Objective:To investigate the clinical characteristics of infantile neuroblastoma (NB) and the factors that affect prognosis.Methods:We retrospectively analyzed the clinical data collected from 44 cases of NB who received treatment in The Fourth Affiliated Hospital of China Medical University from March 2008 to March 2017 to summarize the clinical characteristics of NB and the factors that affect prognosis.Results:Among the 44 cases, 21 were male and 23 were female, with a median age of 5.5 months (range, 0 days-12 months). Four cases had stage I NB, seven cases stage II NB, five cases stage III NB, 15 cases stage IV NB, and 13 cases stage IVs NB. The tumors were located in the adrenal glands and retroperitoneum ( n = 26, 59.1%), posterior mediastinum ( n = 15, 34.1%), pelvis ( n = 2, 4.5%), and neck ( n = 1, 2.3%). The median follow-up time was 90 months (range, 2-144 months). The 3-year and 5-year overall survival rates were 93.2% and 90.9%, respectively. Among 35 cases who survived more than 5 years, 30 cases survived healthily, 5 cases survived with tumor, and 4 cases died. Bone marrow metastasis, bone metastasis, and the extent of tumor resection greatly affect the prognosis of NB ( χ2 = 6.92, 12.19, 4.70, all P < 0.05). Conclusion:The overall prognosis of NB is good in infants. NB mainly occurs in the abdomen. The survival rate of infants with stage IVs NB is lower than that of infants with stages I, II, and III NB. The prognosis of NB occurring in the abdomen is poorer than that occurring in other regions. Bone marrow metastasis, bone metastasis, and the extent of tumor resection are adverse factors affecting the prognosis.

Objective:To investigate whether the early developmental dynamic phenotypes and kinetic parameters of embryos used for embryo selection are affected by the differences in the components of culture media utilized.Methods:The clinical data of patients undergoing in vitro fertilization (IVF) at Center for Reproductive Medicine and Genetics of People's Hospital of Guangxi Zhuang Autonomous Region from October 2016 to December 2018 were analyzed in a retrospective cohort study. According to the different culture media utilized, IVF cycles were divided into Cook group and Vitrolife group. After 1∶1 propensity-score matching (PSM), 59 IVF cycles were included in each group. Time-lapse imaging technology was used to analyze the early developmental dynamics of normal fertilized embryos between insemination and 68 h post insemination. Seven developmental dynamic phenotypes of embryos were annotated and the differences in the composition of dynamic phenotypes were compared between the two groups. Thirteen early developmental kinetic parameters were calculated, and the differences in the kinetic parameters of normal dynamic phenotypic embryos between the two groups were compared. According to the two published time-lapse embryo selection algorithms, the hierarchical distribution of normal dynamic phenotypic embryos of two groups was compared. Results:1) In Cook group, the composition of developmental dynamic phenotypes of embryos were 54.0% normal phenotype, 3.0% abnormal first cytokinesis (A1 cyt), 17.4% abnormal cleavage (AC), 5.2% reverse cleavage (RC), 3.2% chaotic cleavage (CC), 3.5% multinucleation (Mn) and 13.7% mixed phenotype, which were 49.3%, 4.0%, 19.1%, 7.5%, 2.1%, 6.4% and 11.6% in Vitrolife group, respectively. No statistically significant differences were observed between the two groups for the composition of dynamic developmental phenotypes ( P>0.05). 2) Compared with Vitrolife group, the 13 developmental kinetic parameters (tPNa, tPNf, t2, t3, t4, t5, t6, t7, t8, cc2, s2, t5_PNf and t8_PNf) of normal dynamic phenotype embryos in Cook group were slightly longer, and the average number of blastomeres in 68 h post insemination (EB68hpi) was less, but the differences were not statistically significant (all P>0.05). 3) No significant difference in hierarchical distribution of embryos was observed between Vitrolife group and Cook group according to algorithm A ( P>0.05). The difference of embryo hierarchical distribution between the two groups was statistically significant according to algorithm B ( P=0.040), the proportion of grade A + embryos in Vitrolife group was higher than that in Cook group [59.8% (125/209) vs. 43.3% (94/217)], and grade C proportion was lower [9.6% (20/209) vs. 20.3% (44/217)]. Conclusion:Although the early developmental dynamic phenotypes and kinetic parameters of embryos were not affected by the differences between Cook and Vitrolife sequential culture media, the applicability of different time-lapse embryo selection algorithms to the culture media is different, the embryo culture media utilized should be considered when selecting or constructing the algorithms.

