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 compare efficacy and side effects of intravenous versus oral indomethacin treatment for symptomatic patent ductus arteriosus (PDA) in preterm infants.Methods Fourty-nine preterm infants were reviewed retrospectively who were diagnosed as having symptomatic PDA confirmed by echocardiography.According to the using type and approach that were divided into 2 groups (intravenous group,n=21;oral group,n=28) and their doses and intervals were same.The rates of ductal closure and side effects were compared in 2 groups.Results There were no significantly different between 2 groups in single ductal closure and complicating other diseases. Soon closure of intravenous group was higher significantly than oral group [61.9 %(13/21) vs 28.6 %(8/28),P

Objective To study the relationship between clinical diagnosis and children ventricular premature beat(VPB) electrocardiogram location and morph.Methods Both organic heart disease and without organic heart disease relationship with 109 cases of children ventricular premature beat electrocardiogram location and morph were retrospectively analyzed.Results Children ventricular premature beat location shows that organic heart disease mostly results from left ventricle, without organic heart disease often comes from right ventricle. There was significant difference between above two groups (? 2=37.25 P

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

Adolescent ; Adult ; Aged ; Diagnostic Errors ; Female ; Humans ; Lumbar Vertebrae ; injuries ; Male ; Middle Aged ; Spinal Diseases ; diagnosis ; Young Adult

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 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

The hybrid PET/MR has been gradually applied in clinical practice.However,the hybrid PET/MR is a com plex advanced technique,and it brings to the new challenges,especially regarding the workflow and scan protocols.The guidelines for hybrid PET/MR in brain imaging include information related to the indications and contraindications,preparation before examination,procedures of examination (PET imaging,conventional MRI brain imaging and special MRI imaging for brain disease),application of radiopharmaceutical and MRI contrast-enhanced agent.The purpose of the guidelines is to offer a framework that would be practical and helpful for clinical PET/MR brain imaging.In PET tracers,the guidelines only limit to the 18 F-FDG.

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 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.