Clinical analysis of leukemia secondary to malignant solid tumor in children / 国际儿科学杂志

Objective:To investigate the clinical characteristics, diagnosis and treatment and prognosis of children with leukemia secondary to malignant solid tumor.Methods:From January 2012 to January 2022, a total of 2 275 children under 15 years of age with malignant solid tumor were admitted to the First Affiliated Hospital of Zhengzhou University.Six children diagnosed with secondary leukemia after follow-up to August 1, 2022 were selected as the study objects.Their clinical data were retrospectively analyzed and the literature was reviewed.Results:(1)A total of 2 275 children with malignant solid tumors included 1 369 males and 906 females.There were 6 children with secondary leukemia, with an incidence rate of 0.26%, including 4 males and 2 females.The age of onset of solid tumor was 5.5(2.8, 9.7)years, and the age of secondary leukemia was(9.1±3.9)years, and the interval between them was(26.2±17.3)months.(2)Malignant solid tumor types: according to the time of secondary leukemia, there were hip malignant rhabdomyoma in 1 case, intracranial medulloblastoma in 2 cases, intracranial and pelvic malignant germinoma in 1 case respectively, and pancreatic blastoma in 1 case.Intracranial lesion biopsy was performed in 1 case, and tumor resection was performed in the other 5 cases.Three patients with intracranial tumors underwent local tumor bed, whole brain and spinal radiotherapy.All the 6 children received chemotherapy, and the main chemotherapy drugs were doxorubicin, vincristine, cyclophosphamide, platinum, ifosfamide, etoposide, bleomycin, temozolomide, etc.Complete remission was achieved in 3 cases, partial remission in 1 case, stable disease in 1 case, and disease progression in 1 case.(3)The secondary leukemia types were as follows: acute myeloid leukemia(AML)M5 in 3 cases, M1 in 1 case, M2 in 1 case, and acute B-lymphoblastic leukemia(B-ALL)in 1 case.All six cases refused hematopoietic stem cell transplantation(HSCT).One case with B-ALL gave up after receiving hydroxyurea and dexamethasone.Five cases with AML received chemotherapy according to the AML-2006 Protocol of Hematology Group of Pediatrics Society of Chinese Medical Association.The outcome of the disease was as follows: 2 cases died early, 4 cases achieved complete remission after 1 ~ 2 courses of chemotherapy, among which 2 cases did not continue treatment after 3 courses of chemotherapy due to pulmonary infection, deep mycosis, osteomyelitis, etc, and then recurred and died.By the end of follow-up, 2 cases survived and continued treatment, of which 1 case relapsed.After the diagnosis of secondary leukemia, the 1-year overall survival rate of the 6 cases was(33±26)%.Conclusion:Leukemia secondary to malignant solid tumors in children is rare and mostly occurs in older children.The pathogenesis is related to genotoxic injury caused by exposure to chemotherapy or radiotherapy, and the prognosis is unfavourable.HSCT after chemotherapy combined with immunotherapy is the best treatment strategy.

Clinical study of Voriconazole suspension formula for prevention and treatment of invasive fungal infection during allogeneic hematopoietic stem cell transplantation in children / 中华实用儿科临床杂志

