Clinical effect of multicenter multidisciplinary treatment in children with renal malignant tumors / 中国当代儿科杂志

OBJECTIVE@#To study the long-term clinical effect of multicenter multidisciplinary treatment (MDT) in children with renal malignant tumors.@*METHODS@#A retrospective analysis was performed on the medical data of 55 children with renal malignant tumors who were diagnosed and treated with MDT in 3 hospitals in Hunan Province from January 2015 to January 2020, with GD-WT-2010 and CCCG-WT-2016 for treatment regimens. A Kaplan-Meier survival analysis was used to analyze the survival of the children.@*RESULTS@#Of the 55 children, 10 had stage I tumor, 14 had stage Ⅱ tumor, 22 had stage Ⅲ tumor, 7 had stage IV tumor, and 2 had stage V tumor. As for pathological type, 47 had FH type and 8 had UFH type. All children underwent complete tumor resection. Of the 55 children, 14 (25%) received preoperative chemotherapy. All children, except 1 child with renal cell carcinoma, received postoperative chemotherapy. Among the 31 children with indication for radiotherapy, 21 (68%) received postoperative radiotherapy. One child died of postoperative metastasis. The incidence rate of FH-type myelosuppression was 94.4%, and the incidence rate of UFH-type myelosuppression was 100%. The median follow-up time was 21 months and the median survival time was 26 months for all children, with an overall survival rate of 98% and an event-free survival rate of 95%.@*CONCLUSIONS@#Multicenter MDT has the advantages of high success rate of operation and good therapeutic effect of chemotherapy in the treatment of children with renal malignant tumors, with myelosuppression as the most common side effects, and radiotherapy is safe and effective with few adverse events. Therefore, MDT has good feasibility, safety, and economy.

Clinical features of neuroblastoma: an analysis of 44 children / 中国当代儿科杂志

OBJECTIVE@#To study the clinical features of neuroblastoma (NB) and the factors influencing survival rate.@*METHODS@#A total of 44 children with NB who were admitted from April 2016 to February 2020 were enrolled as research subjects. A retrospective analysis was performed on their medical data and follow-up data.@*RESULTS@#The common clinical symptoms of these 44 children were fever (10/44, 23%), mass (9/44, 20%), abdominal pain (8/44, 18%), cough (7/44, 16%), pale complexion (3/44, 7%), claudication (2/44, 5%), and abnormal activity (2/44, 5%). According to the INSS stage, 2 children (4%) had stage I NB, 5 children (11%) had stage II NB, 5 children (11%) had stage III NB, and 32 children (73%) had stage IV NB. The mean follow-up time was (15.3±1.5) months, with a recurrence rate of 20% and an overall survival rate of 82%. Among the 44 children, 29 (66%) achieved event-free survival and 7 (16%) had survival with tumor. The univariate analysis showed that a pathological type of NB and an increase in serum neuron-specific enolase (NSE) decreased the overall survival rate of children with NB (P<0.05).@*CONCLUSIONS@#The clinical symptoms of children with NB are not specific at the first visit. Fever, abdominal pain, and mass are common symptoms, and there is a high proportion of children in the advanced stage. The pathological type of NB and an increase in serum NSE may be associated with a reduction in the overall survival rate of children with NB.

Clinical characteristics and genetic analysis of hereditary spherocytosis caused by mutations of ANK1 and SPTB genes / 中国当代儿科杂志

This study analyzed the clinical features of 5 children with hereditary spherocytosis (HS) and the characteristics of ANK1 and SPTB gene mutations. All 5 children were confirmed with HS by peripheral blood genetic detection. Anemia, jaundice and splenomegaly were observed in all 5 children. Three children had an increase in erythrocyte osmotic fragility. All 5 children had negative results of the Coombs test, glucose 6 phosphate dehydrogenase test, sucrose hemolysis test, acidified-serum hemolysis test and thalassemia gene test. Peripheral blood smear showed an increase in spherocyte count in one child. High-throughput sequencing revealed ANK1 gene mutations in patients 1 to 3, namely c.3398(exon29)delA, c.4306C>T and c.957(exon9)_c.961(exon9)delAATCT, among which c.3398(exon29)delA had not been reported before. Patient 4 had c.318delGExon3 mutation in the SPTB gene. Patient 5 had mutations in the SPTB and SLC4A1 genes, among which c.3484delC in the SPTB gene was a spontaneous mutation; the mutation site of the SLCA4A1 gene was inherited from the father and was a non-pathogenic gene. This study suggests that anemia, jaundice and splenomegaly are major clinical manifestations of HS children. Most children with HS do not have the typical spherocytic changes. Genetic detection may help with the accurate diagnosis of HS.

