High serum superoxide dismutase activity improves radiation-related quality of life in patients with esophageal squamous cell carcinoma

OBJECTIVES: Esophageal squamous cell carcinoma (ESCC) is one of the most common malignant tumors in China. Intensity-modulated radiation therapy and volume-modulated arc therapy have become the main treatments for esophageal carcinoma; however, side effects caused by radiotherapy greatly impact the quality of life in these patients. This study aimed to explore the impact of serum superoxide dismutase (SOD) levels on the prognosis of patients with ESCC undergoing radiotherapy. METHODS: Patients aged between 18 and 80 years with lower-middle ESCC who underwent radiotherapy were eligible for this assessment. Adverse events, responses, treatment outcomes, and overall survival (OS) were assessed. Between 2012 and 2014, 195 patients were enrolled, of which 65 were assigned to the low- and high-SOD groups based on their serum SOD values. RESULTS: The baseline characteristics were similar between the two groups, except for the T staging. Adverse events in the low-SOD group were significantly higher than those in the high-SOD group (radiation esophagitis, p=0.007; radiation pneumonitis, p=0.032; leukopenia, p=0.023; thrombocytopenia, p=0.037; anemia, p=0.041). There were no significant differences in response, treatment outcomes, or OS. CONCLUSION: In conclusion, high serum SOD activity improved post-radiotherapy quality of life but did not impact the prognosis of patients with ESCC. To the best of our knowledge, this study is the first to report that serum SOD activity is associated with radiation-induced toxicity and moderately increased radiotherapeutic response in patients with ESCC undergoing radiotherapy.

Effectiveness of moderate-to-vigorous physical activity intervention among secondary school students / 中国学校卫生

Objective@#To evaluate the effectiveness of the SHARP intervention model for increasing students’ moderate to vigorous physical activity (MVPA) levels,and to provide a reference for physical activity enriching intervention among middle schools students’.@*Methods@#One-year interventional teaching was carried out in 6 schools selected in the terms of scale and demographics from Nanjing City, Jiangsu Province. Data were collected during physical education (intervention group 105, control group 113; pre-intervention 119, post-intervention 99) data for 218 students. MVPA was assessed at baseline and post-intervention using the Observed Health and Coaching Time System(SOFIT). Interviews with 19 teachers were conducted with intervention schools to explore teachers’ views on interventions.@*Results@#The two-way analysis of variance showed that the intervention of the SHARP model had a significant impact on MVPA, VPA, and motor skills of middle school students. Proportion of the average MVPA class time of the intervention school students(62.80±9.11), and the average proportion of the VPA class time of the intervention school(24.33±12.55), the average class time for intervention in the school’s mastery of skills(32.34±11.78)(t=-7.46, -4.82, -12.08, P<0.01). The MVPA of students in control school remained relatively constant while the VPA decreased. Classroom teaching capability improved significantly in intervention schools, which was further confirmed by teacher interviews.@*Conclusion@#The SHARP intervention model can effectively increase the MVPA level of middle school students.

Association between IL-10 Gene -592(C→A) (rs1800872) SNP and GVHD after Allogeneic Hematopoietic Stem Cell Transplantation in Children / 中国实验血液学杂志

OBJECTIVE@#To study the association between IL-10 gene-592(C→A) (rs1800872) single nucleotide polymorphism (SNP) and the graft versus host disease (GVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in children.@*METHODS@#Ninety-seven childhood patients and seventy-one donors in the Hematology Oncology Center of Beijing Children's Hospital from Jan 2011 to Jul 2017 were enrolled in this study. The genomic DNA was extracted from peripheral blood cells and the SNP genotype was analyzed using TaqMan SNP genotyping assay.@*RESULTS@#In malignant patients with AA genotype, the incidence of Ⅱ-Ⅳ grade acute GVHD (aGVHD) was lower than that in patients with AC and CC genotype (9.1% vs 43.5%) (P＜0.01), and the gastrointestinal aGVHD rate was also lower (9.1% vs 39.1%) (P＜0.05). There's no significant association between patients' genotype and Ⅱ-Ⅳ grade aGVHD in total patients and non-malignant patients. Also, the genotype in patients did not corelate with chronic GVHD (cGVHD) and 1 year transplantation-related mortality (TRM). In cases who received HSCT of donors with AA genotype, the liver aGVHD rate was higher than that in cases who received HSCT of donors with AC and CC genotype (23.1% vs 0.0%) (P＜0.05), but the genotype in donors did not correlate with Ⅱ-Ⅳ grade aGVHD, cGVHD and 1 year TRM.@*CONCLUSION@#AA genotype in the IL-10 gene-592 (C→A) (rs1800872) single nucleotide polymorphism in patients protects pediatric malignant patients against Ⅱ-Ⅳ grade aGVHD and gastrointestinal aGVHD after allo-HSCT. AA genotype in donors is a risk factor for liver aGVHD after allo-HSCT in non-malignant disease.

