Objective To summarize the clinical characteristics,treatment outcomes,and prognostic factors of children with non-metastatic Ewing's sarcoma(ES).Methods A retrospective analysis was conducted on the clinical data of 41 children with non-metastatic ES diagnosed and treated at the Shanghai Children's Medical Center,Shanghai Jiao Tong University School of Medicine from January 2010 to December 2018.All patients underwent chemotherapy based on the RMS-2009 protocol of the center,and local treatment such as surgery and/or radiotherapy was performed according to risk grouping.The Kaplan-Meier method was used to calculate the overall survival(OS)and event-free survival(EFS)rates.Univariate prognostic analysis was performed using the log-rank test,and multivariate analysis was conducted with Cox regression.Results Of the 41 children,21 were male and 20 were female.The median age at diagnosis was 7.7 years(range:1.2-14.6 years).The median follow-up time for patients with event-free survival was 68.1 months(range:8.1-151.7 months).As of the last follow-up,33 patients were in complete remission,and the overall 5-year EFS and OS rates were(78±6)％and(82±6)％,respectively.Univariate analysis by the log-rank test showed that a tumor diameter ≥8 cm,time from diagnosis to start of local treatment ≥16 weeks,and incomplete surgical resection were associated with poor prognosis(P＜0.05).Multivariate Cox regression analysis indicated that incomplete surgical resection(HR=8.381,95％CI:1.681-41.801,P=0.010)was an independent risk factor for poor prognosis in children with ES.Secondary tumors occurred in 2 cases.Conclusions A comprehensive treatment strategy incorporating chemotherapy,surgery,and radiotherapy can improve the prognosis of children with ES.Poor prognosis is associated with an initial tumor diameter ≥8 cm,while complete surgical resection and early initiation of local treatment can improve outcomes.[Chinese Journal of Contemporary Pediatrics,2024,26(4):365-370]

Objective To explore the factors that affect the excretion rate of methotrexate and the occurrence of adverse reactions in high-dose methotrexate chemotherapy for osteosarcoma patients.Methods Retrospectively analyzed methotrexate excretion,liver injury,kidney injury,bone marrow suppression and other adverse drug reactions in 97 high-dose methotrexate chemotherapy cycles of 28 patients with osteosarcoma.The concentration of methotrexate in the blood at 0,24,48,72 h and the level of white protein in the blood were also analyzed.Results When the peak concentration of methotrexate(0h,Cmax)≥700 μmol·L-1 the risk of excretion delay increases:the incidence was 23.21％in group with Cmax ≥ 700 μmol·L-1,and it was 5.00％in group with Cmax＜700 μmol·L-1,(P＜0.05),but when the peak concentration was≥1 000 μmol·L-1,the risk of delayed excretion did not increase further:the incidence was 16.00％in group with Cmax 1 000 μmol·L-1,and it was 15.49％in group with Cmax＜1 000 μmol·L-1,(P＞0.05).Methotrexate blood Cmax has no significant correlation with the occurrence of important adverse reactions such as liver injury and bone marrow suppression.There was significant correlation between low serum albumin level and bone marrow suppression in patients.The average albumin level in group with bone marrow suppression was(39.1±3.4)g·L-1,which in without bone marrow suppression group was(41.2±4.0)g·L-1(P＜0.05).Conclusion During high-dose methotrexate chemotherapy in patients with osteosarcoma,delayed excretion and adverse reactions should not be prevented by lowering the peak concentration.The albumin level of patients is an important factor affecting the occurrence of bone marrow suppression.

Acupuncture and moxibustion has certain advantages in the treatment of post-stroke spastic paralysis，but the treatment methods and diagnosis and treatment ideas are complicated. This paper sortes out the representative contemporary acupuncture and moxibustion schools in the treatment of post-stroke spastic paralysis, analyzes their academic origins，summarizes and compares the theory，acupoint selection and technique characteristics of different schools in the diagnosis and treatment of this disease，so as to provide some references for guiding optimal treatment schemes selection in clinic.
Humans ; Moxibustion ; Muscle Spasticity/therapy* ; Acupuncture Therapy ; Schools ; Acupuncture Points ; Stroke/therapy*

Hyperuricemia is closely related to metabolic diseases.With the development of metabolic syndrome(MS),it can change the mechanical load,hormone and biochemical characteristics of patients,thus perform a complex impact on bone health.Although the increased mechanical load and the production of some hormones can prevent os-teoporosis,it can promote inflammation and oxidation in vivo,which may be harmful to bone health,and uric acid may have antioxidant effect to protect bone.Therefore,the influence of increased uric acid on bone in MS patients is still unclear.The present article will further explore this issue.

