Venous thromboembolism (VTE) is a complication in children with acute lymphoblastic leukemia (ALL). The Chinese Children's Cancer Group-ALL-2015 protocol was carried out in China, and epidemiology, clinical characteristics, and risk factors associated with VTE were analyzed. We collected data on VTE in a multi-institutional clinical study of 7640 patients with ALL diagnosed in 20 hospitals from January 2015 to December 2019. First, VTE occurred in 159 (2.08%) patients, including 90 (56.6%) during induction therapy and 108 (67.92%) in the upper extremities. T-ALL had a 1.74-fold increased risk of VTE (95% CI 1.08-2.8, P = 0.022). Septicemia, as an adverse event of ALL treatment, can significantly promote the occurrence of VTE (P < 0.001). Catheter-related thrombosis (CRT) accounted for 75.47% (n = 120); and, symptomatic VTE, 58.49% (n = 93), which was more common in patients aged 12-18 years (P = 0.023), non-CRT patients (P < 0.001), or patients with cerebral thrombosis (P < 0.001). Of the patients with VTE treated with anticoagulation therapy (n = 147), 4.08% (n = 6) had bleeding. The VTE recurrence rate was 5.03% (n = 8). Patients with VTE treated by non-ultrasound-guided venous cannulation (P = 0.02), with residual thrombus (P = 0.006), or with short anticoagulation period (P = 0.026) had high recurrence rates. Thus, preventing repeated venous puncture and appropriately prolonged anticoagulation time can reduce the risk of VTE recurrence.
Humans ; Child ; Venous Thromboembolism/etiology* ; East Asian People ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/epidemiology* ; Risk Factors ; Thrombosis/chemically induced* ; China/epidemiology* ; Anticoagulants/adverse effects* ; Recurrence

In 2011, the FDA approved ipilimumab, the first immune checkpoint inhibitor(ICI), targeting CTLA-4, opening the field of immune checkpoint therapy (ICT). ICIs can induce durable clinical responses and improve survival in selected population. However, significant challenges still remain, including mechanisms of resistance, patient selection, management of serious immune-related adverse events, and rational therapeutic combinations. This review surveys the current understanding of response and resistance to ICIs and proposes a path forward to improving efficacy and minimizing toxicities.

Objective To investigate the infection status quo and genotype distribution of human papillomavirus(HPV) infection situation among females in west Guangxi area.Methods Cervical exfoliative cells samples from 3 315 women were collected to detect HPV genotyping with Cape flow-through hybridization.Then the results were statistically analyzed.Results The overall HPV infection rate was 21.30%(706/3 315),in the females of HPV positive infection,the high-risk type infection was predominant,accounting for 89.52%(632/706).The HPV infection type was dominated by single type infection,accounting for 72.66% the double infection accounted for 22.10%(156/706). The 21 HPV subtypes were detected.The high-risk HPV subtypes with high detection rate were HPV52(26.77%),HPV16(15.30%) and HPV58(15.01%).The low-risk HPV subtypes with high detection rate were HPV CP8304(11.90%) and HPV6(3.68%).The HPV subtypes were distributed differently at different ages.In 7 age groups of≤20,>20-30,>30-40,>40-50,>50-60,>60-70,>70 years old,the infection rates of high risk HPV were 21.62%(8/37), 19.26%(120/623),17.66%(220/1 246), 14.88%(153/1 028), 16.83%(51/303),15.52%(9/58) and 30.00%(6/20) respectively,showing no statistically significant differences among them(χ2=10.019,P=0.124).Conclusion Cervical HPV infection are mainly high-risk HPV subtypes and single type infection in females of western Guangxi area.The HPV subtypes with high infection rate are 52,16,58 and CP8304.

