[Abstract ] Objective Nephroblastoma is one of the solid malignancies with fair prognosis in children .The lungs, liver, and bones are the common organs for distant metastasis of the tumor and important factors influencing the therapeutic effects as well .This study was to investigate the clinical characteristics and prognosis of nephroblastoma with distant metastasis in children . Methods We retrospectively analyzed the clinical characteristics , pathological features , and prognosis of 9 cases of nephroblastoma with distant metastasis treated in Nanjing Children Hospital from September 2011 to May 2015 . Results The patients presented with abdominal masses, distention and pain at preliminary diagnosis and confirmed with nephroblastoma , with pulmonary metastasis in 7 cases, liver metastasis in 1, and lung and liver metastases in the other .All were treated by surgery, radiotherapy, and chemotherapy and followed up for a median time of 34 months.By the end of the follow-up, 1 patient died of recurrence , 1 was undergoing chemotherapy , and the other 7 were being recovered, including complete disappearance of lung metastasis in 4, obvious reduction or calcification of lung metastasis in 2, evident disappearance of liver metastasis in 1, but relapse in none. Conclusion Lung and liver are common sites of nephroblastoma metastasis in children .As for the treatment of the disease , relatively good results can be achieved by radiotherapy , chemotherapy , and reoperation .

Objective Primitive neuroectodermal tumor ( PNET) is a small round cell tumor occurring mostly in children or young adults and categorized into the Ewing sarcoma family of tumors, the purpose of the study was to investigate the clinical features, treatment and prognosis of Children PNET. Methods A retrospective study was performed on clinical data of 13 children with PNET hospitalized in our hospital from March 2010 to Octorber 2014.In order to analyze the clinical effects and prognostic results, statistical analysis was made on their clinical manifestations, CT and ultrasonic results, therapeutic schemes, postoperative pathology and immu-nohistochemical staining results, along with telephone and outpaitient follow-up of average 19 months. Results Of the 13 patients, 4 cases were central nervous system PNET(CNS-PNET) and 9 cases were peripheral PNET(pPNET).The clinical manifestations of the former were headache, vomiting, convolsion, movement disorder or decreased muscle strength, while the latter mainly showed mas-ses and abdominal distention.3 cases with metastasis to lung, lymph nodes and bones respectively showed masses on surface or in cavi-ty in imaging.Homer-Wright pseudorosette textures were found in 12 patients.Immunohistochemical results showed 11 cases with CD99(+), 9 cases with VIM(+) and 8 cases Syn( +).Among 11 patients underwent chemotherapy, 2 cases were lost to follow-up, 7 cases were in stable condition without occurrence and the other 2 cases recurred 4-6 months after chemotherapy.3 of 4 cases with CNS-PNET survived with the sequelae of decreased muscle strength, convolsion and movement disorder.1 case with CNS-PNET and 1 case with pPNET died 7 months and 16 months after diagnosis respectively. Conclusion PNET in children is a very highly malignant tumor with low long-term survival rate.Immunohistochemi-cal examination including CD99 and VIM is of important diagnostic value and CNS-PNET is prone to sequelae.

Objective: A high-performance liquid chromatographic (HPLC) procedure with a fluorescence detector was developed to rapidly separate ?,?,?,?- tocopherol isomers in human serum Methods: The HPLC system consisted of Inertsil silica column (100-A, 3?m,4.6mm?250mm) and 7% (v/v) methyl-tert- butyl ether in n-hexane as mobile phase . Prior to HPLC, the serum sample wa deproteined by ethanol (BHT 0.0625%) and the tocopherol isomers were efficiently extracted in thei original isomeric conformations using n-hexane-ethyl acetate (5:1) in the presence of 2,6-bi-buty p-methylphenol (BHT). Result: The quantification limits, defined as the lowest quantitatively measurable concentration of the different compounds (ng/ml) are calculated according to the experiment:?-tocophero 1.0,?-tocopherol 1.0,?-tocopherol 0.5,?-tocopherol 0.5. The recovery rates are between 95%~105% Correlation coefficients are over 0.999 when the concentration is between 5 ng/ml~5 ?g/ml. Conclusion This technique is suitable for assay of tocopherol isomers in human serum at all ages.

Objective To observe the contribution of acute normovolemic hemodilution ( ANH) in experiment of cryopreserved dog limb replantation.Methods Sixteen healthy Beagle dogs (male:female=1:1) were divided into two groups.Dogs in the experiment group ( Group B) received ANH in the limb replantation, and dogs in the control group ( Group A) received the same amount of lactate Ringer’ s solution intravenously during the surgical operation.We recorded and compared the hemodynamic indexes, HB, HCT, the resuscitation time, the first rising head time, the first standing time and the first eating and drinking time between the two groups.Results ( 1 ) During the operation, both PaO2 and PCO2 in the two groups were normal, as well as the breathing rate.The heart rate in the group B was lower than that in the group A.Before blood transfusion, there was no statistically significant difference in HB and HCT between the two groups, but after transfusion they were significantly higher in the group B than in the group A.(2) The resuscitation time, the first rising head time, the first standing time and the first eating and drinking time of the group B were all better than those in the group A.Conclusions In cryopreserved dog limb replantation experiments, acute normovolemic hemodilution is helpful to improve the general condition and facilitate the recovery of animals after limb replantation.