Objective Current data are insufficient for comparisons of effectiveness between percutaneous coronary intervention(PCI)and coronary artery bypass grafting(CABG)among patients with coronary artery disease(CAD)and left ventricular dysfunction.Methods A total of 905 CAD patients with reduced left ventricular ejection fraction(LVEF≤35％)in single center of China who underwent either PCI or CABG were enrolled in a real-world cohort study.Clinical outcomes included short-and long-term all-cause mortality,rates of heart failure(HF)hospitalization and repeat revascularization.Propensity score matching was used to balance the 2 cohorts.Results PCI was associated with lower 30-day mortality rate(HR 0.29,95％CI 0.09-0.88,P=0.029).At a mean follow-up of 4.5 years,PCI and CABG had similar all-cause death(HR 1.00,95％CI 0.67-1.50,P=0.990)and HF hospitalization(HR 0.81,95％CI 0.40-1.64,P=0.561),but PCI had higher risk of repeat revascularization(HR 14.46,95％CI 3.43-60.98,P＜0.001).PCI was associated with more significant LVEF improvement than CABG(P=0.031 for interaction).Conclusions CAD patients with reduced LVEF who underwent PCI had lower short-term mortality rate and more LVEF improvement but higher risk of repeat revascularization during follow-up than patients who underwent CABG.PCI showed comparable long-term survival and HF hospitalization risk.

Objective:To explore the indication of bacterial artificial chromosome-on-beads identification/separation technology in prenatal diagnosis and its application value.Methods:The inclusion criteria were as follows: age ≥35 years, high risk/critical risk of serological prenatal screening, high risk of non-invasive gene testing (NIPT), abnormal ultrasonic indexes or adverse pregnancy history. From April 2016 to December 2020, 3579 amniotic fluid samples collected from pregnant women with singletons were detected by bacterial artificial chromosome-on-beads identification/separation technique (BoBs) and G-banding karyotype analysis simultaneously. The aneuploid abnormality/microdeletion/microdeletion samples detected by karyotype analysis or BoBs were verified by fluorescence in situ hybridization (FISH)/SNP array as needed.Results:(1) The percentage of samples with indications of advanced maternal age, high risk of NIPT and high risk of serological screening was 89.44%(3 201/3 579), the detection rate of aneuploidy was 96.19%(202/210), and the detection rate of microdeletion/microduplication was 87.5%(28/32),the total abnormal detection rate was 95.04% (230/242). The samples with abnormal ultrasonic indexes, adverse pregnancy history and critical risk indications of serological screening in the second trimester accounted for 10.66%, and the abnormality of aneuploidy and micro-duplication/micro-deletion was 4.96%. (2) 198 common chromosome aneuploidies (13/18/21/X/Y) were detected by BoBs, and 12 cases with chimeras ≥20% were found, which were consistent with karyotype results. Two copies of 21-trisomy, three copies of X/Y, seven copies of 2, 7, 8, 9, 10, 20, mar karyotype chimerism, eight copies of arm inversion and five copies of translocation outside the detection range of probes were detected by karyotype analysis. The sensitivity, specificity and false negative rate of BoBs detection for five aneuploidies were 94.6%(210/222), 100% and 5.4%(12/222), respectively. BoBs and karyotype analysis detected 32 and 9 cases of microdeletions/microduplications respectively. Compared with single karyotype analysis, the combined application of G-banding karyotype analysis and BoBs can detect an additional 9.4% (23/244)positive samples.Conclusion:The samples with elder age, high risk of NIPT, and high risk of serological screening are more suitable as indications for the application of BoBs in prenatal diagnosis.

In order to realize the rapid and non-destructive detection of SO_2 content in sulphur-fumigated Achyranthis Bidentatae Radix, this paper first prepared the sulphur-fumigated Achyranthis Bidentatae Radix samples with the usage amount of sulphur being 0, 2.5%, and 5% of the mass of Achyranthis Bidentatae Radix pieces. The SO_2 content in different batches of sulphur-fumigated Achyranthis Bidentatae Radix was determined using the method in Chinese Pharmacopoeia, followed by the acquisition of their hyperspectral data within both visible-near infrared(435-1 042 nm) and short-wave infrared(898-1 751 nm) regions by hyperspectral imaging. Meanwhile, the first derivative, AUTO, multiplicative scatter correction, Savitzky-Golay(SG) smoothing, and standard normal variable transformation algorithms were used to pre-process the original hyperspectral data, which were then subjected to characteristic band extraction based on competitive adaptive reweighted sampling(CARS) and the partial least square regression analysis for building a quantitative model of SO_2 content in sulphur-fumigated Achyranthis Bidentatae Radix. It was found that the accuracy of the quantitative model built depending on the visible-near infrared spectra was high, with the determination coefficient of prediction set(R■) reaching 0.900 1. The established quantitative model has enabled the rapid and non-destructive detection of SO_2 content in sulphur-fumigated Achyranthis Bidentatae Radix, which can serve as an effective supplement to the method described in Chinese Pharmacopeia.
Hyperspectral Imaging ; Least-Squares Analysis ; Plant Roots ; Sulfur

