Objective To investigate the leukemia incidence among residents in the vicinity area of a nuclear installation.Methods The data were collected by the retrospective survey.Diagnosis is based on the medical records in all the relevant hospitals.The study area was those residential areas within 10 km of radium surrounding the installation.All residents who had lived in the study area for six months and over were recruited into the study group.Results The survey ascertained 643 newly diagnosed leukemia cases in the study area during 1997 to 2007.The crude rate was 2.51/100,000,and its standardized rate to national population structure was 2.53/100,000.The incidence rate in the study area was slightly lower than that in the whole city.No increase trend was detected during the period.Conclusions No significant difference of the leukemia incidence rate was found between the vicinity area of the nuclear installation and the whole city.

Objective To evaluate the efficacy of itraconazole oral solution for prevention of invasive fungal infection ( IFI ) in neutropenic patients with acute leukemia after chemotherapy.Methods Clinical data of 136 neutropenic patients with acute leukemia after chemotherapy at the Department of Hematology,Nanfang Hospital from January 2008 to December 2010 were retrospectively analyzed.Patients were divided into itraconazole group ( n =67 ) and control group ( n =69).There were 36 patients with acute nonlymphocytic leukemia ( ANLL),31 with acute lymphoblastic leukemia (ALL) in itraconazole group;while in control group,there were 30 patients with ANLL,38 with ALL and 1 with biphenotypic acute leukaemia (BAL).Patients in itraconazole group received intraconazole after chemotherapy until the neutrophil count was increased to 0.5 × 109/L or the body temperature returned to normal and without any imaging evidence of IFI.The incidence of IFI and clinical features were compared between the groups using SPSS 13.0 software.Pearson x2 test was used for nominal variables,for measurement data,t (normal distribution) or Mann-Whitney U (skewed distribution) test were used.Results There were 12 cases ( 17.9％ ) suffering from IFI in itraconazole group and 32 cases (46.4％) in the control group (x2 =12.59,P ＜ 0.01 ).For ANLL patients,the incidence of IFI in itraconazole group was significantly lower than that in control group ( 16.7％ vs.56.7％,x2 =11.53,P ＜0.01 ).In itraconazole group,the incidence of IFI in female patients was significantly lower than that in male patients ( 8.6％ vs.28.1％,x2 =4.35,P ＜0.05 ).And for the female patients,the incidence of IFI in itraconazole group was significantly lower than thatin the control group (8.6％ vs.44.7％,x2 =11.98,P＜0.01).Conclusion Itranconzole oral solution can effectively prevent IFI in neutropenic patients with acute leukemia after chemotherapy,especially for the female patients with ANLL.

Objective To investigate the microbleeding incidence of healthy eldery population and patients with stroke.Methods 30 cases of healthy eldery population,32 cases of cerebral hemorrhage,46 cases of patients with ischemic cerebral vascular diseases were performed of MRI and GRE-T_2 ~* WI examination.Results The microbleeding incidences was 37.5% in cerebral hemorrhage group,28.1% in multiple cerebral infarction group,25.0% in Binswanger's disease group.The most frequently seen microbleeding foci located in ganglia areas,then in thalamus areas,subcortical areas and brain stem,last in cerebellar.Conclusion GRE-T_2 ~* WI,helpful for finding microbleeding and indicating lesion degree of microblooding vessels,plays an important role in the diagnosis of stroke and decision making of treatment.

Case-Control Studies ; Child ; Child, Preschool ; China ; epidemiology ; Enterovirus A, Human ; Female ; Hand, Foot and Mouth Disease ; epidemiology ; virology ; Humans ; Infant ; Male ; Risk Factors

OBJECTIVETo explore the effects of graft composition on hematopoietic reconstitution and graft-versus-host disease (GVHD) in HLA-identical related donor peripheral blood stem cell transplantation (PBSCT) for hematological malignancies.

METHODSThe relationship between the number of graft composition and their hematopoietic reconstitution and GVHD in 107 patients with hematological malignancies undergoing HLA-identical related donor PBSCT was retrospectively analyzed.

