Objective:To analyze the clinical characteristics and prognostic factors of high-risk neuroblastoma (HR-NB) patients with skeletal metastasis.Methods:The clinical features of 336 newly treated HR-NB patients with skeletal metastases admitted to the Department of Medical Oncology of Beijing Children′s Hospital, Capital Medical University from January 2007 to December 2018 were analyzed retrospectively.Kaplan-Meier method was used for the survival analysis, and Log- Rank test was used for univariate prognosis analysis.The Cox model was used to analyze the multifactorial prognostic analysis. Results:A total of 336 HR-NB patients were recruited, involving 188 males and 148 females with the median age of onset of at 43 (4-148) months.Skeletal metastases affected the viscerocranium (89 cases, 26.5%), neurocranium (193 cases, 57.4%), vertebrae (298 cases, 88.7%), sternum and ribs (183 cases, 54.5%), pelvis (270 cases, 80.4%), upper limbs (182 cases, 54.2%) and lower limbs (240 cases, 71.4%). The 5-year event-free survival (EFS) rate and overall survival (OS) rate were (30.4±2.7)% and (41.3±2.9)%, respectively.Univariate analysis showed a significantly lower 5-year OS rate in skeletal metastatic HR-NB patients with poor prognostic classification, the morphology of neuroblastoma (stroma-poor) and ganglioneuroblastoma (intermixed), high index of mitosis-karyorrhexis index, lactate dehydrogenase≥587 U/L, serum ferritin≥92 μg/L, MYCN amplification and 1p loss of heterozygosity, and metastases in the viscerocranium, neurocranium, vertebrae, sternum and ribs, pelvis, upper limbs and lower limbs (all P<0.05). The 5-year OS rate of HR-NB patients with all 7 regions of skeletal metastases was only (14.2±5.9)%, which was significantly lower than that in patients with a single region metastasis or multi-region metastases[(66.0±10.2)% vs.(43.6±3.4)%, χ2=45.722, P<0.05]. Cox multifactorial analysis showed that MYCN amplification ( HR=4.165, 95% CI: 2.356-7.363) and the viscerocranium metastasis ( HR=2.560, 95% CI: 1.519-4.315) were the independent risk factors affecting the prognosis of HR-NB patients with skeletal metastases (all P<0.05). Conclusions:The prognosis is extremely poor in HR-NB patients with multiple skeletal metastases at the initial diagnosis.The amplification of MYCN and the viscerocranium metastasis are the poor prognostic factors for HR-NB patients with skeletal metastases.

Objective:To further improve the department information system, and to establish a multi-parameter critical care medicine database, which can provide data for the analysis and research of big data in critical care medicine, and provide references for other medical institutions to establish relevant databases.Methods:On the premise of fully understanding the needs of clinical and scientific research, based on a Critical Care Medicine Clinical Information System, the department of critical care medicine of the First Medical Center of Chinese PLA General Hospital integrated the patients' case data in hospital information system (HIS), electronic medical records (EMR), monitoring information system (Monitor), laboratory information system (LIS), and radiation information system (RIS), to establish a rudimentary critical care database. On this basis, the related data were analyzed and verified. Further, this database was gradually improved in both its content and structure by referring to Medical Information Mart for Intensive CareⅢ (MIMIC-Ⅲ) database.Results:During the operation of Critical Care Medicine Clinical Information System from September 2017 to February 2020, the database collected diagnosis and treatment data of 2 207 critically ill patients, including data before the patient entering the intensive care unit (ICU) and all data during the ICU, such as demographic data, vital signs, medical treatment, the records of intake and output, sampling time, laboratory examination results, surgical treatment, and a variety of commonly used clinical scoring and diagnosis data. The data in the database were stored in different tables according to different contents, and the tables were connected to each other through the primary key. The data could be analyzed statistically through the information system and has been applied for certain clinical studies, combining clinical practices with scientific studies.Conclusions:The critical care medicine database based on the Critical Care Medicine Clinical Information System can help medical institutions to carry out standardized treatment and clinical research of critically ill patients. With further improvement of the function, the database can be better applied to the data analysis of Chinese critical patients.

