Objective:Secondary pyeloplasty for recurrent ureteropelvic junction obstructions may be a safe and feasible surgical option for patients.This study aimed to demonstrate outcomes of utilizing a non-transecting buccal ...Objective:Secondary pyeloplasty for recurrent ureteropelvic junction obstructions may be a safe and feasible surgical option for patients.This study aimed to demonstrate outcomes of utilizing a non-transecting buccal mucosa graft ureteroplasty for management of recurrent ureteropelvic junction obstruction after prior failed pyeloplasty.Methods:We performed a retrospective review of our Collaborative of Reconstructive Robotic Ureteral Surgery database for all consecutive patients who underwent buccal mucosa graft ureteroplasty between April 2012 and June 2022 for management of recurrent ureteropelvic junction obstructions after prior failed pyeloplasty.The primary outcome included surgical success which was defined as the absence of flank pain and no obstruction on imaging.Results:Overall,ten patients were included in our analysis.The median stricture length was 2.5(interquartile range[IQR]1.8-4.0)cm.The median operative time was 230.5(IQR 199.5-287.0)min and median estimated blood loss was 50.0(IQR 28.8-102.5)mL.At a median follow-up of 10.3(IQR 6.2-14.8)months,80%of patients were surgically successful and there were no major(ClavieneDindo Grade>2)complications.Conclusion:Buccal mucosa graft ureteroplasty is a valuable non-transecting surgical option for patients with recurrent ureteropelvic junction obstructions who failed prior pyeloplasty and has comparable outcomes to the literature regarding standard transecting techniques.展开更多
BACKGROUNDEctopic thyroid at the base of the tongue is a rare congenital condition, and it iseven rarer to have clinical symptoms and require surgical intervention. Thisdisease is easily misdiagnosed preoperatively. T...BACKGROUNDEctopic thyroid at the base of the tongue is a rare congenital condition, and it iseven rarer to have clinical symptoms and require surgical intervention. Thisdisease is easily misdiagnosed preoperatively. This article reports the diagnosis,surgical treatment, and follow-up of a case of lingual thyroid.CASE SUMMARYThe patient was a 54-year-old woman who presented with laryngeal foreign bodysensation and dysphagia for 20 d. The lingual thyroid was considered for generalexamination, and surgery was performed to transpose the lingual thyroid to theright submaxillary region. Pathological analysis confirmed thyroid tissue. Thepatient experienced complete remission after surgery, but developed hypothyroidismand required thyroid hormone replacement therapy, and her thyroidfunction gradually recovered over time.CONCLUSIONWe report a rare case of lingual thyroid with marked laryngeal foreign body sensationand dysphagia. Symptoms were completely relieved by transposition surgerybut postoperative hypothyroidism developed.展开更多
Objective:The objective of the study was to compare the outcome of tunica albuginea urethroplasty(TAU)and buccal mucosa graft(BMG)urethroplasty for anterior urethral stricture.Methods:Thirty patients who met the inclu...Objective:The objective of the study was to compare the outcome of tunica albuginea urethroplasty(TAU)and buccal mucosa graft(BMG)urethroplasty for anterior urethral stricture.Methods:Thirty patients who met the inclusion criteria were randomised into two groups:TAU(Group A)and BMG urethroplasty(Group B).Surgical outcome was evaluated with pre-and post-operative work-up involving retrograde urethrogram,voiding cystourethrogram,uroflowmetry,and urethroscopy.Patients were followed up till 1 year.Results:Mean duration of surgery was statistically significant between two groups(p=0.0005).Maximum urine flow rate was comparable when compared between two groups(p=0.22)but statistically significant when compared pre-and post-operatively(p<0.001).At follow-up of 1 year,the successful outcomes were 80% in Group A and 87%in Group B.A total of five patients who had unsuccessful results required redo urethroplasty.Complications were minimal in both the groups.Conclusion:TAU provides outcomes equivalent to those of BMG urethroplasty.TAU has less operative time,easy to perform,and beneficial in patients with poor oral hygiene.展开更多
