Optimal surgical timing and treatment of thumb duplication in children / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the optimal surgical timing and treatment of congenital duplication of the thumb in children.</p><p><b>METHODS</b>A clinical study was performed on 154 fingers of the 132 patients (including 85 males, 47 females;mean age (1.53 +/- 2.47) years; ranged from 2 months to 13 years). Duplicated thumbs were surgically treated from December 2007 to February 2012. All patients underwent detailed physical examination and radiological assessment. Surgical methods should be selected according to the age, Wassel classification and deformity. The operation steps included resection of the most hypoplastic thumb, followed by skin flap plasty, tendon shift (transplantation) , reconstruction of collateral ligament and articular capsule. 11 cases over the age of 6 underwent osteotomy discretion as appropriate.</p><p><b>RESULTS</b>A total of 117 fingers of the 104 patients were followed up for an average 36. 7 months (range,6-55 months). We adopted upgrade Tada standard to evaluate the follow-up results as excellent in 77 thumbs, good in 21 thumbs, fair in 15 thumbs and poor in 4 thumbs. Three thumbs appeared secondary angular deformity 2 years after operation and one thumb appeared residual osteoepiphysis in the radial side of metacarpophalangeal joint 3 years after operation. The appearance and the function were almost normal after second operation.</p><p><b>CONCLUSIONS</b>The optimal surgical timing of congenital duplication of thumb should be based on the appearance of thumb ossification center. The surgical timing of Wassel type- I and II should be chosen at 1. 5 years old when the ossification center of distal phalanx appears, Wassel type-III and IV should be chosen at 1 year old when the ossification center of proximal phalanx appears, Wassel type-V and VI should be chosen at 2. 5 years old when the ossification center of metacarpal appears, and Wassel type-VII should be chosen at 2. 5 years old. The surgical method should be selected on individualized principle. The key points are reconstruction of collateral ligament, tendon and articular capsule and correction of ulnar deviation (or radial deviation).</p>

Relationship between expression of GYPC and TRIP3 genes and prognosis of acute lymphoblastic leukemia in children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the relationship of GYPC and TRIP3 gene expression and the prognosis of acute lymphoblastic leukemia (ALL) in children in order to explore the molecular biological mechanisms of recurrence and remission of ALL.</p><p><b>METHODS</b>Thirty-eight newly diagnosed ALL children were enrolled. Of the 38 patients, 31 achieved complete remission (CR) and 12 relapsed. Semi-quantitative RT-PCR was employed to measure blood GYPC and TRIP3 gene expression. Twenty blood samples from normal children were used as controls.</p><p><b>RESULTS</b>Blood GYPC expression in newly diagnosed ALL children was significantly higher than that in the control group (p<0.01) and the CR group (p<0.01). The expression of GYPC gene in the CR group was similar to that in the control group. Other than the control group (p<0.01) and the CR group (p<0.01), the GYPC expression of the relapse group was significantly higher than that in the newly diagnosed group (p<0.01). The CR group showed lower GYPC gene expression than the nonjremission group before treatment (p<0.05). Blood expression of TRIP3 gene in the newly diagnosed and the relapse groups was significantly lower than that in the control group (p<0.05). The CR group had increased TRIP3 gene expression compared with the control group (p<0.01) as well as the newly diagnosed and the relapse groups (p<0.01). Of the 38 newly diagnosed ALL children, the patients with positive TRIP3 expression showed higher remission rate than those with negative TRIP3 (p<0.05). The TRIP3 gene expression before treatment in patients who achieved CR was higher than that in non-remission patients (p<0.05).</p><p><b>CONCLUSIONS</b>A high GYPC gene expression is associated with an unfavorable outcome, in contrast, a high TRIP3 gene expression is associated with a favorable outcome in childhood ALL.</p>