Objective:To investigate the clinical efficacy, safety and compliance of Voriconazole suspension formula on the prevention and treatment of invasive fungal infection (IFI) in children with allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods:Clinical data of 25 children treated Voriconazole suspension formula for the prevention and treatment of IFI during the period of allo-HSCT in the Department of Pediatrics, the First Affiliated Hospital of Zhengzhou University from August 1, 2020 to April 30, 2021 were retrospectively analyzed.The plasma trough concentration of Voriconazole was detected by high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS), and the genotype of CYP2C19 was detected by polymerase chain reaction-restriction fragment length polymorphism (RFLP). The effect of CYP2C19 genotype on Voriconazole trough concentration was analyzed by rank-sum test, and Fisher′ s accurate test was used to analyze the influence of severity of gastrointestinal mucositis on serum trough concentration of Voriconazole in children with allo-HSCT. Results:A total of 25 children, including 18 males and 7 females were recruited.The median age at allo-HSCT was 6 (2-13) years.After initial administration of conventional dose of Voriconazole suspension formula during transplantation, plasma trough concentration of Voriconazole was intermittently monitored.Only 13 cases (52.0%) reached the target plasma trough concentration, 11 cases(44.0%) reached the target plasma trough concentration after adjusting the dose according to the plasma concentration, and 1 cases(4.0%) failed to reach it after increasing the dose twice.Genotype detection of CYP2C19 was performed in 20 children, involving 4 cases of poor metabolizers (PM), 9 cases of intermediate metabolizers (IM), 6 cases of extensive metabolizers (EM), and 1 case of ultra extensive metabolizer (UEM). A significant difference in plasma trough concentration was detected among all groups ( F=24.012, P<0.01). During the transplantation, 12 cases developed mild to moderate gastrointestinal mucositis, and 7 cases had severe gastrointestinal mucositis.The stan-dard rate of plasma trough concentration in children with severe gastrointestinal mucositis (1/7 cases, 14.3%)was significantly lower than those with mild to moderate gastrointestinal mucositis (9/12 cases, 75.0%) ( P=0.02). Five children (71.4%) with severe gastrointestinal mucositis could reach the target trough concentration after increasing the drug dose, suggesting that severe gastrointestinal mucositis had a great influence on the plasma concentration of Vorico-nazole suspension.The incidence of IFI in 25 children with allo-HSCT was 0, and the compliance of children taking Voriconazole dry suspension was 100.0%.The incidence of adverse reactions was 24.0% and all adverse reactions were relieved after symptomatic treatment. Conclusions:The plasma concentration of Voriconazole varies greatly among children and in different states of the same patient.Therefore, it is necessary to monitor the trough concentration of the drug and adjust the drug dose.The use of Voriconazole suspension formula for the prevention and treatment of fungal infection during allo-HSCT in children is clinically safe and effective, with a good compliance in children.

Determination of formononetin and harmful elements of heavy metals in Jinji Pill / 国际中医中药杂志

Objective:To use the high performance liquid chromatography method to determine the content of formononetin in Jinji Pills and by using atomic absorption spectrophotometry,method to determine the harmful elements of heavy metal in Jinji Pills in orer to provide the scientific foundation for improving its quality standards and safety evaluation. Methods:Use Waters XBridge? C18 column (4.6 mm × 250 mm, 5 μm), set mobile phase at acetonitrile-1% phosphoric acid solution (27:73), flow rate 1.0 ml/min, column temperature 30 ℃, detection wavelength 249 nm, column temperature 30 ℃; Lead (Pb) and cadmium (Cd) was detected by graphite furnace method; arsenic (As) was detected by cold steam series graphite furnace method; copper (Cu) was detected by flame method; mercury (Hg) was detected by cold steam method.Results:The formononetin had a good linear relationship between 0.02-2.01 μg, the recovery rate was 98.5%, RSD was 1.53%. Lead (Pb) recovery rate was 103.6%, cadmium (Cd) recovery rate was 95.7%, arsenic (As) recovery rate was 92.4%, mercury (Hg) recovery rate was 104.9%, copper (Cu) recovery rate was 112.5%. Conclusion:This method is of accuracy, specificity, high sensitivity and good reproducibility, which could provide strong evidence for quality improvement and safety use of Jinji pill.

Clinical efficacy of Ruxolitinib in combination with Methylprednisolone as a bridge to allogeneic hematopoietic stem cell transplantation for relapse/refractory Epstein-Barr virus-associated hemophagocytic syndrome in pediatric patients / 中华实用儿科临床杂志

