Objective To evaluate the clinical indication,research value and surgical techniques of retroperitoneal laparoscopic ureter lithotomy for ureteral calculi.Methods Clinical data of 98 cases were retrospectively analyzed.All the patients underwent RLU,KWB,IVP,CTU or MRU examination and diagnosed with ureteral calculi,with 42 cases of upper ureteral calculi,35 cases of middle ureteral calculi,and 21 cases of low ureteral calculi.Laparoscopic ureter lithotomy was performed on all the patients.Results All the 98 cases underwent laparoscopic ureter lithotomy (RLU) successfully,with the sizes of stones ranging from 1.5 to 3.0cm,the mean operative time 60 minutes (from 45 to 100 minutes),and mean blood loss 30 mL (from 20 to 60ml).Complication had not been observed in 85 cases for 3-38 months follow-up.Conclusions The treatment of ureteral calculi with lapa-endo-scopic ureter lithotomy shows its unique superiority on the basis of skilled operative technology.Lapa-endo-scopic ureter lithotomy can be a preferred method to be performed or be a compensation method in some cases.

Objective To investigate the clinical effect of the 1 470 nm diode laser for the treatment of superficial bladder tumor.Methods Two hundreds and sixteen patients diagnosed with superficial bladder tumor were treated in our hospital from January 2012 to January 2014 and divided into the laser group and electric cutting group.The two groups were treated by 1 470 nm diode laser and transurethral plasma kinetic resection respectively.The basic data and the observation indexes were compared be tween the two groups.Results The operation time,intraoperative bleeding volume,indwelling catheter time and hospital stay time in the laser group were significantly less than those in the electric cutting group.The levels of epinephrine,norepinephrine and an giotensin Ⅱ in operation and at postoperative 6 h in the laser group were significantly lower than those in the electric cutting group (P＜0.05).The obturator nerve reflex and bladder perforation did not occur in the laser group,and the total complications occurrence rate was 5.1％,the bladder tumor recurrence rate in postoperative 24 months was 7.1％.The obturator nerve reflex occurrence rate was 7.6％,the vesical perforation rate was 1.7％,the total complications occurrence rate was 15.3％,the bladder tumor recurrence rate in postoperative 24 months was 17.8 ％ in the electric cutting group.The above indexes of the laser group were significantly lower than those of the electric cut group(P＜0.05).Conclusion The 1 470 nm diode laser for the treatment of noninvasive superficial bladder tumor has definitely curative effect,is easy to operate with low postoperative complication occurrence rate,high safety and low middle and long term recurrence rate,moreover has little influence on patient's stress level.

The plants in genus Gentianella Moench (Gentianaceae) which comprised approximately 250 species, are mainly distributed in temperate regions of the world.Many Gentianella plants are intensely bitter and employed in traditional medicine to stimulate appetite, treat disorders of the gallbladder, and treat fever like the other bitter gentians in various regions of the world.Some species exhibit other remarkable therapeutic effects in the treatments of obesity,diabetes, and heart diseases.Eleven iridoids, twenty-eight xanthones, three C-glucoflavonoids, and eight other compounds have been isolated from the genus.Most of these compounds are associated with antimicrobial,anti-inflammatory, anti-oxidant, hypoglycemic, and antitumor activities, which provide an empirical base for the traditional utilization of the plants in genus Gentinella Moench.

Objective To discuss the clinical correlation between chronic prostatitis (CP) and erectile dysfunction (ED).Methods A retrospective analysis was made on the clinical data from patients who were diagnosed as CP in urology department of the First People's Hospital of Yunnan Province and the First Affiliated Hospital of Sun Yat-sen University.Patients' data were collected from July 2005 to July 2012.All the patients were diagnosed as CP based on their clinical manifestation,the NIH Chronic Prostatitis Symptom Index,prostatic fluid examination,routine urine examination and ultrasonography.The condition of erectile function was inquired on every patient and recorded.Results There were 4 315 patients diagnosed as CP in present study,while their age ranged from 17 to 64 years (average,31 years).Sixty-one (1.41％) patients were identified as moderate and severe types of ED (International Index of Erectile Function 5 ≤ 11),while 42 (0.97％) patients were confirmed as ED after they got CP.435/4 315 patients (10.08％)felt obviously sexuality descent after they got CP,and the sexuality was reported improved in 426/435 pa-tients after prostatitis symptomatic relief.Conclusions The incidence rate of ED in CP patients is not ob-viously higher than that in common community.And sexuality descent in patients might be caused by localindisposition and anxiety after CP.

