Objective To investigate the recurrence and metastasis patterns of gastric cancer after curative resection and to guide target definition of prophylactic radiotherapy.Methods In the past 8 years,130 gastric cancer patients with treatment failure after radical resection were retrospectively analyzed.The failure sites were confirmed by B ultrasonography, CT or MRI imaging.Ten of 28 patients with ascites were found to have adenocarcinoma cells in the ascites.All superficial node and abdominal wall metastases were diagnosed pathologically by biopsy.And 27 patients with gastric remnant and/or anastomotic recurrence were diagnosed pathologically by biopsy.Results Of 130 patients, 53 were presented with multiple recurrences or metastases, 27 with gastric remnant and/or anastomostic recurrence, 28 with peritoneal metastases, 22 with liver metastases, 9 with pancreatic metastases, 60 with abdominal lymph node (LN) metastases, 8 with abdominal wall metastases, 5 with pelvic implantations, 6 with lung metastases, 5 with brain metastases, 5 with bone metastases, 8 with cervical lymph node metastases, 9 with mediastinal lymph node metastases and 8 with other metastases.Of 60 patients with abdominal LN metastases, 35, 16 and 9 had peri-gastric LNs,peri-pancreatic LNs and para-aortic LNs metastases.Abdominal LN metastases were found in 33 from 77 patients with primary gastric fundus or cardiac carcinoma, 20 from 40 patients with gastric body carcinoma,and 7 from 13 patients with pyloric carcinoma, respectively.Conclusions The failure sites of gastric cancer after radical resection are mainly the gastric stump/stoma, peritoneum, liver and abdominal LN.The perigastric, peri-pancreatic and/or para-aortic LN metastases are the most common failure of LNs.Thus, the peri-gastric, peri-pancreatic and para-aortic LN regions and gastric stump/stoma should be included in postoperative radiotherapy, and current chemotherapy is recommended.

Objective To study the hemoprotective effects of a rotary magnetic field (RMF) to radiation-injured mice. Methods 132 male BALB/c mice were randomly divided into four groups: a normal group (N), a magnetic treatment group (M), an irradiation group(R) and an irradiation combining magnetic treatment group (R + M). Mice in the N group received no treatment. Mice in the R and R + M groups received total body irradiation with 6.0 Gy 60Co γ/rays. Mice in the M and R + M groups were treated with a RMF for one and half an hour at a time, twice a day, totally for 30 days. The survival rate was observed for 30 days. On days 0, 5, 9, 15, 21, 30, the subjects' peripheral blood cells were counted. On day 9, 23 and 30, the number of bone marrow nucleated cells (BMNCs), colony forming unit-spleen (CFU-S), spleen-body ratio, the cell cycle and apoptosis of bone marrow cells were measured. The pathological sectioning of the femur was performed and the expression level of bone morphogenetic proteins (BMP2/4) in the bone marrow was evaluated. Results ①No mice died in the N and M group. The RMF treatment increased the survival rate and survival days among the irradiated mice (P < 0.01). ②The RMF treatment increased the number of blood cells in their peripheral blood of the R + M group. ③The number of BMNCs, CFU-S and the proportation of G2 + M stage in the R + M were markedly higher than that of the R group, but the proportation of the apoptosis was lower than that of the R group on the 9th day (P < 0.05). Furthermore, the spleen index in the R + M group was also higher than that of the R group on the 23rd day (P < 0.05). ④RMF could improve the expression level of BMP2/4 in the radiation-injued mice. Conclusion The RMF treatment had an obvious protective effect against the effects of irradiation and it accelerated the recovery of hematopeiesis and the hematopoietic microenvironment in mouse bone marrow.

OBJECTIVETo compare the clinical features and co-infection between pneumonia caused by influenza virus A (IVA) and pneumonia caused by influenza virus B (IVB) among children.

METHODSA total of 165 children with pneumonia caused by influenza virus (IV) were included in the study. These subjects were divided into IVA(n=71) and IVB pneumonia groups (n=94) according to the subtypes of IV. The IVA pneumonia group was further divided into simple infection (n=14) and co-infection subgroups (n=57), and the IVB pneumonia group was also further divided into simple infection (n=27) and co-infection subgroups (n=67). Co-infection rate and pathogen spectrum were analysed in children with IV pneumonia.

