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Background and objectivesTo investigate the risk factors of renal function deterioration after radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC).MethodsA total of 153 patients with UTUC who underwent radical surgery at a high-volume center in China from January 2015 to December 2019 were included in this study. The renal function of all patients was evaluated during follow-up. Besides, these patients were grouped according to postoperative renal function. The risk factors of renal function deterioration included age, sex, body mass index (BMI), T stage, tumor location and size, lymph node invasion, lymph node dissection (LND), surgical margin, tumor histology, lymphovascular invasion (LVI), hypertension, diabetes, hematuria, blood transfusion, hydronephrosis on the affected side, urine specific gravity, creatinine, uric acid, and preoperative glomerular filtration rate (GFR) on the healthy and affected sides. The correlation between risk factors and inclusion indexes was analyzed using univariate and multivariate analyses.ResultsA total of 153 patients were enrolled in this study, and the follow-up continued for 14 (11, 24) months. Acute kidney injury (AKI) was diagnosed in 65 patients in the short-term follow-up after RNU, and renal function deterioration was diagnosed in 52 patients in the long-term follow-up after RNU. The univariate analysis of 65 patients with short-term AKI revealed that there were statistically significant differences in preoperative hydronephrosis, hypertension, urinary protein, tumor size, preoperative Hb, preoperative creatinine, blood transfusion, and preoperative GFR of the healthy kidney. The multivariate Logistic regression analysis results showed that preoperative creatinine, GFR of the healthy kidney, and blood transfusion were independent risk factors for AKI. Moreover, The multivariate Logistic regression analysis of 52 patients with long-term renal insufficiency after surgery indicated that there were statistically significant differences in preoperative hydronephrosis, tumor size, preoperative GFR of the healthy kidney, and postoperative AKI.ConclusionFor patients with UTUC, the preoperative creatinine level is high, blood transfusion was given during or after procedure and the GFR of the healthy kidney is low, it is easy to have AKI in the short term after operation. In addition, there was no hydronephrosis before operation, the tumor size was small, the GFR of the healthy kidney was low before operation, AKI occurred after operation, the renal function was easy to deteriorate for a long time after operation. The above risk factors may aggravate renal function deterioration of these patients after surgery, resulting in the loss of the opportunity to continue treatment.

AbstractAlthough the existing research on educational robots has exhibited the assistance for EFL learners’ English skills, the evidence which shows robot-assisted systems’ effect on adult learners’ English read-aloud is still rare. Nevertheless, read-aloud is still treated as a useful approach in English classes for speech pronunciations in particular in Asia. This study aims at the design of a system that uses a robot as a tutor equips automatic speech recognition to diagnose learners’ errors while they are reading aloud the English passages. The learner is able to practice and improve pronunciations via the diagnosis. An experiment designed with a pretest, a posttest, and a delayed posttest was conducted to evaluate the proposed robot-tutoring system. 19 university students in Taiwan enrolled in the experiment, and learned with the system for 90 minutes per round, with a total of 2 rounds of self-learning. The results showed the participants’ accuracy of read-aloud in the delayed posttest was significantly better than those of the pretest and immediate posttest. In addition, when looking into the investigation of the participants’ perceptions of the system, most were impressed by the system, and also agreed the system was a useful and helpful tool to help reading English passages aloud. Therefore, this study provides evidence of the effects of robot-tutoring approach on adults’ English read-aloud in Taiwan.

Constipation symptoms of Parkinson's disease (PD) seriously reduce the quality of life of patients and aggravate the development of the disease, but current treatment options still cannot alleviate the progress of constipation. Electroacupuncture (EA) is a new method for the treatment of constipation, which can effectively treat the symptoms of constipation in PD patients. However, the specific regulatory mechanisms of EA in the treatment of constipation symptoms in PD remain unclear. The aim of this study is to investigate the therapeutic effect of EA on PD constipation rats and its regulatory mechanism. A rotenone (ROT)-induced gastrointestinal motility disorder model was used to simulate the pathological process of constipation in PD. The results showed that EA could effectively promote gastrointestinal peristalsis, reduce α-synuclein accumulation in substantia nigra and colon and colonic injury in rats after ROT administration. Mechanistically, EA activation of the central-cholinergic pathway increases acetylcholine release in the colon. At the same time, EA up-regulated the co-expression of enteric glial cells (EGCs) and α7 nicotinic acetylcholine receptor (α7nAChR). EA increased the expression of choline acetyltransferase (ChAT), neuronal nitric oxide synthase (nNOS), and tyrosine hydroxylase (TH) in the colon of PD rats. Further mechanistic studies showed that EA increased the expression of glial cell-derived neurotrophic factor (GDNF), GFRa1 and p-AKT in colon tissues. The present study confirmed that EA upregulates α7nAChR through a central-cholinergic mechanism to promote GDNF release from EGCs, thereby protecting intestinal neurons and thereby improving gastrointestinal motility.

Neoehrlichia mikurensis (N. mikurensis) is an emerging tick-borne pathogen that can cause neoehrlichiosis. Rodents are considered the major host for N. mikurensis. Currently, N. mikurensis has been detected in rodents in several studies from China and other countries. However, no research on N. mikurensis infection in rodents has been reported in the Liupan mountain region. The region of Liupan Mountain, located in northwestern China, is the center of the triangle formed by the cities of Xi’an, Yinchuan, and Lanzhou, with multiple tourist sites in the region. To survey whether there is N. mikurensis in hosts, rodents were captured in this region in September 2020. A nested polymerase chain reaction was used to detect the DNA of N. mikurensis, followed by nucleotide sequencing and phylogenetic analysis. In the region, among 88 rodents, 3 rodents were detected positive for N. mikurensis, a detection rate of 3.4%. Based on phylogenetic analysis of the partial groEL gene sequences, N. mikurensis from rodents in Liupan Mountain clustered in the same evolutionary branch with those found in rodents from Japan, Russia, and northeastern China, and also in ticks and clinical cases from Heilongjiang Province in northeastern China.

Synthesis of multi-satellite altimetry facilitates the acquisition of long-term changes in lake level but may induce biases due to inconsistent data sources, and thus remains largely unexplored. This study investigates the integrated application of Ice, Cloud, and land Elevation Satellite (ICESat), ICESat-2, and CryoSat-2 missions to provide consecutive lake level series in 2003–2020. The sample comprises 48 lakes in the world with gauge-based or Hydroweb water level data. The CryoSat-2 data are first adjusted to the ICESat-2 height reference based on the mean values of their monthly water level difference during their overlapping period (2018–2020). Then, the corrected CryoSat-2 data are used to link the ICESat and ICESat-2 data. Results show that in the sample lakes, the deviations between CryoSat-2 and ICESat-2 data vary and range from −0.78 m to 0.13 m. The data quality of the synthesized time series is evaluated by comparing against the validation data, with an average R2 of 0.84. This study shows that CryoSat-2 has the potential of filling the gap between ICESat and ICESat-2. The three altimeters can be expected to integrate effectively for monitoring lake water level changes in the past two decades.