Objective To evaluate the therapeutic effect of ureteroscopy with holmium laser on ureteral stricture associated with calculi.Methods The clinical data of 36 cases of ureteral stricture associated with calculi undergoing ureteroscopy with holmium laser treatment were analyzed retrospectively with 26 cases of male patients and 10 cases of female patients.The age was 26-65 years.There were upper and middle ureteral stricture associated with calculi in 8 cases,and lower segment of ureteral stricture associated with calculi in 28 cases.All the patients were treated with ureteroscopy with holmium laser.All cases were followed up for 6-12 months.In the follow-up of 36 cases B ultrasound and urinary tract flat piece or intravenous urinary tract imaging were performed to evaluate the therapeutic effect.Results Thirty-six patients underwent ureteroscopy with holmium laser successfully.No conversion to open surgery occurred.Mean operating time was 30 (20-45) min.Mean hospital stay postoperatively was 3-5 d.Postoperative 8 cases with low thermal,alleviated by the anti-infection treatment,no ureteral avulsion,leakage and severe complications such as hemorrhage.Postoperative follow-up,32 cases (89％,32/36) were cured and 4 cases (11％,4/36) were improved.Conclusion Ureteroscopy with holmium laser in treatment of ureteral stricture associated with calculi is a simple and effective minimally invasive method.

Objective T o understand the assessm ent on the criminal responsibility of drug-induced m ental disorders and judicial experts’ opinions. Methods T he judicial experts from institutes of forensic psychi-atry in Shanghai were selected. T hey were asked to finish a self-m ade questionnaire of assessm ent on the criminal responsibility of drug-induced m ental disorders by letters and visits. Results Most of experts knewthe special regulation,“not suitable for evaluation” towards the criminal responsibility of drug-in-duced m ental disorders of the guideline prom ulgated by Ministry of Justice. B efore and after the guide-line was issued, no expert m ade a no-responsibility opinion in such cases. After the guideline was issued, som e experts m ade a full-responsibility or lim ited-responsibility opinion in such cases. T here was a little disagreem ent am ong the experts in the case that the crime was unrelated with m ental sym ptom s or the criminals used drugs even though he knewit could induced insanity. B ut there were still m any obvious disagreem ents am ong experts in the case that crime was related to such sym ptom s and person was no ability to debate. Most experts agreed to settle the disagreem ents with im proved legislative perfection. Conclusion Most experts are not strictly com plying with the assessm ent guidelines during their practice, and there is still an obvious disagreem ent towards the criminal responsibility of drug-induced m ental disorders.

Objective To explore the m ain perform ance of personality change in people w ith m ild psy-chiatric im pairm ents w hich due to the brain traum a caused by traffic accidents and its value in assess-m ent of psychiatric im pairm ent. Methods The condition of personality change of patients w ith traum atic brain injury caused by traffic accident w as evaluated by the Scale of Personality Change Post-traum atic Brain Injury (SPCPTBI). Furtherm ore, the correlation betw een the personality change and the degrees of traum atic brain injury and psychiatric im pairm ent w ere explored. Results In 271 sam ples, 239 (88.2% ) w ith personality changes. A m ong these 239 sam ples, 178 (65.7% ), 46 (17.0% ), 15 (5.5% ) w ith m ild, m oderate and severe personality changes, respectively. The ratio based on the extent of personality changes to the degree of brain traum a w as not significant (P>0.05), but the total score difference betw een the groups w as significant (P<0.05). There w as no statistical significance betw een the m edium and high severity brain traum a groups. The higher degree of personality changes, the higher rank of m ental disabilities. The total score difference of the scale of personality change am ong the different m ild psychiatric im pair-m ent group w as significant (P<0.05). The difference betw een other psychiatric im pairm ent levels had statistical significance (P<0.05) except level 7 and 8. Conclusion The occurrence of personality change due to traum atic brain injury caused by traffic accident w as high. Correlations exist betw een the personality change and the degree of psychiatric im pairm ent. Personality change due to brain traum a caused by traffic accident can be assessed effectively by m eans of SPCPTBI, and the correlation betw een the total score and the extent of traum atic brain injury can be found.

Objective To explore the impact of four different anesthetic drugs commonly used in animal experi-ments on cardiovascular system in rats.Methods Electrocardiogram ( ECG) and blood pressure were dynamically recor-ded by a BioPac MP150 system after anesthesia.In addition, the blood glucose at different time points and hepatic func-tion, kidney function, cardiac enzymes and electrolytes at the end of the test were collected.Rusults Chloral hydrate caused severe ventricular arrhythmia.Isoflurane had inhibitory effect on the heart rate.Pentobarbital sodium induced a in-crease of ECG P wave.Urethane caused J point elevation of ECG.Blood pressure in the urethane-and pentobarbital sodi-um-treated groups were increased.Chloral hydrate caused CK to be raised, while isoflurane showed the opposite effect on CK and CKMB.Alanine aminotransferase and aspartate aminotransferase in the pentobarbitol sodium and isoflurane groups were decreased.Creatinine in the chloral hydrate, pentobarbital sodium and isoflurane groups were lower, and the serum sodium and potassium were decreased in the four groups.Conclusions Chloral hydrate has obvious effect on the cardio-vascular system, and is not suitable for animal studies on cardiovascular diseases.Pentobarbital sodium, urethane, isoflu-rane can be chosen for animal studies on cardiovascular diseases.

