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中国大样本急性髓细胞白血病分析结果首次发表陈赛娟院士领导的研究组在《血液》杂志发表了对1185例急性髓细胞白血病(AML)基因突变检测和预后相关性的研究结果。这是科学家首次发表中国大样本急性髓细胞白血病分析结果,为进一步风险调整治疗及靶向治疗打下良好的基础。     

小儿阑尾炎21例误诊原因分析

小儿阑尾炎容易误诊而导致阑尾穿孔、脓肿形成、腹膜炎、败血症及肠梗阻等严重并发症,并使患儿失去早期手术的机会,影响切口愈合甚至造成死亡。本文通过造成误诊的原因分析,得出早期临床症状不典型、病史采集不够详细、小儿自身的生理特点及查体常不合作是导致误诊的关键。     

高原地区妇科感染性急腹症误诊急性化脓性阑尾炎分析

目的探讨高原地区妇科感染性疾病误诊为阑尾炎的原因,提出减少误诊的方法。方法回顾性分析我院妇科感染性疾病误诊为急性化脓性阑尾炎12例患者临床资料。结果急性化脓性盆腔炎,右侧输卵管炎并积脓、卵巢囊肿并感染常误诊为阑尾炎。结论临床经验不足、妇科相关病史及检查的疏漏或误导、过分依赖辅助检查、未请相关科室会诊是妇科感染性疾病误诊发生的主要原因。     

小儿脑性瘫痪早期诊断避免误诊的临床分析

目的研究小儿脑性瘫痪早期诊断避免误诊的方法。方法将2002年～2003年收治脑瘫患儿121例进行病因,临床分类,误诊率,误诊时间进行分析。结果121例脑瘫患儿入院前早期误诊85例,误诊率为70%,80%有病因,常见窒息,早产,高胆红素血症等,误诊疾病有佝偻病68例,癫痫9例,智力低下5例,染色体及遗传代谢病3例,误诊时间多为6个月以内。结论小儿脑性瘫痪早期诊断避免误诊应当注意病因(围产期高危因素),早期表现,异常姿势,反射异常,肌张力异常,结合CT等辅助检查就可明确诊断避免误诊。     

小儿阑尾炎21例误诊原因分析

<正>阑尾炎是小儿急腹症主要疾病之一,由于小儿自身的生理特点及小儿阑尾炎状不典型,大约1/3患儿被误诊而导致阑尾穿孔、脓肿形成、腹膜炎、败血症及肠梗阻等,并使患儿失去[1]早期手术的机会,影响切口愈合甚至造成死亡。本文回顾分析21例阑尾炎的误诊原因现报告如下。1资料与方法     

急性淋巴细胞白血病靶向治疗机制

不同急性淋巴细胞白血病患者的预后存在差异,部分患者会由于复发难治而失去生命,其难以根治的原因之一是体内存在白血病干细胞,而目前由于白血病细胞对对化疗药物产生耐药,严重阻碍了急性淋巴细胞白血病的治疗。伴随着人们对急性淋巴细胞白血病的分子生物学机制不断深入了解,全基因组学研究进一步拓展了对其发病机制及预后的认识,发现了众多肿瘤细胞的耙点,而基于靶点的生物技术在临床不断被应用并取得了显著的疗效。随着医学技术的快速发展,把向治疗的地位越来越重要。本文主要对该病草巴向治疗的方法、机制及现状进行了综述。     

急性淋巴细胞白血病靶向治疗的研究进展

不同急性淋巴细胞白血病患者的预后存在差异,部分患者会由于复发难治而失去生命,其难以根治的原因之一是体内存在白血病干细胞,而目前由于白血病细胞对对化疗药物产生耐药,严重阻碍了急性淋巴细胞白血病的治疗。随着医学技术的快速发展,靶向治疗的地位越来越重要。本文主要对该病靶向治疗的方法、机制及现状进行了综述。     

中药提取物可治疗M2型白血病

上海血液学研究所在建所20周年之际透露：继在急性早幼粒细胞白血病诱导分化、凋亡靶向治疗领域获得举世瞩目的成果后，另一种白血病类型——M2型白血病基础研究和诱导分化治疗也获得了重要的新进展，目前已经完成临床前试验并进入药物开发阶段。     

含巯基胞嘧啶的多核苷酸及单核苷酸对人癌细胞株的抑制作用(摘要)

