Current 5 -year overall survival rates (OS)for children and adolescents treated for Hodgkin lym-phoma (HL)exceed 90%.However,this early success is negatively impacted by late mortality due to adverse health -related squeal of therapy.This challenge has resulted in the development of various strategies aimed at identifying the optimal balance between maintaining OS and avoidance of long -term morbidity of therapy.With new imaging tech-niques,the success of reducing therapy in a subset of rapid early responders is demonstrated.Treatment strategy is not only a risk -adjusted but also response -based combined -modality therapy.

Primary central nervous system lymphoma (PCNSL) is a form of extranodal non-Hodgkin lymphoma (NHL) and it is typically confined to brain, spinal cord, cranial nerves, eyes, and meninges without evidence of system spread.It is a rare subtype of NHL in childhood and adolescence, with an increased risk among patients with immunodeficiency.In the absence of prospective pediatric clinical trials, data from recent pediatric series and adult prospective trials was summarized, so as to help audience better understand the role of surgery, whole brain radiation therapy, and chemotherapy in the treatment as well.

Mature B-cell non-Hodgkin lymphoma (B-NHL) represents about 55%-60%of all NHL cases in children and adolescents. Burkitt lymphoma and diffuse large B-cell lymphoma are the most common subtypes. Current combination chemo-therapy regimen succeeds in overall survival rates of more than 80%. Risk factors for the prognosis of childhood and adolescent B-NHL include bone marrow and central nervous system involvement, serum lactate dehydrogenase level and kinetics of re-sponse to therapy. Future strategies should include further understanding of the genetic alternation of B-NHL and utilization of novel target therapies to decrease treatment-related toxicity. We performed a retrospective analysis on the treatment of child and adolescent mature B-cell lymphoma.

Children who recovered from hematological malignancies have different degrees of secondary immunodeficiency.They are prone to acquire various infectious diseases, thus affecting their health and even endangering their life and may become the source of infection that affects the health of the surrounding people and residents of co-mmunities.Preventive vaccination is the easiest and most effective measure to prevent infectious diseases.However, in addition to the limited qualification of vaccination, due to the lack of the understanding to the safety, effectiveness and contraindications in the vaccination for this type of patients, there still exists blankness in the preventive vaccination work for this group in China.This paper summarizes some consensus on the vaccination for discharged patients of hematological malignancies in light of providing reference for the implementation of this clinical work in China.

Pediatric inherited cancer predisposition syndromes are a group of diseases caused by germ-line mutation of cancer related genes. The patients are susceptible to cancers. TP53 germ-line mutation is the most commonly seen mutant gene in cancers that accounts for 20%-30%of all germ-line mutations of inherited cancers. TP53 gene mutation screening could help clinicians to better manage the patients and their family members.

Objective To review the clinical characteristics of idiopathic portal hypertension (IPH).Methods The clinical and pathological data of 10 patients with idiopathic portal hypertension admitted from December 2008 to December 2014 were retrospectively analyzed.Results Among 10 patients 5 were males and 5 females with averaged age of (38.6 ± 16.1) years.There were splenomegaly and esophageal varices in all 10 cases,upper gastrointestinal bleeding in 3 cases,thrombocytopenia in 9 cases and anemia in 6 cases.Liver function was normal in 7 cases,mild abnormality in 3 cases.Ten cases underwent ultrasound examination and 7 cases had CT scan,cirrhosis was suggested with ultrasound/CT scan in 6 cases.Liver histology showed lobular architecture in existence,no false flocculus to form,variable degree of portal fibrosis appeared.Eight cases were misdiagnosed as liver cirrhosis,the duration of misdiagnosis varied from 1 month to 15 years.Conclusions The clinical manifestation of IPH is similar as cirrhosis caused portal hypertension.Liver histopathological examination can exclude liver cirrhosis,and portal fibrosis and liver terminal portal branch occlusion in histopathology is helpful to the diagnosis of IPH.

Objective To compare the difference of therapeutic effect of surgical operation and non-operation for acute damnification of elbow ulnar collateral ligament in rabbits.Methods A total of 81 New Zealand rabbits were randomly and equally divided into three groups(27 rabbits per group),ie,Group A(control group):the ulnar collateral ligaments of right elbow joint were only enclosed;Group B:the ulnar collateral ligaments of right elbow joint were severed and sutured;Group C:the ulnar collateral ligaments of right elbow joint were severed,without suture.The biomechanics was detected at time intervals of 3 and 6 weeks.Results Twelve weeks after transplantation,the displacements of the ligaments in Groups B and C were(6.06±0.4)mm and(7.72±0.44)mm,with statistical difference(P ＜ 0.05).The displacement of the ligaments in Group A was(5.87±0.46)mm,which was similar to that of Group B(P＞0.05).The maximum loads of the ligaments of Groups B and C were(68.23±5.64)N and (42.45±3.66)N respectively,with statistical difference(P＜0.05).The maximum load of the ligaments of Group A was(72.86±2.99)N,which was similar to that of Group B(P ＞ 0.05).The rigidities of the ligaments of Groups B and C were(11.33±1.52)N/mm and(5.52±0.67)N/mm respectively,with significant difference(P ＜ 0.05).The rigidities of the ligaments of Group A was(12.49±1.44)N/mm,which was similar to that of Group B(P ＞ 0.05).The power consumption of the ligaments of Groups B and C were(0.206±0.017)J and(0.163±0.013)J respectively,with statistical difference(P＜0.05).The power consumption of the ligaments of Group A was(0.213±0.010)J,which was similar to that of Group B(P＞0.05).Conclusion Surgical operation is more effective than the non-operation in dealing with acute damnification of the ulnar collateral ligaments of elbow ulnar collateral ligament in rabbits.

