Flexible ureteral lithotripsy (FURL) under general anesthesia (GA) is the dominant method in the treatment of renal and upper ureteral calculi，but some patients cannot tolerate GA.In recent years，there has been a growing interest in the use of local anesthesia (LA) as a safe and effective alternative.And it is also an option for patients who have calculi ≤20 mm with high fragility，lower CT value and better compatibility.Before surgery，it is important to conduct relevant examinations，evaluate the status of patients，prevent infections，and indwell ureteral stents.During surgery，lithotomy position，scissors position，prone leg position and other positions should be selected according to the specific conditions of patients.LA drugs should be used to control physiological pain and relieve psychological anxiety.Patients' breathing state should be carefully monitored，and appropriate ureteroscope and lens sheath should be selected for the success and safety of the operation.In this paper，the perioperative management of FURL under LA is briefly summarized，so as to provide reference for clinical practice.

In recent years， the incidence of colorectal cancer has been rising in China， and with the promotion of early screening and early diagnosis， most colorectal cancers are able to achieve long-term survival through timely diagnosis and treatment. Nevertheless， 30%-70% of patients with early to mid-stage colorectal cancer after radical surgery still have psychological problems such as anxiety， depression， and fear of recurrence and metastasis， and they hope to seek help from traditional Chinese medicine（TCM） treatment. In order to further standardize the integrated traditional Chinese and western medicine psychological rehabilitation interventions of stage Ⅰ-Ⅲ colorectal cancer after radical surgery， and to improve the diagnosis and treatment level， under the support of the pilot project of clinical collaboration between Chinese and western medicine for major and difficult diseases of National Administration of TCM， experts in oncology， integrated Chinese and western medicine， psychology， surgery， nursing， evidence-based medicine and other disciplines from 10 units nationwide participated in the work， led by Xiyuan Hospital，China Academy of Chinese Medical Sciences and Beijing Cancer Hospital. Based on the methodology and process of guideline development of the World Health Organization Handbook for Guideline Development and the Regulations for Group Standards of China Association of Chinese Medicine， the Guidelines for Psychological Rehabilitation Intervention Combined Integrated Traditional Chinese and Western Medicine After Radical Surgery for Early and Middle Stage Colorectal Cancer have been developed according to the current best evidence， extensive consultation with clinical experts and following the situation of current clinical practice. The guideline provides the psychological characteristics， the needs and willingness to accept psychological rehabilitation， the interventions for psychological rehabilitation， evaluation of efficacy， follow-up review， educational guidance and others of patients with stage Ⅰ-Ⅲ colorectal cancer after radical surgery. It can provide guidance for TCM（integrated Chinese and western medicine） clinicians and psychologists engaged in the psychological rehabilitation of integrated Chinese and western medicine oncology， especially for doctors in primary medical institutions.

OBJECTIVE To explore standardized evaluation process for clinical comprehensive evaluation of blood lipid- regulating drugs and perform rapid assessment of clinical comprehensive evaluation of blood lipid-regulating drugs with different mechanisms so as to provide reference for the drug catalogue selection and rational drug use of medical institutions. METHODS Referring to guidelines and consensus such as the guideline for the management of comprehensive clinical evaluation of drugs， the methods such as literature research， expert interviews， and Delphi expert consultation were used to establish a multi-dimensional and multi-criteria clinical comprehensive evaluation index system and quantitative scoring table for blood lipid-regulating drugs around the two main lines of technical evaluation and policy evaluation. Then 13 blood lipid-regulating drugs with different mechanisms in 21 third-grade class-A medical institutions from five provinces and regions of Northwest China were scored from both technical and policy dimensions to form a comprehensive evaluation result. RESULTS The clinical comprehensive evaluation index system and corresponding rapid evaluation quantitative scoring table were constructed for blood lipid-regulating drugs in the five northwest provinces and regions. The technicalevaluation section included 6 primary indicators， 13 secondary indicators， and 34 tertiary indicators， totaling 110 points. The policy evaluation section included 4 primary indicators and 6 secondary indicators， with a total score of 40 points （30 points for some drugs） and a total score of 150 points （or 140 points）. The scoring results showed that the highest score was atorvastatin， followed by rosuvastatin and simvastatin. CONCLUSIONS Statins are still the cornerstone of drug therapy for patients with dyslipidemia； the rapid evaluation quantitative scoring table constructed in this study is comprehensive， systematic and operable. The evaluation process in this study can provide empirical references for other groups to exploring the standardized path and quality control mechanism of clinical comprehensive evaluation of drugs.

