Efficacy and safety of programmed death-1 inhibitor combined with transarterial chemoembolization and anti-angiogenic drugs in treatment of advanced hepatocellular carcinoma / 临床肝胆病杂志

Objective To investigate the efficacy and safety of programmed death receptor-1 (PD-1) inhibitor combined with transarterial chemoembolization (TACE) and anti-angiogenic drug tyrosine kinase inhibitor (TKI) versus TACE combined with TKI in the treatment of advanced hepatocellular carcinoma (HCC) and related influencing factors for prognosis. Methods An analysis was performed for all patients who received TACE+TKI+PD-1 inhibitor and some patients who received TACE+TKI in The First Affiliated Hospital of Air Force Medical University from June 2018 to July 2021. Related clinical data were collected, and propensity score matching (PSM) was used to balance the baseline characteristics between groups. The chi-square test was used for comparison of categorical data between two groups; the Wilcoxon rank-sum test was used for comparison of the number of TACE procedures between two groups; the Kaplan-Meier method was used to analyze overall survival (OS), and univariate and multivariate Cox regression models were used to analyze the influencing factors for prognosis. Results A total of 181 patients with advanced HCC were screened out, among whom 50 patients were treated with TACE+TKI+PD-1 inhibitor; after PSM, 40 patients treated with TACE+TKI+PD-1 inhibitor were enrolled as observation group and 40 patients treated with TACE+TKI were enrolled as control group. At the end of follow-up, the median follow-up time was 28.6 (95% confidence interval [ CI ]: 22.1-35.1) months, and the median OS was 15.9 (95% CI : 7.5-24.2) months in the observation group and 11.2 (95% CI : 5.0-17.5) months in the control group. The Cox regression analysis showed that the application of PD-1 inhibitor (hazard ratio [ HR ]=0.42, 95% CI : 0.23-0.80, P =0.008), the number of TACE procedures ( HR =0.67, 95% CI : 0.46-0.99, P =0.043), Child-Pugh class ( HR =2.40, 95% CI : 1.15-5.00, P =0.019), and vascular invasion ( HR =3.42, 95% CI : 1.11-9.42, P =0.031) were independent influencing factors for prognosis. The incidence rate of grade > 2 adverse events was 40% for both the observation group and the control group, and there was no significant difference between the two groups ( P =0.818). Conclusion Compared with TACE+TKI, TACE+TKI+PD-1 inhibitor can significantly prolong the OS of patients in advanced HCC, with relatively controllable adverse events.

Clinical features and prognosis of primary myelofibrosis with hepatic vascular disease and/or portal hypertension / 临床肝胆病杂志

Objective To investigate the clinical features, liver histopathological features, treatment, and prognosis of primary myelofibrosis (PMF)-associated hepatic vascular disease and portal hypertension. Methods A retrospective analysis was performed for the clinical and pathological features of 68 patients who were diagnosed with PMF in 960 Hospital of the PLA Joint Logistics Support Force and Xijing Hospital of Digestive Diseases, Air Force Medical University, from July 2010 to December 2020, among whom 22 patients had hepatic vascular disease/portal hypertension as the main manifestation. The patients were divided into two groups according to the presence or absence of thrombosis, and treatment and prognosis were summarized. The Kaplan-Meier method was used to plot survival curves, and the log-rank test was used to compare long-term survival rate between the two groups. Results Among the 68 patients with PMF, 22 had hepatic vascular disease and/or portal hypertension, resulting in a prevalence rate of 32.35%, and among these 22 patients, 13 (59.1%) had extrahepatic portal vein occlusion, 1 (4.5%) had Budd-Chiari syndrome, and 8 (36.4%) had portal hypertension. Biopsy was performed for 7 patients, and pathological results showed extramedullary hematopoiesis in the liver and varying degrees of infiltration of lymphocytes, plasma cells, and eosinophils at the lobular and portal areas, but the lobular structure was normal. A total of 7 patients died during follow-up, among whom 5 died of complications associated with thrombosis or portal hypertension. The overall median survival time was 57.99 months for all patients; the median survival time was 45.33 months in patients with thrombosis and 64.00 months in patients without thrombosis, and although there was no significant difference between the two groups ( χ 2 =3.035, P =0.081), the non-thrombosis group tended to have better survival and prognosis than the thrombosis group. Conclusion The possibility of PMF as the primary disease should be considered for patients with hepatic vascular disease and portal hypertension. Patients with PMF should be screened for hepatic vascular disease, and early intervention should be given. The patients without thrombosis tend to have better survival and prognosis than those with thrombosis.

