Objective To investigate the risk factors for traumatic lumbar punctures in children with acute lymphoblastic leukaemia. Methods 132 children with acute lymphoblastic leukemia totally received 2634 lumbar punctures. The basic data on age, sex, body mass index (BMI), platelet count, interval between two punctures, and presence or absence of ultrasound-guided procedure were collected and analyzed. The risk factors for traumatic lumbar puncture were identified by logistic regression. Results The risk for traumatic lumbar puncture was higher in children younger than 1 year, and it was relatively lower in those aged 1 to 10 years. The risk for traumatic lumbar puncture was slightly higher in children with a BMI index of more than 95. The longer the interval between two punctures, the lower the risk. If lumbar puncture was guided under ultrasound or radiographic images, the risk was much smaller. Conclusions Age of younger than 1 year, BMI index of more than 95, shorter interval between two punctures, and direct puncture can increase the risk for traumatic lumbar puncture.

Animals ; Behavior, Animal ; Reproduction ; physiology ; Social Behavior ; Tupaiidae ; physiology

Objective To investigate the effect of chlorhexidine gluconate in prevention of surgical site infection ( SSI ) . Methods Randomized controlled clinical trial method was used in the study. Comparison was made in the rates of SSI between the experiment group using 2% chlorhexidine gluconate and the control group. Results The rate of SSI in experiment group was significantly lower than that in control group (0.83% vs.5.83%, χ2 =3.23,P =0.035).Differences of hospital stay, total cost, infection in other sites and mortality rate of SSI were not statistically significant between the two groups ( P>0 .05 ) . Conclusion Preoperative head disinfection by chlorhexidine gluconate has remarkable effect in prevention of cerebral surgical site infection.

Objective To study the effect and prognosis of percutaneous coronary intervention(PCI) for pa- tients with coronary artery disease(CAD).Methods Selected coronary angiography was performed in 31 patients with CAD.PTCA and stent implantation were performed in the patients of coronary stenosis(≥75 % in diameter). The effect and prngnosis of coronary interventionary therapy in patients were observed.Results The results of coro- nary angiongraphy suggested there were 18 patiens of coronary stenosis(≥75 % in diameter),PTCA and stent im- plantation were performed in 13 patients.Symptom was relieved greatly after the operation.There were 2 patients of coronary stenosis again,and 5 patients died.Conclusion Selected coronary angiography was an effective way to di- agnose CHD.The coronery interventioned therapy was not only effective in relieving symptom,but also in improving the quality of life of patients with CAD.

OBJECTIVETo explore the expression and clinical significance of Caudal-type homeobox transcription factor 2 (CDX2) gene in acute myeloid leukemia (AML) patients.

METHODReal time quantitative PCR (RQ-PCR) was used to test the expression level of CDX2 gene in 108 de novo AML patients and the clinical features of these patients were analyzed.

RESULTSCDX2 gene transcript levels were detectable in bone marrow mononuclear cells from 108 AML patients and 7 healthy donors, the median expression level were 1179.44 (range 14.15 - 867 961.10) and 105.30 (range 22.30 - 453.11). There was a statistically significant difference in expression level of CDX2 gene between the AML patients and normal donor (P < 0.01). All 14 patients with FLT3-ITD(+) were in CDX2 gene higher expression group (P = 0.018), including 10 patients with normal karyotype. In the 83 treated AML patients (P = 0.046) and 57 higher WBC count (≥ 10×10(9)/L, P = 0.048) patients, the higher expression level of CDX2 gene was associated with lower complete remission (CR) rates.

CONCLUSIONSHigher expression level of CDX2 gene was seen mostly in AML patients with FLT3-ITD mutation and with lower CR rates. CDX2 gene might be a prognostic molecular marker in AML patients with normal karyotype.

