1
|
Guo BY, Wang Y, Li J, Li CF, Feng XQ, Zheng MC, Liu SX, Yang LH, Jiang H, Xu HG, He XL, Wen H. [Clinical features and prognosis of core binding factor acute myeloid leukemia children in South China: a multicenter study]. Zhonghua Er Ke Za Zhi 2023; 61:881-888. [PMID: 37803854 DOI: 10.3760/cma.j.cn112140-20230224-00126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/08/2023]
Abstract
Objective: To analyze the clinical features, efficacy and prognosis factors of core binding factor (CBF) acute myeloid leukemia (AML) children in South China. Methods: This was a retrospective cohort study. Clinical data of 584 AML patients from 9 hospitals between January 2015 to December 2020 was collected. According to fusion gene results, all patients were divided into two groups: CBF-AML group (189 cases) and non-CBF-AML group (395 cases). CBF-AML group were divided into AML1-ETO subgroup (154 cases) and CBFβ-MYH11 subgroup (35 cases). Patients in CBF-AML group chosen different induction scheme were divided into group A (fludarabine, cytarabine, granulocyte colony stimulating factor and idarubicin (FLAG-IDA) scheme, 134 cases) and group B (daunorubicin, cytarabine and etoposide (DAE) scheme, 55 cases). Age, gender, response rate, recurrence rate, mortality, molecular genetic characteristics and other clinical data were compared between groups. Kaplan-Meier method was used for survival analysis and survival curve was drawn. Cox regression model was used to analyze prognostic factors. Results: A total of 584 AML children were diagnosed, including 346 males and 238 females. And a total of 189 children with CBF-AML were included, including 117 males and 72 females. The age of diagnosis was 7.3 (4.5,10.0)years, and the white blood cell count at initial diagnosis was 21.4 (9.7, 47.7)×109/L.The complete remission rate of the first course (CR1) of induction therapy, relapse rate, and mortality of children with CBF-AML were significantly different from those in the non-CBF-AML group (91.0% (172/189) vs. 78.0% (308/395); 10.1% (19/189) vs. 18.7% (74/395); 13.2% (25/189) vs. 25.6% (101/395), all P<0.05). In children with CBF-AML, the CBFβ-MYH11 subgroup had higher initial white blood cells and lower proportion of extramedullary invasion than the AML1-ETO subgroup, with statistical significance (65.7% (23/35) vs. 14.9% (23/154), 2.9% (1/35) vs. 16.9% (26/154), both P<0.05). AML1-ETO subgroup had more additional chromosome abnormalities (75/154), especially sex chromosome loss (53/154). Compared with group B, group A had more additional chromosome abnormalities and a higher proportion of tumor reduction regimen, with statistical significance (50.0% (67/134) vs. 29.1% (16/55), 34.3% (46/134) vs. 18.2% (10/55), both P<0.05). Significant differences were found in 5-years event free survival (EFS) rate and 5-year overall survival (OS) rate between CBF-AML group and non-CBF-AML group ((77.0±6.4)%vs. (61.9±6.7)%,(83.7±9.0)%vs. (67.3±7.2)%, both P<0.05).EFS and OS rates of AML1-ETO subgroup and CBFβ-MYH11 subgroup in children with CBF-AML were not significantly different (both P>0.05). Multivariate analysis showed in the AML1-ETO subgroup, CR1 rate and high white blood cell count (≥50×109/L) were independent risk factors for EFS (HR=0.24, 95%CI 0.07-0.85,HR=1.01, 95%CI 1.00-1.02, both P<0.05) and OS (HR=0.24, 95%CI 0.06-0.87; HR=1.01, 95%CI 1.00-1.02; both P<0.05). Conclusions: In CBF-AML, AML1-ETO is more common which has a higher extramedullary involvement and additional chromosome abnormalities, especially sex chromosome loss. The prognosis of AML1-ETO was similar to that of CBFβ-MYH11. The selection of induction regimen group FLAG-IDA for high white blood cell count and additional chromosome abnormality can improve the prognosis.
Collapse
Affiliation(s)
- B Y Guo
- Department of Pediatrics, the First Affiliated Hospital of Xiamen University, Xiamen 361003, China
| | - Y Wang
- Department of Pediatrics, the First Affiliated Hospital of Xiamen University, Xiamen 361003, China
| | - J Li
- Department of Pediatrics, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - C F Li
- Nanfang-Chunfu Children's Institute of Hematology & Oncology, Taixin Hospital, Dongguan 523128, China
| | - X Q Feng
- Department of Pediatrics, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - M C Zheng
- Hematology and Oncology, Hunan Children's Hospital, Changsha 410007, China
| | - S X Liu
- Department of Hematology, Shenzhen Children's Hospital, Shenzhen 518026, China
| | - L H Yang
- Department of Pediatrics, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China
| | - H Jiang
- Hematology and Oncology, Guangzhou Women and Children's Medical Center, Guangzhou 510145, China
| | - H G Xu
- Department of Pediatrics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
| | - X L He
- Children's Medical Center, People's Hospital of Hunan Province, Changsha 410002, China
| | - H Wen
- Department of Pediatrics, the First Affiliated Hospital of Xiamen University, Xiamen 361003, China
| |
Collapse
|
2
|
Zhang M, Wu P, Duan YL, Jin L, Yang J, Huang S, Liu Y, Hu B, Zhai XW, Wang HS, Fu Y, Li F, Yang XM, Liu AS, Qin S, Yuan XJ, Dong YS, Liu W, Zhou JW, Zhang LP, Jia YP, Wang J, Qu LJ, Dai YP, Guan GT, Sun LR, Jiang J, Liu R, Jin RM, Wang ZJ, Wang XG, Zhang BX, Chen KL, Zhuang SQ, Zhang J, Zhou CJ, Gao ZF, Zheng MC, Zhang Y. [Mid-term efficacy of China Net Childhood Lymphoma-mature B-cell lymphoma 2017 regimen in the treatment of pediatric Burkitt lymphoma]. Zhonghua Er Ke Za Zhi 2022; 60:1011-1018. [PMID: 36207847 DOI: 10.3760/cma.j.cn112140-20220429-00390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
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.
