Objective:To analyze the clinical features and prognosis of acute B lymphoblastic leukemia (B-ALL) children carrying a TCF3: : PBX1 fusion gene and to evaluate the prognostic value of this gene.Methods:Retrospective cohort study.A total of 2 164 B-ALL children aged 0-18 years diagnosed and treated at 19 pediatric centers from October 2016 to June 2022 were enrolled.They were divided into the positive group and the negative group according to whether they carried a TCF3: : PBX1 fusion gene.The clinical characteristics, treatment response, adverse reactions, and prognosis of the 2 groups of patients were analyzed.The rank sum and Kruskal-Wallis tests were used to compare two and more than two groups of numerical variables, respectively.Fisher′s exact test was used to compare categorical variables.Results:Among the 2 164 patients, 116 (5.4%) were TCF3: : PBX1 positive, of which 70 patients were female, accounting for 60.3%.There were 840 female patients in the TCF3: : PBX1-negative group, accounting for 41.0%.There was a significant difference in the ratio of females between the TCF3: : PBX1-positive and TCF3: : PBX1-negative groups ( P<0.001).No significant difference was observed in age of onset between the two groups( P>0.05).The proportion of bone marrow naive cells [54.00 (14.00, 76.50)% vs.29.00 (3.00, 68.00)%], white blood cell counts [25.30 (10.46, 60.94)×10 9/L vs.9.03 (4.38, 30.73)×10 9/L] and hemoglobin counts [82.00(63.00, 101.00) g/L vs.74.00(60.00, 90.00) g/L] in the TCF3: : PBX1-positive group were significantly higher than those in the negative group at the onset (all P<0.05).In terms of treatment response, the proportion of peripheral blood naive cells on Day 8 in the TCF3: : PBX1-positive group was significantly higher than that in the negative group [2.00 (0, 9.00)% vs.0 (0, 2.00)%, P<0.001].The proportion of minimal residual disease <0.1% on Day 15 in the TCF3: : PBX1-positive group was significantly higher than that in the negative group ( P=0.038).There were no significant differences in cumulative recurrence rate, treatment-related mortality (TRM), and overall survival (OS) between the TCF3: : PBX1-positive group and TCF3: : PBX1-negative group (all P>0.05).The cumulative recurrence risk of TCF3: : PBX1-positive patients was 9.646 times higher than that of ETV6: : RUNX1-positive patients with better prognosis( HR=9.646, 95% CI: 1.026-90.700, P=0.047).There were no significant differences in TRM and OS between TCF3: : PBX1-positive and ETV6: : RUNX1-positive patients (all P>0.05).A significant enrichment of PAX5 mutations was detected in TCF3: : PBX1-positive patients.Among the 7 high-risk TCF3: : PBX1-positive patients in a single center, 4 patients had PAX5 mutations, and this proportion was significantly higher than that in other patients ( P<0.001). Conclusions:B-ALL children carrying a TCF3: : PBX1 fusion gene have a high remission rate and good long-term prognosis after intensive chemotherapy.It is suggesting that TCF3: : PBX1-positive B-ALL patients should be rated at intermediate risk to receive intensive chemotherapy.

