Objective To analyze the clinical characteristics and treatment of post - renal acute renal failure (ARF)induced by Ceftriaxone in children. Methods The clinical data of 7 cases of post - renal acute renal failure in children from June 2012 to June 2014 induced by Ceftriaxone were analyzed. According to the changes in urine volume, serum creatinine,blood urea nitrogen and serum potassium level,liquid therapy,retrograde ureteral catheterization (RUC)and peritoneal dialysis was performed by step sequential therapy respectively. Results Seven cases were given intravenous Ceftriaxone under the fluid loss state. Abdominal pain,sudden anuria or oliguria appeared in the children af-ter 2. 6 d on the average,B ultrasonography and CT scanning showed multiple calculus in the bilateral renal pelvis and ureteral calculi. Blood BUN was 15. 2 - 37. 9 mmol/ L[(23. 3 ± 8. 6)mmol/ L],and blood Cr was 180 - 636 μmol/ L [(378. 9 ± 148. 4)μmol/ L]. These indicators met the diagnostic criteria for acute renal failure. In 7 cases,2 cases (28. 6% )received fluid therapy of sodium bicarbonate alkalization and anisodamine spasmolytic,4 cases(57. 1% )re-ceived fluid therapy and RUC,and 1 case(14. 3% )underwent fluid therapy and RUC and peritoneal dialysis. All of 7 cases(100% )were alive. In the average 4. 4 days renal function of 7 cases was returned to normal,and urine volume and electrolyte were also restored. Conclusions Step sequential therapy including fluid therapy,RUC and peritoneal dialysis is effective with post - renal ARF in children induced by Ceftriaxone.

Objective To investigate the present situation of quality of life in the elderly residents aged more than 60 years in Zhanjiang city and to analyze its influence factors .Methods 418 elderly residents over 60 years sampled by the random sampling in Zhanjiang city were performed the questionnaire survey by using the Chinese Scale of World Health Organization QOL (WHOQOL-BREF) .Results The quality of life in the physical ,psychological and environmental fields in male residents was higher than that in the female residents ;which in the psychological and environmental fields in the high cultural level residents was higher than that in the low cultural level residents ;which in the social relations field in the high income residents was higher than that in the low in-come residents ;there were no statistical differences in the quality of life among the elderly residents with different occupations be-fore retirement and marital status ;the Logistic regression analysis showed that gender and occupation were the influence factors of quality of life self evaluation in elderly residents .Conclusion Gender ,occupation ,educational level and income level are the influ-ence factors of quality of life in elderly residents .

Objective To compare the clinical therapeutic results of percutaneous transluminal stenting between patients with acute and chronic aortic dissections. Methods From May 2002 to October 2007,42 patients with acute type B aortic dissection and 40 patients with chronic aortic dissection underwent stenting. The clinical data of the patients were analyzed. Results Comparing with the chronic aortic dissection group,the acute aortic dissection group had higher percentage of pleural effusion(16.7% vs 0,P=0.01)and visceral /leg ischemia(23.8% vs 2.5%,P=0.01). The acute aortic dissection group had higher complications in early term(38.1% vs 15.0%,P=0.02). All patients were followed up for an average of(18.7 ± 17.3)months. The rate of complications were higher in the patients with acute aortic dissection than those with chronic aortic dissection(21.4% vs 5.0%,P=0.03). Kaplan-Meier analysis showed no difference of survival rate between the 2 groups during follow-up period(P=0.38). The 5-year survival rate was 90.0% in acute aortic dissection group years and 92.5% in chronic aortic dissection group,respectively. The event-free survival rate was higher in the patients with chronic dissection than that with in the patients acute aortic dissection(P=0.04). Conclusions Percutaneous transluminal stenting is effective in the treatment of type B aortic dissection,but there are more complications in acute than in chronic aortic dissection group.

