Impact of rhG-CSF on Clinical Efficacy and Immune Cell Subsets after Initial Induction Chemotherapy in AML.

BACKGROUND: The impact of recombinant human granulocyte colony-stimulating factor (rhG-CSF) in acute myeloid leukemia (AML) is still controversial. The purpose of this study is to explore the impact of rhG-CSF administration on clinical efficacy and immune cell subsets after initial induction chemotherapy in AML. METHODS: The clinical efficacy and immune cell subsets were compared in the newly diagnosed patients with AML according to whether rhG-CSF was used after initial induction chemotherapy. Next, rhG-CSF stimulation experi-ments on leukemia cell lines and primary leukemia blasts were performed in vitro. RESULTS: There was no statistical difference between control group and rhG-CSF therapy group in complete remission rate and relapse free survival. The duration of agranulocytosis was significantly shortened in rhG-CSF therapy group compared with control group. The percentage of circulating monocytic myeloid-derived suppressor cells (M-MDSCs) and regulatory T cells (Tregs) were significantly increased after the administration of rhG-CSF. Furthermore, it was found that rhG-CSF did not promote the proliferation of leukemia cell lines and primary leukemia blasts, but increased the proportion of M-MDSCs and Tregs in vitro. CONCLUSIONS: Administration of rhG-CSF after initial induction therapy of AML does not affect the clinical remission and relapse rate, but reduces the duration of agranulocytosis and increases the proportion of M-MDSCs and Tregs.

[Clinical features and prognostic analysis of hepatoblastoma in children under six years old].

Objective: To summarize and analyze the clinical features, treatment effects and related factors affecting the prognosis of hepatoblastoma (HB) in children under six years old. Methods: Clinical data of 382 children with HB under six years old who were pathologically diagnosed at the Pediatric Single Center of Beijing Tongren Hospital from May 2005 to May 2019 were analyzed retrospectively. The factors affecting the treatment effect and survival rate of HB were analyzed. The independent risk factors affecting the prognosis of HB were studied by Cox regression model. The χ(2) test was used to compare the enumeration data between groups. Kaplan-Meier method was used for survival analysis. Log-rank test was used to compare the survival rates among subgroups. Results: Children enrolled were with median age of 1.75 (0.08 ~ 5.92) years old and a male to female ratio of 1.5. Alpha-fetoprotein (AFP) median level was 197 406.5 µg/L at initial diagnosis, and the pathological tissue type was mainly epithelial (55.8%). Preoperative PRETEXT stage was mostly stage III (58.6%). 86 cases (22.5%) had portal vein or hepatic vein, and vena cava invasion. 73 cases (19.1%) had extrahepatic adjacent tissues and organs invasion. Twenty-four cases (6.3%) had tumor rupture and bleeding. 171 cases (44.8%) had distant metastases, and 96 cases (25.1%) had multiple intrahepatic lesions. Patients were followed-up to May 2020 (median follow-up time was 56 months). After comprehensive treatment, 218 cases were completely relieved, and 69 cases were partially relieved, and the treatment efficiency was 75.1%. Kaplan-Meier survival analysis showed that the 1, 3, and 5-years overall survival rates (OS) were 93.7%, 84.0%, and 73.9%, respectively, and the event-free survival rates were 90.5%, 79.2%, and 67.5%, respectively. Comparison of the clinical factors of 5-year OS showed that AFP < 100 µg/L (HR = 3.341, P = 0.005), PRETEXT stage IV (HR = 4.026, P = 0.001), vascular invasion (HR = 2.178, P = 0.019) and distant metastasis (HR = 2.634, P = 0.010) were independent risk factors in each subgroup affecting the prognosis of children with HB, and the difference was statistically significant. Conclusion: HB prognosis is related to AFP level, PRETEXT stage, presence or absence of vascular invasion and distant metastasis. Therefore, its survival and prognosis will be different in the presence of different risk factors.

[Clinical features and treatment efficacy of infantile renal tumors: a multicenter retrospective study].