RESULTSNone of the graft composition numbers had correlation with the time of neutrophil reconstitution. There was a negative correlation between the number of mononuclear cells (MNCs) or CD34+ cells and the time of platelet reconstitution (P < 0.05) with the absolute correlation coefficients below 0.4, and so did between the number of CD34+ or CD34+ CD38- cells and the development of acute GVHD (P < 0.05) and their absolute correlation coefficients. Each lymphocyte subset number had no correlation with acute GVHD. There was a positive correlation between the number of CD25+ CD4+, CD3+ or CD4+ CD3+ cells or CD4+ /CD8+ ratio and the development of chronic GVHD (P < 0.05). And the correlation coefficients all exceeded 0.4, more over, CD25+ CD4+ cells number reached up to 0.78. CD34+, CD34+ CD38- cells number had no correlation with chronic GVHD.

CONCLUSIONIn HLA-identical related donor PBSCT, further increasing infused MNC, CD34+, CD34+ CD38- cells can no more accelerated hematopoietic reconstitution after these cells attained their threshold values, otherwise the incidence of cGVHD might increase due to the increase of the accompanied lymphocytes.

Adolescent ; Adult ; Child ; Female ; Graft vs Host Disease ; immunology ; pathology ; Hematologic Neoplasms ; therapy ; Humans ; Male ; Middle Aged ; Peripheral Blood Stem Cell Transplantation ; Retrospective Studies ; Tissue Donors ; Transplantation, Homologous ; Young Adult

Objective To explore the diagnosis and therapy experience of vascular ring combined with tracheal compression in infants and neonates.Methods Sixteen cases(including 7 boys and 9 girls,aged 1 day to 12 months)with vascular ring combined with tracheal compression hospitalized in Guangdong General Hospital from Jun.2004 to Dec.2009 were enrolled.In these 16 children,13 cases had congenital heart malformations.All children underwent X-ray,echocardiography and spiral computed tomography examination.Nine cases received bronchoscopy study.Fifteen cases performed surgical division of vascular ring with cardiopulmonary bypass and 1 case underwent vascular ring division and tracheoplasty.Eleven cases received management of congenital heart defect simultaneously.Results Vascular ring anomalies included pulmonary artery sling in 5 children,right aortic arch-left ligmentum/aberrant left subclavian artery in 8 cases,double aortic arch in 1 case,innominate artery compression in 1 case,and pulmonary sling combined with right aortic arch-aberrant left subclavian artery in 1 case.There were 2 ring-sling complex cases in this study.The diagnosis of vascular ring were correctly made by echocardiography in 7 children and made by spiral computed tomography in all 16 cases.Two cases combined with tracheal ring died.In the follow-up study of 11 cases,5 cases were still vulnerable to wheezing.Conclusions The common presentation of tracheal compression in infants and neonates associated with vascular ring are tachypea,stridor,and dyspnea.Multi-slices spiral computed tomography is an important imaging modality.Surgical divisions of vascular ring are safe procedure in most cases and tracheal compression can be relieved by this operation.In patients with severe tracheal stenosis,tracheoplasty should be recommended.