Traumatic myocardial injury is a rare complication after blunt chest injury.The most common symptom is nonspecific chest pain, followed by ventricular premature beat and bundle branch block, with slight elevation of myocardial necrosis markers, which should be differentiated from acute myocardial infarction.One case of traumatic myocardial injury misdiagnosed as acute myocardial infarction was received in our hospital, except for acute myocardial infarction after corresponding examination.This kind of patients should be concerned by professional doctors, especially the elderly patients, who are more complicated with basic cardiovascular diseases, should be paid more attention in clinical work.

Objective To evaluate the diagnostic value of magnetic resonance spectroscopy analysis in patients with prostate specific antigen (PSA) abnormal prostate disease. Methods The patients who had abnormal PSA from January 2017 to December 2018 in Weifang People′s Hospital were selected. Patients with prostate puncture indications were as research target. A total of 137 patients including 44 patients with prostate cancer and 93 patients with benign prostatic hyperplasia were diagnosed by puncture. All patients underwent magnetic resonance scan and enhancement and spectroscopy before surgery. The comparative value of magnetic resonance scan + enhancement, magnetic resonance spectroscopy and joint examination was obtained. Results Sensitivity of magnetic resonance imaging and enhancement was 77.3% (34/44), specificity was 86.0% (80/93), and accuracy was 83.2% (114/137). Sensitivity of magnetic resonance spectroscopy was 52.3% (23/44), specificity was 77.4% (72/93), and accuracy was 69.3% (95/137). The sensitivity of the combined application was 90.9% (40/44), specificity was 91.4% (85/93), and accuracy was 91.2% (125/137). Conclusions The application of magnetic resonance spectroscopy can increase the sensitivity, specificity and accuracy of magnetic resonance plain scan and intensive examination for diagnosis of prostate cancer.

Objective: To analyze the clinical characteristics of newly treated high-risk group neuroblastoma (NB) patients with bone marrow metastasis and to explore the prognostic factors. Methods: The clinical features (sex, age, stage, risk group, pathological type, metastatic site, etc.) of 203 newly treated high-risk NB patients with bone marrow metastasis admitted to Hematology Oncology Center, Beijing Children′s Hospital from January 2007 to December 2016 were analyzed retrospectively. There were 118 males (58.1%) and 85 females (41.9%). Kaplan-Meier method was used for survival analysis and Cox regression was used to analyze the prognostic factors. Results: The age at onset of the 203 patients was 41 months (9-147 months). The metastatic sites at diagnosis were as follows: bone in 195 cases (96.1%), distant lymph nodes in 104 cases (51.2%), skull and endomeninx in 61 cases (30.0%), orbit in 30 cases (14.8%), pleura in 16 cases (7.9%), liver in 13 cases(6.4%), canalis spinalis in 13 cases (6.4%), other sites in 11 cases (5.4%) and skin and soft tissue in 10 cases (4.9%). In all, 194 cases were enrolled for prognostic analysis. The follow-up time was 36 months (1 day-138 months) , and the 5-years event free survival (EFS) and overall survival (OS) were 36.1% and 39.7%, respectively. A total of 118 patients (60.8%) had events (first relapse or death) with the time to event occurrence was 15 months (1 day-72 months), whereas 112 patients (57.7%) died with the event occurrence to death time was 3 months (1 day-21 months). There was no significant difference in 5-years OS between radiotherapy group and non-radiotherapy group (42.3% vs. 38.3%, χ²=3.671, P=0.055). The 5-years OS in transplantation group was significantly better than the non-transplantation group (44.3% vs. 35.5%, χ²=8.878, P=0.003), and the radiotherapy combined transplantation group also had a better 5-years OS rate than the non-radiotherapy combined transplantation group (45.8% vs. 37.3%, χ²=5.945, P=0.015). Univariate survival analysis showed lactate dehydrogenase ≥ 1 500 U/L, the amplification of MYCN, the metastatic sites of orbit, canalis spinalis and pleura were associated with poor prognosis of newly diagnosed high-risk NB patients (χ²=21.064, 13.601, 3.998, 6.183, 15.307, all P<0.05). The amplification of MYCN and the metastatic sites of pleura were risk factors for prognosis of newly diagnosed high-risk NB patients by Cox regression models (HR=1.896,1.100, 95%CI: 1.113-3.231, 1.020-1.187, both P<0.05). Conclusions The prognosis is unfavorable in high-risk group NB patients with BM metastasis. Radiotherapy combined with transplantation can further improve the prognosis of these patients. The amplification of MYCN and the metastatic sites of pleura were the poor prognostic factors for high-risk NB patients with bone marrow metastasis.

