Objective To explore the dead reasons and related factors of acute leakemia(AL)in children.Methods The clinical data of 42 dead cases of children with AL,who were admitted to Guangzhou Children's Hospital between Jan.1999 and Mar.2007 were reviewed.Nineteen cases were boys,23 cases were girls;the aging from 4 months to 12 years old and 5 months.Of 42 children,21 cases were acute lymphoblastic leukemia(ALL),18 cases were acute myeloid leukemia(AML),3 cases were unclassified AL.Results Ten out of 12 early-dead cases died of bleeding.Among 30 cases who received chemotherapy,4 cases died of bleeding,others of myelosuppression combined with infection,14 of whom died from sepsis,3 cases with fungal infection,1 case with virus infection,4 cases with unknown pathogens.Sixteen children relapsed among those who got remission,half of them relapsed within 1 year since diagnosed.Treatment-related mortality(TRM)was 90%(27 out of 30 cases).The main causes of TRM were infection and hemorrhage.Hyperleukocytosis and bleeding were 2 risk factors related to early death in new-diagnosed children.Conclusions More emphasizes should be put on bleeding tendency during early treatment in children with AL and treatment of infection complications during induction chemotherapy to reduce TRM.

Adrenergic beta-2 Receptor Agonists ; administration & dosage ; pharmacokinetics ; therapeutic use ; Asthma ; drug therapy ; Bronchitis ; drug therapy ; Bronchodilator Agents ; administration & dosage ; therapeutic use ; Child ; Child, Preschool ; Delayed-Action Preparations ; Drug Synergism ; Drug Therapy, Combination ; Glucocorticoids ; administration & dosage ; therapeutic use ; Humans ; Infant ; Leukotriene Antagonists ; administration & dosage ; therapeutic use ; Respiratory Sounds ; drug effects ; Terbutaline ; administration & dosage ; analogs & derivatives ; pharmacokinetics ; therapeutic use ; Transdermal Patch

Abdominal Neoplasms ; metabolism ; pathology ; surgery ; Actins ; metabolism ; Angiomyolipoma ; metabolism ; pathology ; Desmin ; metabolism ; Diagnosis, Differential ; Humans ; Leiomyosarcoma ; metabolism ; pathology ; surgery ; Liposarcoma ; metabolism ; pathology ; surgery ; Male ; Middle Aged ; Neoplasms, Multiple Primary ; metabolism ; pathology ; surgery ; Retroperitoneal Neoplasms ; metabolism ; pathology ; surgery ; S100 Proteins ; metabolism

Objective:To compare psychosocial factors and immune function between patients with breast cancer and benign tumor before operation.Methods:The patients of breast tumor(56 case)were measured by clinical psychological rating scale(EPQ、HAMD、HAMA、LES、SSRS、DSQ)before operation,and their serum levels of IgA, CD_4~+,CD_(19)~+ and the activity of NK cell were measured.The patients of breast tumor were divided into breast cancer group(36 case)and benign tumor group(22 case)bases on results of pathology.Results:In breast cancer group, there were significantly higher scores of neurotic,total and negative life events,immature defense styles,HAMA and HAMD than those in benign tumor group;while NK cell activity,levels of CD_4~+ and CD_(19)~+ and the score of mature defense,social supports,subjective supports and utility degree of supports were marked lower.There were significantly correlation between immune function(NK cell activity,content of CD_4~+,CD_(19)~+,IgA)and psychosocial factors(social support,P score of EPQ,HAMD and HAMA total score,quantity of negative life events etc). Conclusion:Cancer patients had more server psychosocial problems and lower immune function.The immune function of patient with breast cancer before operation is associated with the various psychosocial factors.

Objective To explore the clinical characteristics and pathologic mechanism of basal ganglia calcification combined with cerebral infarction.Methods The clinical data,radiation demonstration and prognosis in 53 cases of cerebral infarction were reviewed retrospectively,31 cases with basal ganglia calcification and 22 cases without basal ganglia calcification.Results Cerebral infarction with basal ganglia calcification mostly occurded in infants and after slight traumar,CT scan all showed lacunar infarction in basal ganglia and MRA demonstrated no severe changes on cerebral vessal.Compared with the infants without basal ganglia calcification,the infants with basal ganglia calcification recovered quickly and had better prognosis.Conclusions The infants of cerebral infarction with basal ganglia calcification had unique clinical characteristics.The occurrence of cerebral infarction is closely associated with basal ganglia calcification which perhaps resulted from cerebral hypoxia and ischemia previously.

3 cases with esophageal fistula following anterior cervical fixation were reported. The diagnosis, treatment, nursing and prevention were summarized with literature.

Objective To summarize the clinical characteristics of small intestinal stromal tumors(SIST), and evaluate the diagnostic values of various imaging or endoscope examinations for SIST. Methods From July 2004 to June 2009, 74 patients whose operation or endoscopy biopsy tissues pathologically confirmed SIST were collected. The clinical data, imageology including enteroclysis, abdominal ultrasound, spiral computered tomography (CT) and the double-balloon enteroscopy report of the patients were analyzed retrospectively. According to biological behavior, the SIST was divided into four risk degree such as extremely low risk, low risk, moderate risk and high risk. The correlation between pathologic characters and spiral CT feature was analyzed. Results The most predilection site of SIST was jejunum in 43 patients (58.1 %); secondarily duodenum in 17 cases (23%); and 10 cases (13.5%) in ileum. About 94.6 percent of patients (70/74) showed clinical signs, the most common symptom was gastrointestinal bleeding in 46 cases (67. 2 % ), abdominal pain in 23 cases (31.1%). Of various photogrammetry examinations and endoscopy, spiral CT has the highest diagnosis rate and diagnosis coincidence rate, which was 100% and 72. 1% respectively. Among the 74 SIST lesions, 14 cases were extremely low biological risk (18. 9 % ), 21 at low risk (28.4 % ), 15 at moderate risk (20. 3%) and 24 at high risk (32.4%). Spiral CT is helpful for the SIST risk diagnosis. Conclusions The onset of SIST was concealed and early diagnosis was very difficult. Spinal CT which could help to predict the tumor's risk degree and prognosis was noninvasive, convenient and reliable. Therefore, it could be the first choice for SIST examination at present.