Adolescent ; Adult ; Aged ; CDX2 Transcription Factor ; Case-Control Studies ; Female ; Homeodomain Proteins ; genetics ; Humans ; Karyotyping ; Leukemia, Myeloid, Acute ; diagnosis ; genetics ; Male ; Middle Aged ; Mutation ; Prognosis ; Young Adult ; fms-Like Tyrosine Kinase 3 ; genetics

OBJECTIVETo study the role of trisomy 8 in pathogenesis and progression of hematologic disease with trisomy 8.

METHODSThe clinical data on 38 cases with trisomy 8 were investigated retrospectively. Fluorescence in situ hybridization (FISH) using Spectrum Orange labeled chromosome 8 centromere specific probe was carried out to detect trisomy 8 in 10 cases.

RESULTSThirty-two of 38(84.2%) cases with trisomy 8, and fourteen of 17(82.4%) cases with trisomy 8 as the sole chromosome aberration were myeloid disorders such as myelodysplastic syndrome (MDS), acute myelocytic leukemia (AML), chronic myelocytic leukemia (CML). The incidence of trisomy 8 was higher in myeloid disease than in lymphocytic disease (5% vs 1.3%); the incidence of trisomy 8 was higher in acute monocytic leukemia than in other AML (6.1% vs 2.4%), and the incidence of trisomy 8 in chronic myelomonocytic leukemia( CMML) was higher than that in other myelodysplastic syndrome (MDS) (25% vs 13.2%); 17 cases had trisomy 8 as the sole chromosome aberration, 21 cases had other additional chromosome aberrations. The chromosome aberration was confirmed by FISH in 10 cases with trisomy 8 as the sole chromosome aberration. Eleven cases were treated with chemotherapy, among them only 10 cases data were available. Seven cases acquired complete remission but 3 of them were M3, the other 3 cases had no response after two courses of chemotherapy.

CONCLUSIONTrisomy 8 may play an important role in the pathogenesis and progression of the hematological disease, especially myeloid disease. Trisomy 8 might be related with differentiation abnormality of monocyte.

Adolescent ; Adult ; Aged ; Chromosomes, Human, Pair 8 ; Female ; Humans ; In Situ Hybridization, Fluorescence ; Leukemia ; genetics ; Male ; Middle Aged ; Myelodysplastic Syndromes ; genetics ; Trisomy

The purpose of this study was to investigate 135 cases of chronic myelogenous leukemia with non-simple Philadelphia chromosome and to analyze their cytogenetic date. Chromosome preparations in 135 cases of patients were performed by using direct method and/or short-term culture, and karyotyping was performed with R-banding technique. The results showed that the overall frequency of chronic myelogenous leukemia with non-simple Philadelphia chromosome (based on 1210 cases of chromosome detection in chronic myelogenous leukemia) was 11.16%, which included 87 cases of chronic phase, 21 cases of accelerated phase and 27 cases of blastic phase. Among 87 cases of patients in chronic phase, 14 cases were with simple variant translocation and 22 cases had complex variant translocation while the others were with other chromosomal abnormalities including 4 cases of +8, 4 cases of + Ph and 2 cases of i (17); among 21 cases of patients in accelerated phage, 4 cases were with +8 and 4 cases were with + Ph while 3 cases were with i (17); among 27 cases of patients in blastic phage, 2 cases were with simple variant translocation and 3 cases had complex variant translocation while the others were with other chromosomal abnormalities including 5 cases of +8, 5 cases of + Ph and 2 cases of i (17). The detection rate of extra chromosomal abnormalities in this group of 135 cases patient were + Ph, +8, i (17), -Y, +19 and +21 in order. There were 16 cases with simple variant translocation and 25 cases with complex variant translocation in in this group of 135 cases. It is concluded that karyotype analysis is helpful in diagnosis, prognosis, pathogenesis and treatment selection for chronic myelogenous leukemia.
Adolescent ; Adult ; Aged ; Child ; Female ; Humans ; Karyotyping ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; genetics ; Male ; Middle Aged ; Philadelphia Chromosome ; Young Adult

OBJECTIVETo investigate the clinical and laboratory characteristics of four acute myeloid leukemia with t(3;3) translocation.