Objective:To investigate the effect of rapamycin on the proliferation and apoptosis of rheumatoid arthritis synovial fibroblasts (RA-FLS) and its mechanism.Methods:Synovial tissues were collected from patients with RA during joint replacement surgery, and primary synovial fibroblasts were extracted by trypsin digestion. The effect of rapamycin on the proliferation of RA-FLS was detected by cell counting kit (CCK-8) method. RA-FLS were divided into the control group and the rapamycin group (10 nmol/L). The effect of rapamycin on apoptosis of RA-FLS cells was detected by flow cytometry. The mRNA expres-sion levels of mammalian target of rapamycin (mTOR), serine/threonine-protein kinase AKT, B lymphocy-toma-2 (Bcl-2) associated X gene (Bax) and Bcl-2 were detected by RT-PCR. The protein expression levels of Bax, Bcl-2, mTOR, p-mTOR (2448), AKT, p-AKT and mTORC1 downstream related molecules protein S6 kinase 1(S6K1), p-S6K1, eukaryotic translation initiation factor-binding protein 1 (4EBP1) and p-4EBP1 were detected by Western blot. Differences between the two groups were compared using two independent samples t-test. Results:The results showed that the proliferation efficiency of RA-FLS treated with rapamycin was significantly weaker than that of the control group, and the drug inhibition rate of rapamycin increased with the increase of rapamycin concentration. The apoptosis rate of rapamycin group was significantly higher than that of the control group (5.31±0.59)% vs (3.49±0.40)%, t=7.83, P=0.001). The expression of Bax mRNA in rapamycin group was significantly increased (1.35±0.04 vs 1.00±0.00, t=15.60, P=0.004), while the expression of Bcl-2 mRNA (0.790±0.003 vs 1.000±0.000, t=85.50, P=0.007), mTOR mRNA (0.41±0.08 vs 1.00±0.00, t=14.37, P=0.044) and AKT mRNA (0.59±0.08 vs 1.00±0.00, t=7.54, P=0.017) were decreased, and the differences were statistically significant when compared with the control group. Compared with the control group, the protein expression of Bax in rapamycin group was significantly increased (0.75±0.10 vs 0.48±0.09, t=4.04, P=0.007), and the expression levels of Bcl-2 (0.632±0.055 vs 0.758±0.020, t=7.35, P=0.002), p-AKT/AKT(0.61±0.07 vs 0.88±0.04, t=5.61, P=0.005), p-mTOR/mTOR(0.92±0.12 vs 1.28±0.09, t=5.05, P=0.002), p-S6K1/S6K1(0.884±0.020 vs 1.023±0.058, t=4.52, P=0.004) and p-4EBP1/4EBP1 were decreased(0.86±0.05 vs 1.11±0.05, t=6.00, P=0.004). Conclusion:Rapamycin may inhibit the proliferation and induce apoptosis of RA-FLS cells by inhibiting AKT/mTORC1 pathway.

OBJECTIVETo evaluate the prognostic significance of a new grading and scoring system (based on the new IASLC/ATS/ERS classification) in stage I pulmonary adenocarcinoma, as compared with the WHO grading system.

METHODSThe clinicopathologic characteristics of 125 patients with stage I pulmonary adenocarcinoma primarily treated by surgical resection were reviewed retrospectively. All cases were classified according to the new IASLC/ATS/ERS classification and graded into three prognostic groups based on the new classification, the Sica scoring system and the WHO grading system, respectively. The differences in prognosis of the three groups were analyzed.

RESULTSThere was a statistically significant correlation between the new grading system and the WHO grading system (P = 0.000). Both of them showed negative correlation with overall survival. The new scoring system however better correlated with disease recurrence and/or metastasis (P = 0.855, P = 0.073 versus P = 0.011). According to univariate Log-rank test, the prognosis correlated with tumor size (P = 0.004), clinical stage (P = 0.000), the WHO grading (P = 0.020), the new grading system (P = 0.000), the new scoring system (P = 0.000), vascular invasion (P = 0.021), and recurrence and/or metastasis (P = 0.000). The Cox regression analysis demonstrated that clinical stage (P = 0.014), the new grading system (P = 0.047), the new scoring system (P = 0.043), and recurrence and/or metastasis (P = 0.018) were significantly independent poor prognostic factors.

CONCLUSIONSThe new grading and scoring system shows good correlation with the WHO grading system. Compared with the WHO grading system, the new scoring system based on the new IASLC/ATS/ERS classification provides valuable information in categorizing stage I pulmonary adenocarcinoma cases with different risks of disease recurrence, tumor metastasis and prognosis.

Adenocarcinoma ; classification ; pathology ; surgery ; Adenocarcinoma, Mucinous ; pathology ; surgery ; Adult ; Aged ; Aged, 80 and over ; Carcinoma in Situ ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Lung Neoplasms ; classification ; pathology ; surgery ; Male ; Middle Aged ; Neoplasm Grading ; methods ; Neoplasm Invasiveness ; Neoplasm Metastasis ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Prognosis ; Research Design ; Retrospective Studies ; Societies, Medical ; Young Adult

OBJECTIVETo comprehend the abnormalities of JAK2, c-mp, EPOR, MPW515L/K and TET2 genes in patients with familial myeloproliferative neoplasm (MPN) and their relatives, and to explore mechanism of MPN pathogenesis.