Objective:To analyze the clinical features and prognosis of acute B lymphoblastic leukemia (B-ALL) children carrying a TCF3: : PBX1 fusion gene and to evaluate the prognostic value of this gene.Methods:Retrospective cohort study.A total of 2 164 B-ALL children aged 0-18 years diagnosed and treated at 19 pediatric centers from October 2016 to June 2022 were enrolled.They were divided into the positive group and the negative group according to whether they carried a TCF3: : PBX1 fusion gene.The clinical characteristics, treatment response, adverse reactions, and prognosis of the 2 groups of patients were analyzed.The rank sum and Kruskal-Wallis tests were used to compare two and more than two groups of numerical variables, respectively.Fisher′s exact test was used to compare categorical variables.Results:Among the 2 164 patients, 116 (5.4%) were TCF3: : PBX1 positive, of which 70 patients were female, accounting for 60.3%.There were 840 female patients in the TCF3: : PBX1-negative group, accounting for 41.0%.There was a significant difference in the ratio of females between the TCF3: : PBX1-positive and TCF3: : PBX1-negative groups ( P<0.001).No significant difference was observed in age of onset between the two groups( P>0.05).The proportion of bone marrow naive cells [54.00 (14.00, 76.50)% vs.29.00 (3.00, 68.00)%], white blood cell counts [25.30 (10.46, 60.94)×10 9/L vs.9.03 (4.38, 30.73)×10 9/L] and hemoglobin counts [82.00(63.00, 101.00) g/L vs.74.00(60.00, 90.00) g/L] in the TCF3: : PBX1-positive group were significantly higher than those in the negative group at the onset (all P<0.05).In terms of treatment response, the proportion of peripheral blood naive cells on Day 8 in the TCF3: : PBX1-positive group was significantly higher than that in the negative group [2.00 (0, 9.00)% vs.0 (0, 2.00)%, P<0.001].The proportion of minimal residual disease <0.1% on Day 15 in the TCF3: : PBX1-positive group was significantly higher than that in the negative group ( P=0.038).There were no significant differences in cumulative recurrence rate, treatment-related mortality (TRM), and overall survival (OS) between the TCF3: : PBX1-positive group and TCF3: : PBX1-negative group (all P>0.05).The cumulative recurrence risk of TCF3: : PBX1-positive patients was 9.646 times higher than that of ETV6: : RUNX1-positive patients with better prognosis( HR=9.646, 95% CI: 1.026-90.700, P=0.047).There were no significant differences in TRM and OS between TCF3: : PBX1-positive and ETV6: : RUNX1-positive patients (all P>0.05).A significant enrichment of PAX5 mutations was detected in TCF3: : PBX1-positive patients.Among the 7 high-risk TCF3: : PBX1-positive patients in a single center, 4 patients had PAX5 mutations, and this proportion was significantly higher than that in other patients ( P<0.001). Conclusions:B-ALL children carrying a TCF3: : PBX1 fusion gene have a high remission rate and good long-term prognosis after intensive chemotherapy.It is suggesting that TCF3: : PBX1-positive B-ALL patients should be rated at intermediate risk to receive intensive chemotherapy.

Objective To detect serum IgG4 and IgE levels in children with allergic asthma and rhinallergosis to provide an im-portant laboratory evidence for its diagnosis ,treatment and prevention.Methods The serum IgG4 and IgE levels were detected in 118 children patients with allergic asthma ,167 children patients with rhinallergosis and 150 healthy children(control group) under-going physical examination in the same period.Results The levels of serum IgG4 and IgE in the allergic asthma group and rhinal-lergosis group were significantly higher than those in the control group ,the difference was statistically significant (P<0.05).In the intra-group comparison of the allergic asthma group and rhinallergosis group ,the positive rate of serum IgG4 was higher than that of serum IgE ,the difference was statistically significant (P<0.05).The positive rate of joint detection of serum IgG4 and IgE in these two groups was higher than that of single index detection ,the difference was statistically significant (P<0.05).The positive rate of serum IgG4 in the allergic asthma group was lower than that in the rhinallergosis group ,the difference was statistically sig-nificant(P<0.05).The positive rate of serum IgE in the allergic asthma group was lower than that in the rhinallergosis group ,but the difference was not statistically significant (P>0.05).Conclusion Serum IgG4 and IgE have a certain clinical significance in the occurrence ,treatment and surveillance of allergic asthma and rhinallergosis in children.

ObjectiveTo explore the clinical feature of severe hand, foot and mouth disease (HFMD) in pediatric patients, and to observe the hemodynamic changes in those with acute pulmonary edema.Methods A prospective observation study was conducted. Thirty-five severe HFMD pediatric patients with acute pulmonary edema admitted to the intensive care unit (ICU) and Department of Pediatric of First People's Hospital of Foshan from May 2008 to September 2014 were enrolled. The clinical features were thoroughly investigated. Hemodynamic data were monitored by pulse-indicated continuous cardiac output (PiCCO) in 5 cases, and the changes in PiCCO parameters were observed at ICU admission (0 hour), and 24, 48, 96 hours after treatment.Results Thirty-five patients who met the diagnostic standard of severe HFMD were enrolled, including 22 male and 13 female, aged from 7 months to 4 years. Six patients were younger than 1 year, 13 1-2 years, 12 2-3 years, and 4 patients 3-4 years old. The most common time of occurrence of pulmonary edema was 3-4 days after the onset of the disease. Fever and central nervous system symptoms were found in all the patients, and examination of the cerebral spinal fluid (CSF) revealed non-bacterial inflammatory changes. PiCCO results showed a tendency of lowering of heart rate (HR), systemic vascular resistance index (SVRI), and extravascular lung water index (EVLWI) after the treatment, and the values obtained at 96 hours were significantly lower than those at 0 hour [HR (bpm): 119.0±14.7 vs. 200.8±19.7, SVRI (kPa·s·L-1·m-2):148.9±14.6 vs. 209.6±58.7, EVLWI (mL/kg): 10.5±1.9 vs. 34.8±10.8,P< 0.05 orP< 0.01], global end-diastolic volume index (GEDVI) was also gradually decreased without significant differences among all the time points, together with a tendency of increase in stroke volume index (SI) and cardiac index (CI). The values of the parameters at 96 hours were significantly higher than those at 0 hour [SI (mL/m2): 38.5±6.5 vs. 17.4±2.8, CI (mL·s-1·m-2): 75.0±8.0 vs. 55.5±8.5, bothP< 0.01]. Left atrium was found to be enlarged, and left ventricular systolic function decreased in two patients by cardiac ultrasonic. Four out of 35 patients died, and functional disability of extremities was found in 1 patient. Other patients were cured and discharged without any sequelae.Conclusions Severe HFMD complicated by acute pulmonary edema is a perilous condition in children, accompanied commonly by pathologic changes in central nervous system and systolic dysfunction of left ventricle. According to the results with PiCCO monitoring, HFMD patients suffering from acute pulmonary edema may be of cardiac origin in addition to neurogenic origin.

