Objective:To analyze the factors affecting delayed chemotherapy in children with Burkitt lymphoma (BL) and their influence on prognosis.Methods:Retrospective cohort study. Clinical data of 591 children aged ≤18 years with BL from May 2017 to December 2022 in China Net Childhood Lymphoma (CNCL) was collected. The patients were treated according to the protocol CNCL-BL-2017. According to the clinical characteristics, therapeutic regimen was divided into group A, group B and group C .Based on whether the total chemotherapy time was delayed, patients were divided into two groups: the delayed chemotherapy group and the non-delayed chemotherapy group. Based on the total delayed time of chemotherapy, patients in group C were divided into non-delayed chemotherapy group, 1-7 days delayed group and more than 7 days delayed group. Relationships between delayed chemotherapy and gender, age, tumor lysis syndrome before chemotherapy, bone marrow involvement, disease group (B/C group), serum lactate dehydrogenase (LDH) > 4 times than normal, grade Ⅲ-Ⅳ myelosuppression after chemotherapy, minimal residual disease in the interim assessment, and severe infection (including severe pneumonia, sepsis, meningitis, chickenpox, etc.) were analyzed. Logistic analysis was used to identify the relevant factors. Kaplan-Meier method was used to analyze the patients' survival information. Log-Rank was used for comparison between groups.Results:Among 591 patients, 504 were males and 87 were females, the follow-up time was 34.8 (18.6,50.1) months. The 3-year overall survival (OS) rate was (92.5±1.1)%,and the 3-year event-free survival (EFS) rate was (90.5±1.2)%. Seventy-three (12.4%) patients were in delayed chemotherapy group and 518 (87.6%) patients were in non-delayed chemotherapy group. The reasons for chemotherapy delay included 72 cases (98.6%) of severe infection, 65 cases (89.0%) of bone marrow suppression, 35 cases (47.9%) of organ dysfunction, 22 cases (30.1%) of tumor lysis syndrome,etc. There were 7 cases of chemotherapy delay in group B, which were seen in COPADM (vincristine+cyclophosphamide+prednisone+daunorubicin+methotrexate+intrathecal injection,4 cases) and CYM (methotrexate+cytarabine+intrathecal injection,3 cases) stages. There were 66 cases of chemotherapy delay in group C, which were common in COPADM (28 cases) and CYVE 1 (low dose cytarabine+high dose cytarabine+etoposide+methotrexate, 12 cases) stages. Multinomial Logistic regression analysis showed that the age over 10 years old ( OR=0.54,95% CI 0.30-0.93), tumor lysis syndrome before chemotherapy ( OR=0.48,95% CI 0.27-0.84) and grade Ⅲ-Ⅳ myelosuppression after chemotherapy ( OR=0.55,95% CI 0.33-0.91)were independent risk factors for chemotherapy delay.The 3-year OS rate and the 3-year EFS rate of children with Burkitt lymphoma in the delayed chemotherapy group were lower than those in the non-delayed chemotherapy group ((79.4±4.9)% vs. (94.2±1.1)%, (80.2±4.8)% vs. (92.0±1.2)%,both P<0.05). The 3-year OS rate of the group C with chemotherapy delay >7 days (42 cases) was lower than that of the group with chemotherapy delay of 1-7 days (22 cases) and the non-delay group (399 cases) ((76.7±6.9)% vs. (81.8±8.2)% vs. (92.7±1.3)%, P=0.002).The 3-year OS rate of the chemotherapy delay group (9 cases) in the COP (vincristine+cyclophosphamide+prednisone) phase was lower than that of the non-chemotherapy delay group (454 cases) ((66.7±15.7)% vs. (91.3±1.4)%, P=0.005). Similarly, the 3-year OS rate of the chemotherapy delay group (11 cases) in the COPADM1 phase was lower than that of the non-chemotherapy delay group (452 cases) ((63.6±14.5)% vs. (91.5±1.3)%, P=0.001). Conclusions:The delayed chemotherapy was related to the age over 10 years old, tumor lysis syndrome before chemotherapy and grade Ⅲ-Ⅳ myelosuppression after chemotherapy in pediatric BL. There is a significant relationship between delayed chemotherapy and prognosis of BL in children.

