[Short-term results of a multicenter study based on a modified N7 induction regimen combined with arsenic trioxide in the treatment of children with high-risk neuroblastoma].

Objective: To analyze the short-term clinical efficacy and safety of arsenic trioxide (ATO) combined with a modified N7 induction regimen in the treatment of children with high-risk neuroblastoma (NB). Methods: This study was a prospective, single-arm, multicenter phase Ⅱ clinical study. Sixty-seven high-risk NB children from eight units of Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Wuhan Children's Hospital of Tongji Medical College of Huazhong University of Science and Technology, First Affiliated Hospital of Guangxi Medical University, Hainan General Hospital, Affiliated Hospital of Guangdong Medical University, Kunming Children's Hospital, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, and Guangdong Provincial Agricultural Reclamation Center Hospital were enrolled from January 2019 to August 2023 and were treated with ATO combined with a modified N7 induction regimen. The efficacy and adverse effects at the end of induction chemotherapy were assessed and analyzed, and the differences in the clinical characteristics were further compared between the treatment-responsive and treatment-unresponsive groups by using the Fisher's exact test. Results: Among 67 high-risk NB children, there were 40 males (60%) and 27 females (40%), with the age of disease onset of 3.5 (2.6, 4.8) years. Primary NB sites were mostly in retroperitoneum (including adrenal gland) (56/67, 84%) and the common metastases sites at initial diagnosis were distant lymph node in 25 cases (37%),bone in 48 cases (72%),bone marrow in 56 cases (84%) and intracalvarium in 3 cases (4%). MYCN gene amplification were detected in 28 cases (42%). At the end of induction, 33 cases (49%) achieved complete remission, 29 cases (43%) achieved partial remission, 1 case (1%) with stable disease, and 4 cases (6%) were assessed as progressive disease (PD). The objective remission rate was 93% (62/67) and the disease control rate was 94% (63/67). The percentage of central system metastases at the initial diagnosis was higher in the treatment-unresponsive group than in the treatment-responsive group (2/5 vs. 2% (1/62), P=0.013), whereas the difference in MYCN gene amplification was not statistically significant between two groups (3/5 vs.40% (25/62), P=0.786). Grade Ⅲ or higher adverse reactions during the induction chemotherapy period were myelosuppression occurred in 60 cases (90%), gastrointestinal symptoms occurred in 33 cases (49%), infections occurred in 20 cases (30%), hepatotoxicity occurred in 4 cases (6%), and cardiovascular toxicity occurred in 1 case (2%). There were no chemotherapy-related deaths. Conclusion: ATO combined with N7-modified induction regimen had a superiority in efficacy and safety, which deserved further promotion in clinical practice.

[Analysis of clinical guidelines for oro-maxillofacial cone-beam CT].

Oro-maxillofacial cone-beam CT (CBCT) is the most widely used three-dimensional imaging method in the field of oral and maxillofacial radiology. It has been widely used in China, while radiation safety, examination indications and other issues still lack comprehensive regulations and standards. Over the years, clinical guidelines and position statements for the rational use of CBCT examinations have been issued in the world, providing standardized instructions for local practitioners. This paper reviewed these guidelines to provide reference for the formulation of relevant guidelines in China.

Utilization of urban sewage sludge: Chinese perspectives.

PURPOSE: Urbanization and industrialization in China has resulted in a dramatic increase in the volume of wastewater and sewage sludge produced from wastewater treatment plants. Problems associated with sewage sludge have attracted increasing attention from the public and urban planners. How to manage sludge in an economically and environmentally acceptable manner is one of the critical issues that modern societies are facing. METHODS: Sludge treatment systems consist of thickening, dewatering, and several different alternative main treatments (anaerobic digestion, aerobic digestion, drying, composting, and incineration). Agricultural application, landfill, and incineration are the principal disposal methods for sewage sludge in China. However, sewage sludge disposal in the future should focus on resource recovery, reducing environmental impacts and saving economic costs. RESULTS: The reuse of biosolids in all scenarios can be environmentally beneficial and cost-effective. Anaerobic digestion followed by land application is the preferable options due to low economic and energy costs and material reuse. CONCLUSION: It is necessary to formulate a standard suitable for the utilization of sewage sludge in China.

Cadmium exposure and health effects among residents in an irrigation area with ore dressing wastewater.

About 0.05 mg Cd l-1 was found in the irrigation water contaminated by the wastewater discharged from tungsten ore dressing plants, and about 1 mg Cd kg-1 was found in irrigated acid soils. The main sources of cadmium intake by residents of the polluted areas are agricultural products. The average intake of cadmium was 367-382 micrograms day-1, and for smokers 417 micrograms day-1. Among the residents who have been exposed to cadmium for more than 25 years, cadmium absorption (urinary cadmium greater than or equal to 10 micrograms g-1 creatine) was 60% and an early effect on the target organ (urinary cadmium greater than or equal to 15 micrograms g-1 creatinine and urinary beta 2-microglobulin greater than 500 micrograms g-1 creatinine) was detected in 17% of the sample of 433 persons. Levels of urinary cadmium and blood cadmium exceeded the critical value in the exposed group. The concentrations of urinary calcium, beta 2-microglobulin and N-acetyl-beta-D-glucosaminidase were significantly higher in residents of contaminated areas than in those of control areas. Case-control study of the residents shows that many have suffered from a nephropathy with tubulo-interstitial abnormalities. Owing to the combined cadmium effect, the cases with fractional beta 2-microglobulin excretion greater than 0.10 were 46% in the exposed population, and were much higher than that in the control group (20.3%).