OBJECTIVE: To analyze the risk factors affecting prognosis of children with hemophagocytic lymphohistiocytosis (HLH). METHODS: The clinical manifestations and laboratory data of 143 HLH children who met the HLH-2004 diagnostic criteria in Shenzhen Children's Hospital from January 2009 to May 2017 were retrospectively analyzed, and the independent factors affecting prognosis were also analyzed. RESULTS: The median age of 143 HLH children was 1.9 (0.1-14.3) years old, and the median follow-up time was 6.7 years (1 day - 11.9 years). The overall survival rate of 1 month, 1 year, and 10 years was (87.4±5.5)%, (81.1±6.5)%, and (81.1±6.5)%, respectively. The deaths occurred within 1 year after onset. Multivariate analysis showed that central nervous system (CNS) involvement (P=0.047), low hemoglobin (P=0.002), prolonged activated partial thromboplastin time (APTT) (P<0.001), high triglyceride (P=0.005) were all the independent risk factors affecting survival of the children. Receiver operating characteristic curve indicated that APTT (AUC=0.753, P<0.001) was more valuable than other risk factors in predicting death of the children. The cut-off value of APTT was 56.6 s, and the sensitivity and specificity of which was 55.6% and 89.7%, respectively. CONCLUSION Hypohemoglobinemia, prolonged APTT, hypertriglyceridemia, and CNS involvement the risk factors affecting prognosis of HLH, and prolonged APTT shows a strong predictive value for death.
Adolescent ; Child ; Child, Preschool ; Humans ; Infant ; Lymphohistiocytosis, Hemophagocytic ; Prognosis ; Retrospective Studies ; Risk Factors ; Survival Rate

Objective: To evaluate clinical outcomes of autologous (auto-HSCT) and allogeneic hematopoietic stem cell transplantation (allo-HSCT) for angioimmunoblastic T-cell lymphoma (AITL) . Methods: From June 2007 to June 2017, clinical data of AITL patients who underwent HSCT in eight hospitals were assessed retrospectively. Results: Of 19 patients, 13 male and 6 female with a median age of 50 (32-60) years old, 12 auto-HSCT and 7 allo-HSCT recipients were enrolled in this study, all donors were HLA-identical siblings. Two of allo-HSCT recipients were relapsed auto-HSCT ones. There were 5 patients (5/12) in complete response (CR) status and 7 (7/12) in partial remission (PR) status before transplantation in auto-HSCT group, and 2 (2/7) in PR status and 3 (3/7) in progression disease (PD) status before transplantation in allo-HSCT group. The median follow-up for the surviving patients was 46.5 months (range, 1-100 months) for the whole series, two patients lost in auto-HSCT group. Three patients developed acute graft-versus-host disease (aGVHD) and 5 chronic graft-versus-host disease (cGVHD) after allo-HSCT. Three patients died of primary disease and 1bleeding in auto-HSCT group. One patient died of primary disease and 2 transplantation-related mortality in allo-HSCT group. The 3-year cumulative overall survival (OS) were 56% (95%CI 32%-100%) and 57% (95%CI 30%-100%) for auto-HSCT and allo-HSCT, respectively (P=0.979) . The 3-year cumulative progression-free survival (PFS) were 34% (95%CI 14%-85%) and 57% (95%CI 30%-100%) for auto-HSCT and allo-HSCT, respectively (P=0.451) . Conclusion: Both auto-HSCT and allo-HSCT were optimal choices for AITL. In clinical practice, which HSCT was better for AITL patients should be based on comprehensive factors including sensitivity to chemotherapy, risk stratification and disease status at transplantation.
Adult ; Female ; Graft vs Host Disease ; Hematopoietic Stem Cell Transplantation ; Humans ; Lymphoma, T-Cell/therapy* ; Male ; Middle Aged ; Retrospective Studies ; Transplantation, Autologous ; Transplantation, Homologous ; Treatment Outcome

The isolation of the MeOH extract from the flower bud of Magnolia biondii Pamp. using various column chromatographies and HPLC led to eleven neoglignan derivatives (1 - 11). Their structures were mainly determined by 1D and 2D NMR spectral data analysis and physiological methods. The isolated compounds (1 - 11) were tested for anti-allergic effects using IL-2 inhibitory assay in Jurkat T cells.
Chromatography ; Chromatography, High Pressure Liquid ; Flowers* ; Interleukin-2* ; Magnolia* ; Magnoliaceae ; Statistics as Topic ; T-Lymphocytes*

OBJECTIVETo investigate the risk factors for the development of congenital anal atresia in neonates.