Comparision of Different Detection Methods for Blood Flow Infection with Cryptococcus Neoformans / 中国实验血液学杂志

OBJECTIVE@#To compare the sensitivity and specificity of real-time fluorescent quanttative PCR(FQ-PCR), blood culture and serum capsular antigen test for the detection of blood flow infection with cryptococcus reoformans, so as to provide the experimental evidence for use of FQ-PCR to detect the blood flow infection with cryptococcus neoformans.@*METHODS@#Sixty male Sprague-Dawley (SD) rats were randomly divided into group A (immune suppression plus infection), group B (immune normal plus infection), group C (immune suppression plus non infection) and group D (normal control). The rats in group A were injected intraperitoneally with cyclophosphamide at D1 of experiment and were injected with suspension of cryptococcus neoformans by tail vein at D4 of experiment; the rats in group B were injected intraperitoneally with saline at D1 and were injected with suspension of cryprococcus neoformans by tail vein at D4; the rats in group C were injected intraperitoneally with cyclophosphamide at D1 and were injected with saline by tail vein at D4; the rats in group D were injected intaperitoneally with saline at D1 and were injected with saline by tail vein at D4.At D 4 after successful extablishment of rat model with infection, the blood samples were collected from ocular veneous plexus at 0, 6, 12, 24, 48 and 72 hours by parity number respectively, then the plasma was extracted, and the blood samples infected at different time were detected by FQ-PCR, and at the same time, the blood culture and serum capsular antigen test were performed. The detected results obtained from above-mentioned 3 kinds of detection methods were compared.@*RESULTS@#The FQ-PCR detection of cryptococcus neoformoms showed that the positive rate detected after 12 hours in A group significantly increased (P<0.05), as compared with B, C and D groups. For the blood samples, the positive rate detected by FQ-PCR was significantly higher than that detected by the blood culture and serum capsular antigen test, moreover the detected results could be quantified, and difference was statistically significant (P<0.05).@*CONCLUSION@#The FQ-PCR system for detection of cryptococcus neoformant can detect the pathogens in blood of infected rats, and its sensitivity is superior to the blood culture and serum capsular antigen test; the FQ-PCR can detect the pathogens in blood of infected rats much more early, as compared with the blood culture and serum capsular antigen test.

Expression of TOPK/PBK in children with malignant lymphoma or reactive lymphoid hyperplasia / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the difference in expression of TOPK/PBK in lymph nodes between children with malignant lymphoma and those with reactive lymphoid hyperplasia.</p><p><b>METHODS</b>Eighty children with malignant lymphoma and twenty children with reactive lymphoid hyperplasia were enrolled as subjects. Immunohistochemistry was used to determine the expression of TOPK/PBK in all the subjects. The expression of TOPK/PBK was compared between the two groups.</p><p><b>RESULTS</b>The TOPK/PBK-positivity rate was significantly higher in children with malignant lymphoma than in those with reactive lymphoid hyperplasia (P<0.05). There was no significant difference in the TOPK/PBK-positivity rate between the children with Hodgkin's lymphoma and non-Hodgkin's lymphoma (NHL). There were significant differences in the TOPK/PBK-positivity rate among children with different pathological types of NHL (P<0.05): the children with lymphoblastic lymphoma showed the highest TOPK/PBK-positivity rate and those with mature B-cell lymphoma and mature T/NK-cell lymphoma had a similar TOPK/PBK-positivity rate.</p><p><b>CONCLUSIONS</b>The expression of TOPK/PBK is up-regulated in the lymph nodes of children with malignant lymphoma. The expression level of TOPK/PBK may be related to the pathological type of NHL.</p>

Risk Factors of Intrauterine Adhesion after Hysteroscopic Resection of Endometrial Polyps / 中国医学科学院学报

