This study analyzes the disease burden of Attention-Deficit Hyperactivity Disorder (ADHD) in children and adolescents in China and globally from 1990 to 2021, providing data support and strategic recommendations for public health policy and disease intervention.

Objective A rat model of cerebral small vessel disease(CSVD)was established by unilateral injection of a single dose of sodium laurate into the internal carotid artery.The effectiveness of the model was assessed by behavior scoring and analysis of serum-related indicators,cerebral infarction volume,cerebral microvascular density,hemodynamics,brain histopathology and the expression of blood-brain barrier(BBB)-related proteins.Methods SPF-grade male SD rats were divided randomly into a control group and a model group(n=6 per group).The model group received a single injection of 100 μL of sodium laurate(2 g/L)via the internal carotid artery,while the control group underwent the same surgical procedure but received an equal volume of saline.Neurobehavioral assessments were conducted using the Longa score and postural reflex test.Serum homocysteine(HCY)levels were measured by enzyme-linked immunosorbent assay.Cerebral infarction volume was detected by magnetic resonance imaging and changes in cerebral vascular density were observed by cerebrovascular imaging.The resistance index(RI)and perfusion index(PI)were measured by ultrasonography.Histopathological changes in brain tissue were evaluated by hematoxylin and eosin(HE)staining.Expression of the cerebral microvascular marker CD31 and tight junction proteins ZO-1 and Occludin in brain cortex tissue were detected by immunohistochemical staining.Results The Longa score,postural reflex score(P＜0.05),and cerebral infarction volume were significantly increased(P＜0.05)while the cerebral vascular density was decreased in the model group compared with the control group.Serum HCY levels,carotid RI,and PI values were all significantly increased in the model group(P＜0.05).HE staining revealed solidified neuronal nuclei and enlarged perivascular spaces in the brain cortex in the model group.Immunohistochemical staining revealed that CD31,ZO-1,and Occludin expression were significantly reduced in the brain cortex in the model group compared with the control group(P＜0.05).Conclusions A rat model of CSVD can be established rapidly and effectively by a single unilateral injection of high-concentration sodium laurate via the internal carotid artery.This model is characterized by neurobehavioral abnormalities,cerebral infarction,insufficient cerebral blood supply,reduced vascular density,and disruption of the BBB,suggesting that it may serve as an effective rat model for the study of CSVD.

Objective A rat model of cerebral small vessel disease(CSVD)was established by unilateral injection of a single dose of sodium laurate into the internal carotid artery.The effectiveness of the model was assessed by behavior scoring and analysis of serum-related indicators,cerebral infarction volume,cerebral microvascular density,hemodynamics,brain histopathology and the expression of blood-brain barrier(BBB)-related proteins.Methods SPF-grade male SD rats were divided randomly into a control group and a model group(n=6 per group).The model group received a single injection of 100 μL of sodium laurate(2 g/L)via the internal carotid artery,while the control group underwent the same surgical procedure but received an equal volume of saline.Neurobehavioral assessments were conducted using the Longa score and postural reflex test.Serum homocysteine(HCY)levels were measured by enzyme-linked immunosorbent assay.Cerebral infarction volume was detected by magnetic resonance imaging and changes in cerebral vascular density were observed by cerebrovascular imaging.The resistance index(RI)and perfusion index(PI)were measured by ultrasonography.Histopathological changes in brain tissue were evaluated by hematoxylin and eosin(HE)staining.Expression of the cerebral microvascular marker CD31 and tight junction proteins ZO-1 and Occludin in brain cortex tissue were detected by immunohistochemical staining.Results The Longa score,postural reflex score(P＜0.05),and cerebral infarction volume were significantly increased(P＜0.05)while the cerebral vascular density was decreased in the model group compared with the control group.Serum HCY levels,carotid RI,and PI values were all significantly increased in the model group(P＜0.05).HE staining revealed solidified neuronal nuclei and enlarged perivascular spaces in the brain cortex in the model group.Immunohistochemical staining revealed that CD31,ZO-1,and Occludin expression were significantly reduced in the brain cortex in the model group compared with the control group(P＜0.05).Conclusions A rat model of CSVD can be established rapidly and effectively by a single unilateral injection of high-concentration sodium laurate via the internal carotid artery.This model is characterized by neurobehavioral abnormalities,cerebral infarction,insufficient cerebral blood supply,reduced vascular density,and disruption of the BBB,suggesting that it may serve as an effective rat model for the study of CSVD.