Objective:To investigate whether the early developmental dynamic phenotypes and kinetic parameters of embryos used for embryo selection are affected by the differences in the components of culture media utilized.Methods:The clinical data of patients undergoing in vitro fertilization (IVF) at Center for Reproductive Medicine and Genetics of People's Hospital of Guangxi Zhuang Autonomous Region from October 2016 to December 2018 were analyzed in a retrospective cohort study. According to the different culture media utilized, IVF cycles were divided into Cook group and Vitrolife group. After 1∶1 propensity-score matching (PSM), 59 IVF cycles were included in each group. Time-lapse imaging technology was used to analyze the early developmental dynamics of normal fertilized embryos between insemination and 68 h post insemination. Seven developmental dynamic phenotypes of embryos were annotated and the differences in the composition of dynamic phenotypes were compared between the two groups. Thirteen early developmental kinetic parameters were calculated, and the differences in the kinetic parameters of normal dynamic phenotypic embryos between the two groups were compared. According to the two published time-lapse embryo selection algorithms, the hierarchical distribution of normal dynamic phenotypic embryos of two groups was compared. Results:1) In Cook group, the composition of developmental dynamic phenotypes of embryos were 54.0% normal phenotype, 3.0% abnormal first cytokinesis (A1 cyt), 17.4% abnormal cleavage (AC), 5.2% reverse cleavage (RC), 3.2% chaotic cleavage (CC), 3.5% multinucleation (Mn) and 13.7% mixed phenotype, which were 49.3%, 4.0%, 19.1%, 7.5%, 2.1%, 6.4% and 11.6% in Vitrolife group, respectively. No statistically significant differences were observed between the two groups for the composition of dynamic developmental phenotypes ( P>0.05). 2) Compared with Vitrolife group, the 13 developmental kinetic parameters (tPNa, tPNf, t2, t3, t4, t5, t6, t7, t8, cc2, s2, t5_PNf and t8_PNf) of normal dynamic phenotype embryos in Cook group were slightly longer, and the average number of blastomeres in 68 h post insemination (EB68hpi) was less, but the differences were not statistically significant (all P>0.05). 3) No significant difference in hierarchical distribution of embryos was observed between Vitrolife group and Cook group according to algorithm A ( P>0.05). The difference of embryo hierarchical distribution between the two groups was statistically significant according to algorithm B ( P=0.040), the proportion of grade A + embryos in Vitrolife group was higher than that in Cook group [59.8% (125/209) vs. 43.3% (94/217)], and grade C proportion was lower [9.6% (20/209) vs. 20.3% (44/217)]. Conclusion:Although the early developmental dynamic phenotypes and kinetic parameters of embryos were not affected by the differences between Cook and Vitrolife sequential culture media, the applicability of different time-lapse embryo selection algorithms to the culture media is different, the embryo culture media utilized should be considered when selecting or constructing the algorithms.

Objective:To establish a prognostic Nomogram model for predicting the risk of early death in polytrauma patients.Methods:Data extracted from a polytrauma study on Dryad, an open access database, was selected for secondary analysis. Patients from 18 to 65 years old with polytrauma in the original data were included. All patients with missing variables, such as blood lactic acid (Lac), Glasgow coma score (GCS) and injury severity score (ISS) at admission, were excluded. The differences of gender, age, Lac, ISS and GCS scores between the patients who died within 72 hours and those who survived were analyzed. The risk factors for 72-hour death were analyzed by Logistic regression, and the Nomogram prediction model was established using R software. The receiver operating characteristic (ROC) curve was used to evaluate the predictive ability of the model, and the Bootstrap method was used for internal verification by repeating sample for 1 000 times. Decision curve (DCA) was applied to analyze the clinical practical value of the model.Results:A total of 2 315 polytrauma patients were included. Logistic regression analysis showed that Lac, GCS score and age > 55 years old were the risk factors for early death in polytrauma patients [Lac: odds ratio ( OR) = 1.36, 95% confidence interval (95% CI) was 1.29-1.42, P < 0.001; GCS score: OR = 0.76, 95% CI was 0.73-0.79, P < 0.001; age > 55 years old: OR = 1.92, 95% CI was 1.37-2.66, P < 0.001]. The prediction model was established by using the above risk factors and displayed by Nomogram. ROC curve analysis showed that the area under the ROC curve (AUC) of Nomogram model to predict the risk of death within 72 hours was 0.858, and the predictive ability of Nomogram model was significantly higher than that of Lac (AUC = 0.743), GCS score (AUC = 0.774) and ISS score (AUC = 0.699), all P < 0.05. The model calibration chart showed that the predicting probability was consistent with the actual occurrence probability, and the DCA showed that Nomogram model presented excellent clinical value in predicting the 72-hour death risk for polytrauma patients. Conclusions:The prognostic Nomogram model presents significantly predictive value for the risk of death within 72 hours in polytrauma patients. Prognostic Nomogram model could offer individualized, visualized and graphical prediction pattern, and provide physicians with practical diagnostic tool for triage system and management of polytrauma according to precision medicine.

Objective To observe the changes of serum iron in patients with bronchopneumonia (bacterial pneumonia,mycoplasmal pneumonia) before and after treatment,and to discuss whether it can be used as an indicator of infection.Methods Forty cases with bacterial pneumonia and 41 cases with mycoplasmal pneumonia were recruited.The serum iron levels before and after treatment in bacterial pneumonia group and mycoplasmal pneumonia group were compared and analyzed.The correlation between white blood cell count,percentage of neutrophils,serum C-reactive protein (CRP) levels and the serum iron levels before treatment,and changes of the serum iron before and after treatment were analyzed.Results The level of serum iron after treatment in the bacterial pneumonia group [(16.28 ±5.81) μmol/L] was significantly higher than that before treatment [(4.83 ± 2.12) μ mol/L] (t =-11.19,P＜0.001).The level of serum iron after treatment in the mycoplasmal pneumonia group [(15.17 ±5.31) μmoL/L] was also significantly higher than that before treatment [(4.77 ± 1.99) μmol/L] (t =-11.29,P ＜0.001).The serum iron levels between the two groups before and after treatment had no statistically significant differences (t =0.135,0.898,P =0.893,0.373).There was no correlation between white blood cell count,percentage of neutrophils,CRP and serum iron levels before treatment (bacterial pneumonia group:r =-1.87,-0.219,-0.152;mycoplasmal pneumonia group:r =-0.032,-0.302,-0.274) and changes of the serum iron before and after treatment (bacterial pneumonia group:r =0.098,0.062,0.205;mycoplasmal pneumonia group:r =0.01 1,0.171,-0.105,P ＞ 0.05).Conclusion The serum iron level is significantly decreased in children with pulmonary infectious diseases and increased to normal level after anti-infection treatment.Serum iron can not be used as an indicator of infection in children.