Advances in local ablation therapy for liver cancer with portal hypertension / 临床肝胆病杂志

With the comprehensive application of a variety of treatment methods, the survival time of patients with primary liver cancer is gradually increasing. For patients with early-stage liver cancer and portal hypertension, local ablation therapy can achieve long-term survival and play a positive role in stabilizing portal venous pressure, preserving liver function, and reducing complications. In addition, it can be combined with other techniques such as transarterial chemoembolization, transjugular intrahepatic portosystemic shunt, splenectomy, and pericardial devascularization to further improve treatment outcome. Several measures can be taken in the perioperative period to improve the management efficiency of patients after ablation, such as objective evaluation of portal venous pressure, prevention of esophagogastric variceal bleeding, correction of hypersplenism, prevention of postoperative liver failure, and multidisciplinary team management.

Influence of pre-pregnancy parental body mass index, maternal weight gain during pregnancy, and their interaction on neonatal birth weight / 中国当代儿科杂志

OBJECTIVE@#To investigate the influence of pre-pregnancy parental body mass index (BMI), maternal weight gain during pregnancy, and their interaction on neonatal birth weight.@*METHODS@#A total of 1 127 pregnant women who underwent regular prenatal examinations and full-term singleton delivery in the First Hospital of Xi'an Jiaotong University from January 2017 to October 2018 were enrolled. The data on their pre-pregnancy BMI, maternal weight gain during pregnancy, pre-pregnancy BMI of the husband, and neonatal birth weight were collected. The interaction between pre-pregnancy parental BMI and maternal weight gain during pregnancy was analyzed, and their correlation with neonatal birth weight was analyzed.@*RESULTS@#Among the 1 127 full-term neonates, the detection rates of low birth weight neonates and macrosomia were 2.22% (25/1 127) and 3.82% (43/1 127) respectively. There were significant differences in pre-pregnancy parental BMI and maternal weight gain during pregnancy among the low birth weight, normal birth weight, and macrosomia groups (P<0.05). Neonatal birth weight was positively correlated with pre-pregnancy parental BMI and maternal weight gain during pregnancy (r=0.097-0.322, P<0.05). Low maternal weight before pregnancy increased the risk of low birth weight (RR=4.17, 95%CI: 1.86-9.38), and maternal overweight/obesity before pregnancy (RR=3.59, 95%CI: 1.93-6.67) and excessive weight gain during pregnancy (RR=3.21, 95%CI: 1.39-7.37) increased the risk of macrosomia. No interaction between pre-pregnancy maternal BMI and maternal weight gain during pregnancy was observed.@*CONCLUSIONS@#Pre-pregnancy parental BMI and maternal weight gain during pregnancy are related to neonatal birth weight, and there is no interaction between pre-pregnancy maternal BMI and maternal weight gain during pregnancy.

HSV-2 infection and associated factors among people participating premarital physical examination from 2013 to 2014 in Minhang District of Shanghai / 复旦学报（医学版）

Objective To explore herpes simplex virus type 2 (HSV-2) infection and associated factors among people participating premarital physical examination in 2013-2014 in Minhang District of Shanghai.Methods During 2013 to 2014,people participating premarital physical examination in Minhang District were interviewed with questionnaire regarding HIV/AIDS related Knowledge,sexual behaviors,etc.Blood samples were collected to detect HIV,HSV-2 and syphilis.Results A total of 2 116 participants were investigated,among which 92 were infected with HSV-2,with a prevalence rate of 4.35％.The HSV-2 infection rates were 3.69％ and 5.01％ for male and female,respectively.Multivariate logistic regression analysis showed that for the males,education level of high school and below (OR=2.47,95％CI:1.195-5.108),fiancee infected with HSV-2 (OR=9.29,95％CI:4.279-20.164) were more susceptible to HSV-2.For the females,aged above 25 years (OR=9.29,95％CI:4.279-20.164),census register of other cities in China (OR =2.19,95％CI:1.091-4.378),education level of high school and below (OR =3.37,95％CI:1.721-6.596),never used condoms (OR =3.45,95％CI:1.265-9.392),fiance infected with HSV-2 (OR =8.46,95％CI:3.700-19.351) were more susceptible to HSV-2.Conclusions The prevalence of HSV-2 among premarital population is relatively low in Minhang District.However,low condom use rate leads to an increase in the risk of HSV-2 infection when either partner infected with HSV-2,suggesting increasing condom use between affianced couples.

