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Objective@#To understand the behavioral problems of children infected with HIV, and to provide reference for further psychological intervention.@*Methods@#The survey was conducted from January to December 2017. A total of 256 HIV-infected 10-16 years old school-aged children who were receiving highly active antiretroviral therapy (HAART) in Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention were invited to participate. Another 256 children without HIV infection who were matched with sex and age were selected as the control group. Achenbach Children’s Behavior Scale was used to conduct psychological questionnaires in the two groups of children.@*Results@#Activity, social competence, and learning ability in the study group scored lower than control group (P<0.05). In children with HIV infection group, score of social competence in boys and girls aged 10-11 years were (14.35±3.96) (15.26±5.00), respectively, and was (14.21±4.64) and (14.57±5.50) in boys and girls aged 12-16 years was significantly lower than age and sex-matched control group (19.38±6.77 and 18.09±5.16 in boys and girls aged 10-11 years, 17.26±6.88 and 17.84±6.76 in boys and girls aged 12-16 years) (P<0.05). The total detection rate of behavioral problems in the study group (13% and 10% in boys and girls aged 10-11 years, 17% and 13% in boys and girls aged 12-16 years) was significantly higher than that in the control group (5% and 3% in boys and girls aged 10-11 years, both 4% in boys and girls aged 12-16 years) (P<0.05).@*Conclusion@#Behavioral problems in HIV-infected children are prevalent, which worth more attention to carry out psychological intervention among this vulnerable population.
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Objective To investigate the clinical efficacy and prognostic factors for M4/M5subtypes in chil-dren with acute myeloid leukemia(AML).Methods A retrospective analysis of the clinical data of M4/M5subtypes in Shanghai Children′s Hospital Affiliated to Shanghai Jiaotong University,from January 2009 to December 2014 was carried out.The long-term efficacy,prognosis and relapse factors were analyzed.Results The clinical data of 46 ca-ses were collected,among which 38 cases were treated with more than 2 courses,including 22 male,16 female,19 cases M4and 19 cases M5.The median age was 5 years.5-year overall survival(OS)rate and 5-year event-free survival (EFS)rate were(57.7 ± 9.3)% and(47.2 ± 8.9)%,and 5-year EFS of M4and M5were(52.4 ± 12.7)% and (45.4 ± 11. 9)%. Compared with the international risk stratification:5-year EFS rate of favorable-risk, intermediate-risk and poor-risk were(77.2 ± 12.4)%,(49.5 ± 14.9)% and(25.0 ± 19.8)%(χ2=6.305,P=0.043).Single factor analysis showed that extramedullary infiltration(χ2=4.828,P=0.028),Chromosome karyotype (χ2=10.178,P=0.017),the eighth day assessment(χ2=5.382,P=0.020)and course of treatment(χ2=4.771, P=0.029)were prognostic factors;multivariate analysis showed extramedullary infiltration(HR =5.323,95%CI:1.620-17.490,P=0.006)and less-than-6 courses of treatment(HR=6.186,95%CI:1.726-22.176,P=0.005)were the independent risk factors of affecting survival.Conclusions (1)Strengthening treatment and ade-quate courses of treatment are the critical to improve the overall curative effect in children with M4/M5subtypes.(2) Extramedullary infiltration was the risk factor for survival and recurrence in M4/M5subtypes.(3)It is suggested that the children who have the initial symptoms and molecular biology with poor prognostic factors choose hematopoietic stem cell transplantation as early as possible.
