Objective To explore the management therapy of pediatric rhabdomyosarcoma.Methods Retrospective analysis of treatment of 29 cases with rhabdomyoscroma from Oct.1998 to Jun.2006.Primary sites included 5 cases of neck,1 chest wall,2 abdominal wall,12 retroperitoneal pelvic cavity and 9 extremity.Pathologic types included embryonal type 19(65.5%),alveolar 8(27.6%),pleomorphic 2(6.9%).According to IRS staging system they were Ⅰstage(n=2),Ⅱstage(n=6),Ⅲstage(n=9)and Ⅳstage(n=12).Most tumors were large than 5 cm(n=26).Results Twenty-seven cases were followed up but 2 of the cases were lost,19 cases got complete remission(4 cases relapsed or died after stopping treatment for 3 months to 3 years and 1 case relapsed after giving up treatment for 3 months),4 cases got partial remission(3 cases relapsed after 6 months diagnosed),4 cases got no response(3 of which deteriorated or relapsed and 1 case surved with tumor).Fourteen cases had constant remission between 5-77 months,averaging 22.9 months with average guitting time of treatment 16.9 months.Conclusion Total tumor resection,chemotherapy and radiotherapy play an important role in management of pediatric rhabdomyosarcoma.

Objective To study the diagnosis and treatment of the model of multidisciplinary team treatment on hepatoblastoma in children.Methods Retrospective analysis of treatment and long term follow-up of 16 patients with hepatoblastoma(8 cases were boys,8 cases were girls;aged 3 months to 11 years old,average age was 2 years old) during Aug.1998 to Jan.2006 in Shanghai Children's Medical Center.Special in multidisciplinary team treatment,preoperative evaluate and operation.Results The morbility locum of 8 cases were in right liver lobe,8 cases were in left liver lobe.Fifteen cases of the clinical presentation were abdominal mass,1 case was peritonitis.According to International Society of Pediatric Oncology(SIOP) Pretext staging system,43.7%(7/16)cases were stage Ⅱ,43.7%(7/16)cases were stage Ⅲ,12.5%(2/16)cases were stage Ⅳ.In 7 cases of stage Ⅱ,6 cases were accepted tumor total resection,1 case was accepted emergency surgery because tumor was fracture.Patients were given ICE protocal.In 7 cases of stage Ⅲ,6 cases were able to undergo delayed tumor resection following open biopsy and subsequent treatment with chemotherapy 2-3 courses.One case gave up treatment because its had poor response to chemotherapy.In 2 cases of stage Ⅳ,1 case was received liver transplantation due to poor respond to chemotherapy.One case was not received any treatment.In 7 cases of stage Ⅱ,6 cases were alive,1 case died,3-year free survival rate was 100%(4/4).In 7 cases of stage Ⅲ,5 cased were alive,3-year free survival rate was 75%(3/4).Two cases of stage Ⅳ all died.Conclusions Surgery play a very important role in the treatment of hepatoblastoma in children.Chemotherapy has improved the resectability of the tumor.Multidisciplinary team treatment is an effective model for diagnosis and treatment on childhood hepatoblastoma.

Objective To explore the effect of surgical treatment on primary gastrointestinal non-Hodgking lymphoma(NHL) in children.Methods Nine cases of clinical and follow-up data of primary gastrointestinal NHL were studied retrospectively to evaluate the effect of surgical treatment on primary gastrointestinal NHL in children.Results Seven cases were male and 2 cases were female.The mean age was(5.59?3.27)years old.The clinical manifestation included abdominal mass (7 cases),abdominal pain (5 cases),fever (2 cases),haematemesis and melena (2 cases),constipation (1 case) and paroxysmal abdominal pain with vomiting (1 case).Nine cases were diagnosed as primary gastrointestinal NHL,including 1 case of intussusception,1 case of acute appendicitis,2 cases of gastrointestinal obstruction,2 cases of gastrointestinal bleeding and 3 cases of abdominal mass.One case received the operation of intussusception reduction,tumor resection and intestinal anastomosis.One case received appendectomy.One case received the operation of tumor biopsy and transverse colon colostomy.Six cases received laparotomy.Six cases were diagnosed as Burkitt lymphoma.One case was anaplastic large cell lymphoma and 2 cases were diffuse large B-cell lymphoma.One case was at stage Ⅰ,1 case was at stage ⅠE,2 cases were at stage Ⅱ,3 cases were at stage ⅡE and 2 cases were at stage Ⅲ.Nine patients had received operation.One case died after operation and 8 cases had received combined chemotherapy.The 1 and 3 years survival rates were 75.0% and 37.5%,respectively.Conclusions Acute abdomen is often the first symptom of primary gastrointestinal NHL in children and comprehensive surgical treatment is an effective procedure for it.