METHODSA total of 70 neonates who were admitted to 17 hospitals in Foshan, China from January 2011 to December 2014 were enrolled as case group, and another 70 neonates who were hospitalized during the same period and had no anal atresia or other severe deformities were enrolled as control group. Univariate and multivariate logistic regression analyses were used to investigate the risk factors for the development of congenital anal atresia.

RESULTSThe univariate analysis revealed that the age of mothers, presence of oral administration of folic acid, infection during early pregnancy, and polyhydramnios, and sex of neonates showed significant differences between the case and control groups (P<0.05). The multivariate logistic regression analysis revealed that infection during early pregnancy (OR=18.776) and male neonates (OR=9.304) were risk factors for congenital anal atresia, and oral administration of folic acid during early pregnancy was the protective factor (OR=0.086).

CONCLUSIONSInfection during early pregnancy is the risk factor for congenital anal atresia, and male neonates are more likely to develop congenital anal atresia than female neonates. Supplementation of folic acid during early pregnancy can reduce the risk of congenital anal atresia.

Anus, Imperforate ; etiology ; Female ; Humans ; Infant, Newborn ; Logistic Models ; Male ; Pregnancy ; Risk Factors

OBJECTIVES: The objective of this study is to find out the differences in psychopathology, temperament, and character factors between young adults with and without childhood attention-deficit hyperactivity disorder (ADHD) symptoms. METHODS: The subjects consisted of 314 university students (male=72, female=242) in Gongju. They were divided into childhood ADHD group (N=54) and normal group (N=260) to the Wender-Utah Rating Scale. Participants were assessed using Korean Adult ADHD Scale, Beck Depression Inventory-II, Beck Anxiety Inventory, Kimberly Young's Internet Addiction Test, Barratt Impulsiveness Scale, Paranoia Scale, Korean-Schizotypal Ambivalence Scale, Lubben Social Network Scale, and Temperament and Character Inventory-Revised. Descriptive statistics, t-test, chi-square, spearman correlation, and stepwise multiple regression were applied to analyze the data. RESULTS: Participants with childhood ADHD symptoms had high level of adult ADHD symptoms (p<.001), impulsiveness (p=.001), depression (p<.001), anxiety (p<.001), internet addiction (p<.001), paranoia tendency (p<.001) and low level of self-esteem (p<.001) compared to normal group. Self-directedness (p<.001) was lower, Harm avoidance (p=.001) and Self-transcendence (p=.029) were higher in the childhood ADHD group. In correlation and stepwise multiple regression, childhood ADHD symptoms were significantly associated with cooperativeness (r=-0.515 and beta=-0.547, p<.001 respectively). CONCLUSION: This result showed that young adults with childhood ADHD symptoms had various forms of psychopathology and childhood ADHD symptoms were influenced by character such as cooperativeness. Therefore, more thorough evaluation regarding childhood ADHD symptoms is needed.
Adult* ; Anxiety ; Chungcheongnam-do ; Depression ; Humans ; Internet ; Paranoid Disorders ; Psychopathology* ; Temperament* ; Young Adult

OBJECTIVETo analyze epidemiological characteristics of burn inpatients in Hainan province over 8 years.

METHODSSix thousand and ninety-nine burn patients admitted to 6 hospitals of Hainan province from January 2002 to December 2009 were enrolled in the study. The clinical data of these patients were analyzed retrospectively, including age, gender, injury cause, wound position, burn area, ailment prior to admission, admission time, medical insurance, length of hospital stay, and mortality rate, relationship among inpatient distribution, admission time, and ambient temperature at the time of admission. Data were processed with SPSS 13.0 software.

