Objective: To analyze the clinical characteristics of children with Burkitt lymphoma (BL) and to summarize the mid-term efficacy of China Net Childhood Lymphoma-mature B-cell lymphoma 2017 (CNCL-B-NHL-2017) regimen. Methods: Clinical features of 436 BL patients who were ≤18 years old and treated with the CNCL-B-NHL-2017 regimen from May 2017 to April 2021 were analyzed retrospectively. Clinical characteristics of patients at disease onset were analyzed and the therapeutic effects of patients with different clinical stages and risk groups were compared. Survival analysis was performed by Kaplan-Meier method, and Cox regression was used to identify the prognostic factors. Results: Among 436 patients, there were 368 (84.4%) males and 68 (15.6%) females, the age of disease onset was 6.0 (4.0, 9.0) years old. According to the St. Jude staging system, there were 4 patients (0.9%) with stage Ⅰ, 30 patients (6.9%) with stage Ⅱ, 217 patients (49.8%) with stage Ⅲ, and 185 patients (42.4%) with stage Ⅳ. All patients were stratified into following risk groups: group A (n=1, 0.2%), group B1 (n=46, 10.6%), group B2 (n=19, 4.4%), group C1 (n=285, 65.4%), group C2 (n=85, 19.5%). Sixty-three patients (14.4%) were treated with chemotherapy only and 373 patients (85.6%) were treated with chemotherapy combined with rituximab. Twenty-one patients (4.8%) suffered from progressive disease, 3 patients (0.7%) relapsed, and 13 patients (3.0%) died of treatment-related complications. The follow-up time of all patients was 24.0 (13.0, 35.0) months, the 2-year event free survival (EFS) rate of all patients was (90.9±1.4) %. The 2-year EFS rates of group A, B1, B2, C1 and C2 were 100.0%, 100.0%, (94.7±5.1) %, (90.7±1.7) % and (85.9±4.0) %, respectively. The 2-year EFS rates was higher in group A, B1, and B2 than those in group C1 (χ²=4.16, P=0.041) and group C2 (χ²=7.21, P=0.007). The 2-year EFS rates of the patients treated with chemotherapy alone and those treated with chemotherapy combined with rituximab were (79.3±5.1)% and (92.9±1.4)% (χ²=14.23, P<0.001) respectively. Multivariate analysis showed that stage Ⅳ (including leukemia stage), serum lactate dehydrogenase (LDH)>4-fold normal value, and with residual tumor in the mid-term evaluation were risk factors for poor prognosis (HR=1.38,1.23,8.52,95%CI 1.05-1.82,1.05-1.43,3.96-18.30). Conclusions: The CNCL-B-NHL-2017 regimen show significant effect in the treatment of pediatric BL. The combination of rituximab improve the efficacy further.
Adolescent ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Burkitt Lymphoma/drug therapy* ; Child ; Disease-Free Survival ; Female ; Humans ; Lactate Dehydrogenases ; Lymphoma, B-Cell/drug therapy* ; Male ; Prognosis ; Retrospective Studies ; Rituximab/therapeutic use* ; Treatment Outcome

