Objective:To evaluate the safety and efficacy of endoscopic cryoablation (ECA) in patients with upper tract urothelial carcinoma (UTUC).Methods:The clinical data of 9 patients with UTUC treated with ECA from April 2018 to September 2019 were retrospectively analyzed. Patients consisted of 3 males and 6 females, with median age of 76 years old (ranging from 50 to 88 years old). Among the patients, 6 cases had tumors of ureter, 1 case had tumor of renal pelvis and 2 cases had tumors of renal pelvis combined with ureter. Of the 9 patients, two had bilateral UTUC, six were presented with single lesion, three were presented with multiple lesion. The size of tumors were (1.53±0.91)cm. The tumors of all cases were localized (≤stage T 2), and there was no carcinoma or suspicious lymph node/distant metastasis. All patients enrolled in this study had strong will to choose kidney-sparing therapy. Biopsy, resection of intraluminal lesion with laser and cryoablation under ureteroscopy or percutaneous nephroscopy was performed under general aneasthesia.Ureteroscopy was performed 3 months after cryoablation. Perioperative complications and follow-up results were recorded and assessed. Results:Cryoablation was successfully performed in patients under ureteroscopy (n=8) or nephroscopy (n=1). The median cryoablation time was 6 (ranging from 4-16) minutes. The median follow-up was 16 months (ranging from 4-24 months). No tumor recurrence was observed at primary sites during follow-up. Two patients with multiple lesions were observed denovo ureteral neoplasms outside the primary sites 3 months and 6 months after cryoablation and treated with second cryoablation. One case died due to cardiovascular events 4 months after surgery. One patient underwent ureteral stricture during follow-up and received ureteroscopic balloon dilatation. No recurrent stricture was found in this case during the subsequent follow-up of 16 months. The other 5 cases showed no recurrence or complications like stricture during follow-up.Conclusions:ECA could probably be a promising treatment for localized UTUC. No recurrence in primary site and low incidence of ureteral stricture was observed during follow-up. The efficacy and safety of ECA need to be verified with large sample study.

Objectives To explore the clinical intervention of prenatal diagnosed congenital choledochal cyst in infants. Methods 37 infants with prenatally diagnosed congenital choledochal cyst from September 2006 to February 2013 were di-vided into early (0-3 month) operation group (Group A, n=20) and late (>3 month) operation group (Group B, n=17) according to the timing of surgery. The clinical characteristics, the preoperative and postoperative liver function, postoperative com-plications and pathological examination of liver biopsy were retrospectively analyzed. Results Five infants in group A and 2 infants in group B became jaundiced after birth. No statistical difference was found in alanine aminotransferase (ALT) and aspartate aminotransferase (AST) between two groups (P>0.05). Preoperative and postoperative levels of total bilirubin (TBIL) and direct bilirubin (DBIL) in group A were signiifcantly higher than those in group B (P<0.05). Two cases had anastomotic stricture and one case had bile leakage in group A while no postoperative complication was found in group B. Liver biopsy re-sults showed that there were 11 cases of biliary cirrhosis, including 4 cases in group A (36.36%) and 7 cases (63.64%) in group B, but no statistical difference in incidence of cirrhosis between two groups (P=0.160). Conclusions Infants with prenatally diagnosed congenital choledochal cyst should be closely observed. Once jaundice, clay-coledstool, increased ALT and AST, fast growing enlarged cysts were found, infants should be surgically treated as soon as possible to reduce liver damage and the incidence of liver cirrhosis.

BACKGROUND:Chronic visceral pain is one of major complaints of irritable bowel syndrome which seriously affects patient’s quality of life. Recent researches have shown that moxibustion therapy has positive effects on aleviating chronic visceral pain in irritable bowel syndrome patients.
OBJECTIVE: To study the clinical utility of moxibustion in coping with chronic visceral pain of irritable bowel syndrome patients, and shed light on the theoretical basis of moxibustion analgesia, thereby to give insights into the further research and application on moxibustion.
METHODS: With the key words of “moxibustion, irritable bowel syndrome, visceral pain, abdominal pain” in Chinese and in English, respectively, a computer-based search was performed in CNKI, VIP, Wanfang and PubMed databases for articles published from January 1990 to October 2014. After the initial screening, the remained articles went through further selection and categorization.
RESULTS AND CONCLUSION:The result shows promising results of moxibustion on relieving chronic visceral pain for both two subtypes of irritable bowel syndrome patients, diarrhea type and constipation type. Moxibustion may exert an analgesic effect on chronic visceral pain in irritable bowel syndrome patients through regulation of visceral hypersensitivity, gastrointestinal motility disorders, brain-gut axis and neuroendocrine system disorders, immune dysfunction and low-grade inflammation in the gut, psychological abnormalities, and alteration of intestinal flora. However, to fuly understand the analgesia effect of moxibustion and elucidate its mechanism, more standardized randomized controled trials employing advanced scientific techniques and equipments wil stil be needed in the future.

BACKGROUND:Warm acup-moxibustion is an effective treatment in Chinese traditional medicine, which combines acupuncture with moxibustion. With an immediate analgesia or/and long-term effect, warm acup-moxibustion has been used clinicaly for acute and chronic pain. OBJECTIVE:To analyze the progress in the studies about clinical application of warm acup-moxibustion as analgesic therapy for acute and chronic pain and to discuss the influential factors. METHODS: CNKI, VIP and Wanfang databases were searched for relevant articles published between January 1995 and July 2015 using the keywords of “warm needling; warm acup-moxibustion; pain; analgesic” in Chinese. According to the exclusion and inclusion criteria, 51 articles were included in result analysis. RESULTS AND CONCLUSION: Compared with ordinary acupuncture, medicine and other treatment methods, warm acup-moxibustion can play an analgesic role in multiple systems, which is better than ordinary acupuncture and Western medicine. Warm acup-moxibustion combined with drugs and acupuncture techniques can increase the analgesic effect and improve joint function activity. Warm acup-moxibustion with the overal regulatory role plays an effective analgesic pain role in the multiple systems and shortens the duration of treatment, which is an effective method for treating pain and worthy of further promotion and application.