Objective:To explore the clinical efficacy and safety of Ruxolitinib, a Janus kinase inhibitor, in combination with Methylprednisolone as a bridge to allogeneic hematopoietic stem cell transplantation (allo-HSCT) for relapsed/refractory Epstein-Barr virus-associated hemophagocytic syndrome (EBV-AHS) in pediatric patients.Methods:The clinical data of 4 patients with relapsed/refractory EBV-AHS treated with Ruxolitinib in combination with Methylprednisolone as a bridge to allo-HSCT at the Department of Pediatrics, the First Affiliated Hospital of Zhengzhou University from August 2018 to February 2020 were retrospectively analyzed, and the disease characteristics, diagnosis and treatment process, clinical experience and related research progress were analyzed and summarized.Results:Among 4 patients with relapsed/refractory EBV-AHS, 2 patients were treated with low-dose Ruxolitinb in combination with Methylprednisolone for 6-10 weeks after partial remission.The disease did not progress, and they survived after being bridged to allo-HSCT.One patient was treated with large-dose Ruxolitinib in combination with Methylprednisolone due to the intolerance to chemotherapy, with the biochemical indicators of hemophagocytic syndrome significantly improved, and then the bridging to allo-HSCT was performed 2 months ago and this patient survived.One patient with EBV-AHS relapsed was relieved by chemotherapy again, then was given maintenance therapy with Ruxolitinib and Methylprednisolone, but the condition still progressed and the treatment was ineffective.This patient underwent allo-HSCT for salvage treatment more than 1 year ago and survived.Except that 1 patient developed mild anemia, the other 3 patients had no significant Ruxolitinib-related toxicities.Conclusions:Ruxolitinib in combination with Methylprednisolone can be safely employed as a salvage treatment for pediatric patients with relapsed/refractory EBV-AHS and a bridge to allo-HSCT, which has favorable safety, efficacy and tolerance in clinical practice.

Acute myeloid leukemia combined with lymphoblastic lymphoma in children: report of one case and review of literature / 白血病·淋巴瘤

Objective:To raise awareness of acute myeloid leukemia (AML) combined with lymphoblastic lymphoma (LBL) in children.Methods:The clinical characteristics, diagnostic methods, treatment plans and prognosis of a child with AML combined with LBL who was admitted to the First Affiliated Hospital of Zhengzhou University in April 2016 were retrospectively analyzed, and the relevant literature was reviewed.Results:The patient was an 11-year-old boy with fever, abnormal hemogram and cervical lymph node enlargement as clinical manifestations. A biopsy of the cervical lymph node was performed and the patient was diagnosed as T-lymphoblastic lymphoma (T-LBL). After the bone marrow morphology, immunology, cytogenetics and molecular biology (MICM) classification examination, the diagnosis was AML. The patient met the diagnostic criteria of two diseases at the same time, and thus he was confirmed as AML combined with T-LBL. AML chemotherapy regimens were given, and the patient achieved complete remission and disease-free survived.Conclusions:AML with LBL is extremely rare in children. The diagnosis mainly depends on MICM classification examination of bone marrow and pathological examination of lymph nodes. There is currently no standard treatment scheme, and the prognosis is extremely poor. AML chemotherapy followed by bridging hematopoietic stem cell transplantation is the best treatment option for these patients.

Association between Toll-like receptor 4 and pancreatic cancer / 临床肝胆病杂志

Toll-like receptor 4 (TLR4) is a key regulator of innate and adaptive immune response. The role of TLR4 in pancreatic diseases is a research hotspot in recent years, and a large number of studies have shown that TLR4 is closely associated with pancreatic cancer. This article mainly discusses the abnormal expression and regulation mechanism of TLR4 in pancreatic cancer and its potential in cancer treatment, so as to provide new ideas for the pathogenesis and treatment of pancreatic cancer.

Clinical effect of laparoscopic splenectomy and pericardial devascularization in portal hypertension patients with Child-Pugh A/B liver function / 临床肝胆病杂志

