[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: 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 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 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.

Objective To investigate the pathogens,drug resistance and outcomes of continuous ambulatory peritoneal dialysis(CAPD) patients with peritoneal dialysis-related peritonitis in our peritoneal dialysis(PD) centers. Method Data including clinical manifestations,pathogens,treatment,outcome of 93 CAPD cases with peritoneal dialysis-related peritonitis in our peritoneal dialysis(PD) centers were retrospectively analyzed.Results Dialysate culture of 75cases was positive with a positive rate of 80.2％,including 45 cases of gram-positive cocci,21cases of gram-negative bacilli,2 cases of fungi and 5 cases of mixed infection.Coagulase-negative staphylococci were the most common gram-positive cocci.All the gram-positive cocci were sensitive to vancomycin,but the resistance rate to cefazolin was 60.0％ with an increasing tendence year by year.Resistance rate of gram-negative bacilli to ceftazidime was 46.1％.All the gram-negative bacilli were sensitive to imipenem.The withdraw rate of CAPD was 17.2％(16/93) because of peritonitis. Noobviousside-effectofperitonealadministrationofvancomycinwasfound.Conclusions Gram-positive cocci are major pathogens in CAPD-related peritonitis.Now cefasolin is not suitable for the empiric initial treatment.Peritoneal administration of vancomycin should be recommended for peritonitis caused by gram-positive cocci.

Objective To investigate the impact and the associated parameters of malnutrition and inflammation status on hospitalization and mortality of maintenance hemodialysis (MHD) patients. Method A total of 118 MHD patients were included in the study with 1 year's follow-up.The malnutrition and inflammation parameters were compared between the hospitalized patients and out-patients.Cox's proportional hazard regression model was used to explore the malnutrition and inflammation parameters which could forecast the risk of hospitalization and mortality. Result The hospitalization rate of MHD patients with mild,moderate and severe malnuttition was 32.93％,56.67％ and 83.33％ respectively,and the mortality was 3.66％,6.67％ and 80.00％ respectively.The hospitalization rate of MHD patients with or without microinflammation status was 56.45％ and 46.43％,and the mortality was 14.29％ and 1.61％.Inpatients had a higher malnutrition-inflammation score(MIS,8.36 vs 5.86,P＜0.05) and subjective global assessment of nutrition (MQSGA,14.49 vs 12.88,P＜0.05),a lower creatinine level (886.83 μmol/L vs 991.76 μmol/L,P＜0.05 ) and a lower albumin level (38.57 g/L vs 40.27 g/L,P＜0.05) than out-patients.Inpatients also had a higher level of TNF-α (65.41 μg/L vs 59.76 μg/L,P＜0.05) than out-patients.Cox proportional hazard model analysis showed that MIS and TNF-α were associated with patient's first hospitalization risk. Conclusions For the MHD patients,the more severe the malnutrition and micro-inflammation status is,the worse the clinical outcome is.The higher levels of MIS and TNF-α result in greater risk of hospitalization.