Metastasis of lung cancer?

BACKGROUND: Sarcoidosis is a multi-system, idiopathic, inflammatory disorder that affects the lungs in over 90% of patients. The incidence of bone lesions in sarcoidosis is only 1-13%. CASE REPORT: This study describes a 60-year-old woman with a previous history of thyroid cancer, and a more recent diagnosis of lung cancer with suspicious metastatic lesions, which were confirmed to be sarcoidosis. CONCLUSION: This case suggests that pulmonary neoplasms and pulmonary sarcoidosis can coexist and be easily confused. When lung cancer is accompanied by symmetric hilar lymph node enlargement and multiple lung nodules, sarcoidosis should be considered in addition to metastasis, and a biopsy should be performed for confirmation.

Treatment Outcomes in COVID-19 Patients with Brucellosis: Case Series in Heilongjiang and Systematic Review of Literature / 生物医学与环境科学（英文）

OBJECTIVE@#Clinical characteristics and outcome in COVID-19 with brucellosis patients has not been well demonstrated, we tried to analyze clinical outcome in local and literature COVID-19 cases with brucellosis before and after recovery.@*METHODS@#We retrospectively collected hospitalization data of comorbid patients and prospectively followed up after discharge in Heilongjiang Infectious Disease Hospital from January 15, 2020 to April 29, 2022. Demographics, epidemiological, clinical symptoms, radiological and laboratory data, treatment medicines and outcomes, and follow up were analyzed, and findings of a systematic review were demonstrated.@*RESULTS@#A total of four COVID-19 with brucellosis patients were included. One patient had active brucellosis before covid and 3 patients had nonactive brucellosis before brucellosis. The median age was 54.5 years, and all were males (100.0%). Two cases (50.0%) were moderate, and one was mild and asymptomatic, respectively. Three cases (75.0%) had at least one comorbidity (brucellosis excluded). All 4 patients were found in COVID-19 nucleic acid screening. Case C and D had only headache and fever on admission, respectively. Four cases were treated with Traditional Chinese medicine, western medicines for three cases, no adverse reaction occurred during hospitalization. All patients were cured and discharged. Moreover, one case (25.0%) had still active brucellosis without re-positive COVID-19, and other three cases (75.0%) have no symptoms of discomfort except one case fell fatigue and anxious during the follow-up period after recovery. Conducting the literature review, two similar cases have been reported in two case reports, and were both recovered, whereas, no data of follow up after recovery.@*CONCLUSION@#These cases indicate that COVID-19 patients with brucellosis had favorable outcome before and after recovery. More clinical studies should be conducted to confirm our findings.

Clinical application of preferential manual bronchoplasty in single-port video-assisted thoracoscopic upper lobectomy: A retrospective analysis in a single center / 中国胸心血管外科临床杂志

@#Objective     To explore the safety and feasibility of preferential manual bronchoplasty in single-port video-assisted thoracoscopic surgery (VATS) upper lobectomy. Methods    The clinical data of 457 patients with non-small cell lung cancer who underwent single-port VATS lobectomy in the Department of Thoracic Surgery of Peking University First Hospital from March 2020 to March 2022 were retrospectively analyzed. The patients were divided into a preferential manual bronchoplasty group and a traditional single-port VATS lobectomy group with a 1 : 1 propensity score matching for further research. Results     A total of 204 patients were matched, and there were 102 patients in each group. There were 50 males and 52 females aged 62.2±10.1 years in the preferential bronchoplasty group, and 49 males and 53 females aged 61.2±10.7 years in the traditional single-port VATS group. The preferential bronchoplasty group had shorter surgical time (154.4±37.0 min vs. 221.2±68.9 min, P<0.01), less bleeding (66.5±116.9 mL vs. 288.6±754.5 mL, P=0.02), more lymph node dissection (19.8±7.5 vs. 15.2±4.7, P<0.01), and a lower conversion rate to multi-port or open surgery (2.3% vs. 13.8%, P=0.04) in left upper lobe resection. In the right upper lobe resection surgery, there was no statistical difference in postoperative results between two groups. There was no perioperative death or occurrence of bronchopleural fistula in both groups. Conclusion    Compared with traditional single-port VATS upper lobectomy, preferential bronchoplasty has similar safety and feasibility. In addition, priority bronchoplasty in left upper lobectomy has the advantages of shorter surgical time, less bleeding, more lymph node dissection, and lower conversion rate to multi-port or open surgery.

A PW12/Ag functionalized mesoporous silica-coated magnetic Fe3O4 core-shell composite as an efficient and recyclable photocatalyst.

