Objective To analyze the clinical features of acute leukemia(AL) with positive mixed lineage leukemia(MLL)fusion gene in children,and explore their treatment protocols,prognosis factors,and so on.Methods Clinical features,treatment protocols,and prognosis factors were studied retrospectively among 51 AL patients with MLL fusion gene.MLL fusion gene was detected by morphology immunology,cytogenetics,molecul arbiology and reverse transcrption polymerase chain reaction(RT-PCR).Results Fifty-one AL patients with MLL fusion gene positive,included 37 cases of acute lymphoblastic leukemia(ALL) and 14 cases of acute myelocytic leukemia(AML).Forty-two patients exhibited abnormal clonal chromosome 11.MLL fusion gene rearrangements and MLL fusion gene partial tandem duplication were found among 36 cases and 15 cases,respectively.Thirty-two cases who received regular chemotherapy were followed up.Twenty-four cases including 19 cases of ALL and 5 cases of AML had achieved complete remission(CR).Six cases including 5 cases of ALL and 1 cases of AML had achieved more than 2 years CR.Sixteen cases were alive update including 12 cases of ALL and 4 cases of AML.Ten cases of positive MLL fusion gene were turning negative.Up to now,6 cases relapsed and 6 cases were dead.Conclusions The incidence of AL children with positive MLL fusion gene is low.It has some features,such as,high replapse rate and poor prognosis.A few patients sensitive to chemotherapies can achieve CR.They live with constant negative MLL fusion gene.

Bone Marrow Cells ; metabolism ; DNA-Activated Protein Kinase ; genetics ; metabolism ; Humans ; Leukemia ; genetics ; Nuclear Proteins ; genetics ; metabolism ; PTEN Phosphohydrolase ; genetics ; metabolism ; RNA, Messenger ; Telomerase ; genetics ; metabolism

Objective To investigate the efficacy of the combination ofJiangtang decoction and insulin in the treatment of type 1 diabetes mellitus in children.Methods A total of 43 children with type 1 diabetes mellitus were enrolled and randomly allocated to either a insulin group (control group) and a insulin plusJiangtang decoction group (treatment group) using the table of random digits, with 23 patients in the control group and 20 in the treatment group. The patients in the control group were treated with insulin, and those in the treatment group were administrated withJiangtangdecoction on the basis of the treatment in the control group for 2 months. Body mass index (BMI), fasting plasma glucose (FPG), postprandial blood glucose (PBG) and hemoglobin A1c (HbA1c) were measured.Results The levels of FPG, PBG and HbA1c were significantly decreased in the treatment group (twere 3.376, 54.493, and 2.798, respectively; allP<0.01), and the PBG level was significantly decreased in the control group (t=29.714,P=0.000). The levels of FPG, PBG and HbA1c in the treatment group were significantly lower than those in the control group (twere 2.715, 2.191 and 5.627, respectively;P<0.05 orP<0.01). There was no difference in BMI between the treatment group and the control group (t=0.159,P=0.874). The proportion of patients with HbA1c <7.5% in the treatment group (60.0%, 12/20) was higher than that in the control group (26.1%, 6/23;χ2=5.055,P=0.025).Conclusion Combination ofJiangtang decoction and insulin can decrease the level of FPG, PBG and HbAlc, and its therapeutic effect is superior to insulin alone for type 1 diabetes in children.

Objective To evaluate the implementation effect of Malaria Elimination Project supported by the Global Fund in Shaanxi Province so as to provide the evidence for the scientific implementation of Malaria Elimination Action Plan and the exami-nation and evaluation work. Methods The data of malaria prevention and control work were collected and analyzed statistically in 27 counties from 2010 to 2012 in order to evaluate the measures and effects of malaria control. Results There were 64 reported cases in the project areas from 2010 to 2012,and the average annual incidence rate was 0.15/10 million with a declining trend. The infected area sources of patients were mainly imported overseas accounting for 79.69%of the total cases. The blood completion rate of febrile patients was 94.14%,and the scope of the blood smears testing work had expanded to 88 counties(including 61 third-class counties). The training coverage rate of malaria prevention knowledge and skills had achieved to 100%. The awareness rates of malaria prevention and control were 91.68%and 89.44%in the students and local residentsrespectively. The case reporting with-in 24 h after diagnosed,epidemiological case study and outbreak disposal,laboratory testing and confirming and the other case management capabilities had also improved significantly. Conclusions The implementation of the Global Fund Malaria Project in Shaanxi Province has accelerated the process of Malaria Elimination work and improved significantly the malaria control ability in the project areas.

