The development of effective therapy for children with acute lymphoblastic leukemia (ALL) is one of the greatest successes of clinical oncology. However, cure rates for adults with ALL remain relatively low. Adolescents are the special population between children and adults. These patients group will be received protocol from either pediatric or adult oncologists depending on referral pattern. In recent years, researchers from abroad large cooperative groups show pediatric-based protocol has better outcome than adult-based protocol. In this article, the protocol of ALL in children and adults are compared . It seems the first and probably the most important reason is the dose intensity of the nonmyelosuppressive chemotherapeutic agents, especially asparaginase.

Objective To find the mechanism of traditional Chinese medicine Heshouwuyin(HSWY) in anti-aging in ovary of the aging model rats,so as to provide theoretical and experimental evidence to anti-aging in female sexual gland.Methods Thirty-six rats were divided into three groups at random: normal group,aging model group,prevent aging group.Rats the in prevent aging group were subdivided into four groups: HSWY low dosage group,HSWY medium dosage group,HSWY high dosage group and Heshouwan(HSWW) group.The sub-acutely aging model rats were induced by D-galactose,and rats in the prevent aging group were received intragastric administration of HSWY and HSWW with D-galactose intraperioneal injection.The gene expressions of p53,p19~(ARF),Rb and p16 were detected in the ovaries of each group with reverse transcription polymerase chain reaction,and the protein expressions of Rb and p16 in the ovaries with Western blotting.Results The model group rats were in the aging status with low spirits and withered and yellowed hair.The ovaries of the rats in the model group expressed aging change.The gene expressions of p53,p19~(ARF),Rb and p16 were up-regulated and the protein expressions of Rb and p16 were increased in the ovaries of aging rats.HSWY significantly suppressed the gene expressions of p53,p19~(ARF),Rb and p16(P

AIM:To explore the changes of intraocular pressure measured by noncontact tonometer (IOPNCT) with high myopia and analyze the relative fators after small incision lenticule extraction(SMILE).METHODS:A retrospective study.Totally 108 cases (216 eyes) with high myopia received SMILE during March 2015 to October 2016 were involved.The IOPNCT, corneal central thickness (CCT) and corneal curvature for 3mo were recorded and analyzed by ANOVA, LSD t test.The Pearson correlation analysis and multiple linear regression model analysis were used to evaluate the relationship between IOPNCT and its influence factors.RESULTS:(1) There was significant statistical difference in IOPNCT after SMILE at 1d, 1wk, 1 and 3mo compare with preoperative (t=17.785, P=0.019;t=17.981, P=0.016;t=18.841, P=0.012;t=19.364, P=0.001);the IOPNCT after SMILE decreased.The IOPNCT values at every time after SMILE was no statistical difference (t=1.871, P=0.818;t=3.062, P=0.328;t=1.143, P=0.373).(2) The IOPNCT in high myopia were positive correlated with CCT and corneal curvature after SMILE (r=0.4356, 0.295;P<0.05), respectively.(3) The multiple linear regression model analysis revealed that Y=-14.601+0.348X1+0.03X2 (Y was IOPNCT, X1 was corneal curvature, X2 was CCT,P<0.001);Y=3.679+0.28X1+0.012X2 (Y was△IOPNCT,X1 was variation of corneal curvature,X2 was△CCT, P<0.001).CONCLUSION:The IOPNCT decreased after SMILE in high myipia, and it showed that there was no significant influence to use glucocorticoid eye drops in short terms.There was positive correlation among IOPNCT, CCT and corneal curvature after SMILE.

?The small incision lenticule extraction ( SMILE ) with femtosecond laser is a new mode of corneal refractive surgeryrecently. The safety, efficacy, stability and predictability of SMILE lead the corneal refractive surgery to a new world that only use femtosecond laser to correct myopia.With the development and popularity of SMILE, the clinical effect has aroused much concern.But there remain exited disputes in refractive stability, visual quality and corneal biomechanical property, contrast sensitivity and glare symptoms, corneal sensitivity and dye eye, corneal endothelial cells and intraocular pressure.These will be summarized in this review.