Objective To evaluate the outcomes of mature B-cell acute lymphoblastic leukemia(mature B-ALL) and to assess the safety and efficacy of the treatment protocol.Methods From February of 2003 to December of 2012,15 children were diagnosed as mature B-cell acute lymphoblastic leukemia/lymphoma possible (mature B-ALL/NHLp) in Shanghai Children's Medical Center(SCMC) were enrolled,and they were treated with SCMC-mature B-ALL/NHLp-2003 protocol.All of the clinical characteristics,therapeutic effects and long-term outcomes were analyzed.The statistical data were processed by SPSS 21.0.Results The median age on diagnosis was 8.7 years (1 year and 5 months to 14 years and 4 months).Among them,4 cases presented with local mass including maxillofacial tumors,neck and abdominal mass.The others had systemic manifestations such as fever and pale face.These neoplastic cells retained the expressions of surface membrane immunoglobulin M,terminal deoxynucleotidyl transferase,Cμ,CD10,CD19,cCD79 a differently.Follow-up was updated to November 30,2013.The median follow-up period was 80 months (39-128 months).Theestimated 5-year event free survival rate was (80.0 ± 10.3) ％.According to univariate analysis,increased lactate dehydrogenase level (＞ 4-times the normal value),increased serum ferritin level (＞ 2-times the normal value),no small residual disease markers were indepen-dent poor prognostic factors(x2 =5.49,4.89,5.49,all P ＜ 0.05).Conclusions SCMC-mature B-NHL/ALLp-2003 protocol is feasible and safe for children with mature B-ALL/NHLp,but more sample cases need to be investigated.

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 study the influence of t(8;21) on the curative effect and prognosis of children with acutemyelocytic leukemia M2(AML-M2). Methods The clinical characteristics, curative effects, relapse rate, mortality andevent-free survival (EFS) rate of 14 cases of M2 children with t(8;21) and 21 cases of M2 children without t(8;21) wereanalysed. Results There was no statistical difference in age, initial WBC count and clinical characteristics between theM2 patients with t ( 8; 21 ) and without t(8; 21 ) ( P ＞ 0.05 ). The complete remission rate (92.9 % ) in M2 patients witht(8 ;21) was significantly higher than that (57.1% ) of children without t(8;21) ( P ＜ 0.05), while the relapse rateand mortality were of no marked difference between the two groups ( P ＞ 0.05). The overall EFS rate in M2 childrenwith t(8;21) was lower (69.2%) than that (77.8%) of children without t(8;21) ( P ＜0.05). Conclusions Theprognosis of the M2 children with t(8;21) was not better than that of the M2 children without t(8;21). The infuence oft(8;21 ) on the prognosis of M2 might be different from race and region.

OBJECTIVETo observe the expression of dynamin-1 and phosphor-dynamin-1 in the hippocampus of children and rats with mesial temporal lobe epilepsy (MTLE) and to investigate the roles of dynamin-1 and phosphor-dynamin-1 in the development of MTLE.

METHODSMale Sprague-Dawley rats (aged 25 days) were randomly divided into acute control (AC), acute seizure (AS), latent control (LC), latent seizure (LS), chronic control (CC) and chronic spontaneous seizure (CS) groups. Lithium chloride-pilocarpine was used to induce a rat model of MTLE. The hippocampus samples of 5 children with a pathologically confirmed hippocampal sclerosis who received surgical operation were collected as a human model (HM) group, and the hippocampus samples of 4 dead children (without organic lesion of the hippocampus) were collected by autopsy as a human control (HC) group. The expression of dynamin-1 and phosphor-dynamin-1 in the hippocampus of children and rats with MTLE was measured by Western blot and immunohistochemistry.

RESULTSThe Western blot showed that the expression of phosphor-dynamin-1 was significantly lower in the AS and CS groups than in the corresponding control groups (AC and CC groups) (P<0.05). The expression of phosphor-dynamin-1 was significantly lower in the HM group than in the HC group (P<0.05). There were no significant differences in the expression of dynamin-1 among the AS, LS and CS groups and between the HM and HC groups (P>0.05). The immunohistochemical results showed that phosphor-dynamin-1 was highly expressed in the cytoplasm of hippocampal neurons of AC, CC and HC groups, but its expression was significantly reduced in the AS, CS and HM groups (P<0.05).

CONCLUSIONSThe expression of phosphor-dynamin-1, not dynamin-1, is downregulated in the hippocampus of children and rats with MTLE during seizures, which suggests that the phosphorylation/dephosphorylation of dynamin-1 may be involved in the development of MTLE.

