Background and purpose:Medulloblastoma(MB),which is a primitive neuroectodermal tumor(PNET),is the most common malignant brain tumor of childhood.The mean age at diagnosis is 6 years.Due to the tremendous improvements in techniques of radiotherapy and chemotherapy,the 5-year overall survival(OS) is increased to 70% now,compared with 20% in the 1970s.Factors which include local relapse,whether or not there has occurred metastases before resection,residual tumor and age etc.are mostly considered to have significant effects on prognosis.We studied the effects and side effects of the three dimensional conformal radiation therapy(3D-CRT) for the children with medulloblastoma,and summarized the reasons of failure of the therapy.Methods:From August 2001 to August 2007,34 children with medulloblastoma were treated in our hospital.Among all the patients(3-16 years,mean age was 9.5 years) there were 16 cases in high-risk group,and 18 cases in low-risk group.All of them underwent total or subtotal resection before radiation therapy.Patients were not given radiotherapy and chemotherapy before surgery.The interval between surgery and radiotherapy was less than 3 weeks.The 3D-CRT was done for all the patients with the same techniques:30 Gy to the whole cranialspinal axis followed by a boost of 20-25 Gy to the posterior fossa,witha median fraction dose of 180 cGy.Chemotherapy was given according to the protocol which consisted of lomustine,cisplatinum and vincristine after radiotherapy,but the patients were not given intrathecal chemotherapy.Blood counts and chemistries and renal and hepatic evaluations were performed regularly before every course.Results:5-year OS and 5-year event free survival(EFS) were 71% and 62% respectively.The mean follow-up was 36.5 months.The 5-year OS of the high risk group and low risk group were 88.9% and 50.0% respectively.There was significant difference between them(P=0.01).13 patients were failures.Of all failure patients,3 had recurrence in the region of the cribriform plate.The complete remission was 70.5%,and the partial remission was 14%.If metastases were found before surgery,the 5-year OS was 12.5%(1/8),and if the residual tumor was more than 1.5 cm3,the 5-year OS was 0%(0/5).Whether or not the metastases were found before surgery,and the presence of residual tumor,both had significant impacts on the prognosis of the children with medulloblastoma(P

OBJECTIVE　To detect the trace glutaraldehyde in the fluid from venous circuit tube of hemodialysis,a HPLC assay was developed.METHODS　20 mL fluid taken from the venous circuit tube were derived with DNPH for 3 h,then filtered and injected. Chromatography was conducted on C18 column at 29℃.The mobile phase was consisted of 60% CH3N and 40% H3PO4 with the flow rate at 1 mL*min-1, and the detetion wavelength was at 365 nm.RESULTS　The concentrations of glutaraldehyde in the fluid ranged from 14.99 to 37.40 μg.mL-1.CONCLUSION　This HPLC method is simple and accurate to detect the trace glutaraldehyde remained in the fluid from venous circuit tube.

Receptor-interacting protein kinase 1(RIPK1)is a multi-domain serine/threonine protein kinase that causes downstream signal transduction and biological effects by phosphorylating specific proteins.In recent years,with the in-depth study of RIPK1,scholars have found that it is of great significance in autoimmune diseases,neurodegenerative diseases,and a variety of solid tumors and hematological tumors.On the one hand,RIPK1 promotes cell survival and inflammatory responses by activating specific pathways such as nuclear factor-κB(NF-κB)and mitogen-activated protein kinase(MAPK).On the other hand,RIPKl promotes apoptosis by interacting with cysteinyl aspartate specific proteinase-8(caspase-8),or promotes necroptosis by interacting with RIPK3 and mixed lineage kinase domain-like protein(MLKL).As an upstream signal,RIPK1 has different expression levels in patients with different tumors.Its scaffold function and kinase activity can regulate cancer progression,initiate adaptive immunity,inhibit tumor progression,and generate an immunosuppressive tumor microenvironment to promote tumor development.Its dual role has been demonstrated in regulating the occurrence and development of tumors and the body's immune response,and can be used as a new therapeutic target to control cancer progression.This paper starts with the structure of RIPKI to further explore its function in regulating cancer progression and immune response,and to provide new ideas for the development of cancer-targeted drugs.

Objective To explore the effect of applying humanistic care concept in patients that were performed radical cystectomy and urinary diversion.Methods Eighty-eight patients undergoing radical cystectomy and urinary diversion in our hospital from January 2011 to May 2016 were selected.All patients were randomly divided into experiment group and control group.Of them,control group was given routine nursing care.Experiment group was administered humanistic care pattern-based nursing measures.Self-evaluation on social function was conducted in both groups 1,3 and 6 months after surgery,and the results were compared between two groups.All evaluation indexes were expressed as differences in all scales at various stages.Results Willingness score of ostomy self-nursing and score of ostomy nursing skill in experiment group upon discharge to 1 month after discharge,1 to 3 months after discharge,and 3 to 6 months after discharge,respectively,which were better than those in control group.Differences were of statistical significance(P<0.05).Anxiety score and depression score in experiment group at those three periods,respectively,were better than those in control group(P<0.05).Evaluation score of self-nursing ability in experiment group at those three periods,respectively,were better than those in control group(P<0.05).Score of quality of life in experiment group at those three periods were better than those in control group.All differences were of statistical significance(P <0.05).Judging from the point of view of incidence of complications 6 months after surgery,10 and 23 cases in experiment and control groups developed complications,respectively(P <0.05).Conclusions Applying humanistic care concept in clinical nursing contributes to effectively improving the postoperative recovery of social function in patients and enhancing their quality of life.It shows high application value in clinical practice.

