ObjectiveTo provide a new method for the predictive diagnosis of PIH through the detection of the PTA blood flowing indexes of the pregnant women. MethodTo adopt the color Doppler ultrasonic wave the conduct the contrast normal pregnant women and PIH women of post-pregnancy 30 cases respectively. Results①The peak value flow rate of blood at diastolic period (short for D), the average blood flow rate (short for MN), the ratio of the peak value blood flow rate (S/D) for PIH group are higher than those for the other two groups respectively (P<0.01); ②There is no statistic difference in the changes of the PTA artery internal diameter between the three groups. ConclusionThe changes in the PTA blood flow indexes of the PIH patients provides a new method for the diagnosis of this disease, which is of some reference value. Such indexes as S, MN and S/D of the PTA are better targets for observation.

Objective To explore clinical significance of muhidetector(64-row)computed tomography carotid atherosclerosis angiography(MDCTA)in detecting carotid atherosclerotic plaque.Methods Data of 116 patients with carotid atherosclerosis undergone with MDCTA stayed at Huashan Hospital,Shanghai from January to August,2008 were analyzed retrospectively.Results Three hundred and seventy-seven plaques were identified among all the 116 patients in the study,with an incidence of calcified plaque of 63.40 percent,and more detected at the common carotid artery(27.85%).the carotid bifurcation(39.78%)and the internal carotid artery (21.48%).There was significantly statistical difference in plaque types between those with mild,moderate and severe carotid stenosis(P=0.000)and between those aged equal to or lower than 50 years and equal to or greater than 70 years(P=0.005).Plaque types at the common carotid artery were significantly difierent from those at the carotid bifurcation(P=0.000)and at the internal carotid artery(P=0.000).Results of regression analysis showed a positive and significant association between carotid occlusion and clinical symptomatology(with a coefficient of correlation of 1.080.P=0.023)and inverse association between calcified plaque and clinical symptomatology(with a coefficient of correlation of 0.688,P=0.006).Conclusions Not only imaging characteristics of carotid atherosclerotic plaque can be accurately assessed by MDCTA,but also measurement of its stenosis degree.Assessment of plaque type,degree of stenosis and distribution of plaque in different Vascular segments with MDCTA can be used to predict clinical occurrence of cerebevaseular events in patients with carotid atherosclerosis.

Aim To investigate the effect and mecha-nism of quercetin combined with cisplatin on prolifera-tion and apoptosis of human osteosarcoma cell line MG-63 . Methods MG-63 cells were treated with quercetin alone or combined with cisplatin. Cellular morphologic changes were observed under inverted phase contrast microscope. The effects of proliferation inhibition were assayed by CCK-8 method. The combination effect was judged through Chou-Talaly analysis. The apoptosis ra-tios of cells were analyzed by flow cytometry. The gene expression of Bcl-2 and caspase-3 was detected by RT-PCR assay. The protein expression of Bcl-2 and caspase-3 was measured by Western blot assay. Re-sults Quercetin alone or combined with cisplatin could inhibit the proliferation, but induce the apoptosis of MG-63 cells. Combination of quercetin and cisplatin revealed a synergistic effect on cell proliferation and apoptosis as it reduced the expression of Bcl-2 but en-hanced that of caspase-3 at both gene and protein lev-els. Conclusion Synergistic effect of quercetin com-bined with cisplatin on cell proliferation and apoptosis of MG-63 cells is possibly due to reduction of Bcl-2 and enhancement of caspase-3 expression.