RESULTSThe IVB pneumonia group had significantly increased mean age of onset and significantly prolonged mean duration of fever compared with the IVA pneumonia group (P<0.05). Co-infection rate among children with IV pneumonia was 75.2%, who were co-infected with bacteria (44.2%), Mycoplasma pneumoniae (MP, 21.8%) and other viruses (45.5%). Respiratory syncytial virus (RSV) was most common in children co-infected viruses (89% ). The rate of co-infection with RSV was significantly higher in the IVA pneumonia group than in the IVB pneumonia group. There were no significant differences in age, length of hospital stay, duration of fever, percentage of neutrophils, prealbumin, C-reactive protein, alanine aminotransferase, and creatine kinase-MB between the simple infection and co-infection subgroups of each group.

CONCLUSIONSChildren with IVB pneumonia have prolonged duration of fever and increased age of onset compared with those with IVA pneumonia. Co-infection rate is high among children with IV pneumonia, who may be co-infected with bacteria, viruses and MP. Co-infection with RSV is more common in children with IVA pneumonia. It is difficult to identify the presense of co-infection using clinical indices.

Age of Onset ; Child ; Child, Preschool ; Coinfection ; epidemiology ; Female ; Fever ; etiology ; Humans ; Influenza A virus ; Influenza B virus ; Influenza, Human ; virology ; Male ; Pneumonia, Viral ; virology

Objective: To investigate the clinical characteristics, treatment and prognosis of malignant rhabdoid tumor (MRT) in children. Methods: Clinical data total of 18 children with MRT treated in the Department of Hematology and Oncology, Children's Hospital, the First Affiliated Hospital of Zhengzhou University between June 2015 to June 2021 were analyzed retrospectively. The patients were grouped according to age, gender, tumor type, clinical stage and other factors.Progression free survival (PFS) and overall survival (OS) were calculated by Kaplan-Meier method, survival differences among different groups were compared by Log-rank test, and prognostic factors were analyzed by Cox regression model. Results: Among the 18 patients, there were 5 males and 13 females. The age of disease onset was 30.5 (12.0, 75.0) months, the tumor diameter was (80±29) mm, and no integrase interactor 1 (INI-1) expression was detected by immunohistochemistry. There were 7 cases of malignant rhabdoid tumor of the kidney (MRTK), 6 cases of atypical teratoid rhabdoid tumor (ATRT) and 5 cases of extrarenal extracranial rhabdoid tumor (EERT). At the time of early diagnosis, 12 patients were clinically stage Ⅲ-Ⅳ, 11 patients had local or distant metastasis, and 4 patients had metastasis during treatment. Surgical excision is the preferred treatment. There were 3 cases with preoperative puncture biopsy, 13 cases with complete resection, 4 cases with partial resection, and 1 case without operation. Thirteen patients were treated with the domestic conventional chemotherapy regimen for Wilms' tumor, medulloblastoma and rhabdomyosarcoma, and 5 patients were treated with the international conventional chemotherapy regimen. Nine patients received radiotherapy, including 1 case of MRTK, 4 cases of ATRT and 4 cases of EERT. By the end of follow-up in January 2022, 7 patients survived and 11 patients died. The 3-year PFS and OS rates were (8±8) % and (14±12) %. Log-rank test showed that the 5-year OS of EERT group was higher than ATRT and MRTK groups (χ²=16.31, P<0.001), the tumor diameter <80 mm group was higher than that of the ≥80 mm group (χ²=4.49, P=0.034), and the radiotherapy group was higher than no radiotherapy group (χ²=3.97, P=0.046). The differences were statistically significant. There was no significant difference in the influence of tumor type, age, tumor diameter, radiotherapy and chemotherapy on OS by Cox regression model (all P>0.05). Log-rank test showed that the 3-year PFS of EERT group was higher than ATRT and MRTK groups (χ²=11.14, P=0.004),>3 years group was higher than ≤3 years group (χ²=10.10, P=0.001), the differences were statistically significant. Tumor type, clinical stage, tumor diameter, age, tumor rupture and radiotherapy were included in the Cox regression model, and the results showed that clinical stage (HR=0.49, 95%CI 0.26-0.94, P=0.031), tumor diameter (HR=8.67, 95%CI 1.84-40.89, P=0.006), age (HR=0.01, 95%CI 0.00-0.15, P=0.001) had statistical significance on PFS. Conclusions: MRT is one of the most aggressive and fatal cancers in early childhood and infancy. There is no standard treatment and the prognosis is extremely poor. Clinical stage, tumor size and age are risk factors for disease progression.
Child ; Child, Preschool ; Female ; Humans ; Kidney Neoplasms ; Male ; Prognosis ; Retrospective Studies ; Rhabdoid Tumor/therapy* ; Rhabdomyosarcoma, Embryonal ; Survival Rate

