Objective To analyze the clinical characteristics of juvenile myelomonocytic leukemia(JMML) and the PCNA levels of the hyperoxia -exposure group (6 h)decreased,and the difference in PCNA protein expres-sion levels was significant of gene diagnose for JMML.Methods Clinical data were retrospectively analyzed in 21 pa-tients suffering from JMML based on new 2009 World Health Organization diagnostic criteria from January 201 3 to June 201 4 in Beijing Children′s Hospital,Capital Medical University.Results There were 85.7% (1 8 /21 cases)patients within 4 -year -old children,and the median age was 23 months (2 -86 months).Fever and abdominal symptoms were the prominent clinical symptoms,52.4% (1 1 /21 cases)with fever,38.1 % (8 /21 cases)with abdominal dis-tention,diarrhea and other abdominal symptoms,80.5% (1 9 /21 cases)had splenomegaly (mild 1 9.1 %,middle 33.3%,severe 38.1 %),and some patients had other tissue infiltration,such as rash,yellow tumor and lymphnode enlargement.Peripheral blood cell count showed that the white blood cells increased because of anemia or thrombocyto-penia,ranging from 1 0.40 ×1 09 /L to 82.1 4 ×1 09 /L(median,26.1 0 ×1 09 /L),and the monocyte counts ranged from 1 .46 ×1 09 /L to 21 .60 ×1 09 /L(median,3.79 ×1 09 /L),characteristics of JMML gene abnormality was detected in 1 7 cases:including 1 1 single gene mutation,and 6 cases with double gene mutations.PTPN11 was the highest frequency of occurrence,accounting for 52.9% (9 /1 7 cases),and NF1 mutation was 35.3% (6 /1 7 cases).All the patients were followed up by phone call,the median follow -up time was 371 days (57 -562 days),6 patients were lost to follow -up,7 patients died,2 patients were alive after hematopoietic stem cell transplantation,1 patient converted to acute non lymphocytic leukemia,and 5 patients were still alive after receiving symptomatic treatment.Among dead cases,PTNT11 gene mutation and NF1 gene mutation were detected in 6 patients;among living children after hematopoietic stem cell transplantation,RAS and PTNT11 mutations were detected in 2 patients;among living children after symptomatic treat-ment,RAS mutation was detected in 2 patients and PTPN11 +CBL mutation in 1 case.Conclusions The symptom and laboratory examination of JMML have no specificistics,with poor prognosis,gene diagnose has guiding significance for JMML diagnose and for selecting therapy.

The Borf1 protein is encoded by an immediate-early gene of the bovine foamy virus (BFV) and plays a key role in the viral life cycle. Borf1 is a DNA binding protein which can transactivate both the long terminal repeat (LTR) and the internal promoter (IP) of BFV by specifically binding to the transactivation responsive element (TRE). To analyze the subcellular localization of Borf1 during the BFV life cycle, this gene was cloned into a prokaryotic expression vector and expressed in a soluble form. After the purification and immunization, we raised the mouse anti-Borf1 serum with a high titer based on ELISA results. Western blot analysis showed that the antiserum could specifically recognize the Borf1 protein that was expressed in 293T cells. With this specific serum, we revealed the nuclear and cytoplasmic localization of Borf1 in HeLa cells that was transfected with Borf1. Moreover, the immuno-fluorescence assay also showed that the localization of Borf1 during the infection and transfection of BFV was identical.

