Congenital pelvi-uretedc junction obstruction in children with congenital hydronephrosis is the most common etiology,but its pathogenesis is poorly understood in the past.With the development and application of genetic molecular biology techniques,the development of the ureter is clarified from molecular biological mechanism,and people have more in-depth understanding of the occurrence of the pelvi-ureteric junction obstruction at the level of gene molecular biology.

Objective:To establish an HPLC method for the determination of calcium disodium edetate in fosaprepitant dimeglu-mine for injection. Methods:The chromatographic column was Agilent Zorbax Eclipse XDB C18(250 mm ×4.6 mm,5μm). The mo-bile phase consisted of 0. 2% tetrabutylammonium hydroxide(adjusting pH to 4. 0 with phosphoric acid)-acetonitrile(85∶15). The flow rate was 1. 0 ml·min-1 . The detection wavelength was 254 nm. The chromatographic column temperature was 35℃. The injection volume was 20μl. Results:The calibration curve was linear within the range of 26. 06-104. 24μg·ml-1(r=0. 999 8) for calcium di-sodium edetate. The average recovery was 99. 51% (RSD=0. 25%, n=9). Conclusion: The method is simple, rapid, accurate, specific and reproducible, and can be used in the determination of calcium disodium edetate in fosaprepitant dimeglumine for injection.

Objective:To establish a headspace capillary gas chromatography method for the determination of residual solvents in erlotinib hydrochloride .Methods:A DB-624 capillary column (30 m ×0.53 mm, 3.0 μm) was used and the carrier gas was nitro-gen.The flow rate was 2.0 ml· min-1 and the inlet temperature was 190℃.The FID detector temperature was 230 ℃.The column temperature program was with the initial temperature of 35℃( maitaining 8 min) , risen to 170℃with the rate of 28℃· min-1 ( main-taining 8 min) , and then risen to 200℃with the rate of 32℃· min-1 ( maintaining 7 min) .The headspace vial temperature was 100℃and the time was 30 min.Results:Ethanol, isopropanol, methylene chloride and n-butanol had a good linear relationship within the range of 0.68-409.14 μg· ml-1 (r=0.999 8),0.67-404.88 μg· ml-1 (r=0.999 8),1.71-51.31μg· ml-1 (r=0.999 7) and 0.72-431.12 μg· ml-1(r=0.999 8), respectively.The average recovery was 99.0% (RSD=0.41%, n=9), 100.2%(RSD=0.52%, n=9),97.1%(RSD=1.75%, n =9) and 102.5% (RSD=1.08%, n=9), respectively.Conclusion: The method is simple and accurate , which can be used for the determination of four residual organic solvents in erlotinib hydrochloride .

Aim To investigate the effect of resveratrol (Res)on septic mice and LPS-insulted H9c2 cells,as well as its involved mechanisms.Methods By use of a mouse cecal ligation and puncture-induced septic model (CLP),the survival of septic mice was evalua-ted after resveratrol treatments.H9c2 cells were insul-ted by LPS and then treated with resveratrol,the mR-NA expressions of TNF-α,SIRT1 and other class III HDAC members were detected using RT-PCR and real-time PCR,Finally,the protein levels of nuclear p65, an important subunit of NF-κB,were measured in H9c2 cells using Western blot assay,to reveal the effect of resveratrol on LPS-induced nuclear transloca-tion of NF-κB.Results Compared with the control septic animals,intraperitoneal injection of resveratrol (1 or 5 mg·kg -1 ·d -1 )significantly increased the survival of septic mice.Furthermore,resveratrol signif-icantly increased mRNA expressions of SIRT1,SIRT2, SIRT6 and SIRT7 in LPS-insulted H9c2 cells.Res-veratrol also remarkably inhibited LPS-induced nuclear translocation of NF-κB.Conclusion An appropriate dose of resveratrol protects septic mouse hearts from the injury induced by LPS through the activation of SIRT family members and the inhibition of NF-κB pathway.

The teaching for medical advanced students is a routine and important task in teaching hospital.To increase the teaching quality,we should emphasize professional theory learning,increase clinical skill training,strengthen medical records writing training and enhance emotional exchange.

