Objective To estimate the incidence,clinicopathological characteristics and therapeutic features in children with solid pseudopapillary tumors of the pancreas(SPTP).Methods Nine eases of children SPTP after diagnosis were collected in our hospital.Routine HE,PAS staining and immunohiatochemical staining of multiple indicators were analyzed,combined with literature analysis of clinical manifestations,imaging,pathological features,surgical treatment and follow-up case.Results The average age in nine cases of SPTP was 10.3 years.The SPTP patients in children in our hospital accounted for 29.0% of pancreas solid tumors.Many clinical manifestations were abdominal pain(5 cases,55.56%),abdominal mass(3 cases,33.33%),jaundice(1 cases,11.11%),and other symptoms.B-ultrasonography and CT showed pancreatic lesions,clear boundary,was solid and cystic,and some have a little calcification.Pathological features:tumor limitations,capsule integrity,and cross-section alternating solid and cystic lesions,tumors organizations sheet hemorrhage,necrosis and cystic change.Immunohistochemically,the positive rates were 100% for α1-AT,66.7% for NSE,33.3% for S-100 and 100% for PAS.The patients were followed-up for 4 months to 10 years and were alive postoperatively,but no local recurrence and distant metastasis.Histological examination showed solid with cystic areas and papillary protrusions.Conclusion SPTP should be the second most common pancreatic tumor in children.Girls were more frequently affected.The overall prognosis following surgical resection was good.

Objective To study the relationship between clinical-biological significance and the expression of CD44v6 and Survivin in multifocal papillary thyroid carcinoma (PTC). Methods Immunohistochemical SP method was used to investigate the expression of CD44v6 and Survivin in 47 cases of multifocal PTC and adjacent tissues, and 122 cases of single focal PTC tissues. The expression of CD44v6 and Survivin and the risk factors among different clinical factors were analyzed between solitary PTC and multifocal PTC group. Results Tumor foci were found in 27.8 % (47/169) patients. The patients with multifocal were characterized by a higher ratio of family history of thymid tumor, lymph node metastasis and extra-thymidal extension (χ2 = 4.189, 6.159, 4.079, P ＜0.05), and not related with sex, age, size and the number of the tumors (P ＞0.05).The positive rates of CD44v6 and Survivin were 70.2 % (33/47) and 66.0 %(31/47), respectively, in multifocal PTC, both of which were significantly higher than that in nodular goiter,Hashimoto' s thyroiditis and normal thyroid tissues (χ2 =47.184, P ＜0.05). Overexpressions of CD44v6 and Survivin in multifocal PTC were related to the degree of the infiltration(χ2 = 4.723, P =0.030; χ2 =4.023,P =0.045) and lymph node metastasis (χ2 =5.771, P =0.016; χ2 =5.686, P =0.017), and not related with sex,age, family history and the number of the tumors (P ＞0.05).The expression of CD44v6 was correlated positively with Survivin (r =0.514, χ2 =10.15, P ＜0.01).There was no significant difference in expressions of CD44v6 and Survivin between multifocal and single focal PTC (P ＞0.05).By the sept.2010, the patients with single and mutiple focal PTC were all survival.Conclusion Multifocus is one of the clinical features of PTC.The high expressions of CD44v6 and Survivin in multifocal PTCs relate to the development, invasion and metastasis.

Objective To explore the effects of nutritional intervention on body composition,blood biochemical parameters and blood pressure of overweight adults with metabolic syndrome.Methods Forty overweight adults with metabolic syndrome (body mass index (BMI) ＞ 28.0 kg/m2,waist circunference ≥85 cm(for male)or ≥80 cm(for female))participated in this investigation.Changes of serum lipid profiles,blood glucose,blood pressure and other indicators were compaired before and after 2-months'intervention.SPSS 18.0 Software was used for data analysis.Results After two rnonths' nutritional intervention,body weight,body fat,BMI,visceral fat area and waist hip ratio were significantly improved(t =17.02,11.07,5.11,10.35,9.58 ; P ＜ 0.05).The glutamic-pyruvic transaminase,glutamic-oxalacetic transaminease,cholesterol,triacylglycerol,fasting blood-glucose,systolic blood pressure and diastolic blood pressure were also significantly improved after nutrition intervention(t =2.87,2.91,3.33,2.24,2.56,5.74,6.99 ;P ＜ 0.05).Conclusion Nutrition intervention may contribute to improved levels of blood pressure,blood glucose and serum lipid profiles of obesity individuals through body weight and body fat control and lead to reduced insulin resistance caused by obesity.