ObjectiveTo investigate the clinical effect of laparoscopic splenectomy and pericardial devascularization (LSPD) in patients with portal hypertension and the long-term effect of LSPD. MethodsA total of 40 portal hypertension patients with Child-Pugh A/B liver function who received LSPD in The First Hospital of Jilin University from August to December 2017 were enrolled as surgical group, and 44 portal hypertension patients with Child-Pugh A/B liver function who received conservative treatment during the same period of time was enrolled as internal medicine group. The patients were followed up to June 30, 2019, and liver function parameters, upper gastrointestinal bleeding, and portal vein thrombosis were recorded for all patients at each time point. The t-test was used for comparison of normally distributed continuous data between two groups; an analysis of variance was used for comparison between multiple groups, and the Bonferroni test was used for further comparison between two groups. The Kruskal-Wallis H test was used for comparison of continuous data with skewed distribution; between multiple groups, and the Mann-Whitney U test was used for further comparison between two groups. The chi-square test was used for comparison of categorical data between groups. ResultsAt 6, 12, and 24 months after discharge, compared with the internal medicine group, the surgical group had a significantly higher level of cholinesterase (t=3.527, 3.849, and 5.555, all P＜0.05) and a significantly lower Child-Pugh score (t=2.498, 2.138, and 2.081, all P＜0.05). Compared with the internal medicine group at 12 and 24 months after discharge, the surgical group had a significantly higher level of albumin (t=3.120 and 2.587, both P＜0.05) and a significantly lower incidence rate of upper gastrointestinal bleeding (χ2=4.947 and 5.155, both P＜0.05). At 24 months after discharge, the surgical group had a significantly lower number of patients who had a significant increase in alpha-fetoprotein level than the internal medicine group (χ2=4.648, P=0.031). At 12 months after discharge, the surgical group had a significantly higher incidence rate of portal vein thrombosis than the internal medicine group (χ2=4.395, P=0.036). The surgical group had significant improvements in albumin (F=2.959, P=0.013), cholinesterase (F=11.022, P＜0001), prothrombin time (H=94.100, P＜0.001), and Child-Pugh score (F=3.742, P=0.003) from admission to 12 and 24 months after surgery. ConclusionIn portal hypertension patients with Child-Pugh A/B liver function, LSPD can improve liver function and reduce the incidence rate of upper gastrointestinal bleeding, and the high incidence rate of portal vein thrombosis can be effectively reduced by oral aspirin and rivaroxaban.

Current status of the treatment of common bile duct stones after Billroth Ⅱ subtotal gastrectomy / 临床肝胆病杂志

Common bile duct stones are a common of digestive system disease, and as one of the long-term complications after Billroth II subtotal gastrectomy, it has attracted more and more attention from clinicians. Common bile duct stones after Billroth II subtotal gastrectomy have a complex pathogenesis, including neurological, humoral, and mechanical factors. Even though there are many methods to remove stones, there are still controversies over the selection of digestive endoscopy, surgical operation, or percutaneous transhepatic approach. Clinicians should fully evaluate the specific conditions of patients and formulate individualized treatment regimens to achieve the best treatment outcome.

Risk factors for pancreatic fistula after laparoscopic pancreaticoduodenectomy / 中华普通外科杂志

Objective:To investigate the preoperative and intraoperative risk factors of clinical pancreatic fistula after laparoscopic pancreaticoduodenectomy (LPD).Methods:Clinical data of 100 patients undergoing LPD at the Second Department of Hepatobiliary and Pancreatic Surgery of the First Hospital of Jilin University from Jan 2019 to May 2019 were studied.Results:The total incidence of pancreatic fistula was 8%, and the incidence of clinical pancreatic fistula (grade B, C) was 6%. Univariate analysis found that gender (male), preoperative pancreatic plain CT value <33HU, soft texture of the pancreas, long operation time, alcoholic consuming history may be risk factors for pancreatic fistula after LPD( P<0.05), and further multivariate analysis found gender (male), preoperative pancreatic plain CT value <33 HU, soft texture of the pancreas were independent risk factors for clinical pancreatic fistula after LPD( P<0.05). Conclusions:Male patients, preoperative pancreatic plain CT value <33HU, soft texture of the pancreas were respectively independent risk factors predicting post-LPD clinical pancreatic fistula.