ObjectiveTo explore the effect of acupuncture combined with training of the modified rehabilitation apparatus on upper limb motor function of patients with ischemic stroke.Methods86 patients with ischemic stroke were divided randomly into the treatment group ( treated by acupuncture combined with training of the rehabilitation apparatus) and the control group (treated by simple acupuncture). The upper limb motor function of two groups was evaluated by Fugl-Meyer Assessment (FMA) before and after treatment.ResultsAfter 28 days treatment, scores of FMA of two groups were all raised significantly, but it was significantly greater for the treatment group than the control group (P<0.01).ConclusionIt is shown that acupuncture combined with training of the rehabilitation apparatus can improve the upper limb motor function and activity of daily living of patients with ischemic stroke.

Objective To study the relationship between the variation of the 20 exon of leptin receptor (LEPR) and lipid metabolism of the children with obesity. Methods Polymerase chain reaction-restricted fragments length polymorphism (PCR-RFLP) and polyacrylamide gel electrophoresis were used to analyze the variation of the 20 exon of the LEPR gene of the obesity group (120 obese children) and the control group (120 healthy children). Their serum triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), height, weight measured and the body mass index (BMI), fat percent (%fat) were calculated. Results 3 genotypes of the 20 exon of LEPR gene has been detected. Compared with the control group, the frequency of the gene variation at 3057 nucleotide G→A transversion is higher (P<0.05).The concentration of the serum TG, the level of BMI and %fat of the obese children with A/A genotype were higher than that with the G/G genotype (P<0.01),but the level of the serum HDL was lower (P<0.01).To the children with A/G genotype, only their TG level in serum are higher than that with the G/G genotype (P<0.05). Conclusion There is polymorphism at 20 exon LEPR gene in children with obesity, which may affect the lipid metabolism and the fat distribution. The obese children with A/A genotype should pay more attention to their diet to avoid some diseases followed obesity.

Objective To approach the changes of cytosol phospholipase A2α(cPLA2α)and nitric oxide (NO)in patients with chronic obstructive pulmonary disease(COPD)and its significance. Methods One hundred patients with COPD admitted into Department of Critical Care Medicine of Affiliated Wuqing Traditional Chinese Medicine(TCM)Hospital of Tianjin University of TCM were enrolled,and according to the COPD severity grading standards,they were divided into mild group(25 cases),moderate group(25 cases),severe group(26 cases) and extremely severe group(24 cases);simultaneously,90 cases with normal pulmonary function who had taken health examination were chosen and assigned to the healthy control group. The cPLA2α level was detected by enzyme linked immunosorbent assay(ELISA),the level of uric acid(UA),total cholesterol(TC),triacylglycerol (TG)were detected by enzymatic method,and serum NO metabolites(NOx)level was detected by nitrate reductase method. Results Compared with the healthy control group,the serum levels of cPLA2α and UA in patients with different severity of COPD were significantly increased;along with the increase of patient's COPD grade of severity,the cPLA2α,UA levels were gradually increased,while NOx level was gradually decreased in mild, moderate, severe, extremely severe groups〔cPLA2α(ng/L):125.60±8.17, 155.20±6.42, 190.20±9.32, 255.80±11.28 vs. 88.50±7.99;UA(μmol/L):381.23±32.22,434.95±87.71,464.81±52.65,487.45±82.61 vs. 241.95±52.33;NOx(μmol/L):59.90±17.52,45.60±6.17,38.20±4.08,25.70±3.04 vs. 74.90±18.31,all P<0.05〕. The differences in blood cPLA2αand serum NOx level among groups with different severity of COPD were of statistical significance(P<0.05). The levels of TC,TG among these different severity groups had no statistical significance(all P>0.05). The cPLA2αand NOx levels presented significant negative correlation(rs=-0.798,P=0.013). Conclusion The combined examination of blood cPLA2αand serum NOx levels can evaluate the severity degree of COPD patients,and cPLA2αcan be used as a new target index for COPD grading.

