Childhood malignant solid tumors exhibit a wide variety of vagueness signs and symptoms in the early stage,which are usually nonspecific,therefore the diagnosis of childhood malignant solid tumor can be challenging when the disease is in the early stage.As a result,the delay of diagnosis causes mistreatment,and which makes childhood malignant solid tumors become a leading cause of death in children.Physicians should recognize the early warning signs of childhood cancer,and a good clinical history and careful physical examination can help physicians determine whether the children have cancer and make referrals in time.Some children with possible cancers require immediate initial treatment before referral to be stabilized in order to make the referrals possible and increase the chance of receiving appropriate treatment in time and the possibility of being cured,saving more children with malignant solid tumors to the maximum extent.

Objective:To assess whether familial occurrence has an influence on the morphological characteristics of patients with nonsyndromic cleft lip and/or palate (NsCL/P).Methods:A case-control analysis was performed on the morphological characteristics of familial group and sporadic group,using medical records of 1967 patients with NsCL/P treated in the Affiliated Stomatological Hospital of Nanchang University from 2002 to 2014.Results:164 (8.34％) cases presented a positive history of cleft in their families.The cleft types,the positive familial rate of cleft lip only (CLO),cleft lip and alveolar ridge(CLA),cleft lip and palate (CLP) and cleft palate only (CPO) were 8.11％,8.54％,6.19％ and 9.65％ respectively.A positive family history of NsCL/P was associated with 0.66 times risk of CPO (P =0.036,OR =0.66,95％ CI 0.44-0.98) compared to those of CLO,CLA and CLP.In familial group of CLP,the lateral incidence of male patients was different from that of female patients (P ＜ 0.001).There was no significant difference between familial group and sporadic group on birth weights,parental child-bearing age and clinical manifestations of patients.Conclusion:Familial occurrence might have an influence on cleft type,laterality and gender of the patients with NSCL/P.

OBJECTIVEThis study described the clinical, surgical, and radiographic findings of simple bone cysts.

METHODSA retrospective study was conducted for patients diagnosed with simple bone cysts in the Department of Oral and Maxillofacial Surgery of the Affiliated Stomatological Hospital of Nanchang University from March 2005 to March 2015. Clinical, radio-graphic, surgical, and follow-up data were gathered. Results were statistically analyzed by central tendency and dispersionusing SPSS 20.0 software.

RESULTSEleven cases of simple bone cysts were collected, including three male and eight female patients. Ten cases (90.9%) were asymptomatic and one case developed symptoms of swelling. All of the cases had no history of trauma in the affected area, and all were solitary; ten cases (90.9%) were unilocular, and one (9.1%) was multilocular.The shape of each lesion could be assigned to four categories: cone (3 cases), round (2 cases), oval (4 cases), and irregular (2 cases). The treatment in 10 cases consisted of surgery to explore the cavity and curettage of the bone walls. During surgery,the bone cavity in seven cases (70%) was vacant, whereas serous fluid was found in two cases (20%) and serous-bloody fluid in one case (10%). Of the ten cases, three cases exhibited complete bone healing and seven cases showed new bone formation.

CONCLUSIONSimple bone cysts of the jaws are usually asymptomatic and appear incidentally on routine radiographies. The prevalence is higher in the mandible and young people. The patient usually has no history of trauma, and the bone cavity of lesion is mostly vacant. Curettage of the bone walls of the lesion is suggested for simple bone cysts. Systemic clinical and radiologic follow-up are necessary to ensure successful treatment.

Bone Cysts ; Dental Caries ; Female ; Hospitals ; Humans ; Jaw Cysts ; diagnosis ; pathology ; Male ; Mandible ; Mandibular Diseases ; Radiology ; Retrospective Studies ; Software

Objective To optimize preparation process of Zushima Gel Cream. Methods The comprehensive evaluation set sensory evaluation, initial adhesive force, viscous force, and peeling strength score as indexes. The mixing time, refining temperature, mixing speed, and powder adding sequence were investigation factors. Orthogonal experiment was used to optimize forming process. Results Conditions of optimized preparation process were as following: add Zushima powder in Viscomate NP-700 and glycerol; mixing time was 5 min; refining temperature was 40 ℃; mixing speed was 100 r/min. Conclusion The preparation process is good and optimized Zushima Gel Cream has a good adhesive force, good glossiness and excipients. The preparation process is good.