Objective To understand the situation of downward dislocation of intrauterine device (IUD) and the impact related to the effectiveness of IUD use, in China. Methods An epidemiological survey with cross-sectional, retrospective and prospective study designs was conducted to investigate 18 922 IUD users who were selected by a multi-phase stratified cluster sampling method. Results IUD's downward dislocation had been an important unsuccessful issue related to the IUD insertion that accounted for 20% of total the cases of failure. The top three failure outcomes would include extrusion,removal due to downward dislocation and unintended pregnancy. Respectively, the cumulative rates and the ranking due to IUD failure (per 100 women) in the first, third, sixth and twelfth month were shown as follows: extrusion appeared as 0.33%, 1.13%, 2.21% and 4.30%; removal as 0.10%, 0.37%, 0.80% and 2.34% ; while unintended pregnancy were 0.03%, 0.14%, 0.41% and 1.14%. Conclusion IUD' s downward dislocation made great impact on the effectiveness of IUD use that should call for attention from relative governmental sectors and researchers in the areas of prevention, diagnosis and treatment.

KRAS is one of the most frequently mutated human oncogenes. In spite of mounting efforts on the development of direct or indirect inhibition targeting KRAS, little has been achieved because of insurmountable difficulties, titling KRAS "undruggable". Recently, subtype-specific inhibitors have shown great hope. Some KRAS^G12C inhibitors have entered clinical trials, including adagrasib and sotorasib, and have shown preliminary clinical effectiveness. Experiences from the inhibitors targeting the downstream factors of RAS pathways show that the anticancer activity of these drugs will be limited due to the development of drug resistance. Preclinical studies of KRAS^G12C inhibitors have revealed that the application of these agents might be hampered by the drug resistance issue. The current review aims to describe the current status of KRAS^G12C inhibitors, and discuss the mechanisms underlying KRAS^G12C inhibitor resistance, so as to provide the clues for the combat of drug resistance.

Objective To evaluate the effect of the esophagus invert stripping without opening the thoracic cavity on carci- noma in the inferior pharynx, cervical esophagus or the cardia. Method Eighteen patients with carcinoma in the inferior pharynx, cervical esophagus or the cardia were treated surgically with invert stripping of the exophagus without opening the thoracic cavity. Ten patients received antidromic esophagus invert stripping and the other 8 underwent orthodromic esophagus invert stripping. The esophagus of these patients were replaced with either the stomach (in 15 cases) or the colon (in 3 cases), and complete removal of the pharynx and larynx were performed in 2 cases, both of which received permanent fistulization. Result No death occurred during the operation and the complications included anastomotic leakage (2 cases), injury of the recurrent laryngeal nerve (2 cases), pulmonary infection (3 cases), and incision infection (1 case). The follow-up survey showed that the 1-year, 3-year and 5-year survival rates were 77%, 44% and 22%, respectively. Conclusions This surgical approach reduces the damage of the cardiopulmonary function, which can be meaningful for senior patients and those with cardiac or pulmonary problems. The carcinoma in the inferior pharynx or cervical part of the esophagus should be treated surgically to improve the survival rate, but this approach should be avoided in patients with carcinoma in thoracic part of the esophagus.

Objective To evaluate the effect of the esophagus invert stripping without opening the thoracic cavity on carci- noma in the inferior pharynx, cervical esophagus or the cardia. Method Eighteen patients with carcinoma in the inferior pharynx, cervical esophagus or the cardia were treated surgically with invert stripping of the exophagus without opening the thoracic cavity. Ten patients received antidromic esophagus invert stripping and the other 8 underwent orthodromic esophagus invert stripping. The esophagus of these patients were replaced with either the stomach (in 15 cases) or the colon (in 3 cases), and complete removal of the pharynx and larynx were performed in 2 cases, both of which received permanent fistulization. Result No death occurred during the operation and the complications included anastomotic leakage (2 cases), injury of the recurrent laryngeal nerve (2 cases), pulmonary infection (3 cases), and incision infection (1 case). The follow-up survey showed that the 1-year, 3-year and 5-year survival rates were 77%, 44% and 22%, respectively. Conclusions This surgical approach reduces the damage of the cardiopulmonary function, which can be meaningful for senior patients and those with cardiac or pulmonary problems. The carcinoma in the inferior pharynx or cervical part of the esophagus should be treated surgically to improve the survival rate, but this approach should be avoided in patients with carcinoma in thoracic part of the esophagus.