Objective To investigate the inhibitory effect of Withaferin A ( WFA) on the growth of orthotopic xenograft tumor of hepatocellular carcinoma in nude mice and the mechanism of its antitumoral effect. Methods For in vivo model, anti-tumor efficacy of Withaferin A was evaluated in nude mice mod-els of human liver cancer orthotopic xenograft. The nude mice were randomly divided into model group, Sunitinib group,and Withaferin A groups [6, 3 mg/(kg·d)]. All mice were given intraperitoneal injec-tion for 14 days. Tumor volume and tumor weight were observed. Antiangiogenic effects were assessed in vi-vo by the tumor inhibition rate and microvessel density. Quantitative polymerase chain reaction ( QPCR) as-say was used to detect the mRNA expression of vascular endothelial growth factor ( VEGF) , basic fibroblast growth factor (bFGF), angiopoietin-2 (Ang-2), vascular endothelial growth factor receptor 2 (VEGFR2) from tumor tissues. For in vitro experiments, the cell count kit 8 ( CCK8 ) assay was used to detect the effect of Withaferin A on HepG2 cells proliferation. QPCR assay and enzyme-linked immunosorbent assay ( ELISA) were used to detect the mRNA expression of VEGF. Results Compared to the model group, the high-dose Withaferin A group and the Sunitinib group had a significantly lower tumor weight (P<0. 05). The tumor inhibition rate was 42. 69％ in the high-dose Withaferin A group, 20. 22％ in the low-dose With-aferin A group, and 49. 43％ in the Sunitinib group. The growth of HepG2 cells was significantly inhibited by different concentrations of Withaferin A,and the 50％ concentration of inhibition ( IC50 ) of Withaferin A were (2. 64 ± 0. 18)μmol/L at 24 h. Withaferin A (6,3 μmol/L) could inhibit the protein and mRNA ex-pression of VEGF ( P<0. 05 ) . Conclusions Withaferin A significantly reduces the growth of orthotopic xenograft tumor of hepatocellular carcinoma in nude mice via antiangiogenic effect. Downregulation of the protein and mRNA expression of VEGF by WFA may be one mechanism of its anti-liver cancer effect.

OBJECTIVETo report an acute promyelocytic leukaemia (APL) case with translocation of rob (13;21) t(15;17) (q22;q21) and review its clinical and laboratory characteristics.

METHODSBased on routine karyotype analysis and bone marrow morphology, we further used double color double fluorescent in situ hybridization (DCDF-FISH) and reverse transcriptase PCR (RT-PCR) to examine the patient's abnormities on cytogenetic and molecular biology, and reveal the clinical characteristics of this rare translocation also from the related literatures.

RESULTSThe clinical manifestation and bone marrow morphology examination of this patient were in accordance with pathologic feature of APL. On first visit, immunophenotyping analysis showed positive myeloid markers. Through R-banding, the patient's karyotype was confirmed as 45, XX, rob(13;21) t(15;17) (q22;q21) [6]/45, XX, rob(13;21) [14]. FISH results showed that 68.9% cells were typical t(15;17) pattern. The positive rates of fusion gene of PML-RARα detected by RT-PCR was 25.8%. Patient was treated by induction and consolidation therapy, the karyotype was 45, XX, rob(13;21 )[20] after complete remission. The positive rate of fusion gene of PML-RARα by FISH and its level were 2.5% and 0.003% respectively.

CONCLUSIONAPL with rob (13;21) t(15;17) (q22;q21) was very rare, which was accorded with clinical and laboratory characteristics of APL. The value of chromosome abnormality as a prognostic marker in APL needs to be further observed..

Chromosome Aberrations ; Chromosome Banding ; Chromosomes, Human, Pair 15 ; Chromosomes, Human, Pair 17 ; Chromosomes, Human, X ; Humans ; In Situ Hybridization, Fluorescence ; Karyotype ; Leukemia, Promyelocytic, Acute ; Oncogene Proteins, Fusion ; Remission Induction ; Translocation, Genetic

Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Boronic Acids ; administration & dosage ; Bortezomib ; Humans ; Multiple Myeloma ; diagnosis ; drug therapy ; Pyrazines ; administration & dosage

OBJECTIVETo analyze the impact of the occurrence and severity of acute and chronic graft versus host disease (GVHD) on the long-term outcome of allogeneic peripheral blood stem cell transplantation (allo-PBSCT) for leukemia.

METHODSA total of 231 patients with leukemia, who underwent allo-HSCT in Changhai Hospital from Jan 1st, 2001 to Dec 31th, 2011, were retrospectively analyzed. The overall survival (OS), disease-free survival (DFS), transplantation-related mortality (TRM) and relapse rate (RR) were estimated according to the degree of acute and chronic GVHD.

RESULTS(1) Among the 224 assessable patients, aGVHD was observed in 85 patients, in which 46 developed grade I, 25 grade II and 14 grade III-IV. A total of 213 patients who survived beyond 100 days, cGVHD was observed in 109 patients, in which 84 developed limited cGVHD and 25 extensive cGVHD. (2)The incidence of 3-year OS and EFS of patients with aGVHD grade 0-I was significantly higher than that of grade II-IV (69.5% vs 33.6%, P<0.01; 60.7% vs 33.7%, P<0.01). The 3-year TRM of patients with 0-I grade aGVHD was significantly lower than that of the grade II-IV group (15.0% vs 56.7%, P<0.01). (3)The 5-year OS of patients with limited cGVHD was higher than patients without or with extensive cGVHD (79.8% vs 55.6% and 56.4%, P<0.01 and P=0.038, respectively). The 5-year TRM in patients with extensive cGVHD was higher than patients with limited cGVHD (14.1% vs 41.1%, P=0.018). However, the 5-year RR in patients without cGVHD was higher than patients with limited cGVHD or extensive cGVHD (47.2% vs 10.9% and 12.4%, P<0.01 and P=0.007, respectively). (4) The COX analysis showed that unrelated donor and myeloablative conditioning regimen were main factors affecting aGVHD; Meanwhile, aGVHD was the only factor affecting the cGVHD.

