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>

Meta-analysis on efficacy and safety of Brucea javanica oil emulsion injection combined with chemotherapy for patients with advanced gastric carcinoma / 中国中药杂志

Eligible studies were searched in Cochrane library, Pubmed, Medline, CBM, CNKI and VIP databases from establishment to June 2014. Two researchers independently identified 7 randomized controlled trials (RCTs) and extracted data of Brucea javanica oil emulsion injection combined with chemotherapy. Based on the published studies, the researchers analyzed them by RevMan 5.2 software and investigated the efficacy and safety of Brucea javanica oil emulsion injection combined with chemotherapy for patients with advanced gastric cancer by Meta analysis. Meta analysis showed that, compared with the simple chemotherapy, Brucea javanica oil emulsion injection combined with chemotherapy could increase objective response rate by 43%(RR=1.43, P<0.001). In addition, the incidence of neutropenia (RR=0.56, P<0.001), thrombocytopenia (RR=0.64, P=0.02), nausea, vomit (RR=0.66, P=0.002) decreased in these patients. However, the quality of life was not improved significantly in gastric carcinoma patients with combined therapy (RR=1.36, P=0.07). The paper suggested Brucea javanica oil emulsion injection combined with chemotherapy could increase efficacy and safety, which might be a promising therapy for patients with advanced gastric cancer.

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>

Survey on iodine nutrient in vulnerable population in Linxia Hui Autonomous Prefecture of Gansu in 2006 / 中国地方病学杂志

Objective To assess iodine nutrient levels of vulnerable population in Linxia Hui Autonomous Prefecture of Gansu. Methods Local pregnant, lactation, child-bearing age women and 0 - 3 years old infants were selected. The urinary iodine (UI) were determined by arsenic-Ce catalytic spectrophotometry (WS/T 107-1999) and salt iodine content was determined using direct titration method (GB/T 13025.7-1999). The development quotient (DQ) among 0 - 3 years old infants were surveyed by the scales of neuropsychologists development among 0 - 6 years old, and their body height and weight were then investigated. Results The consumption and coverage rates of iodized salt at household level were all below than 90% in 5 counties among 8 counties. The median urine iodine (MUI) among pregnant, lactation, child-beating age women and 0 - 3 years old infants were 90.17, 89.28, 84.85 and 107.28 μg/L, respectively. The UI proportion less than 50 μg/L were 29.6%(278/938), 30.7%(239/778), 32.2% (265/824), and 23.9%(252/1056), respectively. The UI proportion equal or more than 50 μg/L and less than 100 μg/L were 25.1%(235/938), 24.0%(187/778), 23.7%(195/824), 23.7%(250/1056). MUI in pregnant were all less than 150 μg/L in 8 counties, and MUI in lactation women were less than 100 μg/L in 6 counties. The DQ median of infants 0 - 3 years old was 93.0, and 59.9%(395/659), 34.4%(227/659) and 5.6%(37/659)had a DQ below middle, at middle and above middle, respectively. Forty point seven percent (266/654), 50.2%(328/654) and 9.1% (60/654) had a body height below middle,at middle and above middle, respectively. Thirty-five percent (232/663), 51.3%(340/663) and 13.7%(91/663) had a body weight below middle, at middle and above middle, respectively. Conclusions The local qualified iodized salt consumption rate and iodized salt coverage rate are still low. The urine iodine level is below than the reference value recommended. The iodine nutrient is not enough among iodine deficiency disorder vulnerable population, especially in pregnant and lactation women. Infants growth development is retarded.