OBJECTIVES: To study the clinical features and chemotherapy response of Burkitt's lymphoma (BL) in children and the influence of rituximab on the prognosis of children with BL. METHODS: A retrospective analysis was performed for the medical data of 62 children with BL, including clinical features, therapeutic efficacy, and prognostic factors. The Cox regression model was used to identify the factors associated with poor prognosis in children with BL. According to whether rituximab was used, the children with advanced (stage III/IV) BL were divided into two groups: chemotherapy plus rituximab and chemotherapy alone. The prognosis was compared between the two groups. RESULTS: For these 62 children, the median age of onset was 5 years (range 1-14 years), and there were 58 boys (94%) and 4 girls (6%). The primary site was abdominal cavity in 41 children (66%), and head and neck in 16 children (26%). There were 1 child with stage I BL (2%), 8 with stage II BL (13%), 33 with stage III BL (53%), and 20 with stage IV BL (32%). The median follow-up time was 29 months, with progression/recurrence observed in 15 children (24%), and the 3-year overall survival (OS) rate and event-free survival (EFS) rate were 82.8%±5.2% and 77.3%±5.8%, respectively. For the children with stage III/IV BL, there was a significant difference in the 3-year the OS rate between the chemotherapy plus rituximab group (16 children) and the chemotherapy alone group (30 children) (93.3%±6.4% vs 65.6%±9.9%, P=0.042), while there was no significant difference in the 3-year EFS rate between the two groups (86.2%±9.1% vs 61.8%±10.1%, P>0.05). The Cox regression analysis showed that central nervous system involvement, lactate dehydrogenase >1 000 U/L, and early incomplete remission were the factors associated with poor prognosis (P<0.05). CONCLUSIONS Chemotherapy combined with rituximab can improve the prognosis of children with stage III/IV BL. Central nervous system involvement, elevated lactate dehydrogenase level, and early incomplete remission may indicate a poor prognosis in children with BL.
Adolescent ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Burkitt Lymphoma/pathology* ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Lactate Dehydrogenases ; Male ; Prognosis ; Retrospective Studies ; Rituximab

OBJECTIVES: To study the efficacy and safety of rituximab combined with chemotherapy in the treatment of children and adolescents with mature B-cell non-Hodgkin's lymphoma (B-NHL) through a Meta analysis. METHODS: The databases including PubMed, Embase, the Cochrane Library, ClinicalTrials.gov, Web of Science, China National Knowledge Infrastructure, Wanfang Data, and Weipu were searched to obtain 10 articles on rituximab in the treatment of mature B-NHL in children and adolescents published up to June 2022, with 886 children in total. With 3-year event-free survival (EFS) rate, 3-year overall survival (OS) rate, complete remission rate, mortality rate, and incidence rate of adverse reactions as outcome measures, RevMan 5.4 software was used for Meta analysis, subgroup analysis, sensitivity analysis, and publication bias analysis. RESULTS: The rituximab+chemotherapy group showed significant increases in the 3-year EFS rate (HR=0.38, 95%CI: 0.25-0.59, P<0.001), 3-year OS rate (HR=0.29, 95%CI: 0.14-0.61, P=0.001), and complete remission rate (OR=3.72, 95%CI: 1.89-7.33, P<0.001) as well as a significant reduction in the mortality rate (OR=0.31, 95%CI: 0.17-0.57, P<0.001), as compared with the chemotherapy group without rituximab. There was no significant difference in the incidence rate of adverse reactions between the two groups (OR=1.28, 95%CI: 0.85-1.92, P=0.24). CONCLUSIONS The addition of rituximab to the treatment regimen for children and adolescents with mature B-cell non-Hodgkin's lymphoma can bring significant survival benefits without increasing the incidence of adverse reactions.
Child ; Adolescent ; Humans ; Rituximab/adverse effects* ; Lymphoma, B-Cell/drug therapy* ; Progression-Free Survival ; Remission Induction ; China ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use*

Cyclic adenosine monophosphate(cAMP)is a “second messenger” that regulates cell signal transduction. Adenylyl cyclases(ACs)and phosphodiesterases(PDEs)can directly regulate cAMP level in cells and then regulate the downstream signaling pathways. Increasing intracellular cAMP level can inhibit inflammation and enhance smooth muscle relaxation, which is an effective strategy for the prevention and treatment of chronic obstructive pulmonary disease(COPD). This paper briefly summarizes the signaling pathways regulating cAMP and their mechanisms and related drugs in COPD therapy, hoping to provide references for further research and development of new target drugs which regulate cAMP for the prevention and treatment of COPD.