5巯基胞嘧啶多核苷酸(5-Mercaptopolycytidylic acid,MPC)是DNA和RNA聚合酶的强有力抑制剂,亦能抑制白血病小鼠的骨髓和脾细胞的集落形成。德国临床试用表明MPC对小儿急性淋巴细胞性白血病有一定效果。本文报道MPC体外对人癌细胞株(肺癌A549,大肠癌HT-29,成骨肉瘤HOS)及正常羊膜细胞株(WISH)的抑制作用,并与Poly Ⅰ·MPC(系由等分子量的MPC和多次黄嘌呤核苷酸合成)作比较。为了了解这种抑癌作用究系MPC本身抑或由其降解产物所致,还同时观察了MPC、5巯基胞嘧啶核苷酸(SH~5-CMP)及5巯基胞嘧啶对上述细胞株的影响。     

儿童白血病七成可治愈

正白血病女孩罗一笑没能在2016年的平安夜笑着走下去,与病魔战斗107天后,这个6岁的女孩离开了人世。人们在感到遗憾的同时,也产生了诸多困惑,白血病是否真的那么可怕?真是不治之症吗?白血病并非不治之症白血病分为急性和慢性两大类。急性淋巴细胞白血病(简称"急淋")的发病率随年龄增长呈U字形变化,     

血管内皮生长因子和白细胞介素-12在急性白血病中的表达及临床意义

目的 通过检测急性白血病（AL）患者静脉血清中血管内皮生长因子（VEGF）和 白细胞介素12（IL-12）的含量，探讨VEGF和IL-12在急性白血病中的含量及临床意义。方法 应用定量酶联免疫吸附实验测定10例初诊未治、10例缓解期、5例复发患者和9例正常对照血清中VEGF和IL-12的含量。结果 初诊未治组的VEGF含量（521.06±163.85pg/ml）明显高于缓解组（307.62±55.40pg/ml）及对照组（262.01±141.66pg/ml）（p均<0.05）。对照组的IL-12水平（58.96±38.11pg/ml）与初诊复发组（初诊未治组与复发组的合称32.51±14.58pg/ml）、缓解组（71.67±119.09pg/ml）之间均有显著性差异（p均<0.05）。正常对照组VEGF的含量与IL-12之间存在负相关性。结论 VEGF和IL-12与AL的病情变化有一定的关系。     

Vitamin a status in children with diarrhoea

Vitamin A status was measured in 50 pre-school children with acute and persistent diarrhoea. It was measured by (a) Fluorometric micromethod and (b) Conjunctival impression cytology (CIC). The results were compared with 25 normal children. Vitamin A status was lower in children with persistent diarrhoea whereas the results were comparable between the children with acute diarrhoea and control subjects.     

Lipid profile in leukemia and Hodgkin's disease

A number of epidemiologic studies has been published in recent years showing an increase risk of death from cancer in subjects with low plasma cholesterol levels. Although several authors proposed that hypocholesterolemia is predisposing factor for cancer development, no causative relation has been established so far and that it may be that low plasma cholesterol is secondary to malignant disease. Hence, the present study was undertaken to examine the lipid profile in children patients with leukemia and Hodgkin's disease in comparison with age matched controls. The study included 52 normal healthy controls and 105 patients with leukemia and Hodgkin's disease. Lipid profile included serum cholesterol, HDL & LDL cholesterol and triglycerides. Serum cholesterol, HDL & LDL cholesterol were found to be inversely associated with incidence of cancer, whereas triglycerides were significantly elevated in cancer patients. The inverse association between cancer and serum cholesterol may reflect a physiological response to early undiagnosed stages of cancer.     

Filaria associated clinical manifestations in children in an endemic area and morbidity control by immunomonitoring and optimal DEC therapy: Sevagram experience

Lymphatic filariasis is a major public health problem in India with 412 million people living in bancroftian endemic areas and is a major cause of clinical morbidity. Twenty million people are reported to suffer from chronic disease manifestations such as lymphoedema, hydrocele or elephantiasis. At least twice the number have been shown to suffer from acute and occult filarial infections in an endemic area without diagnosis. Due to non-availability of suitable diagnostic test for confirming filaria aetiology other than parasitological examination, no significant study on filariasis in children has been reported earlier. Studies in our laboratory for more than a decade showed usefulness of microfilarial excretory-secretory antigen in confirming filarial aetiology in acute and occult infections in adults as well as in children. This study reports acute and atypical manifestations such as lymphadenopathy, asthmatic bronchitis, pulmonary eosinophilia, mono-arthritis, recurrent URI, pneumonia, nutritional anemia, pain in abdomen etc. in children living in filaria endemic area having no microfilaraemia but showing filaria aetiology by immunomonitoring for the presence of antibody or antigen and responding to optimal DEC therapy.     