Objective: To provide an important tool for the study of diagnose and treatment of prostate cancer (PCa) osseous metastasis and change of bone stress force on prostate cancer (PCa) osseous metastasis and a platform, which is more congruous to clinical process, for prevention and cure of neoplastic bone metastases, and to carry out the construction and improvement of animal models of PCa with different positional osseous metastasis in vivo.Methods: Different gradient concentrations of RM-1 cells were inoculated into the cavity of left femoral bone or lumbar vertebra of mice (C57BL/6) respectively.The change of mouse activity, tumor formation, tumor size and survival time were observed respectively.And the femur tissue and spinal tissue were obtained from the mice after death.The gray value of iconography were measured by imageological examination of femur tissue, and the final histopathological examination were taken to determine the tumor type in both femur and spinal tissue.Results: The tumor growth could be touched at the puncture site in all the mice after inoculated for 7 days.There were no obvious differences in the time of tumorigenesis, the rate of tumor growth and tumor size among the mice in the same group (P>0.05).As the result, the construction femoral bone and lumbar vertebra metastatic models of PCa had been confirmed by iconography and pathology detection.At the same time, the survival time of the mice inoculated with low concentrations of PCa cells was obviously longer than that of high concentrations of PCa cells (at least 2 weeks longer).Conclusion: The animal models with different positional osseous metastasis (limbs and axial skeleton) of PCa using the same PCa cells (RM-1) had been first constructed successfully in our study.At the same time, a high success rate of construction of PCa animal model with bone metastasis was obtained by femoral bone marrow cavity injection of PCa cells.The rate of tumor growth was rapid, animal survival time was appropriate, and the PCa animal model with bone metastasis can be stably reproduced by our method.These animal models can be used to explore the pathogenesis of different positional PCa bone metastasis and provide a new platform, which were more congruous to clinical process, for prevention and cure of neoplastic bone metastases.

Objective Meningovascular syphilis is the intima inflammation of blood vessels caused by the syphilitic infec-tion, which is associated with the occurrence of ischemic stroke.The study analyzed the clinical, imaging features and prognosis for meningovascular syphilis so as to improve its diagnosis and treatment. Methods 14 patients diagnosed with meningovascular syphilis were collected prospectively from December 2007 to March 2015 in the neurological department of Jinling Hospital.The patients were followed for a period of 21.5(range 10.2~37.9)months,and the prognosis were evaluated. Results Patients with meningovascular syphilis presented with dizziness, hemiplegia, hemidysesthesia and cognitive decline.Lesions showed multiple, scattered on MR ima-ging, intracranial vascular stenosis was seen in the CTA/MRA, and the laboratory examination had characteristic changes.With a large dose and sufficient courses of penicillin treatment, meningovascular syphilis may hopefully get predominant effects.78.57%patients got good prognosis(modified Rankin Scale ,mRS≤2)at 3 months and 85.71% patients got goodlong-term prognosis(mRS≤2). Conclusion Meningovascular syphilis was usually presented as acute onset, lacks the specific clinical and neuroimaging manifesta-tions.Most patients has favourable prognosis after treatment of syphilis with full course of penicillin.

Objective To investigate the clinical features,diagnosis and therapy of adrenal incidentalomas. Methods The data of 66 cases of adrenal incidentalomas were retrospectively analyzed. Results The accuracy rates of localization detected by B-Ultrasound,CT scan and MRI were 84.3%,100% and 100% respectively. The accuracy rates of qualitative diagnosis by B-Ultrasound, CT scan and MRI were 30.0%,75.5% and 79.2% respectively. There were 60 cases underwent operation and the postoperative pathological examination confirmed that there were 31 cases of adrenal cortical adenoma, 6 cases adrenal cyst, 5 myelolipoma, 5 pheochromocytoma, 3 adrenal cortical carcinoma, 3 metastatic carcinoma, 3 ganglioneuroma, 1 adrenal neurilemmoma, 1 adrenal hematoma, and 1 nodular hyperplasia of adrenal cortex. Conclusions Ultrasonography is the first choice of scanning adrenal incidentaloma. However the CT scan and MRI are satisfactory in localization of the tumour. The qualitative diagnosis of adrenal incidentaloma will depend on the diameter, imaging features of tumors, the age of patients, and endocrine examination.