Animals ; Blotting, Western ; Child ; Dynamin I ; analysis ; metabolism ; Epilepsy, Temporal Lobe ; metabolism ; Female ; Hippocampus ; chemistry ; metabolism ; Humans ; Immunohistochemistry ; Male ; Phosphorylation ; Rats ; Rats, Sprague-Dawley

Objectives To evaluate the long-term outcomes of childhood low-or intermediate-risk neuroblastoma (NB) and their relevant prognostic factors. Methods A total of 70 new cases of low-or intermediate-risk NB diagnosed and treated by NB-99 protocol between 1999 and 2008 were analyzed retrospectively. Results Of these 70 NB patients, fourteen patients were in low-risk group and 56 were in intermediate-risk group. Sixty-seven patients reached complete remission (CR) or very good partial remission and 3 (5%) achieved partial remission. Ten patients relapsed. One patient occured second malignant neo-plasm. No patients died of chemotherapy-related adverse events or infections. The 5 year overall survival rate was 85.9%, event-free survival rate was 81.0%. Bone marrow infiltration, age at diagnosis, stage, lactate dehydrogenase level had a significant effect on prognosis. Conclusion Develop cytogenetic and molecular biology tests and pretreatment risk stratification are im-portant for further improvement of treatment protocol.

Objectives To evaluate the clinical features, treatment scheme and long-term outcomes of stage 1、2 childhood neuroblastoma (NB). Methods The retrospective study included 49 newly diagnosed NB stage 1、2 patients from June 1998 to December 2010. Clinical data and long-term outcomes were analyzed. Results Twenty-four patients with stage 1 NB and twenty patients with stage 2 NB were found among all 237 patients with NB enrolled in this study. The median age at diagnosis was 25 months( 2 week to 9 year old),29 males and 20 females. Thirty-one patients (63.6%) without symptoms were discovered with tumor by physical or imaging examination. Thorax and abdomen were the most common sites of primary tumor (21 and 22 cases, accounting for 42.9% and 44.9% of all patients, respectively). Forty (81.6%) NB patients had favorable pathology classification. One patient was of MYCN amplification status. Urine vanilla mandelic acid was normal in 32 (91.4%) patients, and serum lactate dehydrogenase was less than five times of the normal value in all patients. Ten NB patients were treated ac-cording to the low-risk protocol who received surgery alone.Thirty-nine patients were treated according to intermediate-risk protocol who received both surgery and chemotherapy. All the patients achieved very good partial remission (100%).The medi-an follow-up period was 60 months(22 months to148months). Nine patients were lost after a follow up of 3 months in medi-an. The 2-、3-、5-year event free survival and overall survial of all 49 patients was 100%. Conclusions The prognosis for neu-roblastoma of stage 1、2 in this study was with 100%survival, which provides opportunity for further reduction of dosage and/or duration of episodes in chemotherapy.

OBJECTIVETo study on the inhibitory action of combined acupuncture and medicine therapy on the model rat of hyperplasia of mammary glands and the mechanism.

METHODSThe model rat of hyperplasia of mammary glands were prepared. After modelling, they were randomly divided into an acupuncture group, a Chinese drug group and a combined acupuncture and drug group, a control group and a model group. Except both the control group and the model group, other 4 groups were treated respectively with acupuncture, Chinese drug, combined acupuncture and Chinese drug, and Premormine, once each day, 9 sessions constituting one course. After treatment of 3 courses (30 days), changes of the breast tissue form were observed, and the diameter and the area of the acina cavity were determined and expressions of estrogen receptor subgroups (ERalpha and ERbeta) were detected with immunohistochamical methods.

RESULTSThe diameter and the area of the acina cavity were increased in the model group as compared with those in the normal group (both P < 0.01), and in the treatment group they were decreased as compared with those in the model group (P < 0.05 or P < 0.01)); both acupuncture and Chinese drug could up-regulate the expression of ERbeta and down-regulate the expression of ERalpha.

CONCLUSIONBoth acupuncture and moxibustion, and Chinese medicine have inhibitory action on hyperplasia of mammary glands in the rat, with the strongest inhibitory action of the combined acupuncture and medicine treatment which is basically close to the level of Premormine. The mechanism is possily related with the up-regulation of ERbeta expression and down-regulation of ERalpha expression.

Acupuncture Points ; Acupuncture Therapy ; Animals ; Combined Modality Therapy ; Estrogen Receptor alpha ; analysis ; Estrogen Receptor beta ; analysis ; Female ; Hyperplasia ; Mammary Glands, Animal ; chemistry ; drug effects ; pathology ; Medicine, Chinese Traditional ; Rats ; Rats, Wistar