Background::The role of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in children with high-risk (HR) T-cell acute lymphoblastic leukemia (T-ALL) in first complete remission (CR1) is still under evaluation. Moreover, relapse is the main factor affecting survival. This study aimed to explore the effect of allo-HSCT (especially haploidentical HSCT [haplo-HSCT]) on improving survival and reducing relapse for HR childhood T-ALL in CR1 and the prognostic factors of childhood T-ALL in order to identify who could benefit from HSCT.Methods::A total of 74 newly diagnosed pediatric T-ALL patients between January 1, 2012 and June 30, 2018 were enrolled in this retrospective study. Patients were stratified into the low-risk chemotherapy cohort ( n = 16), HR chemotherapy cohort ( n = 31), and HR transplant cohort ( n = 27). Characteristics, survival outcomes, and prognostic factors of all patients were then analyzed. Results::Patient prognosis in the HR chemotherapy cohort was significantly worse than that in the low-risk chemotherapy cohort (5-year overall survival [OS]: 58.5% vs. 100%, P = 0.003; 5-year event-free survival [EFS]: 54.1% vs. 83.4%, P = 0.010; 5-year cumulative incidence of relapse [CIR]: 45.2% vs. 6.3%, P = 0.011). In HR patients, allo-HSCT improved the 5-year EFS and CIR compared to that of chemotherapy (5-year EFS: 80.1% vs. 54.1%, P = 0.041; 5-year CIR: 11.6% vs. 45.2%, P = 0.006). The 5-year OS was higher in the HR transplant cohort than that in the HR chemotherapy cohort (81.0% vs. 58.5%, P = 0.084). Minimal residual disease re-emergence was an independent risk factor for 5-year OS, EFS, and CIR; age ≥10 years was an independent risk factor for OS and EFS; and high white blood cell count was an independent risk factor for EFS and CIR. Conclusion::Allo-HSCT, especially haplo-HSCT, could effectively reduce relapse of children with HR T-ALL in CR1.

Objective:To study the distribution and drug resistance of Carbapenem-Resistant Organism (CRO) and to analysis the risk factors of CRO 30-day mortality.Methods:A total of 181 patients with CRO infection diagnosed in Department of Hematology, Fujian Medical University Union Hospital from January 2018 to June 2020 were retrospectively investigated. The clinical and laboratory data of the patients were collected, the prognosis of patients diagnosed with CRO infection in day 30 was followed up, and the risk factors of prognosis were analyzed. The clinical significance of Carbapenem-Resistant Enterobacteriaceae (CRE) active screening was further evaluated in the CRE subgroup.Results:Among the total of 181 CRO isolates, 47.2% were CRE, 37.0% were Pseudomonas aeruginosa, and 32.6% were Klebsiella pneumoniae, which were highly resistant to carbapenem and had high MIC value, 76.8% (139/181) of CRO were MIC of imipenem resistance≥16 μg/ml. The main sources of isolates were blood and sputum. The 30-day all-cause mortality rates of patients with CRO or CRE infection were (41.4±3.7) % and (44.7±5.4) %, respectively. The COX multivariate regression analysis showed that the level of procalcitonin >0.2 ng/ml and the MIC value of imipenem resistance ≥ 16 μg/ml were independent risk factors for 30-day mortality of CRO infected patients. The CRE subgroup analysis showed that MIC value of imipenem resistance ≥16 μg/ml were independent risk factors for 30-day mortality of CRE infected patients. The 30-day cumulative survival rate of patients with CRE active screening was higher than the patients without CRE active screening [ (68.0±9.3) % vs (50.0±6.5) %, P=0.21]. Conclusion:The high MIC value of imipenem resistance isolates seriously affects the prognosis of patients with CRO infection in the hematology department, and the mortality rate was high. CRE active screening is expected for early prevention, early diagnosis, and early treatment for high-risk patients.

Ear and upper airway are portal organs of human body. Because of their fine and narrow structure, the non-invasive research and the effect of clinical diagnosis and treatment in traditional medicine are always unsatisfactory. With the development of computer technology, numerical simulation has become an effective means of auxiliary research. Numerical simulation can reproduce or evaluate the diagnosis and treatment of ear and upper airway diseases, and it is a powerful means to promote the development of basic medicine and technology of clinical diagnosis and treatment. The application of numerical simulation in relationship between the structure and function of ear and upper airway, the influence of diseases on function, the evaluation of clinical diagnosis and treatment technology， as well as the design of related medical devices were reviewed. The clinical application of numerical research in ear and upper airway was prospected, so as to provide references for the future clinical diagnosis and treatment of ear and upper airway.