Objective: To further understand the clinical features, treatment efficacy and risk factors for poor prognosis in infantile-onset renal tumors. Methods: Clinical data of 45 cases of infantile-onset renal tumors from June 2011 to November 2019 in Peking University First Hospital, Beijing Children's Hospital, Beijing Tongren Hospital and Beijing Shijitan Hospital were analyzed retrospectively. The clinical features were summarized and the prognoses were evaluated. Multi-disciplinary diagnosis and treatment was used, including surgery, chemotherapy and radiotherapy. Kaplan-Meier analysis was used to calculate the overall survival rate and the event-free survival rate, while the chi-square test was used to analyze the risk factors for poor prognosis. Results: Among 45 patients, 24 were males and 21 females. The age of onset was 7 (ranged 3-11) months, and the length of tumor at initial diagnosis was 9.7 (ranged 4.9-25.0)cm. The International Society of Pediatric Oncology (SIOP) staging: 5 cases (11%) were in stage Ⅰ, 22 cases in stage Ⅱ (49%), 8 cases in stage Ⅲ (18%), 6 cases in stage Ⅳ (13%), and 4 cases in stage Ⅴ (9%). Risk groups included 5 cases (11%) in the low-risk group, 22 cases (49%) in the intermediate-risk group, and 18 cases (40%) in the high-risk group. Forty-four cases (98%) did not receive preoperative biopsy, 26 cases (58%) received preoperative chemotherapy, 39 cases (87%) received postoperative chemotherapy, and 2 cases (4%) received three-dimensional conformal radiotherapy. The 5-year overall survival rate was (83±7)%, and the 5-year event-free survival rate was (76±8)%. Hematuria as the first symptom (3/8 vs. 83% (30/36), χ²=7.005, P=0.024), tumor long diameter≤8 cm (5/11 vs. 85% (28/33), χ²=5.606, P=0.027) and high-risk pathological group (7/18 vs.100% (26/26), χ²=21.928, P<0.01) were risk factors for poor prognosis of children with renal tumors in this group. Conclusion: The prognosis of children with infantile-onset renal tumors is fairly well, nevertheless the prognosis is poor in patients with hematuria as the first symptom and in high-risk pathological group.

Frailty Index and Its Relation to Falls and Overnight Hospitalizations in Elderly Chinese People: A Population-based Study.

OBJECTIVES: To investigate current status of frailty index (FI) defined as deficit accumulation and its relations to falls and overnight hospitalizations in an elderly Chinese population. DESIGN: A cross-sectional cohort study. SETTING: All of the 31 valiages in Jiang'an township, a typical medium-sized township in Rugao city, China. PARTICIPANTS: Overall 1773 participants aged 70-84 years were randomly recruited. MEASUREMENTS: A FI including symptoms, activities of daily living, co-morbidities, cognitive and psychological function was constructed using 45 health deficits. RESULTS: The mean of FI was 0.14 in men and 0.19 in women. According to a usual FI cut-point of 0.25, 8.2% of men and 23.2% of women were classified as frail. Literate participants had lower levels of FI than their illiterate counterpart. In men, the FI was positively related to age (r = 0.186, p<.001), with a mean rate of deficit accumulation of 0.032 (on a log scale) per year. Each increment of 0.01 on the FI was associated with significantly increased risks of falls and overnight hospitalizations, with odds ratios of 1.05 (95% CI: 1.03, 1.07) and 1.05 (95% CI: 1.03, 1.08). Similarly, the aforementioned associations were observed in women. Education level moderated the associations of FI with falls in men and women. CONCLUSION: Elderly Chinese women were more frail than men. The FI significantly increased with chronological age and was significantly associated with falls and overnight hospitalizations, and education level may play an important role. This study provides preliminary but crucial evidences for future researches on frailty in China.

Global characterization of interferon regulatory factor (IRF) genes in vertebrates: glimpse of the diversification in evolution.