The pks genomic island encodes non-ribosomal peptide synthase (NRPS), polyketide synthases (PKS), and hybrid NRPS/PKS synthetase. This genomic island is mainly found in the members of the family Enterobacteriaceae, and is especially common in Escherichia coli of phylogroup B2 while frequently coexisting with other virulence factors. The pks-positive E. coli is able to synthesize colibactin, a genotoxic chemical compound. Thus, this pks-positive bacteria may induce the breaking of DNA double-strand and chromosomal instability, which lead to senescence and apoptosis of cells. As a result, pks-positive E. coli is positively associated with the occurrence of diseases such as colorectal neoplasms, neonatal meningitis, and septicemia. Epidemiological studies have also confirmed that pks-positive E. coli is associated with a variety of diseases. However, the exact pathogenic mechanism of pks-positive E. coli is still not understood. Despite its genotoxicity, the pks-positive E. coli also exhibits some positive effects including anti-inflammatory, analgesic, and antibiotic abilities. Therefore, the biological role of pks-positive E. coli is complicated. In this review, an overview of the pks genomic island and its prevalence in Enterobacteriaceae, as well as the biological function of pks-positive E. coli is described, aiming to provide references for further researches.

Objective To analyze related behaviors of individual preparedness and influencing factors on violent terrorist attacks among undergraduates.Methods A total of 1 800 undergraduates from 5 colleges or universities in Guangzhou were selected,using the stratified cluster method.A questionnaire involving the response to violent terrorist attack behavior was used to assess the individual preparedness behaviors among undergraduates.A self-made questionnaire was applied to collect information on demographic factors,cognitive and preparedness behaviors.Results The mean score of individual preparedness behavior among undergraduates was 13.49 ± 5.02 while information on seeking behavior was 4.27 ± 1.64,avoidance behavior was 5.97± 2.16 and violent terrorist attack response behaviors was 23.73 ± 7.21,with 30.0 percent of undergraduates behaved properly.Significant differences were found in the scores of behaviors on the response to violent terrorist attack with different gender,major they pursue or religious belief (P＜0.05),among undergraduates involved in this study.Results from the logistic regression analysis revealed that persons being girls (OR=1.46,95％ CI:1.06-2.01),with bigger perceived probability (OR=1.60,95％ CI:1.12-2.30),with higher alertness (OR=3.77,95％ CI:2.15-6.61),with stronger coping confidence (OR=0.34,95％ CI:0.24-0.48) and bigger affective response (OR1=3.42,95％ CI:2.40-4.86; OR2 =0.23,95 ％ CI:0.1 3-0.41),would present more prominent behavior responses when facing the violent terrorist attack.Conclusion Individual response behaviors to violent terrorist attacks among undergraduates were relatively ideal.Perceived probability,alertness,coping confidence and affective response appeared to be independent influencing factors related to response behaviors against violent terrorist attack.In colleges and universities,awareness on violent terrorist attacks should be strengthened among undergraduates.Focus should target on psychological education dealing with disaster,knowledge and skills needed for emergency response,so as to respond to the emergency on campus.

Objective To explore the effects of Clark comfortable nursing mode on self efficacy and quality of life in hospitalized patients with stroke .Methods This research selected 100 hospitalized patients with stroke in recovery period in department of neurology at a hospital where the author was .They were divided into control group (50 cases, usual nursing) and observation group (50 cases, Clark comfortable nursing mode ) according to nursing mode .The self efficacy , quality of life , and degree of satisfaction was compared in patients of two groups on admission and 6 months after nursing care .Results The score of self efficacy (33.04 ±5.09) of patients in observation group was higher than that ( 26 .73 ±4 .75 ) in control group with a significant difference (t=3.726, P=0.015);the score of quality of life (40.80 ±5.72) of patients in observation group was higher than that (35.41 ±5.53) in control group with a significant difference (t=4.210, P<0.001);the degree of satisfaction (96.00%) of patients in observation group was higher than that (74.00%) in control group with a significant difference (P=0.007).Conclusions The Clark comfortable nursing mode applied to the nursing care of hospitalized patients with stroke not only can improve patients ′self efficacy and quality of life, but also can increase the degree of satisfaction of patients .