The novel composite, Fe3O4@SiO2@mSiO2-PW12/Ag, was successfully prepared by in situ loading Ag nanoparticles (Ag NPs) on the surface of grafted phosphotungstate (denoted as PW12) Fe3O4@SiO2@mSiO2via a photoreduction deposition method. PW12 not only acts as a reducing agent and stabilizer for Ag NPs but also as a bridge to link Ag NPs and the SiO2 shell in the loading process. Its activity toward the photodegradation of methyl orange (MO) and photoreduction of Cr2O72- anions was evaluated. Experimental results showed that Fe3O4@SiO2@mSiO2-PW12/Ag with 5.3 wt% Ag loading and 18.65 wt% of PW12 exhibits the highest photocatalytic efficacy, and complete degradation of MO and 91.2% photoreduction of Cr(vi) were realized under simulated sunlight for 75 min, respectively. The enhanced catalytic activities of the composite are due to its high specific surface area, the synergistic effect among the components and the formation of a heterojunction of PW12/Ag. The possible enhanced photocatalytic mechanism is proposed. The catalyst is durable and can be easily recovered using a magnet for recycling without a significant loss of catalytic activity.

Evaluation of curettage and bone grafting combined with locking compression pediatric hip plate in the treatment of tumor-like lesions of femoral neck in children / 中华实用儿科临床杂志

Objective:To analyze the curative effect of locking compression pediatric hip plate (LCH-PHP) in the treatment tumor-like lesions of femoral neck in children.Methods:From January 2012 to June 2019, 45 children with Erol type Ⅱ-Ⅳ tumor-like lesions of femoral neck were retrospectively analyzed, involving 32 males and 13 females, aged 2-14 years.Among them, 27 cases were simple bone cyst, 15 cases were fibrous dysplasia, 3 cases were Langerhans histiocytosis, and 17 cases were accompanied with pathological fracture.Patients without pathological fracture were divided into 2 groups according to different surgical methods: lesion removal and bone grafting+ LCH-PHP preventive fixation group (group A) and lesion removal and bone grafting group (group B). Patients with pathological fracture were divided into 2 groups according to the different surgical methods: lesion removal and bone grafting+ LCH-PHP fixation and reduction group (group C) and lesion removal and bone grafting group (group D). The loss of femoral neck-stem angle, healing time and Musculoskeletal Tumor Society (MSTS) scores were compared between group A and group B. Changes of femoral neck-stem angle were compared between group C and group D at postoperative 1 day and the last follow-up.Results:Forty-five patients were followed up for an average of 2.6 (1-4) years.The loss of femoral neck-stem angle in group A and group B were (0.50 ± 0.45)°, and (2.26 ± 1.64)°, which was significantly different ( t=-3.193, P<0.05). There were no significant differences in the healing condition, healing time and MSTS scores at the last follow-up between group A and group B(all P>0.05). In group C, the ipsilateral femoral neck-stem angle at the postoperative 1 day and the last follow-up were (133.67±4.53)°and (133.00±4.32)°, respectively, which was comparable ( P>0.05). In group D, the ipsilateral femoral neck-stem angle at the postoperative 1 day and the last follow-up were (133.36±7.82)°and (130.63±8.24)°, respectively, which was significantly different ( t=7.11, P<0.05). Conclusions:LCH-PHP fixation can effectively maintain the femoral neck-stem angle and prevent the occurrence of pathological fracture children with Erol Ⅱ-Ⅳ tumor-like lesions of femoral neck.

Efficacy analysis of T?nnis triple osteotomy for developmental dysplasia of the hip in older children / 中华实用儿科临床杂志

Objective:To explore the outcomes of T?nnis triple osteotomy for developmental dysplasia of the hip (DDH) in older children.Methods:Clinical data of 21 children (22 hips, 12 left and 10 right hips) treated by T?nnis triple osteotomy from October 2016 to June 2019 were retrospectively analyzed.There were 8 males and 13 females with a mean age of operation at 13.5 (8.6-16.8) years.Based on the T?nnis classification, all the cases were in Grade Ⅰ.Statistical analysis was performed using the SPSS 22.0 statistical software.Results:All recruited patients were followed up for 1.5-3.5 years.Compared with preoperative values and those at the last follow-up visit, the mean Sharp acetabular angle of the affected side recovered from 53.5°±5.2° to 40.8°±2.3°.The mean center-edge angle increased from 10.5°±2.9° to 35.4°±5.6°.The mean acetabular roof angle decreased from 38.6°±2.8° to 6.7°±1.3°.The mean acetabular head index enhanced from (54.3±5.2)% to (86.2±2.7)%.The differences between the preoperative and postoperative values were statistically significant ( t=24.3, 17.6, 50.1, 27.5; all P<0.05). According to the Harris classification, there were 17, 3 and 2 hips achieved excellent, good and fair outcomes at the last follow-up visit, respectively, with the percentage of excellent and good outcomes up to 90.9%(20/22 hips). Accor-ding to the Severin radiographic classification, 8, 12 and 2 hips were in grade Ⅰ, Ⅱ, and Ⅲ, respectively, with the percentage of excellent and good hips at 90.9%(20/22 hips). At the last follow-up visit, the bone healing of iliac and pubic bones was well, and the nonunion of ischial bones were reported in 3 cases (13.6%). Conclusion:The outcome of the T?nnis triple osteotomy is satisfactory for DDH in older children.

