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Objective To observe the adverse effects of two different high-dose methotrexate(MTX) in pediatric acute lymphoblastic leukemia.Methods Totally 25 cases acute lymphoblastic leukemia children were grouped according to the risk factor,the low-risk group(13 patients) received MTX 3 g/m2 continuous infusion and high-risk group(12 patients) received MTX 5 g/m2 continuous infusion.Using Calcium Folinate(CF) 36 h after first dose MTX (1/6 total dose) ,then compare the incidence rates and the severity of the MTX of adverse effects.Results Gastrointestinal syptoms, hver damage, mucosal damage were the most common adverse effects after high-dose MTX infusion, the two groups had no significant difference (P ＞ 0.05).Conclusion The incidence rates and the severity of adverse reactions of high dose MTX were related directly with the level and the persistencetime of the plasma concentration.
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Objective: To describe the clinical characteristics with long-term prognosis in patients with mid-ventricular obstructive hypertrophic cardiomyopathy (MVOHCM). Methods: A total of 66 MVOHCM patients treated in our hospital were retrospectively studied for their morbidity, clinical characteristics and mortality. The cumulative survival rate was calculated by Kaplan-Meier method; the risk factors for cardiac death and cardiovascular events were analyzed by uni- and multivariate Cox proportional hazard model. Results: There were 66 (2.74%) patients suffering from MVOHCM among 2413 patients of hypertrophic cardiomyopathy and the average diagnostic age was (40.16 ± 14.64) years. With (7.30 ± 6.25) years of follow-up study, the cardiovascular mortality was 13.6% and unexplained syncope (HR=13.37, 95% CI: 1.65-114.46, P=0.015) was the independent predictor for cardiovascular death. There were 45.45% (30/66) patients experienced at least 1 time of cardiovascular event and the most frequent one was non-sustained ventricular tachycardia (NSVT); 19.70% (13/66) of patients combined with apical aneurysms, and they were more inclined to experience NSVT. Conclusion: MVOHCM patients usually have unfavorable prognosis with the higher incidence of cardiovascular events, some patients may develop apical aneurysm. The early diagnosis of MVOHCM is important for appropriate treatment.
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<p><b>OBJECTIVE</b>To compare the clinical features and long-term outcome of patients with midventricular obstructive hypertrophic cardiomyopathy (MVOHCM) and patients with apical hypertrophic cardiomyopathy (AHCM) in China.</p><p><b>METHODS</b>This retrospective study analyzed clinical data of 66 patients with MVOHCM and 263 patients with AHCM from a consecutive single-center cohort consisting of 2 413 patients with HCM. The clinical features, cardiovascular mortality and morbidity were compared between the two groups.</p><p><b>RESULTS</b>Compared with the AHCM, patients in the MVOHCM group was younger and more likely to be symptomatic over a mean follow-up of 7 years. The proportion of MVOHCM and AHCM were 2.7% (66/2 413) and 10.9% (263/2 413) (P < 0.001), respectively, in this cohort. Cardiovascular mortality of the two groups were 13.6% (9/66) and 0.8% (2/263) (P < 0.001), and cardiovascular morbidity of the two groups were 53.0% (35/66) and 14.4% (38/263) (P < 0.001).</p><p><b>CONCLUSION</b>MVOHCM is rarer, but the clinical manifestations and long-term outcomes are worse compared with AHCM in this patient cohort.</p>