RESULTSThere were more burn male patients than female, with ratio of 2.1: 1.0. Most patients were younger than 13 years (57.2%, 3488/6099). The most common burn area was smaller than or equal to 10% TBSA (67.4%, 4108/6099), and the fewest patients had burn areas of over 50% TBSA (2.0%, 121/6099). The main causative agents were hot liquid and flame, accounting for 71.5% (4358/6099), 17.9% (1092/6099), respectively. Most patients had injuries of more than two body areas (60.7%, 3705/6099), and lower extremity injury (17.1%, 1042/6099) was predominant in wound of single body area. Among 703 cases who had other ailments prior to admission (11.5%), the highest rate of prior ailments was found in patients older than 60 years (18.5%, 48/260), it was lowest in children younger than 1 year (8.0%, 32/398). The length of hospital stay was 1 to 375 day, and the admission time was 10 minutes to 90 days after burn. Total mortality rate was 0.4% (26 cases). The number of inpatients aged from 19 to 59 was obviously higher in months with high ambient temperature (from June to August), and for inpatients younger than 13 years the incidence of burn injury showed no obvious seasonal change. The inpatients who had medical insurance accounted for 10.9% (66/603) to 19.5% (121/619) from 2002 to 2005, which increased to 46.0% (372/808) in 2007 and 79.1% (869/1098) in 2009.

CONCLUSIONSFor burn inpatients in Hainan province, the main injury cause of burn injury is hot liquid, the number of burn adults aged from 19 to 59 seems to increase in months with high ambient temperature, while the incidence of burn in children showed no obvious seasonal change. The number of inpatients and those with medical insurance showed a tendency of increase from 2005 to 2009 in Hainan province.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Burns ; epidemiology ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Incidence ; Infant ; Inpatients ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

OBJECTIVETo compare and evaluate clinical effects between locking intramedullary nail fixation and skeletal traction in order to provide the best therapeutic choice for tibiofibula fractures.

METHODSFrom November 1989 to December 2000, 108 patients with tibiofibula fractures (group A) were treated with skeletal traction, there was 76 males and 32 females; the age was from 29 to 66 years with an average of (40.3 +/- 9.6) years; according to AO classification standard,48 cases were type A, 46 type B, 14 type C, of which the standard typing Gustio, type I in 15 cases, type II in 13, type III A in 2. And from January 2001 to July 2007, 57 patients with tibiofibula fractures (group B) were treated with locking intramedullary nail fixation,there was 40 males and 17 females,the age was from 21 to 69 years with an average of (38.1 +/- 8.9) years; according to AO classification standard, 27 cases were type A, 22 type B, 8 type C, of which the standard typing Gustio, type I in 7 cases, type II in 6, type III A in 1. Four indexes were compared, including the time of fracture healing, the time of achieved 90 degrees genuflection, the time of off-bed weight-bearing and complication.

RESULTSComparison of fracture healing time: group A was (19.0 +/- 0.6) weeks and group B was (14.0 +/- 0.5) weeks; the time of achieved 90 degrees genuflection in group A was (92.0 +/- 8.2) d and in group B was (39.0 +/- 6.1) d; the time of off-bed weight-bearing in group A was (96.0 +/- 6.3) d and in group B was (38.0 +/- 6.5) d. Complication occurred in 42 cases in group A and 6 in group B. There was significantly difference in 4 items between two groups (P < 0.01). The method of locking intramedullary nail fixation was better than skeletal traction in treating tibiofibula fractures.

CONCLUSIONTreatment of tibiaofibula fractures with locking intramedullary nail fixation can obtain satisfactory effect, which has less complication, the fracture heals and weigh-loading can be achieved early.

Adult ; Aged ; Female ; Fibula ; injuries ; surgery ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Humans ; Male ; Middle Aged ; Tibial Fractures ; physiopathology ; surgery ; Time Factors ; Traction ; Treatment Outcome ; Weight-Bearing

OBJECTIVETo explore the value of the POSSUM scoring system in predicting postoperative morbidity and mortality of pancreatoduodenectomy (PD).