The band patterns of Western bolt in different clinical stages of HIV-1 infection / 复旦学报（医学版）

Objective To investigate the band pattern characteristics of Western bolt (WB) by analyzingthe change of anti-virus antibodies from patients with different clinical stages of human immunodeficiency virus 1 (HIV-1) infection.Methods Antibodies were detected by WB test,CD4+ T cells by flow cytometer.Results Among 208 cases,193 male cases accounted for 92.79％,and 163 cases of men who have sex with men (MSM) accounted for 78.37％.The antibodies against viral protein gp160,gp120,gp41,p66,p51,p31,p24 showed high positive rates,and no significant different was detected across different clinical stages.The positive rate of p55 antibody,encoding by gag gene,was significantly higher in those HIV positive individuals infected via homosexual compared with HIV-1 positive individuals through heterosexual contact (P＜0.05).The 5 common WB bands patterns were as following:all bands①,missing p55②,missing p39③,missing p55 + p39④ and missing p39 + p55 + p17⑤.Primary stage infection group showed the highest appearance rate of all bands (44.2％).Conclusions The WB bands patterns and CD4+ T lymphocyte counts can help to judge immune status,determine disease stages and monitor disease progression.We should take effective measures for the MSM and floating population.

HSV-2 infection and associated factors among people participating premarital physical examination from 2013 to 2014 in Minhang District of Shanghai / 复旦学报（医学版）

Objective To explore herpes simplex virus type 2 (HSV-2) infection and associated factors among people participating premarital physical examination in 2013-2014 in Minhang District of Shanghai.Methods During 2013 to 2014,people participating premarital physical examination in Minhang District were interviewed with questionnaire regarding HIV/AIDS related Knowledge,sexual behaviors,etc.Blood samples were collected to detect HIV,HSV-2 and syphilis.Results A total of 2 116 participants were investigated,among which 92 were infected with HSV-2,with a prevalence rate of 4.35％.The HSV-2 infection rates were 3.69％ and 5.01％ for male and female,respectively.Multivariate logistic regression analysis showed that for the males,education level of high school and below (OR=2.47,95％CI:1.195-5.108),fiancee infected with HSV-2 (OR=9.29,95％CI:4.279-20.164) were more susceptible to HSV-2.For the females,aged above 25 years (OR=9.29,95％CI:4.279-20.164),census register of other cities in China (OR =2.19,95％CI:1.091-4.378),education level of high school and below (OR =3.37,95％CI:1.721-6.596),never used condoms (OR =3.45,95％CI:1.265-9.392),fiance infected with HSV-2 (OR =8.46,95％CI:3.700-19.351) were more susceptible to HSV-2.Conclusions The prevalence of HSV-2 among premarital population is relatively low in Minhang District.However,low condom use rate leads to an increase in the risk of HSV-2 infection when either partner infected with HSV-2,suggesting increasing condom use between affianced couples.

The band patterns of Western bolt in different clinical stages of HIV-1 infection / 复旦学报（医学版）

Objective To investigate the band pattern characteristics of Western bolt (WB) by analyzingthe change of anti-virus antibodies from patients with different clinical stages of human immunodeficiency virus 1 (HIV-1) infection.Methods Antibodies were detected by WB test,CD4+ T cells by flow cytometer.Results Among 208 cases,193 male cases accounted for 92.79％,and 163 cases of men who have sex with men (MSM) accounted for 78.37％.The antibodies against viral protein gp160,gp120,gp41,p66,p51,p31,p24 showed high positive rates,and no significant different was detected across different clinical stages.The positive rate of p55 antibody,encoding by gag gene,was significantly higher in those HIV positive individuals infected via homosexual compared with HIV-1 positive individuals through heterosexual contact (P＜0.05).The 5 common WB bands patterns were as following:all bands①,missing p55②,missing p39③,missing p55 + p39④ and missing p39 + p55 + p17⑤.Primary stage infection group showed the highest appearance rate of all bands (44.2％).Conclusions The WB bands patterns and CD4+ T lymphocyte counts can help to judge immune status,determine disease stages and monitor disease progression.We should take effective measures for the MSM and floating population.