CONCLUSIONOur results showed that the patients with acute GVHD tended to have poor outcomes, especially with grade III-IV. On the contrary, the patients with limited cGVHD had lower RR and a long-term DFS.

Disease-Free Survival ; Graft vs Host Disease ; Humans ; Leukemia ; therapy ; Peripheral Blood Stem Cell Transplantation ; Retrospective Studies ; Transplantation Conditioning ; Transplantation, Homologous ; Treatment Outcome ; Unrelated Donors

Objective To analyse the clinical features of pelvic insufficiency fractures (PIF) in patients with cervical cancer after radiotherapy and explore the risk factors affecting its occurrence .Methods 55 cases of patients with cervical cancer that used radia-tion therapy as a single treatment were chosen in our hospital from February 2007 to May 2010 and the clinical features were ana-lysed;The fractures of spine ,sacrum ,sacroiliac joint ,ilium and pubis and femoral were observed and the density of fifth lumbar (L5 ) vertebrae ,left and right sacrum were detected via the CT or MRI (Hounsfield Unit)after 2-year follow-up ,the different factors on the incidence of PIF were explored .Results 12 cases (19 sites) of patients in 55 patients occured PIF after follow-up 2years ,the cumulative incidence was 21 .82% ;the distribution of PIF parts were followed :lumbar vertebrae had 5 cases ,sacral had 5 cases ,pu-bis had 4 cases ,sacroiliac joint had 2 cases ,iliac had 2 cases and femoral head had 1 case .The incidence rate of PIF that density of fifth lumbar vertebrae was ≤130 HU and >130 HU were 16 .36% and 5 .45% respectively ,the PIF′incidence rate that density of left side of sacrum was≤ -35 HU and > -35 HU were 18 .18% and 3 .64% respectively ,the incidence rate of PIF that density of right side of sacrum was ≤ -35 HU and > -35 HU were 20 .00% and 1 .82% respectively ,the density of the three parts all had statistical difference on the incidence of PIF (P<0 .05) .Univariate analysis showed that menopausal status and the average density of CT had statistical effects on PIF (P<0 .05);Multiple analysis showed that the average density of CT was the independent factors affecting PIF′incidence after radiotherapy .Conclusion The patients with cervical cancer may occur pelvic insufficiency fracture af-ter radiotherapy ,and its incidence is related to menopausal status and bone mineral density .

Objective In order to explore the effects of rehabilitation training and acupuncture on the neural function deficit and motor function in patients with ischemic streke.Methods Eighty patients with ischemic stroke were randomly divided into rehabilitation and acupuncture groups.According to different recovery stages,the rehabilitation group received purposeful rehabilitation training for 28 days while the acupuncture group received scalp needling combined with body acuptmcture.The neural deficit scores(NDS)and motor fimction comprehensive assessment(FCA) were evaluated at the recruitment(M_0),the 28~(th)(M_1)and 56~(th)(M_2)days after treatment.Results No significant difierences were found in the NDS and motor FCA between the rehabilitation and the acurluncture groups at the recruitment.The significant differences appeared at the 28~(th) and the 56~(th) days comparing with baseline assessments in each group.There was no significant difference in the changes of NDS and motor FCA between the two groups at 28~(th) day,however,the NDS and motor FCA in rehabilitation group revealed better outcome than the acupuncture group at the 56~(th) day.Conclusion The study indicated that both rehabilitation training and acupuncture could improve the neural function and enhance the motor function in patients with ischemic stroke.

To investigate the effect of ethanol on the zero-stress state of rabbit artery, a rabbit animal model of blood ethanol concentration gradient was established by intragastric administration of ethanol (IGAE). The blood ethanol concentration of each group was measured. The zero-stress state characterized by opening angle was observed by an image processing system. The results revealed that the blood ethanol concentration of each group increased after IGAE. The magnitude of the blood ethanol concentration came to the peak at 1.5-2 h after IGAE. The opening angle decreased with the increase of the magnitude of blood ethanol concentration and the opening angle in each group. These findings suggest that the zero-stress state of the rabbit artery has close relationship with ethanol concentration.
Animals ; Aorta ; physiology ; Arteries ; physiology ; Dose-Response Relationship, Drug ; Ethanol ; blood ; pharmacology ; Female ; Male ; Rabbits ; Random Allocation ; Stress, Mechanical ; Vasoconstriction ; physiology ; Vasodilation ; physiology