Objective:To describe the outcome of female anterior wall(pubic side)onlay urethroplasty with buccal mucosal graft using laterally extended surgical dissection in patients with previously failed minimally invasive tec...Objective:To describe the outcome of female anterior wall(pubic side)onlay urethroplasty with buccal mucosal graft using laterally extended surgical dissection in patients with previously failed minimally invasive techniques.Methods:From January 2016 to April 2018,17 symptomatic patients with previously failed minimally invasive procedures were enrolled in the study.The diagnosis of urethral stricture was confirmed based on a combination of patients’symptoms,post-void residual urine,video-urodynamics,and cystoscopy.Urethroplasty with lower lip mucosal graft was performed using the modified laterally extended dissection.Patients were evaluated pre-operatively and 12-month post-operatively with the American Urological Association symptom score,post-void residual urine,and maximum flow rate.Results:Despite the previously failed minimally invasive procedures,urethroplasty with lower lip buccal graft and laterally extended dissection resulted in favorable outcomes(success rateZ94%).The meanstandard deviation of American urological association symptom score improved from pre-operative levels at the 12-month post-operative follow-up(25.823.97 to 10.885.57);so did postvoid residual urine(71.1274.98 mL to 15.0028.30 mL),and maximum flow rate(7.881.72 mL/s to 25.825.59 mL/s)with all statistically significant(p<0.05).Conclusion:The current study showed that female urethroplasty with buccal graft could be highly successful in experienced hands.An anterior approach could be superior to the posterior one due to higher mechanical support and lower sacculation rate.A laterally extended incision may improve visualization and better graft placement by providing wider working space.The results should be evaluated in the future studies with larger sample size.展开更多
随着互联网信息的发展,如何有效地表示不同语言所含的信息已成为自然语言处理(Natural Language Processing,NLP)领域的一项重要任务.然而,很多传统的机器学习模型依赖在高资源语言中进行训练,无法迁移到低资源语言中使用.为了解决这一...随着互联网信息的发展,如何有效地表示不同语言所含的信息已成为自然语言处理(Natural Language Processing,NLP)领域的一项重要任务.然而,很多传统的机器学习模型依赖在高资源语言中进行训练,无法迁移到低资源语言中使用.为了解决这一问题,结合迁移学习和深度学习模型,提出一种多语言双向编码器表征量(Multi-lingual Bidirectional Encoder Representations from Transformers,M-BERT)的迁移学习方法.该方法利用M-BERT作为特征提取器,在源语言领域和目标语言领域之间进行特征转换,减小不同语言领域之间的差异,从而提高目标任务在不同领域之间的泛化能力.首先,在构建BERT模型的基础上,通过数据收集处理、训练设置、参数估计和模型训练等预训练操作完成M-BERT模型的构建,并在目标任务上进行微调.然后,利用迁移学习实现M-BERT模型在跨语言文本分析方面的应用.最后,在从英语到法语和德语的跨语言迁移实验中,证明了本文模型具有较高的性能质量和较小的计算量,并在联合训练方案中达到了96.2%的准确率.研究结果表明,该文模型实现了跨语言数据迁移,且验证了其在跨语言NLP领域的有效性和创新性.展开更多
To evaluate the effect of proteolytic enzymes on the absorption of insulin in the buccal mucosa, the trichloroacetic acid (TCA) method was used to estimate the degradation of insulin under different conditions in the ...To evaluate the effect of proteolytic enzymes on the absorption of insulin in the buccal mucosa, the trichloroacetic acid (TCA) method was used to estimate the degradation of insulin under different conditions in the buccal mucosal homogenates. In vivo experiments estimating the enhancement of hypoglycaemic effect by enzyme inhibitors were also conducted. The results showed that proteolytic enzymes in the buccal mucosa were less active than in the intestine. Bacitracin, aprotinin and sodium deoxycholate could inhibit the degradation of insulin in the buccal mucosal homogenates. The degradation of insulin in buccal mucosal homogenates of normal hamsters was smaller than that of diabetic hamsters. In vivo experiments of hypoglycaemia supported the in vitro results. When given buccally, bacitracin, aprotinin and sodium deoxycholate could increase the relative pharmacological bioavailability of insulin. When co-administered with aprotinin(0.1%), bacitracin(0.5%) and sodium deoxycholate(5%), the relative pharmacological bioavailabilities of insulin were 4.84%, 6.60% and 14.95% respectively. The in vitro and in vivo results suggest that proteolytic enzymes are present in the buccal mucosa, which limit absorption of insulin. Co-administration with some enzyme inhibitors can improve the bioavailability of insulin via buccal delivery and sodium deoxycholte is more efficient than some enzyme inhibitors used for improving buccal absorption.展开更多