METHODSTwo hundreds and sixty-five consecutive PDs were performed between January 2005 and December 2007. POSSUM scores which relied on 12 physiologic and 6 operative variables were prospectively calculated for each case. Expected morbidity and mortality were estimated based on POSSUM scores and were compared with observed morbidity, which were diagnosed according to the Clavien complication scheme and domestic reference criteria respectively, and mortality.

RESULTSPhysiologic scores of 265 cases ranged from 12 to 24,the mean was 15. Operative scores ranged from 14 to 24, the mean was 17. The overall POSSUM scores ranged from 0.24 to 0.88. Average expected morbidity was 43.8%, expected cases were 116. Observed morbidity rate was 39.6% (105/265). The expected and observed morbidities and cases had no significantly differences. All patients were classified to 1 of 4 strata based on their individual POSSUM scores and subsequent risk of morbidity. Predictive value was the highest when scores ranged from 0.4 to 0.8. POSSUM exhibited less predictive value for mortality, but if POSSUM was more than 0.5, it was useful for mortality predicting.

CONCLUSIONSPOSSUM scoring system has high value for predicting the risk of morbidity in PD and can be helpful in guiding surgery and postoperative management decisions.

Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Pancreaticoduodenectomy ; mortality ; Postoperative Complications ; Prospective Studies ; Risk Assessment

Objective To observe neural stem cell activation and proliferation in situ afterintracerebal hemorrhage (ICH) and its effect on the neurological function of the injured adult rats.Methods Seventy-two adult rats were randomized into ICH and sham operation groups (n=36). In theICH group, type Ⅳ collagenase was injected into the internal capsule through a microinfusion pump toinduce intracerebral hemorrhage, and the rats in the sham operation group received only phosphate buffersolution injection. The neurological functions of the rats were observed by rotarod motor test on days 1, 7,14, 21, 28, and 35 after the injection. One day before sacrifice, the rots were subjected to intraperitonealBrdU injection to label the regenerated cells, and immunohistochemistry was used to detect theexpressions of nestin and BrdU in the brain tissue. Results No nestin- or BrdU-positive cells werefound in the brain of the rats in the sham operation group. In rats with ICH, nestin- and BrdU-positivecells were found predominantly in the basal ganglion around the hematoma, in the ependyma and near thesubventricular zone (SVZ) in the brain; the number of the positive cells increased significantly 7 daysafter ICH, peaked on day 14 and then significantly reduced on day 28. The rats exhibited no obviousimprovement of the impaired motor function over the period from day 1 to 35 after ICH. Activation andproliferation of the neural stem cells was not obviously related to the recovery of the neurologicalfunctions. Conclusion Endogeneous neural stem cells in the brain are activated in rats after ICH, butthese stem cells possess rather limited capacity of proliferation and can not sufficiently compensate forICH-induced neurological function impairment.

To investigate the relaxation effect and underlying mechanism of U50,488H (a selective kappa-opioid receptor agonist) on aorta in the rat, isolated aortic ring was perfused and the tension of the vessel was measured. It was shown: (1) kappa-opioid receptor stimulation with U50,488H relaxed rat aorta dose-dependently; (2) the relaxation effect of U50,488H on aorta was partially endothelium-dependent; (3) the relaxation effect of U50,488H was significantly attenuated in the presence of glybenclamide and glipizide, two ATP-sensitive K(+) channel (K(ATP)) blockers; and (4) the relaxation effect of U50,488H on vessel bore no relationship to muscarinic-receptor, beta-adrenoceptor, prostaglandin and nitric oxide (NO). These results indicate that kappa-opioid receptor stimulation with U50,488H relaxes the aortic artery at least partially via K(ATP) channel in the rat.
3,4-Dichloro-N-methyl-N-(2-(1-pyrrolidinyl)-cyclohexyl)-benzeneacetamide, (trans)-Isomer ; pharmacology ; Animals ; Aorta ; physiology ; In Vitro Techniques ; KATP Channels ; metabolism ; Male ; Rats ; Rats, Sprague-Dawley ; Receptors, Opioid, kappa ; agonists ; physiology ; Vasodilation ; physiology