Objective No consensus has yet been achieved on the relationship of serum albumin with the functional out-come of acute ischemic stroke.The aim of our study was to determine whether the serum albumin level was associated with the short-term functional outcome of acute ischemic stroke in well-nourished patients. Methods Totally, 113 patients with first-ever acute ischemic stroke were recruited from Nanjing Stroke Registration Program between January and June 2015.Baseline data including de-mographic and body parameters, vascular risk factors, and laboratory results were collected.The NIH Stroke Scale ( NIHSS) was used to evaluate the severity of neurological deficits and the modified Rankin Scale ( mRS ) employed to assess the short-term functional outcome.According to the mRS at discharge, the patients were divided into a good outcome group ( mRS<3 ) and a poor out-come group ( mRS≥3 ) .The independent predictors of the short-term functional outcome were evaluated by multivariate logistic regression analysis. Results Of the 113 acute ischemic stroke patients included, 52 (46.0%) were in the good outcome group, and 61 (54.0%) in the poor outcome group.Those in the former group had a significantly higher BMI, lower serum LDL-C, lower WBC count, and lower NIHSS at admission than those in the latter .Multivariate logistic regression analysis showed that low serum albumin, NIHSS at admission, and arteriole occlusion were independent predictors of the poor short-term functional outcome ( OR=0.684, 95% CI:0.490-0.956, P=0.026). Conclusion Low serum albumin is an independent predictor of poor short-term functional outcome in acute ischemic stroke patients in well-nourished status.

Objective: To explore the mediating effect of anxiety, insomnia, and family cohesion between Internet addiction and non suicidal self injury (NSSI) behavior among junior and senior school students, so as to develop interventions to promote adolescent mental health. Methods: A total of 3 026 junior and senior school students from Yixing, Jiangsu Province, China, were selected by stratified cluster sampling from December 2022 to February 2023, and were administered the Ottawa Self injury Inventory (OSI), Depression, Anxiety and Stress Scale-21 (DASS-21), Family Environment Scale-Chinese Version (FES-CV), Insomnia Severity Index (ISI), and Chinese Internet Addiction Scale Revised (CIAS-R). A mediating effect model was constructed to analyze the mediating effect of anxiety, insomnia, and family cohesion on Internet addiction and NSSI. Results: Internet addiction ( r = 0.24), insomnia ( r =0.28), and anxiety ( r =0.27) were positively correlated with NSSI, while the latter was negatively correlated with family cohesion ( r =-0.23) ( P <0.01). The mediating effect model was well fitted ( CFI=0.999, TLI=0.978, RMSEA = 0.030 ). Anxiety (mediation effect value:0.12, 95% CI =0.08-0.18) and family cohesion (mediation effect value:0.08, 95% CI = 0.03 -0.13) had a separate mediating effect. A chain meditating effect was found in the case of anxiety and insomnia (mediation effect value:0.14, 95% CI =0.10-0.20), family cohesion and anxiety (mediation effect value:0.05, 95% CI =0.03-0.07), family cohesion and insomnia (mediation effect value:0.05, 95% CI =0.03-0.07), and family cohesion, anxiety, and insomnia (mediation effect value:0.06, 95% CI =0.04-0.08). The mediating effect accounted for 14.9%, 10.1%, 17.5%, 6.0%, 5.6%, and 7.1%, respectively. Conclusions Anxiety, insomnia, and family cohesion partially mediate Internet addiction and NSSI. Schools and families should pay attention to Internet addiction among junior and senior school students and develop appropriate interventions to promote adolescent mental health, so as to reduce the prevalence of NSSI.

Objective: To explore the association between negative emotion (depression, anxiety and stress), family intimacy and Internet addiction, so as to provide a basis for the intervention of Internet addiction among junior and senior high school students. Methods: Students were selected by stratified random cluster sampling method from junior high schools and senior high schools from December 2022 to February 2023 in Yixing City, Jiangsu Provicne. A total of 3 026 students completed the questionnaire survey, including the demographic characteristics, Depression, Anxiety and Stress Scale-21 (DASS-21), Family Environment Scale-Chinese Version (FES-CV), and Chinese Internet Addiction Scale Revised (CIAS-R). Bivariate correlation was used to analyzed the association of family intimacy, depression, anxiety, stress, and Internet addiction. Mediating effect model was used to analyzed the mediating effect of negative emotion between family intimacy and Internet addiction. Results: The average score of Internet addiction among junior and senior high school students was (46.26±15.58), and there were statistical differences in the average scores of Internet addiction across different grades ( F=87.15, P <0.01). Depression ( r =0.57), anxiety ( r =0.56), stress ( r = 0.57) were positively correlated with Internet addiction, and family intimacy ( r =-0.34) was negatively correlated with Internet diction ( P <0.01). In the mediating effect model, family intimacy negatively predicted negative emotion ( β =-0.48) and Internet addiction ( β =-0.10), and negative emotion positively predicted Internet addiction ( β =0.45) ( P <0.01). Negative emotion played a partial mediating role between family intimacy and Internet addiction (the mediation value:-1.71, 95% CI =-1.96--1.49, mediation ratio:67.9%, P <0.05). Conclusions There are associations between negative emotion, family intimacy and Internet addiction among junior and senior school students. Family intimacy indirectly affects Internet addiction mainly through negative emotion. It suggests that family education is in need of attention to reduce the prevalence rate of Internet addiction among junior and senior high school students, especially family intimacy.