Sixty ASA Ⅰ-Ⅱ male patients aged 45-65 yrs undergoing general anesthesia in Chenzhou First People′s Hospital from May to September 2019 were randomly divided into two groups with 30 cases in each. Before the recover from anesthesia, patients in group L were irrigated with 100 mg lidocaine and 20 ml normal saline through the urinary catheter, while those in group C were irrigated with 20 ml normal saline in the same way. After irrigation, the catheter was clamped for 5 min and then released. The of urination intention when patient is conscious was observed and urethral irritation score was assessed. The cases of unconscious catheter grasping behavior, catheter-related restlessness and the need for rescued medication were compared between two groups. Compared to group C, group L had lower urinary intention rate (3.3%), lower urethral irritation score (1.94±0.15), lower rate of unconscious catheter grasping (6%), lower incidence of catheter agitation (0) and remedial medication (0). It is suggested that bladder irrigation with lidocaine before anesthesia recovery can reduce the symptoms of catheter-related irritation.

From January 2016 to June 2017, 68 patients with thoracic osteoporotic compression fractures were treated with percutaneous kyphoplasty, including 31 cases with ultrasound-guided thoracic paravertebral nerve block (group A) and 37 cases with local anesthesia (group B). The duration of analgesia in group A was longer than that in group B (P<0.05). The satisfaction of anesthesia in group A was higher than that in group B (90% vs. 68%, P<0.05). There was no significant difference in length of hospital stay and cost between the two groups (P>0.05). The post-operative VAS scores was significantly lower than those of pre-operation in both groups (P<0.05). The intraoperative VAS score of group A was lower than that of group B (P<0.05). There was no significant difference between the two groups in mean arterial pressure and heart rate (P>0.05). No cardiovascular and cerebrovascular adverse reactions occurred in both groups. Ultrasound-guided thoracic paravertebral nerve block is a safe and effective method used in percutaneous kyphoplasty.

Objective To investigate the inhibition of rutaecarpine (Rut) on left ventricular hypertrophy rat induced by abdominal aorta coarctation (AAC) and further explore the potential mechanisms. Methods Left ventricular hypertrophy was induced by AAC in male Sprague-Dawley rats.Fifty rats were randomly divided into five groups:model control group,sham operation group,low-,middle- and high-dose (10,20,40 mg?kg-1?d-1 ) Rut group,with 10 rats of each group.Rut was administrated by gavage once daily from the first day after operation for consecutive 4 weeks.The sham operation and model groups were administrated with equal volume of 0.9％ sodium chloride solution.The hemodynamics parameters were detected by BL-420 E biology function laboratory system,and the left ventricular hypertrophy index (LVHI,left ventricular weight/ body weight) was measured at 8 h after administration of the last dose.The pathological changes of left ventricular hypertrophy were evaluated by HE staining.To elucidate the mechanism of protection,the mRNA expressions of atrial natriuretic factor ( ANF),extracellular signal-regulated kinase 2 (ERK2) and MAPK phosphatase-1 (MKP-1) were analyzed by real time RT-PCR,and the protein expressions of MKP-1 and phosphorylated ERK2 (p-ERK2) were examined by Western blotting. Results Left ventricular hypertrophy induced by AAC was evidenced by the increased left ventricular weight (LVW) and LVHI (P<0.01),the decreased± dp/ dt max (P<0.01),and the elevated expression of ANF (P<0.01).Compared with model control,Rut (20,40 mg?kg-1?d-1 ) treatment significantly attenuated AAC-induced rat left ventricular hypertrophy,decreased the LVHI (P<0.05),left ventricular systole pressure (LVSP),and left ventricular end diastolic pressure ( LVEDP ) ( P < 0. 05), and increased ± dp/ dtmax ( P < 0. 01). In addition, Rut ( 20, 40 mg?kg-1?d-1 ) downregulated the expression of ANF,ERK2 mRNA,and ERK2 protein,but upregulated the MKP-1 mRNA and protein expression.However,Rut low-dose (10 mg?kg-1 ?d-1 ) was ineffective (P> 0.05). Conclusion Rut alleviates left ventricular hypertrophy induced by abdominal aorta coarctation,and the protection appears to be due,at least in part,to its inhibitory effects on the MAPK/ ERK signal pathway.