Objective To investigate the effect of carteolol hydrochloride eye drops on 24-hour variation of intraocular pressure (IOP). Methods The 30 patients who had never used any anti-glaucoma eye drops were chosen, and their 24-hour variation of IOP (at 2:00 AM, 6:00 AM, 10:00 AM, 2:00 PM, 6:00 PM, 10:00 PM) were measured. Then carteolol hydrochloride eye drops were used twice a day (7:00 AM and 7:00 PM), 1-2 drops each time. Fifteen days later, their 24-h IOP was measured again and the data were analyzed. Results The average IOP at six monitoring points before treatment were (19.77±2.51) mm Hg, (19.52±2.34) mm Hg, (20.38±2.71) mm Hg, (20.07±3.65) mm Hg, (19.97±4.10) mm Hg and (19.97±4.31) mm Hg, the corresponding data after 15 days of treatment were (17.12±2.38) mm Hg, (17.42±2.60) mm Hg, (18.18±2.36) mm Hg, (18.02±3.77) mm Hg, (17.72±3.17) mm Hg and (17.35±3.40) mm Hg (t=11.68, P=0.000). The difference before and after treatment was (2.46±2.05) mm Hg during day and (2.17±1.88) mm Hg during night, and no significant difference was found between them. Conclusions Carteolol hydrochloride eye drops could significantly reduce the IOP, the decreased extent of 24-h IOP is stable.

BACKGROUND:Bone ultrastructural destruction is an important cause for bone strength decrease,bone friability and bone fracture incidence increase in osteoporosis.OBJECTIVE:To observe the ultrastructural changes of distal femur cancellous bone in glucocorticoid (GC)-treated rats by scanning electron microscopy (SEM).METHODS:A total of 32 female Sprague-Dawley rats,aged 3.5 months old,were respectively treated with methylprednisolone 3.5 mg/kg per day by subcutaneous injection to induce osteoporosis and normal saline.At 4 and 9 weeks,the distal femurs were coronary sectioned and rinsed with distilled water,dehydrated in graded ethanol,coated with gold,and observed by SEM.RESULIS AND CONCLUSION:Compared to the control,the number of bone trabeculae in the GC group was significantly decreased,and the bone trabeculae became thin,fragile,discontinuous;network structures of bone trabeculae were destroyed,and bone resorption surface increased,with disorderly arranged collagenous fibers and increased micro-damage.Rats treated with GC for 4 weeks maintained better bone ultrestructure compared with rats treated with GC for 9 weeks.Results show that GC can induce bone mass lost,destroy network structures of bone trabeculae,accelerate bone resorption in rat cancellous bone,and accordingly lead to increased bone brittleness and decreased bone functional of biodynamics.

Objective To explore the effects of murinecytomegalovirus(MCMV)infected mouse embryonic fibroblasts(MEF)on the proliferation and activation of regulatory T cell in vitro. Methods A co-culture system of T cell and MCMV infected MEF(T-MEF MCMV)was established.The viral load of supernatant was determined by plaque assay.The proliferation of T cells was observed with cell counting.The proportion of CD4+ CD25+ cells was measured by flow cytometry.The levels of Foxp3 protein were measured by Western blot.Reverse transcription polymerase chain reaction(RT-PCR)assay was utilized tO determine whether MCMV infection of MEF influenced the level of transforming growth factor(TGF)-β mRNA.The level of TGF-β protein in supernatant was measured by double-antibody sandwich enzyme linked immunosorbent assay(ELISA).The difference between T-MEF MCMV group and control group was assessed by one-way ANOVA.Results When T cells were co-cultured with MCMV infected MEF for 1 day and 3 days,the viral load in supernatant decreased.But when co-culture lasted for 6 days,the antiviral effect obviously diminished,as the viral load[(5.58±0.67)×105 PFU/mL]of the experimental group showed no statistic difference with MEF MCMV control group[(6.05±0.34)×105PFU/mL].When co-cultured with MCMV infected MEF for 3 days,T cell increased from pre-culture level of[(2.02±0.05)×106/mL]to(2.25± 0.13)×106/mL(P＜0.05).But when co-culture lasted for 6 days,the number of T eelI returned to (2.08±0.14)×106/mL,which had no statistic difference with that of co-culture for 3 days system. Both the expressions of Foxp3 protein and the proportion of CD4+ CD25+ Foxp3+ Treg cells in T-MEF MCMV group were up-regulated as the infection time extended,which were two times and three times of the control group level,respectively.The mRNA level(A value)of TGF-β in MCMV infected MEF increased from baseline of 1.09±0.13 to 3.15±0.54 on day 3 after infection.The expression of TGF-β in supernatant 3 days after infection was(3.85±0.32) μg/L,which was significantly higher than that before infection[(1.74±0.14)μg/L,P＜0.05].Conclusions Activated T cells have antiviral effect.However,the function of T cells is rapidly inhibited after activation,which may be due to the expression of Foxp3 mRNA induced by MCMV infected MEF and increased CD4+ CD25+ Treg proportion of the co-cultured T cells.TGF-β level is significantly increased after CMV infection,which may be an important mechanism of Treg proliferation.MCMV may manipulate Treg to evade specific immune elimination and,as a result,to cause CMV replication.