Objective To study and analyze the theory, policy framework, and core content of physical activity policies and physical activity guidelines. Methods Using a policy research and content analysis approach and the theory of the six components of World Health Organization (WHO) health service system, we specifically analyze the theory, framework, and core content of WHO Global Action Plan on Physical Activity and WHO Physical Activity Guidelines. Results The Global Plan of Action for Physical Activity 2018-2030 (Action Plan) is an international policy document on physical activity issued by WHO that incorporates physical activity within the context of the seven principles of human rights, the life span, evidence-based practice, proportional universality, policy coherence and integration of health into all policies, participation and empowerment, and multisectoral partnerships into health services and social development. The Action Plan consists of four strategic objectives and 20 policy actions, covering six areas of WHO health service system, and the integration of physical activity policies into health services is of great importance in promoting the achievement of the United Nations Sustainable Development Goal 3 of universal health coverage. As a technical document for the implementation of the Action Plan, 2020 WHO Guidelines on Physical Activity and Sedentary Behavior (Guidelines) adopted the PI/ECO approach to analyze the physical activity needs of various groups of people, and provide guidelines to increase physical activity and reduce sedentary behavior for children and adolescents, adults, older adults, pregnant and postpartum women, people with chronic diseases and people with disabilities. The guidelines cover duration, frequency, and intensity of physical activity, types of physical activity, critical and important health outcomes of physical activity, and health risk prevention and related considerations. The Guidelines implement the relevant guiding principles of the Action Plan and aim to improve overall population participation in physical activity at the micro level and improve critical and important health outcomes for the overall population. Conclusion As a health and development strategy, the Action Plan promotes the integration of physical activity into the health delivery system to facilitate the achievement of the United Nations 2030 Sustainable Development Goal 3 of universal health coverage.The four strategic objectives and 20 policy actions of the Action Plan can be integrated into these six areas based on the six components of WHO Health Service Delivery System: leadership and governance, financing, human resources, service delivery, medical technology, and health information. As a technical document to implement the Action Plan, the Guidelines are based on the PI/ECO approach framework and provide guidance on increasing physical activity and reducing sedentary behavior for children and adolescents, adults, older adults, pregnant and postpartum women, chronic patients, and persons with disabilities. The core content addresses the target populations, duration, frequency, and intensity of physical activity, types of physical activity, critical and important health outcomes of physical activity, and health risk prevention and related considerations.

OBJECTIVE: To investigate the clinical features and outcome of neonatal acute respiratory distress syndrome (ARDS) in southwest Hubei, China. METHODS: According to the Montreux definition of neonatal ARDS, a retrospective clinical epidemiological investigation was performed on the medical data of neonates with ARDS who were admitted to Department of Neonatology/Pediatrics in 17 level 2 or level 3 hospitals in southwest Hubei from January to December, 2017. RESULTS: A total of 7 150 neonates were admitted to the 17 hospitals in southwest Hubei during 2017 and 66 (0.92%) were diagnosed with ARDS. Among the 66 neonates with ARDS, 23 (35%) had mild ARDS, 28 (42%) had moderate ARDS, and 15 (23%) had severe ARDS. The main primary diseases for neonatal ARDS were perinatal asphyxia in 23 neonates (35%), pneumonia in 18 neonates (27%), sepsis in 12 neonates (18%), and meconium aspiration syndrome in 10 neonates (15%). Among the 66 neonates with ARDS, 10 neonates (15%) were born to the mothers with an age of ≥35 years, 30 neonates (45%) suffered from intrauterine distress, 32 neonates (49%) had a 1-minute Apgar score of 0 to 7 points, 24 neonates (36%) had abnormal fetal heart monitoring results, and 21 neonates (32%) experienced meconium staining of amniotic fluid. Intraventricular hemorrhage was the most common comorbidity (12 neonates), followed by neonatal shock (9 neonates) and patent ductus arteriosus (8 neonates). All 66 neonates with ARDS were treated with mechanical ventilation in addition to the treatment for primary diseases. Among the 66 neonates with ARDS, 10 died, with a mortality rate of 15% (10/66), and 56 neonates were improved or cured, with a survival rate of 85% (56/66). CONCLUSIONS Neonatal ARDS in southwest Hubei is mostly mild or moderate. Perinatal asphyxia and infection may be the main causes of neonatal ARDS in this area. Intraventricular hemorrhage is the most common comorbidity. Neonates with ARDS tend to have a high survival rate after multimodality treatment.
China ; Female ; Humans ; Infant, Newborn ; Meconium Aspiration Syndrome ; Pregnancy ; Respiratory Distress Syndrome, Newborn ; Retrospective Studies

