Abstract: Objective To investigate the clinical phenotype and genotype characteristics of mitochondrial encephalomyopathy (ME) families in children. Methods　The clinical data and genetic test results of eleven ME families who were admitted to the department of pediatrics of three tertiary hospitals in Hainan Province from January 2007 to December 2021 were retrospectively analyzed. Results　A total of 13 cases were diagnosed in eleven ME families, including 6 males (46.15%) and 7 females (53.85%). The age of onset ranged from 6 months to 12 years, the interval from onset to diagnosis was 9 months to 8 years and Morava score was 6-11. Clinical symptoms mainly included abnormal movement, developmental retardation or regression, seizures, stroke-like episodes; among the 13 children, 11 (84.62%) had elevated blood lactic acid and 4 (30.77%) had elevated blood creatine kinase. Cranial MRI mainly involved temporal parietal occipital lobe, cerebellum, brainstem and basal ganglia, some with brain atrophy. Gene detection showed that 8 families (72.72%) were caused by mtDNA mutation, of which 5 families and 6 patients were caused by MT-TL1, m.3243A>G, and 5 asymptomatic carriers of 4 families (80.00%) were detected; MT-ND5, m.13513 G>A was detected in 2 families and 3 patients, and an asymptomatic mutation carrier was detected in a family (50.00%); MT-ND3, m.10191T>C was detected in one family and one patient, and 2 asymptomatic mutation carriers were detected. Three families were caused by nDNA mutations (27.27%). A compound heterozygous mutation of c.751C>T and c.516-2A >G in SURF1 gene was found in one family and one patient, which followed autosomal recessive inheritance. The pathogenic loci were inherited from mother and father, respectively. Two new spontaneous mutations c.1040C>G and c.2060_2062delTAG in DNM1L gene were respectively detected in two families and two patients. All children were given mitochondrial cocktail therapy and symptomatic treatment after diagnosis by genetic testing. Follow-up to June 2022, two families were lost to follow-up and 9 families were followed up regularly; three of the 11 children were still survived. Conclusions　For children diagnosed with ME, genetic testing of family members can screen out early asymptomatic pathogenic mutation carriers, achieve early diagnosis of ME and guide clinical genetic counseling. Two new pathogenic sites of DNM1L gene were found in this study, which expanded the genotype spectrum.

Abstract： Objective　To investigate the clinical characteristics and pathogenic genetic mutation of a case with encephalopathy due to defective mitochondrial and peroxisomal fission-1 (EMPF1). Methods　The clinical data and genetic test results of a patient with EMPF1 admitted to the Department of Pediatrics, the Affiliated Hospital of Xiangya Medical College of Central South University in August 2020 were retrospectively analyzed. Results　An 8-year-old girl, her main clinical features were developmental regression, microcephaly, hypotonia, refractory epilepsy, cranial MRI suggesting brain atrophy and abnormal signals in the right temporal-occipital-parietal cortex, aEEG showing slow wave discharge in the right hemisphere; Whole-exome sequencing of families suggested that the child had a heterozygous missense variant at the c.1040C>G site in the DNM1L gene and the verification results by Sanger sequencing showed that her parents had no variant in this site, which was a novel mutation in accordance with autosomal dominant inheritance; bioinformatics analysis predicted that the mutation was pathogenic. After 2 years of outpatient follow-up, the patient's condition was stable after mitochondrial cocktail therapy and antiepileptic drugs, no epileptic seizure occurred in the past year, mental state and swallowing function improved, and she could be fed orally with occasional nausea and vomiting. Conclusions　The main clinical manifestations of EMPF1 are psychomotor developmental delay or regression, dystonia, limb paralysis, epilepsy and so on. According to the clinical phenotype and genetic test results, the rare disease can be diagnosed early.

Objective To evaluate the effectiveness of music therapy on anxiety and adverse reactions induced by chemotherapy in breast cancer patients after modified radical mastectomy. Methods One hundred and ten breast cancer patients were divided into intervention group and control group. The patients in the intervention group received music therapy,progressive muscle relaxation and guided inner image in addition routine nursing care. State Anxiety Inventory and Rotterdam Symptom Checklist (RSCL) were administered before the 2nd chemo-cycle and before the 3rd chemo-cycle. Results There was trend of lower scores on the Rotterdam Symptom Checklist total score and the State Anxiety score in intervention group than in control group (P＜0.05). Conclusion Music relaxation therapy can alleviate chemotherapy related adverse reactions and anxious.Therefore,music relaxation therapy is a practical psychological behavioral intervention for the breast cancer patients during the chemotherapy after modified radical mastectomy.

