Objective: To evaluate the development, safety and efficacy of percutaneous nephrolithotomy(PNL) for management of upper urinary tract calculi in pediatric patients.Methods: In the study, 77 pediatric patients undergoing 87 PNLs through mini or standard tract for upper urinary tract calculi between January 2005 and December 2016 in Peking University People''s hospital were reviewed, including 69 renal calculi, 6 upper ureteral calculi, 12 renal and upper ureteral calculi, 35 single calculi, 43 multiple calculi and 9 staghorn calculi.The development and efficacy of PNL in pediatric patients were studied by analyzing the characteristics and clinical indexes, and by reviewing the associated literature.The Clavien classification system was used to evaluate the complications after PNL.Results: A total of 87 PNLs were performed in 77 pediatric patients.Eighty-one upper urinary tract calculi were managed through a single tract(93.1%), 5 pediatric patients were managed through 2 tracts(5.7%), and 1 pe-diatric patient was managed through 3 tracts(1.2%).The mean operating time was (77.0±29.8) min.The stone-free rate after one session was 100% for single calculi and 71.2% for multiple or staghorn calculi, 5(5.8%) children underwent auxiliary procedure to remove the residual calculi and the final stone-free rate of PNL was 88.5%.One of the main complications of pediatric PNL was fever.Sixteen(18.4%) had moderate fever(38-39 ℃), 5(5.7%) had high fever(39-40 ℃) and there were no severe complications of infection, such as sepsis or septic shock.The mean hemoglobin loss was (10.3±16.1) g/L and the serum creatinine rise was (7.0±13.3) μmol/L.One(1.2%) pediatric patient suffered ureteroscopic lithotripsy because of the obstruction by the residual stone in ureter.No injury of organs or retroperitoneal urinary extravasation occurred.General assessment of the complications showed Clavien grade Ⅰ complications in 14 (16.1%) pediatric patients, grade Ⅱ in 7(8.0%) children and grade Ⅲ in 1(1.2%) children.There was no grade Ⅳ or Ⅴ complications.The overall complication rate was 25.3%.Conclusion: PNL for management of upper urinary tract calculi in pediatric patients is effective.Complications after PNL, as assessed with Clavien classification system, are mild and PNL in pediatric patients is safe.

Objective To observe the effect of acupoint sticking plus cervical plexus block anesthesia on post-operative pain in patients undergone subtotal thyroidectomy.Method Sixty patients who were going to receive unilateral subtotal thyroidectomy were randomized into group A and group B, 30 cases in each group. Group A was intervened by acupoint sticking plus cervical plexus block anesthesia, while group B was by cervical plexus block anesthesia alone. The Visual Analogue Scale (VAS) scores under static and swallowing condition were recorded at 6 h, 12 h, 24 h, and 48 h after the operation. Tramadol hydrochloride tablets were given to help cease pain when static incision VAS>3, and the total dose and adverse reactions in 48 h after the operation were recorded.Result There were no significant differences in comparing the VAS scores at static and swallowing status between the two groups at 6 h, 12 h, 24 h, and 48 h after the operation (P>0.05). The total dose of Tramadol hydrochloride tablets used in 48 h after the operation was (110±55)mg in group A, versus (210±48)mg in group B, and the difference was statistically significant (P<0.05). There was a significant difference in comparing the occurrence rate of adverse events in 48 h after the operation between the two groups (P<0.05).Conclusion Acupoint sticking plus cervical plexus block anesthesia can effectively alleviate the pain after subtotal thyroidectomy, reduce the use of analgesics in 48 h after the operation, and lower the occurrence rate of post-operative adverse events.

