Objective To explore the behavior characteristics in children with benign epilepsy combined with centro-temporal spikes(BECTS).Methods Eighty-two children with BECTS aged 2.5-3.0(2.65?2.31)years old,51 male,31 female,who were free of mental retardation assessed with Gesell developmental schedules,untreated with antiepileptic drugs,and were investigated 15 days after the latest seizure.Eighty-two healthy children with sex and age matched to the cases,53 male,29 female,aged 2.5-3.0(2.6?0.4)years old.The behavior characteristics of infants in BECTS group and control group were assessed with CBCL,including 6 behavior factors which were sleep problem,social flinches,depression,physical aspect,attacking,act of sabotage and the infants-middle school student social ability scale.Results The total scores of behavior characteristics and the scores of depression,sleep problem,attacking and act of sabotage in BECTS group were all higher than those in control group,the differences were statistically significant.However,scores of social flinches,and physical aspect in BECTS group had no significant differences compared with those of control group.There were no significant difference of social adaptive component between the BECTS and control group.Conclusions Children with BECTS have behavior disorders to some extent,but their social adaptive capacity are the same as normal children.

0.05).Compared with the CSS,GMFM and WV before treatment,there were statistically difference after 6 and 12 weeks treatment in two groups(Pa

Objective Data on the leukapheresis from 26 pediatric patients with hematologic or solid malignancies was retrospectively evaluated to screen predictive factors affecting the efficacy of peripheral blood stem cell(PBSC) collection from donors,as well as hematopoietic recovery in recipients.Methods We present our experience with 49 apheresis from 26 granulocyte-colory Stimulating factor mobilized donors and analyzed the correlations between the mobilization,the leukocyte count in the donor peripheral blood and the MNC and CD_(34)~+ cell yields in collecting products and the neutrophil and platelet recovery of recipients.Results The process of mobilization and apheresis were well tolerated by our pediatric donors.The median numbers for harvested MNCs and CD_(34)~+ cells were 4.5?10~8/kg and 1.9?10~6/kg of recipient body weight,respectively.Mobilizing dose positively affected the number of mononuclear ceus(MNC) but not CD_(34)~+ cells in the apheresis products.The CD_(34)~+ cell number in the apheresis product was influenced significantly by donor circulating MNC on the day of harvest and correlated with recipient′s engraftment after PBSC was reinfused.Conclusions The MNC yield was stable and met with the demand for autologous stem cell transplantation while the CD_(34)~+ cell number varies obviously from each donor.Since a rapid engraftment was associated with a high number of CD_(34)~+ cells collected,which was in turn predicted by the level of the pre-apheresis CD_(34)~+ cells in the peripheral blood of donors,it is necessary to monitor the donors′ CD_(34)~+ cell during mobilization to determine the optimal time for apheresis.J Appl Clin Pediatr,2006,21(3):148-150

Objective To understand the nutrition status of primary school students in Namling County of Shigatseand so as to provide references for nutrition health intervention for students. Methods By random cluster sampling, 5 primary schools were randomly selected, and 1 class was randomly selected from each grade. A total of 1097 subjects, aged from 7 to 12 years were selected and their height and weight were measured. Results The rate of overweight was 0.46%. The rate of malnutrition was 32.27%, and boys (36.61%) were higher than girls (27.75%) ( 2=9.847, P=0.002).The rate of malnutrition was the lowest (25.00%) in the 8 years old group, and the highest (53.38%) in 12 years old group ( 2=37.808, P<0.001). The rate of stunting was 15.86%. There was no significant difference between boys (17.14%) and girls (14.53%) ( 2=1.408, P=0.235), and the highest (31.76%) in 12 years old group and the lowest (9.66%) in 7 years old group ( 2=34.206, P<0.001). The rate of wasting was 20.78%, boys (24.46%) was higher than girls (16.95%) ( 2=9.411, P=0.002). There was significant difference among different age groups ( 2=25.493, P<0.001). Conclusions Malnutrition is still a serious public health problem among students and the main characteristic was high-rate of stunting and wasting. It is necessary to strengthen nutrition education to improve the nutritional status of students.

OBJECTIVETo evaluate the outcomes of childhood acute myeloid leukemia (AML) treated with AML-XH-99 protocol and explore how to improve the event-free survival (EFS) rate.

METHODSEighty-two patients entered AML-XH-99 clinical trial. Survival rates were evaluated by Kaplan-Meier method with SPSS.

RESULTSAmong the 82 patients, 58 (70.7%) achieved complete remission (CR) after one course treatment, and the total CR rate was 84.1%. The overall 5 year EFS rate was (46.1 +/- 9.1)% and disease-free survival (DFS) rate was (54.3 +/- 10.3)% over a median observation period of 23 months. The 5 year EFS rate of 56 patients received high-dose cytarabine(HD-Ara-C) as intensification therapy was (47.2 +/- 12.9)%. Relapse occurred in 19 patients (26.0%) with a median time of 10 months (ranges 2 approximately 53 months), 28 patients died.

CONCLUSIONAML-XH-99 protocol resulted in a higher CR rate, especially one course CR rate, which was one of the key factors for long-term EFS and HD-Ara-C intensification therapy was effective in the treatment of childhood AML.