To analyze the clinical characteristics of newly treated high?risk group neuroblastoma (NB) patients with bone marrow metastasis and to explore the prognostic factors. Methods The clinical features (sex, age, stage, risk group, pathological type, metastatic site, etc.) of 203 newly treated high?risk NB patients with bone marrow metastasis admitted to Hematology Oncology Center, Beijing Children's Hospital from January 2007 to December 2016 were analyzed retrospectively. There were 118 males (58.1%) and 85 females (41.9%). Kaplan?Meier method was used for survival analysis and Cox regression was used to analyze the prognostic factors. Results The age at onset of the 203 patients was 41 months (9-147 months). The metastatic sites at diagnosis were as follows: bone in 195 cases (96.1%), distant lymph nodes in 104 cases (51.2%), skull and endomeninx in 61 cases (30.0%), orbit in 30 cases (14.8%), pleura in 16 cases (7.9%), liver in 13 cases(6.4%), canalis spinalis in 13 cases (6.4%), other sites in 11 cases (5.4%) and skin and soft tissue in 10 cases (4.9%). In all, 194 cases were enrolled for prognostic analysis. The follow?up time was 36 months (1 day-138 months), and the 5?years event free survival (EFS) and overall survival (OS) were 36.1% and 39.7%, respectively. A total of 118 patients (60.8%) had events (first relapse or death) with the time to event occurrence was 15 months (1 day-72 months), whereas 112 patients (57.7%) died with the event occurrence to death time was 3 months (1 day-21 months). There was no significant difference in 5?years OS between radiotherapy group and non?radiotherapy group (42.3% vs. 38.3%, χ2=3.671, P=0.055). The 5?years OS in transplantation group was significantly better than the non?transplantation group (44.3% vs. 35.5%, χ2=8.878, P=0.003), and the radiotherapy combined transplantation group also had a better 5?years OS rate than the non?radiotherapy combined transplantation group (45.8% vs. 37.3%, χ2=5.945, P=0.015). Univariate survival analysis showed lactate dehydrogenase ≥1 500 U/L, the amplification of MYCN, the metastatic sites of orbit, canalis spinalis and pleura were associated with poor prognosis of newly diagnosed high?risk NB patients (χ2=21.064, 13.601, 3.998, 6.183, 15.307, all P<0.05). The amplification of MYCN and the metastatic sites of pleura were risk factors for prognosis of newly diagnosed high?risk NB patients by Cox regression models ( HR=1.896, 1.100, 95%CI :1.113-3.231, 1.020-1.187, both P<0.05). Conclusions The prognosis is unfavorable in high?risk group NB patients with BM metastasis. Radiotherapy combined with transplantation can further improve the prognosis of these patients. The amplification of MYCN and the metastatic sites of pleura were the poor prognostic factors for high?risk NB patients with bone marrow metastasis.