Collapse
Affiliation(s)
- M Zhang
- Medical Oncology Department, Pediatric Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing Key Laboratory of Pediatric Hematology Oncology, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China
| | - P Wu
- Department of Hematology, Hunan Children's Hospital, Changsha 410007, China
| | - Y L Duan
- Medical Oncology Department, Pediatric Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing Key Laboratory of Pediatric Hematology Oncology, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China
| | - L Jin
- Medical Oncology Department, Pediatric Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing Key Laboratory of Pediatric Hematology Oncology, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China
| | - J Yang
- Medical Oncology Department, Pediatric Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing Key Laboratory of Pediatric Hematology Oncology, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China
| | - S Huang
- Medical Oncology Department, Pediatric Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing Key Laboratory of Pediatric Hematology Oncology, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China
| | - Y Liu
- Department of Pediatric Lymphoma, Beijing GoBroad Boren Hospital, Beijing 100070, China
| | - B Hu
- Department of Pediatric Lymphoma, Beijing GoBroad Boren Hospital, Beijing 100070, China
| | - X W Zhai
- Department of Hematology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China
| | - H S Wang
- Department of Hematology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China
| | - Y Fu
- Department of Hematology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China
| | - F Li
- Hematology & Oncology Department, Children's Hospital Affiliated to Shandong University, Jinan 250022, China
| | - X M Yang
- Hematology & Oncology Department, Children's Hospital Affiliated to Shandong University, Jinan 250022, China
| | - A S Liu
- Department of Hematology & Oncology, Xi'an Children's Hospital, Xi'an 710002, China
| | - S Qin
- Department of Hematology & Oncology, Xi'an Children's Hospital, Xi'an 710002, China
| | - X J Yuan
- Department of Pediatric Hematology/Oncology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Y S Dong
- Department of Pediatric Hematology/Oncology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - W Liu
- Department of Hematology & Oncology, Zhengzhou Children's Hospital, Zhengzhou 450018, China
| | - J W Zhou
- Department of Hematology & Oncology, Zhengzhou Children's Hospital, Zhengzhou 450018, China
| | - L P Zhang
- Department of Pediatrics, Peking University People's Hospital, Beijing 100044, China
| | - Y P Jia
- Department of Pediatrics, Peking University People's Hospital, Beijing 100044, China
| | - J Wang
- Department of Hematology & Oncology, Anhui Children's Hospital, Hefei 230022, China
| | - L J Qu
- Department of Hematology & Oncology, Anhui Children's Hospital, Hefei 230022, China
| | - Y P Dai
- Department of Pediatric Hematology & Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
| | - G T Guan
- Department of Pediatric Hematology & Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
| | - L R Sun
- Department of Pediatric Hematology & Oncology, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
| | - J Jiang
- Department of Pediatric Hematology & Oncology, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
| | - R Liu
- Department of Hematology, Children's Hospital, Capital Pediatric Research Institute, Beijing 100020, China
| | - R M Jin
- Department of Pediatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Z J Wang
- Department of Pediatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - X G Wang
- Department of Hematology and Oncology, Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052
| | - B X Zhang
- Department of Pediatrics, Second Hospital of Hebei Medical University, Shijiazhuang 050004, China
| | - K L Chen
- Department of Hematology and Oncology, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430016, China
| | - S Q Zhuang
- Department of Pediatrics, First Hospital of Quanzhou Affiliated to Fujian Medical University, Quanzhou 362002, China
| | - J Zhang
- Department of Hematology & Oncology, the First People's Hospital of Urumqi, Urumqi 830002, China
| | - C J Zhou
- Pathology Department, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Z F Gao
- Department of Pathology, Peking University Third Hospital, Beijing 100191, China
| | - M C Zheng
- Department of Hematology, Hunan Children's Hospital, Changsha 410007, China
| | - Yonghong Zhang
- Medical Oncology Department, Pediatric Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing Key Laboratory of Pediatric Hematology Oncology, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China
| |
Collapse
|
3
|
Xu LH, Geng X, Liao N, Yang LH, Mai HR, Wan WQ, Huang LB, Zheng MC, Tian C, Chen HQ, Chen QW, Long XJ, Zhen ZJ, Liu RY, Li QR, Wu BY, Wang LN, Kong XL, Chen GH, Fang JP, Li Y. Prognostic significance of CNSL at diagnosis of childhood B-cell acute lymphoblastic leukemia: A report from the South China Children's Leukemia Group. Front Oncol 2022; 12:943761. [PMID: 36033509 PMCID: PMC9399517 DOI: 10.3389/fonc.2022.943761] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 07/20/2022] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES The prognostic significance of acute lymphoblastic leukemia (ALL) patients with central nervous system leukemia (CNSL) at diagnosis is controversial. We aimed to determine the impact of CNSL at diagnosis on the clinical outcomes of childhood B-cell ALL in the South China Children's Leukemia Group (SCCLG). METHODS A total of 1,872 childhood patients were recruited for the study between October 2016 and July 2021. The diagnosis of CNSL depends on primary cytological examination of cerebrospinal fluid, clinical manifestations, and imaging manifestations. Patients with CNSL at diagnosis received two additional courses of intrathecal triple injections during induction. RESULTS The frequency of CNLS at the diagnosis of B-cell ALL was 3.6%. Patients with CNSL at diagnosis had a significantly higher mean presenting leukocyte count (P = 0.002) and poorer treatment response (P <0.05) compared with non-CNSL patients. Moreover, CNSL status was associated with worse 3-year event-free survival (P = 0.030) and a higher risk of 3-year cumulative incidence of relapse (P = 0.008), while no impact was observed on 3-year overall survival (P = 0.837). Multivariate analysis revealed that CNSL status at diagnosis was an independent predictor with a higher cumulative incidence of relapse (hazard ratio = 2.809, P = 0.016). CONCLUSION CNSL status remains an adverse prognostic factor in childhood B-cell ALL, indicating that additional augmentation of CNS-directed therapy is warranted for patients with CNSL at diagnosis.