Acute Myeloid Leukemia: Advancements in Diagnosis and Treatment / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>Leukemia is the most common pediatric malignancy and a major cause of morbidity and mortality in children. Among all subtypes, a lack of consensus exists regarding the diagnosis and treatment of acute myeloid leukemia (AML). Patient survival rates have remained modest for the past three decades in AML. Recently, targeted therapy has emerged as a promising treatment.</p><p><b>DATA SOURCES</b>We searched the PubMed database for recently published research papers on diagnostic development, target therapy, and other novel therapies of AML. Clinical trial information was obtained from ClinicalTrials.gov. For the major purpose of this review that is to outline the latest therapeutic development of AML, we only listed the ongoing clinical trials for reference. However, the published results of complete clinical trials were also mentioned.</p><p><b>STUDY SELECTION</b>This article reviewed the latest developments related to the diagnosis and treatment of AML. In the first portion, we provided some novel insights on the molecular basis of AML, as well as provided an update on the classification of AML. In the second portion, we summarized the results of research on potential molecular therapeutic agents including monoclonal antibodies, tyrosine kinase/Fms-like tyrosine kinase 3 (FLT3) inhibitors, epigenetic/demethylating agents, and cellular therapeutic agents. We will also highlight ongoing research and clinical trials in pediatric AML.</p><p><b>RESULTS</b>We described clonal evolution and how it changes our view on leukemogenesis, treatment responses, and disease relapse. Pediatric-specific genomic mapping was discussed with a novel diagnostic method highlighted. In the later portion of this review, we summarized the researches on potential molecular therapeutic agents including monoclonal antibodies, tyrosine kinase/FLT3 inhibitors, epigenetic/demethylating agents, and cellular therapeutic agents.</p><p><b>CONCLUSION</b>Gene sequencing techniques should set the basis for next-generation diagnostic methods of AML, and target therapy should be the focus of future clinical research in the exploration of therapeutic possibilities.</p>

The Role of NM23 in Patients with Colorectal Cancer: A Systematic Review and Meta-Analysis / 华中科技大学学报（医学）（英德文版）

This meta-analysis was carried out to evaluate the relationship between NM23 expression and the prognosis of patients with colorectal cancer.We searched PubMed,EMBASE and Web of Science for relevant articles.The pooled odd ratios (ORs) and corresponding 95％CI were calculated to evaluate the prognostic value of NM23 expression in patients with colorectal cancer,and the association between NM23 expression and clinicopathological factors.In total,2289 patients were pooled from 24 available studies.The incorporative OR combined by 16 studies with overall survival showed that high NM23 expression was associated with better overall survival (OR=0.67,95％CI:0.49-0.93,P=0.02,I2=56％,Ph=0.004).And a new estimate without heterogeneity was produced when only combining high-quality studies (OR=0.70,95％CI:0.56-0.86,P=0.0007,I2=46％).In disease free survival (DFS),we also obtained a good prognosis (OR=0.30,95％CI:0.14-0.68,P=0.004).Although we failed to find any significance in N status (P=0.10),elevated NM23 expression was related to well tumor differentiation (OR=0.60,95％CI:0.44-0.820,P=0.001) and Dukes' A&B (OR=0.55,95％CI:0.32-0.95,P=0.03).These results indicated that over-expressed NM23 might be an indicator of good prognosis,well tumor differentiation and Dukes' A&B of patients with colorectal cancer,but no significance was found in N status.

