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Background: Acute lymphoblastic leukemia with MLL/AF4 rearrangement remains a major hurdle to improving outcomes. Gene network and circRNAs have been found to participate in tumorigenesis, while their roles in leukemia still need to be explored. Recent patents have shown that circRNAs exhibit the markers for the children ALL, although the target and related mechanism remain to be elucidated. Objective: This study aims to explore the possible targets and mechanisms of ALL with MLLAF4 rearrangement. Methods: We first generated a gene network focusing on MLL-AF4 rearrangement. Cell viability was determined with Cell Counting Kit-8 assay. The cell apoptosis was tested by the Annexin V/PI assay. The RNA-protein complexes were analyzed by qRT-PCR, and the pathway proteins were analyzed by western blot. Results: This gene network was associated with biological processes, such as nucleic acid metabolism and immunity, indicating its key role in inflammation. We found that circ_0008012 was upregulated in MLL/AF4 ALL cells and regulated cell proliferation and apoptosis. Further computed simulation and RIP showed that IKKβ was the strongest protein in the NF-κB pathway binding with circ_0008012. As a result, possible regulation of circ_0008012 is suggested by binding IKKβ in the IKKα:IKKβ:IKKγ compound, which then phosphorylates IκB and activates NF- κB:p65:p300 compound in cell nucleus, thereby leading to leukemia. Conclusion: We identified a gene network for MLL/AF4 ALL. Moreover, circ_0008012 may be a therapeutic target for this subtype of ALL.

Pecan (Carya illinoinensis) is an important oilseed nut and is rich in fatty acids and flavonols. Pecan fatty acid has significantly edible, industrial, and clinical value. To investigate the dynamic patterns and compositions of fatty acid, and the molecular mechanism that controls fatty acid accumulation in pecan, lipidomic and transcriptomic analyses were performed to determine lipid profiles and gene expression in pecan’s fatty acid biosynthesis pathway. In the present study, compared to cultivars ‘Caddo’ and ‘Y-01’, ‘Mahan’ formed larger and heavier embryos and accumulated higher oil content. Lipidomic analysis showed that fatty acid and (O-acyl)-1-hydroxy fatty acid contents were higher in ‘Mahan’ at the mature stage. Based on full-length and comparative RNA-Seq, differential expression gene enrichment analysis revealed that many functional genes participated in the pathways of ‘fatty acid biosynthesis’, ‘fatty acid metabolism’, and ‘linoleic acid metabolism’. High fatty acid accumulation model from ‘Mahan’ demonstrated that key enzyme encoding genes played an important role in regulating fatty acid biosynthesis. Co-expression module analysis indicated that several transcription factors (MYB, TCP, bHLH, Dof, ERF, NAC) were involved in fatty acid accumulation by regulating the expression of functional genes, and real-time quantitative PCR verification proved that these transcription factors had a high correlation with pecan fatty acid accumulation pattern. These findings provided an insight into the molecular mechanism of fatty acid accumulation in C. illinoinensis embryo, which contributes to pecan oil yielding and pecan molecular breeding.

Acute promyelocytic leukemia (APL) is a special type of acute myeloid leukemia (AML), accounting for about 5% to 10% of children with AML. At the genetic level, APL is featured by a unique chromosome translocation t(15;17) which results in the PML-RARA gene fusion. Most patients can be diagnosed by traditional karyotype analysis, Fluorescence-In-Situ Hybridization (FISH), or Reverse Transcription-Polymerase Chain Reaction (RT-PCR). We report the case of a child with acute promyelocytic leukemia (APL) who had characteristic chromosome translocation t(15;17) and rare PML-RARA gene mutation. This patient had an excellent response to chemotherapy, suggesting that this mutation will not affect the treatment and prognosis of APL.