Bufalin Induces Glioma Cell Death by Apoptosis or Necroptosis.

INTRODUCTION: Bufalin is a component of Chinese traditional medicine, Chansu, which is reported to induce cell death among various kinds of tumors. Apoptosis evasion is a common problem of cancer treatment. MATERIALS AND METHODS: The proliferation of U-87 and U-373 treated by bufalin combined with or without apoptosis inhibitor was detected by MTT assay. The protein levels related to apoptosis and necroptosis were measured by Western blotting. Immunoprecipitation (IP) was applied for monitoring the formation of necrosome. The gene knockdown by CRISPR/Cas9 was applied to determine the roles of the proteins in apoptosis and necroptosis. RESULTS: In this study, we found that bufalin could induce apoptosis or necroptosis when U-87 and U-373 escaped from apoptosis. Bufalin triggered cell death by upregulating tumor necrosis factor (TNF) -α, TNF receptor 1 (TNFR1) and receptor-interacting protein 1 (RIPK1). Antagonizing cellular inhibitor of apoptosis 1 (cIAP1) and cIAP2 were also contributory. Caspase-8 activation led to apoptosis. When caspase-8 was functionally lost, necrosome consisted of RIPK1, receptor-interacting protein 3 (RIPK3) and mixed lineage kinase domain-like protein (MLKL) formed and necroptosis happened. The knockdown of above genes or the drug treatment confirmed the mechanism of bufalin-induced cell death. Cytotoxicity of bufalin to caspase-8 knockdown cell lines made control cell lines more sensitive to bufalin in their mixture. DISCUSSION: The cytotoxicity of bufalin to U-87 and U-373 was by inducing apoptosis or necroptosis when they were sensitive to apoptosis or not. The results indicated that seeking for treatments that could induce apoptosis and necroptosis was a good solution for the tumor evasion of apoptosis.

ROS-augmented and tumor-microenvironment responsive biodegradable nanoplatform for enhancing chemo-sonodynamic therapy.

Nanocarrier for augmenting the efficacy of reactive oxygen species (ROS) by tumor microenvironment (TME) has become an emerging strategy for cancer treatment. Herein, a smart biodegradable drug delivery nanoplatform with mitochondrial-targeted ability, pH-responsive drug release and enzyme-like catalytic function is designed. This efficient ROS-generating platform uses ultrasound with deeper penetration capability as excitation source for combined chemotherapy and sonodynamic therapy (SDT) of tumor. In vitro experiments show that the nanoplatform can co-load Ce6 and DOX and be degraded in slight acid environment, and the DOX release rate is 63.91 ± 1.67%. In vivo experiments show that the nanoplatform has extremely biosafety and can be enriched in tumor site and excluded from body after 24 h. More significantly, after combined treatment, the tumors are eliminated and the mice still survive healthily without recurrence after 60 d. This is because not only it can achieve mitochondrial targeting and use platinum particle to increase oxygen content in TME to enhance the effect of SDT, but also it can use weak acidic TME to accelerate drug release to achieve the combination of chemotherapy and SDT. The probe provides a new strategy for designing ROS-based nanoplatform for the treatment of malignant tumor.

Clinical effect analysis of retrograde elastic stable intramedullary nailing in distal humerus metaphysis-diaphyseal junction fractures in children / 中华实用儿科临床杂志