Ojective To explore the effect of the hydroxyapatite(HAp)and gelatin(Gel)coating on the healing of the polyethylene terephthalate(PET)artificial ligament.Methods The artificial ligaments were divided into a PET group with a pure PET surface and a PET/HAp/Gel group coated with HAp and Gel.Both coatings were observed using the scanning electron microscope(SEM).Forty-eight male New Zealand rabbits were randomly divided into two groups and underwent anterior cruciate ligament reconstruction,before two kinds of artificial ligaments were implanted respectively.Four weeks and 8 weeks after the operation,the rabbits were sacrificed,and histological hematoxylin and eosin (HE)staining as well as the biomechanical examination were performed.Results HAp/Gel coating was found depositing on the surface of PET artificial ligaments.Histological HE staining showed a thick fibrous connective tissue forming at the graft-host bone interface 4 weeks postoperatively,and the interface width of both groups were narrowed,with significantly more shrinking in the PET/HAp/Gel coating group.And new bone tissues were found in the interface of PET/HAp/Gel group 8 weeks after the operation.The biomechanical examination found significant differences in the failure load between the PET(46.16 ± 2.88 N) and PET/HAp/Gel group(71.32 ± 3.92 N)8 weeks after the surgery(P=0.0021).And 4 weeks and 8 weeks after the surgery,significant differences were found in the stiffness between the PET group and the PET/HAp/Gel group(11.06 ± 1.14 N/mm vs 16.20 ± 1.17 N/mm,P=0.0199;14.37 ± 0.88 N/mm vs 24.35 ± 1.35 N/mm,P=0.0008).Conclusion HAp/Gel coating can enhance the osteogenesis of PET artificial ligaments,promoting the new bone formation at the graft-host bone interface and herein strengthening the graft-host bone healing.

Objective:To compare the effectiveness and safety of all-suture anchors and single-row suture anchors for rotator cuff repair.Methods:A prospective randomized controlled study was conducted to analyze the clinical data of 50 patients with rotator cuff tear admitted to Second Affiliated Hospital of Zhejiang University School of Medicine between July 2019 and September 2021. They were divided into two groups according to the random table: 25 patients to receive repair with single-row suture anchors (control group) and the other 25 with all-suture anchors (trial group). Visual Analogue Scale (VAS), University of California, Los Angeles (UCLA) shoulder score, American Shoulder and Elbow Surgeons (ASES) score and shoulder range of motion were compared between the two groups before surgery, at 3 months after surgery and at the last follow-up. The rotator cuff retear rate of the two groups was evaluated according to Sugaya classification at 6 months after surgery. Breakage or anchor loosening during surgery, healing of incision and presence of infections or neurological complications after surgery, and change of the anchor position and periosteal reaction at the insertion site at 3 and 6 months after surgery were observed in the two groups.Results:A total of 50 patients with rotator cuff tear were involved in this study, including 17 males and 33 females, aged 40-73 years [(59.1±10.3)years]. All patients were followed up for 6-9 months [(6.7±1.0)months]. The differences in VAS, UCLA shoulder score, ASES score, and shoulder range of motion between the two groups were statistically insignificant before surgery (all P>0.05). The VAS at 3 months after surgery and at the last follow-up in the control group was 2.0 (2.0, 4.0)points and 2.0 (0.0, 2.0)points, respectively, with no statistical differences from 2.0 (2.0, 2.0)points and 2.0 (0.0, 2.0)points in the trial group (all P>0.05). In the control group, the UCLA shoulder score and ASES score at 3 months after surgery and the ASES score at the last follow-up were (25.1±4.5)points, 78.8 (71.6, 85.8)points and 85.8 (85.8, 93.0)points, respectively, with no statistical differences from (26.8±4.7)points, 85.8 (82.3, 85.8)points, and 92.8 (85.8, 100.0)points in the trial group (all P>0.05). At the last follow-up, the UCLA shoulder score of the control group was (29.2±3.9)points, which was lower than that of the trial group [(31.6±2.4)points] ( P<0.05). The differences in shoulder motion between the two groups at 3 months after surgery and at the last follow-up were not statistically significant (all P>0.05). The VAS, UCLA shoulder score, and ASES score at 3 months after surgery and at the last followup in both groups were significantly improved compared to their preoperative values (all P<0.05); further improvements were observed at the last follow-up compared with those at 3 months after surgery (all P<0.05). The rotator cuff retear rate at 6 months after surgery was 16.7% (4/24) in the control group, not statistically different from 4.3% (1/23) in the trial group ( P>0.05). There were no incidences of anchor loosening or breakage during surgery. All incisions were healed after surgery, with no infections or neurological complications. No grades II to III periosteal reactions at the anchor insertion sites were observed in either group at 3, 6 months after surgery. The percentage of patients with grade 0 periosteal reaction at the anchor insertion site at 3 months after surgery was 4.2% (1/24) in the control group, significantly lower than 30.4% (7/23) in the trial group ( P<0.05). Conclusion:All-suture anchors and single-row suture anchors are effective in rotator cuff repair, but the former results in better shoulder function and fewer periosteal reactions in the anchor insertion site in the early stage.