Objective To investigate the relationship between angiotensin converting enzyme(ACE) gene polymorphism and carotid plaque composition,vessel wall morphology,and clinical symptoms based on vessel wall magnetic resonance imaging. Methods Totally 75 hypertensive patients(75 internal carotid artery plaques) with maximum plaque thickness≥1.5 mm,according to the ACE insertion(I) or deletion(D) gene polymorphism,were divided into ACE 2 genotype group(n=37) and ACE ID/DD genotype group(n=38). The influences of plaque composition,vessel wall morphology,clinical symptoms,and use of ACE inhibitor or angiotensin receptor blocker(ACEI/ARB) on vessel wall morphology were analyzed. Results Compared with ACE 2 genotype group,the ACE ID/DD genotype group had significantly higher incidence of ischemic stroke(Χ=3.921,P=0.048). The plaque composition and vessel wall morphology showed no significant difference between these two groups. Inside ACE ID/DD genotype group,the carotid remodeling index was significantly lower in users of ACEI/ARB than non-users of ACEI/ARB(1.85±0.60 vs. 2.48±0.40;t=3.854,P=0.001).Conclusion In primary hypertension,ACE ID/DD genotype may be associated with carotid atherosclerotic plaque.

Objective To evaluate the significance of liver biopsy and B ultrasonograpgy in the diagnosis of fatty liver. Methods The results of 62 patients with liver steatosis diagnosed by liver puncture biopsy but not by B-ultrasonograpgy were contrastively analyzed and combined with liver function, blood lipids, blood glucose, and body mass index. Results The 62 cases which were not diagnosed as fatty liver by B-ultrasonograpgy were proved to be 5％-33％liver steatosis after liver puncture biopsy. Among the 62 cases, 23 cases were indicated by the B-ultrasonograpgy that the liver parenchyma echo did not see abnormalities, 18 cases showed the liver parenchyma echo slightly was enlarged, 17 cases showed the liver parenchyma echo density was a bit enhanced and 4 cases were diffuse liver damage,which respectively were 37.01％、29.03％、27.42％and 6.45％. Pathologically it indicated that 45 cases were 5％≤liver steatosis≤19％. Among the 45 cases, 18 cases were indicated by the B-ultrasonograpgy that the liver parenchyma echo was not seen abnormalities, 8 cases showed the liver parenchyma echo slightly was enlarged, 17 cases showed the liver parenchyma echo density was a bit enhanced, and 2 cases were diffuse liver damage, and the change of ultrasound was mainly showed by the liver parenchyma echo not seen abnormalities and the enhanced liver parenchyma echo density. Pathologically it indicated that 17 cases were 20％≤liver steatosis≤33％, 6 cases were indicated by the B-ultrasonograpgy that the liver parenchyma echo did not see abnormalities, 5 cases showed the liver parenchyma echo slightly was enlarged, 5 cases showed the liver parenchyma echo density was a bit enhanced, and 1 case was diffuse liver damage, and the change of ultrasound was mainly showed by the liver parenchyma echo not seen abnormalities, the slightly enlarged liver parenchyma echo and the enhanced liver parenchyma echo density. By analyzing the influence to the ultrasound changes by patients' liver function, body mass index, blood fat and blood sugar, and with logistic regression analysis through a disorderly classification, it was found that the larger value of the glutamine transferase, alkaline phosphatase, body mass index, triglyceride and low density lipoprotein cholesterol, the higher possibility of diffuse liver damage, and the higher level of fatty degeneration, the higher possibility of diffuse liver damage. Conclusion In the diagnosis of fatty liver, when the fatty degeneration is below 1/3, B-ultrasonic examination can't show characteristic changes of fatty liver. It should be closely observed or take liver puncture biopsy to make a definite diagnosis of fatty liver.