Management of patients with gallstones and acute cholecystitis during the epidemic of coronavirus disease 2019 / 临床肝胆病杂志

At present, the epidemic of coronavirus disease 2019 is still serious, and the prevention and control of this epidemic is taken seriously throughout the country. As one of the most common acute abdominal diseases in hepatobiliary surgery, gallstones with acute cholecystitis has sudden onset and rapid progression and thus requires early diagnosis and timely and effective treatment. During the prevention and control of the epidemic, patients should be admitted properly to reduce nosocomial infection. Gallstones with acute cholecystitis is often accompanied by pyrexia, and therefore, the presence or absence of severe acute respiratory syndrome coronavirus 2 infection should be clarified. Treatment regimen should be selected appropriately and individualized treatment measures should be developed. While ensuring that patients receive timely and effective diagnosis and treatment, hospitals should adopt prevention and control measures for patients and their caregivers to reduce nosocomial infection. The personal protection of medical personnel should also be taken seriously, and scientific measures should be implemented to guarantee their safety.

Application of Hong's pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy on 184 patients / 中华肝胆外科杂志

Objective@#To evaluate the efficacy and safety of Hong's pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy.@*Methods@#A retrospective analysis was carried out on 184 patients who underwent laparoscopic pancreaticoduodenectomy using Hong's pancreaticojejunostomy (the Hong’s pancreaticojejunostomy group) compared with 100 patients who underwent laparoscopic pancreaticoduodenectomy using traditional pancreaticojejunostomy (the traditional pancreaticojejunostomy group) at Department of Second Hepatobiliary and Pancreatic Surgery, the First Bethune Hospital of Jilin University, from April 2016 to December 2018. The differences between the two anastomotic methods in operation time, pancreaticojejunostomy time, intraoperative blood loss, postoperative hospital stay, postoperative complications, and incidences of pancreatic fistula were compared.@*Results@#The operation time, pancreaticojejunostomy time and intraoperative blood loss of the Hong's pancreaticojejunostomy group were significantly less than the traditional pancreaticojejunostomy group [(278.2±49.3) min vs. (337.3±67.4) min, (33.7±6.6) min vs. (46.8±8.5) min, (123.1±44.7) ml vs. (203.8±138.6) ml], respectively, (all P<0.05). There were no significant differences in postoperative hospital stay and pancreatic fistula rates between the two groups (all P>0.05).@*Conclusions@#Hong's pancreaticojejunostomy was safe, rapid and effective compared with traditional pancreaticojejunostomy. It did not increase the incidence of pancreatic fistula.

Effect of Yisui Shengxue Granules on CD4+ CD25+ Foxp3 Regulatory T Cells of Aplastic Anemia in Rats / 世界科学技术-中医药现代化

This paper was aimed to observe the effect of Yisui Shengxue (YSSX) granules on CD4+ CD25 + regulatory T cells (Treg cells) and its treatment mechanism in aplastic anemia (AA) rats.Male SD rats were selected and randomly divided into different groups according to their weight.In the model group,subcutaneous injection of benzene (1 mL· kg-1)was given every other day for 7 consecutive weeks.Ten days before the rats were sacrificed,intraperitoneal injection of CTX (25 mL · kg-1) was given for 3 consecutive days.On the 4th week,model rats were divided into the model group,stanozolol group,and the YSSX granules group.Intragastric administration of corresponding drug was given.Same volume of normal saline was given to the normal group and the model group.At the end of the experiment,WBC,RBC,HGB and PLT in peripheral blood were detected.Blood smear and bone marrow smear were prepared.The Foxp3 protein expression of Treg cells in spleen tissues was detected by immunohistochemistry (IHC).RT-PCR was used to detect the Foxp3 mRNA expression in bone marrow tissues.The results showed that compared with the normal group,WBC,RBC,HGB and PLT in the model group were significantly reduced (P ＜ 0.01).The blood smear showed poor permeability of blood cells,reduced WBCs,and increased degenerated cells.The bone marrow smear indicated significantly increased fat drops,significantly reduced hematopoietic cells,and increased nonhematopoietic cells.After the treatment of YSSX granules,WBC,RBC,HGB and PLT were significantly increased (P ＜ 0.01).Both the blood smear and bone marrow smear showed cell permeability improvement,cell form returns to normal,fat drops significantly reduced,significantly increased hematopoietic cells,significantly increased Foxp3 protein expression in spleen tissues and Foxp3 mRNA expression in bone marrow tissues (P ＜ 0.01).It was concluded that YSSX granules can upregulate both gene and protein expression of Foxp3,regulate AA immune function in order to improve the AA immune environment,promote the recovery of bone marrow hematopoietic function,which played an important role in AA treatment.