Objective:To assess the clinical effect of retrograde elastic stable intramedullary nailing(ESIN) in distal humerus metaphysis-diaphyseal junction fractures in children.Methods:A total of 14 cases of children with distal humerus metaphysis-diaphyseal junction fractures treated by retrograde ESIN in Children′s Hospital of Nanjing Medical University from January 2016 to December 2018 were retrospectively analyzed.There were 9 males and 5 females, aged 3.0-13.2 years old(median: 6.4 years old). Nine cases had fractures on the left side and 5 cases on the right side.Two prebent ESINs were inserted into the proximal humerus metaphysis through the humerus marrow cavity from medial and lateral sides of the distal humerus respectively after the closed/open reduction of fractures.After surgery, the shoulder abductor stent or long arm plaster was used for fixation post-operatively.X - ray examination was performed at regular post-operative follow-up.The stability of internal fixation was analyzed by measuring the Baumann angle and checking whether humeral anterior lines passed through capitulum humeri in lateral radiographs immediately after the surgery and at the last follow-up.Meanwhile, efficacy was evaluated according to Flynn functional evaluation criteria.Results:All the 14 patients in this group were followed up for 10-27 months after the operation, with an average of 18.4 months.The Baumann angle was within the normal range at both the end of the operation and the last follow-up, and no significant difference was observed.Lateral radiographs showed humeral anterior lines passed through the capitulum humeri.According to Flynn functional scores, there were 13 excellent cases and 1 good case.No wound infection, intramedullary nailing displacement, Volkmann contracture, cubital varus deformity, or iatrogenic nerve injury occurred in any of the children.Conclusion:Retrograde ESIN technique is a safe and reliable treatment for children with distal humerus metaphysis-diaphyseal junction fractures.

Effect of moxibustion at "Guanyuan" (CV 4) and "Sanyinjiao" (SP 6) on bone morphology, metabolism and ERα of bone marrow mesenchymal stem cells in the ovariectomized rats / 中国针灸

OBJECTIVE@#To observe the effects of moxibustion at "Guanyuan" (CV 4) and "Sanyinjiao" (SP 6) on bone morphology, metabolism and ERα of bone marrow mesenchymal stem cells (MSCs) in the ovariectomized rats and explore the underlying mechanism of moxibustion at Guanyuan (CV 4) and Sanyinjiao (SP 6) on the regulation of bone metabolism.@*METHODS@#A total of 60 SD rats were randomized into a normal group (20 rats) and an ovariectomy group (40 rats). In the normal group, no any treatment was provided. In the ovariectomy group, the classical ovariectomy was adopted to set up the osteoporosis model. In the 13th week after ovariectomy, 10 rats were collected from each of the normal group and the ovariectomy group for model identification. After model identification, the ovariectomy group was subdivided into a model group, an estradiol group and a moxibustion group, 10 rats in each one. In the normal group and the model group, the gavage was provided with 2 mL 0.9% sodium chloride solution, once a day. In the estradiol group, the gavage was provided with 17β-estradiol 100 μg/(kg•d), once a day. In the moxibustion group, moxibustion was applied at "Guanyuan" (CV 4) and "Sanyinjiao" (SP 6), 15 min at each acupoint, once a day. The 6 treatments were as one course, with 1 day of interval, 12 courses were required. After 12-week intervention, the dual-energy X-ray was adopted to determine the bone mineral density (BMD) and bone mineral content of the whole body in living condition. After sacrificed, HE staining was adopted to observe femur structure, the enzyme-linked immunosorbent assay was to determine the absorbance of estradiol (E) and alkaline phosphatase (ALP) in serum and the real-time quantitative PCR method was to determine the mRNA expressions of ERα of MSCs in tibia and femur.@*RESULTS@#Compared with the model group, BMD was increased obviously in the pelvis and spine in the moxibustion group and the estradiol group (0.05). Compared with the model group, the bone trabeculas were stronger and well connected in the moxibustion group, indicated by HE staining. Compared with the model group, the concentrations of E in serum were increased obviously in the estradiol group and the moxibusiton group (both <0.01), and ALP concentrations reduced obviously in the estradiol group and the moxibustion group (both <0.001), the mRNA expressions of ERα in MSCs increased in the estradiol group and the moxibustion group (both <0.001).@*CONCLUSION@#Moxibustion at "Guanyuan" (CV 4) and "Sanyinjiao" (SP 6) effectively increases BMD and bone strength in the ovariectomized rats and the mechanism may be related to the improvement of serum E concentration, the decrease of serum ALP concentration and the up-regulation of mRNA expression of ERα in MSCs.

Diagnosis and treatment of seven primary mediastinal yolk sac tumors / 北京大学学报(医学版)

