Long term outcomes of Cohen’s cross trigonal reimplantation for primary vesicoureteral reflux in poorly functioning kidney

BACKGROUND Open ureteric reimplantation by cross trigonal technique described by Cohen is considered a common surgical option for correction of vesicoureteral reflux(VUR). There is a lack of evidence in literature though for what happens to such kidneys, in the long run, particularly those which are poorly functioning.AIM To assess the long-term outcomes of ureteric reimplantation in poorly functioning kidneys in children with unilateral primary VUR.METHODS Children with unilateral primary VUR and a relative renal function of less than 35% who underwent open or laparoscopic ureteric reimplantation between January 2005 and January 2017 were included in the study. Patients who had a follow up of less than five years were excluded. Preoperative evaluation consisted of a voiding cystourethrogram and Dimercaptosuccinic acid(DMSA) scan. In the follow-up period, patients underwent a diuretic scan at 6 weeks and 6 months.Follow up ultrasound was done for change in grade of hydronephrosis and retrovesical ureteric diameter. Subsequent follow up was done at 6 monthly intervals with evaluation for proteinuria and hypertension and any recurrent urinary tract infection(UTI). For assessment of cortical function, DMSA was repeated annually for 5 years after surgery. A paired-samples t-test was used to test the mean difference of DMSA between pre-post observations.RESULTS During this period, 36 children underwent ureteric reimplantation for unilateral primary VUR. After excluding those with insufficient follow-up, 31 were included in the analysis. Most of the patients were males(n = 26/31, 83.8%). Patient’s age(mean ± SD, range) was 5.21 ± 3.71, 1-18 years. The grades of VUR were grade Ⅱ(1patient), grade Ⅲ(8 patients), grade Ⅳ(10 patients), and grade Ⅴ(12 patients). The pre and postoperative DMSA was 24.064 ± 12.02 and 24.06 ± 10.93, which was almost the same(statistically equal, paired-samples t-test: P = 0.873). The median(range) follow-up duration was 82(60-120)mo. One patient had persistent reflux after surgery(preoperative: grade Ⅳ, postoperative: grade Ⅲ), and the very same patient developed recurrent UTI. The difference in the preoperative and postoperative DRF was less than 10% in 29 patients. In one patient, the DRF decreased by 17%(22% to 05%) while in another patient, the DRF increased by 12%(25% to 37%) after surgery. None of the patients had an increase in scarring after surgery. 15% of patients were hypertensive before surgery and all of them continued to be hypertensive after surgery while none developed hypertension after surgery. None of the patients had significant proteinuria(> 150 mg/d) during the follow-up period.CONCLUSION Children with unilateral primary VUR and poorly functioning kidney maintain the renal function over the long term in most cases. Hypertension and proteinuria do not progress over time in these patients.

Does endoscopic sclerotherapy in filarial chyluria affect renal function and morphology? A prospective study using dimercaptosuccinic acid renal scan

Objective:To look for change in relative renal function and document renal scarring following endoscopic renal pelvic instillation sclerotherapy(RPIS)in patients with chyluria by dimercaptosuccinic acid(DMSA)renal scan.Methods:A prospective study was performed between November 2015 and September 2016.All patients with biochemically documented chyluria who underwent RPIS using either 1%-silver nitrate or 0.1%-povidine iodine were included.Patients received either 3-,6-or 9-doses.DMSA renal scan was performed before and 2e3 months after sclerotherapy.Results:Of the 34 patients,22 were males.Mean age was 41.08±16.64 years(range,15-70 years).Thirty-two patients(94.1%)responded to therapy while two did not respond even after 9-doses.Average follow-up was 8.94±3.70 months.The mean relative renal function(preinstillation)of normal kidney was 50.76%±3.55%while that of affected renal unit(side of instillation)was 49.20%±3.44%(range,43.0%-61.0%).After instillation therapy,the mean relative renal function of normal side was 52.26%±3.57%while that of affected renal unit was 47.50%±3.56%(range,41.0%-54.0%).The relative renal function did not change>5%from the baseline value in any patient except one(in which the differential function increased paradoxically by 12%).Two patients developed renal scar in post-instillation renal scan.Conclusion:Endoscopic sclerotherapy in chyluria is safe and effective.The relative renal function does not deteriorate by more than 5%.There is a small risk of development of renal scar.More studies involving larger number of patients are needed to answer this dilemma.