Role of regulatory B cells in children with newly diagnosed immune thrombocytopenia / 中华实用儿科临床杂志

Objective To investigate the role of regulatory B cells (Breg)in children with newly diagnosed immune thrombocytopenia (ITP).Methods A total of 35 newly diagnosed ITP children admitted to the Pediatric De-partment,the First Affiliated Hospital of Zhengzhou University from January to December 201 4 were recruited in this study,and another 20 gender -and age -matched healthy children from the Department of Medical Examination Center of the same Hospital were recruited as controls during the same period.Peripheral blood samples (3 mL from each chil-dren)were collected from all the newly diagnosed ITP children and the normal controls.Breg cells were tested by Flow Cytometry,and the expression levels of interleukin -1 0 (IL -1 0)and transforming growth factor -β1 (TGF -β1 ) mRNA were measured by real time fluorescence quantitative polymerase chain reaction.Meanwhile,the correlation be-tween Breg cells and the expression levels of IL -1 0,TGF -β1 mRNA were analyzed by Pearson correlation.Results The percentages of Breg cells in the peripheral blood of the newly diagnosed ITP children [(2.37 ±0.67)%]were sig-nificantly lower than those of the normal controls [(4.92 ±1 .32)%],and there was a significant difference (t =-7.47,P =0.000);the expression levels of IL -1 0 mRNA in the newly diagnosed ITP children(0.202 ±0.059) were significantly decreased compared with those of the normal controls(0.41 5 ±0.21 2),and there was a significant difference(t =-5.1 75,P =0.000);while the expression levels of TGF -β1 mRNA in the newly diagnosed ITP chil-dren(1 .587 ±0.823)were significantly increased than those in the normal controls(0.61 9 ±0.322),and there was a significant difference(t =4.081 ,P =0.001 ).There was a significant positive correlation between Breg cells and the ex-pression levels of IL -1 0 mRNA(rs =0.828,P <0.05),but no correlation between Breg cells and expression level of TGF -β1 mRNA was found (rs =0.527,P =0.1 1 7).Conclusions The decrease expressions of Breg cells can be found in the newly diagnosed ITP children,and the abnormal expression of Breg cells may play a key role in the immu-nological pathogenesis of the newly diagnosed ITP children.

The study of risk factors for neonatal Streptococcus agalactiae infection and sensitivity analysis of antibacterials / 国际检验医学杂志

Objective To analyze the related risk factors of neonatal Streptococcus agalactiae infection and sensitivity of antibac‐terials ,in order to provide for provide evidence for the prevention and treatment of neonatal infection .Methods A total of 1 200 neonatal blood ,gastric juice ,pus specimens ,and maternal reproductive tract specimens were collected from Jan .2013 to Dec .2013 for bacterial culture and drug sensitive test .And clinical data about types of neonatal diseases ,maternal infection status ,mode of de‐livery ,medication in late pregnancy ,situation of neonatal death were retrospectively analyzed .Results A total of 80 cases of neo‐nates were infected by Streptococcus agalactiae ,,and the neonates diagnosed with septicemia ,omphalitis ,premature birth ,intrau‐terine infection and aspiration pneumonia were accounted for 8 .75% ,10 .00% ,15 .00% ,22 .50% and 43 .75% ,respectively .The positive rate of Streptococcus agalactiae infection in mother′s reproductive tract specimens was 51 .25% ,and the results of drug sensitive test were consistent with those of neonates .9 cases of cesarean section ,accounted for 11 .25% ;71 cases of natural child‐birth ,accounted for 88 .75% .In the 80 strains of Streptococcus agalactiae ,the sensitivity of vancomycin ,linezolid ,penicillin and ceftriaxone were all 100 .00% ,and resistance rates of Streptococcus agalactiae to erythromycin ,clindamycin and levofloxacin were higher ,and were 77 .50% ,57 .50% and 33 .75% respectively .Conclusion Maternal Streptococcus agalactiae carriers and mode of delivery may be risk factors for neonatal Streptococcus agalactiae infection .Obstetricians should pay attention to routine screening of Streptococcus agalactiae in perinatal pregnant women ,the laboratory should improve the efficacy in detecting Streptococcus aga‐lactiae and provide the results of antibacterials resistance of Streptococcus agalactiae immediately ,in order to provide references for clinical rational drug use .

