Objective: To analyze the clinical features, etiological distribution and drug sensitivity of primary nephrotic syndrome (PNS) complicated with urinary tract infection (UTI) in children. Methods: The clinical data and etiological characteristics of 221 PNS patients complicated with UTI were retrospectively analyzed, who were hospitalized from January 2008 to December 2017 in the Department of Nephrology, Children′s Hospital of Chongqing Medical University. Results: The PNS patients complicated with UTI were mainly preschoolers (129/221 cases, 58.4%). The incidence of relapsed PNS with UTI (134/822 cases, 16.3%) was higher than that of initial PNS with UTI (87/1 663 cases, 5.2%), and the difference was statistically significant (χ²=83.200, P<0.05). The clinical manifestation was mainly present with asymptomatic bacteriuria (173/221 cases, 78.3%). The proportions of relapsed PNS (112/173 cases) and using prednisone and/or immunosuppressant(126/173 cases) in asymptomatic UTI group were respectively significantly higher than those of the symptomatic UTI group (22/48 cases and 27/48 cases, respectively), and the difference was statistically significant (χ²=5.627, 4.850, all P<0.05). The incidence of recurrent UTI (RUTI)was 13.1% (29/221 cases). Compared with initial UTI group, RUTI group had longer course [(9.3±3.5) months vs.(4.4±3.7) months, t=9.427, P<0.05], and significantly higher proportions of relapsed PNS (29/29 cases vs.105/192 cases, P<0.05), using prednisone and/or immunosuppressant (26/29 cases vs.127/192 cases), decreased hemoglobin(Hb)(14/29 cases vs.51/192 cases) and complement C₃ (14/29 cases vs.31/192 cases) and higher abnormal rate of urinary system (7/29 cases vs.6/192 cases) (χ²=5.480, 5.721, 16.039, 20.094, all P<0.05). Gram-negative bacteria were the dominant pathogens (174/263 cases, 66.1%), and Escherichia coli was the main bacteria (54/263 cases, 20.5%). The proportions of Escherichia coli, Pseudomonas aeruginosa and extended-spectrum β-lactamases(ESBLs) producing bacteria were significantly higher in RUTI group than those in initial UTI group(26/62 cases, 11/62 cases, 21/62 cases vs.28/201 cases, 15/201 cases, 15/201 cases)(χ²=22.776, 5.620, 27.970, all P<0.05). The drug sensitivity test indicated that gram-negative bacteria were more sensitive to Amikacin, Meropenem, and Piperacillin/Tazobactam, and gram-positive bacteria were more sensitive to Vancomycin, Linezolid and Teicoplanin. Conclusions Preschoolers with PNS and relapsed PNS are prone to UTI.The clinical manifestation of UTI was mainly presented with asymptomatic bacteriuria.UTI should be considered when children with PNS relapsed.PNS with longer course, anemia, decreased complement, and urinary system abnormity may be more likely to develop RUTI.Gram-negative bacteria were the dominant pathogens.Escherichia coli was the main bacteria with high drug resistance and ESBLs producing bacteria may be more common in RUTI.Piperacillin/Tazobactam could be the first choice of empirical antimicrobial agents for PNS complicated with UTI.

Objective:To explore the clinical efficacy of excimer laser atherectomy (ELA) in the treatment of diabetic foot with infrapopliteal arteriopathy.Methods:The clinical data of 36 patients (40 limbs) with diabetic foot complicated with inferior knee artery disease treated by ELA in Xinjiang Uygur Autonomous Region People′s Hospital from December 2019 to May 2021 were analyzed retrospectively. The success rate of ELA in the treatment of diabetic inferior genicular artery disease, ankle-brachial index (ABI), limb salvage rate and Visual Analogue Scale (VAS) score at 3 days and 3 and 6 months after operation was observed.Results:All the 36 patients were operated successfully, including 2 cases of flow-limiting dissection, 2 cases of arterial embolism and 1 case of hematoma at the puncture point. The ABI of patients 3, 6 months after operation was significantly higher than that before operation (all P<0.05), and the VAS score 3, 6 months after operation was significantly lower than that before operation (all P<0.05). The rate of limb (toe) salvage were 92.5%(37/40), 82.5%(33/40) at 3 d, 3 months and 77.5%(31/40) at 6 months after operation. Conclusions:ELA is safe and effective in the treatment of diabetic foot infrapopliteal arteriopathy, and the recent efficacy is fair.