Objective To investigate the relationship between MRI rating of white matter hyperintensities (WMH) within cholinergic pathway and vascular dementia in Binswanger's disease.Methods 41 patients with Binswanger's disease undergone inspection of MRI. On 4 selected axial images, the severity of WMH in the cholinergic pathways was rated on a 3-point scale for ten regions identified with major anatomical landmarks. The cholinergic pathways hyperintensities scale (CHIPS) were developed by Bocti based immunohistochemical tracings of the cholinergic pathways. Subjects underwent neuropsychological testing with the Mattis Dementia Rating Scale (DRS) to assess cognitive domains of interest (attention, episodic memory, executive functions). Spearman correlation coefficients were used to compute association between CHIPS score and DRS score.Results The total score of DRS, the scores of DRS attention subscale and memory subscale were 105.6±18.2, 29.5±4.2 and 11.3±3.2 respectively. The score of CHIPS was 35.6±13.7. After accounting for age and education in a multiple linear regression model, the CHIP ratings were associated with impaired performance on the DRS ( r=-0.43, P<0.05).Conclusion The MRI rating of WMH within cholinergic pathway has strong correlations with cognitive performance in patients with Binswanger's disease.

Objective To analyze the characteristics of clinical manifestation, brain magnetic resonance imaging ( MRI ) and 18 F-fluoro-deoxy-glucose positron emission tomography ( FDG-PET ) , inflammatory cerebrospinal fluid ( CSF ) , electroencephalography ( EEG ) , and associated tumour in autoimmune epilepsy ( AE) patients with different autoantibodies. Methods Forty-two patients diagnosed as AE with different autoantibodies in Beijing Tiantan Hospital, Capital Medical University between May 2014 and May 2017 were recruited. The clinical manifestation, brain MRI and PET, CSF findings, EEG and biochemical examination of these patients were analyzed. Results Specific autoimmune antibodies were detected in 42 patients, including anti-amphiphysin in one patient, anti-contactin-associated protein 2 in two, anti-γ-aminobutyric acid-B receptor in six, anti-leucine-rich glioma inactivated 1(LGI1) in 24, anti-N-methyl-D-aspartate receptor ( NMDAR ) in nine. The case series of 42 patients had an average age of (49. 9 ± 14. 5) years with a male to female ratio of 5:1. Except anti-NMDAR associated AE, most patients (21/33) presented with the symptoms of limbic encephalitis including temporal lobe seizures, memory decline, personality and neuropsychiatric changes, mesial temporal lobe abnormality in MRI or FDG-PET, and CSF inflammation. The seizure semiologic characteristics included frequent seizure, short seizure duration and common secondarily generalized tonic-clonic seizures during sleeping. Faciobrachial dystonic seizures and hyponatremia were the special clinical manifestation of AE with anti-LGI1. AE patients with all kinds of antibodies presented as initial resistance to anti-epilepsy drugs ( AEDs) and favorable outcome of immunosuppressive treatment in combination with AEDs. Conclusions AE patients with each type of antibody have the special clinical manifestation. Except anti-NMDAR associated AE, the seizure semiologic characteristics often present as frequent and short seizures. All AE patients present as drug refractory epilepsy initially. Seizures in AE patients can be well controlled by immunotherapy combined with AEDs.

Objective To compare the effects of three kinds of artificial hydronephrosis in percutaneous nephrolithotomy.Methods A total of 120 patients who underwent single-tract percutaneous nephrolithotomy in the Eighth Hospital of Wuhan from May 2020 to April 2022 were selected and divided equally into three groups according to different methods of artificial hydronephrosis.Patients in group A were received preoperative indwelling ureteral catheter and injection of normal saline through ureteral catheter to dilate renal pelvis and form artificial hydronephrosis.Patients in Group B were placed with double J catheters before surgery,and the bladder was filled with physiological saline through the catheter.The renal pelvis was dilated through the double J catheters,resulting in artificial hydronephrosis.Patients in Group C were received intravenous injection of furosemide and stimulated diuretic method to actively dilate renal pelvis to form hydronephrosis.The one-time puncture success rate,channel establishment time,overall operation time,stone clearance rate and incidence of surgical complications of percutaneous nephrolithotomy after hydronephrosis were compared among the three groups.Results The operation was successfully completed in the three groups.There was no significant difference in the one-time puncture success rate and channel establishment time between group A and group B(P>0.05),which were all higher than group C(P<0.05).The overall operation time of group B was shorter than that of group A and group C(P<0.05).There were no significant differences in stone clearance rate and surgical complications among the three groups(P>0.05).Conclusion Preoperative indwelling of double J tubes to create artificial kidney hydronephrosis has advantages such as high success rate of one-time puncture,short channel establishment time,and surgical time.