Significance of soluble CD163 and soluble CD25 in diagnosis and treatment of children with hemophagocytic lymphohistiocytosis / 中华儿科杂志

<p><b>OBJECTIVE</b>To explore significance of serum soluble CD163(sCD163) and soluble CD25(sCD25) in diagnosis and guiding treatment of children with hemophagocytic lymphohistiocytosis (HLH).</p><p><b>METHOD</b>Data of 42 cases of children with HLH, 32 cases of non-HLH children with infection presented to First Affiliated Hospital of Zhengzhou University pediatric clinic and ward were collected from December 2013 to December 2014. Twenty-four healthy children were enrolled into a normal control group in the same period.Peripheral venous blood specimens (3 ml) were taken from the children with HLH after fasting before treatment, two weeks after treatment and eight weeks after treatment.Peripheral venous blood specimens (3 ml) were also taken from children of non-HLH infected group and normal control group after fasting at the initial visit. Serum sCD163 and sCD25 levels in the peripheral blood in three groups were determined by ELISA. According to cause of disease, children with HLH were divided into infection-related HLH, tumor-related HLH, primary HLH and others; relationship between serum sCD163 and sCD25 level and cause of disease was analyzed.</p><p><b>RESULT</b>Serum sCD163 of HLH group ((6 094 ± 2 769) µg/L) and serum sCD163 of non-HLH infection group ((2 174 ± 950) µg/L) were significantly higher than that of normal control group ((777 ± 256) µg/L), F=71.396, P<0.05), and the differences among groups were statistically significant (P<0.05); serum sCD25 of HLH group ((41 963 ± 31 821) ng/L) and serum sCD25 of non-HLH infection group ((6 700 ± 4 105) ng/L) were significantly higher than that of normal control group ((2 440 ± 1 870) ng/L, F=37.513, P<0.05).There was no statistically significant difference between the non-HLH infection group with the normal control group (P>0.05), and the difference between the remaining groups was statistically significant (P<0.05). And serum sCD163 and sCD25 level of HLH group had a positive linear correlation, and Pearson correlation coefficient r=0.742 (t=7.000, P<0.05). The difference of serum sCD163 and sCD25 level among the different cause of disease in HLH group was significant (P<0.05).Pairwise comparison showed that serum sCD163 and sCD25 level of tumor-associated HLH group significantly increased as compared with infection-associated HLH group (P<0.05), but the difference was not statistically significant between the other groups (all P>0.05). Serum sCD163 and sCD25 level of HLH group before treatment, 2 weeks and 8 weeks after treatment showed a statistically significant tendency of decrease (P<0.05). Seen from the ROC curve, when sCD163 cut-off point was 2 359.08 µg/L, the diagnostic sensitivity was 83.3%, and specificity was 83.9%.When sCD25 cut-off point was 14 901.024 ng/L, the diagnosis sensitivity was 76.2%, and specificity was 98.2%.</p><p><b>CONCLUSION</b>Serum sCD163 and sCD25 levels may be used for diagnosis of HLH.Dynamically monitoring of serum sCD163 and sCD25 level can help to determine deterioration of HLH and guide treatment.</p>

Effect of Bu-Shen Yi-Sui Sheng-Xue Method for Medicated Serum of Rats with Aplastic Anemia on Mechanism of Proliferation and Differentiation of Hematopoietic Progenitor Cells / 世界科学技术-中医药现代化