BACKGROUND:The laparoscopy is superior to open surgery for being less invasive, inducing mild stress reaction and allowing quick recovery after operation, however the effects of laparoscopy on perioperative serum cytokine levels are controversial, and only a few studies discuss these effects among pediatric patients.OBJECTIVE: To compare the changes in perioperative cytokine levels and their clinical significance in pediatric patients undergoing laparoscopy and open surgery.DESrGN: Non-randomized concurrent controlled observation.SETTTNG: Department of Urology in Xijing Hospital of the Fourth Military Medical University of Chinese PLA.PARTICT PANTS: From May 2004 to December 2006, 135 pediatric patients for elective operation were recruited from Department of Urology in Xijing Hospital of the Fourth Military Medical University of Chinese PLA. Sixty-five patients were scheduled for laparoscopic surgery while the remaining 70 patients for open surgery.METHODS: Serum levels of interleukin-1 beta (IL-1β), IL-6, IL-10 and tumor necrosis factor-alpha (TNF-α) were measured at 24 hours before operation, and 3, 24, 48 hours after operation respectively. Duration of hospitalization time of all the children was also recorded.MAIN OUTCOME MEASURES: Levels of IL-1β, IL-6, IL-10 and TNF-α of all the patients were measured 24 hours preoperatively, and 3, 24, 48 hours postoperatively.RESULTS: All the 135 cases were included for statistical analysis. ①There were no significant perioperative changes in cytokine levels after laparoscopic surgery (P ＞ 0.05). In the open surgery group, IL-1β and IL-6 levels increased significantly at 3 and 24 hours after operation (P ＜ 0.05), and normalized within 48 hours postoperatively. No significant perioperative differences were found in IL-10 and TNF-α levels (P ＞ 0.05). The levels of IL-1β and IL-6 were significantly higher in the open surgery group than in the laparoscopic surgery group (P ＜ 0.05). ②Duration of hospitalization was shorter in the laparoscopic surgery group than in the open surgery group [(3.5±1.0), (7.5+1.5) days, P＜ 0.05].CONCLUSTON: Pediatric patients undergoing laparoscopic surgery had less perioperative changes in cytokine levels and quicker recovery.

Objective To analyze the follow-up results and clinical characteristics of one case of highly sensitized recipient after combined kidney transplantation and splenic fossa auxiliary heterotopic liver transplantation.Methods This patient was diagnosed as having chronic renal insufficiency in the uremia period 10 years ago,subjected to kidney transplantation 9 years ago,and got renal allograft loss 8 years ago.The recipient was positive for PRA (for class Ⅰ,31％,and for class Ⅱ,63％).Under the general anesthesia,the patient was given combined kidney transplantation and splenic fossa auxiliary heterotopic liver transplantation.The ATG was used for immune induction.Rituximab and plasma exchange were applied to prevent acute rejection.Regular follow-up was done after discharge.Results On the postoperative day (POD) one,ALT was 256 IU/L,AST was 342 IU/L and serum creatinine was 502 μmol/L.On the POD 6,ALT and AST levels were normal and serum creatinine was 141 μmol/L.Serum creatinine increased to 202 μmol/L and the volume of urine reduced on the POD 7.The ultrasound displayed graft size increased slightly,substantial echogenicity enhanced,artery blood flow RI increased to 0.8,suggesting the occurrence of acute rejection.A single dose of Rituximab,intravenous IG,and plasma exchange were given.On the POD 60,serum creatinine was reduced to 131 μmol/L.During a follow-up period of 28 months,imrnunosuppresants were given:Tac + MMF + Pred.FK506 valley concentration was maintained at 6-8 μg/L.The function of the transplanted kidney and liver was normal,and the general conditions were good.Conclusion Combined kidney transplantation and splenic fossa auxiliary heterotopic liver transplantation is safe.Individualized medication and regular follow-up are the important factors for long-term survival of recipients.

BACKGROUND: The nutritional support, as well as the water and electrolyte balance during the perioperative period in the renal transplantation recipients at diuresis stage are important to the functional restoration of transplanted kidneys.OBJECTIVE: To explore the method and opportunity of the nutritional support and the handling of the water and electrolyte balance in perioperative period of renal transplantation.DESIGN, TIME AND SETTING: A retrospective clinical analysis was performed in the Department of Urology, Xijing Hospital from June 2003 to June 2007.PARTICIPANTS: Ninety-six patients of chronic renal failure underwent allograft renal transplantation. They comprised 59 males and 37 females, aged 17-67 years, with a mean of 35.7 years.METHODS: The perioperative physiological features of the renal transplantation recipients were summarized retrospectively. The recipients' condition during the perioperative period was divided into two stages at the opening point of allograft blood current. The vital signs of the patients maintained at a stable level before operation. All patients received blood transfusion since the operation began, and were supplemented with albumin before opening the vessels. Urinary production exceeding 100 mL per hour indicated the beginning of fluid replacement, which was a simplified transfusion for the patients at diuresis stage following renal transplantation.MAIN OUTCOME MEASURES: Blood inosine, urea nitrogen, electrolyte, blood sugar and urine of the patients were detected at one day postoperatively.RESULTS: During 12-16 hours postoperatively, the urinary production was 260-1 200 mL, average 520 mL per hour. Blood routine test showed 8 cases developed mild hyponatremia, accounting for 8.3%, 3 cases occurred high potassium and healed after renal functional recovery, 1 case presented low potassium and healed with supplement therapy. There were no abnormal changes of blood chlorine. The blood glucose among 21 cases (21.9%) was higher than the normal level, and recovered following hormone maneuver. The electrolytes and blood glucose were detected to be normal in other patients, without any case with low calcium or magnesium. The urine specific gravity arranged during 1.010-1.015.CONCLUSION: The colloid such as erythrocytes, blood plasma and albumin should be mainly infused before the opening of allograft blood current. And the water and electrolytes is recommended to administrate promptly and regularly during the diuresis stage. The healing of the stoma benefits from the adequate nutritional support. The metabolic acidosis still should be prevented when the urinary production returns normal.