Collapse
Affiliation(s)
- Lu-Hong Xu
- Department of Pediatric Hematology/Oncology, Children’s Medical Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xu Geng
- Department of Pediatric Hematology/Oncology, Children’s Medical Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Ning Liao
- Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Li-Hua Yang
- Department of Pediatric Hematology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Hui-Rong Mai
- Department of Hematology and Oncology, Shenzhen Children’s Hospital, Shenzhen, China
| | - Wu-Qing Wan
- Department of Pediatrics, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Li-Bin Huang
- Department of Pediatrics, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Min-Cui Zheng
- Department of Hematology, Hunan Children’s Hospital, Changsha, China
| | - Chuan Tian
- Department of Pediatrics, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Hui-Qin Chen
- Department of Pediatrics, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Qi-Wen Chen
- Department of Pediatrics, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xing-Jiang Long
- Department of Pediatrics, Liuzhou People’s Hospital, Liuzhou, China
| | - Zi-Jun Zhen
- Department of Pediatric Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Ri-Yang Liu
- Department of Pediatrics, Huizhou Central People’s Hospital, Huizhou, China
| | - Qiao-Ru Li
- Department of Pediatrics, Zhongshan People’s Hospital, Zhongshan, China
| | - Bei-Yan Wu
- Department of Pediatrics, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Li-Na Wang
- Department of Pediatrics, Guangzhou First People’s Hospital, Guangzhou, China
| | - Xian-Ling Kong
- Department of Pediatrics, Boai Hospital of Zhongshan, Zhongshan, China
| | - Guo-Hua Chen
- Department of Pediatrics, Huizhou First People’s Hospital, Huizhou, China
| | - Jian-Pei Fang
- Department of Pediatric Hematology/Oncology, Children’s Medical Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yang Li
- Department of Pediatric Hematology/Oncology, Children’s Medical Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- *Correspondence: Yang Li,
| |
Collapse
|
4
|
Jiang QX, Wang YL, Yijie YJ, Liu XQ, Xu J, Zheng MC, Feng H, Wang WW, Sun HL, Zhu SL, Li WJ, Zhao N. [Multicenter cross-sectional investigation on the cleaning status and influencing factors of skin cleaning outside the wound in adult trauma patients]. Zhonghua Shao Shang Za Zhi 2021; 37:429-436. [PMID: 34044525 DOI: 10.3760/cma.j.cn501120-20210116-00023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the status and influencing factors of skin cleaning outside wound (hereinafter referred to as skin) in adult trauma patients. Methods: A multicenter cross-sectional investigation was conducted. From September 1 to 30, 2020, a total of 952 adult trauma patients who met the inclusion criteria were admitted to wound care clinics or trauma surgery wards of 13 military or local Grade Ⅲ Level A hospitals, including the General Hospital of the Eastern Theater Command of People's Liberation Army and the Army Medical Center, etc. A self-designed questionnaire on cleaning status of skin in trauma patients was released through the "questionnaire star" website to investigate basic information such as gender, age, education level, living status, and self-care ability, trauma information such as cause of injury, wound duration, trauma site, trauma depth, wound pain, wound peculiar smell, and wound cleaning solution, and skin cleaning status after injury such as whether to clean or not, cleaning method, cleaning frequency, cleaning duration in each time, or reasons for not cleaning. The patients who cleaned skin regularly after injury were included in cleaning group, and the other patients were included in no cleaning group. The basic information, trauma information, and skin cleaning status after injury of patients in 2 groups were investigated. Data were statistically analyzed with chi-square test, and binary multivariate logistic regression analysis was performed on indicators with statistically significant differences between the two groups to screen the independent influencing factors of skin cleaning in trauma patients. Results: A total of 952 questionnaires were received, and the recovery rate was 100%. Three invalid questionnaires were eliminated, and 949 valid questionnaires were obtained, with an effective rate of 99.68%. In 949 patients, there were 461 (48.6%) males and 488 (51.4%) females, aged 18-100 (50±18) years. Most patients were less than 60 years old, lived with their families, and could take care of themselves completely. Nearly half of the patients were with junior high school or below education level. The main causes of injury were sharp cutting injury and falling injury, the wound duration was 2-365 days, most of the injured parts were limbs and trunk, the wound depth was mostly full-thickness injury, and most patients had wound-related pain and no peculiar smell and used 5 g/L iodophor to clean the wound. Totally 684 (72.1%) patients cleaned their skin after injury, mainly by scrubbing with warm water, the cleaning frequency was mainly once or twice a week, and the cleaning time was mainly 10 or 15 min for each time. Totally 265 (27.9%) patients didn't clean their skin after injury, and the main causes for not cleaning were following the doctor's advice, followed by worrying about wound infection and loss of self-care ability. There were significantly statistical differences in constituent ratios of education level, self-care ability, cause of injury, wound pain, and wound peculiar smell of patients in 2 groups (χ2=12.365, 24.519, 22.820, 9.572, 92.342, P<0.01). Education level, self-care ability, cause of injury, wound pain, and wound peculiar smell were potential influencing factors of skin cleaning in patients. Binary multivariate logistic regression analysis showed that self-care ability, wound pain, and wound peculiar smell were independent influencing factors of skin cleaning in patients (odds ratio=1.51, 0.52, 3.72, 95% confidence interval=1.08-2.12, 0.42-0.89, 2.66-5.22, P<0.05 or P<0.01). Conclusions: Self-care ability, wound pain, and wound peculiar smell are independent influencing factors of skin cleaning in adult trauma patients.
