Objective To evaluate a thrombolytic system of portal vein port-catheter kit (PC) in the treatment of portal vein thrombosis (PVT). Methods In this study, 42 PVT patients with liver cirrhosis and portal hypertension after splenectomy from 2005 to 2007 were divided into two groups. In group A (20 eases) thrombolysis was administered through the PC device. Urokinase at the dosage of 1000 U?kg-1?h-1 was given for a consecutive 3 -6 days through the PC, and then the therapy was converted to 100 AxaIU/kg of low molecular heparin twice a day for 7 days subcutaneously. In group B, the thrombolysis was performed on 22 patients through peripheral veins. The therapy was same as in group A except for that the urokinase dosage was doubled. The complete thrombolysis rate, the effective thrombolysis rate, the time of thrombolysis, the long-term recurrence rate and the incidence of complication were compared between the two groups. Results The complete thrombolysis rate and the effective thrombolysis rate in group A were 75%, 90% respectively, compared with that of 41%, 59% respectively in group B. The significant differences in the complete thrombolysis rate, the effective thrombolysis rate, the time of thrombolysis and the incidence of complication were found between the two groups, while the thrombolysis recurrence rate had no significant difference between the two groups. Conclusion PC regime is an effective and safe method for the treatment of portal vein thrombosis.

Objective To investigate the breakfast behaviors and nutritional quality among primary and secondary students,and to provide scientific evidence for developing intervention strategies.Method Random three-stage clustering sampling method was employed in the study.A questionnaire survey was conducted among 9194 primary and secondary students aged 6-17y,from seven cities in China.Results The rates of primary and secondary students having breakfast everyday were 97.0%,92.4%,and 93.4%,Most of the students had their breakfast within 30 min after getting up,the rates being 75.4%,74.7%,and 68.6% respectively.Mothers primarily cook breakfast for the students,the rates being 53.1%,49.9%,and 49.7% respectively.In most cases,they had breakfast at home,the rates being 71.8%,67.0%,and 63.8% respectively.The rates of students having poor quality breakfast were above 80%.Conclusion Primary and secondary students are one of the focal target people for preventing unhealthy dietary behaviors due to shortcomings of eating breakfast.It is necessary to improve the nutritional quality of breakfast for better health of students.

Objective To explore the effect of bladder muscle flaps for long segment defect of ureter middle-lower segment and reconstruction method in laparoscopic surgery. Methods Clinical data of 3 patients with long segment defect of ureter middle-lower segment, all of whom underwent laparoscopic surgery from May 2014 to April 2016 was retrospectively evaluated. There were 1 male and 2 females, in 2 cases with history of ureteroscopy holmium laser lithotripsy in ureter middle-lower segment, in 2 cases with history of repeated ESWL. Preoperative urinary tract ultrasound, CT and intravenous urography imaging showed severe hydronephrosis, ureter middle-upper segment severe hydroureter, ureter middle-lower segment severe stricture. Results Operations were successful in 3 cases. After reconstruction bladder muscle flaps average length of is 9.6 cm, The average operation time of 180 min, The average length of hospital stay for 10 d, Postoperative eighth weeks extracted the double J tube and used ureteroscopy showed anastomotic unobstructed, it may smooth Through 8.5 F ureteroscopy, and no infection and urinary leakage occurred, Follow-up ranged from 3 to 18 months. 3 cases hydronephrosis and hydroureter significantly reduce, ureter unobstructed, no narrow in ureter and muscle flap of tube joint, serum creatinine valueswere in normal range. Conclusions The bladder muscle flaps for the treatment of long segment defect of ureter middle-lower segment in laparoscopic surgery was a safe and effective therapy, but it must be accomplished by seasoned doctors.

Objective To explore the efficacy and safety of Transurethral vaporization of the prostate using 1 470 nm diode laser in treatment of BPH.Methods 58 cases BPH patients underwent transurethral vaporization of the prostate using 1 470 nm diode laser from Dec. 2015 to Apr. 2016 were retrospectively analyzed, including the mean operation time and compared hemoglobin, electrolyte, urinary symptoms, before and after surgery.Result Operations were successfully performed in all the 58 cases, with average operation time of (48.2 ± 16.3) min. No difference was found in either hemoglobin decrease or electrolyte decrease before and after surgery. The patients were followed up for 1~3 months, which revealed a signiifcant reduction in IPSS and improvement in Qmaxand PVR (P < 0.05), compared with pre-operation. No severe complications were reported, including transurethral resection (TUR) syndrome, urinary incontinence and impaired erectile function.Conclusion Transurethral vaporization of the prostate using 1 470 nm diode laser is a safe and effective therapy for BPH. It has advantages of short learning curve, very little blood loss, high efifcacy. It has promising broad prospects.