Pneumonia is one of the most common medical complications after stroke.Stroke-associated pneumonia (SAP) can not only increase the length of hospital stay and medical cost of patients,but also an important risk factor for mortality and morbidity in patients with stroke.All these indicate that the importance of prediction and prevention of SAP.This article reviews the advances in research on the prediction and prevention of SAP.

Child, Preschool ; Heart Diseases ; physiopathology ; Humans ; Iliac Vein ; physiopathology ; Leukemia, Lymphoid ; complications ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; complications ; Thrombosis ; etiology ; physiopathology

Child ; Cytochrome P-450 CYP3A ; genetics ; Disease Susceptibility ; enzymology ; Female ; Genome-Wide Association Study ; Humans ; Male ; Polymorphism, Genetic ; genetics ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; genetics

Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Leukemia, Myeloid ; pathology ; physiopathology ; Male

BACKGROUND: Coronary angiography is called "the golden standard" for the diagnosis of coronary heart disease (CAD). Foreshortening of vessel segments in angiographic projection images usually caused by the inappropriate projection angles or positions may lead to misdiagnosis or missed diagnosis.OBJECTIVE: To investigate the optimal angiographic views of main coronary artery and its branches in different somatotype or heart type patients and to investigate the specific relationships between the optimal angiographic views and the different somatotypes and heart types with computer-assisted techniques.DESIGN: A controlled observation.SETTING: Department of Cardiology, the Second Affiliated Hospital of Nanchang University.PARTICIPANTS: Altogether 1 369 patients were admitted to the Second Affiliated Hospital of Nanchang University to undergo coronary angiography from January 2001 to December 2006 and recruited for this study. Written informed consents of coronary angiography were obtained from all the patients. The protocol was approved by the Medical Ethics Committee of Medical College of Nanchang University.METHODS: All 1 369 inpatients were assigned into 3 groups by body mass index (BMI): fat somatotype group (n =489, BMI: 26-31 kg/m2, transverse heart type), general somatotype group (n =502, BMI: 23-25 kg/m2, general heart type), and thin somatotype group (n =378, BMI: 17-22 kg/m2 vertical heart type). In each group, all arteries including left main coronary artery (LM), proximal segment of the anterior descending coronary artery (LAD), distal-mid segment of LAD, proximal segment of circumflex branch (LCX), distal-mid segment of LCX, proximal-mid and distal segments of right coronary artery (RCA) were properly and carefully analyzed using Compart software, and then we got its optimal angiographic viewing angle. Finally, we arranged these data and induced whether different somatotype group patients have different optimal angiographic viewing angles specifically for some coronary artery or not.MAIN OUTCOME MEASURES: Optimal angiographic viewing angles.RESULTS: All 1369 patients participated in the final analysis. Optimal angiographic viewing angle for LM: left anterior oblique (LAO)(40±5)°/ caudal (CAU)(25±5)° or right left anterior oblique (RAO) 25°/CAU35°. In the fat somatotype group, the angle should be added 10° to its optimal angle, and in the thin somatotype group, the angle should be decreased by 10°, and the differences between the general somatotype group and the fat somatotype group or the thin somatotype group were statistically significant (all P < 0.05). Optimal angiographic viewing angle for proximal segment of LAD: RAO (50±8)°/ cranial (CRA)(23±8)°. In the fat somatotype group, the optimal angle should be added 10°, but in the thin somatotype group, it should be decreased by 10°. The differences between the general somatotype group and the fat somatotype group or the thin somatotype group were statistically significant (all P < 0.05). Optimal angiographic viewing angle for distal-mid segment of LAD: RAO (40±5)°/CRA (45±5)° or LAO (11±5)°/CRA (45±5)°. Optimal angiographic viewing angle for proximal segment of LCX: LAO (45±5)°/CAU (35±5)° or anteroposterior (AP)/CAU36°. Optimal angiographic viewing angle for distal-mid segmental of LCX: LAO (45±5)°/CAU (35±5)° or RAO (6±4)°/CAU (30±5)°. Optimal angiographic viewing angle for proximal-mid segment of RCA: LAO (35±5)°/CAU (14±5)° or LAO (48±5)°/CRA (15±5)°. For the thin or fat somatotype group, the optimal LAO angle should be increased by 15°, the optimal RAO angle should be decreased by10° for fat somatotype group and should be increased by 10° for thin somatotype group, and the differences between the general somatotype group and the fat somatotype group or the thin somatotype group were statistically significantly (P < 0.05). Optimal angiographic viewing angle for distal segment of RCA: LAO (53±5)°/CAU (17±5)°.CONCLUSION: The message can be got clearly about the whole coronary artery and the accuracy percentage of stenosis by changing angiographic viewing angle regularly to its own optimal angle in different somatotype or heart type patients. It's very important for making the choice of diagnosis and therapy