Objective To explore the clinical characteristics and relevant factors affecting treatment and prognosis of TCF3-PBX1 positive acute lymphoblastic leukemia (ALL). Methods The clinical data of 29 children with newly diagnosed TCF3-PBX1 positive ALL from August 2006 to August 2015 were analyzed retrospectively. The expression level of TCF3-PXB1 fusion gene was monitored by regular quantitative reverse transcription polymerase chain reaction. The factors influencing prognosis in children with TCF3-PBX1 positive ALL were analyzed. Results There were 29 children (16 males and 13 females) with a median age of 8 years (9 months to 16 years). The most common immunophenotype was pre-B cell type (pre-B) (58.6％). The karyotype analysis showed that unbalanced translocation was more common (41.4％). The complete remission rate was 100％ on thirty-third day in 29 children, but the minimal residual disease (MRD) was not completely negative. Three cases were relapsed, all of whom were MRD positive. Cox multivariate regression analysis showed that age was an independent risk factor for 5 year overall survival (P<0.05). The 5 year overall survival rate and disease-free survival rate were (82±8)％ and (81±7)％respectively. Conclusions Childhood TCF3-PBX1 positive ALL is a highly heterogeneous disease with high rate of complete remission and good long-term efficacy. The risk stratification and individualized treatment is the key to improve the cure rate.

Objective To summarize the clinical and biological characteristics and to analyze the prognosis of childhood lymphoma. Methods Clinical data of 60 patients diagnosed as lymphoma during the past ten years were retrospectively studied. All cases were classified according to the WHO classification criteria of lymphoma and the St. Jude staging system. Results Of all the 60 patients, the ratio of male to female was 2.5: 1. The median age was 8 years old (range from 6 months to 15 years). Localized mass was the most common chief complaint for first consultation accounting for 35.0%. The proportion of the bone marrow and central nervous system involvement was 63.3% and 6.7%, respectively. Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) counted for 8.3% and 91.7%, respectively. All HL were classified as CHL. As to NHL, LBL, BL/B-ALL, ALCL, and DLBCL were the main types. According to St. Jude staging, the advanced stage accounted for 95.0%. There were 8 cases with progressive disease/relapse with median time of 14 months (ranged from 6 months to 84 months). 6. In all patients,the 5-year anticipated overall survival(OS)rate was(78%±6%);the 5-year OS for HL and NHL were 100% vs(76%±8%). The survival rate of the two groups showed no significant difference (P=0.270). Cox multivariate analysis indicated that sex (P=0.038) was independent prognostic factors. Conclusions Pediatric lymphoma occurred more in male than in female, peaked at school age. The main histologic type was NHL. Most patients were diagnosed as advanced stage. By gender, female is a poor factor that affects prognosis.

Objective To observe the effect of rhubarb enema on serum level of high mobility group protein B1 (HMGB1) in patients with severe acute pancreatitis (SAP).Methods A total of 60 cases of patients with SAP in our hospital were collected from October 2014 to October 2016,and were randomly divided into the observation group and control group (30 cases in each group).Serum levels of HMGB1 were dynamically detected on the 1st,3rd and 5th day after admission.The acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) was conducted.The recovery time of gastrointestinal function and time for continuous renal replacement therapy (CRRT) were observed.Results On the 1st day after admission,no statistically significant difference was found in serum level of HMGB1 between the two groups (P＞0.05).The serum level of HMGB1 in the observation group was obviously decreased on the 5th day after admission,which was lower than that in the control group,there was statistically significant difference(P＜0.05).In the observation group,the value of difference between serum level of HMGB1 on the 1st day after admission and that on the 3rd day after admission was significantly negatively related with the APACHE Ⅱ score on the 3rd day after admission(r=-0.604,P＜0.05).In the observation group,the remission time of abdominal pain and abdominal distension,first time of exhaust and defecation and time for CRRT were significantly shorter than those in the control group,there were statistically significant differences (P＜0.05).Conclusion Rhubarb could improvesymptoms and prognosis of patients with SAP through effectively inhibit the expression of HMGB1.