To investigate the initial experience of coated metal ureteral stent(CMUS)for treatment of pelvic lipomatosis induced hydronephrosis(PLH).The clinical and follow-up data of 8 patients who were diagnosed as PLH treated with CMUS in Peking University People's Hospital from August 2018 to February 2021 were retrospectively analyzed.Inclusion criteria included:Imaging evidence of excessive adipose tissue around the bladder in the pelvic cavity,bladder elevation in an"inverted pear shape",and bladder wall thickening;Cystoscopy indicated follicular hyperplasia of bladder mucosa and biopsy pathology indicated glandular cystitis;Unilateral or bilateral hydronephrosis and ureteromegaly.Exclusion criteria included:Ureteral atresia;Recurrent obstruction of the bladder outlet.Preoperative baseline data included age,gender,serum creatinine,pelvis width and ureteric stent symptoms questionnaire(USSQ)score.Intraoperative data included the location and length of ureteral stenosis observed by retrograde urography.Postoperative follow-up data included serum creatinine,pelvis width,and USSQ score.In the study,8 patients(11 sides)with PLH were all male,with an average age of(38.7±8.6)years.Uni-lateral hydronephrosis was found in 5 cases and bilateral hydronephrosis in 3 cases.Preoperative mean serum creatinine was(90.0±10.3)μmol/L,and the mean renal pelvis width was(3.0±1.5)cm.The lower ureteral stricture was found in all cases,and the mean stricture length was(1.9±0.9)cm.Before operation,3 patients had ureteral Double-J stents,with USSQ scores of 97.0,68.0 and 100.0,respectively.Five patients underwent retrograde CMUS stenting,and 3 patients retrograde and antegrade.At the last follow-up,the average serum creatinine was(82.0±11.1)μmol/L and the mean renal pel-vis width was(1.9±0.5)cm,which were significantly lower than those before operation(t=3.12,P=0.02;t=3.23,P=0.02).In the 3 patients with Double-J stent before surgery,the USSQ scores were 87.0,62.0 and 89.0,respectively,which were significantly improved after CMUS stenting.The average follow-up time was(10.0±6.3)months.During the follow-up,1 patient developed CMUS re-lated symptoms,and no stent-associated infection and stent encrustation were found.In one case,the stent migrated to the bladder 3 months after operation,and the hydronephrosis disappeared after 3 months follow-up.CMUS stenting for treatment of PLH has certain efficacy and safety,which can explore a new therapeutic method for the long-term treatment of PLH.

Objective:To assess health related quality of life(HRQOL)in patients with kidney stones and to predict risk factors for reduced HRQOL in the patients by the Chinese version of Wisconsin stone quality of life questionnaire(C-WISQOL).Methods:The patients with renal stones admitted to Peking University People's Hospital from July 2020 to June 2021 were prospectively enrolled.The inclusion cri-teria included the patients with renal stones aged 18-80 years and sufficient Chinese language founda-tion,and the exclusion criteria included the patients with internal ureteral stents,malignant tumors,sep-sis,etc.Demographic data and clinical data related to kidney stones were collected,and the C-WISQOL and the short form 36 health survey(SF-36)questionnaire completed by the patients was recorded.C-WISQOL included four domains(D):emotional impact(D1),social impact(D2),stone-related im-pact(D3)and vitality impact(D4).Cronbach's α coefficient was used to verify the internal consistency of C-WISQOL,Spearman's rho coefficient was used to verify the criterion validity between C-WISQOL and SF-36 questionnaire,confirmatory factor analysis was used to verify the structural validity,conver-gent validity and discrimination validity of C-WISQOL,and univariate and multivariate analyses were used to explore the risk factors leading to the decline of HRQOL in the patients with kidney stones.Re-sults:The study included 307 patients with kidney stones,of whom 212(69.1％)were male,with a mean age of(51.9±13.5)years,and a mean body mass index(BMI)of(25.4±3.6)kg/m2.160(52.1％)patients were complicated with metabolic syndrome(MS),202(65.8％)had history of cal-culi,217(70.7％)had calculi related symptoms,53(17.3％)had bilateral renal calculi,82(26.7％)had ureteral calculi,199(64.8％)had hydronephrosis,78(25.4％)had renal insufficien-cy,and urinary tract infection(UTI)was found in 168 patients(54.7％)with an average diameter of(15.6±5.9)mm.The mean total score of C-WISQOL questionnaire for all the patients was(94.9±13.7)points,D1 was(27.2±4.2)points,D2 was(23.8±3.7)points,D3 was(27.0±3.6)points,and D4 was(10.1±1.9)points.The Cronbach's α coefficient of the total score of C-WISQOL questionnaire was 0.968 and the four dimensions ranged from 0.860 to 0.898.The Spearman's rho co-efficient between C-WISQOL and SF-36 total score was 0.564,and the Spearman's rho coefficient between dimensions was 0.684-0.901,indicating that C-WISQOL had good internal consistency and criterion validity.Confirmatory factor analysis showed that C-WISQOL had good structural validity,convergent va-lidity and discrimination validity.Univariate analysis showed that the patients with MS(OR=1.607,P＜0.001),calculi related symptoms(OR=1.268,P＜0.001),bilateral kidney stones(OR=1.900,P＜0.001),combined with ureteral calculi(OR=1.018,P＜0.001),accompanied by hydronephrosis(OR=1.685,P＜0.001),and UTI(OR=1.275,P＜0.001)were risk factors for decreased HRQOL in the patients with kidney stones,and multivariate analysis showed that the patients with MS(OR=1.475,P＜0.001),calculi related symptoms(OR=1.546,P=0.043)and UTI(OR=1.646,P=0.005)were independent risk factors for HRQOL decline in the patients with renal calculi.The t-test re-sults showed that C-WISQOL scores were significantly higher in the patients without MS,stone-related symptoms and UTI than those in the patients with associated risk factors(P＜0.001).Conclusion:C-WISQOL the questionnaire can be used to evaluate the HRQOL of patients with kidney stones with good reliability.The combination of MS,stone-related symptoms and UTI were independent risk factors for HRQOL reduction in the patients with renal stones.