OBJECTIVETo detect the expression of CD133 in human tongue squamous cell carcinoma Tea8113 cell line and observe proliferation ability of CD133 groups in vitro.

METHODSLimiting dilution assay was employed to observe the proliferating character of Tca8113 single cell in vitro. The ability of growing as cancer spheroids was observed with ultra-low attachment plates. The flow cytometry was used to detect the expression of putative tumor-initiating cell marker CD133 in human tongue squamous cell carcinoma Tca8113 cell line. The selective technique of immunomagnetic beads was applied to purify CD133 tumor cells, CD133 tumor cells were cultured and their ability of proliferation were observed in vitro.

RESULTSAfter 12 days, the result of single cell culture in vitro revealed that about 5.23% of cultured Tca8113 cells possessed the capacity of continue proliferation. The cells line fromed floating clusters with one week of passaging cells into non-adherent plates. Approximately 0.95% of cells in Tca8113 cell line expressed CD133. Compared with CD133- cells and control Tca8113 cells, CD133+ cells demonstrated increased proliferation capacity. The proportion of CD133 cells decreased in culture as days passed. The percentage of CD133+ cells decreased from 92.45% to 1.62% in twelve days' culture.

CONCLUSIONTumor stem cells have the character of heterogenity and lower proportion of CD133 but higher ability of proliferation, and the diferentiation in human tongue squamous cell carcinoma Tca8113 cell line in vitro, CD133 may be one of makers for tumor-initiating cell of human tongue squamous cell carcinoma Tca8113 cell line.

Carcinoma, Squamous Cell ; Cell Line, Tumor ; Cell Proliferation ; Flow Cytometry ; Humans ; Tongue Neoplasms

OBJECTIVETo evaluate the results of manipulative reduction and percutaneous pin fixation for the treatment of severely displaced proximal humeru fracturess in children.

METHODSFrom January 2006 to December 2010, 43 patients with severely displaced proximal humeru fractures were treated with manipulative reduction and percutaneous pin fixation. There were 28 boys and 15 girls,ranging in age from 3 to 17 years,with an average of 11.1 years. Preoperative diagnoses were confirmed by the X-ray films as Neer-Horwitz type III or IV fractures. All the patients were close fractures without nerve or vascular injuries. Under C-arm X-ray machine, anatomical reduction was achieved by manipulative reduction according to the bone fracture type. The fractures were fixed by percutaneous pinning. Postoperative X-ray confirmed anatomical reduction. Follow-up index were recorded: intra-operative and postoperative complications, postoperative radiographic examination, upper extremity length and range of shoulder motion. Neer score system was used to evaluate shoulder function.

RESULTSAll the patients were followed up, and the duration ranged from 3 to 37 months with an average of 20.4 months. The mean Neer score of the injured side was (95.0 +/- 4.3) (ranged, 85 to 100). Thirty-eight patients got an excellent result, 5 good. The X-ray showed all the fractures healed without shortening deformity or epiphyseal arrest at early stage. All the patients could participate in the normal physical activities and had a normal range of motion and excellent strength of the shoulder joint.

CONCLUSIONThe method of manipulative reduction and percutaneous pin fixation is relatively reliable treatment for severely displaced proximal humerus fractures in children.

Adolescent ; Child ; Child, Preschool ; Female ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Humeral Fractures ; surgery ; Internal Fixators ; Male ; Treatment Outcome

OBJECTIVETo explore the correction for shortened and broaden prolabium deformity following bilateral cleft lip repair.

METHODSWe designed the upper lip double flag-shaped flaps. The quadrilateral original surgical scar (flap flag pole part) was resected and the incision was made along the direction of nasolabial groove at the nostrils bottom to form two flag-shaped flaps (the section of the flag face). Lip tubercle were tracted and blunt dissection of upper philtrum were performed to form a wound, 4-6 mm in width. The flag-shaped flaps on both sides were rotated to the central, in order to form a new nasal base and new prolabium, followed by V-Y or Z plasty procedure to correct the defect of tubercle and vermilion.