Objective To investigate the influence of EMR and ESD of endoscopic surgery on perioperative clinical parameters, complete resection rate and complications of patients with neuroendocrine tumors of digestive tract. Methods 40 patients with neuroendocrine tumors of digestive tract were chosen from June 2009 to June 2016 and randomly divided into 2 groups: A group (20 patients) with EMR and B group (20 patients) with ESD; and the operation time, the treatment cost, the lesion size, the lesion thickness, the complete resection of tumor, the negative rate of vertical margin and the complication incidence of the two groups were compared. Results The operation time and the treatment cost of B group were significant better than A group (P < 0.05). There was no significant difference in the lesion size and the lesion thickness between the two groups (P < 0.05). The completed resection rate of B group were significant higher than A group (P < 0.05). There was no significant difference in the negative rate of vertical margin between the two groups (P < 0.05). The complication incidence of B group were significant higher than A group (P < 0.05). Conclusion EMR and ESD of endoscopic surgery in the treatment of patients with neuroendocrine tumors of digestive tract possess the same clinical effects; EMR application can efficiently shorten the operation time and decrease the economic burden and ESD application maybe helpful to reduce the complication risk.

AIM:To investigate the value of pattern visual evoked potential (PVEP) and flash electroretinogram (FERG) in early diagnosis and prevention of diabetic retinopathy (DR), analyzing the correlation of early stage DR with PVEP and FERG.
METHODS: Sixty patients, 30 males and 30 females, participated in observation group. Their average age was 19. 42 ± 7. 78years. The duration of DM was < 5a. Best corrected visual acuity was 5. 0. Fasting blood glucose was 7. 8± 3. 6mmol/ L. There were 60 subjects, 30 males and 30 females, in control group. Their average age was 17. 2 ± 6. 52years. Best corrected visual acuity was 5. 0. Every participator was tested with PVEP and FERG according to ISCVE standard. The amplitude of PVEP and P100 latency were recorded. And the b-wave latency, b-wave amplitude, a - wave latency, a - wave amplitude were showed down.
RESULTS: In observation group, P100 amplitude decreased and P100 latency increased, compared to those of control group ( P< 0. 01); b - wave latency, b -wave amplitude, a - wave latency, a - wave amplitude were different from those in control group(P<0. 01); the fasting blood glucose kept stable; P100 amplitude, b -wave amplitude and a-wave amplitude were not related to the DM duration; P100 latency, a-wave latency and b-wave latency were related to the DM duration.
CONCLUSION: PVEP are sensitive to optic neuron damage; FERG is desirable to detect the lesion of Müller cells and bipolar cells. P100 amplitude by PVEP, b-wave amplitude by FERG may be the most sensitive parameter for DR at early stage.

To investigate the effect and possible mechanism of echinacoside-containing serum on the osteogenic differentiation in rat bone marrow mesenchymal stem cells. Rat bone marrow mesenchymal stem cells were cultivated by the whole bone marrow adherence method. The 3rd generation of cells were divided into 3 groups: the blank control group, the classic osteogenic-induced group and the 10% echinacoside-containing serum group. The expression of alkaline phosphatase and osteocalcin were detected by ELISA. The ex- pression of ZHX, protein was detected by Western blot technique. RT-PCR technique was used to detect the expression of ZHX₃mRNA. According to the result, the expressions of the alkaline phosphatase and osteocalcin in the classic osteogenic-induced group and the 10% echinacoside-containing serum group were significantly higher than that of the blank control group (P <0. 01). And expressions of the alkaline phosphatase activity and osteocalcin in the 10% echinacoside-containing serum group were significantly higher than that in the classic osteogenic-induced group (P < 0.01). Meanwhile, the classic osteogenic-induced group and the 10% echinacoside-containing serum group showed obviously higher ZHX₃ protain and mRNA expression than that of the black control group, with significant differences (P < 0.01); the 10% echinacoside-containing serum group showed obviously higher ZHX₃ protain and mRNA expression than that of the classic osteogenic-induced group, with a significant difference (P < 0.01). In conclusion, 10% echinacoside-containing serum can promote the differentiation of the bone marrow mesenchymal stem cells cultured in vitro. Its mechanism may be correlated with the increase in the ZHX₃expression.
Animals ; Cell Differentiation ; drug effects ; Cell Proliferation ; drug effects ; Cells, Cultured ; Female ; Glycosides ; blood ; pharmacology ; Homeodomain Proteins ; genetics ; metabolism ; Male ; Mesenchymal Stromal Cells ; cytology ; drug effects ; metabolism ; Osteogenesis ; drug effects ; Rats ; Rats, Sprague-Dawley ; Serum ; chemistry ; Transcription Factors ; genetics ; metabolism