Objective To investigate the effecs of evidence-based nursing of the treatment with propranolol forthe intractable infantile hemangiomahemangioma. Methods Dividing the children who were treated with propranolol into experimental groups and matched groups randomly according to the random number table each 42 .The experimental group adopted evidence-based care,according to PICO tool description of the problem and combining the results of theresponsibility nurse′s regular follow-up and assessment to come up with evidence-based problems,seeking for high-level evidences,combining the existing conditions of careand having formulated corresponding care norms,contingency plans for adverse reactions,healthy education card,the operation videos and other measures and they are implemented.The control group adopted the routine care procedure.two groups of effects were determined by the Achauer level 4 classification after 12 months of treatment,and evaluating the condition of occur of blood pressure drop ,slow heart beat ,diarrhea, sleepdisorders, hypoglycemia and other adverse reactions in both groups during the process of treatment. Results there was statistical significance in the difference of two groups′Achauer 4 levels. The numbers of Ⅰ, Ⅱ, Ⅲ, and Ⅳ in the two groups were 3, 7, 20, 12, and 11, 15, 11, 5, respectively (t1=1372, t2=2132, P<0.05). The two groups had a statistically significant difference in blood pressure, heart rate, diarrhea, sleep disorder, and low blood sugar response. The numbers of two groups were 12, 2, 3, 6, 1 and 26, 15, 12, 21, 8 respectively (χ2=6.098-12.464, all P<0.05). Conclusions Evidence-based nursing enhances the treatment effectiveness of theintractable infantile hemangioma with propranolol effectively and has preventing the occur of adverse reactions during the process of treatment.

Objective To investigate the screening results and risk factors for precancerosis and early gastric cancer in southern Jiangsu province. Methods A total of 8 647 participants aged over 40 years were randomly sampled from 7 of 35 counties in Shengze District.Initial screening was performed with antibody testing to determine the pepsinogen Ⅰ/Ⅱratio(PGR),gastrin-17(G-17)level,and prevalence of Helicobacter pylori (Hp) infection, in addition to a questionnaire survey. Based on blood test results, participants were assigned to a low-,moderate,or high-risk group.Those assigned to moderate and high-risk groups were referred for endoscopy. In the low-risk group, 210 participants (30/county) were randomly selected for endoscopy.Results The overall prevalence of Hp infection was 51.2%.Female sex,body mass index,number of family members,and smoking were identified as risk factors based on the results of logistic regression, while educational level, drinking, and history of gastric cancer and digestive diseases were identified as protective factors.Based on the results of gastric functional testing, 2 391 participants(210 of 6 466 in the low-risk group and all participants in the moderate and high-risk groups) were referred for endoscopy.Of 2 381 participants,1 290 underwent endoscopy,with a response rate of 54.0%.According to the endoscopic and pathological findings, 925 participants were diagnosed with gastritis, 233 with atrophic gastritis and intestinal metaplasia,136 with intestinal metaplasia,32 with hyperplastic polyps,26 with mild dysplasia, 3 with moderate dysplasia, 6 with early gastric cancer,and 2 with advanced gastric cancer.The relevance ratio for gastric cancer was 92.5/100 000 in this specific region.Age,history of gastric cancer,Hp infection, over-/under-expression of PGI, PGR, and G-17 level were identified as risk factors for precancerous lesions. In the moderate and high risk groups, the prevalence of precancerous lesions was 24.6% in males and 24.4% in females,with adjustment using propensity score modeling.Conclusion The relevance ratio for early gastric cancer and precancerous lesions was slightly higher in those aged over 40 years in southern Jiangsu Province.It is essential to provide specific intervention and long-term follow-up for those screened for gastric cancer and precancerous lesions.

