Objective To study the clinical features of diagnosis and treatment in children with low-risk myelodysplastic syndrome(MDS) and improve the diagnosis and treatment.Methods The examinations of 17 children with low-risk MDS were analyzed.The blood concentrations of cyclosporine,one of the therapeutic drugs,were monitored and the responses to the treatments were evaluated.Results Exa-mination of full blood count showed that the reductions of 3 cell types,2 cell types and 1 cell type were 11 (64.7%)cases,5(29.4%)cases and 1(5.9%)case,respectively.Reticulocyte count showed an increase in 82.4% of the patients and normal in 3 cases.Fourteen in 17 cases were hyperplastic marrow and 3 cases were hypoplastic marrow.Among all cases,one lineage,2 lineages and 3 lineages dyspoiesis were seen in 8(47.1%),7(41.2%) and 1 (5.9%)cases,respectively.One case showed no dyspoiesis.Cytogenetics examination showed normal in 10(58.8%) cases and abnormal in 7(41.2%) cases.Fifteen (88.2%) cases had normal proportions of CD59 negative cells,while 2 cases had higher proportions.The blood concentrations of cyclosporine that were tested in 9 cases at the end of the third week were in a range of 95.3-316.5 ?g/L.The therapeutic effect of 10 cases were evaluated at the end of the third month after being treated.Eight cases achieved haematological improvement and 2 cases didn′t.The rate of improvement was 80%.Conclusions The patients of low-risk MDS are mostly school-aged children and pancytopenia is the most common sign.The combination of predisone,cyclosporine and stanozolol agents shows good effect to treat low-risk MDS.The absorption of cyclosporine is different individually,so it is significant to adjust the dosage of cyclosporine according to the concentration regularly in clinical practice.

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

Chromosome Deletion ; Chromosomes, Human, Pair 15 ; genetics ; Humans ; Infant ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; genetics ; Male ; Mutation

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.

Objective To analyze prognostic factors in children with acute myeloid leukemia(AML).Methods Retrospective analyze the relationship between many factors of the diagnosed children with AML and their 3-years event-free survival(EFS).Statistics was analyzed with ?2 test.Results The 3-years EFS was 47.5%.According to the analysis of statistics,EFS of some children groups had statistical differences with their controls (P

0.1).One(1.3%) of them suffered from intracranial hemorrhage.Conclusions 1.(L-ASP) may affect the function of coagulation system,such as prolonged APTT and hypofibrinogenemia.2.There was no statistical difference in side effects of coagulation,in use of domestic L-ASP and foreign L-ASP,intravenous dosing and intramuscular dosing.

We used 4 methods,such as ultrasonic crush(UC),ultrasonic rinse(UR),whorl surge(WS)and rubbing(RU),to isolate epiphytic bacteria from red alga Gracilaria lemaneiformis.Then,we counted bacteria numbers,detected bacterial species,observed bacterial configuration and characteristic of cell wall.Compared with these methods and with different treatments in one method,the results were drawn:the UR and RU were inferior in all methods to isolate bacterial numbers and species,the UC and WS were better,especially,the treatment 30W 30s of UC was the best in experiment,which isolated 12 of 16 bacterial species,and got 1.75 10~6 cells per gram wet weight G.lemaneiformis.

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.

Objective To evaluate safety and efficacy of EUS-FNA for occupying pancreatic lesions.Methods Data of 62 patients with occupying pancreatic lesions,who underwent EUS-FNA between June 2011 and June 2014,were analyzed for completion and complications,with surgery and clinical follow-up as the golden standard.Accuracy,sensitivity and specificity of EUS-FNA were calculated.Results A total of 62 patients with pancreatic lesions successfully underwent EUS-FNA and median puncture number was 4.2(3 to 8).Success rate of puncture was 100％ and sampling satisfaction rate was 90.3％ (56/62).No complications such as fever,infection,bleeding,perforation,severe pancreatitis or death were found.With the final diagnosis as the golden standard(39 malignant lesions and 23 benign lesions),overall diagnostic accuracy of EUS-FNA was 88.7％(55/62).The cytology diagnostic accuracy was 69.4％ (43/62),significantly higher than that of the tissue pathology of 30.6％ (19/62,P＜0.01).Sensitivity and specificity of the procedure were 87.2％(34/39) and 91.3％(21/23) respectively.Conclusion EUS-FNA is an effective and safe procedure in diagnosis of occupying pancreatic lesions.

The main biological function of cytotoxic T cell-associated protein 4 (CTLA-4) is to suppress the T cell response and suppress the immune response, and its mutation will cause a series of immune related abnormalities. This case reports a rare case of onset of lymphocytosis, immune hemolysis, repeated infection, and other similar symptoms of autoimmune lymphoproliferative syndrome which caused by CTLA4 Exon2 c. 151 C＞T mutation. Sequencing validation was performed to clarify the source of gene mutation. We review the pathogenesis of CTLA4 and new progress in treatment in this case, and the follow-up treatment for the patient was prospected.