OBJECTIVESTo compare the sensitivity of mammogram and breast dedicated MRI in detecting ductal carcinoma in situ with microinvaion (DCIS-MI) and ductal carcinoma in situ (DCIS) lesions, and to further investigate the independent predictive factors of mammogram and MRI sensitivity.

METHODSFrom August 2009 to November 2011, 122 consecutive confirmed breast cancer patients who had received operations were recruited for this clinical research. These patients were divided into two groups including DCIS (72 cases) and DCIS-MI (50 cases) based on pathologic reports. All the patients were female, with mean ages of 52.6 years and 54.4 years. Preoperative bilateral breast mammogram, breast dedicated MRI depictions and reports as well as histopathological reports were collected.

RESULTSSensitivity of MRI outstood mammogram in each subgroups: 84.7% vs. 42.4% in DCIS (χ(2) = 27.028, P = 0.000), 94.0% vs. 80.0% in DCIS-MI group (χ(2) = 4.540, P = 0.040). And further analysis showed that MRI was more sensitive to high nuclear grade DCIS and DCIS-MI lesions than low nuclear grade ones (OR = 3.471, P = 0.031).

RESULTSof logistic regression analysis proved microcalcification was an independent predictive factor of mammogram sensitivity (OR = 11.287, P = 0.001).

CONCLUSIONSSensitivity of breast dedicated MRI is superior to mammogram in detecting DCIS and DCIS-MI groups. Lesions with microcalcifiation is an independent predictive marker which meant that mammogram would achieve high detection rate in cancers presented calcification on mammogram image when compared with non-calcification. Diagnostic performance of breast MRI is less affected by clinical and pathological characteristics of the early stage breast cancer patients but further increased detection rate is observed in DCIS and DCIS-MI with high nuclear grade lesions which indicated that MRI could detect more early stage cancers with relative more aggression biological behaviour and provide these patients with early surgical interventions before possible progression to invasive breast cancers.

Breast Neoplasms ; diagnosis ; Calcinosis ; diagnosis ; Carcinoma, Ductal, Breast ; diagnosis ; Carcinoma, Intraductal, Noninfiltrating ; diagnosis ; Female ; Humans ; Magnetic Resonance Imaging ; Mammography ; Middle Aged ; Sensitivity and Specificity

OBJECTIVETo seek the problems of position, measuring and locating methods of Baliao points (posterior sacral foramina) in modern researches.

METHODSUsing Baliao (eight sacral foramina), Shangliao(BL 31), Ciliao(BL 32), Zhongliao(BL 33), Xialiao(BL 34), Dihoukong (posterior sacral foramina), Dikong (sacral foramina) and Digu(sacrum) as the key words, literature in the database of the CNKI from 1957 to 2012 were re trieved and analyzed.

RESULTSProblems were found in the past researches including limited numbers of relative literature, disunity of the measurement targets, complicated terms of indices, disunity of the starting and ending point of measurement, unclear weight of indices, deviation of results, lacking of combination with clinical practice and variety of locating methods.

CONCLUSIONPosition of Baliao points (eight sacral foramina) are clear. However, the locating methods are blurred and vary a lot. Study on living body has more significance for measurement and researches. Factors of gender, body weight, height and childbearing should also be taken into consideration. Therefore, it is necessary to find a more accurate and easier way of locating.

Acupuncture Points ; Acupuncture Therapy ; Humans ; Sacrum ; anatomy & histology ; diagnostic imaging ; Tomography, X-Ray Computed