Estimation of Relative Ecological Value of Returning Farmland to Forest & Mountain Enclosure for Grazing Prohibition——A case study in Yongxing Township of Jingyuan County,Gansu Province

[Objective]Returning farmland to forest and mountain enclosure for grazing prohibition ecological effect and economy rationality were explored.[Methods]A case study of returning farmland to forest and barren hills grazing prohibition in Yongxing Township of Jingyuan County was used to discuss and estimate the relative ecological function and relative ecological value.[Results]1）The ecological value of the forest of returning farmland was far more than the sum of the ecological value of farm crops and the agricultural output,and also more than the national subsidy standard.So the state policy of returning farmland to forests is not only favorable to local eco-environment restoration,but also reasonable in economic development.2）The ecological value of mountain enclosure for grazing prohibition was less than the opportunity cost of prohibiting grazing,also less than the national subsidy standard.The sum of the relative ecological value of prohibiting grazing and the state subsidies was more than the opportunity cost of prohibiting grazing.However,the ecological value of new vegetation through returning farmland to forest project was greater than the China＇s average ecological value of grassland.[Conclusion]The relative ecological value can be used to solve the problems in the equivalent conversion among various ecological indexes and between ecological indexes and economic indexes.

INTEGRATION OF A ZONAL FUNCTION RELATED TO THE LOCAL HARMONIC ANALYSIS ON SPHERES

In studying Local harmonic analysis on the sphere S',R.S.Strichartz introduced certain zonab functionsid(x,y))which satisfy the equation

Relations and Functions

Using ordered pairs,we can formulate themathematical theory of relations in set-theoreticlanguage.By a relation we mean here something likemarriage (between men and women) or belonging(between elements and sets).Looking at any specific relation,such asmarriage for instance,we might be tempted toconsider certain ordered pairs (x,y),namely justthose for which x is a man,y is a woman,and x ismarried to y.We have not yet seen the definition

A comparative study of pancreatic endocrine function and related metabolism after long-term survival between the patients with combined kidneypancreas transplantation vs those with combined en bloc ' liver-pancreas transplantation

Objective To compare the effects of combined en bloc liver - pancreas transplantation ( LPT) with portal vein drainage and simultaneous combined kidney - pancreas transplantation ( KPT) with systemic venous drainage on the pancreatic endocrine function and related me-

Neuroprotection against vascular dementia after acupuncture combined with donepezil hydrochloride：P300 event related potential

Acupuncture can be used to treat various nervous system diseases.Here,168 vascular dementia patients were orally administered donepezil hydrochloride alone（5 mg/day,once a day for 56 days）,or combined with acupuncture at Shenting（DU24）,Tianzhu（BL10）,Sishencong（Extra）,Yintang（Extra）,Renzhong（DU26）,Neiguan（PC6）,Shenmen（HT7）,Fengchi（GB20）,Wangu（GB12） and Baihui（DU20）（once a day for 56 days）.Compared with donepezil hydrochloride alone,P300 event related potential latency was shorter with an increased amplitude in patients treated with donepezil hydrochloride and acupuncture.Mini-Mental State Examination score was also higher.Moreover,these differences in P300 latency were identified within different infarcted regions in patients treated with donepezil hydrochloride and acupuncture.These findings indicate that acupuncture combined with donepezil hydrochloride noticeably improves cognitive function in patients with vascular dementia,and exerts neuroprotective effects against vascular dementia.

A Sound Quality Objective Evaluation Method Based on Auditory Peripheral Simulation Model

Based on auditory peripheral simulation model, a new Sound Quality Objective Evaluation (SQOE) method is presented,which can be used to model and analyze the impacts of head, shoulder and other parts of human body on sound wave trans-mission.This method employs the artificial head technique, in which the head related transfer function was taken into account tothe outer ear simulation phase.First, a bionic artificial head was designed as the outer ear model with considering the outersound field in view of theory and physical explanations.Then the auditory peripheral simulation model was built, which mimicsthe physiological functions of the human hearing, simulating the acoustic signal transfer process and conversion mechanismsfrom the free field to the peripheral auditory system.Finally, performance comparison was made between the proposed SQOEmethod and ArtemiS software, and the verifications of subjective and objective related analysis were made.Results show thatthe proposed method was economical, simple, and with good evaluation quality.

Interval Estimation in a Two Parameter Weibull Distribution Based on Type-2 Censored Data

In this paper, we consider the construction of the approximate profile- likelihood confidence intervals for parameters of the 2-parameter Weibull distribution based on small type-2 censored samples. In previous research works, the traditional Wald method has been used to construct approximate confidence intervals for the 2-parameter Weibull distribution under type-2 censoring scheme. However, the Wald technique is based on normality assumption and thus may not produce accurate interval estimates for small samples. The profile-likelihood and Wald confidence intervals are constructed for the shape and scale parameters of the 2-parameter Weibull distribution based on simulated and real type-2 censored data, and are hence compared using confidence length and coverage probability.

Confidence Intervals for the Binomial Proportion: A Comparison of Four Methods

This paper presents four methods of constructing the confidence interval for the proportion p of the binomial distribution. Evidence in the literature indicates the standard Wald confidence interval for the binomial proportion is inaccurate, especially for extreme values of p. Even for moderately large sample sizes, the coverage probabilities of the Wald confidence interval prove to be erratic for extreme values of p. Three alternative confidence intervals, namely, Wilson confidence interval, Clopper-Pearson interval, and likelihood interval, are compared to the Wald confidence interval on the basis of coverage probability and expected length by means of simulation.