Role of microphthalmia-associated transcription factor in melanoma metastasis / 国际肿瘤学杂志

In recent years, the function of microphthalmia-associated transcription factor (MITF) is a hot field in melanoma.The abnormal expression of MITF is closely related to the occurrence and metastasis of melanoma.In addition, the down expression of MITF promotes its invasion.Studying the regulation of MITF and its related molecules and signaling pathways will let us further understand the molecule mechanism of malignant melanoma metastasis and provide help to exploit novel molecular targeted drug.

Strategies of strengthening the cultivation of medical graduate students' ability of clinical scien-tific research / 中华医学教育探索杂志

Graduate education is the maln approach to cultivate advanced medical talents. However, the current clinical research ability tralning for postgraduate students is poor. This article discusses about four possible reasons: the misunderstanding of the medical research, system defects of the endowment of scientific research fund, drawbacks of evaluation criteria, and deficiency of grad-uate student curriculum. In order to improve the clinical research ability of medical graduates, this article also discusses the possible solutions: clarifying the understanding, strengthening policy support, im-proving the evaluation methods, and perfecting the tralning course of the clinical medical research.

Interventional treatment of liver metastases / 中华消化外科杂志

Liver is one of the most predilection sites of hematogenous metastasis of a variety of malignances,especially for gastrointestinal tumors.Surgical resection was the first choice for the treatment of liver metastases,while it could not apply to patients who had multiple metastatic lesions or other organs involvement.Interventional technique has been widely recognized for the advantages of minimal trauma,little pain,quick recovery and obvious efficacy.

The abnormal expression of microRNA-25 in the serum of gastric cancer patients and its clinical signification / 中华消化杂志

Objective To investigate the abnormal expression of microRNA (miRNA)-25 in the serum of gastric cancer patients and its clinical significance. Methods In Xijing Hospital of Digestive Diseases,Fourth Military Medical University,86 gastric cancer patients with operation and completed follow-up data,70 gastric adenoma patients and 80 healthy controls were selected as study objects.Total RNA was isolated from the serum. After the stable and sensitive miRNA-25 absolute quantity detection method established,the serum levels of miRNA-25 in gastric carcinoma patients,gastric adenoma patients and healthy controls were tested according to this method. The expression differences of miRNA-25 in the serum of patients with gastric cancer and gastric adenoma and healthy controls were analyzed with statistic analysis,and the correlation between miRNA-25 expression level and clinic pathological features of gastric cancer was also analyzed. Results The expression level of miRNA-25 in the serum of gastric cancer patients (135. 6 fmol/μg total RNA) was significantly higher than that of gastric adenoma patients (67. 7 fmol/μg total RNA) and healthy controls (62. 2 fmol/μg total RNA)(P＜0. 01). The receiver operating characterisstic curve of miRNA-25 indicated that serum miRNA-25 with good specificity and sensitivity in gastric cancer diagnosis (AUC=0. 827). The serum level of miRNA-25 in gastric cancer patients with lymph node metastasis [(148. 3±10. 2) fmol/μg total RNA] or clinicopathological stage Ⅲ /Ⅳ patients [(146. 7±9.5) fmol/μg total RNA] was significantly higher than that of gastric cancer patients without lymph node metastasis [(120. 3±10. 1)fmol/μg total RNA] or clinicopathological stage Ⅰ/Ⅱpatients [(119. 4±12. 2) fmol/μg total RNA] (P＜0.05). The correlation statistical analysis result indicated that there was no significant difference in survival period between serum miRNA-25 highly expressed and lowly expressed gastric cancer patients (P＞0. 05).Conclusion Serum miRNA-25 testing maybe helpful in diagnosis and prognosis of gastric cancer.