OBJECTIVE To investigate the pathogenic distribution and drug resistance of nosocomial infection occurred in pediatric patients with hematologic malignancy and therefore provide the information in rational administration of antibiotics to pediatric patients with hematologic malignancy complicated with nosocomial infection.METHODS Flora cultivation and isolation were operated with the routine methods and drug-sensitivity was determined by Kirby-Bauer method.RESULTS Totally 116 strains of pathogenic bacteria were isolated,in which included 78 strains of G-bacteria and 38 strains of G+ bacteria.Fungi were also very common.In this study,both G-and G+ bacteria were resistant to antimicrobial agents tested.CONCLUSIONS The bacterial spectrum and their drug-resistance characteristics in pediatric patients with hematologic malignancy are quite different to that encountered in pediatric patients with other systemic diseases.Most strains present high resistance to antibiotics,so our administration of antibiotics for nosocomial infections should be directed and carry out according to the susceptibility tests in different area and different periods.

ObjectiveTo develop an EZ screw remover for screwing out the skidded screws,discuss its design features and biomechanical characteristics and verify its extracting effect by clinical applications.MethodsFresh skeleton specimens were used in the study,including the femur (n =3),tibia ( n =3 ),radius and ulna ( n =3 ).The screws were fixed to the specimens according to clinical requirements and bone cement was filled into the medullary cavity.The specimens were randomized into three biomechanical test model groups,ie,Group A (measuring the skidded screws with the biggest torsion when the screws were taken out by screwdriver),Group B (measuring the skidded screws with the biggest torsion when the screws were taken out by one handle of EZ screw remover) and Group C ( measuring the skidded screws with the biggest torsion when the screws were taken out by two handles).The fixed screws were divided into two types of φ4.5 mm and φ3.5 mm.The experimental specimens were tested on the universal testing machines to measure the maximum torque,torsion angle,power consumption value and efficiency when drawing out the screws. The experimental data were compared between groups.The skidded screws encountered in clinical were taken out with EZ screw remover to verify the extracting effect.ResultsThe pullout torque in Groups A,B and C was 2.87-3.27 N · m,3.06-4.83N · m and 4.12-8.36 N · m respectively ( P ＜ 0.05 ).The average torsion angle value in each corresponding group was 0.77°,0.28°,0.16° respectively (P ＜ 0.05 ).When the screws were screwed out,the average power consumption was 21 J,32 J and 45 J in Groups A,B and C respectively and power ( mechanical efficiency) was 0.35 J/s,0.53 J/s and 0.75J/s in Groups A,B and C respectively,with significant differences ( P ＜ 0.05 ).Seventeen pieces of the cannulated skidded screws of φ7.3 mm in seven patients were successfully taken out by using the EZ screw remover.ConclusionEZ screw removerhas enough resistance strength and rigidity to torsion as well as powerful clamping force and hence is an ideal tool for screwing out the skidded screw in orthopedics.

Objective To evaluate the outcomes of children with stage Ⅳ malignant extracranial germ cell tumors. Methods Twenty-five patients were enrolled in the retrospective analysis. Event-free survival (EFS) and overall survival (OS) rates were estimated by Kaplan-Meier method with SPSS 13.0. Results Of the 25 children, there were 13 males and 12 females. The mean age at diagnosis was 2 years old (ranged 1 to 11). Five patients receiving chemotherapy in another hospital before (n=1), or giving up treatment after confirmed diagnosis (n=1), or giving up effective treatment after received less than 2 cycles (n=3) were excluded from this analysis. Of the 20 patients, 90.0% (18/20) achieved complete remission and 5.0% (1/20) achieved partial remission after treatment. The 5-year EFS rate and 5-year OS rate were 70.0%±10.2% and 82.4%±9.2% respectively. There was no death occurred due to complications. Conclusions The effect of this treatment program is positive. The cumulative dose of the drugs is not high, compared with other schemes such as PEB, but there are more drugs involved. Whether these drugs may cause long-term adverse reactions needs further research.