AIM:To reveal the characteristics and patterns of mental activity in the cerebral cortex of patients with attention deficit hyperactivity disorder (ADHD) and explore the pathogenetic characteristics of ADHD.METHODS: The ADHD patients were asked to record their mental activity, general health condition and obsessions before the onset of pathological symptoms by means of psychological introspective reports.RESULTS: The direct cause of attention distraction and failure of attention focus is the patients' inability to perform cognitive tasks (including perception, memory and recollection, imagination, association and thought)in a continuously ongoing manner in relaxation. The frequent stagnancy and pause during the course of recognition precipitated the patients in a stressful state, which contributed to the onset of various hyperactivities and also resulted in the acquisition of "silent verbal thinking". This is an important psychopathological phenomenon long been neglected. All theses abnormalities caused the patients much discomfort, which was naturally relieved by means of impulsive and irritable behaviors.CONCLUSION: A series of clinical symptoms of ADHD arises from the same pathogenic factor of difficulty in mental activity and inability to carry out the activities in the cerebral cortex in a relaxed manner. The difficulty in mental activity is the key problem of ADHD and the source of various synptoms, which should be ;reated for the first place. The cause of this key problem is possibly lowered metabolism of the cerebral cortex, and the effect of "instinct" can not be neglected in the attempt to explain the pathogenesis of ADHD.

Objective To observe clinical curative effect of modified total cystectomy and Mainz Ⅱ neobladder. Methods Seventeen patients with bladder neoplasms were treated with modified total cystectomy and Mainz Ⅱ neobladder for urinary diversion. The paries posterior allantois with intestinum rectum and colon sigmoideum were taken 10 cm respectively, split the mesenterium edges, conduplicated and bilayer sutured from the junction of intestinum rectum and colon sigmoideum, bilateral ureters antireflux anastomosed respectively with colon sigmoideum and rectal papilla, then bilayer sutured paries anterior became Mainz allantois. Results There was no surgical mortality. The operative time was 340 ～ 420 mins (mean, 350 mins).Blood transfusion was 400 ～ 800 ml ( mean 600 ml). The follow-up was 4 ～ 18 months, urine and dejecta were shunt, uresis continence was fine and the operation had fewer severe complications. Conclusion Modified total cystectomy and Mainz Ⅱ neobladder to be an effective method for urinary diversion because of its simple operation, fewer severe complications, good uresis continence and high quality of life.

Objective To investigate the inhibitory effect of agonistic CD40 monoclonal antibody on the colon cancer cells (HCT116) proliferation in vitro.Methods The DCs (dendritic cells) loaded with tumor cells (HCT116) antigens were activated by different methods.According to the activation method,the cells were divided into three groups:agonistic CD40 monoclonal antibody group,blank control group and TNF-α positive control group.The cells were cultured for 7 days,and the expression rates of CD80,CD83,CD86 and HLA-DR on DC surface in each group were detected by flow cytometry.The concentration of cytokine IL-12(p70) in DCs culture supernatant was determined by ELISA kit.The proliferation activity of the T lymphocytes was evaluated by MTT (methyl thiazolyl tetrazolium).Then the inhibition rate of colon cancer HCT116 cells proliferation,which induced by the tumor-specific effector T lymphocytes,was assayed.Results Compared with the blank control group,the agonistic CD40 monoclonal antibody group had a significantly higher expression rates of CD80,CD83,CD86 and HLA-DR on DC surface (P＜0.05).The concentration of IL-12 in the supernatant of DC was also much higher in the agonistic CD40 monoclonal antibody group (P＜0.05,(716.80±53.43) pg/ml vs.(405.51 ±12.17) pg/ml).The DCs activated by CD40 monoclonal antibody had stronger ability to stimulate proliferation of T lymphocytes (P＜0.05,the stimulation index was (2.006 2±0.438 3) to (1.365 0±0.209 8)).The tumor-specific CTLs induced by DCs in the agonistic CD40 monoclonal antibody group had stronger ability to inhibit colon cancer HCT116 cells (P＜0.05,the inhibition rate was (66.08±0.41)％ vs.(46.60± 1.10)％).However,there was no statistical significance between the agonistic CD40 monoclonal antibody group and the TNF-α positive control group (P＞0.05).Conclusion Agonistic CD40 monoclonal antibody in vitro can promote activation and mature of DCs,then the activated DCs can induce the production of tumor-specific CTL,which can significantly inhibit the proliferation of colon cancer HCT116 cells.