Objective As a collaborator of Beijing Institute of Medical Device Testing for value assignment of state standard ma-terial candidate Cystatin-C ,we have used the internationally accepted reference material to assign value for state standard material candidate Cystatin-C ,and help Beijing Institute of Medical Device Testing get Cystatin-C national standard material certificate . Methods According to the target value and operational procedure of international reference material ERM-DA471 ,We have tested 6 dilutions of standard material candidate Cystatin-C on calibrated Hitachi 7180 immunoassay system .Results The results demon-strate good repeatability and commutability ,and have been accepted in calculating the final value for the candidate standard materi-al ,our data has assisted Beijing Institute of Medical Device Testing in passing the criteria and obtaining Cystatin-C national standard material certificate .Conclusion Compared to the data from all participating collaborators ,our results hit right on the target value , and no significant matrix effects have been observed .

Objective To compare the temporomandibular joint changes in adolescent Class Ⅱ division 1 malocclusion patients with mandibular retrusion treated with Twin-block and Class Ⅱ elastics.Methods Sixty Class Ⅱ division 1 malocclusion patients with mandibular retrusion were divided into 3 groups (Twin-block group,Class Ⅱ elastic group and control group,20 patients in each group) randomly.Differences of condylar process morphology were compared using cone-beam CT(CBCT) before and after treatment.Results Condylar largest anteroposterior diameter and upper condylar height increased after treatment in both Twin-block groupand Class Ⅱ elastic group.The condylar largest anteroposterior diameter and upper condylar height were longer in both Twin-block group [(8.51 ± 1.48) and (7.39 ± 1.42) mm] and Class Ⅱ elastic group [(8.44± 1.03) and (7.24±0.89) mm] than those in the control group[(7.47± 1.27) and (6.47 ± 1.56) mm] (P＜0.05).No significant difference was found in other measurements (P＞0.05).Conclusions Condylar largest anteroposterior diameter and upper condylar height in Class Ⅱ division 1 malocclusion patients increased after treatment using Twin-block and Class Ⅱ elastics.There was no significant difference between two groups.