Objective:To understand the incidence and clinical characteristics of dopamine agonist(DA) therapy-related impulse control disorders(ICDs) in prolactinoma patients.Methods:Outpatients diagnosed with prolactinoma from the Department of Endocrinology in Huashan Hospital from December 2019 to June 2020 were consecutively included and clinical data were collected. Impulse control disorders were screened with Questionnaire for Impulsive-Compulsive Disorders in Parkinson′s Disease(QUIP). Barratt Impulsiveness Scale 11(BIS-11) was used to evaluate personality construct of impulsiveness from three sub-factors . Health related quality of life was evaluated by the MOS 36-Item Short Form Health Survey(SF-36).Results:Among the 111 cases included, 40 were male and 53 were female, with an average age of(34.74±9.05) years and an average disease duration of(66.69±50.70) months. The initial prolactin level was 147.25(89.97, 470) ng/mL and the percentage of macroadenoma was 46.8%. Ninety cases received DA while 21 cases didn′t. According to the QUIP, any ICD was screened positive in 22 cases(24.7%) in the DA group and 3 cases(14.3%) in the untreated group. The attention impulsiveness scores of BIS-11 in the DA group were higher than the untreated group(23.32±3.67 vs 21.71±2.55, P=0.022). Among the ICDs positive cases in the DA group, the most common disorders were pathological gambling(40.6%) and hypersexuality(40.6%). Compared with the negative group, the non-planning impulsiveness scores of BIS-11 in the positive group were higher, while the scores of social function(69.32±24.62 vs 83.08±17.11, P=0.021), role emotional(50.00±45.72 vs 71.10±40.68, P=0.043) and mental health(55.27±22.75 vs 64.59±17.53, P=0.048) in SF-36 scale were lower in the positive group. Besides, the percentage of male(68.2% vs 38.2%, P=0.014) and initial prolactin level[470.00(130.00, 3 770.00) vs 140.29(79.50, 465.59) ng/mL, P=0.028] in the positive group were higher. Male was an independent risk factor of the presence of ICDs( OR=3.46, 95% CI 1.24-9.61, P=0.017). No significant difference was found in the type of drugs, duration, maximal or cumulative dose of treatment with DA between the two groups. Conclusion:Impulse control disorders may occur in prolactinoma patients receiving DA treatment and affect the quality of life. Endocrinologists should screen impulse control disorders in this patient set.

Objective:To analyze the causes and influencing factors of conversion from laparoscopic surgery to laparotomy.Methods:To analyze and summarize the clinical data of 84 patients who converted to laparotomy in 16 203 cases of laparoscopic surgery from August 2017 to August 2020 in the Department of Gynecology of the Affiliated Hospital of Qingdao University, each patient converted to surgery was matched with 2 patients who underwent simple laparoscopic surgery. The patients were divided into conversion to laparotomy group (84 cases) and control group (168) cases, and analyze the influencing factors of laparoscopic conversion to laparotomy. χ 2 test or corrected χ 2 test or Fisher exact probability method were used for the comparison of counting data between groups, and conditional regression analysis was used for the multivariate analysis of case control design. Results:The conversion rate of gynecologic laparoscopic surgery to laparotomy was 0.52%(84/16 203). The reasons for 84 cases of conversion from laparoscopic surgery to open surgery were as follows: pelvic adhesion 50.0%(42/84), unexpected malignant tumor 19.0%(16/84), tumor oversize or special shape and location 14.3%(12/84), hemostasis difficulty 7.1%(6/84), multiple uterine fibroids 3.5%(3/84), simultaneous surgery 3.5%(3/84), bladder injury 1.2%(1/84), and subcutaneous emphysema 1.2%(1/84) during the operation. There were no significant differences in body mass index and comorbidities (diabetes, hypertension, coronary heart disease, thyroid disease) between the two groups (all P>0.05). And the history of endometriosis was 36.9% (31/84) and the history of pelvic surgery in the transperitoneal group was 60.7% (51/84) higher than that in the conversion to laparotomy group of 20.8% (35/84), 30.6% (51/84) (χ 2=7.482, 21.42, P=0.006). The results of conditional regression analysis showed that that surgical history( OR=3.979, 95% CI 2.010-7.874, P<0.001 and thyroid history ( OR=15.333, 95% CI 1.087-216.346, P=0.005) increased the risk of conversion to laparotomy; Hypertension history ( OR=0.203, 95% CI 0.067-0.622, P=0.005) reduced the risk of conversion to laparotomy. Further analysis of which operation type affected the conversion to laparotomy showed that cesarean section ( OR=2.105, 95% CI 1.109-4.351, P=0.044), myomectomy ( OR=11.605, 95% CI 3.306-40.735, P<0.001), and ovarian cyst removal ( OR=7.914, 95% CI 2.157-21.037, P=0.002) affected the conversion to laparotomy. Conclusion:The main reason for conversion from gynecologic laparoscopic surgery to laparotomy is pelvic adhesion. The history of surgery and thyroid disease are the risk factors for conversion to laparotomy. Among them, myomectomy and ovarian cyst removal are important factors for conversion to laparotomy. Before operation, appropriate clinical operation methods should be selected according to the patient's medical history and condition to ensure the patient's safety.