The Office of the Ministry of Health announced the “formula-related urinary stones in infants and young children diagnosis and treatment program” I. Clinical manifestations 1, unexplained crying, especially during urination, may be accompanied by vomiting; 2, naked eye or microscopic hematuria; 3, acute obstructive renal failure, manifested as oliguria or anuria; 4, stones can be discharged from the urine, such as male infants with stone obstruction of the urethra can be manifested as urinary pain, urinary difficulties; 5, there may be high blood pressure, edema, Renal pain on percussion. Diagnostic points: 1. History of feeding Sanlu brand infant formula. 2. 2.One or more of the above clinical manifestations. Laboratory tests: urine routine (visual or microscopic hematuria), blood biochemistry, liver and kidney function, urinary calcium/urinary creatinine (generally normal), urine erythrocyte morphology (non-glomerular hematuria), parathyroid hormone measurement (generally normal). 4, imaging: preferred urinary tract ultrasound. If necessary, abdominal CT scanning and intravenous urography (anuria or renal failure is contraindicated), the conditions of feasible renal nuclide scanning evaluation of subrenal function. Ultrasound examination of urinary stones in infants and children caused by consumption of contaminated Sanlu brand infant formula: General features: enlargement of both kidneys; parenchymal echogenicity enhancement, the parenchyma is mostly of normal thickness; mild dilatation of the renal pelvis and calyces, and the calyces are rounded; if the obstruction is located in the lumen of the ureter, the dilatation of the ureter is above the point of obstruction; perirenal fat pads and the periureteral soft tissues of some cases are edematous; with the progression of disease, secondary ureteral and pelvic walls may appear. With the development of the disease, the wall of the renal pelvis and the ureteral wall may appear secondary edema and thickening changes; a small amount of ascites can be detected in a few patients. Characteristics of stones: most of the stones involve bilateral collecting system and bilateral ureter; ureteral stones are mostly located in the renal pelvic-ureteral junction, ureter across the iliac arteries and uretero-vesical junction; stones are crushed and accumulated, with a large range of involvement and a pale shadow in the posterior area, most of which are different from calcium oxalate stones, and the posterior edge of the stones can be detected; ureteral obstruction caused by stones is more complete. Differential diagnosis 1, hematuria differentiation: pay attention to exclude glomerular hematuria. 2, the identification of stones: stones are generally X-ray negative stones, urinary X-ray film does not show, and can be differentiated from X-ray positive stones such as calcium oxalate, phosphate. 3, the identification of acute renal failure, note that except pre-renal and renal renal failure. Treatment 1, immediately stop using Sanlu brand infant formula. Conservative internal medicine treatment: replenish fluids, alkalize urine, promote the discharge of stones; correct water, electrolyte and acid-base balance disorders. In the course of conservative treatment, closely test the urine routine, blood biochemistry, renal function, repeat ultrasound (especially pay attention to the degree of dilatation of the renal pelvis, ureter, and changes in the morphology and location of the stones). Because the stone is loose or sand-like, it is more likely to be discharged by itself. 3.Treatment of combined acute renal failure: first of all, life-threatening conditions such as hyperkalemia should be corrected, such as the application of sodium bicarbonate and insulin, if the conditions are available to take blood purification, peritoneal dialysis and other methods as soon as possible, and surgical intervention to lift the stone obstruction if necessary. 4.Surgical treatment: If there is no change in the shape and location of the stone after conservative medical treatment, and the hydronephrosis and renal damage aggravate, or the renal failure does not have the condition to carry out blood purification or peritoneal dialysis, the obstruction can be lifted surgically. Cystoscopic retrograde ureteral cannulation and drainage, percutaneous nephrostomy and drainage, surgical incision and stone extraction, and percutaneous nephrolithotomy can be chosen. Because the stone is loose, the uric acid component is dominant, the patient is an infant, extracorporeal shock wave lithotripsy has greater limitations, need to be carefully considered. V. Follow-up of the child after treatment, stone obstruction lifted, general condition improved, renal function returned to normal, urination can be discharged. Post-discharge follow-up: routine urinalysis; urinary ultrasound; renal function tests; if necessary, intravenous pyelography.