Acute lymphoblastic leukemia (ALL) is one of the most common malignancies in children. Our aim was to identify a novel miRNA that can predict prognosis of childhood ALL patients and explore its potential mechanism.The miRNA expression profiles of childhood ALL were analyzed using GEO database and HiSeq instruments. The expression of miR-155 was examined by RT-PCR in 42 ALL patients. To investigate the role of miR-155 in ALL, four ALL cell lines (CEM-C1, Jurkat, MOLT-3 and MOLT-4) were transfected with miR-155 mimics, miR-155 inhibitors or corresponding controls. Dual-luciferase reporter system was applied to confirm the miR-155 target ZNF238. Moreover, proliferation and apoptosis were evaluated by MTT and flow cytometry.Dataset GSE56489 and GSE23024 demonstrated that miR-155 was up-regulated and ZNF238 was down-regulated at diagnosis status of ALL. High miR-155 expression was associated with poor outcome. Overexpressed miR-155 promoted ALL cell proliferation and inhibited apoptosis. Dual-luciferase reporter result showed that miR-155 directly regulated ZNF238. Silencing ZNF238 promoted cell proliferation in ALL cells.Our research indicating that miR-155 might possess potential value as a biomarker for predicting the prognosis of individuals. However, the role of ZNF238 in childhood ALL remain unknown. In the present study, we found the possible role of ZNF238 as a new tumor suppressor in ALL, which might be necessary for the antiproliferative functions of normal cells to counteract ALL formation.Our results propose that miR-155 is in association with poor prognosis of childhood ALL. Furthermore, miR-155 could promote cell proliferation targeting ZNF238.

The prognosis of patients with acute myeloid leukemia (AML) caused by the FLT3-ITD mutation is poor. Arsenic trioxide (ATO) and all-trans retinoic acid (ATRA) can down-regulate FLT3-ITD level and selectively kill leukemia cells carrying the FLT3-ITD mutation. However, the mechanisms of action of these two compounds are unknown. Here, we found that ATO could bind FLT3-ITD at Lys91 and Asp225, whereas ATRA could bind FLT3-ITD at Lys5 and Gln6. Both compounds could not bind wild-type FLT3. Further studies revealed that ATO/ATRA may suppress the Expression of FLT3-ITD by promoting the UBE2L6-mediated ubiquitination pathway and decreasing the expression of C-MYC. However, further studies are needed to define the mechanisms of these compounds on AML. Our research provides an experimental basis for the use of ATO/ATRA in FLT3-ITD AML in clinical practice.

Background: The poor prognosis of acute myeloid leukemia (AML) is partly due to the immunosuppressive leukemia environment. A therapeutic approach to induce pyroptosis is promising to work on this issue. Pyroptosis, a form of inflammatory cell death, is capable to release pro-immune factors and enhance the infiltration and cytotoxicity of natural killer (NK) cells. Chemical drugs have been verified to enhance anti-tumor immunity by inducing pyroptosis. Arsenic trioxide (ATO), a clinical drug in leukemia, is reported to be effective to kill AML cells, but it’s still unclear about its mechanism in AML. Our research is aimed at exploring the ATO effect on pyroptosis induction and the anti-tumor immunity of NK cells in AML.Methods: Pyroptotic phenomenon was detected by confocal microscopy, Annexin-V / propidium iodide staining, LDH release assay, and western blotting; The release of cytokines was detected by SDS-PAGE, proteomic analysis, ELISA, etc.; AML xenograft models were established to explore the ATO effect in vivo and the anti-tumor effect of ATO treatment was identified by tumor-volume measurement, HE staining and KI67 staining; The activity of NK cells was evaluated by immunofluorescence, flow cytometric analysis, etc.; The differential expressed proteins were identified by quantitative proteomic analysis and western blotting.Results: We first discovered that ATO induced pyroptosis in AML cells and activated caspase-3/gasdermin E (GSDME) pathway to induce pyroptosis, and enhances the release of LDH, HMGB1, and IL-1β. Moreover, we revealed that ATO treatment promoted the proliferation, tumor-infiltration, and degranulation of NK cells in AML and its leukemia microenvironment. The further proteomic clues indicate the potential mechanisms of the ATO anti-leukemia effect in vivo.Conclusions: These findings indicate that ATO treatment induces pyroptosis via caspase-3/GSDME pathway, enhances the release of pro-inflammatory cytokines, and activates NK cells in AML. Our data identify what is to our knowledge the first clinical drug that induces pyroptosis in AML, revealing the potential anti-leukemic and pro-immune properties of ATO treatment in the leukemia microenvironment of AML, which may be beneficial in reducing the recurrence problems associated with the leukemia microenvironment.