Objective To analyze the risk factors of intrauterine adhesion (IUA) after hysteroscopic resection of endometrial polyps. Methods Totally 359 patients undergoing hysteroscopic resection of endometrial polyps from January 2013 to December 2016 were enrolled in this study. The clinical data of IUA group and non-IUA group were compared. Univariate analysis was performed to identify the risk factors of IUA,and multivariate Logistic regression analysis was further performed to get the independent risk factors. Results Of these 359 patients,IUA occured after operation in 56 patients (15.60%). Univariate analysis showed underlying diseases (χ=7.381,P=0.004),multiple polyps (χ=3.376,P=0.040),uterus with uterine fibroids or endometrial hyperplasia (χ=6.495,P=0.009),history of curettage(χ=31.576,P=0.000),pelvic infection (χ=8.582,P=0.001),intrauterine device (χ=7.161,P=0.006),history of cesarean section (χ=5.493,P=0.014),and multigravida were (χ=16.886,P=0.000) the risk factors of IUA. Logistic regression analysis showed other diseases of uterus(χ=19.542,P=0.026),history of curettage (χ=29.614,P=0.000),pelvic infection (χ=5.627,P=0.002),intrauterine device (χ=11.342,P=0.08),history of cesarean section(χ=8.549,P=0.035),and multigravida (χ=15.493,P=0.000) were the independent risk factors of IUA after hysteroscopic resection of endometrial polyps. Conclusion Other diseases of uterus,history of curettage,pelvic infection,intrauterine device,history of cesarean section,and/or multigravida can increase the risk of IUA after hysteroscopic resection of endometrial polyps.

Influence of thymidylate synthase gene polymorphisms on high-dose methotrexate-related toxicities in childhood acute lymphoblastic leukemia / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the influence of thymidylate synthase (TS) gene polymorphisms on high-dose methotrexate (HD-MTX)-related toxicities in childhood acute lymphoblastic leukemia (ALL).</p><p><b>METHODS</b>A total of 73 children who were diagnosed with ALL between March 2011 and March 2013 were included into this study. Genomic DNAs were extracted from their peripheral blood. And then the genotypes of TS 5'-UTR were determined by direct DNA sequencing after PCR. The toxicity response of 73 patients receiving HD-MTX chemotherapy were observed and recorded, and plasma MTX concentrations at 42-48 hours after chemotherapy were measured.</p><p><b>RESULTS</b>The main HD-MTX-related toxicities of 73 patients receiving HD-MTX chemotherapy were neutropenia, decreased hemoglobin level, thrombocytopenia, liver toxicity, mucosal damage, and gastrointestinal reactions. There were no significant differences in the incidence rate of HD-MTX-related toxicities between children with different TS 5'-UTR genotypes after chemotherapy (P>0.05). TS 5'-UTR genotype was not significantly correlated with plasma MTX concentrations at 42-48 hours after chemotherapy (P>0.05).</p><p><b>CONCLUSIONS</b>TS gene polymorphisms have no influence on the incidence of HD-MTX-related toxicities in childhood ALL.</p>

Viral etiology in children with acute lower respiratory tract infections plus platelet disorders in Changsha, China: an analysis of 255 cases / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the viral etiology in hospitalized children with acute lower respiratory tract infections (ALRTI) plus platelet disorders.</p><p><b>METHODS</b>A total of 255 children with ALRTI plus platelet disorders and 442 children with ALRTI and normal platelets, all of whom were hospitalized between March 2010 and February 2011, were included in the study. Their nasopharyngeal aspirate samples were collected, and RT-PCR or PCR was performed to detect 14 viruses.</p><p><b>RESULTS</b>Of 255 ALRTI patients with platelet disorders, thrombocytosis was found in 253 cases (99.2%) and thrombocytopenia in 2 cases (0.8%). Among ALRTI patients with platelet disorders, 173 (67.8%) were infected with at least one virus, with human rhinovirus as the most common one, followed by parainfluenza virus type 3 (PIV3) and respiratory syncytial virus (RSV). The detection rate of PIV3 in the abnormal platelet group was significantly higher than in the normal platelet group (P<0.05). In contrast, the detection rate of influenza virus B (IFVB) in the abonormal platelet group was significantly lower than in the normal platelet group (P<0.05). The age distribution showed significant difference between the abnormal and normal platelet groups (P<0.01). Platelet disorders were mainly found in children under one year of age (P<0.01).</p><p><b>CONCLUSIONS</b>Thrombocytosis is often found in children with ALRTI caused by viruses, especially PIV3, but infection with IFVB seldom causes platelet disorders. Hospitalized children with ALRTI under one year tend to develop platelet disorders.</p>