Objective To evaluate the clinical efifcacy of sorafenib in preventing the recurrence of primary liver cancer after radical surgery. Methods Seventy patients with primary liver cancer undergoing radical surgery in the Third Affiliated Hospital of Sun Yat-sen University between June 2009 and June 2012 were enrolled in this prospective study. The informed consents of all patients were obtained and the local ethical committee approval had been received. According to different postoperative therapies, the patients were divided into the sorafenib group (n=24) and control group (n=46). In the sorafenib group, there were 22 males and 2 females with a mean age of (48±10) years. A dose of 400 mg sorafenib was orally administered twice daily for consecutive 6 months. In the control group, there were 40 males and 6 females with a mean age of (48±11) years. The patients were orally administered with placebo. All patients received postoperative follow-up. Postoperative recurrence rate, survival rate and drug-induced adverse reactions were observed. Postoperative recurrence rate and incidence of adverse reactions of two groups were compared using Chi-square test or Fisher exact probability test. Postoperative survival rate was analyzed by Kaplan-Meier plot and Log-rank test. Results In the sorafenib group, the 1-, 2-and 3-year recurrence rates were 25%(6/24), 42%(10/24), 50%(12/24) respectively, and 28%(13/46), 46%(21/46), 53%(25/46) respectively in the control group. No signiifcant difference was observed between two groups (χ2=0.020, 0.102, 0.120;P>0.05). The 1-, 2-and 3-year cumulative survival rates in the sorafenib group were 95.83%, 87.50%and 70.83%, and no signiifcant difference was observed compared with 91.30%, 82.61%and 63.04%in the control group (χ2=0.078, P>0.05). In the sorafenib group, the incidence of hand-foot skin reaction, diarrhea, hypertension and erythema were 42%(10/24), 29%(7/24), 21%(5/24) and 25%(6/24), which were signiifcantly higher compared with 7%(3/46), 7%(3/46), 2%(1/46) and 4%(2/46) in the control group (χ2=10.663, 4.885, 4.828, 4.762;P<0.05). Conclusion Sorafenib can neither decrease postoperative recurrence of peimary liver cancer after radical surgery nor enhance the overall survival rate.

Objective To investigate the mechanism of intestinal bacterial translocation in rats with liver cirrhosis after partial hepatectomy. Methods Forty healthy spelific pathogen free male Sprague-Dawley (SD) rats [4 weeks old, average weight: (90±10)g] were randomly divided into sham operation group (SO group) and partial hepatectomy group (PH group) with 20 rats in each group after liver cirrhosis model was established. Rats in SO group underwent separation of perihepatic ligaments then the abdomen was closed. Rats in PH group underwent modified partial hepatectomy including resection of left medial lobe, lateral lobe and middle lobe. The volume of resected liver was about 2/3. Portal pressure was tested in 10 rats from each group 24 h after operation. The levels of plasma D-lactate, endotoxin, content of bacteria in mesenteric lymph nodes, histological change of small intestinal mucosa, contents of tight junction protein ZO-1 and Claudin-1 of small intestinal tissue, expressions of tumor necrosis factor (TNF)-α, interferon (IFN)-γ, myosin light chain kinase (MLCK) of small intestinal tissues, changes of fecal flora were tested in the other 10 rats of each group 24 h after operation. The experimental data with normal distribution in 2 groups were compared using t test. The Chiu's scores of small intestinal mucosa in 2 groups were expressed in M(Q25, Q75) and were compared using rank sum test. The comparison of rates in 2 groups was conducted using Chi-square test. Results The portal pressure in PH group [(22.9±0.7)cmH2O] (1 cmH2O=0.098 kPa) was signiifcantly higher than that in SO group [(15.4±1.1)cmH2O] (t=-11.15, P<0.05). The level of plasma endotoxin in PH group [(52.6±2.3)EU/ml] increased obviously, compared with that in SO group [(48.6±2.4)EU/ml] (t=-3.31, P<0.05) . The content of bacteria in mesenteric lymph nodes in PH group was (162±55)%of that in SO group, which was signiifcantly higher than that in SO group (t=-2.22, P<0.05). The level of plasma D-lactate was (60.6±5.0)mg/L in PH group, which was significantly higher than that in SO group [(37.4±2.8)mg/L] (t=-9.70, P<0.05). The median of Chiu's score of small intestinal mucosa was 4(3, 4) in PH group, which was signiifcantly higher than that in SO group [1(1, 2)] (Z=-3.52, P<0.05). The contents of tight junction protein ZO-1 and Claudin-1 of small intestinal tissue in PH group were 0.50±0.14, 0.33±0.13 respectively, which were signiifcantly lower than those in SO group (0.70±0.09, 0.62±0.10) (t=2.78, 2.98;P<0.05). The strong positive expression rates of TNF-α, IFN-γ, MLCK were 50%(5/10), 40%(4/10), 70%(7/10) in PH group, which were significantly higher than those in SO group [20%(2/10), 10%(1/10), 20%(2/10)] (χ2=4.87, 8.37, 5.01;P<0.05). The contents of fecal Escherichia coli, Bacteroides, Fusobacterium, Klebsiella pneumoniae, Bifidobacteria in PH group were (288±74)%, (185±48)%, (278±82)%, (551±96)%, (43±7)%of those in SO group. The contents of fecal Escherichia coli, Bacteroides, Fusobacterium, Klebsiella pneumoniae in PH group were signiifcantly higher than those in SO group, while the content of Biifdobacteria was signiifcantly lower (t=2.49, 3.68, 2.24, 5.50,-3.89;P<0.05). Conclusions The mechanism of intestinal bacterial translocation in rats with liver cirrhosis after partial hepatectomy may be associated with the damage of intestinal mechanical barrier and bacterial barrier. Reducing the portal pressure and level of inlfammatory factor, and correcting the intestinal bacterial imbalance may be effective methods for reducing intestinal bacterial translocation.