Cognitive function in ultra high-risk subjects and first degree relatives with schizophrenia

Objective To explore the characteristics of cognitive impariment in ultra high-risk subjects and familial high risk group with schizophrenia.Methods The cognitive function was assessed by the Trail Marking Test,Symbol Coding(SC),Hopkins Verbal Learning Test-Revised(HVLT-R),Brief Visual spatial Memory

BANDPASS FILTERING ANALYSIS WITH GAUSSIAN WEIGHTING FUNCTION IN TWO-DIMENSIONAL FIELDS

This paper examines the response of the bandpass filter with Gaussian weighting function to arbitrary two-dimensional fields and proposes a new concept of relative response function.Based on the properties of relative re- sponse function,satisfactory weighting parameters C_1 and C_2 are obtained.By studying two cases,the procedure of us- ing structure function curves to choose the maximum response wavelength is formulated.It is shown that bandpass fil- tering offers some improvements to the analysis and forecast of mesoscale weather processes.

On Functional Relations for the Alternating Analogues of Tornheim's Double Zeta Function

In this paper,new proofs of two functional relations for the alternating analogues of Tornheim's double zeta function are given.Using the functional relations,the author gives new proofs of some evaluation formulas found by Tsumura for these alternating series.

THE RELATION OF PARATHYROID FUNCTION TO PREGNANCY-INDUCED HYPERTENTION

Parathyrin (PTH) and calcitonin were measured with radioimmunoassay in 39 cases of pregnancy-induced hypertension (PIH) in late pregnancy, 76 cases in normal early pregnancy and 278 cases in late pregnancy without PIH. Markedly increased PTH was noted in the women in late pregnancy, indicating the state of secondary hyperparathyroidism. PTH values in the women in late pregnancy with PIH were higher than those in the normal early pregnancy group, but lower than those in the women in late pregnancy without PIH. The difference between PTH values in the PIH group and late pregnancy without PIH group was of statistical significance (P<0.05), while no significant difference was seen between calcitonin values of the two groups (P > 0.05). The results suggest that the pathogenesis of PIH may be related to the function of parathyroid.

Relation between sound transfer function from diffuse sound field to the eardrum and temporary threshold shift

Twelve volunteers with normal hearing (9 males and 3 females) participated in this work The sound transfer functions (STFS) from diffuse sound field to the subject's eardrums were measured and correlated to the temporary threshold shift (TTS) due to fiffuse-exposure.A probe tube with a miniature microphone was used for STF measurements in which successive 1/3 oct bandwidth random noise with central frequency from 0.25 kKz to 8 kHz were used. The subjects were divided into two groups, with the STF maxima at 2 kHz and 4 kHz respectively Pre- and post- exposure sweep Bekesy audiograms were recorded and the temporary thresh old shift calctilated as the difference between the two. Frequency of the maximum TTS was correlated to that of the maximum STF. The average TTS was very small or zero at frequen cies below the band noise exposure , but was noticeable even at the highest measured frequency (8 kHz) for beyond the noise band. Also individual differences in STF were found at frequencies between 2 kHz and 4 kHz

The intertextuality of argumentation:a semiotic approach to academic writing in higher education

The importance of argumentation in academic writing,while historically recognised,has arguably lost prominence alongside the rapid expansion of higher education since the early 1990s in the UK.This has been exacerbated by an increasingly prevalent technological intervention in teaching and learning processes.With this as a background,this article presents a semiotic analysis of student dissertation extracts to illustrate the role of intertextuality in governing interpretative,evaluative,and concluding propositions in argumentation.Each proposition is perceived as indexed to syntactical compositionality by which a previous proposition elicits a present one that awaits a future one,thus forming a line of argument.The analysis teases out what is at stake concerning the interdependence of signifying codes in textual relations and functions.This brings into view a network of sign actions that lends itself to instances of signification in mediating and coordinating propositions in argumentation.The article concludes with reflection on the medium of English as a lingua franca for studies in higher education,highlighting a semiotic understanding of the intertextuality of argumentation in academic writing.

Soft Fault Diagnosis for Analog Circuits Based on Slope Fault Feature and BP Neural Networks

Fault diagnosis is very important for development and maintenance of safe and reliable electronic circuits and systems. This paper describes an approach of soft fault diagnosis for analog circuits based on slope fault feature and back propagation neural networks (BPNN). The reported approach uses the voltage relation function between two nodes as fault features; and for linear analog circuits, the voltage relation function is a linear function, thus the slope is invariant as fault feature. Therefore, a unified fault feature for both hard fault (open or short fault) and soft fault (parametric fault) is extracted. Unlike other NN-based diagnosis methods which utilize node voltages or frequency response as fault features, the reported BPNN is trained by the extracted feature vectors, the slope features are calculated by just simulating once for each component, and the trained BPNN can achieve all the soft faults diagnosis of the component. Experiments show that our approach is promising.