Objective To discuss the surgical treatment and its effects for hepatocellular carcinoma (HCC) in late pregnancy. Methods Clinical data of 3 patients with HCC in late pregnancy who were admitted in Department Hepatobiliary Surgery, the First People's Hospital of Foshan from November 2011 to December 2011 were analyzed retrospectively. The age of the patients was 23, 33 and 26 years old respectively. Case 1 with 35 weeks pregnancy was admitted to hospital for 3+weeks of progressive jaundice in skin and sclera after caesarean, and the alpha-fetoproteins (AFP) was 49 096μg/L. Case 2 with 29+4 weeks pregnancy was admitted to hospital after 1 week of ifnding a giant occupying lesion in the right lobe of liver, and the AFP was 973μg/L. Case 3 with 30+6 weeks pregnancy was admitted to hospital for 1 month of right upper quadrant abdominal dull pain after 2 d of ifnding a giant occupying lesion in the right lobe of liver, and the AFP was>1 210μg/L. The patients who had a history of viral hepatitis B began to take obstetrical examinations from 3+month of pregnancy, but not including the upper abdomen ultrasonic scan. All of them were diagnosed with HCC by ultrasound, computed tomography (CT), or magnetic resonance imaging (MRI). The informed consents of 3 patients were obtained and the ethical committee approval was received. Case 1 underwent percutaneous transhepatic cholangial drainage (PTCD) to reduce jaundice, then underwent right hemihepatectomy by anterior approach+thrombectomy through choledochotomy+left hepatic duct-jejunum end-to-side anastomosis. Case 2 delivered a healthy baby girl by caesarean after 2 weeks of conservative treatment, then underwent right hemihepatectomy by anterior approach+hepatic segmentⅣnodulectomy. Case 3 delivered a healthy baby boy naturally after 1 week of conservative treatment, then underwent segmentⅥ,Ⅶ,Ⅷhepatectomy by anterior approach. Results Case 1 recovered well after operation and was found with multiple intrahepatic metastasis in January 2013. Then transcatheter arterial chemoembolization (TACE) was performed. Case 2 was discharged from hospital with improvement 10 d after operation. Multiple hepatic and pulmonary metastasis was found 4 months after operation, and then treatments of targeted therapy of sorafenib combined with local radiofrequency ablation were given to the patient. Case 3 suffered bile leakage, bile duct and right subphrenic infection, and pancreatic tail infection and necrosis after operation and was discharged from hospital with improvement 93 d after treatments of repeated anti-infection, percutaneous peritoneal drainage, enternal nutrition support and so on. And then multiple pulmonary metastasis was found in February 2013. All the patients survived till this article was submitted. Conclusions Once the diagnosis of HCC in late pregnancy is conifrmed, the patient is suggested to keep pregnant till 32 weeks in order to save baby’s life and undergo hepatectomy as early as possible. Most of the patients are late HCC and the curative effect is poor.

To improve the teaching quality of neonatal diseases,we analyzed the diseases register of 760 neonates hospitalized in one year,two editions of textbook of pediatrics and the teaching outline,8 times of examination after the students had finished the exercitation.Accounted for 88.55%,673 cases of the neonates suffered from 15 diseases,which were included in the 17 diseases required by the teaching outline.Among the 669 cases of the neonates suffering from 10 common diseases,105 cases suffered from 5 diseases,which were not required by the teaching outline.As the second common disease,neonatal pneumonia was asked to be familiar with instead of mastering by the students.Accounted for 58.82%,10 diseases were required by the teaching outline without having them in the exams.Therefore it is important:1.to stand out the keystone on the clinic teaching of neonatal diseases such as neonatal jaundice,premature,and pneumonia which were required by the teaching outline as well as herpangina,vomit,humid lung-which were common diseases.2.to put neonatal vomit into the textbook and ask the students to master neonatal pneumonia.3.to perfect the setting of test paper:in the test paper neonatal diseases accounting for 20.00%,the diseases required by the teaching outline accounting for 85.00%.The proportion of important diseases to common diseases is 1.80∶1.

We analyszed 108 examination papers that were taken when the students of 8 groups had finished theexercitation. The attainment was 73.6?4.4 points. Among the 400 selective questions, the difficult questions whichwere concentrated only on a few diseases accounted for 35.3%. There was mush difference between the proportion of theselective questions and that of the demands of the teaching program in different system of diseases. There was few or noselective question in the important diseases of the teaching program. It is suggested that the proposition of difficultquestions must include the important diseases in the teaching program. The diseases that are not commonly encountereddiseases may be deleted from the teaching program, but the commonly encountered must be put in the teaching program.It is necessary to reinforce the ability of students to analyse and resolve problems[

Objective To investigate the relationship between newborn's feeding pattern and mother's knowledge-attitude-behavior in nutrition(K-A-B). Methods 246 pairs of mother and her newborn, 28?3 days old,were enrolled in the study,and questionnaire on the K-A-B was sent. Results The breaset-feeding rate of the newborn was 65.1%. 9.8% newborns were fed inappropriately. Only 65.5% mothers passed the examination of nutritional knowledge. However,88.5% mothers had positive attitude to receiving nutritional education. A lot of mothers have food preference. Nutritional lecture ,consultation in out patient department and by telephone were the nutritional education channels choiced by 78.5% mothers. Conclusion Breast-feeding rate of the newborns had been significantly reduced in comparison with that(85.1%) two years ago. Solid foods were given too early to the newborns. The major contributing factor is lack of knowledge in nutrition of mothers . Mothers should learn more about nutrition and improve their feeding skill through nutritional education.