Ecological principle meets cancer treatment: treating children with acute myeloid leukemia with low-dose chemotherapy

Standard chemotherapy regimens for remission induction of pediatric acute myeloid leukemia (AML) are associated with significant morbidity and mortality. We performed a cohort study to determine the impact of reducing the intensity of remission induction chemotherapy on the outcomes of selected children with AML treated with a low-dose induction regimen plus granulocyte colony stimulating factor (G-CSF) (low-dose chemotherapy (LDC)/G-CSF). Complete response (CR) after two induction courses was attained in 87.0% (40/46) of patients receiving LDC/G-CSF. Post-remission therapy was offered to all patients, and included standard consolidation and/or stem cell transplantation. During the study period, an additional 94 consecutive children with AML treated with standard chemotherapy (SDC) for induction (80/94 (85.1%) of the patients attained CR after induction II, P = 0.953) and post-remission. In this non-randomized study, there were no significant differences in 4-year event-free (67.4 vs. 70.7%; P = 0.99) and overall (70.3 vs. 74.6%, P = 0.69) survival in the LDC/G-CSF and SDC cohorts, respectively. After the first course of induction, recovery of white blood cell (WBC) and platelet counts were significantly faster in patients receiving LDC/G-CSF than in those receiving SDC (11.5 vs. 18.5 d for WBCs (P < 0.001); 15.5 vs. 22.0 d for platelets (P < 0.001)). To examine the quality of molecular response, targeted deep sequencing was performed. Of 137 mutations detected at diagnosis in 20 children who attained hematological CR after two courses of LDC/G-CSF (n = 9) or SDC (n = 11), all of the mutations were below the reference value (variant allelic frequency <2.5%) after two courses, irrespective of the treatment group. In conclusion, children with AML receiving LDC/G-CSF appear to have similar outcomes and mutation clearance levels, but significantly lower toxicity than those receiving SDC. Thus, LDC/G-CSF should be further evaluated as an effective alternative to remission induction in pediatric AML.     

Oxidative status parameters in children with urinary tract infection

Introduction:

Urinary tract infection (UTI) is one of the most common bacterial infectious diseases in children. The aim of this study was to determine the total prooxidant and antioxidant capacity of children with UTI, as well as changes of oxidative status parameters according to acute inflammation persistence and acute kidney injury (AKI) development.

Materials and methods:

The patients enrolled in the study comprised 50 Caucasian children (median age was 6 months) with UTI. Total oxidant status (TOS), total antioxidant status (TAS), oxidative stress index (OSI), inflammation marker C-reactive protein (CRP) and renal function parameters urea and creatinine were analyzed in patient’s serums.

Results:

According to duration of inflammation during UTI, TAS values were significantly higher (0.99 vs. 0.58 mmol/L, P = 0.017) and OSI values were significantly lower (0.032 vs. 0.041 AU, P = 0.037) in the subjects with longer duration of inflammation than in the subjects with shorter duration of inflammation. We did not find significant difference in basal values of oxidative status parameters according to AKI development.

Conclusions:

OSI values could detect the simultaneous change of TAS and TOS due to change in the oxidative-antioxidant balance during the recovery of children with UTI. TAS and OSI as markers of oxidative stress during UTI are sensitive to accompanying inflammatory condition. Further investigations are needed to evaluate whether TAS, TOS and OSI could be used to monitor disease severity in children with UTI.     