OBJECTIVE: To explore the application value of next generation sequencing (NGS) in preimplantation genetic diagnosis of α/β complex thalassemia couple. METHODS: The coding regions of α-globin genes (HBA1, HBA2) and β-globin gene (HBB) were selected as the target regions. The high-density and closely linked single nucleotide polymorphism (SNP) sites were selected as the genetic linkage markers in the upstream and downstream 2M regions of the gene. After NGS, the effective SNP sites were selected to construct the haplotype of the couple, and the risk chromosome of the mutation carried by the couple was determined. The NGS technology was used to sequence the variations of HBA1, HBA2 and HBB directly and construct haplotype linkage analysis for preimplantation genetic diagnosis. RESULTS: Direct sequencing and haplotype linkage analysis of HBA1, HBA2 and HBB showed that two of the six blastocysts were α/β complex thalassemia, one was β-thalassemia heterozygote, two were α-thalassemias heterozygotes, and one was intermediate α-thalassemia. A well-developed embryo underwent preimplantation genetic diagnosis was implanted into the mother's uterus, and a healthy infant was born at term. CONCLUSION Preimplantation genetic diagnosis can be carried out by NGS technology in α/β complex thalassemia couples, and abortion caused by aneuploid embryo selection can be avoided.
Female ; High-Throughput Nucleotide Sequencing ; Humans ; Mutation ; Pregnancy ; Preimplantation Diagnosis ; alpha-Thalassemia ; beta-Globins/genetics* ; beta-Thalassemia/genetics*

Objective: To analyze the reported characteristics of pulmonary tuberculosis (TB) in children aged 0-14 years in four provinces (municipalities), Beijing, Hubei, Chongqing and Sichuan, in China, and provide evidence for the prevention and control of pulmonary TB in children. Methods: The incidence data of childhood pulmonary TB were collected from notifiable disease and tuberculosis management information system of Chinese information system for disease control and prevention,and descriptive epidemiological methods were used to analyze the medical care seeking flow, characteristics and management inclusion of pulmonary TB cases in children. Statistical analysis and data visualization were conducted with softwares Excel 2015, R 4.1.2 and Echart 4.7.0. Results: A total of 6 811 pulmonary TB cases in children were reported in the four provinces during 2019-2021, in which 4 741 (69.6%) were clinically diagnosed and 2 070 (30.4%) were laboratory confirmed. A total of 526 medical institutions reported TB cases in children, including 356 general hospitals (67.7%, 356/526) reporting 4 706 cases, 11 infectious disease hospitals (2.1%, 11/526) reporting 836 cases and 5 children's hospitals (1.0%, 5/526) reporting 542 cases. A total of 6 249 (91.7%) local cases and 562 (8.3%) non-local cases were reported. The reported local incidence rates of TB from 2019-2021 were 6.20/100 000, 7.10/100 000 and 7.20/100 000, respectively, showing an increase trend year by year. The sex ratio of the cases were 0.98∶1(3 373∶3 438). The cases were mainly distributed in age group 10-14 years (4 887 cases, 71.8%). The cases were mainly students (5 167 cases, 75.9%). The management inclusion rates of the local cases and non-local cases were 20.60% and 2.67%, respectively. Conclusions: The main medical institutions reporting pulmonary TB cases in children were children's hospitals, infectious disease hospitals and TB special hospitals, the incidence of pulmonary TB in children in Sichuan was higher. In 2020, the inter-provincial medical seeking behavior of the pulmonary TB cases decreased significantly. The incidence rate in boys was lower than that in girls, and children aged 10-14 years were the population with high incidence of pulmonary TB. The management inclusion rate in non-local cases was lower than that in local cases.
Male ; Child ; Female ; Humans ; Tuberculosis, Pulmonary/epidemiology* ; Hospitals, Chronic Disease ; China/epidemiology* ; Asian People ; Hospitals, General

Betacoronavirus ; China ; epidemiology ; Coronavirus Infections ; prevention & control ; Disease Outbreaks ; Emergencies ; Hospitals, General ; Humans ; Internet ; Pandemics ; prevention & control ; Pneumonia, Viral ; prevention & control