Background Medulloblastoma (MB) is the most common malignant central nervous system tumor of childhood. Management requires interdisciplinary care and is associated with unique challenges in developing regions. Here, we report the characteristics, clinical outcome and treatment barriers for Chinese children with MB based on a multi-institutional cohort from the Chinese Children’s Cancer Group (CCCG). Methods Retrospective cohort study among 12 Chinese pediatric oncology units from the CCCG Brain Tumor Workgroup on patients aged Results 221 patients (male:female = 138:83) were included, 175 (79%) were ≥3 years of age, and 46 (21%) Conclusions We reported the clinical profiles and outcome from the largest cohort of Chinese children with MB after multi-modal therapy. Strengths and limitations on the local provision of neuro-oncology service are identified.

The prognosis of acute myeloid leukemia (AML) with FMS-like tyrosine kinase 3 internal tandem duplication (FLT3-ITD) mutations is poor. Some studies, including our previous study, have indicated that arsenic trioxide (ATO) exhibited significant anti-carcinogenic activity in FLT3-ITD AML cells and explored the possibility of targeting the FLT3-ITD protein for degradation as a therapy. Autophagy is a critical mechanism of the anti-leukemic effects of ATO. In this study, we explored the therapeutic efficacy of ATO treatment in a mouse model bearing FLT3-ITD AML and found that ATO significantly reduced the leukemic burden in bone marrow and spleen. We also found that autophagy was responsible for, at least in part, the degradation of the FLT3-ITD protein by ATO. After ATO treatment, MV4-11 cells showed complete autophagic flux. The autophagy inhibitor bafilomycin A or down-regulation of the key autophagy genes Atg5 and Atg7 reversed the FLT3 degradation induced by ATO. We also found that p62/SQSTM1 delivered FLT3-ITD proteins to the lysosome, where they were subsequently degraded. These results indicate that ATO can induce autophagic degradation of the FLT3-ITD mutated protein in FLT3-ITD AML.

Background The association between methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism (rs1801133) and childhood acute lymphoblastic leukemia (ALL) is inconsistent. Objective To explore the relationship between MTHFR-C677T polymorphism and susceptibility to childhood ALL. Methods PubMed, EMBASE, Web of Science, CNKI, Wanfang, VIP, and other databases were searched from the establishment of the database to November 2019, and all the case-control studies that met the inclusion criteria were collected. Stata 15.0 was used for meta-analysis, with calculation of the odds ratio (OR) of the relationship between MTHFR-C677T polymorphism and childhood ALL susceptibility. Ethnicity was analyzed by subgroup analysis. Results A total of 26 studies were included in this meta-analysis, including 4,682 children with ALL and 7144 controls. The results showed that there was no significant difference in the comparison of population of allele model, dominant gene model, recessive gene model, homozygous gene model, heterozygous gene model, and the comparison of Caucasian children. The results of the Asian child analysis suggested that the combined OR of the dominant gene model (CC + CT versus TT), homozygous model (CC versus TT) and heterozygous model (CT versus TT) was 1.32 (95% confidence interval [CI]: 1.03-1.70), 1.37 (95% CI: 1.02-1.84), and 1.27 (95% CI: 1.01-1.59), respectively, with statistically significant differences. However, there was no significant difference between the allele model and recessive gene model among Asian children. Conclusion The MTHFR C677T polymorphism is related to ALL in children, especially in Asian children. CC + CT, CC, and CT genotypes can increase the risk of ALL, but no association has been found in Caucasian children.