Infections during induction therapy of protocol CCLG-2008 in childhood acute lymphoblastic leukemia: a single-center experience with 256 cases in China / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Infections remain a major cause of therapy-associated morbidity and mortality in children with acute lymphoblastic leukemia (ALL).</p><p><b>METHODS</b>We retrospectively analyzed the medical charts of 256 children treated for ALL under the CCLG-2008 protocol in Beijing Children's Hospital.</p><p><b>RESULTS</b>There were 65 infectious complications in 50 patients during vincristine, daunorubicin, L-asparaginase and dexamethasone induction therapy, including microbiologically documented infections (n = 12; 18.5%), clinically documented infections (n = 23; 35.3%) and fever of unknown origin (n = 30; 46.2%). Neutropenia was present in 83.1% of the infectious episodes. In all, most infections occurred around the 15 th day of induction treatment (n = 28), and no patients died of infection-associated complications.</p><p><b>CONCLUSIONS</b>The infections in this study was independent of treatment response, minimal residual diseases at the end of induction therapy, gender, immunophenotype, infection at first visit, risk stratification at diagnosis, unfavorable karyotypes at diagnosis and morphologic type. The infection rate of CCLG-2008 induction therapy is low, and the outcome of patients is favorable.</p>

Correlation analysis of FPGS rs10760502G>a polymorphism with prognosis and MTX-related toxicity in pediatric B-cell acute lymphoblastic leukemia / 中国实验血液学杂志

This study was aimed to explore the relation between folylpolyglutamate synthetase (FPGS) rs10760502 polymorphism and prognosis and methotrexate (MTX)-related toxicities in pediatric B-cell acute lymphoblastic leukemia (B-ALL). Sequenom MassARRAY was used to genotype rs10760502. The χ(2) test, Kaplan-Meier method and Cox regression models were used to analyze the data. The results indicated that A allele carriers (GA+AA) had poor relapse free survival (RFS, log-rank: P = 0.004) and event free survival (EFS, log-rank: P = 0.022) compared with the GG genotype carriers. Multivariate Cox-regression analysis results showed that A allele is an independent prognosis factor for poor RFS [hazard ratio (HR), 20.173; 95% CI, 2.535-160.545; P = 0.005] and EFS (HR, 8.133; 95% CI, 1.718-38.512; P = 0.008). No relationship was found between any MTX toxicity and rs10760502 polymorphism. It is concluded that FPGS rs10760502G>A polymorphism may affect the treatment outcome of B-ALL patients.

Evaluation of early response to treatment and its prognostic value in childhood acute lymphoblastic leukemia / 中国实验血液学杂志

This study was purposed to investigate the prognostic value of early response to treatment in childhood acute lymphoblastic leukemia (ALL). Four indexes were used to assess early response to treatment including response to prednisone on day 8 (D8-PR), percentage of lymphoblast in bone marrow on day 22 (D22-BM) and day 33 (D33-BM), the level of minimal residual disease (MRD) on day 33 (D33-MRD) by morphological and molecular biological method in 426 children with ALL. Prognostic impact of early response to treatment was analyzed, and multivariate analysis of the predictive value was performed by Cox-regression analysis. All patients were followed up until October 31, 2013, with a median follow-up time of 80 months (0.5 to 106 months). The results showed that there were significant differences between event free survivals (EFS) of the sub-groups divided according to the four indexes. The 8 years-EFS in patients with prednisone good response (PGR) was significantly higher than that in patients with prednisone poor response (PPR);patients with M1 in bone marrow on day 22 or day 33 had the better outcomes than that of patients with M2/M3;patients with high level of MRD ( ≥ 10(-4)) had the worse outcomes as compared with patients with low level of MRD (<10(-4)) (P < 0.001). Cox proportional hazard model analysis showed that BCR/ABL fusion gene positive, D8-PR, D33-BM and D33-MRD were the independent prognostic factors for childhood ALL, and the hazard ratio of D33-MRD ≥ 10(-2) was highest (HR:11.886, P < 0.001). It is concluded that early response to treatment is an independent prognostic factor with important prognostic values, and it has important clinical guiding instructive significance for risk stratification in the treatment of children ALL.