Relationship between immunological characteristics and prognosis in children with acute myeloid leukemia / 中国当代儿科杂志

<p><b>OBJECTIVE</b>The prognostic significance of immunophenotyping in acute myeloid leukemia (AML) has been controversial. This study investigated the relationship of immunophenotypes with French-American-British (FAB) subtypes and chromosomal abnormalities and assessed the prognostic value of immunophenotyping in children with AML.</p><p><b>METHODS</b>From January 1998 to May 2003, 75 children with newly diagnosed AML were enrolled on protocol AML-XH-99. Immunophenotypes were measured with the flow cytometry. According to the McAbs used, the patients were classified into five groups: panmyeloid antigens (CD13, CD33, and MPO), myeloid-lineage associated antigens (CD14, CD15), lineage-specific antigens (CD41, GlyA), progenitor-associated antigens (CD34, HLA-DR) and lymphoid-associated antigens (CD19, CD7). The probability of event-free survival (EFS) was estimated by Kaplan-Meier analysis. The distributions of EFS were compared using the log-rank test. Chi-square analysis or Fisher exact test was used to compare the differences in the distribution of biologic presenting features. A Cox proportional hazards model was used to identify independent prognostic factors.</p><p><b>RESULTS</b>At least one of panmyeloid antigens CD13, CD33 and MPO was expressed in 72 patents (97.3%). Two or more panmyeloid antigens were expressed in 45 patients (60.8%). The proportion of children with AML expressing one or more of the lymphoid-associated antigens was 24.3%. Lymphoid-associated antigen CD19 was expressed by blast cells in most of FAB M2 patients. The patients with acute promyelocytic leukemia were characterized by the absence of HLA-DR and lymphoid-associated antigens CD19 and CD7. Monovariate analysis showed immunophenotypes were not related to the complete remission rate after the first induction course and the 5-year-EFS. Multivariate analysis suggested immunophenotyping had no independent prognostic value in AML.</p><p><b>CONCLUSIONS</b>Immunophenotyping can not be used independently in the evaluation of risk classification in children with AML. However, it is useful in the reorganization of special types of AML.</p>

Tandem application of flow cytometry and polymerase chain reaction for choice targets of minimal residual disease in childhood acute lymphoblastic leukemia / 中国当代儿科杂志

<p><b>OBJECTIVE</b>Minimal residual disease (MRD) is one of the most important prognostic factors in childhood acute lymphoblastic leukemia (ALL). Flow cytometry and PCR are two common techniques for examining MRD in ALL. This study aimed to identify MRD targets by tandem application of both techniques in children with ALL.</p><p><b>METHODS</b>From September 2001 to October 2003, 126 children with newly diagnosed ALL were enrolled on the treatment protocol ALL-XH-99. Tandem application of flow cytometry and PCR was performed to identify MRD targets in these patients.</p><p><b>RESULTS</b>1. Using sets of combined antibodies, immunophenotypic expression of leukemia cells was observed in 95 of 106 B-lineage ALL cases (89.6%). Only one aberrant immunophenotype was observed in 11 cases (11.6%) and most patients with B-lineage ALL (88.4%) expressed at least two suitable targets. 2. Using PCR technique, T-cell receptor (TCR) or immunoglobulin gene rearrangements were identified in 26 of 27 patients (96.3%). Two or more monoclonal/ bi-allelic gene rearrangements were identified in 17 cases (65.4%). The majority (70%) of T-lineage ALL cases contained TCRVgammaI-Jgamma1.3/2.3. Cross-lineage TCR rearrangements were found in 57.1% of cases with B-lineage ALL. 3. Suitable MRD targets of immunophenotypic abnormalities or antigen receptor gene rearrangements were detected in 121 patients (96.0%).</p><p><b>CONCLUSIONS</b>MRD targets were identified using tandem application of flow cytometry and PCR in almost of children with ALL. Cross-lineage TCR rearrangements and bi-allelic gene rearrangements were observed in many patients.</p>

Prognostic value of early treatment response in children with acute lymphoblastic leukemia: a single institution experience in Shanghai, China / 中国当代儿科杂志