文摘Objective:Secondary pyeloplasty for recurrent ureteropelvic junction obstructions may be a safe and feasible surgical option for patients.This study aimed to demonstrate outcomes of utilizing a non-transecting buccal mucosa graft ureteroplasty for management of recurrent ureteropelvic junction obstruction after prior failed pyeloplasty.Methods:We performed a retrospective review of our Collaborative of Reconstructive Robotic Ureteral Surgery database for all consecutive patients who underwent buccal mucosa graft ureteroplasty between April 2012 and June 2022 for management of recurrent ureteropelvic junction obstructions after prior failed pyeloplasty.The primary outcome included surgical success which was defined as the absence of flank pain and no obstruction on imaging.Results:Overall,ten patients were included in our analysis.The median stricture length was 2.5(interquartile range[IQR]1.8-4.0)cm.The median operative time was 230.5(IQR 199.5-287.0)min and median estimated blood loss was 50.0(IQR 28.8-102.5)mL.At a median follow-up of 10.3(IQR 6.2-14.8)months,80%of patients were surgically successful and there were no major(ClavieneDindo Grade>2)complications.Conclusion:Buccal mucosa graft ureteroplasty is a valuable non-transecting surgical option for patients with recurrent ureteropelvic junction obstructions who failed prior pyeloplasty and has comparable outcomes to the literature regarding standard transecting techniques.
文摘BACKGROUNDEctopic thyroid at the base of the tongue is a rare congenital condition, and it iseven rarer to have clinical symptoms and require surgical intervention. Thisdisease is easily misdiagnosed preoperatively. This article reports the diagnosis,surgical treatment, and follow-up of a case of lingual thyroid.CASE SUMMARYThe patient was a 54-year-old woman who presented with laryngeal foreign bodysensation and dysphagia for 20 d. The lingual thyroid was considered for generalexamination, and surgery was performed to transpose the lingual thyroid to theright submaxillary region. Pathological analysis confirmed thyroid tissue. Thepatient experienced complete remission after surgery, but developed hypothyroidismand required thyroid hormone replacement therapy, and her thyroidfunction gradually recovered over time.CONCLUSIONWe report a rare case of lingual thyroid with marked laryngeal foreign body sensationand dysphagia. Symptoms were completely relieved by transposition surgerybut postoperative hypothyroidism developed.
文摘Objective:The objective of the study was to compare the outcome of tunica albuginea urethroplasty(TAU)and buccal mucosa graft(BMG)urethroplasty for anterior urethral stricture.Methods:Thirty patients who met the inclusion criteria were randomised into two groups:TAU(Group A)and BMG urethroplasty(Group B).Surgical outcome was evaluated with pre-and post-operative work-up involving retrograde urethrogram,voiding cystourethrogram,uroflowmetry,and urethroscopy.Patients were followed up till 1 year.Results:Mean duration of surgery was statistically significant between two groups(p=0.0005).Maximum urine flow rate was comparable when compared between two groups(p=0.22)but statistically significant when compared pre-and post-operatively(p<0.001).At follow-up of 1 year,the successful outcomes were 80% in Group A and 87%in Group B.A total of five patients who had unsuccessful results required redo urethroplasty.Complications were minimal in both the groups.Conclusion:TAU provides outcomes equivalent to those of BMG urethroplasty.TAU has less operative time,easy to perform,and beneficial in patients with poor oral hygiene.