METHODSBone marrow cell chromosome karyotype analysis were carried out with direct method and short-term culture and R-banding technique.

RESULTSFour AML patients with t(3;3) translocation were identified. They did not obtain complete remission after chemotherapy and the median survival time was 4.5 months.

CONCLUSIONSt(3;3) translocation is a rare chromosome abnormality, which has mostly been found in myeloid leukemia and the prognosis of these patients is poor.

Adult ; Chromosomes, Human, Pair 3 ; Female ; Humans ; Karyotyping ; Leukemia, Myeloid, Acute ; genetics ; Male ; Middle Aged ; Prognosis ; Translocation, Genetic

OBJECTIVETo compare the safety of intravenous thrombolytic therapy with recombinant tissue plasminogen activator (rtPA) in ischemic patients under the guidance of CT and multi-mode MRI.

METHODSThe clinical, laboratory, and radiologic data from 113 consecutive hyperacute ischemic patients who received intravenous rtPA therapy from June 2009 to October 2011 was retrospectively reviewed. The rate of hemorrhagic transformation (HT) and the clinical outcome between CT and multi-mode MRI was compared. Etiological subgroups were classified according to Chinese ischemic stroke subclassification (CISS).

RESULTSAmong 113 patients treated with intravenous rtPA, the mean age was 66 ±12 years, 74(65.5%) were man, the pretreatment National Institutes of Health Stroke Scale score (NIHSS) was 12.4 ±6.5, and time from symptom onset to therapy was 259.7 ±131.7 min. Postlytic radiological HT was found in 34 patients (30.1%). Symptomatic ICH occurred in 9 patients (8%). Logistic regression analysis suggested that multi-mode MRI was an independent predictor of reduced risk of HT.

CONCLUSIONThe risk of hemorrhagic complications is lower in patients receiving intravenous thrombolytic therapy with rtPA guided by multi-mode MRI than those guided by CT scan.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Brain Infarction ; drug therapy ; Cerebral Hemorrhage ; chemically induced ; prevention & control ; Female ; Humans ; Logistic Models ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Recombinant Proteins ; administration & dosage ; adverse effects ; therapeutic use ; Retrospective Studies ; Stroke ; drug therapy ; Thrombolytic Therapy ; adverse effects ; Tissue Plasminogen Activator ; administration & dosage ; adverse effects ; therapeutic use ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVETo evaluate the cytogenetic and molecular genetic features of chronic myeloid leukemia (CML) in Chinese.

METHODSA total of 1193 CML patients were retrospectively studied. Chromosome preparation of bone marrow cells was made using direct and short-term culture. Karyotype and bcr-abl fusion genes were analyzed by R-banding, RT-PCR, respectively.

RESULTSIn the 1193 cases, 98.07% was Ph chromosome positive (Ph+) and 1.93% negative (Ph-). In the Ph+ patients, 95.64% was classical Ph and 4.36% variant rearrangements. Additional genetic changes were demonstrated in 11.88% of classical Ph cases. Cytogenetic clonal evolution was found in 7.94% of patients in chronic phase (CP), 27.78% in accelerated phase (AP), and 49. 04% in blast crisis (BC). Among the classical Ph cases, +Ph, +8, -21 were found in 14.62%, 10.77% and 7.69% of them respectively. In patients in BC and AP, the most common additional chromosome changes were + Ph (28.57%), +8 (16.67%) and +19 (7.14%), while in CP, -21 (10.26%), +Ph (8.97%), and +8 (8.97%). The combination of +Ph and +8 (3.60%) was the most frequent of combination pattern. 524 cases were investigated for bcr-abl fusion gene, and 54.01% was b3a2 (+) and 27.67% b2a2 (+).

CONCLUSIONIn Chinese CML patients seem to have their unique features in terms of cytogenetic clonal evaluation.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Female ; Fusion Proteins, bcr-abl ; genetics ; Humans ; Karyotyping ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; genetics ; Male ; Middle Aged ; Retrospective Studies