Voriconazole is a second-generation azole widely used for the prevention and treatment of fungal infection in leukemia patients. We report a case of 9-year-old girl with T-cell acute lymphoblastic leukemia who developed hallucinations and visual disturbance after using voriconazole twice. These symptoms began acutely after treatment with voriconazole and resolved rapidly when the voriconazole was stopped. No specific cause was identified, and thus the symptoms were considered to be the adverse drug reactions (ADRs) of voriconazole. Simultaneous development of hallucinations and visual disturbance caused by voriconazole in children rarely have been reported before and the causes of these ADRs are unknown. Several other cases of hallucinations and (or) visual disturbance caused by voriconazole among 15–81 years old patients have been reported in the literature, and are reviewed. Those patients reminded us of the importance of being aware of hallucinations and visual disturbance associated with voriconazole treatment. In addition, we speculate that the hallucinations and visual disturbance are not related to the dosage form of voriconazole. We emphasize that it is also important to monitor the concentration of voriconazole regularly to avoid potential toxicity.

MLL-rearranged leukemia is an aggressive malignancy associated with poor outcome, which is refractory to conventional treatment. Melatonin has been proven to exert anti-tumor activity, but the effect of melatonin on MLL-r leukemia and the underlying mechanism remain poorly understood. In this study, melatonin inhibited cell proliferation and induced apoptosis by activating the caspase-dependent apoptotic pathway in MLL-r leukemia cells. Mechanistic investigations revealed that melatonin suppressed the expression of hTERT by abrogating the binding activity of RBFOX3 to the hTERT promoter. Melatonin also blocked NF-κB nuclear translocation and suppressed NF-κB binding to the COX-2 promoter, thereby suppressing the expression of COX-2. In addition, clinical samples revealed that melatonin exerts anti-leukemic activity in primary MLL-r leukemia blasts ex vivo. In vivo, the mice treated with melatonin experienced a larger reduction in leukemic burden than the control group in a MLL-r leukemia xenograft mouse model. Collectively, these results suggest that melatonin inhibits MLL-rearranged leukemia through suppressing the RBFOX3/hTERT and NF-κB/COX-2 signaling pathways. Our findings provide new insights into the role of melatonin for MLL-r leukemia treatment.

FLT3-ITD mutations occur in approximately 30% of acute myeloid leukemia (AML) and are associated with a poor outcome. Currently available FLT3 inhibitors have in vitro but limited clinical activity in FLT3-ITD AML. Reports have shown that an arsenic trioxide (ATO)/all-trans-retinoic acid (ATRA) combination improves prognosis in acute promyelocytic leukemia, especially with FLT3-ITD, and ATO or ATRA alone enhances apoptosis in FLT3-ITD AML cells treated with FLT3 inhibitors, providing a rationale to investigate the role of ATO/ATRA in FLT3-ITD AML. Here, we demonstrate that an ATO/ATRA combination selectively exerts synergistic cytotoxicity against FLT3-ITD AML cell lines (MV4;11/MOLM-13). The signaling pathways affected by ATO/ATRA include FLT3/STAT5/MYC, FLT3/STAT5/E2F1, FLT3/ERK/ATF5 and FLT3/AKT/ATF5.ATF5 may function as an oncogene in FLT3-ITD AML. Our findings provide experimental evidence that supports further exploration of ATO/ATRA in FLT3-ITD AML in vivo and warrants a clinical evaluation of regimens comprising an ATO/ATRA combination.

BACKGROUND Medulloblastoma is the commonest brain tumor in young children but literature on Chinese is scarce. We hereby present the outcome of children with medulloblastoma managed according to a risk- and age-stratified guideline from ten institutions across China. METHODS Patients RESULTS 112 patients were included with a median age at diagnosis of 6.5 years (range: 0.5–16.7). 16 patients (14.3%) had residual tumor >1.5cm2 and 36 (32%) had metastasis. Available data on histological subtype (n=87) were classic in 56 (64%), desmoplastic/nodular or extensive nodularity in 23 (26%), and large cell/anaplastic in 8 (9%). Molecular subgrouping (n=55) assigned tumors as WNT-activated (n=8, 15%), SHH-activated (n=17, 31%), Group 3 (n=12, 22%) and Group 4 (n=18, 33%). Respective 2-year EFS/OS for patients ≥3 and CONCLUSION We demonstrated feasibility in protocolizing the inter-disciplinary treatment for medulloblastoma in China. This will serve as a prototype for the standardization of pediatric neuro-oncology care in the country.