文摘Objective:To describe the outcome of female anterior wall(pubic side)onlay urethroplasty with buccal mucosal graft using laterally extended surgical dissection in patients with previously failed minimally invasive techniques.Methods:From January 2016 to April 2018,17 symptomatic patients with previously failed minimally invasive procedures were enrolled in the study.The diagnosis of urethral stricture was confirmed based on a combination of patients’symptoms,post-void residual urine,video-urodynamics,and cystoscopy.Urethroplasty with lower lip mucosal graft was performed using the modified laterally extended dissection.Patients were evaluated pre-operatively and 12-month post-operatively with the American Urological Association symptom score,post-void residual urine,and maximum flow rate.Results:Despite the previously failed minimally invasive procedures,urethroplasty with lower lip buccal graft and laterally extended dissection resulted in favorable outcomes(success rateZ94%).The meanstandard deviation of American urological association symptom score improved from pre-operative levels at the 12-month post-operative follow-up(25.823.97 to 10.885.57);so did postvoid residual urine(71.1274.98 mL to 15.0028.30 mL),and maximum flow rate(7.881.72 mL/s to 25.825.59 mL/s)with all statistically significant(p<0.05).Conclusion:The current study showed that female urethroplasty with buccal graft could be highly successful in experienced hands.An anterior approach could be superior to the posterior one due to higher mechanical support and lower sacculation rate.A laterally extended incision may improve visualization and better graft placement by providing wider working space.The results should be evaluated in the future studies with larger sample size.
文摘随着互联网信息的发展,如何有效地表示不同语言所含的信息已成为自然语言处理(Natural Language Processing,NLP)领域的一项重要任务.然而,很多传统的机器学习模型依赖在高资源语言中进行训练,无法迁移到低资源语言中使用.为了解决这一问题,结合迁移学习和深度学习模型,提出一种多语言双向编码器表征量(Multi-lingual Bidirectional Encoder Representations from Transformers,M-BERT)的迁移学习方法.该方法利用M-BERT作为特征提取器,在源语言领域和目标语言领域之间进行特征转换,减小不同语言领域之间的差异,从而提高目标任务在不同领域之间的泛化能力.首先,在构建BERT模型的基础上,通过数据收集处理、训练设置、参数估计和模型训练等预训练操作完成M-BERT模型的构建,并在目标任务上进行微调.然后,利用迁移学习实现M-BERT模型在跨语言文本分析方面的应用.最后,在从英语到法语和德语的跨语言迁移实验中,证明了本文模型具有较高的性能质量和较小的计算量,并在联合训练方案中达到了96.2%的准确率.研究结果表明,该文模型实现了跨语言数据迁移,且验证了其在跨语言NLP领域的有效性和创新性.
文摘To evaluate the effect of proteolytic enzymes on the absorption of insulin in the buccal mucosa, the trichloroacetic acid (TCA) method was used to estimate the degradation of insulin under different conditions in the buccal mucosal homogenates. In vivo experiments estimating the enhancement of hypoglycaemic effect by enzyme inhibitors were also conducted. The results showed that proteolytic enzymes in the buccal mucosa were less active than in the intestine. Bacitracin, aprotinin and sodium deoxycholate could inhibit the degradation of insulin in the buccal mucosal homogenates. The degradation of insulin in buccal mucosal homogenates of normal hamsters was smaller than that of diabetic hamsters. In vivo experiments of hypoglycaemia supported the in vitro results. When given buccally, bacitracin, aprotinin and sodium deoxycholate could increase the relative pharmacological bioavailability of insulin. When co-administered with aprotinin(0.1%), bacitracin(0.5%) and sodium deoxycholate(5%), the relative pharmacological bioavailabilities of insulin were 4.84%, 6.60% and 14.95% respectively. The in vitro and in vivo results suggest that proteolytic enzymes are present in the buccal mucosa, which limit absorption of insulin. Co-administration with some enzyme inhibitors can improve the bioavailability of insulin via buccal delivery and sodium deoxycholte is more efficient than some enzyme inhibitors used for improving buccal absorption.