Objective To summarize the clinical experience of laparoscopic appendectomy(LA).MethodsA retrospective analysis was conducted on the clinical data of 683 patients with appendicitis treated by LA,including 258 cases of chronic appendicitis,425 cases of acute appendicitis(87 cases of complicated appendicitis).ResultsThe procedure was completed in all the patients without conversion to open surgery.The operation time was 30 min in average(15-150 min).The average hospital stay was 4d (2-15d).Postoperative complications included 26 cases of incision infection,3 cases of abdominal abscess,1 case of appendical mesenterium hemorrhage,1 case of small intestine fistula and 1 case of appendical stump fistula.The patients were followed up for 2 to 12 months with a mean of 6 months,during which no intestinal adhesive obstruction occurred.Conclusion LA is safe and effective for appendicitis,with advantages of minimal trauma,lighter pain,quicker recovery,shoter hospital stay,less complications and so on.For complicated appendicitis,the abundant surgical experience and proficient endoscopic technique are indispensable to reduce the occurrence of complications effectively.

OBJECTIVE:To study the stability of Fuke zhidai capsule at accelerated testing and room temperature. METHODS:HPLC was conducted to determine the content of berberine hydrochloride in the preparation:the column was Diamonsil C18 with mobile phase of B methanol-0.7% triethylamine(pH adjusted to 3 by phosphate)(50:50,V/V)at a flow rate of 1 ml/min;detec-tion wavelength was 265 nm,with a column temperature at 45 ℃,and the injection volume was 5 μl;its moisture,disintegration time,accelerated stability and long-term stability were studied according to the 2015 edition of Chinese Pharmacopoeia. RE-SULTS:The linear range of berberine hydrochloride was 0.0217-0.1736 mg/ml(r=0.9999);RSDs of precision,stability and re-producibility tests were lower than 2%;recovery was 97.24%-101.73%(RSD=1.72%,n=6). CONCLUSIONS:The moisture,dis-integration time,accelerated stability and long-term stability were all in line with the quality standards.

Objective To explore the effects of Sinomenine (Sin) on phenotype transdifferentiation in renal tubular epithelial cells. Methods Mice primary tubular epithelial cells and cell line (MCT) were cultured in vitro. Model group cells were stimulated by IL-1?(10 ng/ml). The cells of Sin group were co-incubated with Sin(10, 100 ,500?mol/L) simultaneously. The cells without IL-1?and Sin treatment were regarded as control group. The protein expression of?-smooth muscle actin (SMA) and Vimentin was assessed by immunohistochemistry and Western blotting. The mRNA expression of?-SMA and Vimentin was examined by RT-PCR. Secretion of matrix metalloproteinases was determined by zymography. Results The mRNA expression and protein level of?-SMA and Vimentin, and the enzyme activity of MMP-2 and MMP-9 in tubular epithelial cells stimulated with IL-1?were significantly higher than those in the controls. Sinomenine significantly reduced the expression levels of protein and mRNA of?-SMA and Vimentin. At the same time, the MMP-2 and MMP-9 activities were reduced markedly. Conclusion Sinomenine can decrease the transdifferentiation in renal tubular epithelial cells stimulated by inflammatory factor IL-1?and prevent renal interstitial fibrosis.

Aims To establish a UPLC-MS method for quantifying protocatechuie acid,kaempferol-3-O-β-D-glucoside and quercitrin and to investigate the pharma-cokinetics of three indix components in flower of Poly-gonumorientale L.in rat plasma.Methods The anal-ysis was achieved by BEH C18 column (2.1 mm ×100 mm,1.7 μm)with a mobile phase composed of 0.1%formic acid using step gradient elution.A TQD tandem mass spectrometry equipped with electrospray ionization source was used as detector and operated by selected ion recording(SIR)mode.Results In the selected linear range,calibration curves of the three markers components showed good linearity.Extraction recovery rate,precision,accuracy and stability reached the de-termination request.The parameters of Tmax (h ) in three index components were 0.46 ±0.1,0.79 ±0.33 and 2.63 ±4.6,respectively;Cmax (μg·L -1 )in three index components were 463.8 ±207.81,18.53 ±7.82 and 137.38 ±71.09,respectively.Conclusion The fully validated UPLC-MS method has been successfully applied to the pharmacokinetic study of the three index components in flower of Polygonumorientale L.in rat plasma.

Background lnterleuldn-18(IL- 18) plays a key role in the development,progression and outcome of coronary artery disease and its complications.However,its variability relation to the characterization of atherosclerotic plaque and percutaneous coronary intervention are still unknown.Methods Fifty four patients with coronary artery disease [22 patients with stable angina (SA) and 32 patients with acute coronary syndrome (ACS)] were enrolled in this study.All patients underwent percutaneous coronary intervention (PCI).The stability of the plaques at the criminal vessels was assessed with analogical IVUS.Serum IL-18 levels were measured at the time points of 5 rain before PCI,and Oh,6h,24h and lmonth after PCI in all patients.Results ACS group consisted mainly of lipidic unstable plaques while SA group of fibrous stable plaques.Moreover,compared with those in SA group,eccentricity index (EI) and remodeling index (RI) were significantly higher in ACS group.Positive remodeling was seen in ACS group while negative or no remodeling in SA group.Further,serum IL-18 levels were significantly elevated in patients with ACS than those in SA group before PCI,increased at Oh,6h,24h after PCI (P＜0.05)and were not significant different at 1 month after PCI from those before PCI.Conclusions There is significant difference in the composition and structural characteristics of atherosclerotic plaques between ACS and UA groups.PCI triggersd and enhances the inflammatory response in a short time.Serum levels of IL- 18 are the predictors of progression of unstable plaque in atherosclerosis.Post-operative complications of PCI might be reduced by inhibiting IL- 18.(J Geriatr Cardiol 2008;5:21-24)