Objective:To analyze the influence of lifestyle changes on body weight and metabolic parameters during the early stage of corona virus disease 2019 (COVID-19) epidemic and regular epidemic prevention period in physical examination population.Methods:A total of 801 subjects from Nanjing enterprises and institutions who underwent physical examination in the Department of Health Promotion Center, the First Affiliated Hospital of Nanjing Medical University in May of 2019 to 2021 were included in this study. The basic information and data of body mass index, fasting blood glucose, total cholesterol, low density lipoprotein cholesterol (LDL-C), triglyceride and uric acid were collected. Information about dietary and exercise habits was obtained through pre-examination questionnaires. The data of 2019 was set as baseline data, data of 2020 represented information during the early stage of COVID-19 epidemic and data of 2021 represented information in regular epidemic prevention period. The subjects were divided into underweight group, normal weight group, overweight group, and obese group according to the body mass index at baseline. The Friedman test was applied to compare changes in body mass index and metabolic parameters across the population. Chi-square test was used to compare changes in dietary and exercise habits. Multivariate logistic regression analysis was adopted to explore the influencing factors of body mass index changes.Results:During the early stage of COVID-19 epidemic, the proportion of weight gain was the highest in the underweight group (42.9%), the proportion of weight loss was the highest in the overweight group (24.2%), and the obese group has the most stable body weight (70.6%) ( P=0.004). Men ( OR=0.56, 95% CI: 0.36-0.87) were less likely to gain weight than women ( P=0.010). There was no significant differences in weight change among all groups in the regular epidemic prevention period ( P=0.380). During the early stage of COVID-19 epidemic, the levels of fasting blood glucose, total cholesterol and LDL-C were significantly lower than those of baseline [4.98 (4.66, 5.42) vs 5.23 (4.91, 5.66) mmol/L, 4.98 (4.36, 5.67) vs 5.11 (4.54, 5.77) mmol/L, 2.90 (2.45, 3.33) vs 3.23 (2.77, 3.74) mmol/L], and the uric acid level was higher [333.0 (275.5, 397.0) vs 311.0 (257.5, 368.0) μmol/L] (all P<0.001). In regular epidemic prevention period, the levels of body mass index, fasting blood glucose, total cholesterol and LDL-C were significantly higher than those in the early stage of the epidemic [24.0 (21.9, 26.3) vs 23.8 (21.7, 26.1) kg/m 2, 5.18 (4.85, 5.62) vs 4.98 (4.66, 5.42) mmol/L, 5.12 (4.42, 5.76) vs 4.98 (4.36, 5.67) mmol/L, 3.06 (2.59, 3.57) vs 2.90 (2.45, 3.33) mmol/L], while the uric acid was significantly lower [319.0 (265.0, 377.0) vs 333.0 (275.5, 397.0) μmol/L] (all P<0.001). During the early stage of the epidemic, the reduction proportion of unhealthy diet in the home group was significantly higher than that in the outing group (19.5% vs 11.4%), and the increment proportion of exercise in the outing group was significantly higher than that in the home group (5.1% vs 1.6%) (both P<0.05). In regular epidemic prevention period, the increase rate of unhealthy diet in the home group was significantly higher than that in the outing group (26.8% vs 13.0%) ( P<0.001), and there was no significant difference in exercise between the two groups ( P=0.325). During the early stage of COVID-19 epidemic and in the regular epidemic prevention period, unhealthy diet>3 times per week ( OR=3.85, 3.01, 95% CI: 1.74-8.51, 1.41-6.39) was positively correlated with weight gain, and regular exercise ( OR=4.35, 2.61, 95% CI: 2.05-9.23, 1.15-5.91) was positively correlated with weight loss (all P<0.05). Conclusions:During the early stage of COVID-19 epidemic and in the regular epidemic prevention period, the lifestyle in the physical examination population has an impact on body weight and metabolic indicators. In the early stage of the epidemic, unhealthy diet and exercise decreased, and metabolic indicators such as blood glucose and lipids decreased. People with low body weight tend to gain weight. In the regular epidemic prevention period, the subjects′ exercise increased but unhealthy diet also increased, and blood glucose, lipid and body weight elevated significantly.