Collapse
Affiliation(s)
- Q X Jiang
- Department of Burns and Plastic Surgery, the General Hospital of the Eastern Theater Command of PLA, Nanjing 210002, China
| | - Y L Wang
- Nursing Department, the Army Medical Center, Chongqing 400042, China
| | - Y J Yijie
- Department of Burns, the Affiliated Hospital of Jiangnan University(Wuxi Third People's Hospital), Wuxi 214035, China
| | - X Q Liu
- Medical School, Nanjing University, Nanjing 210008, China
| | - J Xu
- Department of Orthopedics, Suqian People's Hospital of Nanjing Drum-Tower Hospital Group, Suqian 223800, China
| | - M C Zheng
- Department of Colorectal Surgery, Cancer Hospital Affiliated to Sun Yat-Sen University, Guangzhou 510060, China
| | - H Feng
- Department of Urology, the Second Affiliated Hospital of Army Medical University (the Third Military Medical University), Chongqing 400037, China
| | - W W Wang
- Department of Orthopaedics, the Second Naval Hospital of Southern Theater Command of PLA, Sanya 572000, China
| | - H L Sun
- Specialized Nursing Clinic, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - S L Zhu
- Department of Surgery, the First People's Hospital of Lianyungang, Lianyungang 222002, China
| | - W J Li
- Wound Care Clinic of Outpatient Department, the 904th Hospital of the Joint Logistic Support Force of PLA, Wuxi 214008, China
| | - N Zhao
- Nursing Department, the 981st Hospital of the Joint Logistic Support Force of PLA, Chengde 067000, China
| |
Collapse
|
5
|
Yan L, Zheng MC, Ju XL, Hu SY, Jin RM, Guo BY, Yang MH. [Clinical analysis of 14 cases with childhood acute lymphoblastic leukemia complicated with tropical candidemia]. Zhonghua Er Ke Za Zhi 2020; 58:813-817. [PMID: 32987460 DOI: 10.3760/cma.j.cn112140-20200323-00298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the clinical feature, diagnosis, treatment and prognosis of childhood acute lymphoblastic leukemia (ALL) complicated with candida tropicalis bloodstream infection (CTBI), so as to improve the understanding of this disease. Methods: The general information, clinical manifestation, auxiliary examination, treatment and outcome of 14 childhood ALL who were diagnosed with tropical candidemia between January 2015 and December 2018 in 6 hospitals were analyzed retrospectively. Clinical data of non invasive fungal disease (IFD) ALL (28 cases) and other IFD children (9 cases) admitted in the same period were collected as control group. Logistic regression model was used to analyze the risk factor of CTBI. Results: Among 14 cases, there were 7 males and 7 females, with the age ranged from 17 months to 13 years. All the cases had fever, 9 cases had digestive system symptoms and stool fungal culture were positive in 3 of them; 7 cases had respiratory system symptoms and sputum fungal culture was positive in 1 of them; 2 cases had central nervous system symptoms and 10 cases progressed into septic shock. All 14 cases had neutropenia and the neutropenia duration was 1 to 53 days. Among 14 cases, the C-reactive protein was>50 mg/L in 8 cases, in which the proportion was significantly higher than that in other invasive fungal disease(IFD) (8/14 vs. 1/9, P<0.05), meanwhile the 1, 3-β-D-glucan detection, galactomannan detection and pulmonary imaging were not remarkable in all 14 cases. The blood culture results of 14 cases were all candida tropicalis, among which 13 cases finished drug susceptibility tests, the isolates of all cases were sensitive to flucytosine and amphotericin B, and the isolates of 4 cases were sensitive to fluconazole, voriconazole and itraconazole. Among 14 cases, 1 case lost to follow-up after giving up treatment, 1 case died before antifungal therapy and the remaining 12 cases received antifungal therapy; 7 of the 14 cases died. Univariate analysis showed that between ALL with CTBI group (14 cases) and ALL without invasive fungal disease (IFD) group (28 cases), the differences in variables such as ALL not in remission (χ²=37.847, P<0.01), length of hospital stay>15 days (χ2=8.351, P=0.004), neutropenia (χ²=14.280, P<0.01), neutropenia duration>10 days (χ²=10.254, P=0.001), use of broad-spectrum antibiotics (χ²=13.888, P<0.01), skin and mucous membrane damage (χ²= 5.923, P=0.015) were statistically significant. Conclusions: In childhood ALL complicated with tropical candidemia, the drug resistance rate and mortality rate were high. For azole-resistant tropical candida, amphotericin B liposome or echinocandins(caspofungin) -fluorocytosine combined therapy was recommended to reduce treatment-related deaths.