OBJECTIVE@#Primary mediastinal yolk sac tumor, which is also known as endodermal sinus tumor, is a rare but lethal neoplasm and its prognosis is very dismal. The current treatment for this tumor is controversial, and chemotherapy combined with resection of residual lesions is adopted sometimes. We summarized the experience of seven primary mediastinal yolk sac tumors treated with platinum-based chemotherapy and extended resection in Peking University First Hospital.@*METHODS@#Clinicopathological data of the patients with primary mediastinal yolk sac tumor who received operation in Peking University First Hospital between August 2014 and August 2018 were collected and analyzed retrospectively.@*RESULTS@#We experienced seven primary mediastinal yolk sac tumors during this period. Computed tomography scan revealed an anterior mediastinal tumor in all the patients and all of them had markedly raised alphafetoprotein (AFP) and normal β-human chorion gonadotropin (β-HCG). Five patients underwent needle core biopsy before treatment, which showed a mediastinal yolk sac tumor. All of these patients received preoperative platinum-based chemotherapy and they all presented partial response according to computed tomography. Two other patients did not receive preoperative biopsy, so they directly underwent extended resection. All of the seven patients underwent operation successfully and two of them experienced postoperative complications, including one with pneumonia and the other with atelectasis. R0 resection was achieved in six patients and R1 resection was achieved in the other patient. According to postoperative pathology, there were one microcyst subtype, one adenoid subtye, one giant capsule subtype and two hybrid subtypes. Surprisingly, there were no yolk sac tumor tissue in the other two patients after preoperative chemotherapy. All the patients received postoperative chemotherapy, excluded one patient who was unable to tolerate chemotherapy after operation. Three patients experienced postoperative pulmonary metastases within one year and two of them died soon. The other patient received chemotherapy and immunotherapy after recurrence and he was alive at the time of writing. Four other patients were alive without recurrence and metastasis.@*CONCLUSION@#Primary mediastinal yolk sac tumor is rare and its prognosis is poor. A multimodality approach including adjuvant chemotherapy and resection of residual lesions is the optimal treatment and it may lead to long-term survival.

A mini-incision on the anterior hip for pediatric femur neck fractures of type Delbet Ⅱ / 中华外科杂志

Objective@#To investigate the early clinical outcomes of hip anterior short incision and open reduction and internal fixation for the treatment of children with Delbet Ⅱ femoral neck fracture.@*Methods@#A retrospective analysis of 12 children with DelbetⅡ femoral neck fractures was performed with the anterior short incision approach at Department of Pediatric Orthopaedic, Children′s Hospital, Nanjing Medical University from January 2014 to August 2016. There were 7 males and 5 females including 8 cases at left side and 4 cases at right side,aged (11.5±0.8) years (range: 8-14 years).Patients underwent surgery in (12.0±0.9) hours (range: 6-20 hours) after the injury. Displaced fractures were treated by open reduction if closed reduction failed.The surgical incision was performed with the anterior inferior iliac spine centered on, extending along the groin crease, and the length was 3 to 4 cm. The interval between the sartorius and the tensor fascia latae was applied, and the direct and indirect head of rectus femoris were resected to visualize the hip joint capsule. T-shaped incision was made in the capsule. After the reduction was obtained, two or three compression canulated screws were used to fix the fracture site. The healing time, complications and corresponding record outcome by X-ray and clinical examination were recorded. At the latest follow-up,the results were analyzed using the Ratliff criteria and clinical outcomes were assessed by pain, restrictive hip movement, normal activity or the avoidance of games, and the femoral neck in the radiograph.@*Results@#Twelve patients had been followed-up for (30.0±4.1)months(range: 24-36 months). X-ray showed the fractures′ healing time was (8.0±0.4) weeks(range: 7-9 weeks). Ten of the 12 fractures healed after one operation and were associated with no evidence of osteonecrosis of the femoral head. One case occurred premature physeal closure. There were no cases with fracture relocation, coaxvara, delayed union and nonunion or any significant postoperative complications. There was no infection, flexible internal fixation or ruptures. According to Ratliff grade, 9 cases of 12 patients were fine and 3 cases was acceptable.@*Conclusions@#Satisfactory short-term effects can be achieved by a mini-incision on the anterior hip for Delbet Ⅱ pediatric femur neck fractures. The anterior incision has the advantage of less trauma, smaller incision scar, better fracture reduction and fixation, and less wound complications.

Fixation with Kirschner wires plus pediatric hip plate for femoral neck fracture combined with avulsion fracture of the greater trochanter in children / 中华创伤骨科杂志

Objective To investigate the feasibility and clinical effectiveness of fixation with Kirschner wires plus pediatric hip plate (PHP) for femoral neck fracture combined with avulsion fracture of the greater trochanter in children.Methods Between February 2014 and February 2016,6 children were treated by fixation with Kirschner wires plus PHP for femoral neck fracture combined with avulsion fracture of the greater trochanter at Department of Pediatric Orthopaedics,Children's Hospital,Nanjing Medical University.They were 4 boys and 2 girls,aged from 3.5 to 11.1 years (mean,7.2 years).By the Delbet's classification,all the fractures were of type Ⅲ.Clinical efficacy was evaluated according to the Ratliff scoring system at the last follow-ups.Results The intraoperative bleeding ranged from 20 to 50 mL (average,30 mL);the operation time ranged from 45 to 60 min (average,55 min).All the patients were followed up for 12 to 36 months (average,26 months).Bony union was obtained in all cases after an average time of 7 weeks (from 5 to 8 weeks).The Ratliff scores at the last follow-ups showed 5 good and one acceptable cases.No neurovascular lesion or incision infection was observed in the children.Anatomical reduction of the greater trochanter fracture was not achieved in one child but led to no adverse effect.Conclusion Fixation with Kirschner wires plus PHP can successfully treat femoral neck fracture combined with avulsion fracture of the greater trochanter in children.

