Asparaginase(ASP) is an important drug in the treatment of childhood acute lymphoblastic leukemia and non-Hodgkin lymphoma.Asparaginase associated pancreatitis (AAP) is the main treatment-adverse events of asparaginase.After reviewing the recent foreign literatures about AAP and the Chinese expert about polyethylene glycol conjugated asparaginase (PEG-ASP) in the treatment of acute lymphoblastic leukemia and malignant lymphoma with asparaginase,conclude and analysis the data about childhood AAP and show the epidemiology,clinical features,early diagnosis and effective treatment of children with AAP.Make clinical compare of L-asparaginase and PEG-ASP.Based on the full grasp of the relevant data,analyzing,introducing and integrating,this may be helpful to the diagnosis and treatment of childhood AAP.

Since upper limb function disorder exists in many children with cerebral palsy, it is improtant to assess and treat the disorder of the upper extremities. The common assessments include muscle tone, range of motion and upper extremity assessment. The goal of therapy is to decrease the muscle tone and increase the range of motion. In addition we should emphasize the functional ability and purposeful skill of the upper extremity.

Antihypertensive Agents ; therapeutic use ; Humans ; Vaccines

Objective To investigate the protective effect of gynostemma on myocardium and its mechanism in patients with diabetes associated with hyperlipemia.Methods 178 patients with type 2 diabetes mellitus with hyperlipidemia from the department of endocrinology in our hospital were selected and divided into two groups, 89 cases in the control group treated with basic treatment of diabetes+atorvastatin, 89 cases in the experiment group received gynostemma on the basis of the control group, myocardial injury index, blood glucose level, blood lipid level, serum cytokine levels and serum oxidative stress response indexes were detected and compared after the treatment.Results Compared with the control group, serum levels of aspartate aminotransferase(AST), creatine kinase(CK), CK-MB, lactate dehydrogenase(LDH)were lower in the experiment group after treatment, fasting plasma glucose(FPG), 2h postprandial blood glucose(2hPG), HbA1c level were lower after treatment, serum levels of total cholesterol(TC), triglycerides( TG ) , low-density lipoprotein cholesterol ( LDL-C ) were lower, high-density lipoprotein cholesterol ( HDL-C ) level was higher after treatment, serum level of adiponectin(ADPN) was higher, tumor necrosis factor-alpha(TNF-α), interleukin-6(IL-6), interleukin-18(IL-18) levels were lower after treatment, serum levels of malondialdehyde(MDA), reactive oxygen species(ROS) were lower, glutathione peroxidase(GSH-Px), superoxide dismutase(SOD) levels were higher after treatment, with significant difference (P<0.05).Conclusion Gynostemma can significantly reduce the cardiac muscle damage of patients with diabetes associated with hyperlipemia , plays a role in myocardial protection, the mechanism may be to reduce blood glucose and blood lipid levels, inhibit the inflammatory reaction caused by inflammatory cytokines, improve the antioxidant capacity of the body and reduce oxidative stress damage.

We retrospectively analyzed 23 cases of histiocytic necrotizing lymphadenitis (HNL) admitted to our hospital as fever of unknown origin (FUO).Fever,lymphadenopathy and skin rash were the most common clinical manifestation.The major laboratory features included cytopenia,abnormal liver enzyme and elevated inflammatory markers.Three of the 23 cases were finally diagnosed as infectious disease,5 as autoimmune disease,while the left 15 remained as HNL during the follow-up.Four of the 15 HNL patients resolved spontaneously,while the other 11 relieved by steroid use.Two patients relapsed during the follow-up.HNL was one of the rare causes of FUO.Since it would be accompanied with infectious,autoimmune or malignant diseases,long follow-up is necessary.