Objective To evaluate the perinatal outcome of three types of monochorionic diamniotic (MCDA) twins with selective intrauterine growth restriction (sIUGR).Methods From January 2005 to June 2012,clinical data of 42 pairs of MCDA twins (84 fetuses) with sIUGR and 71 pairs of normal MCDA twins (142 fetuses) in the same period were analyzed retrospectively in the First Affiliated Hospital of Sun Yat-Sen University.Fetuses with sIUGR were classified into three groups based on umbilical artery Doppler flow.There were 25 cases of type Ⅰ,11 cases of type Ⅱ and 6 cases of type Ⅲ.The perinatal outcome was compared between sIUGR and normal MCDA twins,and among the three types of sIUGR as well.Perinatal outcomes included gestational age at delivery,rate of intrauterine fetal death (IUFD),birth weight,intertwin discordance of birth weight,neonatal death and survival rate at 6 months.Results (1) The gestational age of sIUGR at delivery was significantly earlier than the control group [(34 ± 3),(36 ±2) weeks,respectively],and the rate of IUFD of both fetuses of sIUGR was significantly higher (4.8％,0,respectively).In the sIUGR group,the average birth weight of large or small twins[(2130 ±.350),(1520 ±400) g,respectively] was smaller than those in the control group [(2470 ± 500),(2340 ± 460) g,respectively].The difference was statistically significant (P ＜ 0.05,P ＜ 0.01,respectively).The intertwin discordance of birth weight in sIUGR group was significantly larger (27.6％) than the control group(4.0％,P＜0.01).(2) The gestational age at delivery in type Ⅱ and type Ⅲ [(34 ±5),(34 ±2) weeks,respectively] was significantly earlier than the control group (P ＜ 0.05).The rate of IUFD of both fetuses in type Ⅱ (18％) was significantly higher than in type Ⅰ (0) and the control group (0,P ＜ 0.05).In sIUGR group,the average birth weight of small twins in type Ⅰ,type Ⅱ and type Ⅲ was (1640 ±430),(1330 ±310) and (1500 ±380) g respectively,all of which were significantly smaller than that in the control group (P ＜ 0.05).The average birth weight of small twins in type Ⅱ was smaller than in type Ⅰ and the difference was statistically significant (P ＜ 0.05).In sIUGR group,the intertwin discordance of birth weight in type Ⅰ,type Ⅱ and type Ⅱ was 24.1％,34.6％,31.3％ respectively,all of which were significantly larger than that in the control group(4.0％,P ＜ 0.05).There were no statistically significant differences of the intertwin discordance of birth weight among the three types of sIUGR(P ＞0.05).Survival rate at 6 months in type Ⅱ (64％) was significantly lower than in type Ⅰ (92％) and the control group (91.5％,P＜0.01).Conclusions The perinatal outcome of MCDA twins with sIUGR is poor.The outcome is different among the three types of sIUGR,and type Ⅰ is the worst.Type Ⅱ is associated with a high risk of intrauterine fetal demise.It is important to monitor the intrauterine situation closely.