<p><b>OBJECTIVE</b>Early response to therapy is one of the most important prognostic factors in childhood acute lymphoblastic leukemia (ALL). This study aimed to assess the prognostic value of morphological assessment of bone marrow blasts during remission induction and determination of minimal residual disease (MRD) after remission induction.</p><p><b>METHODS</b>From January 1998 to May 2003, 193 children with newly diagnosed ALL were enrolled on the ALL-XH-99 protocol. Blast cell count in the bone marrow was examined on day 19 of remission induction and by the completion of remission induction. MRD was measured with the flow cytometry. Event-free survival (EFS) was estimated by Kaplan-Meier analysis and the distributions of EFS were compared using the log-rank test. A Cox proportional hazards model was used to identify independent prognostic factors.</p><p><b>RESULTS</b>The 4-year EFS was significantly worse in patients with > or = 5% lymphoblasts in the bone marrow on day 19 as compared to those with <5% lymphoblasts on that date (42.59%+/- 14.28% vs 74.24%+/- 6.67%; p< 0.01). The 4-year EFS was significantly worse in patients with any amount of lymphoblasts in the bone marrow on the remission date as compared to that of other patients with no morphologically identifiable blasts (63.47%+/-9.23% vs 76.41%+/- 6.09%; p<0.05). The patients with MRD <0.01 had significantly better outcome than those with a level > or = 0.01% (15-month EFS:94.44%+/-5.40% vs 23.81%+/- 20.26%; p<0.01).</p><p><b>CONCLUSIONS</b>Early treatment response as assessed by morphological examination or minimal residual leukemia determination by flow cytometry has important prognostic significance, and can be performed in a resource-poor patient population.</p>

Effect of inhibition of hPOT1 by RNA interference on gene expression of TRF1, TRF2 and Tankyrase1 in human gastric cancer cell BGC823 / 中华消化内镜杂志

Objective To investigate the effect of silence of human protection of telomeres 1 (hPOT1), which was induced by RNA interference, on expression of telomeric repeat factor 1 (TRF1), telomeric repeat factor 2 (TRF2) and Tankyrase 1 in human gastric cancer cell BGC823. Methods The ex-pression of TRF1 ,TRF2 and Tankyrasel at mRNA level were determined by semi-quantitative RT-PCR. Re-sults Significant increase in expression of TRFI, marked decrease of TRF2 and Tankyrase1 at mRNA level were observed in cells of hPOT1 siRNA. Conclusion The significant increase in expression of TRF1 and the marked decease in TRF2 and Tnakyrasel at mRNA level after the inhibited expression of hPOT1 in human gastric cancer cell BGC823 indicate that hPOTI is highly correlated with the expressions of other three te-lomere-specific binding proteins.

Single nucleotide polymorphism in the promoter region of asparagine synthetase and its impact on the gene expression / 中国实验血液学杂志

High expression of cellular asparagine synthetase (AS) is a causative factor for the resistance of leukemic cell to L-asparaginase therapy. This study was aimed to find single nucleotide polymorphism (SNPs) in the promotor region of asparagine synthetase (AS) gene and to determine if these SNPs have influence on the transcriptional activity of AS promotor. The DNA sequences of AS promoter (pAS) from 82 leukemic children and 45 controls were determined to screen for SNPs in this region and the AS mRNA level in these samples was quantified using real-time PCR assay. The results indicated that three SNPs were found in the sequenced pAS fragment. They were -239C/T, -92G/A and -62A/T respectively. The frequency of -92A allele was higher in leukemic samples than that in nonleukemic control (P<0.05). The gene expression level differed among the individuals with genotype of the -92G/A SNP, and the descending order was as follows: GA heterozygote > AA homozygote > GG homozygote. It is concluded that some features in leukemia might associate with SNP on -92A locus, and this SNP in pAS can be one of the factors influencing transcriptional activity of AS gene. The existence of the -92A allele variant contributes to a high expression of AS gene.

Expression of the transcription factor PAX5 in childhood acute leukemic cells / 中国实验血液学杂志

To investigate transcription factor PAX5 expression characteristics in childhood acute leukemic cells, expression levels of PAX5 and CD19 mRNA in 6 hematological tumor cell lines and bone marrow cells of 6 normal children, 58 de novo patients and 4 relapse acute leukemic children, including 39 cases of B-ALL, 10 cases of T-ALL and 13 cases of AML, were detected by a real-time RT-PCR. The results showed that PAX5 and CD19 mRNA expression levels were 2.35% and 2.52% in Namalwa (B-cell lines) respectively, but almost not detectable in other T- and myeloid cell lines. Among clinical samples, expression of PAX5 mRNA in B-ALL was significantly higher than that in T-ALL and AML (P = 0.029 and P = 0.013 respectively). PAX5 expression was significantly lower in T-ALL and AML than that in normal controls. The difference of PAX5 mRNA expression levels between T-ALL and AML was not significant. Individual difference of PAX5 mRNA expression levels in children with B-ALL was great. Moreover, PAX5 mRNA expressions in de novo and relapse patients with B-ALL were significantly higher than those in remission (P = 0.011 and P = 0.006 respectively). As binding sites for B-cell specific activator protein have been identified in the promoter regions of CD19, the study found that in B-ALL, there was clear correlation between the expression levels of PAX5 and CD19, which was also studied by real-time RT-PCR. It is concluded that PAX5 transcripts are readily detectable and quantifiable in clinical materials with B-ALL by real-time RT-PCR. The strong PAX5 mRNA expression in some B-ALL can be considered to be particularly interesting for further analysis.

