Objective To investigate the effect of the extent of surgical resection on the prognosis of children patients with advanced neuroblastoma. Methods Thirty-seven children patients with advanced neuroblastoma were selected as our subjects,who underwent surgical treatment in the People's Hospital Binzhou from Jan. 2001to Dec. 2006. All the patients were treated with surgical operation or surgical operation combined with chemotherapy,among them 24 cases were completely removal,and 13 cases were partially removal. All patients were followed-up for more than 5 years. Log rank test and multivariate COX regression analysis were used to explore the effect of surgery resection on prognosis. Results The influencing factors of the complete resection group included lymphatic metastasis,clinical stage,combined with chemotherapy,tumor markers neuronspecific enolase(P = 0. 002,0. 000,0. 019,0. 015 respectively). COX regression analysis showed that the independent factors included chemotherapy( OR = 1. 952,95% CI = 1. 258 - 2. 759,P = 0. 000),lymph node metastasis(OR = 2. 856,95% CI = 1. 356 - 3. 859,P = 0. 019),and extent of surgical resection(OR = 3. 069, 95% CI = 1. 585 - 4. 685,P = 0. 005). The shortest survival period of patients in this study was a month,and the median survival period was 33. 96 months. One year survival rate was 62. 21% and 2-year survival rate was 41. 09% as well as 3-year survival rate was 23. 59% . The average survival period between total and partial of surgical resection was significant((56. 96 ± 13. 22)months,(19. 63 ± 10. 20)months;P = 0. 019). Conclusion Surgical resection is an important factor of the prognosis of patients with NB. If the patient's own conditions permit,it can be appropriate to expand the scope of surgical resection in order to reduce the risk of tumor recurrence.

Objective To evaluate guglidnai detachable ceil(GDC)embolization therapy in treatment of acnte stage ruptured aneurysms.Methods 86 patients were involved in our study,we treat aneurysms with different intravascular therapy techniques,anti-artery-spasm treatment and lumber centesis were performed after therapy.Resuits 72 patients received 100% embolization,10 patients received 95% embolization,4 patients received 90% embolization,no patient died due to therapy in follow-up,further function recover was found.Conclusion Acute stage intravascular therapy combined with comprehensive measures can effectively improve the outcome of patients with ruptured aneurysms.

Objective To summarize the surgery effect of removal of tuberculum sellae meningiomas by anterior interhemispheric approach.Methods The data of 18 cases of removal of tuberculum sellae meningiomas by anterior interhemispheric approach were analyzed retrospectively.Results Simpson grade Ⅰ resection was achieved in 5 cases;grade Ⅱ in 10 cases and grade Ⅲ in 3 cases.15 patients were followed up for 6 months to 7 years,3.1 years on average.6 patients recovered normal ability in work and life,6 patients' symptom was improved after sugery,3 patients' postoperative visual acuity remained unchanged,2 patients got the result of medium disability and 1 patient died.Conclusion Large tuberculum sellae meningiomas that grows anteriorly and superiorly can be well exposed through anterior interhemispheric approach,the amount of page pull is reduced,so the satisfactory sugical effect can be achieved.

Objective To explore the clinical significance of treating severe patients with frontal lobe and temple lobe with enlarging pterion approach operation. Methods All the severe patients with frontal lobe and temple lobe injury were divided into two groups at random. One group adopted the standard large trauma craniotomy, the other group adopted enlarging pterion approach operation. Under the same conditions, score of GCS, patients ages in two groups were analyzed. And we compare their operation results. Results Compared the standard large trauma cranioto-my,the good recover rates rise 9.2% (P < 0.05) and the death rate reduce 10.2% (P < 0.05) by using the enlarging pterion approach operation. Conclusion The enlarging pterion approach operation could improve existing quality and decrease mortality and disabled rate in patients with severe brain injury in frontal lobe and temple lobe.

Interferon stimulated gene 15 kDa protein (ISG15) is the first ubiquitin-like protein identified, which plays vital roles in a variety of fields including viral infection and immunological regulation. In this study, liquid chromatography-tandem mass spectrometry was used to analyze ISG15-modified proteins in A549 cells in response to infection by influenza virus, which was enriched by immunoprecipitation. A total of 22 cellular host proteins were identified in A549 cells infected by influenza virus, including ubiquitin-like ISG15 protein, cyclin-T1, heat shock protein 71 kDa, caldesmon, eukaryotic translation initiation factor, and so on. Besides, non-structural protein (NS1) from influenza virus was also identified. Among the 22 host proteins identified, 6 proteins were also identified in the control non-infected A549 cells, including annexin A1, fructose-bisphosphate aldolase A, ATP synthase subunit g, enolase, actin, and tubulin. Bioinformatics analysis revealed that the identified ISG15-modified host proteins induced by influenza virus infection could be classified into 9 protein classes: chaperone, oxidoreductase, enzyme modulator, transferase, nucleic acid binding, transcription factor, kinase, cytoskeletal protein, and structural protein. This study provided a specific and effective tool for analyzing ISG15-modified proteins in proteome level.