Objective To explore the effect of glucose fluctuation on resistin. Methods The phorbol-12-myristate-13-acetate(PMA)-activated and differentiated U937 cells were exposed to experimental condition for 3 days, three groups of cells were formed, each one receiving the following fresh medium every 6 hours, respectively: (1) continuous 11.1 mmol/L glucose concentration medium (Con group), (2)continuous 22.2 mmol/L glucose concentration medium (CHG group), (3) alternating 11.1 mmol/L glucose concentration and 22. 2 mmol/L glucose concentration medium every 6 hours (IHG group). The supernatants of cell mediam at the last 6 hours were collected to test resistin concentration. Besides, 92 subjects were selected and classified into three groups according to the results of oral glucose tolerance test:normal glucose tolerance group ( NGT group, n =30), impaired glucose tolerance patients (IGT group, n =31) and newly diagnosed type 2 diabetes patients (T2DM group, n =31). Blood glucose and serum resistin levels were measured at 0 h and 1 h during oral glucose tolerance test ( OGTT) to compare the glucose fluctuation (△Glu1-0) and the change of serum resistin level (△lnRes1-0) among the three groups. Results Resistin concentration in the Con , CHG and IHG group was (73.62 ± 5.07)ng/L, (97.78 ±7.00)ng/L and(212.49 ± 28. 81 )ng/L respectively and in IHG group it was higher as compared with the other two groups (P<0.05). △Glu1-0 in NGT, IGT and T2DM group was(2.31 ±2.30)mmol/L,(5.70 ±2.08)mmol/L and (8.41 ±2.63)mmol/L respectively; △Glu1-0 increased gradually in all the three groups (P<0.05). Serum resistin level from 0 h to 1 h in the NGT group was 6.41 (1.52-15.76) μg/L to 6. 96( 1.52-22. 70) μg/L, in the IGT group 5.47( 1.49-24. 09)μg/L to 9. 12( 1.27-21.94)μg/L and in the T2DM group 5.77( 1.11-30.10) μg/L to 9. 27(1.02-48.15)μg/L In the IGT and T2DM group serum resistin level increased from 0 h to 1 h (P<0.05), but no difference was observed in the NGT group (P>0. 05).△lnRes1-0 in these 3 groups was (0.05 ± 0.05) μg/L, (0.25 ± 0.04) μg/L and (0.37 ± 0.03 )μg/L respectively and the change in the T2DM group was significant as compared with that in the NGT group,△lnRes1-0 was positively correlated with △Glu1-0 (r = 0.23, P = 0.02). Conclusion Glucose fluctuation induced monocyte/macrophage to secrete resistin, greater the glucose fluctuation, greater the change of amplitude of serum resistin.

OBJECTIVE: To study the trend of surgical type, surgical procedure and etiological distribution of upper urinary tract repair in recent 10 years. METHODS: The preoperative and perioperative variables and follow-up data of upper urinary tract reconstruction surgery in RECUTTER (Reconstruction of Urinary Tract: Technology, Epidemiology and Result) database from 2010 to 2021 were searched, collected and analyzed. The surgical type, surgical procedure, duration of hospitalization, time of operation, incidence of short-term complications, and proportion of the patients undergoing reoperations were compared between the two groups of 2010-2017 period and 2018-2021 period. RESULTS: A total of 1 072 patients were included in the RECUTTER database. Congenital factors and iatrogenic injuries were the main causes of upper urinary tract repair. Among them, 129 (12.0%) patients had open operation, 403 (37.6%) patients had laparoscopic surgery, 322 (30.0%) patients had robot-assisted laparoscopic surgery and 218 (20.3%) patients had endourological procedure. In the last decade, the total number of surgeries showed a noticeable increasing annual trend and the proportion of robot-assisted laparoscopic surgery in 2018-2021 was significantly higher than that in 2010-2017 (P < 0.001). The 1 072 patients included 124 (11.6%) cases of ileal ureter replacements, 440 (41.1%) cases of pyeloplasty, 229 (21.4%) cases of balloon dilation, 109 (10.2%) cases of ureteral reimplantation, 49 (4.6%) cases of boari flap-Psoas hitch surgery, 60 (5.6%) cases of uretero-ureteral anastomosis, 61 (5.7%) cases of lingual mucosal onlay graft ureteroplasty or appendiceal onlay flap ureteroplasty. Pyeloplasty and balloon dilatation had been the main types of surgery, while the proportion of lingual mucosal onlay graft ureteroplasty plus appendiceal onlay flap ureteroplasty had increased significantly in recent years (P < 0.05). In addition, the time of operation was significantly increased (P < 0.05) after 2018, which was considered to be related to the sharp increase in the proportion of robot-assisted laparoscopic surgery. We found that minimally invasive surgery (endourological procedure and robot-assisted laparoscopic surgery) as an independent risk factor (P=0.050, OR=0.472) could reduce the incidence of short-term post-operative complications. CONCLUSION We have justified the value of the RECUTTER database, created by the Institute of Urology, Peking University in data support for clinical research work, and provided valuable experience for the construction of other multi-center databases at home and abroad. In recent 10 years, we have observed that, in upper urinary tract reconstruction surgery, the surgery type tends to be minimally invasive and the surgery procedure tends to be complicated, suggesting the superiority of robot-assisted laparoscopic surgery.
Humans ; Laparoscopy/methods* ; Retrospective Studies ; Robotic Surgical Procedures ; Treatment Outcome ; Ureter/surgery* ; Ureteral Obstruction/surgery* ; Urologic Surgical Procedures/methods*