BACKGROUND: Interferon regulatory factors (IRFs), which can be identified based on a unique helix-turn-helix DNA-binding domain (DBD) are a large family of transcription factors involved in host immune response, haemotopoietic differentiation and immunomodulation. Despite the identification of ten IRF family members in mammals, and some recent effort to identify these members in fish, relatively little is known in the composition of these members in other classes of vertebrates, and the evolution and probably the origin of the IRF family have not been investigated in vertebrates. RESULTS: Genome data mining has been performed to identify any possible IRF family members in human, mouse, dog, chicken, anole lizard, frog, and some teleost fish, mainly zebrafish and stickleback, and also in non-vertebrate deuterostomes including the hemichordate, cephalochordate, urochordate and echinoderm. In vertebrates, all ten IRF family members, i.e. IRF-1 to IRF-10 were identified, with two genes of IRF-4 and IRF-6 identified in fish and frog, respectively, except that in zebrafish exist three IRF-4 genes. Surprisingly, an additional member in the IRF family, IRF-11 was found in teleost fish. A range of two to ten IRF-like genes were detected in the non-vertebrate deuterostomes, and they had little similarity to those IRF family members in vertebrates as revealed in genomic structure and in phylogenetic analysis. However, the ten IRF family members, IRF-1 to IRF-10 showed certain degrees of conservation in terms of genomic structure and gene synteny. In particular, IRF-1, IRF-2, IRF-6, IRF-8 are quite conserved in their genomic structure in all vertebrates, and to a less degree, some IRF family members, such as IRF-5 and IRF-9 are comparable in the structure. Synteny analysis revealed that the gene loci for the ten IRF family members in vertebrates were also quite conservative, but in zebrafish conserved genes were distributed in a much longer distance in chromosomes. Furthermore, all ten different members are clustered in respectively different clades; but the IRF-11 was clustered with one in sea urchin. CONCLUSIONS: In vertebrates, the ten well-characterized IRF family members shared a relatively high degree of similarity in genomic structure and syntenic gene arrangement, implying that they might have been evolved in a similar pattern and with similar selective pressure in different classes of vertebrates. Genome and/or gene duplication, and probably gene shuffling or gene loss might have occurred during the evolution of these IRF family members, but arrangement of chromosome or its segment might have taken place in zebrafish. However, the ten IRF family members in vertebrates and those IRF-like genes in non-vertebrate deuterostomes were quite different in those analyzed characters, as they might have undergone different patterns of evolution.

[Clinical study of treatment of epistaxis of little's area by microwave, anterior nasal packing and trichloroacetic acid cautery].

OBJECTIVE: To study the difference and quality of three different kind of treatment methods for epistaxis of Little's area, such as: microwave, anterior packing of nasal cavity and trichloroacetic acid cautery. METHOD: The cases were divided into three group. The state of bleeding, reaction of after-treatment and recurrence were recorded and analysed. RESULT: Comparing with the anterior nasal packing and trichloroacetic acid cautery, the microwave is characteristic by thorough stop-bleeding, light reaction, less recurrence. CONCLUSION: Microwave is an ideal way to treat epistaxis of Little's area. The patient's reaction is mild and less the clinical effects is obviously better than the anterior packing of nasal cavity and trichloroacetic acid cautery.

[DNA content in laryngeal keratosis, laryngeal cancer and normal laryngeal epithelium].

The DNA content in laryngeal precancerous lesion, laryngeal keratosis, laryngeal carcinoma and normal laryngeal epithelium had been measured in order to study the relationship between histopathologic picture and DNA content. The results showed that the DNA content in keratotic tissue increased to varying degrees as compared with the normal tissue. The DNA content in laryngeal cancer increased distinctly, being much higher than that in normal and keratotic tissues.

Kinetic studies of radiation damage and recovery of murine haemopoietic stem cells during and after continuous irradiation at low dose rate.

Under continuous gamma irradiation at a low dose rate of 0.70 Gy/day, the cellularities of blood forming cells in bone marrow decrease with increasing accumulated radiation dose. The biphasic nature of the dose-response curve may be due to the following factors: an increased rate of proliferation of CFUs, different radiation sensitivities of CFUs, GM-CFC and E-CFC, an increase in the amplification potential of progenitor cells and proliferative haemopoietic cells, and a reduction in differentiation 'pressure' on CFUs. After 49 days of chronic irradiation the content of E-CFC in murine bone marrow recovers rapidly, and approaches the pre-irradiation level by 5 days. However, the number of CFUs and GM-CFC reaches a plateau value of only 40% of normal within 34 days.