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.

This study examined the ability to vegetatively propagate 1-year-old pecan (Carya illinoinensis) through the rooting of hardwood cuttings. Cuttings were treated with varying concentrations of different auxins and different combinations of media and ambient temperatures. Under different temperature conditions, all auxin treatments induced the rooting of cuttings but did not promote sprouting. The effectiveness of the induction of adventitious roots was as follows: 1-naphthalene acetic acid (NAA) > indole 3-butyric acid > indole 3-acetic acid. The base of the parent shoot treated by NAA at a concentration of 0.09%, planted in substrate with bottom heat was the most effective, with 82% rooting, 8.3 roots/cutting and root lengths of 7.3 cm. These findings suggested that auxin and substrate/air temperature differences are both indispensable in the process of adventitious roots formation in pecan. This study revealed that the propagation of hardwood cuttings derived from branches of 1-year-old pecan is possible.

Micromechanical silicon resonant accelerometer can easily realize high-accuracy measurement by taking the digital signal as the output. Thus, this accelerometer has become popular in the field of micromechanical accelerometer. One-mass accelerometer with differential structure has blind area in measuring, and to overcome this deficiency, a new structure without mechanical coupling is designed. This new structure can cut off coupling channels by isolating the mass, and vibration decoupling between two resonators can be achieved structurally. Furthermore, the scale factor of the designed accelerometer is as high as 295 Hz/g. This finding indicates that this accelerometer has high mechanical sensitivity, which reduces the difficulty of follow-up testing.

The development of novel chemotherapeutic drugs is needed for the treatment of patients with acute lymphoblastic leukemia (ALL). In this study, the anti-leukemic effect and the potential molecular mechanisms of action of flavokawain B on ALL were investigated. Flavokawain B was found to significantly inhibit the cellular proliferation of B-ALL and T-ALL cell lines in a dose-dependent manner. It also induced cellular apoptosis by increasing the expression of p53, Bax and Puma, and activating the cleavage of caspase-3 and poly ADP-ribose polymerase (PARP). Furthermore, the enhancement of p53-dependent apoptosis by flavokawain B could be rescued by pifithrin-α, a pharmacological inhibitor of p53 transcriptional activity. Moreover, the proliferation of leukemia blast cells from 16 patients with ALL was inhibited by flavokawain B, and tumor growth in xenograft mice was also suppressed by this drug. In conclusion, our results demonstrate the therapeutic potential of flavokawain B for the treatment of ALL.

Two new prenylflavonoids, morusalbols A and B (1 and 2), were isolated from the branches and leaves of Morus alba, together with three known compounds, kuwanon C (3), morusin (4), morusinol (5). The structures of these two prenylflavonoids were elucidated by extensive analyzes of the spectroscopic data.

Objectives Capsule endoscopy (CE) has been widely used in the diagnosis of small bowel disease (SBD) in the world. To bring CE into the national health insurance directory, and intensify its popularization in primary hospital, the government needs high-quality HTA evidence for decision makers. We were appointed by the National Health and Family Planning Commission of China to evaluate the effectiveness, safety, economy, and applicability of CE in the diagnosis of SBD, to provide the best currently available evidence for decision making. Methods We searched the Cochrane Library (Issue 8, 2013), PubMed, EMbase, INAHTA, VIP, CBM, CNKI and WanFang Data. All confirmed or suspected SBD patients with diagnosis by CE versus other alternative therapies were considered. Health technology assessments (HTAs), systematic reviews (SRs), meta-analyses, randomized controlled trials (RCTs), guidelines and economic studies were included. Two investigators selected studies, assessed the quality and extracted data independently, and a descriptive analysis was used. Results We included 4 HTAs, 11 SRs/meta-analyses, 2 RCTs, 5 guidelines, and 10 economic studies for assessment. The results showed that the disease detection rate of CE was higher than that of many other traditional technologies and that the main adverse event for CE was retention (0.7% to 3.0%). These results were consistent with those of the guidelines. Comprehensive results of economic studies showed the superiority of CE compared with other technologies. As the first choice, CE can decrease potential costs, especially when used in outpatients. Conclusions (i) CE has advantages in diagnostic yield, safety, and cost in the diagnosis of SBD, but some limitations exist. It still needs more high-quality evidence on CE diagnosis accuracy. (ii) When the government approves the introduction of CE in a hospital, many factors must be considered, such as the local disease burden, clinical demand, ability to pay, and staff. At the same time, it is necessary to standardize training for operating physicians, to reduce economic losses caused by poor technical ability of the medical staff.