Study on the relationship of the expression level of Calpain-9 with occurrence and metastasis of gastric carcinoma / 中华老年医学杂志

Objectives To explore the correlation of the expression lcvel of Calpain-9 in gastric carcinoma with clinico pathological features and metastasis of gastric cancer.Methods The expression level of Calpain-9 in gastric carcinoma and matched para-cancerous normal mucosa tissues were detected by Western blotting and immunohistochemistry in 146 patients with gastric cancer respcctively.The relationship between the expression level of Calpain 9 and the various clinicopathological indexes was analyzed.Results The expression level of Calpain-9 was significantly lower in cancerous tissues than in matched para cancerous normal mucosa tissues (P ＜ 0.05),with significantly different expression levels of Calpain-9 in different gastric cancerous histological differentiation degrees,different clinical stages,and with or without a lymph node metastasis(all P＜ 0.05).But no statistical difference was found in different sexes,different ages,different tumor sizes,with or without a distant metastasis (all P＞0.05).The spearman's correlation analysis showed that thc expression level of Calpain-9 in gastric cancer was negatively correlated with lymph node metastasis (r=-0.3826,P＜0.05).Conclusions The expression level of Calpain-9 in gastric cancer tissues is decreased,is negatively correlated with clinical stages,pathological differentiation,and cancerous lymph node metastasis.

Diagnosis and treatment of colorectal polyps in pediatric patients in a northwest area of China / 中国内镜杂志

Objective To investigate the characteristics of the colon polyp in a northwest district of China. Methods 112 cases of patients from 1~18 years old, diagnosed with polyps by means of colonoscopies reference centers were followed-up from January 2015 to December 2016. The clinical variables evaluated in this study included: gender, age, symptoms, age at onset of symptoms, age at identification of the polyp, interval of time between the onset of symptoms and the endoscopic diagnosis of colonic polyps, and family history of colon polyp and/or colorectal cancer. The characteristics of the polyps also included: number, morphological type, diameter, histology, and distribution. The case records of these patients were reviewed. The demographics, clinical course, laboratory results, endoscopic and histopathological features, treatments, and outcomes were analyzed. Results In the 112 patients, the median age was 6.9 years, of which 64.3% (72/112) were male. All the patient had the symptom of hematochezia and just a little of the patients have the symptoms of abdominal pain, prolapse of anal polyp and diarrhea. 9.8% (11/112) was mild anemia and the anemia patient all had the symptom of hematochezia of more than 6 months and have no connection with the polyp location. Juvenile polyps were identified in 91.9% (103/112) patients, inflammatory polyp were identified in 7.1% (8/112) and 0.9% (1/112) were identified with adenoma. 1.8% (2/112) of the patient had the family history of colorectal polyp. Conclusions The morbidity of colorectal polyp in children and adolescents in our region is high. The male was significantly more common seen than female. A little proportion of the patient had the family history of colorectal polyp. The hematochezia could be seen in all patients A little proportion of the patient was mild anemia and the anemia patient all had the symptom of hematochezia of more than 6 months. Mainly the polyp was located in the rectum and sigmoid. Juvenile polyps were the major pathologic type and then the inflammatory polyp and adenoma. The adenoma may located in other place than rectum and sigmoid.

Complications of 2 133 cases of pediatric long bone fracture undergoing elastic stable intramedullary nailing in a single medical center / 中华外科杂志

Objective@#To summarize the clinical data of elastic stable intramedullary nailing(ESIN) in the treatment of long bone fracture of children in a single medical center, and to analyze the problems occurred after the ESIN surgery and corresponding solutions.@*Methods@#A retrospective analysis was conducted regarding the clinical data of 2 133 pediatric long bone fractures conforming to inclusion and exclusion criteria from June, 2005 to December, 2017 in Department of Orthopedics, Children′s Hospital of Nanjing Medical University.There were 1 191 boys and 942 girls, aged from 23 months to 14 years with mean age of (5.7 ± 3.1)years.There were 1 866 cases treated with closed reduction with ESIN, while 267 cases were treated with small incision assisted reduction with ESIN.Postoperative problems have been statistically analyzed.@*Results@#There were altogether 2 133 children, including 603 cases of femur, 311 cases of tibia, 8 cases of fibula, 219 cases of humerus, and 992 cases of ulna/radius.The postoperative complications mainly consist of 62 cases of needle tail irritation reaction, 21 cases of misalignments of fracture alignment, 11 cases of intramedullary nail deformity or angular deformity, 7 cases of limb shortening, 14 cases of limited joint activity, 4 cases of nerve injury, 2 cases of tendon injury, 14 cases of difficult nail removal, 4 cases of cortical cleavage, 8 cases of delayed union, 1 case of nonunion, 6 cases of varus/valgus deformity, 5 cases of epiphyseal injury, 6 cases of ESIN exposure, and 2 cases of metal debris of ESIN′ end.@*Conclusions@#The complications of treatment for children with long bone fractures by ESIN cannot be ignored.To master the important biomechanical properties, to get familiar with the local anatomy and to avoid obvious technical errors can reduce the occurrence of postoperative complications.