Objective To evaluate the distribution characteristics of left ventricular systolic dyssynchrony (LV-SD) in dilated cardiomyopathy (DCM) patients with chronic heart failure (CHF) and normal QRS wave width, by pulsed-wave Doppler tissue imaging (PW-DTI), and study its relation with left ventricular systolic function, ventricular remodeling, and functional mitral regurgitation (FMR). Methods The time to peak systolic velocity (Ts) in 12 left ventricular segments was evaluated by PW-DTI, from which the standard deviation (SD) of Ts in the 12 segments (Ts-SD) and maximum Ts difference (Ts-maxD) were calculated. Results Ts-SD and Ts-maxD in the 12 LV segments of the DCM patients with CHF were significantly higher than those of the healthy controls (P＜0.01). In DCM patients with CHF and normal QRS wave width, the incidence of LV-SD was 29.8% (14/47) and the inferior wall was the most frequent distribution site of contraction delay. Linear regression analysis revealed a negative correlation between Ts-SD, Ts-maxD, and left ventricular ejection fraction (LVEF) (P＜0.01), but a positive correlation between Ts-SD, Ts-maxD and left ventricular end-diastolic volume (LVEDV), lefe ventricular end-systolic volume (LVESV), New York Heart Association (NYHA) cardiac function, FMR (P＜0.01) in DCM patients with CHF. Conclusion LV-SD exists in DCM patients with normal QRS width. LV-SD aggravates the LV systolic function damage, which is closely associated with left ventricular remodeling. LV-SD may contribute to the FMR in DCM patients.

Objective To explore the relationship between transitional care model and diabetic patients. Methods 112 patients with type 2 diabetes mellitus were divided into observation group and control group according to random number table. Control group used the doctor as the center patient management mode. The observation group used thepatient-centeredpatient management, application of home nursing service. Results Glycosylated hemoglobin (HbA1c), triglyceride (TG), high-density lipoprotein (HGL), 2 h postprandial blood glucose (2hPBG), fasting blood glucose (FBG), body mass index (BMI) of observation group before treatment respectively were (11.2±2.4)%, (3.7±1.3) mmol/L, (0.5±0.2) mmol/L, (13.6±2.4) mmol/L, (11.8±2.9) mmol/L, (25.9±4.9) kg/m2. Patients discharged from hospital after care for 3 months respectively were (6.8±0.9)%, (1.0±0.3) mmol/L, (2.5±0.4) mmol/L, (8.9±1.5) mmol/L, (6.8 ± 2.0) mmol/L, (20.8 ± 5.8) kg/m2. There was statistically significant difference (t=3.5-6.6,P<0.05). Control group before treatment respectively were (11.9 ± 3.6) %, (3.8 ± 1.5) mmol/L, (0.6 ± 0.3) mmol/L, (13.9 ± 2.9) mmol/L, (11.6 ± 3.2) mmol/L, (25.9 ± 6.8) kg/m2,while patients discharged from hospital for 3 months respectively were (10.9±3.4)%, (3.3±0.7) mmol/L, (0.7±0.2) mmol/L, (12.8±4.2) mmol/L, (10.6± 2.6) mmol/L, (25.1 ± 6.6) kg/m2, there was no statistically significant difference (t=0.05-1.36,P>0.05). Patients discharged from hospital after 3 months, perception, diet, medication, exercise adherence score of observation group was (34.98 ± 5.67), (41.98 ± 5.00), (40.29 ± 5.60), (40.45 ± 7.21) points, which were obviously higher than (21.18±4.75) , (28.46±4.26), (21.88±4.58), (20.98±2.69) points of control group, the difference was statistically significant (t=13.96-19.03,P<0.01). Conclusions Using home nursing service mode in type 2 diabetes care is helping to improve blood sugar levels and improve patient compliance after discharge, fully improve the patients′prognosis.