Abstract Formaldehyde has been widely employed to immobilize clinical tissue specimens, inactivate toxins and viruses in biomedical fields. Formaldehyde can react with active groups in bio-molecules such as proteins, resulting in protein cross-linking, inactivation, and immobilization. By using several standard peptides and tryptic peptides from matrix protein of influenza virus as experimental models, we studied the chemical modifications of peptides and proteins with formaldehyde by matrix-assisted laser desorption ionization time-of-flight mass spectrometry and nano-electrospray quadruple time-of-flight tandem mass spectrometry. The reaction between formaldehyde and peptides was performed under the same conditions as those during inactivation of virus (4℃, 0. 025% Formalin (V/V), 37% formaldehyde solution (w/w), and 72 h). The results indicated that under above conditions, formaldehyde could react with amino group of N-terminus of standard peptide to generate a methylol adduct, which was further condensed into an imine to generate+12 Da product. Besides, formaldehyde could react with side chain of two amino acids such as arginine and lysine, yielding +12 Da product respectively. The analysis of the reaction between formaldehyde and tryptic peptides from matrix protein of influenza virus showed that +24 Da products could be detected in most peptides due to combinational contribution from N-terminus of peptide (+12 Da ) and side chain of C-terminal arginine or lysine (+12 Da) . Moreover, a +36 Da product was detected for a peptide with miss-cut site. The results indicated that low-concentration formaldehyde primarily reacted with amino group on N-termini of peptides and proteins, as well as the side chains of arginine and lysine residues. The present study suggested an effective mass spectrometry-based method for analyzing the reaction between low-concentration formaldehyde and peptides and proteins, thus provided strategies for interpretation for the mass spectra of reaction products.

OBJECTIVETo assess the efficacy and safety of inhaled nebulized hypertonic saline (HS) solution in infants with acute bronchiolitis.

METHODTotally 129 patients with acute bronchiolitis (clinical severity score ≥ 4, aged 2-18 months) admitted to the Capital Institute of Pediatrics from November 2012 to January 2013 were enrolled. All the subjects were assigned to receive 1.5 ml compound ipratropium bromide solution for inhalation and 1 ml budesonide firstly, twice a day. Then, the subjects were randomized to receive 2 ml doses of nebulized 5% HS (Group A), 3% HS (Group B) or 0.9% NS (Group C), twice a day. The treatment lasted for 3 days. Clinical severity scores before treatment and 24, 48, 72 h after treatment were documented. Bronchospasm, nausea and emesis were recorded to assess safety.

RESULTA total of 124 patients completed this research.Group A included 40 cases, Group B included 42 cases, Group C included 42 cases. Demographic characteristics, pre-treatment duration and clinical severity score before treatment were similar among the 3 group.Seventy-two hours after treatment, the clinical severity score of Group A, B, and C were 3.5 (1.0) , 4.0 (1.0) and 5.0 (0) . At 24, 48, and 72 h after treatment, the clinical severity score were significantly different among the three groups (χ(2) = 36.000, 51.200, 50.800, P < 0.05) .One patient in Group A got paroxysmal cough everytime as soon as he received 5% HS (6 times).Other 3 patients in Group A got paroxysmal cough once. The incidence of adverse effect of Group A was 3.75% (9/240); no adverse event occurred in other group. The incidence of adverse effect among this three group was significantly different (χ(2) = 19.13, P < 0.01).

CONCLUSIONInhalation of nebulized 5% and 3% hypertonic saline could decrease clinical symptoms of patient with acute bronchiolitis; 5% HS was superior to 3% HS. But 2 ml dose of 5% HS may induce paroxysmal cough.

Administration, Inhalation ; Bronchiolitis ; drug therapy ; pathology ; Bronchodilator Agents ; administration & dosage ; adverse effects ; therapeutic use ; Budesonide ; administration & dosage ; therapeutic use ; Cough ; etiology ; Female ; Humans ; Infant ; Ipratropium ; administration & dosage ; chemistry ; therapeutic use ; Male ; Saline Solution, Hypertonic ; administration & dosage ; adverse effects ; therapeutic use ; Severity of Illness Index ; Treatment Outcome

