Objective To investigate the changes and clinical significance of pyroptosis and inflammation in children with acute lymphoblastic leukemia after chemotherapy.Methods A retrospective analysis was con-ducted on the clinical data of 98 children with acute lymphoblastic leukemia who received chemotherapy in the pediatrics and hematology and oncology departments of the hospital from May 2023 to August 2024.Accord-ing to the results of blood culture,the selected children were divided into the Gram-positive bacteria group,the Gram-negative bacteria group,the fungal group and the non-bloodstream infection group,and drug sensitivity tests were conducted.After chemotherapy,the children were divided into the granulocytosis group and the non-granulocytosis group according to the granulocyte level.The relevant indicators were detected and com-pared by methods such as blood routine,flow microsphere array technology,enzyme-linked immunosorbent assay(ELISA),and Western blot.Results After chemotherapy,the pyroptosis related indicators caspase-1,caspase-4,caspase-5,caspase-11,interleukin(IL)-1 β,IL-18,the proportion of pyroptosis cells and the relative expression level of GSDMD protein in children of each infection type were significantly increased compared with those before chemotherapy(P＜0.05).After chemotherapy,the levels of IL-4,IL-6,IL-10 and interfer-on-γ(IFN-γ)in the granulocytosis group were significantly higher than those in the non-granulocytosis group(P＜0.05),and the granulocyte level was negatively correlated with the levels of IL-4,IL-6,IL-10 and IFN-γ(P＜0.05).There were statistically significant differences in the levels of IL-4,IL-6,IL-10 and IFN-γ in dif-ferent infection states after chemotherapy(P＜0.05).Conclusion The number of granulocytes and the levels of serum cytokines can serve as potential indicators of infection in children with leukemia.The regulation of pyroptosis may provide new strategies for the treatment of childhood leukemia.

Objective:To discuss the performance of visual score and heart-to-contralateral lung (H/CL) ratio of 99Tc m-pyrophosphate (PYP) SPECT/CT scintigraphy for diagnosing transthyretin-related cardiac amyloidosis (ATTR-CA) by using Meta-analysis. Methods:Relevant studies on 99Tc m-PYP SPECT/CT diagnosis of ATTR-CA published before August 20, 2023 from databases including Pubmed, EMbase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang and China Science and Technology Journal Database (VIP) were retrieved. Articles were screened and indices which reflect the diagnostic efficiency such as sensitivity and specificity were extracted. Forest plots were drawn, and subgroup analysis was performed to analyze the heterogeneity. Results:A total of 160 articles were retrieved, and 11 articles involving 1 802 patients were enrolled, of whom 605 were diagnosed with ATTR-CA. All 11 articles were enrolled when analyzing the diagnostic efficiency of visual score for diagnosing ATTR-CA. After integration, the sensitivity and specificity were 0.95(95% CI: 0.91-0.97) and 0.95(95% CI: 0.90-0.98), respectively. Ten articles (1 611 patients) were enrolled when analyzing the diagnostic efficiency of H/CL ratio for diagnosing ATTR-CA. After integration, the sensitivity and specificity were 0.93(95% CI: 0.82-0.98) and 0.99(95% CI: 0.90-1.00), respectively. Subgroup analysis indicated that lack of uniformity in diagnostic criteria was the primary source of heterogeneity. Conclusion:99Tc m-PYP SPECT/CT scintigraphy exhibits high diagnostic efficiency for ATTR-CA.