The internal iliac artery originating from the common iliac artery is an important branch, and communicating with the branches of the abdominal aorta, such as lumbar artery and sacral median artery, forming rich collateral circulation and nourishing the blood supply of gluteal muscle and pelvic floor viscera. Surgical intervention is recommended when the maximum diameter of internal iliac artery aneurysms>2 cm. A variety of treatment modalities are available, particularly, endovascular technique has been successfully applied in the clinical treatment of internal iliac artery aneurysms, which can significantly improve the cure and reduce complications and deaths. This article reviews the previous literature and summarizes the progress of internal iliac artery aneurysms treatment.

Objective To investigate the safety and feasibility of transumbilical single-site laparoscopic treatment of Meckel's diverticulum in children.Methods A total of 122 patients with Meckel's diverticulum were treated with transumbilical single-site laparoscopic treatment in our department from January 2019 to June 2023.A longitudinal incision was made through the umbilical cord,and 5 mm trocars were inserted into the left and right sides of the incision.The laparoscope and non-invasive intestinal forceps were inserted via the observation and operation holes to probe the abdominal cavity and locate the diverticulum.After the umbilical cord incision was expanded,the diverticulum was pulled out from the abdominal cavity for external resection and anastomosis.Results All the 122 children were diagnosed by laparoscopy.There were 4 cases who were diagnosed as having acute gangrenous appendicitis preoperatively,but were confirmed as having Meckel's diverticulum with perforation under laparoscope intraoperatively.There were 38 cases of lower digestive tract bleeding,48 cases of inflammatory reaction,12 cases of intussusception,8 cases of intestinal obstruction caused by cord and band compression,and 12 cases of peritonitis caused by perforation.All the operations were successfully completed,and the operation time was 58-125 min,with an average of 78 min.Pathological examination after surgery showed Meckel's diverticulum in all the cases.Two cases of incision infection were cured after dressing change treatment.The patients were given a liquid diet 2-4 d after surgery and discharged 5-9 d later.A total of 119 patients were followed up for 3-18 months after surgery,and the surgical results were satisfactory.There were no serious complications such as rectal bleeding,anastomotic stenosis,adhesive intestinal obstruction,or incisional hernia after surgery.Conclusions Transumbilical single-site laparoscopic treatment of Meckel's diverticulum in children is safe and feasible.Meckel's diverticulum combined with perforation or intestinal obstruction is not a contraindication of transumbilical single-site laparoscopic surgery.

Acupuncture safety is an unavoidable problem in acupuncture clinical. is the earliest ancient literature on acupuncture taboo, which has a far-reaching influence on the clinical acupuncture safety regulation. of - absorbs the essence of , retaining most of the contents of the theory and rearranging it. This paper tries to explore the discussions about , compared with , from the point of "anatomy" and "spirit", to describe the early understanding of acupuncture taboo, to emphasize the importance of acupuncture safety from three aspects, as human anatomy, needle and operation, and mental and functional status. It is suggested that a relatively preliminary acupuncture safety regulation was being formed at the time, in order to bring inspiration to the contemporary acupuncture clinical .
Acupuncture Therapy ; adverse effects ; China ; Moxibustion ; Needles

To review the development history of the experimental animal acupoints. To analyze different historical periods, the names of animal acupoints, positioningmethods and references, it is believed that the understanding of experimental animal acupoints has gone through four stages, including initiation, accumulation, specification and standards. At the same time, some important events in the development of experimental animal acupoints were sorted out, including the publication of key papers, books, teaching materials, and the convening of important conferences. In addition, the significance of the above stages of development and the relationship between them were also analyzed to provide basic clues and evidence for the rational understanding of the characteristics and laws of experimental animals. It is concluded that the development of experimental animal acupoints has evolved from simple to complex, from fuzzy to precise.
Acupuncture Points ; Animals ; Books ; Cognition ; Moxibustion

Objective To revise the determination method in the quality standard of Jingtian Zhitong cream. Methods The total saponins of angelica sinensis, Ligusticum wallichii, Rhizoma corydalis, and Panax notoginseng saponins were qualitatively identified by thin-layer chromatography (TLC). The contents of notoginsenoside R₁, ginsenoside Rg₁, and ginsenoside Rb₁ in the preparation were determined by high performance liquid chromatography (HPLC). Results TLC showed strong specificity and good resolution. The concentration of notoginsenoside R₁ showed a good linear relationship in the range of 0.1604 and 2.0050μg (r=0. 999). The concentration of ginsenoside Rg₁ showed a good linear relationship in the range of 0.8003 and 10.0035μg (r=1.000). The concentration of ginsenoside Rb₁ showed good linearity in the range of 0.6182 and 7.7275μg (r=1.000). The sample recovery rates were 101.43%, 98.75% and 100.95%, respectively. The relative standard deviation (RSD) were 2.56%, 2.71% and 2.75%, respectively. Conclusion The developed method is accurate and reliable with high sensitivity, which can be used for the quality control of Jingtian Zhitong cream.