RESULTS10 cases were enrolled for the clinical application from January 2008 to December 2012. The height of the prolabium was lengthened by 4-6 mm after operation, which fundamentally corrected shortened and broaden prolabium deformity after bilateral cleft lip operation. The procedure can also correct the depression or defect of tubercle, too wide philtrum, philtrum column scar and the deformity of vermilion border continuity. The patients were followed up for a period of 3 months to 3 years with satisfactory results.

CONCLUSIONDouble flag-shaped flaps of the upper lip at the nostrils bottom is a simple and good surgery method to correct the shortened and broaden prolabium deformity following bilateral cleft lip repair.

Adolescent ; Adult ; Cleft Lip ; surgery ; Female ; Humans ; Lip ; abnormalities ; surgery ; Male ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; Surgical Flaps ; Treatment Outcome ; Young Adult

OBJECTIVETo study the relationship between the expressions of thrombin-antithrombin (TAT) complex and excess syndrome of stroke (ESS) and depletion syndrome of stroke (DSS) by dynamically observing the expressions of TAT complex in the plasma and hematoma fluid of intracerebral hemorrhage (ICH) patients.

METHODSSixty patients were assigned to three groups according to syndrome typing, i.e., as yang excess group (18 cases), yin excess group (22 cases), and depletion syndrome group (20 cases). The hemorrhage volume was assessed. NIHSS and GCS were scored. Besides, 30 healthy volunteers at the Physical Examination Center, Second People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine were recruited as the normal control group. Another 10 patients in need of lumbal anesthesia were recruited as the cerebrospinal fluid control group, who suffered from surgical, gynecologic pelvic diseases, or diseases from lower limbs, but unaccompanied with cardio-/cerebrovascular diseases. The expressions of TAT complex were detected in the venous blood and hematoma fluid of the patient groups and in the venous blood or the cerebrospinal fluid of the control group using ELISA.

RESULTSThe syndromes were sequenced as the depletion syndrome > the yin excess syndrome > the yang excess syndrome according to the hemorrhage volume and NIHSS score. They were sequenced as the yang excess syndrome > the yin excess syndrome >the depletion syndrome according to the GCS score. The plasma TAT complex content on the 4th day in the ICH group was lower than that at the rest time points, showing statistical significance (P<0.01). Compared with the normal control group, the plasma TAT complex on the 1st, 2nd, and 4th day all increased with statistical difference (P<0.01). Statistical significance of the TAT complex in the hematoma fluid of the ICH group existed when compared it on the 1st, 2nd, and 4th day (P<0.01). Compared with the cerebrospinal fluid control group, the contents of the TAT complex in the hematoma fluid of the ICH group increased with statistical difference (P<0.01). The hemorrhage volume of ICH patients was positively correlated with NIHSS (r=0.809, P<0.01) and negatively correlated with GCS (r=-0.833, P<0.01). The TAT complex was obviously higher in the ICH group than in the two control groups in a dynamic way (P<0.01). There was obvious difference in the expressions of TAT among yang excess group, yin excess group, and depletion syndrome group (P<0.01). The expressions of TAT in the plasma and the hematoma fluid of the ICH group were negatively correlated with GCS score and positively correlated with NIHSS score (both P<0.01).

CONCLUSIONSTAT complex participated in secondary neuron injury after ICH, which could be taken as an objective index for clinical observation. It also could provide evidence for syndrome quantification of excess syndrome and depletion syndrome.

Antithrombin III ; metabolism ; Case-Control Studies ; Cerebral Hemorrhage ; blood ; diagnosis ; metabolism ; Hematoma ; blood ; diagnosis ; metabolism ; Humans ; Medicine, Chinese Traditional ; Peptide Hydrolases ; metabolism ; Stroke ; blood ; diagnosis ; metabolism ; Thrombin ; metabolism