Objective:To investigate the efficacy of venetoclax-based combined regimen in treatment of adult patients with acute myeloid leukemia (AML).Methods:The data of 50 adult AML (non-acute promyelocytic leukemia) who received venetoclax-based combined regimen in the First Affiliated Hospital of Xiamen University, Dongguan People's Hospital, the First Hospital of Longyan City, Jieyang People's Hospital from December 2018 to May 2021 were retrospectively analyzed. Different doses venetoclax combined with demethylation drugs or low-dose chemotherapy regimen were used to analyze the therapeutic efficacy. The related factors influencing efficacy were analyzed by using logistic regression.Results:The composite complete remission (CR) rate of 50 AML patients was 62.0% (31/50), the overall response rate (ORR) was 76.0% (38/50); 28 patients achieved effectiveness [CR and partial remission (PR)] after the first cycle and could achieve effectiveness by 3 courses of treatment at the latest. Among 50 patients, 28 cases were newly diagnosed AML, the composite CR rate was 60.8% (17/28), ORR was 78.6% (22/28); 22 cases were recurrent and relapsed, the composite CR rate was 63.6% (14/22), ORR was 72.7% (16/22); and there was no statistically significant difference of ORR between the both groups ( χ2 = 0.23, P = 0.743). Logistic regression multivariate analysis showed age was the only independent influencing factor for the treatment effectiveness ( OR = 8.451, 95% CI 1.306-54.697, P = 0.025). The median duration time of patients receiving venetoclax treatment regimen was 4.5 months (1.1-15.0 months); 16 cases who had treatment effectiveness finally relapsed, the median time of maintaining effectiveness was 5 months (1.1-11.0 months). Additionally, the common treatment-related adverse reactions included bone marrow suppression after treatment, followed by some gastrointestinal reactions like nausea, vomiting and stomachache. In addition, no patient stopped medication for more than 1 week due to bone marrow suppression related complications. Conclusion:Venetoclax-based combined regimen shows a good short-term efficacy in treatment of AML. It is also effective and tolerable for elderly patients receiving reduced dose therapy.

Objective:To discuss the screening results and clinical characteristics of children of Miao and Dong nationalities with mediterranean anemia in ethnic minority areas of Qiandongnan State of Guizhou Province,and to clarify the differences of the mediterranean anemia among different minorities.Methods:A total of 1 623 children of Miao and Dong nationalities with mediterranean anemia in minority areas of Qiandongnan State were selected by multistage stratified random sampling method;quantitative analysis of HbA2 and HbF was used to screen the selected children with mediterranean anemia initially;phenol chloroform extraction method was applied to extract the DNA from the children with mediterranean anemia;ASO/RDB-PCR reverse dot blot hybridization method was used to analyze the gene characteristics of the children with mediterranean anemia.Results:A total of 1 623 children of Miao and Dong nationalities were selected as the subjects.Among 938 children with Miao nationality,there were 18 children with positive α-mediterranean anemia and 36 children with positive β-mediterranean anemia,and the positive detection rate was 1.92%.Among 685 children with Tong nationality,there were 13 children with positive α-mediterranean anemia and 24 children with positive β-mediterranean anemia,and the positive detection rate was 3.50%.The detection rates of composite of α-and β-mediterranean anemia in the children of Miao nationality and Tong nationality were 1.49% and 4.61%.There was no significant difference in the detection rates of different kinds of mealiterranean anemia between two nationalities (P<0.05).The major gene mutations in α-mediterranean anemia were——SEA/-αα and-α3.7,and the major gene mutations in β-mediterranean anemia were CD17/N and CD14-15/N,while the major gene types of the composite of α-and β-mediterranean anemia were——SEA/β41-42 and——SEA/β17.There was no difference in the positive rates of major gene types of different kinds of mediter ranean anemia between two nationalities(P<0.05).Conclusion:There is no difference in the positive rate of children of Miao and Dong nationalities with mediterranean anemia in minority areas of Qiandongnan State.CD17/N,——SEA/-αα and ——SEA/β41-42 are the major gene types of α-,β-,and αβ-mediterranean anemia,respectively.

Objective To explore effect of vidarabine monophosphate combined with astragalus injection on serum cardiac troponin I ( cTnI), interleukin 1β(IL-1β), interleukin-10 (IL-10) and tumor necrosis factor-α(TNF-α) in children with hand-foot-and-mouth disease.Methods 60 cases with hand-foot-and-mouth disease from March 2013 to March 2015 in the hospital were selected and divided into two groups treated by different therapy, 30 cases in each group.The control group received conventional treatment + ribavirin injection, and experimental group received vidarabine monophosphate combined with astragalus injection on the basis of conventional treatment, one time per day.All patients were treated for a course of 7 days.The serum cTnI,IL-1β,IL-10 and TNF-αlevels were compared before and after treatment.Results After treatment, the serum cTnI, IL-1β, IL-10 and TNF-αlevels in two groups decreased than those of pre-treatment (P<0.05), the above indicators of experimental group were lower than those of control group (P<0.05).Conclusion The combination of vidarabine monophosphate and astragalus injection could significantly decrease serum cTnI, IL-1β, IL-10 and TNF-αlevels in children with hand-foot-and-mouth disease.