ObjectiveTo compare the clinical effects of extracorporeal shock wave lithotripsy (ESWL) and ureteroscope holmium laser lithotripey(URL) in emergency patients with ureteral calculi.MethodsTwo hundred and forty emergency patients with ureteral calculi were retrospectively analyzed,including 110 patients undergoing ESWL (ESWL group) and 130 patients undergoing URL (URL group).Results The success rate of fragmentation and calculi-free rate were 90.0％ (117/130) and 80.8％(105/130) in URL group,of which were 88.2％(97/110) and 75.5％(83/110) in ESWL group with no significant difference between two groups (P ＞ 0.05 ).The success rate of fragmentation and calculi-free rate of upper ureter in ESWL group were much better than those in URL group[93.1％(54/58) vs.84.3％(59/70),77.6％ (45/58) vs.70.0％ (49/70),P ＜ 0.05 ],those of middle-lower ureter in URL group were much better than those in ESWL group[96.7％(58/60) vs.82.7％(43/52),93.3％(56/60) vs.73.1％(38/52),P＜0.05].ConclusionESWL and URL both have good curative effects in emergency patients with ureteral calculi,and ESWL has better effects for upper ureter while URL for middle-lower ureter.

Objective：To explore the characteristics of behavioral problems and self-concept level in children with attention deficit hyperactivity disorder(ADHD)accompanying anxiety disorder.Methods：With stratified random sampling method,a sampling survey was made in 9495 children(aged 5～17 years)from 6 regions of Hunan province together.Using the two stage epidemiologic research method,three groups,including control group(214 cases),pure ADHD(219 cases)and ADHD accompanying anxiety disorder(111 cases)were determined as the subjects.All the subjects completed the Children's Self-Concept Scale(CSCS),and the Achenbach Child Behavior Checklist(CBCL)was completed by their parents.Results：(1)Compared to the control group,the pure ADHD group scored higher in CBCL [e.g.,the total score:(30.35±24.32)vs.(16.97±14.86)],and scored lower in CSCS [e.g.,total score:(50.85±9.98)vs.(57.46±10.80),P<0.05].(2)Compared to the control group,children with ADHD accompanying anxiety disorder scored higher in CBCL [e.g.,total score:(41.66±28.07),P<0.01],and in CSCS except physical activities(Ps<0.05).(3)Compared to the pure ADHD group,ADHD accompanying anxiety disorder group scored higher in CBCL and lower in CSCS[behavior:(10.44±3.17)vs.(11.55±2.80);anxiety:(8.06±2.61)vs.(9.21±2.61),gregariousness:(7.42±2.22)vs.(8.16±1.89);total score:(47.25±9.93)vs.(50.85±9.98);Ps<0.05].Conclusion：ADHD children have more behavioral problems and lower level of self-concept than normal children,and children with ADHD accompanying anxiety disorder have more prominent presence of behavioral problems and lower self-concept rating than children with pure ADHD.

Objective To evaluate the efficacy and safety of percutaneous nephrolithotomy(PCNL) by middle renal calice used as main access for the treatment of staghorn stones with the combination of pneumatic and ultrasonic lithotrite.Methods Clinical data of 73 patients underwent PCNL by middle renal calices as main access with 57 incomplete staghorn stones and 35 complete staghorn stones.The rate of stone removal and complications were the main points of the analysis.Results Seventy-two cases underwent first session PCNL by single access tract(middle calices),3 cases underwent first session PCNL by double access tracts (2 cases by middle and lower calices,1 case by upper and middle calices).Of these patients,1 case had fragments with no further treatment,16 cases underwent second session PCNL.All were treated by single access tract (middle calices) and 2 cases had extracorporeal shock wave lithotripsy before the second PCNL.Seventy-six cases composed of 27 complete staghorn stones and 49 incomplete staghorn stones had no residual fragments with the stones removal rate 82.6％ (76/92).Hemoglobin dropped 1-4 g/L,11 cases and 3 cases were given blood transfusion in the operation procedure and post operation respectively.One case developed pyelonephritis and 1 case had split renal dysfunction with peri-parenchyma infection.Conclusions By middle calices as a main access to perform PCNL for staghorn stones is effective and safe.Using pneumatic and ultrasonic lithotrite will be very useful with high stones free rate and short procedure time and less complication.