Objective:To assess the value of serum tumor specific protein 70 (SP70) for prognostic stratification in acute myeloid leukemia (AML).Methods:A cohort study design was adopted. 129 newly diagnosed AML patients from September 2022 to January 2024 at the Hematology Department of the First Affiliated Hospital of Nanjing Medical University were included, as well as a control group consisted of 120 healthy individuals and 7 cases with benign hematologic diseases during the same period (total 127 cases). Clinical data were collected from Electronic Medical Records. According to the 2023 edition of the Chinese Leukemia Diagnosis and Treatment Guidelines, AML patients with good or moderate prognosis were categorized as low-to-intermediate risk, while those with poor prognosis were high-risk group. Univariate and multivariate logistic regression analyses were used to identify variables significantly associated with AML prognostic risk. ROC analysis was used to evaluate diagnostic performance. A nomogram for predicting patient prognostic risk was constructed by R 4.0.2 software, and the internal validation was performed using bootstrapping.Results:Among 129 AML patients, there were 71 males (55.0%) and 58 females (45.0%), with 42 (32.6%) classified as high-risk and 87 (67.4%) as low-intermediate risk. The high-risk group had a significantly higher median age [62 (48, 67) years] compared to the low-intermediate risk group [50 (35, 63) years, Z=-2.381, P=0.017], and a significantly higher proportion of males (30 patients, 71.4%) compared to the low-intermediate risk group (41 patients, 47.1%, χ 2=6.760, P=0.009). Multivariate logistic regression analysis indicated that serum SP70 ( OR=2.54, 95% CI: 1.68-3.84, P<0.001), hemoglobin (HB) ( OR=0.96, 95% CI: 0.93-0.99, P<0.05), and bone marrow blast (BM blast) ( OR=1.07, 95% CI: 1.02-1.13, P<0.05) were independent risk factors for high-risk prognosis in AML patients. ROC analysis showed that the area under the curve (AUC) for SP70 predicting high-risk patients was 0.908 (cut-off value of 5.74 ng/ml, 95% CI: 0.845-0.952, sensitivity 90.5%, specificity 82.8%). The combined model of serum SP70, HB, and BM blasts had an AUC of 0.931 (95% CI: 0.890-0.973); C-index=0.925 (95% CI: 0.876-0.963),with no statistically significant difference compared to serum SP70 alone ( Z=1.693, P>0.05). Conclusion:Serum SP70 may be a promising non-invasive molecular biomarker for prognostic stratification in AML.

Objective:To assess the value of serum tumor specific protein 70 (SP70) for prognostic stratification in acute myeloid leukemia (AML).Methods:A cohort study design was adopted. 129 newly diagnosed AML patients from September 2022 to January 2024 at the Hematology Department of the First Affiliated Hospital of Nanjing Medical University were included, as well as a control group consisted of 120 healthy individuals and 7 cases with benign hematologic diseases during the same period (total 127 cases). Clinical data were collected from Electronic Medical Records. According to the 2023 edition of the Chinese Leukemia Diagnosis and Treatment Guidelines, AML patients with good or moderate prognosis were categorized as low-to-intermediate risk, while those with poor prognosis were high-risk group. Univariate and multivariate logistic regression analyses were used to identify variables significantly associated with AML prognostic risk. ROC analysis was used to evaluate diagnostic performance. A nomogram for predicting patient prognostic risk was constructed by R 4.0.2 software, and the internal validation was performed using bootstrapping.Results:Among 129 AML patients, there were 71 males (55.0%) and 58 females (45.0%), with 42 (32.6%) classified as high-risk and 87 (67.4%) as low-intermediate risk. The high-risk group had a significantly higher median age [62 (48, 67) years] compared to the low-intermediate risk group [50 (35, 63) years, Z=-2.381, P=0.017], and a significantly higher proportion of males (30 patients, 71.4%) compared to the low-intermediate risk group (41 patients, 47.1%, χ 2=6.760, P=0.009). Multivariate logistic regression analysis indicated that serum SP70 ( OR=2.54, 95% CI: 1.68-3.84, P<0.001), hemoglobin (HB) ( OR=0.96, 95% CI: 0.93-0.99, P<0.05), and bone marrow blast (BM blast) ( OR=1.07, 95% CI: 1.02-1.13, P<0.05) were independent risk factors for high-risk prognosis in AML patients. ROC analysis showed that the area under the curve (AUC) for SP70 predicting high-risk patients was 0.908 (cut-off value of 5.74 ng/ml, 95% CI: 0.845-0.952, sensitivity 90.5%, specificity 82.8%). The combined model of serum SP70, HB, and BM blasts had an AUC of 0.931 (95% CI: 0.890-0.973); C-index=0.925 (95% CI: 0.876-0.963),with no statistically significant difference compared to serum SP70 alone ( Z=1.693, P>0.05). Conclusion:Serum SP70 may be a promising non-invasive molecular biomarker for prognostic stratification in AML.

