of these putative targets in Wilms tumour may be induced by transcription factors (TFs) such as MYC, E2F1, SOX2, MYCN, MITF and CREM. The hub putative targets of nitidine chloride in Wilms tumour were enriched in pathways such as cell cycle, chemokine signaling pathway, glycolysis and gluconeogenesis. Interpretation: In conclusion, the putative pharmacologic targets and molecular pathways of nitidine chloride in Wilms tumour were unveiled in this study. Further research is necessary for confirming the therapeutic effect of nitidine chloride in Wilms tumour. Funding: This work was supported by Natural Science Foundation of Guangxi, China (2018GXNSFAA294025); Guangxi Medical High-level Key Talents Training "139" Program (2020); Guangxi Medical University Training Program for Distinguished Young Scholars ; Medical Excellence Award Funded by the Creative Research Development Grant from the First Affiliated Hospital of Guangxi Medical University; Guangxi Degree and Postgraduate Education Reform and Development Research Projects, China (JGY2019050); Innovation Project of Guangxi Graduate Education; Guangxi Zhuang Autonomous Region Health and Family Planning Commission Self-financed Scientific Research Project (Z20200317); Innovation Project of Guangxi Graduate Education (YCSW2021121Declaration of Interests: The authors have declared no competing interests.Ethics Approval Statement: All patients provided informed consent and approval of this research project was granted by the medical ethics committee of the First Affiliated Hospital of Guangxi Medical University (2020-ky-guoji-135).All experiments involving animals were conducted according to the ethical policies and procedures approved by the ethics committee of the First Affiliated Hospital of Guangxi Medical Univeristy (Approval no. 2020-ky-guoji-135).

Purpose: The molecular mechanisms and signal pathways of ferroptosis in hepatoblastoma (HB) have not yet been clarified. In previous studies, activating transcription factor 3 (ATF3) was reported to be correlated with several tumors, but the clinical significance of ATF3 has never been determined. Herein, we investigated the clinicopathological value and mechanisms of ATF3 in regulating ferroptosis in HB. Methods: The mRNA microarray and RNA-sequencing data of 402 samples from our hospital and public databases were used to estimate ATF3 expression and assess its clinical role in HB. The standard mean difference (SMD) and summary receiver operating characteristic curves were utilized to judge the discrimination ability of ATF3 between HB and nonHB liver tissues. We examined the expression variation of ATF3 in HB cells after the treatment with erastin. We also predicted the target genes of ATF3 as a transcriptional factor from public Chromatin Immunoprecipitation-sequencing data and selected the ferroptosisrelated genes for a signaling pathway analysis. Results: In ten series, the pooled SMD for ATF3 was -0.91, demonstrating that ATF3 expression was predominantly lower in HB than in non-HB liver tissues. ATF3 downregulation showed moderate potential to distinguish HB from non-HB liver tissues (area under curves = 0.83, 95% confidence interval = 0.79-0.86). Altogether, 4855 putative targets of ATF3 as a transcriptional factor were collected, among which, 60 genes were ferroptosisrelated. Conclusion: The down-regulated ATF3 expression may play a vital role in the occurrence of HB possible partially by regulating ferroptosis.

Hepatoblastoma is a kind of extreme malignancy frequently diagnosed in children. Although surgical resection is considered as the first-line treatment for hepatoblastoma, a relatively large population of patients have lost the preferred opportunity for surgery. Administration of locoregional ablation enables local tumor control but with the deficiency of insufficient ablation, residual tumor, and rapid progression. In this study, we integrated 219 hepatoblastoma and 121 non-cancer liver tissues to evaluate the expression of NR2F6, from which a higher NR2F6 level was found in hepatoblastoma compared with non-cancer livers with a standard mean difference (SMD) of 1.04 (95% CI: 0.79, 1.29). The overexpression of NR2F6 also appeared to be an efficient indicator in distinguishing hepatoblastoma tissues from non-cancer liver tissues from the indication of a summarized AUC of 0.90, with a pooled sensitivity of 0.76 and a pooled specificity of 0.89. Interestingly, nude mouse xenografts provided direct evidence that overexpressed NR2F6 was also detected in residual tumor compared to untreated hepatoblastoma. Chromatin immunoprecipitation-binding data in HepG2 cells and transcriptome analysis of HepG2 xenografts were combined to identify target genes regulated by NR2F6. We finally selected 150 novel target genes of NR2F6 in residual tumor of incomplete ablation, and these genes appeared to be associated with the biological regulation of lipid metabolism-related pathway. Accordingly, targeting NR2F6 holds a therapeutic promise in treating residual recurrent hepatoblastoma after incomplete ablation.