Objective To investigate the pathogenesis,clinical characteristics,diagnosis and treatment of Ceftriaxone-associated urinary tract and biliary pseudolithiasis in children.Methods A 6-year-old boy was treated in our hospital in March 2011.The initial diagnosis was acute suppurative tonsillitis.Ceftriaxone was administered intravenously at a dose of 3 g/d [ 117 mg/( kg · d) ]for three days.After that the boy complained of bilateral abdominal pain and nausea.Abdominal sonogram obtained after cessation of ceftriaxone treatment revealed urinary tract and gallbladder stone and hydronephrosis.After cessation of ceftriaxone treatment and intubation tube into the ureters by cystoscope,symptoms gradually disappeared and renal function recovered.Results After cessation of ceftriaxone treatment,symptoms gradually disappeared,with urinary tract CT scan normal after 10 days.Urinary tract and gallbladder sonograms were found to be normal 22 days after diagnosis without specific treatment.Followed up for 1 month,no recurrence of stone was observed.Conclusions Ceftriaxone-associated urinary tract and biliary pseudolithiasis in children is rare.These complications generally resolve spontaneously with cessation of the ceftriaxone therapy.Physicians should be aware of these complications so as to avoid unnecessary therapeutic procedures.

With the continuous improvement of treatment ability in intensive care unit (ICU), many critically ill and complex patients have survived due to the development of technology. However, most of them suffer from the psychological and physiological problems of post-intensive care syndrome (PICS). Therefore, the early identification and prevention of PICS is particularly critical. We should understand the pathophysiological mechanism of PICS, strictly implement ABCDEFG bundle management measures [including airway management (A), breath (B), reasonable analgesia and sedation treatment (C), prevention of delirium (D), early rehabilitation (E), family engagement (F), good communication (G)] during ICU hospitalization, and pay attention to reasonable nutritional support, optimizing blood glucose management, providing positive psychological intervention and support to patients through family members' encouragement and accompanying, ICU diary and other forms, following up the health status of patients transferred out/discharged from ICU, providing multi-disciplinary and professional continuing medical services, finding the entry point and timing of traditional Chinese medicine intervention, and giving full play to the advantages of integrated traditional Chinese and Western medicine treatment, which can improve the quality of life of patients. This article reviews the pathophysiological mechanism, risk factors, prevention and management measures, traditional Chinese medicine syndrome differentiation and treatment of PICS, in order to improve the early identification, diagnosis and treatment of critical patients with PICS, and improve the prognosis of patients.

This study was aimed to observe different forms of β-amyloid peptide (Aβ) and insulin degrading enzyme (IDE) in the hippocampus and cortex in order to further explore the role of Aβ and IDE on spleen yin deficiency di-abetes-associated cognitive decline (DACD), and the effect of Zi-Bu Pi-Y in method. The rats were randomly divided into five groups, which were the blank control (Cont) group, diabetes (DM) group, spleen yin deficiency (pi) group, spleen yin deficiency diabetes (piDM) group and Zi-Bu Pi-Y in recipe (ZBPYR) group. Soluble and insoluble Aβ in the hippocampus and cortex of rats were extracted by gradient centrifugation, and then measured by ELISA. The ex-pression of IDE was observed by western blot. The results showed that the content of soluble and insoluble Aβ1-42 in the hippocampus and cortex of the DM group and piDM group were higher than the Cont group. The soluble and in-soluble Aβ1-42 content in the hippocampus and cortex of the ZBPYR group were reduced compared with the DM group and the piDM group. The soluble Aβ1-40 in the cortex of the DM group, pi group and piDM group were in-creased compared with the Cont group (P < 0.05). The soluble Aβ1-40 content of the ZBPYR group was decreased compared with the DM group and the piDM group (P < 0.05). The expression of IDE protein was decreased in the hippocampus of the DM group and the piDM group compared with the Cont group (P< 0.05), and the IDE protein level in the hippocampus of the ZBPYR group was increased compared with the DM group and the piDM group (P<0.05). The expression of IDE protein in the cortex of the DM group, pi group and piDM group was lower than the Cont group (P< 0.05). The IDE protein level in the cortex of the ZBPYR group was reduced compared to the DM group (P< 0.05). It was concluded that the increased Aβ1-42 in brain may be a major pathological change of DACD and spleen yin deficiency DACD. The decreased IDE expression may be one of the reasons to induce increasing of Aβ1-42 level. The Zi-Bu Pi-Y in method may decrease the Aβ1-42 content by upregulating IDE protein expression.