Objective To investigate the test analysis of tumor marker CA19‐9 ,CEA ,CA242 ,CA125 and AFP for jointly assess‐ing the chemotherapeutic effect of gastric cancer .Methods Totally 160 patients with gastric cancer in our hospital from January 2010 to December 2013 were selected as the research subjects .The expressions of related tumor markers were detected before treat‐ment and at 3 months after treatment .The relationship between the TNM staging and the tumor markers ,changes of tumor markers before and after treatment ,and changes of tumor markers in the patients with recurrence and metastasis ,and patients without recur‐rence and metastasis were analyzed .Results Different TNM staging had significant correlation with tumor markers associated posi‐tive expression rate .The positive expression rate of related tumor markers in the patients with stage Ⅲ and stage Ⅳ were signifi‐cantly higher than that in the patients with stage Ⅰ - Ⅱ .The positive expression rates of CA19‐9 ,CA242 ,CA125 and AFP after chemotherapy were significantly decreased compared with before treatment (P<0 .05) ,while the CEA level had no statistically sig‐nificant difference before and after treatment (P>0 .05) .After treatment ,the CEA ,CA19‐9 ,CA242 ,CA125 and AFP positive ex‐pression rates were declined ,moreover showing statistical differences compared with pre‐treatment (P<0 .05) .The CEA ,CA19‐9 , CA242 ,CA124 and AFP levels in the patients with recurrence and metastasis were significantly higher than those in the patients without recurrence and metastasis (P<0 .05) .Conclusion CA19‐9 ,CEA ,CA242 ,CA125 and AFP have a significant correlation with tumor TNM staging ,their expression level and positive expression rates have certain correlation with the prognosis in the pa‐tients with gastric cancer ,which is worthy of focus in clinic .

Objective To review experimental study and clinical application of materials to bile duct repair and reconstruction.Methods Comparison of different materials was made between advantages and disadvantages.Results Synthetic grafts such as vitallium,teflon are easy to handle,but have no flexion,and have foreign body reaction.Although autogenous free tissues such as venous patch and peritonium are resistant to infection,they are likley to lead to bile duct stricture because of lacking adeuqate blood supply.Vascularized neibouring tissues for repearing bile duct defect have satisfactory results.Conclusions To avoid bile duct striccture,vary measures should be taken to repair bile duct defecs;for segmental loss of bile duct,end to end anastomosis or Roux-en-Y biliary jejunal reconstruction should be applied.

Experimental incised wounds 8 mm in diameter were made on the right side of the back of 48 rats under anesthesia using aseptic technique. All animals were randomly divided into 12 groups according to the time of wound biopsies which were taken immediately after skin cutting, lh,12h,24h,2,3,4,5,6,7,8,9 and 10 days after wounding.One rat of each group was given colchicine before animal sacrifice in order to observe cell mitosis. Skin specimens were fixed in 10% formalin,embeded in paraffin and sectioned for HE stain,Gorden and Sweet stain for reticular fiber,Weigert stain for elastic fiber,PTAH stain for fibrin and Van Gieson stain.Macroscopically, wounds were getting smaller daily,and reduced in size markedly on the 6～7th day. The histologic changes were as follows:Acute inflammation on the wall of wounds occurred 1h after skin cutting;profuse fibrin exudation at the top of the base and on the wall of wounds at 24h;new capillary formation and regeneration of the epidermis on the 2nd day;granulation tissue formation and collagen fiber deposition on the 3rd day;small artery formation in the granulation tissue on the 4～5th day;granulation tissue maturation and the regenerating tissue covering the whole wound area on thd 6～7th day;the scar formation and contraction on the 8～9th day;further sear contration on the 10th day.The epidermis regenerated from the proliferation of the epidermis at the edge of the wound with the speed of 1.23mm/day. The regeneration of the epithelium proceeded under the necrotic tissue on both the wall and at the base of wounds. The mechanism of the wound contraction was discussed.

Various studies have suggested that adrcnergic activtaion may contribute to deleterious effects on myocardial ischemia. However, very little is known about it s role during reperfusion. This study was designed to explore the relationship between endogenous norepinephrine (NE) and reperfusion injury in intact rabbits. In rabbits(n=5) 35 min of coronary occlusion without reperfusion thc myocardial NE content of the ischemic area was not significantly different from that of the non-ischemic area, nor was tissue calcium content in both areas, while, in 35 min of occlusion followed by 10 min of reperfusion group(n=5), the tissue NE was markedly reduced in reperfused area accompanying significant calcium overloading. These studies suggest that the postischemic reperfusion injury may be, in part, due to endogenous catecholamine release during reperfusion.

Cardiovascular Agents ; therapeutic use ; Chronic Disease ; Clinical Trials as Topic ; Coronary Disease ; drug therapy ; Double-Blind Method ; Humans