Objective:To evaluate the effect of image-guided with cone-beam computed tomography (CBCT) based on volumetric modulated arc therapy (VMAT)-flattening filter free (FFF) on the setup errors of stereotactic body radiotherapy (SBRT) in patients with spinal metastatic tumors.Methods:The clinical data of 15 patients with spinal metastatic tumors who underwent SBRT in Jilin Cancer Hospital from August 2020 to January 2022 were retrospectively analyzed. The radiotherapy dose of bone metastasis was 32 Gy per 4 times and CBCT scanning was performed before and after radiotherapy. Every patient received radiotherapy 4 times; all 15 patients underwent SBRT 60 times in total and 120 CBCT volume images were finally obtained and analyzed. The systematic error (Σ) and random error (σ) were calculated at different correction threshold levels. The translational setup error and rotational setup error at the left-right (X axis), head-foot (Y axis) and front-back (Z axis) directions before and after radiotherapy were compared, which were expressed as Σ ± σ.Results:The pre-SBRT and post-SBRT translational setup errors were (0.14±0.27) cm and (0.07±0.19) cm, respectively ( P<0.001) in the X direction, (-0.05±0.33) cm and (0.00±0.19) cm, respectively ( P = 0.001) in the Y direction, (-0.13±0.19) cm and (-0.02±0.14) cm, respectively ( P = 0.012) in the Z direction. The pre-SBRT and post-SBRT rotational setup errors were (-0.31±0.76)° and (-0.09±0.34)°, respectively ( P < 0.001) in the X direction, (-0.13±0.88)° and (-0.07±0.36) °, respectively ( P < 0.001) in the Y direction, (0.10±0.51)° and (0.16±0.38)°, respectively ( P < 0.001) in the Z direction. Conclusions:CBCT correction could reduce Σ and σof the translational setup and rotational setup, increase the accuracy of SBRT based on VMAT-FFF for patients with spinal metastatic tumors.

Objective To investigate the risk factors for postoperative multi-drug resistant infection in patients with cerebral hemorrhage and establish a Nomogram prediction model.Methods Clinical materials of 241 patients with surgery for cerebral hemorrhage in the hospital from July 2020 to July 2023 were collected,and they were divided into infection group and non-infection group.Logistic re-gression models were used to analyze independent influencing factors for the occurrence of postopera-tive multi-drug resistant infection in patients with cerebral hemorrhage,and a Nomogram prediction model was constructed accordingly.The predictive performance of the Nomogram was evaluated by the consistency index(C-index),the receiver operating characteristic(ROC)curve,and the calibration curve.Results A total of 241 patients with cerebral hemorrhage were included in this study,among which 56 cases(24.24％)had postoperative multi-drug resistant infection.In the infection group,the preoperative Glasgow Coma Scale(GCS)score,ratio of preoperative vomiting,ratio of preopera-tive antibiotic treatment,ratio of gastric tube indwelling,ratio of tracheotomy,and ratio of intubation were significantly higher than those in the non-infection group(P＜0.05).Logistic regression analy-sis revealed that preoperative GCS score ≤ 8,preoperative vomiting,preoperative antibiotic treatment,gastric tube indwelling,tracheotomy and intubation were the independent risk factors for postoperative multi-drug resistant infection in patients with cerebral hemorrhage(OR＞1,P＜0.05).Values of ar-ea under thecurve(AUC)for preoperative GCS score,preoperative vomiting,preoperative antibiotic treatment,tracheotomy and intubation were all above 0.700,indicating these indicators have good predictive value for the occurrence of postoperative multi-drug resistant infection in such patients.Based on these influencing factors,a Nomogram risk model was established.The C-index value of the calibration curve was 0.798,suggesting the Nomogram model has good discriminatory power.The AUC values for the modeling group and validation group in the ROC curve were 0.798 and 0.722 respectively,indicating that the Nomogram model possesses satisfactory predictive efficacy.Conclusion Nomogram prediction model constructed based on independent risk factors for postop-erative multi-drug resistant infection in patients with cerebral hemorrhage can effectively predict the probability of such infections occurring in these patients after surgery.

