Objective To explore the clinical pathological characteristics and prognostic factors of patients with neuroendocrine tumor of the appendix.Methods Data of 42 cases of the appendiceal neuroendocrine tumor from June 2006 to June 2016 at Tianjin Police Hospital were analyzed.Tumors were classified according to 2010 WHO classification.The survival curves were drawn using Kaplan-Meier method.Univariate analysis was performed by the Log-rank test.Results There were 27 males and 15 females,with median age of 60 years.Tumors located in the head of the appendix in 37 cases,in the body in 2 cases and at the base in 3 cases.The median of tumor sizes were 1.2 cm.G1 in 17 cases,G2 in 21 cases,G3 in 4 cases.The follow-up rate was 100％.The overall 1-year survival rate was 92％.Conclusions The clinical symptoms of appendiceal neuroendocrine tumors are most often nonspecific.The diagnosis depends on pathological examination and immunohistochemistry,and prognosis varies with pathological grades.

BACKGROUND:Many studies have showed that neural stem cells therapy is a new strategy for hypoxic-ischemic encephalopathy.
OBJECTIVE:To review and analyze the status of research, transplantation strategies and mechanism of neural stem cells therapy for treatment of hypoxic-ischemic encephalopathy.
METHODS:A computer-based retrieval was performed in PubMed and CNKI database to search papers published from August 2000 to August 2013 using the key words of“hypoxic-ischemic encephalopathy, neural stem cells”in English and Chinese. The papers with objective-independent and repetitive contents were excluded, and final y 39 papers were included for final analysis.
RESULTS AND CONCLUSION:Neural stem celltransplantation can promote recovery of neurological function, which brings new hope to hypoxic-ischemic encephalopathy patients. But the study is at a primary stage and limited in laboratory. There are many critical factors that hinder the clinical transplantation, such as delivery path, transplantation time, single or combined transplantation, mechanisms of action. Application of neural stem cells requires further investigation.

During the course of standardized residents training,the performance appraisal management of the residents was used besides other regular management methods.The allowances of residents were decided monthly by the evaluation and assessment of many kinds of tests or examinations.Through this new measure,the learning enthusiasm of residents could be fully motivated.The authoritative effectiveness of management was enhanced enormously.Meanwhile,the quality of the educational and training has also been improved greatly.This method could be very useful for the training process.

Objective To investigate the mitochondrial energy metabolism in D-galactoseinduced cell ageing model.Methods MRC-5 cells were cultivated for 72 hours in a medium containing 55 mmol/L D-galactose.The analysis of cell proliferation capacity by CCK8 method,β-galactosidase staining and detection of p21 protein expression level were performed for identifying cell senescence.The cell oxidation-reduction state was evaluated by an analysis of cellular ROS levels,SOD activity,MDA content and oxidative damage level of mitochondrial DNA(mtDNA).For purpose of detecting mitochondrial function and its impairment,mitochondrial morphology was observed by electron microscope,mitochondrial quantity was analyzed by flow cytometry,mitochondrial membrane potential(△Ψm) was measured by JC-1 staining,and ATP content was analyzed by HPLC,and mitochondrial oxygen consumption rate was detected by Seahorse cell energy metabolism detection system.Results The decreased MRC-5 cell proliferation,up-expression of p21 protein,increased β-galactosidase activity were observed in D-Gal-treated cells,which indicated the cell premature senescence.When treated with D-Gal,the significantly increased ROS and MDA level,decreased SOD activity and increased oxidized mtDNA proved that the cells kept higher oxidative stress.D-Gal induced-mitochondrial impairment was evidenced by the dimming of mitochondrial cristae and double membrane structure,decrease of transmembrane potential and ATP synthesis,and decrease of its oxygen consumption rate(OCR).Conclusions The 55 mmol/L D-Gal causes an impairment of mitochondrial structure and a decrease of function of energy metabolism,which is associated with cellular senescence induced by D-Gal.

Objective To evaluate the efficacy of Arndt endobronchial blocker (AEB) for airway management during one-lung ventilation (OLV) in pediatric patients.Methods Thirty pediatric patients,aged 4 months-12 yr,weighing 5.6-26.0 kg,of American Society of Anesthesiologists physical status Ⅱ-Ⅳ,scheduled for elective thoracotomy under OLV requiring the use of single lumen tracheal tube assisted by AEB,were enrolled in this study.OLV was performed with the AEB placed outside the single lumen tracheal tube in pediatric patients below 2 years old and with AEB inserted through the single lumen tracheal tube in pediatric patients ≥ 2 years old.The rate of successful establishment of artificial airway at first attempt,time of establishing artificial airway,time of pulmonary collapse,AEB malpositions and airway pressure before and after OLV were recorded,and the efficacy of lung collapse was evaluated.Results The rate of successful tracheal intubation of extraluminal and endoluminal AEB placement at first attempt was 100％ in 30 pediatric patients,and no high airway pressure was found after OLV.The efficacy of lung collapse was poor in one patient and good in one patient,and intraoperative AEB malpositions were found in two patients among the pediatric patients used extraluminal AEB placement.The efficacy of lung collapse was good in one patient,intraoperative AEB malposition was found in one patient,and SpO2 was decreased after OLV in one patient among the pediatric patients used endoluminal AEB placement.Conclusion Reasonably selecting the method of placing AEB followed by enhancing intraoperative airway management can be safely and effectively applied for OLV in pediatric patients.