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Objective To analyze the clinical data of children with Langerhans cell histiocytosis (LCH),to discuss the therapeutic effect,and to analyze the factors related to prognosis.Methods A total of 45 children diagnosed as LCH were divided into group A (18 cases with bone lesion only),group B(6 cases with soft tissue lesion),and group C (21 cases with viscera lesion) according to Shanghai Children's Hospital-LCH-2007 scheme [SCH-LCH-2007 (modified DAL-HX83/90) scheme].(1) Initial treatment:group A was treated with Prednisone (Pred) + Vincristine (VCR) for 28 weeks,and group B was treated with Pred + VCR + Etoposide (VP16) + Mercaptopurine (6MP) for 43 weeks,and group C was treated with Pred + VCR + VP16 + Methotrexate (MTX) +6MP for 52 weeks.(2) Re-treatment scheme after relapse included:①upgrading treatment,group A to group B,group B to group C.②Individual treatment for group C included VP16 modification,and maintained Thymosin and/or Ciclosporin etc.Results The total survival rate was 93.3％ (42/45 cases) and recurrence rate was 26.7％ (12/45 cases).Children in group A and B were all effective,while 2 patients in group C died,and 1 case missed follow-up.Multi-factor analysis showed that the factors like age,sex,group,skeleton,soft tissue,erythra,lymph gland,lung,mouth,ears,hypophysis pituitary had no statistical significance,but liver,spleen and blood involvement had statistical significance in disease relapse:liver (P=0.007 1),spleen (P=0.016 9),and blood (P=0.011 1).Conclusion LCH can affect several organs of children and relapse,and modified DAL-HX83/90 scheme is very effective.The liver,spleen and hematopoiesis system involvement is correlates with the relapse.
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Objective To evaluate the efficacy of different treatment regimens for children with acute promye-locytic leukemia (APL)with positive PML -RARa fusion gene.Methods Thirty -two newly diagnosed APL patients were included in this study,treated either with all -trans -retinoic acid (ATRA)and chemotherapy (CT)(group A) or with ATRA and arsenic trioxide (ATO)(group B).Clinical situation and clinical efficacy were analyzed in patients in different groups.They were also separated into low risk group,intermediate risk group and high risk group according to different risk criteria.Clinical characteristics,complete remission,long -time survival and urine arsenic concentra-tion were analyzed and compared.Results (1 )Fourteen of 1 5 patients (93.3%)in group A achieved hematological complete remission (HCR)with a median time of 38 days (28 -63 days).Sixteen of 1 7 patients (94.1 %)in group B achieved HCR with a median time of 29 days (1 0 -42 days),which was significantly shorter than group A,and there was a significant difference between 2 groups(t =3.53,P =0.002).(2)The 5 -year event -free survival (EFS)of group A and group B was (60.0 ±1 2.6)% and (81 .9 ±9.5)%,respectively;the 5 -year EFS of group B was almost 20% higher than group A;while there was no significant difference between the 2 groups(χ2 =1 .1 5,P =0.28).The 5 -year overall survival (OS)of group A and group B was (72.2 ±1 1 .9)% and (94.1 ±5.7)%,respectively,the 5 -year OS of group B was almost 20% higher than group A;while there was no significant difference between the 2 groups(χ2 =2.88,P =0.1 6).(3)The 5 -year EFS of low plus intermediate group and high risk group patients was (74.0 ±1 0.1 )% and (64.8 ±1 4.3)%,the 5 -year EFS of low plus intermediate group was almost 1 0% higher than high risk group,but there was no significant difference between the 2 groups(χ2 =0.1 4,P =0.71 ).The 5 -year OS of low plus intermediate group and high risk group patients was (84.7 ±8.1 )% and (71 .3 ±1 4.1 )%,the 5 -year OS of low plus intermediate group was almost 1 0% higher than high risk group,while there was no significant difference be-tween the 2 groups(χ2 =0.36,P =0.55).(4)ATO related side effects were mild,including abnormal liver tests and e-lectrocardiogram,but were invertible after supportive therapy.At the end of each chemotherapy course,the urine arsenic concentration remained low and no chronic arsenic toxicity or second malignancies were found during the follow -up period.Conclusions The ATRA plus ATO regimen is a promising and better treatment for childhood APL with positive PML -RARa fusion gene compared with conventional chemotherapy.It was necessary to take risk stratification in APL patients.