Purpose This study was performed to establish and validate a nomogram for predicting the overall survival in children with neuroblastoma. Methods The latest clinical data of neuroblastoma in Surveillance, Epidemiology, and End Results (SEER) database was extracted from 2000 to 2016. The cases included were randomly divided into training and validation cohorts. The survival curves were drawn with a Kaplan-Meier estimator to investigate the influences of certain single factors on overall survival. Also, least absolute shrinkage and selection operator regression was applied to further select the prognostic variables for neuroblastoma. Additionally, receiver operating characteristic (ROC) curves and calibration curves were used to evaluate the accuracy of the nomogram. Results In total, 1,262 patients were collected and 8 independent prognostic factors were achieved, including patients' age, sex, race, tumor grade, radiotherapy, chemotherapy, tumor site, and tumor size. Then we constructed a nomogram by using the data of the training cohort with 886 cases. Subsequently, the nomogram was validated internally and externally with 886 and 376 cases, respectively. The internal validation revealed that the area under the curves (AUC) of ROC curves of 1-, 3-, and 5-year overall survival were 0.69, 0.78, and 0.81, respectively. Accordingly, the external validation also showed that the AUC of 1-, 3-, and 5-year overall survival were all ≥0.69. Both methods of validation demonstrated that the predictive calibration curves were consistent with standard curves. Conclusion The nomogram possess the potential to be a new tool in predicting the survival rate of neuroblastoma patients.

We explored the difference in expression of tubulin alpha 1b (TUBA1B) between Wilms' tumor (WT) and normal tissues (NT) from in-house patients and databases, to determine TUBA1B expression in WT and the predictive pathways of coexpressed genes. In-house RNA-sequencing data were performed with WT and NT from three patients from our institute. Other four RNA-sequencing and microarray data were also downloaded from multiple public databases. The TUBA1B expression between WT and NT was analyzed by Student'st-test and meta-analysis. The correlation between the expression of TUBA1B and other genes in each study was analyzed. Genes with p<0.05 and r>0.5 were considered as the coexpressing genes of TUBA1B. Overlapping the coexpressed genes of the five studies, including three in-house patients (3 WTvs.3 NT), GTEx-TARGET (126 WTvs.51 NT), GSE2172 (18 WTvs.3 NT), GSE11024 (27 WTvs.12 NT), and GSE73209 (32 WTvs.6 NT), were performed with limma and VennDiagram packages in R software. The website of WEB-based GEne SeT AnaLysis toolkit were used to analyze the gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) functional annotations for the overlapped genes. The results showed that the relative expression of TUBA1B in WT tissues from in-house three patients was 280.0086, 141.7589, and 303.8292 and that in NT was 16.5836, 104.8141, and 12.79 (3 WTvs.3 NT, p=0.0285, ROC=100%,SMD=2.74). Student'st-test and meta-analysis in all studies revealed that the expression of TUBA1B was upregulated in WT tissues compared to that in NT (p<0.05, SMD=2.89,sROC=0.98). Finally, the research identified the expression of TUBA1B in WT tissues was significantly upregulated than that in NT. The coexpressed genes of TUBA1B were enriched in the pathway of DNA replication, mismatch repair, cell cycle, pathogenic Escherichia coli infection, and spliceosome.