Packaging thermal stress is harmful to the performance of the micromechanical silicon resonant accelerometer. In order to decrease the packaging thermal stress, correlations of packaging thermal stress with the material properties, curing temperature and geometrical size of adhesive layers of adhesive materials were discussed. A finite element model of package was developed to analyze the influence of surface mounting technology (SMT） on the micromechanical silicon resonant accelerometer. The simulation results show that the Young’s modulus, thermal expansion coefficient, curing temperature and geometrical sizes of adhesive layers are important influencing factors for packaging thermal stress and the warpage of the chip. The thermal stresses during the process of SMT will cause the resonant frequency shift.

A novel fully-decoupled dual-mass silicon micro-machined Gyroscope is presented in this paper to reduce the coupling between the drive mode and sense mode for high performance. The theoretical analysis was made based on the simplified kinematics model. Then, the configuration of the dual-mass double-linear vibratory gyroscope, a three-frame structure, was given. The numerical simulation was made, which shows the decoupling effect of the design. Finally, tests were done on the fabricated prototype. The bias instability is 3.02°/h and the nonlinearity of scale factor is less than 50ppm, which prove that this gyroscope has exhibited good mode-decoupling effect and good performance.

This paper studies the control theory and the methods of the silicon micromachined resonant accelerometers(SMRAs). According to the structure and movement of the resonant accelerometer, the model of its dynamics and the equations of motion are deduced. The model of the closed-loop control is set up with the phase lock loop (PLL). The principle of PLL is expounded in detail. The requirements for phases and gains of the sinusoidal self-drive-oscillation are met by PLL. The average method is to take the average of slowly changing variables within a cycle to find the solutions of nonlinear equations. Using the average method, it analyzes the PLL’s phase control methods in depth and derives the system stability condition. The simulation results verify the correctness of the stability condition. It provides a guiding theory for the realization of SMRA’s precision control.

Objective Treatment and outcome of infant acute leukemia (IAL) in developed countries have been well documented. However, reports summarizing diagnosis and outcome of IAL in developing countries are limited. Methods Five hundred ninety seven pediatric patients were diagnosed with acute leukemia in our hospital between January 1997 and June 2008, of which 19 were younger than 12 months. Data from our 19 cases and the Chinese literature were analyzed. Results Of the 19 cases, 14 had acute lymphoblastic leukemia (ALL) and 5 had acute myeloid leukemia (AML) based on FAB classification. Immunophenotyping and molecular genetic analysis were performed in only 6 cases. Only 16% (3/19) of the infants received treatment. Two infants with immunophenotypic AML who abandoned treatment achieved spontaneous remission without chemotherapy within 2 and 4 months respectively. Combining our data with those from Chinese literature, less than one third of the infants had immunophenotypic and genetic verification of leukemia and 29% (18/63) of them received treatment. Conclusion Family financial difficulties and physicians' lack of confidence in treatment outcome in IAL contributed to a high treatment abandonment rate and poor outcome. Public health insurance as well as physician education on current IAL treatment strategies may decrease treatment abandonment in China. Pediatr Blood Cancer 2009;53:973–977. © 2009 Wiley-Liss, Inc.