Objective: To explore the core features of trait aggression in children and adolescents, so as to provide a theoretical basis for behavioral interventions targeting the central psychological characteristics of aggression in children and adolescents. Methods: From March to May 2020, a simple random convenience sampling method was employed to recruit 39 165 students from grades 4 to 12 in Sichuan, Chongqing, Guizhou, and Shandong. Data were collected via online questionnaires, with all participants completing the Chinese Version of the Aggression Questionnaire. Psychometric network analysis was utilized for data processing. Results: Trait aggression among Chinese children and adolescents was at a moderately low level. The core nodes of the network structure included physical aggression [if someone intentionally causes trouble for me, I will hit them severely (AGG6); if someone hits me, I will retaliate (AGG11)] and self aggression [When I am very irritable, I think of hurting myself (AGG5); when I am in a bad mood, I engage in behaviors that harm my health, such as overeating (AGG25)]. Across grade levels, core nodes primarily originated from the anger dimension [When I m angry, I feel like a powder magazine that could explode at any moment (AGG13); I can t control my temper (AGG18); I am prone to getting angry when I see things that are not pleasing to the eye (AGG23); I will get angry for no reason (AGG27)]. Except for grades 7 and 9, core nodes in other grades included the verbal aggression dimension [I am prone to arguments with people (AGG22)]. Before grade 8, core nodes incorporated the self aggression dimension (AGG 5, AGG 25); after grade 8, core nodes included the physical aggression dimension [AGG 6, AGG 11, I fight slightly more than others (AGG16), and if people around me make things difficult for me to a certain extent, I will fight with them (AGG26)]. No statistically significant differences were found in the trait aggression network structures across grades, genders, or within gender comparisons of different grades. Conclusion These findings broaden our understanding of aggression in children and adolescents, suggesting that behavioral interventions can effectively reduce aggressive behaviors in this population.

[Abstact] Objective To investigate the efficacy and safety of sunitinib as first line therapy in treating those patients with metastatic renal cell carcinoma ( mRCC ) .Methods A total of 66 patients , including 42 male and 24 female cases ,with metastatic renal cell carcinoma were enrolled from January 2009 to June 2014.The median age was 52 years (range 26-75 years).According to American Joint Committee On Cancer (AJCC) staging,there were 35 cases of T3 stage,31 cases of T4 stage.All patients had distant metastasis ,including single organ metastasis in 52 patients and multiple organ metastasis in 14 cases.Sixty-one patients received prior radical nephrectomy ,5 patients received biopsy .Sixty-two patients were diagnosed as renal clear cell carcinoma and 4 patients were diagnosed as renal papillary cell carcinoma .Sunitinib was administered in standard 4/2 regimens.Briefly, patient takes 50 mg once a day orally for 4 weeks.Then the sunitinib will be stopped for 2 weeks.Six weeks was defined as 1 cycle.It should be continued until disease progression or occurrence of intolerable adverse reactions .The efficacy of sunitinib should be evaluated within 2 cycles.Results The duration of following-up ranged from 5 to 66 months.The efficacy could be evaluated in 63 patients.Two patients ( 3.2%) achieved complete remission .Twelve patients ( 19.0%) achieved partial remission.Forty-five patients (71.4%) demonstrated stable disease and 4 patients (6.3%)
developed progressive disease .The disease control rate was 93.7%(59/63) and the objective response rate was 22.2%(14/63).2 (3.2%) patients died due to the progression of disease .The most commonⅠ-Ⅱadverse events included fatigue in 36 cases ( 57.1%) , thrombocytopenia in 36 cases ( 57.1%) , hand-foot syndrome in 32 cases (50.8%),hypertension in 27 cases (42.9%),neutropenia in 15 cases (23.8%), hypothyroidism in 12 cases (19.0%), diarrhea in 6 cases (9.5%) and alopecia in 4 cases (6.3%).Ⅲ-Ⅳ adverse events were hand-foot syndrome in 4 cases ( 6.3%) , hypertension in 2 cases ( 3.2%) , neutropenia in 5 cases (7.9%) and thrombocytopenia in 5 cases (7.9%).Most mild adverse reactions after symptomatic treatment could be alleviated ,did not affect the medication .When the adverse events returned to the Ⅰ-Ⅱdegree, the 37.5 mg sunitinib was resumed once daily by orally.NoⅢ-Ⅳadverse events were reported again.Conclusions Sunitinib was efficacious in the treatment of advanced renal cell carcinoma.Most mild adverse events were tolerable ,and severe adverse events need medical treatment .

