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Objective:To analyze the risk factors for asparaginase-associated pancreatitis (AAP) in children with acute lymphoblastic leukemia (ALL) after treatment with pegaspargase and evaluate the predictive value of pediatric sequential organ failure assessment (SOFA) score, pediatric acute pancreatitis severity (PAPS) score, Ranson′s score and pediatric Ministry of Health, Labour and Welfare of Japan (JPN) score for severe AAP.Methods:Cross-sectional study.The clinical data of 328 children with ALL who received pegaspargase treatment in the Department of Pediatric Hematology, Zhujiang Hospital, Southern Medical University from January 2014 to August 2021, as well as their clinical manifestations, laboratory examinations, and imaging examinations were collected.The SOFA score at the time of AAP diagnosis, PAPS score and Ranson′s score at 48 hours after AAP diagnosis, and JPN score at 72 hours after AAP diagnosis were calculated, and their predictive value for severe AAP was evaluated by the receiver operating characteristic (ROC) curve.Results:A total of 6.7%(22/328) of children had AAP, with the median age of 6.62 years.AAP most commonly occurred in the induced remission phase (16/22, 72.7%). Three AAP children were re-exposed to asparaginase, and 2 of them developed a second AAP.Among the 22 AAP children, 16 presented with mild symptoms, and 6 with severe symptoms.The 6 children with severe AAP were all transferred to the Pediatric Intensive Care Unit (PICU). There were no significant differences in gender, white blood cell count at first diagnosis, immunophenotype, risk stratification, and single dose of pegaspargase between the AAP and non-AAP groups.The age at diagnosis of ALL in the AAP group was significantly higher than that in the non-AAP group ( t=2.385, P=0.018). The number of overweight or obese children in the AAP group was also higher than that in the non-AAP group ( χ2=4.507, P=0.034). The areas under the ROC curve of children′s JPN score, SOFA score, Ranson′s score, and PAPS score in predicting severe AAP were 0.919, 0.844, 0.731, and 0.606, respectively.The JPN score ( t=4.174, P=0.001) and the SOFA score ( t=3.181, P=0.005) showed statistically significant differences between mild and severe AAP. Conclusions:AAP is a serious complication in the treatment of ALL with combined pegaspargase and chemotherapy.Older age and overweight or obesity may be the risk factors for AAP.Pediatric JPN and SOFA scores have predictive value for severe AAP.
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Objective@#To explore the clinical application of facial artery perforator flap in repairing medium-size midfacial defects.@*Methods@#Sixteen patients with facial tumors or trauma were admitted in the Affiliated Hospital of Zunyi Medical University, from October 2017 to March 2018. The patients were 41—74 years of age, including 8 males and 8 females. The tissue defects were caused by basal cell carcinoma(BCC, n=10), trauma (n=4), and squamous cell carcinoma (SqCa, n=2). The size of tumor and trauma ranged from 0.3 cm×2 cm to 2 cm×4 cm. Patients with skin tumors undergone extended radical resection, according to the nature of the tumor. Debridement was performed routinely in patients with trauma. Facial artery perforator flap was designed based on the size and shape of defect area. The scar of donor site was as parallel or hidden in the nasolabial groove. The perforator branch of the lateral nasal artery was used as the pivot point, to cover the wound surface without tension. The ipsilateral secondary relay flap pedicled with the perforator of the nasal artery was designed, which was in triangular shape and slightly larger in size than the primary flap. The pedicle was located in the middle of the flap, then the flap was pushed to cover the donor site of primary flap. The postoperative results were evaluated by patients.@*Results@#All primary and secondary relay skin flaps survived. The follow-up period of the first stage was 3—12 months, with an average of 7.5 months. There was no obvious scar, no eyelid eversion or angular deviation, and no recurrence of tumor was observed. The primary and secondary flaps have similar appearance and matched color with normal skin. Ten patients were very satisfied with the surgical outcome, and 6 were satisfied, at the latest follow-up.@*Conclusions@#The facial artery perforator relay skin flap is an alternative method to repair medium facial defect.
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Aim To explore the protective effects of lithium chloride ( LiCl ) on neurous injuries and phos-phorylation of tau protein at serine262 induced by okada-ic acid( OA) . Methods The neuroblastoma SK-N-SH cells were differentiated by all-trans-retinoic acid ( AT-RA) . The differentiated SK-N-SH cells were treated with OA to establish the Alzheimer′s disease cellular model. SK-N-SH cells′ viability and proliferation were measured by SRB test. Giemsa staining was used to observe cell morphology. The neurite length of SK-N-SH cells was measured by Image-Proplus software. Syn-aptophysin and phosphorylated tau protein at serine262 expression levels were tested by Western blot. Results The SK-N-SH cells which were treated with 10 μmol ·L-1 ATRA for 7 days displayed mature neuronal fea-tures. The synaptic length of SK-N-SH cells became longer. And the levels of serine262 phospho-tau was sig-nificantly elevated. 20~100 nmol·L-1 OA effectively inhibited the viability of differentiated SK-N-SH cells in a concentration-dependent manner and in a time-de-pendent manner. The OA treatment induced obvious synaptic atrophy in differentiated SK-N-SH cells. And the phosphorylation level of tau protein serine262 also greatly increased. The pretreatment with 10 mmol · L-1 LiCl significantly ameliorated the synaptic atrophy, the decrease of synaptophysin expression and the in-crease of tau phosphorylation at serine262 induced by OA in differentiated SK-N-SH cells. Conclusion LiCl could effectively inhibit OA-induced synaptic atro-phy in differentiated SK-N-SH cells, and it could also result in the increase of synaptophysin expression and the decrease of the phosphorylation of tau protein at serine262 .
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@#An expression vector pET-28a-mGM-CSF-X10-βhCGCTP37 plasmid containing the βhCG and mGM-CSF gene was designed and constructed. The fusion protein was induced by lactose and purified by ammonium sulfate precipitation and DEAE-cellulose anion exchange column. Then dendritic cells(DC)in C57BL/6J mice were extracted and sensitized by the fusion protein to obtain DC vaccine. The DC vaccine was inoculated to C57BL of / 6J mice with prostate cancer RM-1. The results indicated that the anti-tumor effects of DC group and DC combined with paclitaxel(DP)group were superior to that of paclitaxel(Pac)group(P< 0. 01), and the anti-tumor effect of DP group was better than that of DC group. Thus, the constructed DC vaccine can inhibit the growth of prostate cancer, and have synergistic anti-tumor when used with paclitaxel.