[ABSTRACT]OBJECTIVETo study the deposition of suspended particles in the respiratory tract during human breathing.METHODSBased on CT data, three dimensional finite element model of an anatomically accurate respiratory tract, including the nasal cavity, oral cavity, pharynx, larynx, trachea and parts of tracheobronchial tree, is established. Numerical analysis for the deposition of suspended particles in the respiratory tract was conducted. RESULTSThe velocity and pressure distributions of airflow in the respiratory tract were obtained, as well as the particles path and their deposition law.CONCLUSION Respiratory tract plays an important role in filtering suspended particles in the air during breathing. The main deposition sites of the particles were at the front of the inferior turbinate and the posterior pharyngeal wall.

[ABSTRACT]OBJECTIVETo explore the basic characters of the airflow-field in Chinese people's nasal cavity by computational fluid dynamics.METHODSThe three-dimensional, finite-element mesh were developed from Spiral CT imaging scans of nose of the 40 healthy Chinese people. Given the following spatial boundaries of the flow field: no-slip condition was imposed at the surface of the nasal airway walls; a standard atmosphere pressure condition was established at the inlet; a velocity vector was specified at the outlet (nasopharynx), which was obtained under the condition of aspiratory flow rate (12 L/min), the full Navier-Stokes and continuity equations were solved to obtain the airflow pattern.RESULTS1. The airflow passed mainly through left or right side of the nasal airway in the whole 40 cases (left 33, right 7),and the volume of air through the main-side is (320±28) ml while non-main-side (180±45) ml. 2. Airflow velocity: airflow of anterior nostrils, internal nostrils, the middle and inferior parts of the total meatus in the main-side were (5.01±2.12) m/s, (7.00±1.75) m/s, (5.08±1.55) m/s, (4.12±1.40) m/s respectively, and those in non-main-side were (2.01±0.94) m/s, (2.40±0.34) m/s, (1.99±1.0) m/s, (2.01±0.65) m/s respectively, which differences between the both sides were of statistical significance (allP<0.05); airflow of middle meatus, inferior meatus and olfactory cleft in the main-side were (2.08±0.43) m/s, (1.60±0.95) m/s, (1.64±0.80)m/s respectively, and those in non-main-side were (1.89±0.52) m/s, (1.49±0.89) m/s, (1.50±0.75) m/s respectively, which differences were significant statistically (allP>0.05); 3. The airflow form appeared to be linear in the middle and inferior parts of the nasal cavity. 4. Velocity in maxillary sinus cavity was almost 0 m/s.CONCLUSIONThe airflow passes mainly through the middle and inferior parts of the meatus with higher velocity in laminar form and airflow of middle meatus, inferior meatus and olfactory cleft are low and the velocity were slow. Besides, airflow in maxillary sinus cavity diffuses free mainly.

Acoustic rhinometry and acoustic pharyngometry (AR/P) can quantify the upper airway condition of air draft by drawing a graph plotting the nasal cavity and pharyngeal cavity cross-sectional area. Based on CT medical images of volunteers, a 3-dimensional finite element model of upper respiratory tract was reconstructed by using the method of surface rendering. The veracity of the model was valued by comparison of the relevant areas between the model and the AR/P graph; and an AR/P was used to help improve and enrich the model. The combination of AR/ P and CT is useful in studying the medicine problem related to the anatomical structure of upper respiratory tract.
Anatomy, Cross-Sectional ; methods ; Finite Element Analysis ; Humans ; Imaging, Three-Dimensional ; methods ; Larynx ; anatomy & histology ; diagnostic imaging ; Nasal Cavity ; anatomy & histology ; diagnostic imaging ; Rhinometry, Acoustic ; methods ; Tomography, X-Ray Computed

The effect of variation of nasal structure on airflow distribution was investigated. Based on the CT images of the nose of a healthy female, a three-dimensional nasal model was developed. Two new nasal models were produced by removing part of inferior turbinate and part of middle turbinate in the left side of the original model. The numerical simulation and analysis for airflow field in the three nasal models was conducted by the finite element method. The simulation results from new models were compared with those from the original model. The airflow rate changed in the two sides of new nasal models. The airflow distribution and the pressure grades varied in the side of nasal model where part of inferior turbinate or part of middle turbinate was removed. The variation of nasal cavity structure will result in airflow redistribution in nasal cavity. The effect of removing turbinate on the airflow distribution in nasal cavity was described quantitatively.
Airway Resistance ; physiology ; Computer Simulation ; Exhalation ; physiology ; Female ; Finite Element Analysis ; Humans ; Image Processing, Computer-Assisted ; Inhalation ; physiology ; Models, Biological ; Nasal Cavity ; diagnostic imaging ; physiology ; Tomography, X-Ray Computed ; Turbinates ; surgery