Objective To explore the microsurgical technique of ependymoma in conus medullaris and cauda equina. Methods Sixteen patients with ependymoma confirmed by pathology after operation in conus medullaris and cauda equina were analyzed retrospectively for their clinical manifestations, imaging features and microsurgical treatment. Results All patients conducted preoperative MRI, and total tumor resection was achieved in 14 patients and subtotal resection in 2 patients. The pathological examinations confirmed the tumor as myxopapillary ependymomas in 7 patients. Symptoms of fifteen patients were alleviated significantly after operation. One patient had urine retention after operation and was gradually restored 1 week after operation. All patients were followed up for 1-3 months, and there was no case of recurrence. Conclusions Ependymoma in conus medullaris and cauda equina is rare and easily misdiagnosed, with no specific clinical manifestations. MRI should be conducted as soon as possible to identify the diagnosis. Microsurgical treatment is an effective method for ependymoma in conus medullaris and cauda equina.

Objective To explore the application value of pulse indicator continuous cardiac output (PiCCO) monitoring in the fluid management of children with acute respiratory distress syndrome (ARDS).Methods Thirty-two children with ARDS admitted to Pediatric Intensive Care Unit(PICU) of Zhengzhou Children's Hospital,from April 2013 to April 2016,were divided into intervention group (15 cases) and control group (17 cases) by adopting random number table method.Fluid management of intervention group by PiCCO,control group by central venous pressure,the 2 groups' oxygenation index (OI),acute lung injury score,mechanical ventilation time and 28 days mortality were statistically compared.The categorical data were analyzed by using SPSS 11.0 software,and the t test was used for the measurement data.The categorical data and mortality comparison were analyzed by adopting x2 test.The difference was statistically significant at P ＜ 0.05.Results After 3 days of mechanical ventilation,the changes of OI in the intervention group were significantly higher than those in the control group [(175.0 ±-43.7) mmHg vs.(143.0 ± 42.8) mmHg (1 mmHg =0.133 kPa),t =2.090 0,P ＜ 0.05].The intervention group was significantly shorter than the control group [(10.45 ± 3.12) d vs.(12.63 ± 2.87) d,t =2.058 7,P ＜ 0.05].There was no significant difference between 2 groups in acute lung injury score,PICU length of stay and 28 days mortality (all P ＞ 0.05).Conclusions PiCCO monitoring and guidance in the fluid management of pediatric ARDS can improve oxygenation after 3 days,reduce mechanical ventilation time,but can not significantly reduce the 28-day mortality.

Determination of exact total protein bonding quantity is often a key step in the preparation of protein-immobilized chiral monolith. In this study, we developed and evaluated a bovine serum albumin(BSA)modified monolith based on glycidyl methacrylate(GMA)and ethylene dimethacrylate(EDMA)for chiral separation. The epoxy groups of the polymer were used directly for the covalent bonding of BSA. A Coomassie brilliant blue(CBB)protein assay(Bradford method)was established to determine the protein bonding quantity, and the influence of some key aspects such as ionic strength, pH value and reaction time were studied. The method was validated with respect to linearity, precision, accuracy and robustness. The maximum amount of immobilized BSA was 11. 90 mg/g, obtained using 65 ∶35 cyclohexanol/dodecanol as the porogen. The monolith was successfully applied in the chiral separation of R/S-warfarin and D/L-tryptophan in only 1-20 min. Furthermore, the chromatographic conditions like pH and organic additive of the mobile phase were optimized. The chiral separation performance of this BSA-immobilized monolith is positively correlated to the protein bonding quantity.

The construction of wound repair discipline in China is still at the initial stage of exploration, and there is no systematic and mature experiences to learn from. The Luzhong Hospital of Beijing University established a professional committee for wound repair, opened a mobile workstation for wound repair, established a wound repair alliance and quality control center, advocated a medical-care integrated treatment model, and carried out academic exchanges and scientific research, the discipline of wound repair in Shandong Province got a rapid development and the pattern of "Zibo mode" of wound repair emerged. The authors introduce the experiences in construction of the discipline of wound repair in Zibo city, in order to provide some references for the grass-roots counterparts.