METHODSThe complete blood counts of 2 brothers diagnosed with MPN in out hospital and their family members (15 persons in together) were performed, and bone marrow (BM) examinations in patients with abnormal blood count were performed PCR, DNA sequencing were used to evaluate the expression of related genes.

RESULTSThe elder brother was diagnosed with essential thrombocythemia (ET), the younger one was polycythemia vera (PV), and others had no clinical manifestation. The third MPN patient was diagnosed based on the blood count and BM examination. The PCR and sequencing results showed that there was JAK2V617F mutation in 3 patients, the elder brother was homozygous, the younger and their father were heterozygous. There were no BCR/ABL fusion gene and c-mp, EPOR, MPW515L/K, TET2 gene mutation in any member. By sequencing the full-length cDNA of familia JAK2 gene, we found that G380A heterozygous mutation was detected in 2 patients, which changed glycine at 127 into aspartic acid, C489T mutation was detected in 13 patients, G2490A mutation in 14, but both of them were synonymous mutations.

CONCLUSIONSJAK2V617F is one of the important indicators to diagnose MPN. The JAK2V617F mutation of this family involves two generations. For newly diagnosed MPN patients, their family members should consider screening, so some familial patients can be diagnosed as early as possible. Gene mutation besides JAK2V627F can be detected by sequencing the full-length of JAK2 gene.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; DNA Mutational Analysis ; Female ; Humans ; Janus Kinase 2 ; genetics ; Male ; Middle Aged ; Myeloproliferative Disorders ; genetics ; Polycythemia Vera ; genetics ; Sequence Analysis, DNA ; Sibling Relations ; Thrombocythemia, Essential ; genetics ; Young Adult

OBJECTIVETo evaluate the effect of thoracic radiation therapy (TRT) on patients with extensive stage small-cell lung cancer (SCLC).

METHODSOne hundred and fifty-four patients with extensive stage SCLC treated in our department between January 2003 and December 2006 were enrolled in this study. Eighty nine patients received chemotherapy and thoracic radiation therapy (ChT/TRT), and 65 patients were treated with chemotherapy alone (ChT without TRT). The chemotherapy was CE (carboplatin and etoposide), PE (cisplatin and etoposide) or CAO (CTX, ADM and VCR) regimens. The total dose of thoracic irradiation was 40-60 Gy with 1.8 - 2.0 Gy per fraction.

RESULTSFor the whole group, the median survival time (MST) was 13.7 months, the 2-year and 5-year overall survival rates were 27.9% and 8.1%, respectively. The MST, overall survival rates at 2 years and 5 years in the ChT/TRT group and ChT without TRT group were 17.2 months, 36.0%, 10.1% and 9.3 months, 16.9%, 4.6%, respectively (P = 0.001). The median progression-free survival (PFS) for all patients was 8.0 months, the 2-year and 5-year PFS were 13.6% and 8.2%, respectively. The median PFS, 2-year and 5-year PFS in the ChT/TRT group and ChT without TRT group were 10.0 months, 17.4%, 10.5% and 6.2 months, 9.8%, 4.9%, respectively (P < 0.001). The incidence of intra-thoracic local failure was 29.6% in the ChT/TRT group and 70.0% in the ChT/without TRT group (P = 0.000).

CONCLUSIONSChemotherapy plus thoracic radiation therapy can improve the overall survival, progress free survival and reduce local regional failure rate in patients with extensive stage SCLC compared with that by chemotherapy alone.

Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Carboplatin ; therapeutic use ; Cisplatin ; administration & dosage ; Combined Modality Therapy ; Disease-Free Survival ; Etoposide ; administration & dosage ; Humans ; Lung Neoplasms ; drug therapy ; radiotherapy ; Prognosis ; Small Cell Lung Carcinoma ; drug therapy ; radiotherapy ; Survival Rate