Objective To explore clinical value of detection of carcinoembryonic antigen(CEA) ,cytokeratin 19 fragment(CY-FRA21-1) and neuron specific enolization enzyme(NSE) in pleural effusion and serum during the differential diagnosis and patho-logical classification of lung cancer .Methods 180 patients with pleural effusion were divided into two groups ,one including 55 be-nign pleural effusion cases(benign pleural effusion group) and the other including 125 lung cancer cases(lung cancer group) .CEA , NSE and CYFRA21-1 in pleural effusion and serum of two groups were measured ,respectively ,and the measure results between two groups were conducted .Results CEA ,NSE and CYFRA21-1 levels in lung cancer group were significantly higher than those in benign pleural effusion group(P<0 .05) .CEA levels in pleural effusion and serum in lung adenocarcinoma group were significantly higher than those in benign pleural effusion group ,lung squamous carcinoma group and small cell lung cancer group(P<0 .05) .CY-FRA21-1 levels in pleural effusion and serum in lung squamous carcinoma group were significantly higher than those in benign pleu-ral effusion group ,lung adenocarcinoma group and small cell lung cancer group(P<0 .01) .NSE levels in pleural effusion and serum in small cell lung cancer group were significantly higher than those in benign pleural effusion group ,lung adenocarcinoma group and lung squamous carcinoma group(P< 0 .01) .The positive detection rate of CEA in lung adenocarcinoma group was significantly higher than that in lung squamous carcinoma group and small cell lung cancer group(P<0 .05) .The positive detection rate of CY-FRA21-1 in lung squamous carcinoma group was significantly higher than that in lung adenocarcinoma group and small cell lung cancer group(P<0 .05) .The positive detection rate of NSE in small cell lung cancer group was significantly higher than that in lung squamous carcinoma group and lung adenocarcinoma group(P<0 .01) .Conclusion CEA ,CYFRA21-1 and NSE in pleural effusion and serum are specific tumor markers of lung adenocarcinoma ,lung squamous carcinoma and small cell lung cancer ,respectively , which may have a certain clinical significance for the differential diagnosis and pathological classification of lung cancer .

Tumor recurrence and drug resistance impact patients'therapeutic effect and prognosis seriously.In recent years,it has been found that epigenetic changes are involved in drug resistance.DNA methylation is one of the ways of epigenetic.DNA methylation of drug metabolism enzyme gene can affect gene's expression,leading to drug resistance.Methotrexate(MTX),a folic acid antagonist,is the most widely used drug in the treatment of malignant tumors,such as leukemia,osteosarcoma,head and neck cancer,and so on.Reduced folate carrier(RFC) is the main transporter cartier of MTX,and gene methylation is related to tumor cells'resistance to MTX.This paper reviews the role of RFC,relation of RFC methylation and methotrexate resistance and the factors of RFC methylation.

Objective To explore the changes of GRO-α and VEGF in the peritoneal fluid of women with endometriosis and their correlation. Methods The levels of GRO-α and VEGF were detected by enzyme linked immunosorbent assay ( ELISA ) method in 39 cases of endometriosis and 25 normal cases of without endometriosis. Results The levels of GRO-αand VEGF in the peritoneal fluid of EMs group were ( 108.77 ± 20. 58 ) pg/ml and ( 199. 67 ± 99. 26 ) pg/ml separately, and it was significantly higher than those in control group ( 71.07 ± 18. 96 ) pg/ml, ( 115.46 ± 32. 39 ) pg/ml. The differences were statically significant( P <0. 05). The level of GRO-α in the peritoneal fluid of the patients in stage Ⅰ and Ⅱ was sig-nificantly lower than that in stage Ⅲ and Ⅳ[(99.43 ± 16.05)pg/ml vs (117.65 ± 20.8)pg/ml, P <0. 05] , while the level of VEGF in the peritoneal fluid of the patients in stage Ⅰ and Ⅱ was significantly higher than that in stage Ⅲ and Ⅳ[(246. 89 ± 114. 34) pg/ml vs ( 152. 82 ± 54. 55 ) pg/ml, P < 0. 05] .There was positive correlation between the level of GRO-α and r-AFS ( r = 0. 439, P < 0. 05 ), but no cor-relation between the level of VEGF and r-AFS ( r = -0. 210, P >0.05). There was no correlation be-tween peritoneal fluid levels of GRO-α and VEGF in the EMs group ( r =-0. 05, P>0. 05). Conclusion Compared with control group, the levels of GRO-α and VEGF in peritoneal fluid of women with endome-triosis were significantly increased, which indicated that the increased GR0-α and VEGF secretion involved in the pathogenesis of this disease. There was correlation between the peritoneal fluid level of GRO-α and the degree of EMs.

One hundred and twenty four patients with cervical intra-epithelial neoplasia(CIN group)and 300 women in routine health check(control group)were recruited in the study.Ureaplasma urealyticum(UU)DNA in cervical secretions was detected by fluorescent quantitative PCR(FQ-PCR),and detectopm pf HPV was also performed in 103 CIN cases.The positive rate of UU was 64.5%in CIN group and 38.7%in control group(P＜0.05).The results demonstrated that UU infection may be associated with cervical intra-epithelial neoplasia,especially for high-grade lesions;and there may be interaction between UU and HPV infection in development of CIN.