Collapse
Affiliation(s)
- L Yan
- Department of Pediatrics, Xiangya Hospital, Central South University, Changsha 410008, China
| | - M C Zheng
- Department of Hematology, Hunan Provincial Children's Hospital, Changsha 410007, China
| | - X L Ju
- Department of Pediatrics, Qilu Hospital of Shandong University, Jinan 250012, China
| | - S Y Hu
- Department of Hematology, Children's Hospital Affiliated to Soochow University, Suzhou 215000, China
| | - R M Jin
- Department of Pediatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - B Y Guo
- Department of Pediatrics, the First Affiliated Hospital of Xiamen University, Xiamen 361000, China
| | - M H Yang
- Department of Pediatrics, the Third Xiangya Hospital of Central South University, Changsha 410013, China
| |
Collapse
|
6
|
Zeng MH, He XL, Yang MH, Zheng MC, Wan WQ, Zou RY, Chen KK. [Clinical and genetic analyses of juvenile myelomonocytic leukemia]. Zhongguo Dang Dai Er Ke Za Zhi 2019; 21:365-369. [PMID: 31014430 PMCID: PMC7389224 DOI: 10.7499/j.issn.1008-8830.2019.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 02/05/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To study the clinical and genetic features of juvenile myelomonocytic leukemia (JMML) and the association between genotype and prognosis. Methods The clinical data of 15 children who were diagnosed with JMML were collected. Next-generation sequencing was used to detect common gene mutations of JMML. RESULTS The male/female ratio was 6.5:1, and the age of onset was 19 months (range 2-67 months). Of the 15 children, 11 (73%) experienced disease onset before the age of 4 years, with abdominal distension and pyrexia as initial symptoms. All children had hepatosplenomegaly and superficial lymphadenectasis, with a number of peripheral blood mononuclear cells of >1.0×109/L and a percentage of juvenile cells of 1%-7% in peripheral blood smear. The percentage of bone marrow blasts + juvenile cells was <20%, and the percentage of monoblasts + promonocytes was 1%-10%. Of the 15 children, 10 (67%) had a higher level of hemoglobin F than the normal level at the corresponding age, with the highest level of 62.5%. All 15 children had the absence of Philadelphia chromosome, and one child had chromosome 7 deletion. All 15 children had a negative result of BCR/ABL fusion gene detection. PTPN11 gene mutation was found in 5 children (33%), NF1 mutation in 4 children (27%), CBL mutation in 3 children (20%), and RAS mutation in 3 children (20%). No children received regular chemotherapy, and one child underwent hematopoietic stem cell transplantation. The median follow-up time of 15 children was 18 months (range 1-48 months). Among the 15 children, 8 died (among whom 4 had PTPN11 gene mutation, 3 had NF1 mutation, and 1 had RAS mutation) and 7 survived. The children with PTPN11 mutation had the worst prognosis and the highest mortality rate, and those with CBL or NRAS mutation had a relatively good prognosis. The level of hemoglobin F was negatively correlated with survival time (rs=-7.21, P=0.002). CONCLUSIONS In children with JMML, the type of gene mutation is associated with prognosis. The children with PTPN11 mutation often have a poor prognosis, and those with CBL or NRAS mutation have a relatively good prognosis.
Collapse
Affiliation(s)
- Min-Hui Zeng
- Department of Hematology and Oncology, Children's Medical Center, Hunan Provincial People's Hospital/First Hospital of Hunan Normal University, Changsha 410005, China.
| | | | | | | | | | | | | |
Collapse
|
7
|
Zeng MH, He XL, Yang MH, Zheng MC, Wan WQ, Zou RY, Chen KK. [Clinical and genetic analyses of juvenile myelomonocytic leukemia]. Zhongguo Dang Dai Er Ke Za Zhi 2019; 21:365-369. [PMID: 31014430 PMCID: PMC7389224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 02/05/2019] [Indexed: 11/12/2023]
Abstract
OBJECTIVE To study the clinical and genetic features of juvenile myelomonocytic leukemia (JMML) and the association between genotype and prognosis. Methods The clinical data of 15 children who were diagnosed with JMML were collected. Next-generation sequencing was used to detect common gene mutations of JMML. RESULTS The male/female ratio was 6.5:1, and the age of onset was 19 months (range 2-67 months). Of the 15 children, 11 (73%) experienced disease onset before the age of 4 years, with abdominal distension and pyrexia as initial symptoms. All children had hepatosplenomegaly and superficial lymphadenectasis, with a number of peripheral blood mononuclear cells of >1.0×109/L and a percentage of juvenile cells of 1%-7% in peripheral blood smear. The percentage of bone marrow blasts + juvenile cells was <20%, and the percentage of monoblasts + promonocytes was 1%-10%. Of the 15 children, 10 (67%) had a higher level of hemoglobin F than the normal level at the corresponding age, with the highest level of 62.5%. All 15 children had the absence of Philadelphia chromosome, and one child had chromosome 7 deletion. All 15 children had a negative result of BCR/ABL fusion gene detection. PTPN11 gene mutation was found in 5 children (33%), NF1 mutation in 4 children (27%), CBL mutation in 3 children (20%), and RAS mutation in 3 children (20%). No children received regular chemotherapy, and one child underwent hematopoietic stem cell transplantation. The median follow-up time of 15 children was 18 months (range 1-48 months). Among the 15 children, 8 died (among whom 4 had PTPN11 gene mutation, 3 had NF1 mutation, and 1 had RAS mutation) and 7 survived. The children with PTPN11 mutation had the worst prognosis and the highest mortality rate, and those with CBL or NRAS mutation had a relatively good prognosis. The level of hemoglobin F was negatively correlated with survival time (rs=-7.21, P=0.002). CONCLUSIONS In children with JMML, the type of gene mutation is associated with prognosis. The children with PTPN11 mutation often have a poor prognosis, and those with CBL or NRAS mutation have a relatively good prognosis.