Objective To evaluate the early and mid-term results of endovascular repair for acute and chronic type B aortic dissection, and to compare the clinical outcomes between the 2 groups. Methods From May 2002 to December 2006, 50 patients with type B aortic dissection were treated by endovascular stent-graft. There were 23 patients in the acute aortic dissection (AAD) group and 27 patients in the chronic aortic dissection (CAD) group. All patients were followed up from 1 to 54 months (average, 17±16 months).The immediate and follow-up clinical outcomes were documented and compared between the 2 groups. Results Placement of endovascular stent-grafts across the primary entry tears was technically successful in all 50 patients. Compared to the CAD group, the AAD group had a higher percentage of pleural effusion (17.4% vs. 0%,P=0.04) and visceral /leg ischemia (26.1% vs 3.7%, P=0.04). Procedure related complications, including endoleak and post-implantation syndrome, occurred more frequently in the AAD group than in the CAD group (21.7% vs 3.7% and 30.4% vs 11.1%, respectively; P=0.08 and P=0.04). Kaplan-Meier analysis showed no difference in the survival rate at 4 years between the 2 groups (86.4% vs 92.3%, P=0.42 by log-rank test). However, the event-free survival rate was higher in patients with chronic dissection than in patients with acute aortic dissection (96.2% vs 73.9%; P=0.02 by log-rank test). Conclusions Endovascular repair with stent-graft was safe and effective for the treatment of both acute and chronic type B aortic dissection. However, both immediate and long term major complications occurred more frequently in patients with acute dissection than in those with chronic dissection.

S-1 and capecitabine are relatively ideal agents for maintenance treatment of advanced gas-tric cancer. In clinical trials of using immune and targeted drugs for maintenance treatment of advanced gastric cancer,ipilimumab fails to obtain positive results,ramucirumab has not obtained research data,and trial regimens of maintenance treatment with trastuzumab,bevacizumab and avelumab have all shown initial efficacy. Traditional Chinese medicine therapy has shown some effectiveness in maintenance treatment,which still needs further researches.

OBJECTIVETo study the chemical constituents of involatile moiety of Pogostemon cablin.

METHODCompounds were isolated and purified by repeated column chromatography, and their structures were elucidated by spectroscopic analysis.

RESULTNine compounds have been isolated and identified: epifriedelinol (1), 5-hydroxymethol-2-furfural (2), succinic acid (3), beta-sitosterol (4), daucosterol (5), crenatoside (6), 3'''-O-methylcrenatoside (7), isocrenatoside (8), and apigenin-7-O-beta-D-(6"-p-coumaryl)-glucoside (9).

CONCLUSIONCompounds 2, 3, 6-8 were isolated from Pogostemon genus for the first time.

Caffeic Acids ; chemistry ; isolation & purification ; Cholestenones ; chemistry ; isolation & purification ; Furaldehyde ; chemistry ; isolation & purification ; Glucosides ; chemistry ; isolation & purification ; Lamiaceae ; chemistry ; Molecular Structure ; Oils, Volatile ; analysis ; chemistry ; isolation & purification ; Sitosterols ; chemistry ; isolation & purification ; Succinic Acid ; chemistry ; isolation & purification

Objective: To study the therapeutic effect of laparoscopic ureteral end-to-side anastomosis at pelvic level for duplicate ureteral malformation. Methods: Clinical data of 10 children with unilateral ureteral duplication, who received laparoscopic ureteral end-to-side anastomosis at pelvic level at Department of Urology, Affiliated Children′s Hospital of Nanjing Medical University from September 2016 to November 2017 were reviewed.There were 6 boys and 4 girls with an average age of 13.9 months(1 month and 21 days to 3 years and 9 months). Ultrasonography, intravenous pyelography and magnetic resonance urography were performed before surgery.There were 6 cases of duplication with hydronephrosis in the upper moiety. The rest 4 cases were complicated with ureteroceles.Presentations included urinary dripping and symptoms caused by urinary tract infections.Urine test, ultrasonography, intravenous pyelography were performed during the 3-16 months follow-ups for all the patients after surgery. Results: The laparoscopic ureteral end-to-side anastomosis was performed successfully in all patients at the pelvic level, the average ope-rating time was 98 minutes (60-125 minutes) and mean hospital stay was 7.3 days(7-8 days). All the presentations disappeared after surgery.All the patients were followed up for 3 to 6 months with relieved hydronephrosis.Postoperative examination of intravenous pyelography in 10 cases showed that there was no anastomotic obstruction. Conclusions The laparoscopic ureteral end-to-side anastomosis can be used for duplicate ureter, and it is a safe and effective method for the treatment of ureteral duplication.