BACKGROUND: Irradiation therapy in the cancer patients after surgery may have negative effects on implant fixation. OBJECTIVE: To observe the effects of 60Co irradiation and trace element zinc on fixation strengths of titanium implant. METHODS: Thirty-six adult male rabbits were involved. One piece of titanium implant was separately placed into the bilateral proximal tibial heads in rabbits to set up animal models of titanium implants. The animals were randomly divided into control group, zinc supplement group, 60Co irradiation group and 60Co irradiation and zinc supplement group. Zinc sulfate of 10 g/L was administered intramuscularly to animals in the zinc supplement group at the dose of 4 mg/kg once per day, and those in the control group were treated with saline at the same dose. The animals in the 60Co irradiation group received 60Co irradiation at the dose of 45 Gy and saline by intramuscular injection. Those in the 60Co irradiation and zinc supplement group received 60Co irradiation and zinc sulfate. The animals were killed at 1, 4 and 12 weeks after treatment. The fixation strengths were measured and compared among groups. RESULTS AND CONCLUSION: (1) Zinc supplement made the titanium implants have higher fixation strengths, and reach a high level at 4 weeks after surgery. (2) 60Co irradiation significantly inhibited the fixation strengths of the implants. After 60Co radiation, zinc supplement stil could promote fixation strengths of titanium implants. (3) It is indicated that amount of zinc supplement after irradiation therapy can al eviate the negative effects of irradiation on implant fixation.

Objective To explore the method of oleic acid two strike to build a better clinical pathophysiology of acute lung injury animal model state.Methods The 60 male and healthy Sprague-Dawley rats, weighing 180 ～ 220g.According to the time of purchase.No.1, 2, 3 The order No.60, Each number, were randomly divided into 3 groups: normal control group(20 rats) : intravenous injection of normal saline 0.07ml/kg, an hour after intravenous injection of saline 0.03 ml/kg.The traditional group(20 rats) : intravenous injection of oleic acid 0.l ml/kg.The model group(20 rats) : intravenous injection of oleic acid 0.07 ml/kg, one hour after intravenous injection of oleic acid 0.03 ml/kg.Close observation of vital signs of breathing and Hemodynamicsin rats.Stable operation of 30 min, Each operation is stable after 30 minutes of measuring arterial blood gas, lung water content, the change degree evaluation of early lung injury of lung tissue pathology.Through the analysis of arterial blood gas, lung water content, HE stained pathological changes of lung tissue in Smith scoring method to determine the degree of lung injury in rats, to evaluate whether the model was successfully established.Results There are 5 rats died after a sharp drop in blood pressure of oleic acid used in traditional group rats, the changes of hemodynamics of traditional group compared with model group were severe, especially in the 5 ～ 30min after injection of oleic acid.The model group was no death, intravenous injection of oleic acid(0.1 ml/kg) from 7 to 8 min after respiratory frequency rats increased gradually, difficulty in breathing, endotracheal see pink frothy sputum.After 1 h pumping and arterial blood gas results showed that pH (7.17 ± 0.15) PaO2, (41.85 ± 8.16) mmHg was significantly lower than that of normal group(P ＜ 0.01) , oxygenation index (PaO2/FiO2) ≤ 300 mmHg, met the diagnostic criteria of acute lung injury, the moisture content(P ＜ 0.05), according to the Smith score, pathological model group compared with normal group significantly increased(P ＜ 0.01).Conclusion Two hit the body can produce severe inflammatory reaction of lung and lasting, build a close clinical pathophysiology of acute lung injury animal model successfully state.Meet the pathophysiological clinical change of acute lung injury, and can be used for basic and clinical research of acute lung injury in infants.

Objective To evaluate the effect of dexmedetomidine on lung injury induced by extremity ischemia-reperfusion.Methods Forty patients,aged 18-60 yr,with body mass index of 20-25 kg/m2,of ASA physical status Ⅰ or Ⅱ,with 1 h ≤ predicted duration of surgery ≤ 1.5 h,were randomly divided into 2 groups (n =20 each) using a random number table:control group (group C) and dexmedetomidine group (group D).In groupD,dexmedetomidine 1 (g/kg was infused intravenously for 10 min,followed by continuous infusion of dexmedetomidine at 0.5 μg· kg-1 · h-1 until the end of the surgery,while in group C the equal volume of normal saline was given instead.Immediately before induction of anesthesia (T1,baseline),at 60 min after tourniquet was inflated (T2) and at 30 min,2 h and 6 h after tourniquet release (T3-5),blood samples were collected from the radial artery for blood gas analysis and for measurement of the levels of plasma interleukin-6 (IL-6),IL-8,tumor necrosis factor-α (TNF-α),malondialdehyde (MDA) and superoxide dismutase (SOD),and arterial partial pressure of oxygen (PaO2) and partial pressure of carbon dioxide (PaCO2) were recorded.Alveolar-arterial oxygen difference (A-aDO2) and respiratory index (RI) were calculated.Results Compared with group C,PaO2 was significantly increased at T5,and A-aDO2 and RI at T5,the levels of plasma IL-6 and IL-8 were decreased at T4,5 and the levels of plasma TNF-α,MDA and SOD were decreased at T3-5 in group D.Conclusion Dexmedetomidine can attenuate lung injury induced by extremity ischemia/reperfusion via inhibiting inflammatory responses and lipid peroxidation.