Collapse
Affiliation(s)
- Min-Hui Zeng
- Department of Hematology and Oncology, Children's Medical Center, Hunan Provincial People's Hospital/First Hospital of Hunan Normal University, Changsha 410005, China.
| | | | | | | | | | | | | |
Collapse
|
8
|
Yang MH, Wan WQ, Luo JS, Zheng MC, Huang K, Yang LH, Mai HR, Li J, Chen HQ, Sun XF, Liu RY, Chen GH, Feng X, Ke ZY, Li B, Tang YL, Huang LB, Luo XQ. Multicenter randomized trial of arsenic trioxide and Realgar-Indigo naturalis formula in pediatric patients with acute promyelocytic leukemia: Interim results of the SCCLG-APL clinical study. Am J Hematol 2018; 93:1467-1473. [PMID: 30160789 PMCID: PMC6282847 DOI: 10.1002/ajh.25271] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Revised: 08/23/2018] [Accepted: 08/26/2018] [Indexed: 12/12/2022]
Abstract
Intravenous arsenic trioxide (ATO) has been adopted as the first‐line treatment for acute promyelocytic leukemia (APL). Another arsenic compound named the Realgar‐Indigo naturalis formula (RIF), an oral traditional Chinese medicine containing As4S4, has been shown to be highly effective in treating adult APL. In the treatment of pediatric APL, the safety and efficacy of RIF remains to be confirmed. This randomized, multicenter, and noninferiority trial was conducted to determine whether intravenous ATO can be substituted by oral RIF in the treatment of pediatric APL. From September 2011 to January 2017, among 92 patients who were 16 years old or younger with newly diagnosed PML‐RARa positive APL, 82 met eligible criteria and were randomly assigned to ATO (n = 42) or RIF (n = 40) group. The remaining 10 patients did not fulfilled eligible criteria because five did not accept randomization, four died and one had hemiplegia prior to arsenic randomization due to intracranial hemorrhage or cerebral thrombosis. Induction and consolidation treatment contained ATO or RIF, all‐trans‐retinoic acid and low intensity chemotherapy. End points included event‐free survival (EFS), adverse events and hospital days. After a median 3‐year follow‐up, the estimated 5‐year EFS was 100% in both groups, and adverse events were mild. However, patients in the RIF group had significantly less hospital stay than those in the ATO group. This interim analysis shows that oral RIF is as effective and safe as intravenous ATO for the treatment of pediatric APL, with the advantage of reducing hospital stay. Final trial analysis will reveal mature outcome data.
Collapse
Affiliation(s)
- Ming-Hua Yang
- Department of Pediatrics; Xiangya Hospital, Central South University; Changsha Hunan China
| | - Wu-Qing Wan
- Department of Pediatrics; Second Xiangya Hospital, Central South University; Hunan China
| | - Jie-Si Luo
- Department of Pediatrics; First Affiliated Hospital, Sun Yat-Sen University; Guangzhou China
| | - Min-Cui Zheng
- Department of Hematology; Hunan Childdren's Hospital; Changsha Hunan China
| | - Ke Huang
- Department of Pediatrics; Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University; Guangzhou China
| | - Li-Hua Yang
- Department of Pediatrics; Zhujiang Hospital, Southern Medical University; Guangzhou China
| | - Hui-Rong Mai
- Department of Hematology and Oncology; Shenzhen Children's Hospital; Shenzhen China
| | - Jian Li
- Department of Pediatric Hematology; Fujian Medical University Union Hospital; Fuzhou Fujian China
| | - Hui-Qin Chen
- Department of Pediatrics; Third Affiliated Hospital, Sun Yat-Sen University; Guangzhou China
| | - Xiao-Fei Sun
- Department of Pediatrics; Sun Yat-Sen University Cancer Center; Guanzhou China
| | - Ri-Yang Liu
- Department of Pediatrics; Huizhou Municipal Central Hospital; Huizhou Guangdong China
| | - Guo-Hua Chen
- Department of Pediatrics; First People's Hospital of Huizhou; Huizhou Guangdong China
| | - Xiaoqin Feng
- Department of Pediatrics; Nanfang Hospital, Southern Medical University; Guangzhou China
| | - Zhi-Yong Ke
- Department of Pediatrics; First Affiliated Hospital, Sun Yat-Sen University; Guangzhou China
| | - Bin Li
- Clinical Trials Unit, First Affiliated Hospital, Sun Yat-Sen University; Guangzhou China
| | - Yan-Lai Tang
- Department of Pediatrics; First Affiliated Hospital, Sun Yat-Sen University; Guangzhou China
| | - Li-Bin Huang
- Department of Pediatrics; First Affiliated Hospital, Sun Yat-Sen University; Guangzhou China
| | - Xue-Qun Luo
- Department of Pediatrics; First Affiliated Hospital, Sun Yat-Sen University; Guangzhou China
| |
Collapse
|
9
|
Kuang WY, Zheng MC, Li WL, Yang HX, Zhang BS, Wu P. [Effects of minimal residual disease level on day 33 of remission induction and IKZF1 genotype on the survival of children with B-lineage acute lymphoblastic leukemia]. Zhongguo Dang Dai Er Ke Za Zhi 2018; 20:538-542. [PMID: 30022754 PMCID: PMC7389200 DOI: 10.7499/j.issn.1008-8830.2018.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 05/15/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To study the effects of minimal residual disease (MRD) level on day 33 of remission induction and IKZF1 genotype on the survival of children with B-lineage acute lymphoblastic leukemia (B-ALL). METHODS A total of 152 children with newly-diagnosed B-ALL who had complete remission after the first cycle of the chemotherapy and had complete follow-up information were enrolled in this study. According to the MRD detection by flow cytometry on day 33 of remission induction, they were divided into three groups: standard-risk (SR) group (MRD <10-4; n=60), intermediate-risk (IR) group (10-4≤ MRD <10-2; n=55), and high-risk (HR) group (MRD ≥10-2; n=37). Nested RT-PCR was used to determine the IKZF1 genotype of all children before chemotherapy. The effects of MRD level on day 33 of remission induction and IKZF1 genotype on the recurrence-free survival (RFS) of children with B-ALL were analyzed. RESULTS There were 7 common IKZF1 subtypes in all the 152 children with B-ALL: IK1, IK2/3, IK4, IK6, IK8, IK9, and IK10. Of the 152 children, 130 had functional subtypes of IKZF1 and 22 had non-functional subtypes of IKZF1. During the follow-up period, relapse occurred in 26 (17%) children, and the recurrence rate was highest in the HR group (P<0.05). However, there was no significant difference in the recurrence rate between the SR group and the IR group (P>0.05). The cumulative recurrence rate of the children with non-functional subtypes of IKZF1 was significantly higher than that of those with functional types of IKZF1 (P<0.01). The predicted 5-year RFS rates in the SR, IR, and HR groups were (94.2±2.9)%, (86.7±3.8)%, and (56.2±4.5)% respectively (P<0.05). The 5-year RFS rate of the children with functional subtypes of IKZF1 was significantly higher than that of those with non-functional subtypes of IKZF1 (P<0.01). There was no significant difference in the predicted 5-year RFS rate between the children with functional subtypes of IKZF1 and those with non-functional subtypes of IKZF1 in the SR group (P>0.05). However, the predicted 5-year RFS rate of the children with functional subtypes of IKZF1 was significantly higher than that of those with non-functional subtypes of IKZF1 in the IR group and the HR group (P<0.05). CONCLUSIONS B-ALL children with non-functional subtypes of IKZF1 have a high recurrence rate, and the recurrence rate will be even higher in B-ALL children with non-functional subtypes of IKZF1 and MRD ≥10-4 on day 33 of chemotherapy.