Objective:To explore the clinical characteristics and treatment regimens of adrenal incidentaloma (AI) in children.Methods:Clinical data of 38 children with AI treated in the Department of Urology, Children′s Hospital of Nanjing Medical University from December 2016 to October 2021 were retrospectively analyzed.A total of 38 children were divided into neonatal group and non-neonatal group according to their age at first diagnosis.The neonatal group had 7 males and 9 females patients, of whom 7 cases were detected with AI during prenatal examinations, 9 cases were diagnosed postnatally.Four children in neonatal group had AI in the left adrenal gland and 12 cases in the right, with the maximum diameter of tumor (MDT) ranging from 16-48 mm.In the non-neonatal group, there were 14 males and 8 females patients aged 7 months and 1 day to 12 years and 1 month, and the MDT was 29-131 mm.Paired t test was used to compare the age and MDT of benign and malignant tumors. Results:In the neonatal group, 3 patients were surgically treated, with 2 cases and 1 case of neuroblastoma and teratoma confirmed by postoperative histology, respectively.The remaining 13 patients in the neonatal group were followed up for 1-31 months, with 8 cases and 5 cases of complete remission and significantly decreased tumor volume, respectively.In the non-neonatal group, there were 3, 9 and 10 patients received open biopsy, laparoscopic adrenalectomy, and open adrenalectomy, respectively.Of these 22 surgically treated cases, 8 cases had a benign lesion, including ganglioneuroma ( n=4), adrenocortical adenoma ( n=1), adrenal cyst ( n=1), teratoma ( n=1), and pheochromocytoma ( n=1); while 14 cases had a malignant lesion, including neuroblastoma ( n=8), ganglioneuroblastoma ( n=5), and adrenocortical carcinoma ( n=1). The mean age of patients with malignant tumors was significantly younger than those with benign tumors[(38.94±35.44) months vs.(95.89±41.43) months, t=3.63, P=0.001]. The mean MDT in malignant tumors was significantly longer than that of benign tumors[(64.43±25.20) mm vs.(41.44±15.66) mm, t=2.45, P=0.023]. Conclusions:AI in children has a high risk of malignancy.Therefore, more detailed examinations are needed to detect tumor markers and endocrinological parameters, and imaging tests such as non-contrast and CT examination should be performed as early as possible.AI in children is predominantly neuroblastic tumors.For non-neonatal patients, surgery should be performed as early as possible.For AI found in the neonatal period and prenatal examination, expectant management is feasible if the tumor is relatively small and limited to the adrenal gland without distant metastases.

Objective To analyze the prognostic factors of adrenal tumor in children under 12 years of age. Methods A total of 90 children with 97 adrenal tumors admitted from June 2006 to August 2017 were selected in Children's Hospital of Nanjing Medical University.The age distribution,tumor type,biochemistry and tumor indicators, treatment,stage classification and prognosis were analyzed.Results There were 46 males and 44 females in 90 cases. Ages ranged from 4 days to 11 years and 1 month,with an average of (38.1 ± 31.3)months.The main clinical mani-festations were abdominal mass,fever and abdominal pain.Eighty cases (82.5%)underwent surgery,while 17 cases (17. 5%)did not.Open resection was performed in 48 cases,open partial resection in 11 cases,laparoscopic surgery in 10 cases,and just biopsy in 11 cases.The pathological examination showed 43 cases with neuroblastoma,13 cases with ganglioneuroblastoma,8 cases with ganglioneuroma,5 cases with adrenocortical carcinoma,3 cases with teratoma,1 case with pheochromocytoma,1 case with malignant rhabdoid tumor.Statistical analysis revealed that neuron－specific eno-lase(NSE)value of neuroblastoma and lactate dehydrogenase(LDH)value of cortical cancer increased significantly. The age was correlated with tumor stage,and patients had older age on stage Ⅳ.Complete resection in surgery was correlated with the stage of the tumor,as tumor in lower tumor stage seemed easier to be completely removed.Fifty－three cases (58.9%)were followed up for 2 months up to 11 years and 4 months.Forty－four cases survived and 9 ca-ses died.Higher tumor stage predicated worse prognosis.Conclusions Adrenal gland tumors need early diagnosis and active treatment.Earlier onset of age,complete surgical resection with patients have better prognosis.Complete resection of the disease was a key factor in the prognosis.