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OBJECTIVE@#To investigate the expression of urokinase-type plasminogen activator (uPA) and its receptor (uPAR) in squamous cell carcinoma of hypopharynx and reveal the correlation of the major clinicopathological parameters and prognosis.@*METHOD@#Samples of 48 hypopharyngeal carcinoma and 10 normal hypopharyngeal tissue were detected by immunohistochemistry method (SP method) for urokinase-type plasminogen activator (uPA) and its receptor (uPAR). The correlation between the expression of urokinase-type plasminogen activator and its receptor and the major clinicopathological parameters of hypopharyngeal carcinoma were analyzed by rank sum test and Spearman correlation analysis. Overall survival were analyzed according to Kaplan-Meier and log-rank statistics, the prognostic relevance of uPA and uPAR and conventional prognostic factors were analyzed by Cox analysis.@*RESULT@#In 48 hypopharyngeal carcinoma specimens, positive expression rates of uPA and uPAR were 77.1% and 68.75% respectively, which were significantly higher than in normal tissues (P < 0.01). The uPA and uPAR positive expression was correlated with pathological grading, lymph node metastases and growth mode of hypopharyngeal carcinoma. The positive expression rate for uPA and uPAR in patients with lower pathological grading, lymph node metastases and invasion growth mode were significantly higher than in patients with higher pathological grading, non-lymph node metastases and non-invasion growth mode. Patients were followed-up postoperatively. The positive expression of uPA and uPAR were correlated with prognosis (P < 0.05 and P < 0.01). According to Log-rank statistics, patients with positive expression of uPA and uPAR had a significantly shorter survival time than those with negative expression of uPA and uPAR. Multivariate Cox analysis revealed that three independent prognostic factors for overall survival time were clinical stage, invasion growth mode and uPAR expression.@*CONCLUSION@#The positive expression of uPA and uPAR in hypopharyngeal carcinoma were significantly higher than in normal tissues. uPAR is a new independent and strong biologically prognostic factors, which positive expression may be a powerful aid in evaluating metastatic potential and High-Risk patients in early stage of hypopharynx carcinoma ryngeal carcinoma.
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Adult , Aged , Female , Humans , Male , Middle Aged , Carcinoma, Squamous Cell , Metabolism , Pathology , Hypopharyngeal Neoplasms , Metabolism , Pathology , Neoplasm Staging , Prognosis , Receptors, Urokinase Plasminogen Activator , Metabolism , Urokinase-Type Plasminogen Activator , MetabolismABSTRACT
Objective To evaluate the efficacy of percutaneous laser ablation in the management of portal vein tumor thrombus(PVTT)of hepatocellular carcinoma(HCC).Methods Under ultrasound guidance,a needle was percutaneously punctured into the portal vein,through the axial of the tumor thrombus,and until the proximal end.An optic fiber was inserted through the needle and repeated pulse laser ablation was given.Results Complications included 102 cases(94.4%)of pyrexia 1～3 d after treatment(37.5～39.5 ℃),84 cases(77.8%)of incisional pain,and 3 cases(2.8%)of upper gastrointestinal bleeding.There were three types of findings of PVTT in 53 cases surviving over 1 year:①the tumor thrombus was atrophied and disappeared in 20 cases;②the thrombus was atrophied and the portal vein exhibited a honeycomb-like appearance in 18 cases;③the thrombus kept on growing and the portal vein was enlarged in diameter in 15 cases.Among 95 cases of totally occluded portal vein,color blood flow signals appeared in all of them on the first postoperative day.The signals could still be seen in 76 cases at 1 month after treatment,in 64 cases(out of 91 cases)at 3 months,in 52 cases(out of 71 cases)at 6 months,in 36 cases(out of 42 cases)at 1 year,in 10 cases(out of 14 cases)at 2 years,and in 2 cases(out of 2 cases)at 3 years.The 1-,2-,and 3-year survival rates were 55.56%,35.20%,and 20.30%,respectively.Conclusions Percutaneous laser ablation is a feasible novel option for the treatment of portal vein tumor thrombus of hepatocellular carcinoma.
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Purpose:To study the therapeutic effect of rhG-CSF upon the severe hypogranulocytosis of children with acute leukemia after intensive chemotherapy. Methods:After intensive chemotherapy, the comparison between the group with rhG-CSF treatment ( n =136) and the control group ( n =65) was made on the ANC dropping time, the incidence rate and the degree of severity of the infection.Results:The period of ANC ≥0.5?109/L was shorter in the group with rhG-CSF treatment than that in the control group ( P