Collapse
Affiliation(s)
- Wen-Yong Kuang
- Department of Hematology, Hunan Children's Hospital, Changsha 410007, China.
| | | | | | | | | | | |
Collapse
|
10
|
Kuang WY, Zheng MC, Zhang GS, Li RJ. [Effect of Icaritin on Proliferation and Apoptosis of THP-1 Cell and Its Mechanism]. Zhongguo Shi Yan Xue Ye Xue Za Zhi 2017; 25:94-98. [PMID: 28245382 DOI: 10.7534/j.issn.1009-2137.2017.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To investigate the effect of icaritin on the proliferation and apoptosis of THP-1 cells and its mechanism. METHODS After treated with various concentrations of icaritin, cell proliferation was detected by MTS method, and apoptosis was measured with flow cytometry and Hoechst 33258 staining. Expression of BCL-2, BAX and Caspase-3 protein in THP-1 cell was detected by Western blot. RESULTS After treatment with various concentrations (4-32 µmol/L) of icaritin for 24, 48, 72 h, the inhibition rate of cell growth significantly increased (P<0.05) in time-dose dependent manner(r=0.946); and the apoptotic rate of cells significantly increased (P<0.05) in time-dose dependent manner(r= 0.924). The expression of BCL-2 protein at 48 h decreased significantly in icaritin-treated group, compared with that in control group (P<0.05), while the expression of BAX and Caspase3 protein at 48 h increased significantly in icaritin-treated group, compared with that in control group (P<0.05). CONCLUSION Icaritin can inhibit proliferation and induce apoptosis of THP-1 in vitro, Icaritin may induce apoptosis in THP-1 cells through the mitochondrial pathway.
Collapse
Affiliation(s)
- Wen-Yong Kuang
- Department of Hematology,Hunan Provincial Children's Hospital,Changsha 410007,Hunan Province,China
| | - Min-Cui Zheng
- Department of Hematology,Hunan Provincial Children's Hospital,Changsha 410007,Hunan Province,China
| | - Guang-Sen Zhang
- Department of Hematology,Second Xiangya Hospital,Central South University, Changsha 410011,Hunan Province,China
| | - Rui-Juan Li
- Department of Hematology,Second Xiangya Hospital,Central South University, Changsha 410011,Hunan Province,China. E-mail:
| |
Collapse
|
11
|
Kuang WY, Zheng MC, Zhang GS, Song GC, Li WL, Yang HX, Jiang XM, Zhang BS, Wu P, Gu YY. [Effect of glucocorticoid on dendritic cells in children with chronic immune thrombocytopenia]. Zhongguo Dang Dai Er Ke Za Zhi 2013; 15:91-94. [PMID: 23428119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To investigate the change in dendritic cells (DCs) in children with chronic immune thrombocytopenia (cITP) and the effect of glucocorticoid on DCs in children with cITP. METHODS Fifteen children with cITP and 20 healthy controls were included in the study. Flow cytometry was used to measure the DC subsets count in the 15 children with cITP before and after glucocorticoid treatment as well as the corresponding values in the 20 healthy controls. The DCs derived from peripheral blood monocytes in children with cITP were cultured in vitro and collected, and their immunophenotypes were determined by flow cytometry. RESULTS Before glucocorticoid treatment, the children with cITP showed no notable change in the absolute count of myeloid DCs (mDCs) but showed decreased absolute count of plasmacytoid DCs (pDCs) and increased mDC/pDC ratio compared with the healthy controls (P<0.05). After glucocorticoid treatment, the children with cITP demonstrated increased absolute count of pDCs and decreased absolute count of mDCs and mDC/pDC ratio compared with before treatment (P<0.05). Before glucocorticoid treatment, the children with cITP had significantly higher positive rates of HLA-DR, CD80, CD83 and CD86 on peripheral blood DCs than the healthy controls (P<0.01). All the positive rates were significantly decreased after glucocorticoid treatment (P<0.01), so that there was no significant difference from the healthy controls (P>0.05). CONCLUSIONS Disproportion and functional disturbance of DC subsets is associated with the pathogenesis of cITP in children. Glucocorticoid can strengthen the immunosuppression of DCs in children with cITP, which may contribute to the effectiveness of glucocorticoid as a treatment.