OBJECTIVE: To investigate regulatory T cells (Tregs) relative content in peripheral blood and bone marrow of patients with myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML) treated with or without decitabine (DAC), analyze the immunomodulatory of Tregs in pathogenesis and remission of MDS and AML, as well as effect of DAC on Tregs. METHODS: From October 2018 to February 2019, 15 patients with MDS and 49 patients with AML (newly diagnosed, treated with DAC or other chemotherapy regimens) were enrolled in this study, and 14 cases with iron deficiency or megaloblastic anemia while without malignant tumor and autoimmune disease as controls. The Tregs relative contents in bone marrow and peripheral blood were analyzed by flow cytometry, meanwhile clinical data of the objects were collected. RESULTS: In peripheral blood and bone marrow of the patients with MDS and AML, the Tregs relative contents at newly diagnosed were higher than those of the control group (P=0.05, P=0.043). The Tregs relative content of AML patients in DAC regimen treatment group was significantly lower than that in the newly diagnosed group and non-DAC chemotherapy group (P<0.05). In DAC regimen treatment group, the Tregs relative contents was significantly lower in remission group than in non-remission group (P<0.05). There was no difference between DAC regimen treatment group and control group in Tregs relative content. CONCLUSION DAC may increase the body's anti-tumor immunity by consuming Tregs content, enhance the body's immune function to identify and kill tumor cells, thereby promote the patients' reliefs.
Antineoplastic Combined Chemotherapy Protocols ; Bone Marrow ; Decitabine/therapeutic use* ; Humans ; Leukemia, Myeloid, Acute/drug therapy* ; Myelodysplastic Syndromes/drug therapy* ; T-Lymphocytes, Regulatory ; Treatment Outcome

COVID-19/epidemiology* ; Humans ; Mental Health ; Pandemics ; Surveys and Questionnaires

OBJECTIVES: The epidemic of acquired immune deficiency syndrome (AIDS) among men who have sex with men (MSM) is severe in China. And MSM has now become a key population for the infection and transmission of AIDS. At present, the bottleneck of AIDS prevention and control among MSM population is low rate of continuous condom use and high incidence of unsafe sexual behavior. Inductive summarization of the literature revealed that the most critical reason for low rate of continuous condom use among the MSM population was condom-related stigma. Although many studies mentioned condom-related stigma among MSM populations, there has been no any definition of MSM-related condom stigma and no measurement for it. Therefore, the paper aims to explore barriers to condom use among MSM, then construct the conceptual and operational definition of "MSM-related condom stigma" through Meta synthesis and concept synthesis, and provide a new perspective for AIDS prevention and control among MSM. METHODS: Based on evidence-based method, "PICoS" framework and Meta-synthesis was used to include the literatures. Then, we used synthesized qualitative evidence from included studies to construct the concept and operational definition of MSM-related condom stigma by the means of thematic analysis and concept synthesis. RESULTS: According to the results of the concept synthesis, MSM-related condom stigma refers to any taboos or misbeliefs about condom use or feeling ashamed or embarrassed to talk about using condoms which perceived by individuals at the individual, interpersonal, and social levels.It was demonstrated through 4 sub-themes at operational level: a symbol of distrust, a symbol of HIV/sexual transmitted infections (STIs) prevention, a symbol of an embarrassing topic, and a symbol of violating the traditional cognition of sexual intercourse. According to the Social-ecological Model (SEM), a symbol of distrust refers to that the MSM population believes that not using condoms represents mutual trust between sexual partners, while using condoms is difficult to express intimacy, trust and loyalty between sexual partners. A symbol of HIV/STIs prevention at the interpersonal level refers to that the MSM population believes that condom use is a "symbol" for the prevention or infection of AIDS; on the one hand, if someone proposes to use condoms, he may be considered infected with HIV or have unsafe sex experiences, thus, making it difficult to propose condom use; on the other hand, if they believe that sexual partners are "AIDS free" (often a wrong perception, such as sexual partners may have the risk of AIDS infection although they do not have AIDS), it is considered that condom use is completely unnecessary. The environmental level includes a symbol of an embarrassing topic and a symbol of violating the traditional cognition of sexual intercourse. A symbol of an embarrassing topic refers to the MSM population feels shame about topics related to sexual behavior and is embarrassed to carry/buy/propose condom use or be ashamed to engage in conversations about whether to use condoms during sexual behavior. And a symbol of violating the traditional cognition of sexual intercourse: The MSM population have limitations in their perception of "sex" or "sexual behavior" and believe that real sex (behavior) is unobstructed contact between the bodies and exchange between all body fluids. CONCLUSIONS The concept of MSM-related condom stigma is proposed for the first time, and its operational definition is given. The concept includes 3 levels and 4 dimensions. It is helpful to understand MSM people's attitude and cognition towards condoms, and adds indicators with cultural sensitivity and behavioral sensitivity to the behavioral intervention for AIDS in the future.
Acquired Immunodeficiency Syndrome/prevention & control* ; Coitus ; Condoms ; HIV Infections/prevention & control* ; Homosexuality, Male ; Humans ; Male ; Sexual Partners ; Sexual and Gender Minorities