Clinical Significance of CRLF2 High Expression in Bone Marrow Mononuclear Cells from Children with Acute Lymphoblastic Leukemia / 中国实验血液学杂志

OBJECTIVE@#To detect the expression of CRLF2 in bone marrow mononuclear cells from children with newly diagnosed acute lymphoblastic leukemia(ALL) and to explore its clinical significance in pediatric ALL.@*METHODS@#A total of 218 children with newly diagnosed ALL who achieveal the complete remission and had the complete follow-up information were selected, and the expression level of CRLF2 in bone marrow mononuclear cells of these children was detected by real-time fluorescent quantitative PCR, and the significance of CRLF2 expression level in clinical prognosis of ALL children was analyzed by using statistical method.@*RESULTS@#28 cases in 218 children with complete data showed high expression of CRLF2. The cumulative recurrence rate in the CRLF2 high expression group was significantly higher than that in the low expression group (53.6% vs 12.6%) (P＜0.01). The predicted 5-year recurrence-free survival rate (RFS) of ALL children with CRLF2 high expression was significantly higher than that of low expression group (P＜0.01). There was no significant difference in the predicted 5-year RFS between ALL children with CRLF2 low and high expression in the standard-risk(SR) group (P＞0.05). The predicted 5-year RFS of ALL children with CRLF2 low expression was higher than that of ALL children with CRLF2 high expression in the intermediate-risk (IR) and high-risk (HR) groups. (P＜0.05). Cox analysis showed that CRLF2 high expression is an independent risk factor for the relapse of children with ALL.@*CONCLUSION@#The recurrence rate of pediatric ALL with CRLF2 high expression is high, and CRLF2 high expression is an important prognostic factor for high risk of relapse in ALL children with IR and HR. It is necessary to use CRLF2 expression as an indicator of risk stratification in pediatric ALL.

Effects of minimal residual disease level on day 33 of remission induction and IKZF1 genotype on the survival of children with B-lineage acute lymphoblastic leukemia / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the effects of minimal residual disease (MRD) level on day 33 of remission induction and IKZF1 genotype on the survival of children with B-lineage acute lymphoblastic leukemia (B-ALL).</p><p><b>METHODS</b>A total of 152 children with newly-diagnosed B-ALL who had complete remission after the first cycle of the chemotherapy and had complete follow-up information were enrolled in this study. According to the MRD detection by flow cytometry on day 33 of remission induction, they were divided into three groups: standard-risk (SR) group (MRD <10; n=60), intermediate-risk (IR) group (10≤ MRD <10; n=55), and high-risk (HR) group (MRD ≥10; n=37). Nested RT-PCR was used to determine the IKZF1 genotype of all children before chemotherapy. The effects of MRD level on day 33 of remission induction and IKZF1 genotype on the recurrence-free survival (RFS) of children with B-ALL were analyzed.</p><p><b>RESULTS</b>There were 7 common IKZF1 subtypes in all the 152 children with B-ALL: IK1, IK2/3, IK4, IK6, IK8, IK9, and IK10. Of the 152 children, 130 had functional subtypes of IKZF1 and 22 had non-functional subtypes of IKZF1. During the follow-up period, relapse occurred in 26 (17%) children, and the recurrence rate was highest in the HR group (P<0.05). However, there was no significant difference in the recurrence rate between the SR group and the IR group (P>0.05). The cumulative recurrence rate of the children with non-functional subtypes of IKZF1 was significantly higher than that of those with functional types of IKZF1 (P<0.01). The predicted 5-year RFS rates in the SR, IR, and HR groups were (94.2±2.9)%, (86.7±3.8)%, and (56.2±4.5)% respectively (P<0.05). The 5-year RFS rate of the children with functional subtypes of IKZF1 was significantly higher than that of those with non-functional subtypes of IKZF1 (P<0.01). There was no significant difference in the predicted 5-year RFS rate between the children with functional subtypes of IKZF1 and those with non-functional subtypes of IKZF1 in the SR group (P>0.05). However, the predicted 5-year RFS rate of the children with functional subtypes of IKZF1 was significantly higher than that of those with non-functional subtypes of IKZF1 in the IR group and the HR group (P<0.05).</p><p><b>CONCLUSIONS</b>B-ALL children with non-functional subtypes of IKZF1 have a high recurrence rate, and the recurrence rate will be even higher in B-ALL children with non-functional subtypes of IKZF1 and MRD ≥10 on day 33 of chemotherapy.</p>

Semi-quantitative analysis of hepatic fat in MR using Dixon technique and its clinical significance / 实用放射学杂志

Objective To investigate the correlation between hepatic fat fraction(HFF)and some clinical indicators by measuring HFF and summarize its clinical significance.Methods A total of 95 patients were included in this study.MR data were acquired with Dixon technique,and the HFF of liver were measured.According to the HFF,all patients were divided into high-fat group and low-fat group.Subcutaneous fat area(SA),visceral fat area(VA)and total fat area(TA)were also measured.The age of patients,blood pressure, fasting blood glucose(FPG),total cholesterol (TC),triglyceride (TG),low density cholesterol (LDL-c)and high density cholesterol (HDL-c) were recorded and the body mass index(BMI)was calculated.Results The levels of FPG,TG,LDL-c,systolic blood pressure,diastolic blood pressure,BMI,VA,TA and visceral fat percentage (VFP)in high-fat group were significantly higher than those in low-fat group (P<0.05), while the abdominal subcutaneous fat percentage (SFP)was significantly lower than that in low-fat group (P<0.05).HFF was positively correlated with FPG,TG,LDL-c,VA,TA,VFP,age and BMI (r=0.354,0.370,0.415,0.299,0.285,0.238,0.203,0.221,respectively;P<0.05).Conclusion Semi-quantitative analysis of hepatic fat using MR Dixon technique can reflect the degree of hepatic fatty infiltration, and can be used as a quantitative indicator for early diagnosis and treatment evaluation of nonalcoholic fatty liver disease.