This study was aimed to investigate the effect of Bu-Shen Y i-Sui Sheng-Xue (BSYSSX) method on pro-liferation and differentiation mechanisms of hematopoietic progenitor cells. The rat models were established by 60Co-γrays and cyclophosphamide. Compound Chinese medicine was gavaged to rats of the normal control group, model group, stanozolol group, Yi-Sui Sheng-Xue (YSSX) group, Wen-Shen Sheng-Xue(WSSX) group and Zi-Shen Sheng-Xue (ZSSX) group. Then, serum of rat was prepared. Rat bone marrow cells were incubated with AA rats serum ac-counted for 20% and the number of hematopoietic progenitor cells colony-forming units (CFU) were counted. The level of GATA-1 and PU.1 mRNA in colony cells were detected with RT-PCR. The results showed that compared with the normal control group, the number of bone marrow cells, CFU-E, BFU-E, CFU-GM, as well as the expres-sion of GATA-1 and PU.1 mRNA in the model group decreased significantly (P< 0.01). Compared with the model group, the number of bone marrow cells, CFU-E, BFU-E, CFU-GM of each treatment group were significantly in-creased (P< 0.01). CFU-E and BFU-E of the ZSSX group were better than the YSSX group (P < 0.01). CFU-GM of the ZSSX group was better than the YSSX group and the WSSX group. The expression of GATA-1 and PU.1 mR-NA in each treatment group were significantly higher than the model group (P< 0.01). The expression of GATA-1 mRNA in the ZSSX group was better than the YSSZ group and WSSX group (P< 0.05). The expression of PU.1 mR-NA in the ZSSX group was higher than the YSSX group and WSSX group. It was concluded that BSYSSX method may increase the expression of GATA-1 and PU.1 mRNA in order to promote the proliferation and differentiation of bone marrow hematopoietic progenitor cells. The ZSSX method was better than the YSSX method and WSSX method.

Diagnosis and surgical therapy for residual gallbladder in 52 cases / 中华普通外科杂志

Objective To evaluate the diagnosis and treatment of residual gallbladder.Methods The diagnosis of residual gallbladder depends on a history of previous cholecystectomy and postoperative existent symptoms suggesting cholecystitis.In this series the diagnosis was finally established by ultrasonography and laparotomy in 52 cases.Results Ten cases received laparoscopic residual cholecystectomy,32 cases underwent residual cholecystectomy,7 cases did residual cholecystectomy plus common bile duct exploration,1 case was treated with residual cholecystectomy,common bile duct exploration and left lateral lobe hepatectomy,1 case with residual cholecystectomy,common bile duct exploration,cholangioenterostomy,1 case by radical resection of residual gallbladder cancer.Conclusions Residual gallbladder is a secondary disease,diagnosis is not difficult,surgery has certain difficulty,the application of intraoperative ultrasound and choledochoscope has great value.

The effect of two different preoperative biliary drainages on malignant obstructive jaundice complicated with acute cholangitis / 中华普通外科杂志

Objective To evaluate effects of two different preoperative biliary drainages on patients of malignant obstructive jaundice complicated with acute cholangitis.Methods Retrospective analysis was made on effects of two preoperative biliary drainages of ultrasound-guided percutaneous transhepatic cholangial drainage (PTCD) and endoscopic nasobiliary drainage (ENBD) in cases of malignant obstructive jaundice complicated with acute cholangitis.Results Days of preoperative drainage(t =3.217,P ＜ 0.05) and declines of bilirubin level after drainage (t =3.178,P ＜ 0.05) were significantly better in ENBD group (26 cases) than PTCD group (22 cases).There were no significant differences between two groups in operation time length and intraoperative blood loss after drainage.However,postoperative hospital stay (t =2.542,P ＜ 0.05) and overall stay (t =3.172,P ＜ 0.05) were significantly shorter in ENBD group compared with PTCD group.Conclusions When preoperative biliary drainage is indicated in the cases of malignant jaundice before radical surgery,ENBD should be the first choice over DTCD.

Treatment of hyperlipidemic pancreatitis / 中华肝胆外科杂志

Recently,there is a gradual increase in the incidence of hyperlipidemic pancreatitis with high serum triglyceride (TG) levels.The treatments include general measures,lipid-lowering drugs,blood purification,low molecular weight heparin and insulin,traditional medicine,improving microcirculation,surgical therapy and gene therapy.The prevention of recurrence of hyperlipidemic pancreatitis is different from other types of pancreatitis.