Detection of siderotic nodules in the liver with susceptibility weighted imaging: correlations to serum ferritin, Child-Pugh grade and hyaluronic acid levels / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Chronic liver disease causes aberrant formation of fibrous tissue that impedes normal liver function, ultimately resulting in liver cirrhosis. Iron uptake can occur within the hepatic parenchyma or within the various nodules that form in a cirrhotic liver, termed siderotic nodules (SN). We aimed to investigate the diagnostic performance of susceptibility weighted imaging (SWI) for detection of SN in patients with liver cirrhosis, and to evaluate the potential of SN numbers for assessing the degree of hepatic iron deposition, liver function, and liver fibrosis stage.</p><p><b>METHODS</b>Ninety-one patients with chronic liver cirrhosis, who underwent megnetic resonance imagine (MRI) scanning in our department between November 2010 and April 2011, were included in the study. A 3.0T MRI scanner was used to acquire T1WI, T2WI, T2WI, and SWI images. The number of nodules, signal intensity ratio (SIR), and contrast noise ratio (CNR) were recorded and analyzed by chi-square and ANOVA statistical tests. Correlation analysis was performed to evaluate the correlations between the number of SN and Child-Pugh classification, ferritin and hyaluronic acid levels.</p><p><b>RESULTS</b>The sensitivity of SWI, T1WI, T2WI, and T2 WI for detecting SN was 62.5%, 12.1%, 24.2% and 41.8%, respectively. SWI detected significantly more nodules than routine T1WI, T2WI, and T2 WI procedures (P < 0.05). The SIR was the lowest in SWI (0.361 ± 0.209), as compared to T1WI (0.852 ± 0.163), T2WI (0.584 ± 0.172), and T2 WI (0.497 ± 0.196). The CNR was the highest in SWI (13.932 ± 5.637), as compared to T1WI (9.147 ± 5.785), T2WI (9.771 ± 5.490), and T2 WI (11.491 ± 4.573). The correlation coefficients of the number of SN with ferritin, Child-Pugh classification, and hyaluronic acid levels were 0.672, -0.055, and 0.163, respectively.</p><p><b>CONCLUSIONS</b>The sensitivity and contrast of SWI for detecting SN in patients with liver cirrhosis are higher than conventional MRI. The number of SN can help to assess the degree of iron deposition in patients with liver cirrhosis.</p>

Study on effect and mechanism of scutellaria baicalensis stem-leaf total flavonoid in regulating lipid metabolism / 中国中药杂志

<p><b>OBJECTIVE</b>To investigate the effect and mechanism of Scutellaria Baicalensis Stem-leaf Total Flavonoid (SSTF) on lipid metabolism in hyperlipidemic rat.</p><p><b>METHOD</b>On the basis of establishing hyperlipidemia rat model, blood lipids, lipid metabolic enzyme, antioxidative capacity were investigated after 30 days feeding of fatty emulsion.</p><p><b>RESULT</b>SSTF significantly reduced the serum TC, TG, LDL-C, ApoB concentration and increased HDL-C and ApoAI levels, improved the activity of lecithin cholesterol acyltransferase (LCAT). SSTF was shown to decreased MDA content in both serum and liver, increased serum SOD activity.</p><p><b>CONCLUSION</b>SSTF could remarkably modulate the lipid metabolic disorder in hyperlipidemic rats, and has a certain regulating function on lipoprotein, inferring that it could reduce the occuring of atherosclerosis. The mechanism of regulating lipid metabolism might be related with the increasing activity of LCAT and antioxidative capacity.</p>

Therapeutic Efficacy of Anagrelide for Thrombocytosis / 대한혈액학회지

BACKGROUND: Thrombocytosis can result in life-threatening thrombotic or hemorrhagic events. Anagrelide acts exclusively on megakaryocytes and has been reported as an useful agent in controlling thromobocytosis associated with chronic myeloproliferative disorders. METHODS: Seven patients with essential thrombocythemia and three with chronic myelogenous leukemia were enrolled and early responses and adverse effects of anagrelide were retrospectively analyzed. The drug was started with a dose of 2 mg/day with increases of 0.5 mg/day every 5~7 days as needed. RESULTS: Anagrelide in starting doses of 2 mg/day reduced the platelet count by 50%, or to less than 600,000/mm3, for at least 28 days in 7 of the 9 (78%) evaluable patients. Adverse effects of the drug were observed in 5 patients and generally well tolerated; headache in 4, gastrointestinal troubles in 2, palpitations and chest tightness in 1, and tinnitus in 1. Changes in hemoglobin or white blood cell counts in peripheral blood were minimal and tolerable. CONCLUSION: The present study shows that anagrelide is a useful platelet-lowering agent in whom hydroxyurea or interferon has failed. Long-term efficacy and adverse effects of the drug remain to be determined.