Diagnostic value of 3.0T dynamic contrast-enhanced MRI and diffusion weighted imaging for common parotid tumors / 中华全科医师杂志

Thirty nine patients with pathologically confirmed parotid tumors,including 18 cases of pleomorphic adenomas,12 cases of papillary cystadenoma lymphomatosum and 9 cases of malignant tumors,were enrolled in the study.Characteristics on routine MR image,diffusion weighted imaging (DWI),timesignal intensity curve (TIC) and apparent diffusion coefficient (ADC) value in different types of tumors were evaluated.There were significant differences in imaging features between benign and malignant tumors (P ＜ 0.01).The TIC types were A,B and C for pleomorphic adenomas,papillary cystadenoma lymphomatosum and malignant tumors,respectively.The mean ADC value of pleomorphic adenomas was significantly higher than that of papillary cystadenoma lymphomatosum and malignant tumors (P ＜ 0.01).No significant difference in ADC values between papillary cystadenoma lymphomatosum and malignant tumors was detected (P =0.73).The study indicates that MR plain scan combined with dynamic contrast enhanced MRI and DWI may be helpful in pre-operative differentiation of common parotid tumors.

MRI measurement of pancreatic fat fraction based on Dixon method and correlation analysis with clinical factors / 中华放射学杂志

Objective To analyze the pancreatic fat fraction based on magnetic resonance Dixon sequence and correlation with clinical factors. Methods A total of 95 cases of adult physical examinees who had underwent abdominal MRI were retrospectively studied. Age, blood pressure, height and weight were recorded for every subject,and BMI was then calculated.The venous blood sample were analyzed for fasting plasma glucose (FPC), total cholesterol (TC), triglycerides (TG), low density lipoprotein-cholesterol (LDL-c)and high density lipoprotein-cholesterol(HDL-c).All cases underwent water-fat separation T1WI,fat inhibition T2WI, DWI, and coronal T2WI scans. We measured PFF of all the examinees, subcutaneous fat area(SA),visceral fat area(VA),and total abdominal fat area(TA)on the images above 8 centimeter of L4 to L5 were also measured, subcutaneous fat percentage (SFP) and visceral fat percentage (VFP) were further calculated. PFF of the 95 cases ranged from 2.1% to 35.0%, and the median PFF was 8.9%. This cohort was divided into low-fat pancreas groups (PFF≤8.9%, n＝51) and high-fat pancreas group (PFF>8.9%, n＝44) according to the median PFF. Independent sample t test was used to test for differences in clinical index between the two groups, Pearson correlation coefficient was used to measure the strength of a linear association between clinical indexes and PFF. Results Excellent water only, fat only, in phase and out of phase images of all the 95 adults were obtained. Signals of MRI images of all pancreas were homogeneous, the anatomic structures of all images were sharp and clear, and all the images had no motion artifact. The levels of BMI, systolic blood pressure, TG, LDL-c, FPC, VA, TA, VFP of high-fat pancreas group were significantly higher than those of low-fat pancreas group, and SFP was lower (P<0.05). The differences in age, diastolic blood pressure, HDL-c, TC, and SA between the two groups were not statistically significant(P> 0.05). PFF was weakly to moderately positively correlated with age, BMI, systolic blood pressure, diastolic blood pressure, TG, LDL-c, FPG, SA, VA, TA and VFP (r=0.219 to 0.515, P<0.05), SFP was moderately negatively correlated with PFF(r=－0.434, P<0.01). Conclusions It's feasible and accurate to measure the PFF with Dixon technique. PFF have a certain correlation with age, BMI, blood pressure, abdominal fat area and blood lipid metabolism.

Effect of glucocorticoid on dendritic cells in children with chronic immune thrombocytopenia / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the change in dendritic cells (DCs) in children with chronic immune thrombocytopenia (cITP) and the effect of glucocorticoid on DCs in children with cITP.</p><p><b>METHODS</b>Fifteen children with cITP and 20 healthy controls were included in the study. Flow cytometry was used to measure the DC subsets count in the 15 children with cITP before and after glucocorticoid treatment as well as the corresponding values in the 20 healthy controls. The DCs derived from peripheral blood monocytes in children with cITP were cultured in vitro and collected, and their immunophenotypes were determined by flow cytometry.</p><p><b>RESULTS</b>Before glucocorticoid treatment, the children with cITP showed no notable change in the absolute count of myeloid DCs (mDCs) but showed decreased absolute count of plasmacytoid DCs (pDCs) and increased mDC/pDC ratio compared with the healthy controls (P<0.05). After glucocorticoid treatment, the children with cITP demonstrated increased absolute count of pDCs and decreased absolute count of mDCs and mDC/pDC ratio compared with before treatment (P<0.05). Before glucocorticoid treatment, the children with cITP had significantly higher positive rates of HLA-DR, CD80, CD83 and CD86 on peripheral blood DCs than the healthy controls (P<0.01). All the positive rates were significantly decreased after glucocorticoid treatment (P<0.01), so that there was no significant difference from the healthy controls (P>0.05).</p><p><b>CONCLUSIONS</b>Disproportion and functional disturbance of DC subsets is associated with the pathogenesis of cITP in children. Glucocorticoid can strengthen the immunosuppression of DCs in children with cITP, which may contribute to the effectiveness of glucocorticoid as a treatment.</p>