Analysis of prognostic variables in childhood acute myeloid leukemia / 中华血液学杂志

<p><b>OBJECTIVE</b>To assess the prognostic value of the biological features and therapy-related factors in childhood acute myeloid leukemia (AML).</p><p><b>METHODS</b>From January 1998 to May 2003, 75 patients with newly diagnosed AML were enrolled on the protocol AML-XH-99. Biological features at presentation [gender, age, white blood cells, platelet count, French-American-British (FAB) subtypes, cytogenetic abnormalities] and therapy-related factors [bone marrow (BM) blast cell counts at 48 h after the first induction course, complete remission (CR) rate after the first course of induction therapy] were analyzed. The probability of event-free survival (pEFS) was estimated by Kaplan-Meier analysis and the distributions of pEFS were compared using log-rank test. Chi-square analysis or Fisher exact test was used to compare differences in the distribution of presenting biological features. A Cox proportional hazards model was used to identify independent prognostic factors.</p><p><b>RESULTS</b>(1) Univariate analysis of the proportion of patients attaining CR after induction indicate that FAB M(5), BM blasts >or= 0.150 at 48 h after the first induction course and no response to the first induction course were associated with lower CR rates (P = 0.001, 0.011, 0.000 respectively). Univariate analysis also demonstrated that the 5-year pEFS for patients with age < 1 year or > 10 years, platelet count < 20 x 10(9)/L, FAB M(5), hepatomegaly, BM blasts >or= 0.150 at 48 h after the first induction course and no response to the first induction course, central nervous system (CNS) leukemia was unfavorable, while the outcome of patients with cytogenetic abnormalities of t (8; 21) or t (15; 17) were better. (2) Multivariate analysis suggested that cytogenetic abnormality of t (15; 17), achieved CR after the first induction course and no CNS leukemia were independent favorable prognostic factors.</p><p><b>CONCLUSIONS</b>Combined analysis of cytogenetic abnormalities with early treatment response has an important prognostic significance, and can predict outcomes.</p>

Prognostic value of minimal residual disease in childhood B-cell acute lymphoblastic leukemia / 中华血液学杂志

<p><b>OBJECTIVE</b>To assess the prognostic value of minimal residual disease (MRD) in childhood B-cell acute lymphoblastic leukemia (ALL) after induction chemotherapy.</p><p><b>METHODS</b>From September 2001 to October 2004, 102 patients with newly diagnosed B-ALL were enrolled in protocol ALL-XH-99. MRD after induction therapy, before high-dose methotrexate and early intensification as well as at 1 year and 2 year maintenance therapy was detected by multiparameter-flow-cytometry (MP-FCM).</p><p><b>RESULTS</b>(1) The probability of 39-month event-free survival (EFS) for patients with a level of MRD < 10(-4), was significantly higher than for those with a higher MRD [(83.00 +/- 9.90)% vs 0.00%, P < 0.01]. (2) Univariate analysis indicated that the MRD level at achieving complete remission (CR) had no relationship with the biologic features at presentation (gender, age, white blood cells and cytogenetic abnormalities), but did with Philadelphia chromosome, the time reaching CR, ALL-XH-99 risk group and lymphoblasts in bone marrow on day 19 after induction therapy (P < 0.05). (3) Multivariate analysis suggested that MRD level after the first induction course was an independent prognostic factor (hazard ratio, 5.381; 95% CI 0.004 to 0.624; P < 0.05).</p><p><b>CONCLUSION</b>The MRD level at achieving CR is one of important prognostic factor in the treatment of childhood B-cell ALL, and might be used to assess the early treatment response.</p>