Objective Acute promyelocytic leukemia (APL) is now highly curable, except in many developing countries. Introduction of current treatment strategies may improve the outcome for children with APL in these countries. Methods The diagnosis was based on the FAB classification and detection of PML-RARα rearrangement. From December 1999 to September 2004, 16 eligible children were treated with an intensive in-house protocol including high-dose AraC and anthracycline. Subsequently, 14 cases were treated with a less intensive protocol modified from the PETHEMA LPA99. Results The 3.5 years event-free survival (EFS) was 37.5% (95% CI, 13.8–61.2%) for patients treated on initial protocol. The treatment failures were: six patients abandoned treatment (37.5%), two who died of intracranial hemorrhage at diagnosis (6.3%) and sepsis in remission (6.3%) respectively, and two who relapsed (12.5%). Those treated on modified PETHEMA had a 3.5 years EFS of 79.6% (95% CI, 52.9–106.3%). Treatment failures included: one who died of intracranial hemorrhage at diagnosis (7.1%) and one who relapsed (7.1%). The patients on modified PETHEMA had a significantly higher EFS (P = 0.012), lower frequency of sepsis during treatment (7.7% vs. 77.8%; P = 0.0015), and lower hospitalization cost (median US$ 4,700 vs. US$ 20,000; P

The physiological responses of 2-year-old seedlings of Nuttall’s oak (Quercus nuttallii) and Southern red oak (Q. falcata) with two treatments i.e., deep-drowning and shallow-drowning, were studied. Taxodium distichum was selected as a control. The survival rates of seedlings were calculated, the photosynthetic indices were detected by Licor-6400 photosynthetic system instrument, and the root activities of seedlings were tested by the method of triphenyltetrazolium chloride (TTC). Results showed that: 1) By experiencing flooding for 76 d and recovering for 60 d after water was drained off, all seedlings survived under the shallow-drowning treatment. None of Q. falcata seedlings died in the deep-drowning treatment until the 49th day. The survival rate of Q. falcata in the deep-drowning treatment was 30%. 2) Within 61 d of waterlogging treatments, the net photosynthetic rate (P n), stomatal conductance (g s) and transpiration rate (T r) showed a tendency of declining, but intercellular concentration of CO2 (C i) increased. With the prolongation of flooding stress, the extents of variation for all indices under deep-drowning treatment were larger than those under the shallow-drowning treatment. The variation of Q. falcata in flooding stress was larger than that of Q. nuttallii. 3) The root vigor and alcohol dehydrogenase (ADH) activities were detected at the 61st day in flooding stress. Waterlogging obviously inhibited root activities. Shallow-drowning made root vigor of Q. nuttallii decreased by 11.7%, and for Q. falcata, by 51.88%. Shallow-drowning treatment had no remarkable effects on ADH activities of seedlings, but deep-drowning increased those of Q. nuttallii seedlings by 227.24%, and decreased those of Q. falcata seedlings by 59.22% in the meantime. We conclude that Q. nuttallii had a stronger waterlogging resistance than Q. falcata, but weaker than T. distichum.

There are challenges for diagnosis and treatment of idiopathic pulmonary hemosiderosis (IPH). This clinical trial was to review the diagnosis and evaluate the efficacy of maintenance therapy with dose-adjusted 6-mercaptopurine (6MP) in IPH children. Fifteen children were enrolled. Prednisone was administered at 2 mg/kg/day for 4 weeks in acute phase of the disease followed by taper. 6MP was also started at 60 mg/m(2)/day simultaneously and continued for 3 years in outpatient. The delay in diagnosis of IPH is common and probably due to a lack of classical triad of IPH in most children. All the patients exhibited response to the initial treatment. Only one of eight patients with relative leukopenia on 6MP maintenance recurred while 5 of 7 others recurred (P < 0.05) during median 4.5-year follow-up. Of the latter five patients who recurred, 4 remained recurrence-free after adjusting the dose of 6MP upwards to keep relative leucopenia. It suggests that children with IPH could achieve steroid-free long term remission on 6MP maintenance therapy, and relative leukopenia on 6MP might be a simple maker of predicting clinical response in most IPH children.