Objective: The objective was to identify the incidence of influenza-like syndromes and related health behavior factors among Beijing residents. Methods: From December 6, 2013 to January 16, 2014, we selected 150 villages or communities from 30 towns or streets as survey locations using a multi-stage random sampling method, and then conducted a cross-sectional study among 7 354 residents who aged 18 years or above and had live in Beijing for more than a half year using self-administered anonymous questionnaires, and totally 7 327 valid questionnaires are collected. The questionnaire consisted of demographic information, self-reported influenza-like syndromes in the past two weeks, and health behaviors. Multiple logistic regression models were used to identify the factors associated with self-reported influenza-like syndromes. Results: The mean (SD) age of the partcipants was 44.6 (15.2) years. Among them, 6.9% (506 cases) reported having influenza like illness during the past two weeks. The multiple logistic regression analysis indicated that regular physical exercise, optimal hand hygiene, and avoidance of going to the crowded places during respiratory infectious disease epidemics were significantly associated with a lower likelihood of reporting influenza-like syndromes, compared with those without regular physical exercises, without optimal hand hygiene, and not avoiding going to the crowded places, and the OR(95%CI) were 0.80 (0.66-0.97), 0.75 (0.57-0.99) and 0.80 (0.65-0.98), respectively. Conclusion Personal health behaviors were associated with the incidence of respiratory infectious diseases such as influenza in Beijing, and future interventions to improve personal hygiene behaviors are needed to prevent the spread of respiratory infectious diseases.

Objective To analyze the preoperative related factors of early weaning of infants with congenital heart disease after operation. Methods From January ,2014 to January ,2017 in Pediatric Cardiology CICU , infants with congenital heart disease were selected as research objects. The clinical data were retrospectively collect ed and the relationship between preoperative influencing factors and postoperative early weaning were analyzed. Early weaning meant mechanical ventilation time was shorter than 24 h and late weaning meant longer than 24 h. Results Single factor analysis showed that early weaning success rate was related to preoperative cardiac function grade 1,NNIS grade 0~1,ASA grade 1,no lung infection and no or mild pulmonary hypertension(average P<0.05). Non conditional logistic regression analysis showed that preoperative heart function grade 1 was an indepen-dent influencing factor,with OR value(95%CI)of 3.9(1.9~7.7). Conclusions In infants with congenital heart disease,preoperative heart function grade 1,NNIS grade 0 ~ 1 ,ASA grade 1,no lung infection and no or mild pulmonary hypertension benefit early withdrawing of ventilator and preoperative cardiac function grade 1 is an inde-pendent factor for early weaning.

Objective To investigate human exposure to live poultry (poultry feeding and purchasing) in the residents in Beijing and related factors during the second wave of avian influenza A (H7N9) epidemic during 2013-2014, and provide scientific evidence for avian influenza prevention and control. Methods A total of 7366 adults aged ≥18 years were selected through multi-stage stratified sampling in Beijing for a questionnaire survey. Logistic regression model was used to analyze the influence factors of human exposure to live poultry. Results The live poultry feeding rate and live poultry purchasing rate in residents in Beijing in the past year were 5.3%(95%CI:4.8%-5.8%) and 6.0% (95%CI: 5.5%-6.5%) respectively. Logistic regression analysis indicated that lower educational level of primary school and below, (OR=1.82, 95%CI:1.22-2.72);being farmer (OR=2.49, 95%CI:1.89-3.29) or being unemployed (OR=1.65, 95%CI:1.08-2.52);being non local resident (OR=1.54, 95%CI:1.10-2.16);living in suburban area (OR=2.36, 95%CI:1.77-3.16);having one child (OR=1.76, 95%CI: 1.42-2.17) or ≥2 children (OR=2.15, 95%CI: 1.43-3.22) in the family were the risk factors associated with feeding poultry compared with higher educational level of college and above, being employed, being local resident, living in urban area and having no child. And being farmer (OR=1.61, 95%CI:1.27-2.02);being non local resident (OR=1.76, 95%CI:1.31-2.35);living in suburban area (OR=2.05, 95%CI:1.61-2.61);having one child (OR=1.24, 95%CI:1.02-1.52) or ≥2 children (OR=1.78, 95%CI: 1.21-2.63) were the risk factors for purchasing live poultry. Conclusion Some residents living in Beijing still have exposure to live poultry, and targeted measures should be taken to reduce the exposure to poultry.