Preliminary analysis of aberrant expression of plasma miR-223 in pediatric acute lymphoblastic leukemia with a direct RT-PCR assay / 中国实验血液学杂志

This study was aimed to investigate the expression of plasma miR-223 in pediatric acute lymphoblastic leukemia (ALL) in different treatment time point. A total of 64 pediatric ALL samples were selected from patients treated in Beijing Children's Hospital from May 2005 to January 2012, including 30 samples at new diagnosis (ND), 30 samples at complete remission (CR) and 4 samples at relapse. Without RNA extraction, the miR-223 levels in plasma were directly detected by a reverse-transcription quantitative real-time PCR assay. The results indicated that the expression of plasma miR-223 in pediatric ALL was lower at ND but elevated after CR. The miR-223 expression in plasma of relapse patients didn't show significant difference probably due to a few cases of relapse. The miR-223 levels in plasma had not displayed significant difference between TEL-AML1 positive patients and no fusion gene B lineage ALL patients either at ND or at CR. It is concluded that the plasma miR-223 decreases at ND and increases in CR of children with ALL. miR-223 may act as an anti-oncogene and may be taken as a potential predictive biomarker for evaluating the therapeutic effect of leukemia.

Progress of studies on genetics of childhood acute leukemia / 中国实验血液学杂志

This study on determination of leukemia-specific chromosomal abnormalities and their relationship with prognosis of childhood acute leukemia (AL) had an important significance for childhood acute leukemia. In recent years, the efficacy of treatment of childhood AL has been greatly improved, but relapse is still a main factor affecting prognosis. Treatment based on the risk stratification by cytogenetic abnormalities can improve the prognosis and survival rate. In the past 3 decades, the genetic techniques have developed rapidly and many new genetic abnormalities have been found. This review highlights the main chromosomal and genomic abnormalities of 3 common childhood AL, including B-cell precursor acute lymphoblastic leukemia (BCP-ALL), T-cell acute lymphoblastic leukemia (T-ALL) and acute myeloid leukemia (AML).

Clinical features and therapeutic effect of 38 children with anaplastic large cell lymphoma / 中华儿科杂志

<p><b>OBJECTIVE</b>To analyze the clinical features and prognostic factors of children's anaplastic large cell lymphoma (ALCL), summarize the therapeutic effect and toxicities.</p><p><b>METHOD</b>A total of 38 ALCL patients admitted to Beijing Children's Hospital from Jan. 2003 to Apr. 2010 were treated with BCH-ALCL-2003 regimen (modified from HK-ALCL-2000).</p><p><b>RESULT</b>Thirty-four cases were ALK(+), male:female ratio = 2.16:1. The median age was 9 years; 86.8% had B symptoms. 94.7% evolved to Stage III and IV on admission. The median follow-up duration was 48 months (12 to 99 months). Median event-free survival (EFS) time was 43 months. Thirty-four patients (89.5%) achieved a remission. The disease relapsed in 3 patients within 20 months after diagnosis. Estimated 4-year EFS was (81.2 ± 6.4)%, estimated 4-year overall survival (OS) rate was (86.4 ± 5.7)%. Univariate analysis indicated that the unfavorable prognostic factors included: more than 3 extra nodal involvement, hepatosplenomegaly (> 3 cm), elevated lactate dehydrogenase (LDH), stage IV, hemophagocytosis in bone marrow, and age < 3 years. The major toxicity was myelosuppression and mucositis. no chemotherapy related death occurred.</p><p><b>CONCLUSION</b>(1) Childhood ALCL patients often have B symptoms and extranodal involvement. (2) In the study, therapeutic effects was good. The disease relapsed mostly within the first 2 years, maintenance therapy with vinblastine is necessary. (3) The regimen is safe to patients.</p>

Epigenetic mechanism of RUNX1 in pathogenesis of leukemia / 中国实验血液学杂志

RUNX1, also called AML1, is a member of RUNX transcriptional factor family, and also is the most frequent target for chromosomal translocations in leukemia. RUNX1 is a very important transcription factor, can enhance or repress the expressions of many hematopoiesis related genes. RUNX1 may receive a series of post-translational modifications, and the activity of RUNX1 can be affected by these post-translational modifications, thus RUNX1 regulates the differentiation, apoptosis and self-renewal of hematopoietic cells. This article reviews the role of RUNX1 in the pathogenesis of leukemia mainly including its target genes, transcriptional mechanism and post-translational modifications.