Objective To explore the effect of simulated food model on diet education in patients with maintenance hemodialysis. Methods A total of 90 patients who had hemodialysis in the Fifth People's Hospital of Shanghai from March to June 2016 were selected into this study according to convenience sampling. The participants were divided into control group(n=45)and intervention group(n=45)based on the dialysis time. The simulated food model was applied to the diet education in the intervention group while the control group received routine diet education. The knowledge of diet,changes in serum creatinine,hemoglobin and serum albumin,and satisfaction of diet education were compared before and after the intervention. Results After the education, the intervention group had significantly higher scores of diet knowledge and satisfaction level compared with the control group(P < 0.05). There were significant differences in serum creatinine between the two groups(P<0.05). However,no statistical differences were found in hemoglobin or serum albumin between the two groups(P> 0.05). Conclusions The simulated food model can effectively improve the knowledge of diet and the satisfaction of diet education in patients with maintenance hemodialysis. It can also reduce the serum creatinine and has a positive effect on diet education.

Objective: To investigate the tendency and safety of percutaneous umbilical cord blood sampling (PUBS) in prenatal screening and diagnosis, and the possibilities of avoiding unnecessary PUBS. Methods: This was a retrospective study of pregnant women who underwent PUBS for prenatal diagnosis in Peking University First Hospital from January 2015 to December 2017. Clinical indications, timing of PUBS, further investigations (chromosome karyotype, molecular genetics and pathogen testing), results, and pregnancy outcomes were collected and analyzed. One-way analysis of variance (ANOVA), Chi-square test for linear trend, Fisher's exact probability test/Cochran-Armitage analysis and Cruskal-Wallis rank-sum test were used for statistical analysis. Results: (1) A total of 412 singleton pregnancies underwent PUBS at 20-38 gestational weeks during the study period, and 379 (92.2%) of them received PUBS before 34 gestational weeks. The positive test results accounted for 10.4% (43/412). There were six (1.5%) miscarriages after PUBS. In vitro cell culture failure occurred in two cases, one in 2015 and the other in 2016. (2) Among the 412 cases, 304 (73.8%) had only one indication. Fourteen cases could be identified as high risk in the first trimester, such as advanced maternal age (AMA, >35 years), pregnant history with chromosomal abnormal fetus and one of the couples carrying abnormal genes. There were four, zero and one case receiving PUBS only for AMA in 2015, 2016 and 2017, respectively. Indications, including high risk suggested by serum screening and fetal abnormality found by ultrasound were identified in 290 cases (70.4%) in the second or third trimester. Other than AMA, there were no statistically significant differences in single indicators. The proportion PUBS with double indicators increased from 2015 to 2017 but without significant difference. AMA and positive serum screening as indicators of aneuploidy screening accounted for 7.6% (8/105) in double-indicator group and 1.9% (8/412) in all. (3) There were 363 PUBS (88.1%) performed for ultrasound abnormalities. Among them, 76.9% (280/363) only had abnormal ultrasound findings, and the percentage was decreased year by year. The other 83 cases (80 with double indicators and three with triple indicators) also presented with other indicators, including AMA, adverse pregnancy history and positive serum screening. The proportion of PUBS performed with the presence of multiple indicators tended to increase recently, but no statistically significant difference was found. All the 18 cases with abnormality diagnosed by molecular genetic testing had abnormal ultrasound findings. Conclusions Although PUBS's complications are rare, it carries some risks. The constitution of single indication has been declined every year. With the improvement of prenatal screening system and application of molecular karyotyping, the necessity of invasive prenatal diagnosis with PUBS is greatly reduced. An improvement in reasonable and standardized application of PUBS needs to be achieved.