This study analyzed the current status of the cultivation process of professional postgraduates of clinical medicine, combining with the case of the auxiliary teaching model of Academic Salons on the WeChat platform in Xiangya Hospital of Central South University. We collected students' satisfaction evaluation of this auxiliary teaching model by questionnaire survey. Through analyzing the results and feedback, we found that the overall satisfaction of this auxiliary teaching model is 71.43%, and the model has a remarkable effect in broadening knowledge, inspiring thinking of clinical diagnosis and treatment, improving ability of scientific research, increasing learning interest, enhancing the ability to link theory with practice, and using the knowledge flexibly. However, there are still some shortcomings in early publicity, understanding students' interests and needs, and improving students' autonomous learning ability. Therefore, using the WeChat platform to carry out academic salons is a good auxiliary teaching model for cultivating the scientific research ability of professional postgraduates of clinical medicine.

Chronic obstructive pulmonary disease (COPD) is a common, preventable and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation due to airway and/or alveolar abnormalities usually caused by significant exposure to noxious particles or gases. In addition to smoking COPD caused by cigarette smoke, the phenotype of non-smoking COPD accounts for at least 1/4. Non-smoking COPD accounts for a large proportion, especially in developing countries. Non-smoking COPD and smoking COPD should be paid equal attention. More in-depth study on the prognosis of non-smoking COPD is needed.

Objective To explore the relationship of discrimination perception and social anxiety of the left-behind children,focusing on the moderating effect of trait gratitude. Methods Totally 588 left-be-hind children were investigated with discrimination perception questionnaire, gratitude questionnaire and Liebowitz social anxiety questionnaire. Data were analyzed by independent t test,correlation analysis and re-gression analysis. Results There was a significant difference in group discrimination between the only child (2. 11±0. 98) and the non-only child (2. 28±0. 93) (t=-2. 11,P<0. 05). Correlation analysis showed that trait gratitude (4. 93± 0. 89) was negatively correlated with individual discrimination ( 2. 53 ± 1. 03) and group discrimination (2. 22±0. 95) (r=-0. 55,r=-0. 56,both P< 0. 05),furtherly negatively correlated with fear of negation (0. 85±0. 47) and social avoidance (0. 81±0. 53) dimensions of social anxiety ( r=-0. 47,r=-0. 48,both P<0. 05). Additionally,discrimination perception was positively correlated with so-cial anxiety (r=0. 61,P<0. 05). Regression analysis showed that discrimination perception could significant-ly predict social anxiety (β=0. 44,P<0. 01),and trait gratitude could significantly moderate this effect (β=-0. 75,P<0. 01). Conclusion Discrimination perception can positively predict social anxiety,and trait gratitude can moderate this effect.

Objective: To explore the relationship of discrimination perception and social anxiety of the left-behind children, focusing on the moderating effect of trait gratitude. Methods: Totally 588 left-behind children were investigated with discrimination perception questionnaire, gratitude questionnaire and Liebowitz social anxiety questionnaire. Data were analyzed by independent t test, correlation analysis and regression analysis. Results: There was a significant difference in group discrimination between the only child (2.11±0.98) and the non-only child (2.28±0.93) (t=-2.11, P<0.05). Correlation analysis showed that trait gratitude (4.93±0.89) was negatively correlated with individual discrimination (2.53±1.03) and group discrimination (2.22±0.95) (r=-0.55, r=-0.56, both P< 0.05), furtherly negatively correlated with fear of negation (0.85±0.47) and social avoidance (0.81±0.53) dimensions of social anxiety (r=-0.47, r=-0.48, both P<0.05). Additionally, discrimination perception was positively correlated with social anxiety (r=0.61, P<0.05). Regression analysis showed that discrimination perception could significantly predict social anxiety (β=0.44, P<0.01), and trait gratitude could significantly moderate this effect (β=-0.75, P<0.01). Conclusion Discrimination perception can positively predict social anxiety, and trait gratitude can moderate this effect.

