Objective To investigate the relationship among methotrexate(MTX) plasma concentration,dosage,clinical effecicy and toxicity, and to evaluate it′s clinical significance.Methods MTX was measured by a flurorescence polarization immunoassay in plasma samples obtained from acute lymphoblastic leukemia(ALL) patients treated in different doses of MTX, and these results were analyzed combined with clinical manifestations.Results 1.The average of plasma concentration at 24 hours increased with the increasing doses of MTX. The relapse rate decreased with increased plasma concentration;2.The cerebrospinal fluid(CSF) concentrations prior to the intrathecal MTXinstillation were all below the effective concentration, so the intrathecal MTX instillation was needed;3.No severe toxicity was observed in the study, because the plasma concentration was below the high risk.Conclusion The study of MTX plasma concentration provides us an objective basis for the individualized chemotherapy.

Neuroglobin is a newly discovered member of globulin family.It has neuronprotec- tive effect under the hypoxic and ischemic conditions.In order to make the acting mechanism of globulin clear,many theories have been raised,and corresponding experiments have been done. This article reviews the latest advances systematically in this field,and puts forward possible research directions in the future.

Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; drug therapy

Arsenic Poisoning ; Child ; Female ; Humans ; Hypercalciuria ; complications

Objective To explore the immunophenotype of children with acute myeloid leukemia(AML) and its clinical significance.Methods Statistics was used to analyze the relationship between the immunophenotype of AML and their French-American-Britain(FAB) classification,complete remission (CR) in one month and 3-years event-free survival(EFS).Results CR rate was 71.6% and 3-years EFS rate was 50.8%. HLA-DR and CD34 absent mainly in M3, associated with higher CR and EFS rate. So did CD33 negative cases, especially in M2. CD13 positive was significantly predictive factor for achieving CR.Co-expression of lymphoid antigens and NK cell antigens(CD56) with M2 which correlated with lower CR and EFS rate.Conclusions The negative of HLA-DR, CD34, CD33,as well as CD13 positive, have relationship with good prognosis. Lymphoid antigens and CD56 are poor prognostic factors.

Objective To investigate the stability of immunophenotyping in the course of relapse or at treatment failure of patients with acute lymphoblastic leukemia(ALL) and that of immunophenotyping of positive minimal residual disease(MRD).Methods From Aug.2000 to Dec.2007,33 children with ALL who relapsed or treated failure were enrolled. These children were detected MRD by flow cytometry. The immunophenotyping of children who relapsed or treated failure were compared with that of initial therapy;the immunophenotyping of MRD relapsed was compared with that of initial therapy.Results 1.In 23 out of 27 cases (85.18%) with B-ALL,changed at least 1 antigen between diagnosis and relapse.Six children with CD45 down-modulation and 2 children with CD45 up-modulation.Two children with CD19 down-modulation and 1 child with CD19 up-modulation.Six children with CD34 down-modulation and 4 children with CD34 up-modulation. Five children with CD10 down-modulation and 7 children with CD10 up-modulation.2.Six children with T-ALL had the same expression in CD45 between relapse and treatment failure. 3.These were 15 children had the least 1 case MRD,25 cases MRD were detected,these was 1 case up-modulation in CD45,1 case down-modulation in CD19,2 cases up-modulation and 8 cases down-modulation in CD34,3 cases up-modulation and 6 cases down-modulation in CD10.Conclusions Immunophenotyping of children with ALL may change at relapse and treatment failure. The frequency of change in B-ALL is higher than that of in T-ALL,but the change can not impact the detection of MRD.

Objective To evaluate the key technique and effectiveness of potency preservation in robotic-assisted laparoscopic radical prostatectomy (RALP).Methods The complete clinical and follow-up data of 30 cases underwent RALP between February and May of 2016 were reviewed retrospectively.The average age of the patients was 67.3 years (48-82 years).The peak PSA level before surgery ranged from 7.6 to 53.4 ng/ml with the average level of 21.1 ng/ml.There were 7,16,6 and 1 case with the Gleason score of 6,7,8,and 9 point,respectively.Preoperative erectile score (IIEF-5) of the 30 patients were list as below:3 cases (0-10 points),4 cases(11-15 points),17 cases(16-20 points),and 6 cases(21-25 points).The key techniques of potency preservation during RALRP includes deep dorsal vein ligation techniques,neurovascular bundles preservation techniques and drain tube placement techniques.Results All 30 cases underwent operation successfully with no transfer to open surgery.Average operative time was 150.7 min (98-240 min) with an estimated blood loss of 165.7ml (50-550 ml).The average drainage removal time was 5.1 d postoperatively.The average bowel recovery time was 2.7 d and average hospitalization time was 8.2 d,respectively.There were two cases with one positive margin on the bladder neck and one on the tip of prostate,respectively.Seventeen cases gained potency preservation six months after surgery.Conclusion It was safe and beneficial for the potency preservation in RALP,which could be considered as one of the best options for the prostate cancer surgery.

Objective To learn more about the clinical and laboratory features of childhood paroxysmal nocturnal hemoglobinuria(PNH) and to improve the diagnosis.Methods The clinical and laboratory features of 12 cases of PNH were analyzed,who were diagnosed from January 2000 to November 2004,and the positive responses to treatments were observed.Results 1) The youngest age of onset was 2 years;the disease often manifested with anemia(100%),recurrent infections(50%) and hemorrhages(33%),occurring mainly in skin and mucosa.No patient developed a thrombosis.2) 66.7% of the patients showed peripheral blood cytopenia.Dysplasia of bone marrow was observed in 25% of patients.Fifty percent of them had an increased percentage of erythroid lineage.3) Positive hemolytic tests included urine OB 41.6%,Ham′s test 33.3% and Rous′ test 25%.Glycosyl-phosphatidyl inositol(GPI) deficient cells were found in 100% of the patients.4) 57.1% of patients was improved after being treated with adrenocortical hormone,androgens or cysporin.Conclusions Besides hemoglobinuria,peripheral blood cytopenia were also the common manifestation of PNH.Flow cytometry based immunophenotypic methods for the analysis of CD_(55) and CD_(59) may improve the diagnosis of PNH.J Appl Clin Pediatr,2006,21(3):153-154

Objective To explore the clinical characteristics of nosocomial infection in children with acute leukemia and the strategy of prevention and treatment.Methods One hundred and thirty-three cases of nosocomial infection in children with acute leukemia were analyzed by retrospective study.The relationship between nosocomial infection and stage of leukemia,hospitalization duration,and the rate of infection were investigated.Results Nosocomial infection rate was 53.4%(71/133 cases),significant difference of infection rate between acute lymphoblastic leukemia and nonlymphoblastic leukemia group was found(P0.05).The main pathogens of septicaemia were gram negative bacilli,and they were generally sensitive to Amicacin and Pi-peracillin/tazobactam.Conclusions Children with acute leukemia have high nosocomial infection rate.The occurrence of nosocomial infection was related to the type and stage of leukemia and hospitalization duration but not to the prognosis.The main pathogens of septicaemia were gram negative bacilli.

The authors explained the process of organizing and implementing of the designed experiments.The designed experi- ments can improve students' creative thinking ability and activate students'initiative and meanwhile,it can improve teachers' level and contribute to making progress in teaching and studying although there are still some problems to solve.