Modified humeral supracondylar step－cut osteotomy for cubitus varus in children / 中华实用儿科临床杂志

Objective To investigate the feasibility and clinical effectiveness of modified humeral supracondy-lar step－cut osteotomy(M－HSSCO)for cubitus varus in children.Methods Between June 2016 and June 2017,the study included 25 children (20 boys and 5 girls)presenting cubitus varus at the age of (8.5 ± 0.3)years old (6－11 years old)in the Children's Hospital of Nanjing Medical University.M－HSSCO was used in the osteotomy operation. The initial osteotomy was performed as a right triangle osteotomy.The inferior margin of this right triangle was outlined parallel to the joint line 0.5－1.0 cm above the olecranon fossa.Then,they were incised from the medial end of this parallel line,which made an angle between the first and second lines equal to the desired corrective humerus elbow－wrist angle.Next,from the lateral end of the second line,the third line perpendicular to the first line was cut.Finally, desired right triangle was outlined and removed.The second right triangle osteotomy from proximal line of osteotomy was similar as the above.The medial cortex and periosteum was used as a hinge and rotated to make two osteotomy parts combined steadily.The Bellemore evaluation system was used to evaluate the difference in carrying angle degree be-tween the affected side and normal side after osteotomy,and the different degree of flexion and extension in the elbow joint between preoperation and post－operation.Residual varus deformity and other complications were also evaluated. Results All patients were followed up for 6－18 months (mean 12 months).The preoperative ipsilateral carrying an-gle was－(15°－30°)[－(22.20 ± 1.40)°],the postoperative was 5°－10°[(7. 60 ± 0.47)°]and the final follow－up was 5°－9°[(7.30 ± 0.40)°].There were statistically significant differences in the flexion angles before surgery and after surgery (t＝23.34,P＝0.000).There were statistically significant differences in the flexion angles before surgery and at final follow－up (t＝23.14,P＝0.000).The mean range of joint motion of the elbow was －5°－130° [(132.5 ± 0.5)°]before surgery,0°－125°[(123.6 ± 1.4)°]after surgery and 0°－130°[(126.8 ± 1.3)°]at fi-nal follow－up.The carrying angle reduced did not happen by the final follow－up.There was no statistically significant difference between the flexion angles before surgery and after surgery or by final follow－up(P＞0. 05).Twenty－three (92.0%)patients got an excellent result,2 cases(18.0%)got a good result and no patient (0)got worse according to the criteria described by Bellemore.The first－class incision healing were achieved in all patients.There was no case with postoperative infection,instabilities,vascular and neural injury or any significant postoperative complications. Conclusions M－HSSCO is an effective osteotomy procedure which shows good feasibility and apparent therapeutic effect in treating cubitus varus in children.

[Establishment of neuritis migration model induced by Slit 2N and silk fibroin mixture in the rat hippocampal neurons in vitro].

OBJECTIVE: To explore a simply feasible and affordable method to establish neuritis migration model induced by Slit 2N and silk fibroin mixture in the rat hippocampal neurons in vitro. METHODS: Neurons were derived from SD rat hippocampal tissues and cultured with a special cell culture-plate in vitro. The cultured neurons were divided into four groups, named as control group, pure silk fibroin, pure Slit 2N and Slit 2N mixture with silk fibroin (mixture group), and 50 different neurons were randomly selected in each group. Moreover, we photographed and recorded the soma coordinate and added the silk fibroin, Slit 2N and mixture to each neurite with a distance of 100 µm, except control group. Record again after 30 min. Property and positive rate of cells were identified by immunofluorescence staining. RESULTS: Neurites of the pure Slit 2N group and the mixture group became shorter, and there was no significant change in the pure silk fibroin and control groups. The results showed that the average duration and length difference before and after changed were in descending order of mixture group, Slit 2N group, silk fibroin group (P<0.05), and the silk fibroin and control groups were no significant change (P>0.05). The positive rate of MAP-2 in four groups was more than 90%. CONCLUSIONS: There were no significant effects of Silk fibroin on induced by Slit 2N in rat hippocampal neuron migration. It had an effect on reducing Slit 2N diffusion rate and extending its working time. It provides an advantageous construction method in vitro on based 3D directed neural repair for the treatment of central nervous system diseases.