BACKGROUND:Adipose-derived stem cel s (ADSCs) are a subset of mesenchymal stem cel s obtained from adipose tissue, which have paracrine functions, already becoming a focus in anti-aging researching. OBJECTIVE:To review the research progress and application outlook of ADSCs’ paracrine functions in facial anti-aging. METHODS:The first author searched the PubMed and CNKI databases using the keywords of“adipose-derived stem cel s, paracrine, anti-aging”in English and Chinese, respectively, to retrieve relevant articles published from January 2001 to May 2016. Repetitive articles or those with no originality were eliminated. Total y 176 articles were searched initial y, and 66 articles were included in result analysis. RESULTS AND CONCLUSION:ADSCs have paracrine function, which can secrete various growth factors (e.g., epidermal growth factor, transforming growth factorβ, platelet-derived growth factor, vascular endothelial growth factor, col agen and fibronectin) and inflammatory factors (e.g., interferon-γ, interleukin-lβ, interleukin-8, interleukin-9, interleukin-12, interleukin-15, interleukin-17 and tumor necrosis factor-α). These paracrine products of ADSCs have significant effects on anti-aging, such as inhibiting skin aging, whitening skin, assisting lipotransfer, promoting hair regeneration.

Objective To clarify the pathogenesis of spleen yin deficiency diabetes-associated cognitive decline (DACD) and mechanism of Zinu Piyin Recipe (ZBPYR) by observing the expression of phosphorylated RNA-dependent protein kinase-like endoplasmic reticulum kinase (PERK), eukaryotic initiation factor 2α subunit (eIF2α), p-eIF2α, glucose-regulated protein 78 (GRP78) in cerebral cortex of spleen yin deficiency diabetes mellitus rats. Methods The rats were randomly divided into control group, diabetes mellitus group, spleen yin deficiency group, spleen yin deficiency diabetes mellitus group (disease-syndrome group) and spleen yin deficiency diabetes mellitus+ZBPYR group (treatment group). Type 2 diabetes mellitus models were established by high-fat food feeding for 4 weeks and low dose STZ intraperitoneal injection. Then the classical compound method was used to construct spleen yin deficiency rats model by improper diet, over exertion and yin fluids exhaustion. The reatment group was given ZBPYR and other groups were given equal volume of normal saline for 15 days, then cerebral cortex was obtained. The expression of p-PERK, p-eIF2α, eIF2α and GRP78 were observed by Western Blot and RT-PCR. Results The protein expression of p-PERK, p-eIF2α, and mRNA expression of GRP78 of diabetes mellitus group, spleen yin deficiency group and disease-syndrome group was enhanced compared with control group (P<0.05). GRP78 protein expression of diabetes mellitus group, disease-syndrome group was increased compared with control group (P<0.05). The protein expression of p-PERK, p-eIF2α, GRP78 and mRNA expression of GRP78 of treatment group was decreased compared with diabetes mellitus group and disease-syndrome group (P<0.05). Conclusion Endoplasmic reticulum stress is involved in spleen yin deficiency DACD. ZBPYR improves learning and memory ability by reducing endoplasmic reticulum stress.

