Objective This study was to evaluate the relative applicability of serum cystatin C(Cys C)-based formulas and serum creatinine-based formulas for renal glomerular filtration rate(GFR) of Chinese children with chronic kidney disease(CKD).Methods Six hundred and nine Chinese CKD patients of less than 18 years old were enrolled from January 2011 to October 2016 in Shengjing Hospital of China Medical University.The value for estimated GFR (eGFR) was derived from using the 11 formulas,and 99mTc-DTPA renal dynamic imaging was the golden standard of standard GFR(sGFR).SPSS 22.0 statistical software was used to compare the accuracy of each assessment formula and the correlation between GFR markers(Cys C, β2-MG) and sGFR.Results A total of 609 children were enrolled,including 332 patients in CKD stage 1 (211 males and 121 females),165 patients in CKD stage 2(99 males and 66 females),70 patients in CKD stage 3(43 males and 27 females),22 patients in CKD stage 4(13 males and 9 females),and 20 patients in CKD stage 5(16 males and 4 females).All of the formulas either overestimate or underestimate GFR in chil-dren with CKD. In contrast with other formulas,CKD-EPI formula and Filler formula performed better regardless of gender and age difference.Serum β2-MG and serum Cys C all showed a negative relationship with sGFR(respectively r= -0.478 and r= -0.585,P<0.01).Conclusion CKD-EPI formula and Filler formula provide the better approximation to sGFR than other formulas in Chinese children with CKD.Howev-er,we need to try our best to enroll more patients to develop a more accurate GFR estimation formula in Chinese children.

Objective:To explore the significance of CAS-R-2 frameless brain stereotactic apparatus assisted trepanation and drainage in the treatment of hypertensive basal ganglia cerebral hemorrhage.Methods:The clinical data of 60 patients with hypertensive basal ganglia cerebral hemorrhage, who underwent CAS-R-2 frameless brain stereotactic apparatus assisted trepanation and drainage in Beijing Luhe Hospital, Capital Medical University from January 2018 to December 2022, were retrospectively analyzed. The surgical related indexes and adverse reactions were recorded. The patients were followed up for 6 months, and the prognosis was evaluated using the Glasgow outcome score (GOS).Results:A total of 60 cases of CAS-R-2 frameless brain stereotactic apparatus assisted trepanation and drainage were all successfully performed, and the operation time was (53 ± 18) min. There were 2 cases (3.3%) of postoperative puncture path hematoma, which were completely resolved with conservative treatment. The expansion of postoperative intracerebral hematoma was not observed. The drainage tube retention after operation ≤2 d was in 44 cases (73.3%), and the drainage tube retained for 3 to 4 d was in 16 cases (26.7%), all of them had no intracranial infection after operation. Fifteen cases (25.0%) were complicated with severe pneumonia after operation, and 2 cases (3.3%) died due to severe pneumonia combined with multiple organ failure. Follow up at 6 months after operation, 17 cases (28.3%) were good, 19 cases (31.7%) had mild disability, 16 cases (26.7%) had severe disability, 6 cases (10.0%) had vegetative survival status, and 2 cases (3.3%) died.Conclusions:The CAS-R-2 frameless brain stereotactic instrument assisted trepanation and drainage for the treatment of hypertensive basal ganglia cerebral hemorrhage has the characteristics of simple operation, accurate positioning, minimal trauma, and fewer complications. It is a safe and effective method for treating hypertensive basal ganglia cerebral hemorrhage.

OBJECTIVETo investigate the outcomes after combined organ radical resection for the recurrent gastric cancer.

METHODSComplete clinicopathological data of 48 recurrent gastric cancer patients who received radical resection before and underwent reoperation again in the Sun Yat-sen Memorial Hospital and The Second Affiliated Hospital of Xinjiang Medical University from January 2008 to December 2013 were analyzed retrospectively. Of 48 patients, 32 received combined organ radical resection(radical group) and 16 received combined organ palliative gastric stump resection (palliative group).

RESULTSIn the radical group, one case(3.1%,1/32) died 5 days after operation due to hepatorenal syndrome and 9 had postoperative complications (28.1%,9/32), including external intestinal fistula, pancreatic fistula, biliary fistula and anastomotic bleeding. In the palliative group, only one patient(6.2%, 1/16) had postoperative pneumonia and partial intestinal obstruction, with lower complication morbidity as compared to the radical group(P<0.05). The median survival time was significantly longer in the radical group(36.0 vs. 11.5 months, P<0.01). The 1- and 3-year survival rates were 93.1%, 72.4% in the radical group, and 31.3%, 18.8% in palliative group, whose differences were statistically significant. Multivariate Cox regression analysis showed that clinical stage (HR:3.106, 95% CI:1.357-6.321, P=0.008), peritoneal metastasis (HR:10.167, 95% CI:3.230-35.234, P=0.000) and radical cure situation(HR:3.256, 95% CI:1.267-9.389, P=0.009) were independent prognostic factors.

CONCLUSIONThe combined organ radical resection can provide better survival for recurrent gastric cancer patients, while the indications should be controlled strictly with preoperative multidisciplinary assessment and precise surgical judgment in order to decrease the complication.

Gastrectomy ; Gastric Stump ; surgery ; Humans ; Neoplasm Recurrence, Local ; surgery ; Postoperative Complications ; Reoperation ; Retrospective Studies ; Stomach Neoplasms ; surgery ; Survival Rate