目的 探讨硬膜内、外腔联合松解术治疗脊髓栓系综合征的临床疗效.方法 回顾性分析1998年1月至2016年6月手术治疗的286例脊髓栓系综合征患儿的临床资料,采用常规手术治疗77例(常规组),采用硬膜内、外腔联合松解术治疗209例(联合松解组).结果 常规组术后并发症发生率(10.4％,8/77)与联合松解组(6.2％,13/209)无统计学差异(P＞0.05).常规组术后6个月Hoffman分级较术前无明显差异(P＞0.05).联合松解组术后6个月Hoffman分级较术前明显改善(P＜0.05),而且明显优于常规组(P＜0.05).术后6个月,常规组显效7例,改善6例,稳定43例,加重21例;联合松解组显效30例,改善32例,稳定132例,加重15例;联合松解组疗效明显优于常规组(P＜0.05).结论 对于脊髓栓系综合征,在硬膜内腔脊髓栓系松解的基础上,探查硬膜外腔,松解硬膜外腔粘连栓系、离断外终丝,可进一步提高手术效果.

BACKGROUND Wilms tumor, or nephroblastoma, is a malignant pediatric embryonal renal tumor that has a poor prognosis. This study aimed to use bioinformatics data, RNA-sequencing, connectivity mapping, molecular docking, and ligand-protein binding to identify potential targets for drug therapy in Wilms tumor. MATERIAL AND METHODS Wilms tumor and non-tumor samples were obtained from high throughput gene expression databases, and differentially expressed genes (DEGs) were analyzed using the voom method in the limma package. The overlapping DEGs were obtained from the intersecting drug target genes using the Connectivity Map (CMap) database, and systemsDock was used for molecular docking. Gene databases were searched for gene expression profiles for complementary analysis, analysis of clinical significance, and prognosis analysis to refine the study. RESULTS From 177 cases of Wilms tumor, there were 648 upregulated genes and 342 down-regulated genes. Gene Ontology (GO) enrichment analysis showed that the identified DEGs that affected the cell cycle. After obtaining 21 candidate drugs, there were seven overlapping genes with 75 drug target genes and DEGs. Molecular docking results showed that relatively high scores were obtained when retinoic acid and the cyclin-dependent kinase inhibitor, alsterpaullone, were docked to the overlapping genes. There were significant standardized mean differences for three overlapping genes, CDK2, MAP4K4, and CRABP2. However, four upregulated overlapping genes, CDK2, MAP4K4, CRABP2, and SIRT1 had no prognostic significance. CONCLUSIONS RNA-sequencing, connectivity mapping, and molecular docking to investigate ligand-protein binding identified retinoic acid and alsterpaullone as potential drug candidates for the treatment of Wilms tumor.

Objective To explore the experiences of diagnosing and treating giant omphalocele in children so as to improve its cognition among pediatric surgeons.Methods The clinical data were collected from one 9-year-old child with giant ompbalocde.The databases of Pubmed,SpringerLink,Google Scholar,CBM,CNKI,Wanfang and CQVIP were searched for the relevant publications using such key words as giant omphalocele,children and delayed.Also a systematic review of literatures was performed.Results For 9 eligible children,the age range was 17 to 180 months.The largest area of abdominal wall defect was 35.0 cm × 25.0 cm and the minimum 9.4 cm × 7.7 cm.Concurrent conditions included tetralogy of the Fallot & bilateral inguinal hernia (n =1),patent ductus arteriosus (n =1),pelvic ectopic kidney & sternal division (n =1),right breast deficiency & dysplasia of right thoracic muscle (n =1).Repairing was one-stage (n =7) and staged (n =2).A tissue expander was placed in intra-abdominal compartment in one case while another case covered with biomaterial patch.One case experienced transient hypertension while another required postoperative mechanical ventilation for 10 days.Conclusions The treatment options for giant omphalocele are diverse.When one-stage procedure is not feasible or carries a high risk,topical care of omphalocele sac is more reasonable.Surgery should be performed immediately upon a complete epithelialization of omphalocele sac.The goal is to utilize proper materials for reconstructing abdominal wall to optimize function and appearance.