Treatment of thoracolumbar vertebral fractures with posterior short segmental pedicle screw fixation and pedicle screw at the fracture level / 中国骨伤

<p><b>OBJECTIVE</b>To explore the feasibility and clinical effects of posterior short segmental pedicle screw fixation adding pedicle screw at the fracture level in treatment of thoracolumbar vertebral fractures.</p><p><b>METHODS</b>From September 2005 to September 2007, 82 patients (male 50 and female 32, the age from 18 to 63 years, at mean age of 36 years,the courses of disease from 2 hours to 7 days with an average of 2 days) with thoracolumbar fractures were treated with posterior short segmental pedicle screw fixation adding pedicle screw at the fracture level. According to the AO classification, 25 patients were type A1 fracture, 48 were type A2 and 9 were type B2. According to the ASIA neurological function grading system, 9 patients were grade C, 17 were grade D and 56 were grade E. Reduction and posterolateral fusion were achieved through fixation of the fractured vertebra and the adjacent normal vertebrae with the transpedicle screw.</p><p><b>RESULTS</b>Eighty-two cases were followed up from 12 to 24 months (averaged 18.3 months). All cases achieved bone fusion, without significant lose of the vertebrae body height and implant failure. The anterior body compression and Cobb angle were significantly improved after surgery (P < 0.05). The anterior body compression and Cobb angle did not significantly lose compared with after-surgery ones (P > 0.05). The caudal intervertebral disc height (h/H) were not significantly improved after surgery (P > 0.05). Improvement of one to two grades of neurological function was observed in patients with incomplete neurological injuries.</p><p><b>CONCLUSION</b>Posterior short segmental pedicle screw fixation with pedicle screw at the fracture level is a safe and effective therapeutic option to treat thoracolumbar vertebral fractures, which can help to correct the kyphosis and maintain the reduction, and avoid the over-distraction of the contiguous discs.</p>

Screening of proteins interacting with avian influenza virus nucleoprotein by yeast two-hybrid system in human brain cDNA library / 生物工程学报

Avian influenza virus Nucleoprotein (NP) is important in viral transcription, replication and determining host specificity of influenza virus. Yeast two-hybrid technique was applied to screen for proteins interacting with virus nucleoprotein, so as to further elucidate the interaction between virus nucleoprotein and cellular proteins, as well as the interaction between virus and host. To explore new proteins interacted with NP protein, a human brain cDNA library was screened using yeast two-hybrid system with NP as the bait. DNA inserts of the positive AD/library plasmids were sequenced. By the BLAST analysis against the GenBank databases seven positive clones resulted in seven genes. Our results could help for the further study on the molecular mechanism of virus replication, transcription and protein-protein interaction. Further investigations were needed to characterize these interactions.

The Anatomic Study on Replacement of Artificial Atlanto-odontoid Joint through Transoral Approach / 华中科技大学学报（医学）（英德文版）

In order to provide anatomical basis for transoral approach (TOA) in dealing with the ventro lesions of craniocervical junction, and the design and application of artificial atlanto-odontoid joint, microsurgical dissecting was performed on 8 fresh craniocervical specimens layer by layer through transoropharyngeal approach. The stratification of posterior pharyngeal wall, course of vertebral artery, adjacent relationship of atlas and axis and correlative anatomical parameters of replacement of artificial atlanto-odontoid joint were observed. Besides, 32 sets of atlanto-axial joint in adults' fresh bony specimens were measured with a digital caliper and a goniometer, including the width of bony window of anterior arch of atlas, the width of bony window of axis vertebra, the distance between superior and inferior two atlas screw inserting points, the distance between two axis screw inserting points etc. It was found that the width of atlas and axis which could be exposed were 40.2±3.5mm and 39.3±3.7mm respectively. The width and height of posterior pharyngeal wall which could be exposed were 40.1±5.2mm and 50.2±4.6mm respectively. The distance between superior and inferior two atlas screw inserting points was 28.0±2.9mm and 24.0±3.5mm respectively, and the distance of bilateral axis screw inserting points was 18.0±1.2mm. The operative exposure position through TOA ranged from inferior part of the clivus to the superior part of the C3 vertebral body. Posterior pharyngeal wall consisted of 5 layers and two interspaces: mucosa, submucosa, superficial muscular layer, anterior fascia of vertebrae, anterior muscular layer of vertebrae and posterior interspace of pharynx, anterior interspace of vertebrae. This study revealed that it had the advantages of short operative distance, good exposure and sufficient decompression in dealing with the ventro lesions from the upper cervical to the lower clivus through the TOA. The replacement of artificial atlanto-odontoid joint is suitable and feasible. The design of artificial atlanto-odontoid joint should be based on the above data.