Objective To explore the expression of sex determining region Y-box 18 (SOX18) in prostate cancer(PCa) and its role on prostate cancer cells.Methods The expression of SOX18 in 98 PCa tissues and 81 adjacent non-tumor tissues was detected by immunohistochemistry.The expression of SOX18 mRNA and protein in PCa cell lines were detected by q-PCR and Western blotting analysis,respectively.After knocking down SOX18 with si-RNA,the proliferation,migration and invasion of PCa cells were analyzed by CCK8,Transwell and Matrigel assays in vitro.Results The rate of high SOX18 expression in prostate cancer tissues was 73.5％ (72/98),which was higher than that in adjacent normal tissues (43.2％,35/81) (P ＜ 0.01).In addition,the rates of high SOX18 expression in clinical stage Ⅲ-Ⅳ [83.7 ％ (36/43) vs.65.5 ％ (36/55),x2 =4.131,P =0.042],pathological grading G3-4 [88.6％ (39/ 44) vs.61.7％ (33/54),x2 =9.424,P =0.002] and Gleason scores ≥ 8 [85.0％ (34/40) vs.65.0％ (38/58),x2 =4.610,P =0.032] groups were higher than those in clinical stage Ⅲ-Ⅳ,pathological grading G1-2 and Gleason scores ≤7 groups.However,there were no differences in the rate of high SOX18 expression in different age groups [77.3％ (38/54) vs.70.4％ (34/44),x2 =0.539,P =0.441].Knockdown of SOX18 notably suppressed the proliferation,migration and invasion of prostate cancer cells.Conclusions SOX18 is over-expressed in prostate cancer,and could promote the proliferation,migration and invasion ability of prostate cancer cells.

Objective To investigate the incidence of occult pancreatobiliary reflux and to evaluate its relation to gallbladder epithelial dysplasia and cancer. Methods From July 2006 to Feb 2008,956 cases underwent selective biliary procedure or preoperative endoscopic retrograde cholangiopanereatography (ERCP), bile was collected and amylase was measured. All removed gallbladders were pathologically examined for dysplasia and cancer. Results Occult pancreatobihary reflux was found in 75 of 754 patients in this study, with an incidence of 9. 9%. The biliary amylase values in the patients with occult pancreatobiliary reflux and in controls were 7701±20 378 IU/L and 16±51 IU/L, respectively ( P <0. 01 ).Gallbladder dysplasia and cancer were found in 31.0% and 3.4% of the patients with occult pancreatobiliaryreflux, respectively, and both were higher than those in the patients without pancreatobiliary reflux ( P <0. 05). In the patients with occult pancreatobiliary reflux, the biliary amylase level with gallbladder dysplasia or cancer was 2388 ± 2745 IU/L and was higher than those without gallbladder dysplasia or cancer (P < 0. 01 ). Conclusions With an incidence of 9.9% in patients of normal pancreatobiliary junction,the occult pancreatobihary reflux may contribute to the pathogenesis of gallbladder epithelial dysplasia and cancer.

Objective To evaluate the health-related quality of life (HRQOL) for prostate cancer patients receiving androgen deprivation therapy (ADT).Methods We studied 200 patients with prostate cancer who were treated with primary ADT in Peking University People's Hospital from June 2014 to June 2015.The patients'average age was 73.9 years.The mean PSA level was 21.57 ng/ml when they were diagnosed with prostate cancer.Of these 200 patients,79％ (158/200) were localized and seclected ADT therapy due to age,body condition,basic diseases or individual will.21％ (42/200) were locally advanced or metastasic,which accord with the indication of ADT therapy.The scales,including the MOS item short from health survey (SF-36),Functional Assessment of Cancer Therapy-General module (FACT-G),Functional Assessment of Cancer Therapy-Prostate instrument (FACT-P),Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS) were used to evaluate their HRQOL.Results According to results of SF36,the physical health component score and mental health component score was 67.41 ± 16.39 and 64.81 ± 17.51,respectively.They indicated that the overall quality of life of these patients was at an acceptable level.And the average score of all domains exceeded 60 except general health domain,which the score was only 40.03 ± 21.89.When it comes to FACT-P,the sum score,emotional well-being score and prostate cancer component score were 8.15 ± 3.72,12.30 ± 4.04 and 77.41 ± 9.95,respectively,which were less than half of their respective top score.However the physical well-being score was 20.41 ±4.29,which was a relatively satisfactory value.In addition,61％ (121/200) patient selected not at all in item I am able to have and keep an erection.The score of SDS and SAS was 46.76 ± 8.29 and 43.25 ±9.69,respectively.And there were 23.0％ (46/200) and 21.5％ (43/200) patiens exhibited depression and anxiety,respectively.Conclusion In the present study,the prostate cancer patients receiving ADT showed acceptable HRQOL,but some patients sufferd from depression,anxiety and erectile dysfunction.