Objective To study the influencing factors of pediatric in-hospital cardiopulmonary resuscitation(CPR).Methods It was a retrospective observational study.We studied a total of 281 children who suffered in-hospital cardiopulmonary arrest(CPA).The outcome was defined as sustained return of spon-taneous circulation ﹥20 min.Results A total of 281 patients met study entry criteria.In 129 children (45.9%),return of spontaneous circulation sustained ﹥20 min and 20 cases(8.8%)survived to hospital discharge.In the univariate analysis,gender,age,weight,time of CPA happened,first cardiac rhythm,pH, blood lactate had no obvious influence on the outcome.Underlying disease,the place of CPA,personnel fac-tors,airway support,the duration of CPR,doses of adrenaline,use of bicarbonate and blood glucose level were associated with outcome.Conclusion At present,the rate of successful CPR and discharge of hospital is still low.Respiratory disease has a higher survival rate.CPR ﹥20 min,use of bicarbonate and using adrenaline≥3 doses are associated with poor outcome and an increase in mortality.

Early detection of HCC is critical for a good prognosis. Therefore, the development of tumor markers that can detect HCC at even earlier stages is urgent. Recent researches show that the human cervical cancer oncogene, gamma-glutamyl transferase mRNA, human telomerase reverse transcriptase mRNA, the proteins such as glypican-3, golgi protein 73, vascular endothelial growth factor and transforming growth factor-β1 could serve as markers for early detection of HCC.

Objective: Our aim was to investigate the relationship between tumor doubling time (TD) and the prognosis of patients with lung cancer.Methods:According to the diameter of tumor or its shadow,the TD of tumor was calculated and postoperative survival time (PST) were predicted based on the Geddes' nomogram.The statistic analysis was performed after comparison with the actual survival time (AST).Results:There was no significant difference of TD among tumors of different histological types (P>0.05).The accumulated survival in patients with TD>100 days was higher than those with TD<100 days, with a significant difference (P<0.05).The AST in patients underwent surgery was markedly higher than the PST,indicating that the operation was effective.Conclusion:Tumor TD may be a valuable parameter for evaluating the prognosis and surgical treatment in patients with lung cancer.

Objective To discuss changes of anxiety and adverse reaction before and after chemotherapy for patients with breast cancer, giving selective nursing intervention for coping with chemotherapy in order to reduce patients pain and increase life quality. Methods The changes of anxiety level and adverse reaction degree of 50 patients with breast cancer after modified radical mastectomy were investigated with questionnaires before the first, second and third time of chemotherapy. Results The postoperative patients showed significant difference in total score of Rotterdam symptom checklist, score of physiological domain, psychological domain and state anxiety, among which the adverse reactions such as lack of appetite, fatigue, lack of energy, nausea, acid ingestion, sore mouth, hair lost, irritability, depressed mood and tension increased after beginning chemotherapy. Conclusions Nurses should help patients to understand correctly chemotherapy and its possible adverse reaction, teach them correct coping method in order to reduce uncomfortable symptom, promote whole rehabilitation and increase life quality.

Nearly 50% patients with head and neck cancer after radiotherapy will recurrence in the previous radiation fields.Salvage surgery is the first choice of treatment.Clinical studies have shown that a small number of patients with recurrent head and neck cancer can benefit from salvage surgery plus postoperative re-irradiation or re-irradiation with or without chemotherapy or targeted therapy,and these patients can achieved tumor control and long-term survival.However, the overall efficacy is not satisfactory, and often accompanied by severe acute and late, and even fatal treatment-related toxicity.Therefore, it is necessary to give full consideration to the condition of recurrent tumor, the first radiotherapy related factors and the patient′s related status before implementation of re-irradiation.The development of radiotherapy technology and comprehensive treatment, including the clinical application of proton and heavy ion and immune therapy, provides the possibility of improving the prognosis and reducing treatment-related toxicity for these patients.

Objective To observe spasmolytic effect of Qianlieantong tablets. Methods Twelve rabbits were randomly divided into 2 groups. One group was to prepare ring muscles, another was to prepare longitudinal muscles. Contraction of trigone muscle was induced by NE. Effects of 6 groups drug were observed, which were high, middle and low concentration Qianlieantong group, Hytrine group, blank group, Tween 80 group (TW-80). Results Qianlieantong tablets can significantly inhibit contraction of NE-inducted rabbit trigone muscle (including ring and longitudinal muscles) in vitro, and the inhibition was positively correlated with concentration, which was less than Hytrine. Conclusions Qianlieantong tablets had spasmolytic effect of alleviating BPH-induced badder outlet obstruction and reducing dynamic factors caused by BPH.

Emerging clinical evidence revealed that postoperative adjuvant chemoradiotherapy (CRT) could improve the clinical outcome for resected head and neck squamous cell carcinoma in high-risk patients. The irradiation targets and doses should be determined by the primary tumor site, clinical stage, pathology reports, and the evaluation of postoperative imaging. Adjuvant concurrent CRT with cisplatin is the current standard treatment for high-risk postoperative head and neck squamous cell carcinoma patients. However, the effect of concurrent CRT with other chemotherapeutic agents and (or) epidermal growth factor receptor (EGFR) monoclonal antibody in these patients is inconclusive. Human papillomavirus (HPV)-positive oropharyngeal cancer has the unique biological characteristics, and the indications and treatment models of postoperative adjuvant CRT for these patients are still unclear. Further study is needed.