Association of the expression of Th1/Th2 cytokines and lymphocyte subsets with clinical characteristics and outcomes in 207 Chinese children with Burkitt’s lymphoma

To the Editor:Burkitt’s lymphoma(BL)is the most common subtype of pediatric non-Hodgkin lymphoma(NHL),accounting for nearly 40%of cases.[1,2]The 5-year overall survival(OS)rate is nearly 90%owing to the use of existing standard chemotherapy regimens in conjunction with rituximab.[2]Approximately 25%patients with pediatric BL present with central nervous system(CNS)disease and a poor prognosis.[1]The significance of the expressions of T helper 1/T helper 2(Th1/Th2)cytokines and lymphocyte subsets in the occurrence,development,and prognosis of adult malignant lymphoma has been reported in the literature,but data on pediatric BL are limited.This study aimed to investigate the characteristics of cytokines and lymphocyte subset expression in patients with pediatric BL,identify the differences between the CNS-positive and CNS-negative groups,and determine the risk factors in the CNS-positive group.

Better design leads to better results-Importance of virological outcome design in clinical trials for antiviral treatment of coronavirus disease 2019

Since the outbreak of the pandemic coronavirus disease 2019(COVID-19),various articles on different fields of the disease published in medical and related journals increased in a way of explosion.A recent literature search at PubMed using the term“COVID-19”only displayed more than 314000 articles.

Echocardiographic Evaluation of Coronary Abnormalities and Cardiac Function in a Murine Model of Kawasaki Disease Using High-frequency Ultrasound

Background： Murine model of coronary arterial inflammation has been widely accepted as an animal model of and used in Kawasaki disease （KD）. This study sought to evaluate the developmental changes of coronary arteries and cardiac function in a murine model of KD with a high-frequency ultrasound system and to provide evidence for the preparation of the model of KD. Methods： Lactobacillus case~ cell wall extract was prepared and injected into C57BL/6 mice intraperitoneally （i.p.） to induce KD. A total of 120 mice were grouped into three groups. The intravenous immunoglobulin （IVIG） treatment group was i.p. injected with IVIG （2 g/kg）, while the KD model and normal control groups were i.p. injected with 0.5 ml of phosphate buffered solution on day 5. All high-resolution echocardiography detection of mouse heart was performed by the same senior technician. Animal echocardiography was performed by measuring the coronary artery dimensions and cardiac function on days 0, 7, 14, 28, and 56 （high-resolution small animal ultrasound [Vevo770 pattem; VisualSonic, Canada] with broadband probe [RMVTM707B; frequency, 30 mHz; depth of focus, 1.2 cm]） which were measured and analyzed with Vevo770 software. Results： Pathological studies revealed focal inflammatory infiltrate asymmetrically distributed around the coronary artery trunk in the KD model group. Echocardiographic study including coronary dimension and cardiac function measurements was successfully performed in all subjects. The KD model and IVIG treatment groups showed left coronary artery dilation on days 7, 14, 28, and 56. The diameter of left coronary artery in the KD model group （0.53 ± 0.09 mm; 0.36 ± 0.07 mm; 0.34 ±0.05 mm; 0.34±0.04 mm） was significantly larger than those of 1VIG treatment group （0.22± 0.02 mm; 0.28 ± 0.03 mm; 0.26± 0.03 mm; 0.27 ±0.05 mm; 0.26 ± 0.03 mm; all P〈 0.01） and the normal control group （0.21 ±0.02 mm; 0.22 ±0.03 mm; 0.22± 0.02 mm; 0.23 ± 0.02 mm; 0.27± 0.04 mm; all P 〈 0.01） on days 7, 14, 28, and 56. No significant differences were observed in the measurements of cardiac fimction among the groups on days 0, 7, 14, 28, and 56 （all P〉 0.05）. Conclusions： Echocardiography could identify the consecutive changes of coronary artery in KD mice. Echocardiography is more convenient and direct in evaluating the coronary abnormalities in this animal model.

effective treatment of post-intubation subglottic stenosis in children with holmium laser therapy and cryotherapy via flexible bronchoscopy

Importance:Post-intubation subglottic stenosis(SGS)in children can be life threatening.Definitive treatment varies and lacks a universally accepted approach.Objective:We performed a prospective study to assess the safety and feasibility of holmium laser combined with cryotherapy delivered via flexible bronchoscopy for the treatment of post-intubation SGS in children.Methods:This study involved all patients with post-intubation SGS seen at the Interventional Pulmonology Department of Beijing Children's Hospital between July 2014 and December 2016.Holmium laser treatment and cryotherapy was then performed under flexible bronchoscopy,whose parents refused to accept the alternative standard treatment of tracheotomy and balloon dilation under direct laryngoscopy.results:Sixteen patients with post-intubation SGS were included in this study.Ages ranged from 2 months to 12.25 years old.According to the Cotton-Myer grading system,three cases were Grade II,12 cases were Grade III,and one case was Grade IV.According to the McCaffrey system,eight cases were Stage 1,two cases were Stage 2,and six cases were Stage 3.The average number of procedures was 4.88.Fifteen of the 16 patients achieved clinical cure.One patient achieved clinical improvement.The average treatment course duration was 55.31 days.No severe complications were seen.Post-treatment clinical symptoms,endoscopic findings and quality of life showed marked improvement.Interpretation:Our study supports the conclusion that holmium laser treatment combined with cryotherapy via flexible bronchoscopy appears to be a safe and feasible treatment for post-intubation SGS in children.

Clinical characteristics of herpes zoster in a pediatric hospital in China from 2007 to 2020

Herpes zoster(HZ)also known as shingles is caused by thereactivationof latentvaricella zostervirus(VZV)from the dorsal root ganglia following primary infection[1,2]and is associated with severe disease in immunocompromised pediatric patients[3-6].Immunosuppression has been demonstrated to be related to a higher incidence of HZ[4].The prevalence and clinical features of HZ in the hospitalization of patients who have a history of other medical conditions has been studied[7].

Independent temporal lobe epilepsy in patients with tuberous sclerosis complex

Tuberous sclerosis complex(TSC)is a rare disease that involves multiple organs,including the brain;approximately 80%-90%of TSC patients exhibit TSC-associated epilepsy.Independent temporal lobe epilepsy(TLE),TSC-unrelated epilepsy,is particularly rare in patients with TSC.Here,we describe three patients with TSC with independent TLEs that were confirmed by stereo-electroencephalography(EEG),postoperative pathological findings,and seizure outcome at follow-up.The patients were retrospectively enrolled at two centers;their ictal epileptiform discharge onsets were determined using electrode contacts in the hippocampus during stereo-EEG.The three patients underwent anterior temporal lobectomies and remained seizure-free at 1-5 years after surgery.Postoperative pathological examinations confirmed hippocampal sclerosis in all three patients.Furthermore,postoperative intelligence quotient improvement was evident in one patient,while the quality of life was improved in two patients at 12 months after surgery.