Adolescent ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Child ; Child, Preschool ; Disease-Free Survival ; Female ; Humans ; Infant ; Leukemia, Myeloid, Acute ; drug therapy ; Male ; Treatment Outcome

OBJECTIVETo analyse the treatment outcome of 158 childhood acute lymphoblastic leukemia (ALL) patients, and explore how to improve the event-free survival (EFS) rate in ALL.

METHODAll of the patients entered the ALL-XH-99 clinical trial. Kaplan-Meier method was used to estimate survival rates and differences were compared with the 2-sided log-rank test, statistics was done by SPSS.

RESULTSOut of the 158 patients, 153 (96.8%) attained complete remission (CR) in a median time of 33 days. The overall EFS rate at 5 years was (72.4 +/- 7.8)% with a median observation duration of 26 months. The EFS rates at 5 years in low-risk (LR), median-risk (MR) and high-risk (HR) groups were (88.9 +/- 5.5)%, (78.5 +/- 8.0)% and (53.4 +/- 10.9)%, respectively (P < 0.05). Relapse occurred in 15 patients (10.0%) in a median time of 12 months, including 13 isolated hematologic relapses, 2 isolated central nervous system (CNS) relapses. Seven patients died of complications, and 13 died of leukemia relapse.

CONCLUSIONThe early response to therapy was an important independent prognostic factor, high-dose methotrexate (HD-MTX) was effective for preventing haematological and testicular relapse. The ALL-XH-99 protocol decreased the rate of therapy-related death and improved the long-term event-free survival rate.

Adolescent ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; drug therapy ; mortality ; Survival Rate

To observe the expressions of CD10 in childhood B-acute lymphoblastic leukemia (B-ALL) and to define the role of CD10 in minimal residual disease (MRD) detection. 58 cases of childhood B-ALL were studied in this program. Four-color flow cytometry was used to analyze the characteristics of B-ALL phenotypes. The four-color fluorochrome labeled antibody combinations of CD10 with other markers were used to detect MRD. The results showed that CD10 overexpression (CD10(bright)) was detected in 65.5% (38/58) of B-ALL patients and a strong correlation between CD10(bright) and CD34 expression was also observed, i.e. CD10(bright) expression most frequently happened in B-ALL with high percentage of CD34 positive cells. In detection of MRD, CD10(bright), combined with other markers, could effectively distinguish normal cells with leukemic cells, even if there was no any other marker that can be used. It is concluded that CD10(bright) expression correlates with high expression of CD34 in B-ALL, it is a good marker for MRD detection. The combination of CD10 and other markers can be applied in B-ALL MRD detection with flow cytometry.
Adolescent ; Antigens, CD34 ; analysis ; Burkitt Lymphoma ; diagnosis ; Child ; Child, Preschool ; Female ; Flow Cytometry ; Humans ; Infant ; Male ; Neoplasm, Residual ; Neprilysin ; analysis ; physiology

OBJECTIVEWilms' Tumor Trial (WT-99) of Shanghai Children's Medical Center was designed and conducted by applying therapeutic regimens stratified by stage and histology in accordance with National Wilms' Tumor Study (NWTS) criteria of U.S.A. The main aim of WT-99 was to reduce treatment of low-stage, favorable-histology (FH) tumors without impairing survival and to improve prognosis of stage III and IV (FH) and unfavorable-histology (UFH) tremors with more intensive chemotherapy.

METHODSDiagnosis and treatment was decided by the multi-disciplinary team including oncologists, surgeons, pathologists, radiologists and diagnostic radiologists. Twenty consecutively diagnosed patients were recruited between October 1998 and October 2002. The regimen for patients at favorable-histology (FH) stage I and II and anaplastic stage I was vincristine (Vcr) and dactinomycin (Act-D) only, while for those at focal anaplastic stage II to IV and FH stage III and IV the regimen was Vcr, Act-D and adriamycin (Adr). Patients at diffuse anaplastic stage II to IV and clear cell stage I to IV received four-drug regimen including Vcr, etoposide (VP16), Adr and cytoxan (CTX). For those at rhabdoid stage I to IV the regimen was carboplatin, VP-16 and CTX. Un-resectable patients received 2 courses of Ifosfamide, Vcr and VP-16 as pre-surgery therapy. No radiation therapy was used for patients at stage I and FH stage II.

RESULTSTwenty patients, from 7 months to 12 years old, were enrolled. Pathologic analysis showed fourteen cases were at their FH, three at unfavorable-histology (UFH), two at clear cell and one at rhabdoid stage. Five patients were at stage I, five at stage II, six at stage III, three at stage IV and one at stage V. Eighteen reached complete response (90%), and two failed. One relapsed after 24 months of CCR and reached the second CR after intensive chemotherapy. No therapy-related death happened. Survival rate (SR) was 90% (18/20) and event-free survival (EFS) was 85% (17/20) at 11-45 months, average 27 months.

CONCLUSIONMulti-disciplinary team work model and protocol WT-99 are safe and effective for Wilms' tumor.

