Objective]To compare the efficacy and safety of retroperitoneal laparoscopic intrasinusal pyelolithotomy (RLIP) and percutaneous nephrolithotomy(PCNL)in the treatment of solitary renal pelvic stone.[Methods]From March 2012 to September 2016,101 patients with solitary renal pelvic stone,divided into RLIP group(n=46)and PCNL group(n=55),were retrospectively analyzed to compare the difference between the two groups in clinical curative effect.[Results]There was no difference between the two groups regarding age,sex,stone side and stone size. Although the operative time was significantly longer,the stone-free rate in the RLIP group was significantly higher than that in the PCNL(P < 0.05). The postoperative complication of urinary tract infection was lower in the RLIP group (P < 0.05),however ,no significant difference was found in postoperative discharge time ,fever (>38.5℃)and the decrease values of hemoglobin and glomerular filtration rate.[Conclusion]Compared to PCNL,RLIP was more efficient and slight safer in the management of solitary renal pelvic stone ,and had a certain value for generalization in clinic.

Objective To explore the effect of brain-derived neurotrophic factor (BDNF) Val66Met polymorphism,environmental factor and their interactions on antidepressant treatment.Methods 340 patients of major depressive disorder (MDD) who met the diagnosis criteria of MDD ( DSM-Ⅳ Axis Ⅰ) were recruited.280 patients of them were finished 12 weeks antidepressant treatment.The severity of depression was measured with the Hamilton Depression Rating Scale (HDRS) before and after 12 weeks antidepressant treatment.Childhood Trauma Questionnaire,28-item Short Form (CTQ-SF) and Life Events Scale (LES) were used to evaluate childhood adverse and life stress before onset.Genotyping of BDNF Val66Met polymorphism was detected by Illumina GoldenGate assays.Results Male patients proportion were significantly higher in non-remitters than remitters (P =0.008 ).After adjusting by gender, the frequencies of genotype and allele for the BDNF Val66Met polymorphism were no significant difference between remitters (AA: AG: GG = 28: 79: 40, A:G = 135:159 ) and non-remitters (AA: AG: GG = 29:81:23 ,A: G = 139:127 ) (P ＞0.05 ).There was no significant difference of CTQ scores and LES scores between the two groups (P＞0.05 ).The regression analysis showed that social intercourse problem and age were the risk factor for the severity of depression.The gender, HDRS baseline scores and mental disorder family history were associated with the efficacy of 12 weeks antidepressant.However,there was no significantly relationship between the interaction of BDNF Val66Met polymorphism and environment with the antidepressant treatment.Conclusion The older men with the mental disorder family history, severe depression symptom would be less-response to antidepressant treatment.However, BDNF Val66Met polymorphism, childhood trauma, life events stress and the interaction of BDNF Val66Met polymorphism and environment have no significantly effect on the 12 weeks antidepressant treatment.

Objective:Object To evaluate the therapeutic effectiveness of postoperative adjuvant mitotane therapy in the context of adrenocortical carcinoma (ACC) by using a meta-analysis methodology.Methods:A comprehensive literature review was conducted by systematically searching the PubMed, EMBASE, Web of Science, and Cochrane Library databases. The search spanned from the establishment of each database to October 2023. Search terms, "mitotane", "adrenocortical carcinoma" or synonyms. Inclusion criteria, Studies comparing outcomes (overall survival (OS) and/or recurrence-free survival (RFS)) in ACC patients with or without mitotane, reporting adjusted hazard ratios (HR) in multivariate Cox regression. Exclusion criteria, Patients with distant metastases, RI(Microscopic residual tumor) rection of ACC, or adjuvant chemotherapy. Data extracted on mitotane treatment concentration, duration, and tumor stage. A meta-analysis was conducted utilizing R4.2.2 software to assess the impact of ACC on OS or RFS through the calculation of HR and 95% confidence intervals (CI). Subgroup analysis of RFS was conducted based on the use of mitotane to reach effective levels or adequate duration, as well as tumor stage ≤T 3. Results:A meta-analysis was conducted, including a total of 15 studies and involving 2084 patients with ACC. Of these patients, 991 received post-surgical treatment with mitotane, while 753 had ACC classified as stages ≤T 3. The results showed that adjuvant mitotane therapy in the ACC group after surgery led to significantly improved OS ( HR=0.45, 95% CI 0.34-0.58, I2=0, P=0.79) and RFS ( HR=0.65, 95% CI 0.51-0.83, I2=76%, P<0.01) compared to non-adjuvant mitotane therapy. Subgroup analysis further revealed that patients with effective mitotane concentration or sufficient time after surgery[Subgroup a(Median follow-up duration < 45 months): HR=0.59, 95% CI 0.44-0.79, I2=0, P=0.38; Subgroup b(Median follow-up duration ≥ 45 months): HR=0.93, 95% CI 0.90-0.96, I2=0, P=1.00 ]and with ≤T 3 stage ACC ( HR=0.61, 95% CI 0.47-0.79, I2=0, P=0.62)had better RFS compared to those who did not achieve the requisite mitotane concentration or postoperative interval, as well as patients with stage T 4 ACC. Conclusions:The administration of adjuvant mitotane therapy following ACC resection has been shown to significantly extend patients' OS and RFS, particularly when the therapy achieves optimal concentration or is administered for an adequate duration. Furthermore, in patients with ACC classified as stage ≤T 3, the effect of adjuvant mitotane therapy on prolonging RFS appears to be more consistent and reliable.