Objective To discuss the optimal operation mode and operation path in minimally invasive technique for living donor nephrectomy.Methods From September 2013 to August 2015, 68 living donor nephrectomy was retrospectively reviewed. Thirty-one patients were performed with robotic-assisted laparoscopic living donor nephrectomy(robotic group), twenty-nine patients underwent totally retroperitoneal laparoscopic living donor nephrectomy(non hand assisted group),and eight patients were performed with hand assisted retroperitoneal laparoscopic living donor nephrectomy(hand assisted group). Operation time, warm ischemia time, intraoperative hemorrhage volume, hospitalization time, complications and preoperative and postoperative serum creatinine value of the recipients between the two groups were compared.Results The operations of three groups were all performed successfully. Intraoperative hemorrhage volume in the three groups were(39±15)ml,(62±37)ml and(53±19)ml, and there were significant differences between these groups(P<0.05). But hospitalization time ,operation time, warm ischemia time and complications occurred rate in the three groups had no significant difference(P>0.05). In robotic group,2 donors occurred with splenic injury during operation and 1 donor was detected with hemorrhage after operation. In non-hand assisted group, 1 donor occurred with urinary tract infection, 1 donor occurred with external iliac vein thrombosis. In hand assisted group 1 donor was detected with wound fat liquefaction after operation. All the donors were followed up for more than 9 months, no hypertension, proteinuria and renal dysfunction complications were detected. The blood creatinine in three groups of recipients after operation of 5th day and 28th day were(118±26)μmol/L, (130±33)μmol/L,(128±41)μmol/L and(114±17)μmol/L,(116±34)μmol/L,(115±29)μmol/L, respectively, and there was no statistical difference(P>0.05).Conclusions Minimally invasive technique for living donor nephrectomy is beneficial to patients' recovery. Surgery doctors should combine personal experience and the hospital's hardware conditions and other factors. The principle is to ensure the donor's safety and to balance the interests of the donor and the recipient, to choose their own most skilled way of surgery.

Objective To investigate the diagnosis and treatment regimen for patients with chronic diarrhea after renal transplantation.Methods The clinical data of 353 patients with chronic diarrhea who underwent renal allograft transplantation at Department of Urology of Xijing Hospital from January 2007 to June 2014 with regular follow-up were analyzed retrospectively.The occurrence of chronic diarrhea after renal transplantation was observed,including incidence,time of occurrence,course of disease and complications. The changes in general conditions and auxiliary examination indexes (body mass index,anemia and other auxiliary examination indexes),treatment and prognosis of the patients with chronic diarrhea were recorded. Results Fifteen cases (4.2%) of 353 renal transplant recipients had chronic diarrhea. The time of symptomatic and etiological treatment was (15 ±7 ) d.Two patients died during diarrhea (died from gastrointestinal hemorrhage and sudden death caused by severe hypokalemia respectively)and other patients were recovered.Among the 13 patients,5 cases had good prognosis,2 cases died (both died from pulmonary infection),5 cases suffered from renal allograft dysfunction and 1 case suffered from renal allograft insufficiency during the follow-up.Conclusions The etiology of chronic diarrhea after renal transplantation is complex and the patients should receive symptomatic and etiological treatment.The patients with chronic diarrhea after renal transplantation combined with severe complications have poor prognosis.