Objective    To explore the efficacy of a novel detection technique of circulating tumor cells (CTCs) to identify benign and malignant lung nodules. Methods     Nanomagnetic CTC detection based on polypeptide with epithelial cell adhesion molecule (EpCAM)-specific recognition was performed on enrolled patients with pulmonary nodules. There were 73 patients including 48 patients with malignant lesions as a malignant group and 25 patients with benign lesion as a benign group. There were 13 males and 35 females at age of 57.0±11.9 years in the malignant group and 11 males and 14 females at age of 53.1±13.2 years in the benign group. e calculated the differential diagnostic efficacy of CTC count, and conducted subgroup analysis according to the consolidation-tumor ratio, while compared with PET/CT on the efficacy. Results     CTC count of the malignant group was significantly higher than that of the benign group  (0.50/ml vs. 0.00/ml, P<0.05). Subgroup analysis according to consolidation tumor ratio (CTR) revealed that the difference was statistically significant in pure ground glass (pGGO) nodules 1.00/ml vs. 0.00/ml, P<0.05), but not in part-solid or pure solid nodules. For pGGO nodules, the area under the receiver operating characteristic (ROC) curve of CTC count was 0.833, which was significantly higher than that of maximum of standardized uptake value (SUVmax) (P<0.001). Its sensitivity and specificity was 80.0% and 83.3%, respectively. Conclusion     The peptide-based nanomagnetic CTC detection system can differentiate malignant tumor and benign lesions in pulmonary nodules presented as pGGO. It is of great clinical potential as a noninvasive, nonradiating method to identify malignancies in pulmonary nodules.

Objective:To investigate the status of vascular access in hemodialysis patients in our center.Methods:The general information of hemodialysis patients and types and complications of vascular access at Xiangya Hospital of Central South University from April 2015 to April 2016,were retrospectively analyzed.Results:Among 258 prevalent patients,87.60％ of them had arteriovenous fistula (AVF),while 12.40％ showed tunneled cuffed catheter.Of the 61 incident patients,80.33％ of them initiated dialysis with a non-tunneled and non-cuffed catheter,8.19％ with an AVF,9.84％ with a tunneled cuffed catheter,and 1.64％ with needle puncture.The types of AVF access included 76.55％ of wrist radiocephalic fistula,7.08％ of mid-forearm cephalic fistula,11.06％ of elbow brachiocephalic fistula,and 5.31％ of antecubital fistula and transposed basilic fistula.Seventy-seven (34.07％) patients with AVF suffered complications and wherein aneurysms accounted for 24.34％.Conclusion:In maintenance hemodialysis patients,autologous AVF is the prevalent vascular access.In the beginners for dialysis,non-tunneled and non-cuffed catheter are their choice.Additional efforts and incentives may be necessary to improve vascular access during the initiation ofhemodialysis.

OBJECTIVETo study the regulation trend of resveratrol on TNF-alpha, IL-1beta, IL-6 expressions in bronchoalveolar layage fluid (BALF) of RSV-infected BALB/c mice at different time points.

METHODRSV-induced BALB/c mice were orally administered with resveratrol. Their BALFs were collected at 24, 72 and 144 h after the first nasal drip with RSV to detect the level of TNF-alpha, IL-1P3, IL-6 by EILSA.

RESULTThe expression of TNF-alpha, IL-1Pf and IL-6 in BALF increased significantly compared with the normal group (P <0. 01) after 24 hours of RSV infection, while the expression of TNF-alpha (P < 0.01), IL-1beta (P < 0.05), IL-6 (P < 0.01) in the resveratrol group decreased notably compared with the model group. After 72 hours of infection with RSV, although the expression of TNF-alpha (P < 0.05), IL-1beta (P < 0.01) and IL-6 (P < 0.01) in BALF in model group were higher than those in the normal group, they were much more lower than at 24 h. The expression of IL-1beta and IL-6 (P < 0.05) in the resveratrol groups were down-regulated significantly, but no difference had been shown in TNF-alpha expression compared with the RSV infection group. After infection with RSV for 144 h, the expression of IL-1beta (P < 0.01) and IL-6 (P < 0.05) in BALF in the model group were higher than those in the normal group, but there was no difference in the secretion of TNF-alpha. The expression of TNF-alpha, IL-1beta and IL-6 showed also no remarkable difference between the resveratrol groups and the RSV infection group.

CONCLUSIONResveratrol can inhibit the over expression of inflammatory factors TNF-alpha, IL-1beta, IL-6 in bronchoalveolar lavage fluid of RSV-induced BALB/c mice and keep them at a low level with the passing of infection time.

Animals ; Bronchoalveolar Lavage Fluid ; immunology ; Female ; Interleukin-1beta ; analysis ; Interleukin-6 ; analysis ; Mice ; Mice, Inbred BALB C ; Respiratory Syncytial Virus Infections ; drug therapy ; immunology ; Stilbenes ; pharmacology ; therapeutic use ; Tumor Necrosis Factor-alpha ; analysis