Collapse
Affiliation(s)
- Wen-Yong Kuang
- Department of Hematology, Children's Hospital of Hunan, Changsha, China
| | | | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Ma AG, Schouten E, Wang Y, Xu RX, Zheng MC, Li Y, Sun YY, Wang QZ. Anemia prevalence among pregnant women and birth weight in five areas in China. Med Princ Pract 2009; 18:368-72. [PMID: 19648759 DOI: 10.1159/000226290] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2008] [Accepted: 01/21/2009] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVES To investigate the current prevalence of anemia among pregnant women in different areas of China and the association with birth weight and educational level. METHODS A total of 6,413 women aged 24-37 in the third trimester of pregnancy from five areas were randomly selected from all gravidas who gave birth in the hospitals from 1999 to 2003. Blood hemoglobin concentration (Hb) was measured by the cyanomethemoglobin method; Hb <110 g/l was considered as anemia. RESULTS The overall prevalence of anemia was 58.6%, ranging from 48.1 to 70.5% in the five areas. There was a significant difference in the prevalence of anemia between women who have mental jobs and those who have physical jobs (52.3 vs. 61.1%, p < 0.01). The prevalence of anemia depended on the level of education: with 52.9, 62.4 and 66.5%, for college, secondary school and primary education, respectively, and the difference was statistically significant (p = 0.005). Results showed that higher birth weight was associated with Hb concentrations ranging from 90 to 140 g/l, whereas lower birth weight occurred below 80 g/l and above 140 g/l Hb. CONCLUSIONS The prevalence of anemia in Chinese pregnant women was high both in rural areas and towns. Area of residence, education level and type of job influenced the prevalence of anemia. Low maternal Hb concentrations influenced birth weight.
Collapse
Affiliation(s)
- A G Ma
- Institute of Human Nutrition, Medical College of Qingdao University, Qingdao, PR China.
| | | | | | | | | | | | | | | |
Collapse
|
13
|
Su XY, Tan Y, Zheng MC. [Application of biofeedback relaxation techniques during chemotherapy]. Zhonghua Hu Li Za Zhi 1997; 32:627-9. [PMID: 9496009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
60 cancer patients during chemotherapy were investigated by using case-control study. 30 of them were recruited as the experiment group and given biofeedback relaxation training, the others were controls. Both of the two groups were assessed with SCL-90 and questionnaire on physical reactions. Results showed that no significant difference was found between the average scores of SCL-90 (including F1, F3, F4, F5, F10) of the two groups before the intervention. However, lower average scores and less serious physical reactions (4 of the 6 items) were seen from the experiment group after the intervention. It is indicated that biofeedback relaxation training is effective in alleviating patient's unhealthy psychosomatic reactions during chemotherapy.
Collapse
Affiliation(s)
- X Y Su
- Faculty of Nursing, Sun Yat-sen University of Medical Sciences GuangZhou
| | | | | |
Collapse
|
14
|
Zhou LS, Zheng MC, Zhang GF. [Bone metabolism in pregnant women]. Zhonghua Fu Chan Ke Za Zhi 1994; 29:157-8, 190-1. [PMID: 8082433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Serum ionized calcium, tartrate-resistant acid phosphatase (TR-ACP) and alkaline phosphatase (ALP) were measured in 80 pregnant women in different gestational weeks. The results showed that calcium level decreased significantly as the gestation week increased. Calcium level of umbilical cord was higher than that of third trimester of pregnancy. It indicated that calcium could be transported to fetus across the placenta against the concentration gradient. Both TR-ACP and ALP activity elevated as gestation week increased. This may suggest that the bone metabolism is very active in pregnant women.
Collapse
Affiliation(s)
- L S Zhou
- Affiliated Hospital of Guilin Medical College
| | | | | |
Collapse
|
15
|
Abstract
The alpha-tocopherol content of breast milk was measured in 71 mothers of preterm and term infants in China. The mean alpha-tocopherol content of breast milk was much lower than that reported in developed countries. alpha-Tocopherol levels were higher in colostrum and then decreased in the transition milk. Mothers of preterm infants produced colostrum with a slightly higher alpha-tocopherol content than that of the mothers of term infants. However, alpha-tocopherol levels in transition milk were similar in both groups.
Collapse
Affiliation(s)
- M C Zheng
- Department of Pediatrics, Guilin Medical College, China
| | | | | |
Collapse
|
16
|
Zheng MC, Zhang GF, Zhou LS, Guo XG, Quan YF. Alpha-tocopherol concentrations in human milk from mothers of preterm and full-term infants in China. Biomed Environ Sci 1993; 6:259-264. [PMID: 8292270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
alpha-Tocopherol content in breast milk of 28 mothers who delivered preterm infants (preterm milk) and 43 mothers who delivered full-term infants (term milk) were measured. alpha-Tocopherol concentration in preterm milk did not differ significantly from that of term milk in the first 12 days of lactation (P > 0.05). There is a higher alpha-tocopherol concentration in the early colostrum, however, it decreases with the lactational days significantly. The investigation suggests that early breast-feeding would be beneficial to the improvement of vitamin E intake in neonates during the early life.
Collapse
Affiliation(s)
- M C Zheng
- Department of Pediatrics, Guilin Medical College, China
| | | | | | | | | |
Collapse
|
17
|
Zheng MC, Zhou LS, Zhang GF. Effects of seasonality on blood ionized calcium in early neonatal periods. Asia Pac J Clin Nutr 1993; 2:125-127. [PMID: 24352143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The levels of whole blood ionized calcium were observed in 200 healthy neonates in the first week of life in spring and in summer. Levels of blood ionized calcium were lower in neonates born in spring compared to those of neonates born in summer. The levels of blood ionized calcium in adults did not change in different seasons. This study suggested that seasonality had a significant effect on blood ionized calcium in early neonatal life.
Collapse
Affiliation(s)
- M C Zheng
- Department of Pediatrics, Affiliated Hospital, Guilin Medical College, Guilin, 541001, China
| | | | | |
Collapse
|