Objective To investigate the efficacy and safety of balloon-assisted catheter directed thrombolysis (CDT) for acute lower extremity deep vein thrombosis (DVT).Methods From September 2008 to February 2011,94 patients with acute lower extremity DVT were admitted.The cases in early stage were treated by CDT (Group A,n =50),and the cases in late stage were treated by balloon-assisted CDT ( Group B,n =44).The clinical data of these patients were retrospectively analyzed.The circumference difference between normal and affected limbs,scores of venous patency,and rates of venous patency were recorded for judging the efficacy.The total dose of urokinase and retention time of infusion catheter was compared between the two groups.The incidence of pulmonary embolism and bleeding were used to judge the safety of treatment.The venous patency was followed up by ultrasound or/and venography.Measurement data with normal distribution was described by mean + standard,and was analyzed using T test.Measurement data with non-normal distribution was described by M ( QL,QU ),QL =P25,QU =P75,and was analyzed using Wilcoxon' s test.Categorical variable data was analyzed using Chi-Square test Results The prior treatment circunfference difference between normal and affectéd limbs were (5.37 ±1.97) cm (thigh) & (4.14 ± 1.57) cm (calf) in Group A and (5.41±2.22) cm (thigh) & (4.05 ±1.61) cm (calf) in Group B ; and the difference between the groups was insignificant ( thigh:t =- 0.113,P=0.910; calf:t =0.288,P =0.774).The post treatment correspondences were:(2.96 ± 1.10) cm (thigh) & ( 1.93 ± 0.84 ) cm (calf) in Group A and ( 1.78 ± 1.40) cm ( thigh ) & ( 1.41± 1.17 ) cm (calf) in Group B; the difference between the groups was significant (thigh:t =4.66,P ＜0.0001; calf:t =2.548,P =0.012 ).The prior treatment score of venous patency was 9 (8,10) in Group A and 8.3(7,10) in Group B without significant difference (Z =- 1.5172,P =0.1292).The post treatment score of venous patency was 3.5 ( 2,5 ) in Group A and 0 ( 0,1) in Group B with significant difference ( Z =-5.7702,P ＜0.01).The rate of venous patency after the treatment was 55.0％ (42.3％,72.4％ ) in Group A and 100％ (88.5％,100％ ) in Group B,with significant difference ( Z =4.9148,P ＜ 0.01).The total dose of urokinase used in the treatment was 5.950 ( 5.525,7.225 ) × 106U in Group A and 4.100 (3.600,5.050) × 106U in Group B with significant difference (Z =-6.0133,P ＜ 0.01).The retention time of perfusion catheter was 10 (9,12) d in Group A and 6 (5,7) d in Group B with significant difference ( Z =- 8.0358,P ＜ 0.01).No symptomatic pulmonary embolism occurred in both groups during the treatment and follow-up period.The rate of bleeding complication was 38.0％ (19/50) in Group A and 22.3％ (10/44) in Group B,without significant difference (x2 =2.5590,P =0.1097 ).The removal rate of optional filter was 88.37％ (38/43) in Group A and 100％ (39/39) in Group B,with significant difference ( x2 =4.829,P =0.028 ).The rate of venous patency at the last follow-up point was 50.0％ (44.4％,59.2％ ) in Group A,and 95.4％ (83.6％,100％ ) in Group B,with significant difference (Z =- 3.2721,P =0.0011).Conclusions Balloon-assisted CDT was a promising treatment for acute lower-extremity DVT.It improved the effect of thrombolysis and reduced the dosage of urokinase,and did not increase the risk of pulmonary embolism.