Objective To investigate the risk factors for postoperative multi-drug resistant infection in patients with cerebral hemorrhage and establish a Nomogram prediction model.Methods Clinical materials of 241 patients with surgery for cerebral hemorrhage in the hospital from July 2020 to July 2023 were collected,and they were divided into infection group and non-infection group.Logistic re-gression models were used to analyze independent influencing factors for the occurrence of postopera-tive multi-drug resistant infection in patients with cerebral hemorrhage,and a Nomogram prediction model was constructed accordingly.The predictive performance of the Nomogram was evaluated by the consistency index(C-index),the receiver operating characteristic(ROC)curve,and the calibration curve.Results A total of 241 patients with cerebral hemorrhage were included in this study,among which 56 cases(24.24％)had postoperative multi-drug resistant infection.In the infection group,the preoperative Glasgow Coma Scale(GCS)score,ratio of preoperative vomiting,ratio of preopera-tive antibiotic treatment,ratio of gastric tube indwelling,ratio of tracheotomy,and ratio of intubation were significantly higher than those in the non-infection group(P＜0.05).Logistic regression analy-sis revealed that preoperative GCS score ≤ 8,preoperative vomiting,preoperative antibiotic treatment,gastric tube indwelling,tracheotomy and intubation were the independent risk factors for postoperative multi-drug resistant infection in patients with cerebral hemorrhage(OR＞1,P＜0.05).Values of ar-ea under thecurve(AUC)for preoperative GCS score,preoperative vomiting,preoperative antibiotic treatment,tracheotomy and intubation were all above 0.700,indicating these indicators have good predictive value for the occurrence of postoperative multi-drug resistant infection in such patients.Based on these influencing factors,a Nomogram risk model was established.The C-index value of the calibration curve was 0.798,suggesting the Nomogram model has good discriminatory power.The AUC values for the modeling group and validation group in the ROC curve were 0.798 and 0.722 respectively,indicating that the Nomogram model possesses satisfactory predictive efficacy.Conclusion Nomogram prediction model constructed based on independent risk factors for postop-erative multi-drug resistant infection in patients with cerebral hemorrhage can effectively predict the probability of such infections occurring in these patients after surgery.

Objective:To understand the cognition degree and demand of the middle-aged and elderly people for wisdom pension and analyze its influencing factors.Methods:This was a cross-sectional study. From March to June 2019, the convenient sampling was used to select 486 middle-aged and elderly people in Nankai District of Tianjin as the research objects. The self-designed general information questionnaire, Wisdom Pension Cognition Questionnaire and Wisdom Pension Demand Questionnaire were used for the investigation.Results:A total of 486 questionnaires were distributed and 445 valid questionnaires were recovered, with an effective recovery rate of 91.56%. A total of 73.5 % (327/445) of the middle-aged and elderly people had high awareness of smart home appliances, 70.0 % (312/445) of smart phones, 65.2% (290/445) of WeChat and 64.9 % (289/445) of QQ. Those with a demand of more than 50% were smart stoves (63.4%) , one-button pagers (53.3%) , harmful gas and smoke alarm devices (51.7%) , community video surveillance devices (50.1%) , contacting relatives and friends by phone (59.8%) and access to information through television (66.0%) . Occupation, income of month, frequency of mobile phone use, whether to use computers and whether there was broadband at home were the common influencing factors of cognition and effective demand (all P<0.05) . The cognitive level of middle-aged and elderly people on wisdom pension was positively correlated with their demands ( r=0.486, P<0.01) . Conclusions:The middle-aged and elderly people have a low overall awareness of wisdom pension and have high but differentiated demands for wisdom pension products and services. Multi-sectoral departments of the society should cooperate and jointly promote the development of wisdom pension services.