Oxidative stress and antioxidant status in patients with chronic myeloid leukemia

Chronic myeloid leukemia is a myeloproliferative disorder with a unique rearrangement, the Philadelphia chromosome. Oxidative stress, a pervasive condition of an increased number of reactive oxygen species, is now recognized to be prominent feature of various diseases and their progression. Thus antioxidants, which control the oxidative stress state, represent a major line of defense regulating overall true state of health. The relationship between antioxidants status and levels of well-known markers of oxidative stress that are measured as lipid peroxides and oxidized proteins reflect better health indices and postures. The aim of this study was to evaluate the role of oxidative stress in pathophysiology of Chronic myeloid leukemia by measuring the circulating plasma lipid peroxide levels in terms of malonyldialdehyde, total lipid hydroperoxide and oxidized proteins as protein carbonyl whereas antioxidant status were estimated in terms of reduced glutathione and total thiol in plasma of Chronic myeloid leukemia patients. The present study included 47 Chronic myeloid leukemia patients and 20 age-and sex-matched healthy subjects. Out of 47 Chronic myeloid leukemia patients, 31 were in chronic phase (CML-CP) and 16 in accelerated phase (CML-AP). The median age of Chronic myeloid leukemia patients was 33 years and that of controls was 32 years. Oxidative stress and antioxidant status in plasma were evaluated by spectrophotometric procedures. There was a significant increase (p<0.05) in plasma malonyldialdehyde, total lipid hydroperoxide and protein carbonyl levels in Chronic myeloid leukemia patients as compared to healthy subjects. Our results also showed that plasma malonyldialdehyde and protein carbonyl levels were markedly elevated (p<0.05) in both chronic phase (CML-CP) and accelerated phase (CML-AP) as compared to healthy volunteers. Antioxidant status was found to be significantly decreased (p<0.05) in Chronic myeloid leukemia patients and its phases as compared to healthy participants. It could be concluded that oxidative stress may be associated with the pathophysiology of Chronic myeloid leukemia.     

浅谈我国隔代教育的局限性及优化路径

隔代教育在中国渊源已久,已经是一个非常普遍的现象,是年轻父母在平衡工作生活与教育子女的产物。随着国家放开二胎政策,很多家庭生了二胎,老一辈人帮助子女带孩子的现象也越来越多;与此同时,农村年轻夫妻外出务工,孩子由老人教养,留守儿童的教育问题更加尖锐。因此,怎样才能在隔代教育和家庭教育中找到教育好孩子的平衡点,发挥出隔代教育的优势,让孩子全面健康成长,是当代年轻父母不容忽视的问题。     

Protective effect of<Emphasis Type="Italic">Bacopa monniera L.</Emphasis> on cytarabine induced biochemical changes in chick embryo

Bacopa monniera, a medicinal plant distributed throughout India. Cytosine arabinoside (1-β-arabinofuranosylcytosine; Ara-C) is the most important antimetabolite chemotherapeutic drug used for acute leukemia. In this study we examined the chemoprotective property of an ethanolic extract of Bacopa monniera on biochemical changes in chick embryo. CA caused biochemical changes in a concentration and time dependent manner in amniotic fluid, liver and heart tissues. Ethanolic extract of BM given to chick embryo at doses of 2, 4, 6 mg per egg. There is significant decrease in biochemical levels of glucose, protein, urea, uric acid, creatinine and inorganic phosphorus. Enzymatic activities of alkaline phosphatase, lactate dehydrogenase, serum glutamate oxaloacetate transaminase, serum glutamate pyruvate transaminase and malatedehydrogenase were also decreased with dose dependent manner in amniotic fluid, liver and heart tissues.     

Validity of acute phase proteins and trace metals as adjuncts in viral hepatitis A and B

The level of seven acute phase proteins was estimated together with copper and zinc in two groups of 15 children each suffering from hepatitis A (HAV) or Hepatitis B (HBV). The mean concentration of α-1 antitrypsin, α-2 macroglobulin, ceruloplasmin, C3 and copper was increased uniformly in both the types of viral hepatitis. α-1 acid glycoprotein, haptoglobin and zinc levels were decreased in both the infections. A significant decrease in albumin level was observed in HAV while the decrease was not significant in HBV. All the paramenters were repeated after one month on the day of discharge following the disappearance of clinical signs and symptoms wherein the haptoglobin level returned to normal in HAV. No change was observed in the level of other acute phase proteins. The level of the trace elements returned to normal. The observed increase in the levels of acute phase proteins at the onset does not seem to have any significant relation to the subsequent course of the disease. However, the level of acute phase proteins and other biochemical parameters may indicate a delayed biochemical recovery phase in conjunction with the underlying hepatic pathological changes in the course of viral hepatitis in spite of clinical recovery.