Objective:To build a comprehensive clinical management of outpatient with orthotopic neobladder based on doctor-nurse cooperation to provide overall service to patients.Methods:The comprehensive clinical management was established in October 2018, 32 patients were collected retrospectively from January 2009 to before the establishment of the clinic, and 14 patients were collected from the establishment of the clinic to January 2020. After the establishment of the clinic, the comprehensive management mode was adopted, including the medical team implementing management from the aspects of implementing doctor-patient joint decision-making, guiding patients to carry out pelvic floor muscle rehabilitation training, teaching family members to carry out new bladder irrigation, and establishing patients′ records. Before the establishment of the clinic, there was no specialized personnel for unified management, and the doctor for new bladder irrigation and so on.Results:The rate of complete urinary control in the 46 patients with orthotopic neobladder was 82.6%(38/46) in the day and 71.7%(33/46) in the night. The rates of complete urine control of patients in the day and night were 12/14 and 9/14 after the establishment of the clinic. The length of stay which was (13.36 ± 9.44) d, and feeding time which was (5.00 ± 2.11) d of the patients after the establishment of the clinic were both less than those of the patients before the establishment of the clinic, which were (17.28 ± 9.98) d and (5.78 ± 2.90) d, but the differences were not statistically significant ( t values were -1.247 and -0.905 respectively, both P>0.05). However, for diurnal and night-time urine control, the proportion of people with more than one diaper was better after the establishment of outpatient clinic than before. Conclusions:The establishment of the comprehensive clinical management meets the needs of patients with orthotopic neobladder, enables patients to get the function of continence and urination sooner, and contributes to improve the clinical outcome of patients.

Objective To explore the availability and safety of ileal ureter replacement combined with ileal augmentation cystoplasty in treating ureteral stenosis with contracted bladder.Methods From August 2015 to November 2018,three patients who underwent ileal ureter replacement combined with augmentation cystoplasty were treated with ileal ureter replacement combined with augmentation cystoplasty.There were 1 male and 2 females with the age ranging from 34 to 55 years (mean 39 years).Two patients suffered from left ureter stenosis,and one patient had stenosis on the both sides.The length of the ureter stenosis ranged from 6 to 18 cm (mean 9.8 cm).The preoperative bladder capacity ranged from 60 to 150 ml (mean 103.3 ml).In the surgery,part of ileum was used to replace the ureter,and the distal intestine was made into U-shape to enlarge the bladder.Results All operation were completed successfully.The operation time ranged from 220 to 400 min (mean 303.0 min),and the blood loss ranged from 150 to 500 ml (mean 283.3 ml).Laparoscopic surgery was performed in 1 case and open surgery in 2 cases.Three weeks after the surgery,the bladder volume underwent cystography ranged from 300 to 400 ml (mean 360.0 ml).Three months after the surgery,the postvoid residual urine volume ranged from 20 to 50 ml (mean 33.3 ml).Postoperative frequency and urgency of urine were completely relieved in 1 case,alleviated in 2 cases.Flank pain was completely relieved in 1 case,and alleviated in 2 cases postoperatively.The serum creatinine of 2 patients mildly increased after the surgery,while 1 patient remained stable.For complications,1 patient had urinary infection,and 1 patient suffered from metabolic acidosis.Conclusions Ileal ureteral replacement combined with augmentation cystoplasty can be the choice of treatment for long segment ureteral stenosis and enlarge the bladder simultaneously.The postoperative complications and the kidney functions should be regularly followed up.

Objective: To investigate the risk factors of clinically diagnosed acute kidney injury (AKI) patients progressing to acute kidney disease (AKD). Methods: The clinical data of AKI patients admitted to the First Affiliated Hospital of Zhengzhou University from January 1, 2018 to December 31, 2018 were retrospectively analyzed. According to the outcome of the patients, AKI patients were divided into non-acute kidney disease (NAKD) group and AKD group. Clinical characteristics and laboratory data of two groups were compared. The risk factors of AKD in patients with AKI were analyzed by logistic regression, and then the receiver operating characteristic curve (ROC) was drawn to evaluate the predictive value of these risk factors. Results: A total of 254 patients with AKI were enrolled, and 186 patients developed AKD with an incidence of 73.2%. The incidences of AKD in stage 1, stage 2 and stage 3 of AKI were 20.0%, 46.7% and 83.5% respectively. Multivariate logistic regression analysis showed increased peak serum creatinine (within 7 days after AKI diagnosis) (OR=2.561, 95% CI 1.584-4.140, P<0.001), proteinuria (OR=2.952, 95% CI 1.162-7.500, P=0.023) and increased intact parathyroid hormone (OR=1.757, 95%CI 1.104-2.797, P=0.017) were independent risk factors for progression to AKD in patients with AKI. The ROC showed that increased peak serum creatinine (within 7 days after AKI diagnosis) was an important predictor of AKD in patients with AKI (AUC=0.798, P<0.001). Conclusion Increased peak serum creatinine (within 7 days after AKI diagnosis), proteinuria and increased intact parathyroid hormone are independent risk factors for progression to AKD in patients with AKI, providing new evidences and ideas for clinical preventions and treatments of AKD.