From October 2014 to June 2015, among 5 800 pediatric patients underwent outpatient sedation in MRI and Special Inspection Departments at our hospital, the incidence of sedation-related ad-verse events was 272%(158 cases), and the mortality rate was 003%(2 cases)in pediatric outpa-tients. The common adverse events were nausea and vomiting(constituent ratio 3214%), regurgitation and aspiration(constituent ratio 2443%), respiratory depression(constituent ratio 2928%), agitation (constituent ratio 1571%)and delayed recovery(constituent ratio 143%). When chloral hydrate was used for sedation, it should be mixed with sugar to prevent the occurrence of nausea and vomiting; young age(especially preterm infant), diseases of respiratory system or nervous system and congenital heart dis-ease were the possible inducements to sedation-related adverse events, and intervention strategy should be performed to decrease the occurrence of adverse events and to improve the quality of sedation in pediatric outpatients.

Objective To analyze the changes of serum markers of liver function and liver fibrosis in patients with fatty liver,and to explore the relationship between them,so as to provide scientific basis for the prevention and treatment of fatty liver into hepatic fibrosis. Methods From January 1st,2015 to December 31st, 2015,one thousand three hundred and forty-six healthy cases were selected,and 361 cases of fatty liver were diagnosed by ultrasound. Liver function index of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) was detected by automatic biochemical analyzer. Hyaluronic acid (HA),laminin (LN),serum type Ⅲprocollagen peptide ( PC Ⅲ) and type Ⅳ collagen ( C-Ⅳ) were detected by enzyme-linked immunosorbent assay. The correlation between liver function and serum liver fibrosis indexes was analyzed by Pearson parameter analysis. Results The liver function index ALT,AST((69. 04±18. 72) U/L,(59. 78±15. 65)U/L) in fatty liver group were higher than those in the non-fatty liver group((25. 71±10. 25) U/L,(23. 68±8. 23) U/L),the differences were statistically significant ( t＝279. 283,388. 461,P＜0. 05) . Four serum fibrosis index HA,LN, PCⅢ,C-Ⅳ in the fatty liver group were (112. 64±21. 63) μg/L,(125. 85±27. 52) μg/L,(127. 28±29. 37) μg/L,(79. 38±18. 52) μg/L,respectively,which were higher than those in the non-fatty liver group ( (53. 98 ±16. 84) μg/L,(86. 31±20. 46) μg/L,(53. 31±18. 23) μg/L,(57. 26±15. 86 ) μg/L),the differences were statistically significant ( t＝727. 724,170. 432,941. 357,71. 169,P＜0. 001) . The correlation analysis of liver function and serum liver fibrosis indexes showed that ALT and AST were positively correlated with the fibrosis indexes HA,LN,PCⅢ( correlation coefficient r＝0. 230,0. 119,0. 370;0. 363,0. 361,0. 509,P＜0. 001),and which had no significant correlation with C-Ⅳ(P＞0. 05). Conclusion Liver function and serum liver fibrosis index can be used as the important basis for monitoring and diagnosis on the progression of fatty liver disease.

Objective To evaluate GIPR protein expression in predicting prognosis of appendical neuroendocrine tumors (A-NET) patients.Methods The clinical data of 40 A-NET cases surgically treated from June 2007 to June 2017 at Tianjin Police Hospital were analyzed.The expression of GIPR markers was detected by immunohistochemistry (IHC).Results There were 25 male and 15 female patients,with an median age of 59 years.Sex,tumor site,tumor size,tumor stage and lymph node metastasis were not related to prognosis (P ＞ 0.05).The expression of GIPR was positive in 18 cases and negative in 22 cases.There were 16 cases in G1 stage,20 cases in G2,4 cases in G3.The expression of GIPR protein and pathological grades were related to prognosis (P ＜ 0.05).Conclusions Symptoms of appendix neuroendocrine tumor are nonspecific.Diagnosis is dependent on pathological examination and immunohistochemistry.Positive GIPR protein expression predicts poor prognosis for A-NETs patients.