Objective:To explore the short-term clinical efficacy, safety and patients' prognostic influencing factors of CyberKnife for the treatment of brain metastases in non-small cell lung cancer (NSCLC).Methods:A retrospective case series study was conducted. The clinical data of 58 NSCLC patients who received CyberKnife treatment for brain metastases at Jilin Cancer Hospital from July 2020 to January 2022 were retrospectively analyzed. At 3 months after CyberKnife treatment for brain metastases, and the efficacy of radiotherapy was evaluated on the basis of changes of brain metastases detected by contrast-enhanced magnetic resonance imaging (MRI) of the head. Overall survival (OS) and local recurrence-free survival (LRRFS) were analyzed in 58 patients by using the Kaplan-Meier method; the efficacy of cumulative brain metastasis volume for determining the survival of CyberKnife-treated NSCLC patients with brain metastases was analyzed by using the receiver operating characteristic (ROC) curve with the survival status of patients during the follow-up period as the gold standard, and the optimal cut-off value of cumulative brain metastasis volume was obtained; the clinical factors affecting OS and LRRFS of CyberKnife-treated NSCLC patients with brain metastases were analyzed by univariate and multivariate Cox proportional hazards models, and the adverse reactions associated with CyberKnife treatment were evaluated.Results:Among the 58 patients, 26 (44.8%) were male and 32 (55.2%) were female, with a median age [ M ( Q1, Q3)] of 64 years old (56 years old, 70 years old); there were 1-7 brain metastatic lesions in each patient, and there were 98 brain metastatic lesions in the 58 patients. There were 2 deaths (3.4%) within 3 months after CyberKnife treatment. At 3 months after treatment, there were 3 cases (5.4%) in complete remission, 36 cases (64.3%) in partial remission, 13 cases (23.2%) in stable disease, and 4 cases (7.1%) in disease progression in the remaining 56 patients. ROC curve analysis showed that the area under the curve for determining the survival of CyberKnife-treated NSCLC patients with brain metastases based on the cumulative brain metastasis volume was 0.593 (95% CI: 0.423-0.763), and the optimal cut-off value of cumulative brain metastasis volume was 15 cm 3. Median follow-up time was 12.6 months (7.5 months, 17.9 months). The 6- and 12-month OS rates were 91.3% and 79.5%, respectively, and the 6- and 12-month LRRFS rates were 93.0% and 89.2%, respectively. Multivariate Cox regression analysis showed that the Karnofsky functional status score (>70 points vs. ≤70 points, HR= 0.103, 95% CI: 0.019-0.545, P = 0.007), control of extracranial tumor (controlled vs. uncontrolled, HR = 0.145, 95% CI: 0.049-0.429, P < 0.001), cumulative brain metastasis volume (≤15 cm 3vs. >15 cm 3, HR = 0.105, 95% CI: 0.028-0.399, P = 0.001) were independent influencing factors for poor OS, and the control of extracranial tumor (controlled vs. uncontrolled, HR = 0.062, 95% CI: 0.006-0.616, P = 0.018), cumulative brain metastasis volume (≤15 cm 3vs. >15 cm 3, HR = 0.440, 95% CI: 0.007-0.292, P = 0.001), and target area total bioequivalent dose (BED) (≤60 Gy vs. >60 Gy, HR = 5.299, 95% CI: 1.020-27.530, P = 0.047) were independent influencing factors for poor LRRFS. Only grade 1-2 headache [53.5% (31/58)], nausea and vomiting [36.2% (21/58)] and other adverse reactions occurred after treatment, and no ≥grade 3 adverse reactions occurred. Conclusions:CyberKnife treatment for NSCLC brain metastases has high local control rate and short-term survival rate with mild adverse effects. Karnofsky functional status score, control of extracranial tumor and cumulative brain metastasis volume may affect OS of CyberKnife-treated NSCLC patients with brain metastases, and the control of extracranial tumor, cumulative brain metastasis volume and total BED may affect local recurrence.

Objective To explore the significance of the initial clinical symptoms and clinical manifestations of neuroblastoma(NB)to achive early identification of NB. Methods A retrospective study was performed on patients diagnosed with NB,who attended the Hematology Oncology Center,Beijing Childrenˊs Hospital from March 31st ,2007 to March 31st,2015. The clinical characteristics were compared between the children 〈1_year_old and≥1_year_old. The result was analyzed to compare the difference in clinical symptoms and tumor biologic characteristics of patients with different initial clinical symptoms between 2 groups. Results A total of 330 patients were included in the study,43 of them were younger than 1 year old,and their most common symptoms were cough and fever( each 17 cases,and accounted for 39. 5%,respectively);while the most common symptoms in patients≥1_year_old(287 cases)was fe_ver(177 cases,61. 7%),followed by lymphadenopathy(107 cases,37. 3%),bone pain(97 cases,33. 8%)and anemia (48 cases,16. 7%). The frequency of symptoms differed significantly between 2 groups(all P〈0. 05),such as fever (39. 5% vs. 61. 7%,χ2 ﹦6. 68),anemia(4. 7% vs. 16. 7%,χ2 ﹦6. 00),bone pain(0 vs. 33. 8%,χ2 ﹦18. 99),abdo_minal pain(0 vs. 25. 3%,χ2 ﹦10. 19),diarrhea(16. 3% vs. 3. 0%,χ2 ﹦12. 73),lymphadenopathy(7. 0% vs. 37. 3%, χ2 ﹦14. 12)and anorexia(9. 3% vs. 33. 4%,χ2 ﹦9. 21). Datients had fever,anemia,lymphadenopathy,cutaneous hemorrhagic spot or periorbital ecchymosis,bone pain,abdominal pain,exophthalmos,and anorexia early in the initial course of the disease,whose serum lactate dehydrogenase values were significantly increased(P〈0. 05). Datients suf_fered from fever,anemia,lymphadenopathy,bone pain,limbs dysfunctions,abdominal pain at the beginning of the disease,whose urine vanillymandelic acid values were higher than normal(P〈0. 05). Conclusions The study of sympto_mology suggests the most common symptoms in patients with NB 〈1_year_old are cough and fever,while those ≥1_year_old are fever,lymphadenopathy,bone pain,and anemia. Por patients with symptoms mentioned,carrying out the necessary NB_diagnose_related laboratory and imaging studies was statistically relevant to patientsˊ ages(〈1_year_old and≥1_year_old),which may contribute to earlier identification and diagnosis of NB.