Academic Medical Centers ; Bone Transplantation ; Child ; Child, Preschool ; China ; Combined Modality Therapy ; Female ; Humans ; Infant ; Kidney Neoplasms ; classification ; therapy ; Male ; Neoplasm Staging ; Transplantation, Autologous ; Treatment Outcome ; Wilms Tumor ; classification ; therapy

OBJECTIVETo investigate the efficacy of autologous hematopoietic stem cell transplantatation in children with advanced solid tumors.

METHODSBone marrow was collected from the anterior crista of iliac in both sides in 13 cases while peripheral mononuclear cell was harvested with CS-3000 cell separator in other 15 patients after G-CSF mobilization. Since one of them was suspected to have bone marrow involvement of the neuroblastoma cells, the autograft was purged with CliniMACS based on the CD34 positive selection. Conditioning regimen was CBV protocol (cyclophosphamide + bischloro-nitrosourea, i.e., BCNU + etopside) in two children with Hodgkin's disease and etopside plus carboplatin plus melphalan in others.

RESULTSThe number of mononuclear cells collected from bone marrow or peripheral blood was equal to (5.4 +/- 2.1) x 10(8)/kg and (4.1 +/- 1.9) x 10(8)/kg, respectively. Hematopoietic reconstitution was achieved in all patients. Mean time of the neutrophil count recovery to 0.5 x 10(9)/L and mean time of platelet recovery over 2.0 x 10(9)/L were 11.8 +/- 5.7 and 21.0 +/- 9.3 days, respectively. Three units of packed red blood cells and three units of platelet products were transfused in the course of transplantation on average. A total of 12 children developed neutropenic fever and 3 of them had positive blood culture, including staphylococcus epidermal, staphylococcus saprophyte and bacillus subtilis. None of the children died of transplantation-associated complication. One child developed acute renal failure, pulmonary edema and pericardial effusion followed by respiratory distress syndrome. Mechanical ventilation and pulmonary surfactant were used and the patient recovered at last. Another patient developed BCNU associated pulmonary injury, severe pulmonary hypertension and eosinophilosis and recovered after treatment. The mean follow up time was 13 months. Among the 27 children, five died of relapse 5 months after transplantation, and one case of NHL had CNS involvement 3 months after transplantation but has got 17 months of survival till now. The remaining twenty one children were in status of disease-free survival.

CONCLUSIONAutologous stem cell transplantation might be effective in the treatment advanced solid tumors in children.

Child ; Hematopoietic Stem Cell Transplantation ; methods ; Humans ; Neoplasms ; pathology ; therapy ; Transplantation, Autologous ; Treatment Outcome

OBJECTIVETo explore the development and prognosis of the acute flaccid paralysis (AFP) associated with enterovirus 71 (EV71) infection through clinical follow-up study for clinical and magnetic resonance imaging (MRI) features based on the research progress of virology and pathology.

METHODSixteen children with HFMD associated with AFP in hospital from May 1, 2011 to August 31, 2011 were investigated and the patients received intensive rehabilitation training. The 16 cases were divided into two groups (the recovery or the sequela) by if the muscle strength recovered to level 4 after intensive rehabilitation. The MRI findings of 15 children were analyzed and among them, 6 patients were reexamined after one month. The clinical markers were compared between groups including course of disease, WBC, WBC in cerebrospinal fluid (CSF), ventilator support, therapy, the worst muscle strength, the initial tendon reflex, the muscle atrophy, and multi-limb paralysis. The data were analyzed by t test and χ2 test with SPSS10.0.

RESULTAll the 16 children were infected with enterovirus 71 (EV71). The myodynamia of 7 children were level 0, 4 children had serious upper limbs paralysis. The neck muscle in 3 cases and the brain stem motor ruckus in 4 cases were involved. The ankle clonus of non-completely paralyzed limbs in 14 cases occurred during rehabilitation. Eight children had the better prognosis, the other 8 children had sequela. 0 level muscle strength (0 case vs. 7 cases, χ2=12.4), the initial tendon reflex (2 cases vs. 8 cases, χ2=9.6), obvious muscle atrophy (0 case vs. 8 cases, χ2=16), were significantly different in the children with the recovery when compared to the sequela (P<0.01). The severe upper limbs paralysis had the worse prognosis than the severe lower limbs paralysis. MR imaging showed signs of spinal nerve root inflammation and the bilateral hyperintense lesions, symmetrical in the posterior portions of the medulla, pons, and asymmetrical in the ventral horns of cervical spinal cord. Signal enhancement occurred only in the early MRI examination.

CONCLUSIONIn the evolution of AFP due to EV71 infection, the upper motor neuron damage is common, the prognosis is related with the severity of early paralysis and neuron damage. MR imaging is helpful to understand the pathological mechanism of AFP.

Child, Preschool ; Enterovirus A, Human ; pathogenicity ; Female ; Follow-Up Studies ; Hand, Foot and Mouth Disease ; diagnosis ; pathology ; virology ; Humans ; Infant ; Magnetic Resonance Imaging ; Male ; Paralysis ; diagnosis ; pathology ; virology ; Prognosis