Objective To investigate the effect of ovarian cycle on the sedative effect of propofol in patients. Methods Forty ASA Ⅰ or Ⅱ patients, aged 20-40 yr, with body mass index 20-25 kg/m2 , scheduled for elective gynecologic laparoscopic surgery, were divided into 2 groups according to the progesterone level ( n = 20 each): follicular phase group (group F, serum progesterone concentration 0.31-1.52 ng/ml) and luteal phase group (group L, serum progesterone concentration 5.16-18.56 ng/ml). Anesthesia was induced with target-controlled infusion (TCI) of propofol and iv injection of fentanyl and cisatracurium. The initial target plasma concentration (Cp) of propofol was set at 2 μg/ml, after the Cp reached the predetermined level, the Cp increased by 0.5 μg/ml every 30 s until the patients lost consciousness and BIS value was decreased to 50. The BIS value and Cp of propofol was recorded when the patients lost consciousness. The Cp of propofol was also recorded when BIS value was decreased to 50. The patients were tracheal intubated and mechanically ventilated. Anesthesia was maintained with TCI of propofol combined with remifentanil. BIS value was maintained at 45-55 by adjusting the Cp of propofol. Results The Cps of propofol were significantly higher when the patients lost consciousness and when BIS value was decreased to 50 in group F than in group L ( P ＜ 0.05 or 0.01) . There was no significant difference in BIS value when the patients lost consciousness between the two groups (P ＞ 0.05). Conclusion Ovarian cycle can affect the sedative effect of propofol in patients, which shows that the sedative effect during the follicular phase is lower than that during the luteal phase.

ObjectiveTo study the mechanism of myocardial dielectric property changes in radio frequency during hypothermic preservation and explore myocardial viability evaluative method. Methods Hybrid young pigs (20-30 kg) were used in the experiment. Heart arrest was induced with GIK solution. According to preservative temperature, the animals were divided into three groups: group A (4 ℃),group B (15 ℃) and group C (25 C). The heart was preserved in saline for 12,6 and 4 h respectively. Myocardial dielectric properties and ATP content were tested every 5 and 30 min during hypothermic preservation respectively. The relationship between tanoδm and ATP content was analyzed. ResultsTanδm of three groups was decreased significantly at the beginning, most slightly in group A and most obviously in group C. There was no significant difference in Tanδm between group B and group C with group A at 1 h,but there was obvious difference at 2,3 and 4 h (P＜0. 05,P＜0. 05,P＜0. 01 ). There was correlation between tanδm and ATP in the three groups. ConclusionTanδm in three groups is dropped with preservation time and temperature, and tanδm had a correlation with ATP content. Detection of myocardial dielectric property in radio frequency is a kind of quick, accurate and noninvasive method.

Objective To evaluate the effectiveness of real time ultrasound guided drainage tube placing under xiphoid. Methods Fifty-one eases of hydropericardium were refractory to traditional therapy.They were used the systemic chemotherapy regime composed of amikacin, levofloxaein aminosalicylate beside other one or two anti-tuberculosis drug never used before, placing drainage tube beneath xiphoid for periodic draining and infusing regime of isoniazide rifampine and dexamthasone. The average course was 3 months.Results All the 51 cases underwent a successful pericardium puncture without any complications. The rainage tubes were placed for 21 to 60 days with mean of (32 ± 3) days; drainage volume range from 1700 to 3800 ml,mean was (2400 ± 55)ml. All the patient showed clinical improvement, complete absorption of hydroperieardium, no constrictive periearditis occurred. Conclusions Ultrasound guided pericardium puncture and drainage tube placing is safe without hurting myoeardium. Indwelled tube this way facilitate sustained eomplete drainage lavage and drug infusing, and its effectiveness is reproducible.