Comparison of three internal fixation techniques for treating displaced femoral neck fractures in children / 中华创伤杂志

Objective To compare the clinical efficacy of three internal fixation techniques,namely K-wire,hollow screw and pediatric hip locking compression plate (LCP),for treating displaced femoral neck fractures in children.Methods The clinical data of 56 patients treated from January 2010 to August 2015 were retrospectively analyzed by case-control study.All the patients received open reduction after unsuccessful closed reduction.According to the methods of internal fixation,the patients were divided into K-wire group (18 cases),hollow screw group (21 cases) and LCP group (17 cases).Operation time,intraoperative blood loss,neck-shaft reduction,bone union time,and complications after surgery were recorded.Ratliff and Harris scores at final follow-up visit were evaluated.Results In K-wire group,hollow screw group and LCP group,the operation times were respective(74.2 ± 12.9) min,(90.2 ± 18.9) min and (125.1 ± 20.6) min,the intraoperative blood loss of the three groups were respective (27.3 ± 15.4) ml,(32.4 ± 18.7) ml and (57.7 ± 22.1) ml,and the neck shaft reduction of the three groups were respective (3.74 ± 0.80) °,(2.96 ± 0.74) ° and (1.22 ± 0.39) °.K-wire group were superior to other two groups in operation time and intraoperative blood loss,and PHP group were better than the other two groups in prevention of neck-shaft reduction(P ＜ 0.05).There was one case in K-wire group with bone nonunion combined with hip varus.In K-wire group,hollow screw group and LCP group,the avascular necrosis were 11％,14％ and 12％,respectively (P ＞ 0.05).There were no statistically significant differences in follow-up time,bone union time,and Ratliff as well as Harris scores among the three groups (P ＞ 0.05).The case of epiphyseal premature closure,iatrogenic injury of blood vessel and nerve as well as osteo-fascial compartment syndrome was not observed after surgery.None of the patients had epiphyseal close,neurovascular injury and osteofacial compartment syndrome.Conclusions All three internal fixation techniques can have good clinical results in children with displaced femoral neck fractures after unsuccessful closed reduction.K-wire has advantages of less blood loss,shorter operation time and easier handling.Hollow screw has no obvious advantages or disadvantages in intraoperative situation and postoperative complications.Pediatric hip LCP can reduce the loss of neck-shaft angle and decrease the occurrence of hip varus.

Influence of probiotics assisted with routine antibiotic regimens on the short-term clinical efficacy, mucosal barrier function and inflammatory response of patients with bacterial peritonitis secondary to liver cirrhosis / 中国基层医药

Objective To investigate the influence of probiotics assisted with routine antibiotic regimens on the short-term clinical efficacy,mucosal barrier function and inflammatory response of patients with bacterial peritonitis secondary to liver cirrhosis.Methods 60 patients with bacterial peritonitis secondary to liver cirrhosis were chosen,and they were randomly divided into two groups according to the digital table,each group in 30 cases.The control group received routine antibiotic regimens alone,and the observation group were given probiotics on the basis of the control group.The short-term clinical efficacy,the levels of DAO,D-Lac and ET before and after treatment of the two groups were compared.Results The short-term effective rates of the control group and observation group were 70.00％,96.67％,respectively.The short-term effective rate of the observation group was significantly higher than that of control group(x2 =9.14,P ＜0.05).After treatment,the levels of DAO of the control group and observation group were (4.33 ± 0.79) U/mL,(2.19 ± 0.47) U/mL,respectively.The levels of D-Lac of the control group and observation group after treatment were (15.88 ± 1.95) U/mL,(8.57 ± 1.03) U/mL,respectively.The levels of DAO and D-Lac of the observation group after treatment were significantly lower than those of the control group and before treatment(t =2.78,3.06;3.44,3.78,3.61,4.10,all P ＜ 0.05).The levels of ET of the control group and observation group after treatment were (0.09 ± 0.02) EU/mL,(0.04 ± 0.01) EU/mL,respectively.The level of ET of the observation group after treatment was significantly lower than that of the control group and before treatment(t =2.49,3.01,3.46,all P ＜ 0.05).Conclusion Probiotics assisted with routine antibiotic regimens in the treatment of patients with bacterial peritonitis secondary to liver cirrhosis can effectively relieve the symptoms and signs,improve the mucosal barrier function and is helpful to reduce the inflammatory response.