做一对上床睡觉的好夫妻

晚上孩子睡着了,照例两人一人一个房间,一人一台电脑.这不知道是多久前形成的习惯了,似乎从来就没有想过有什么不对劲.MSN上跳出一个久不联系的好友,跟我说她结婚了.朋友来自单亲家庭,离异源于父亲的背叛,所以她对男人有种天生的恐惧与不信任.     

Augmented therapy improves outcome for pediatric high risk acute lymphocytic leukemia: results of Children's Oncology Group trial P9906

Background

The augmented BFM regimen improves outcome for children with NCI high acute lymphoblastic leukemia (ALL). Patient age, sex, and presenting white blood cell count (WBC) can be used to identify a subset of approximately 12% of children with B‐precursor ALL that had a 5‐year continuous complete remission (CCR) rate of only about 50% on earlier Pediatric Oncology Group (POG) trials.

Procedures

Children's Oncology Group trial P9906 evaluated a modified augmented BFM regimen in 267 patients with particularly high risk B‐precursor ALL. Minimal residual disease (MRD) was assessed in blood at day 8 and in marrow at day 29 of induction and correlated with outcome.

Results

The 5‐year CCR probability for patients in P9906 was significantly better than that observed for similar patients on POG trials 8602/9006 (62.2 ± 3.7% vs. 50.6 ± 2.4%; P = 0.0007) but similar to POG 9406 (63.5 ± 2.4%; P = 0.81). Interim analysis showed poor central nervous system (CNS) control, especially in patients with initial WBC ≥100,000/microliter. Day 29 marrow MRD positive (≥0.01%) vs. negative patients had 5 year CCR rates of 37.1 ± 7.4% vs. 72.6 ± 4.3%; day 8 blood MRD positive vs. negative patients had 5 year CCR rates of 57.1 ± 4.6% vs.83.6 ± 6.3%. End induction marrow MRD predicted marrow but not CNS relapse. In multivariate analysis, day 29 MRD > 0.01%, initial WBC ≥ 100,000/µl, male gender, and day 8 blood MRD > 0.01% were significant prognostic factors.

Conclusions

Augmented BFM therapy improved outcome for children with higher risk ALL. Day 8 blood and day 29 marrow MRD were strong prognostic factors in these patients. Pediatr Blood Cancer 2011; 57: 569–577. © 2011 Wiley‐Liss, Inc.

     

Stereotactic vacuum-assisted breast biopsy: results, follow-up and correlation with radiological suspicion

PURPOSE: The purpose of this study was to assess the accuracy and clinical usefulness of stereotactic vacuum-assisted biopsy (VAB) for diagnosing suspicious, nonpalpable, only mammographically detectable breast lesions. MATERIALS AND METHODS: We retrospectively evaluated the results of percutaneous stereotactic VAB with 11-gauge needles performed over a period of 34 months on 228 nonpalpable suspicious breast lesions detectable on mammography only [Breast Imaging Reporting and Data System (BI-RADS) 3: 25.9%; BI-RADS 4: 67.1%; BI-RADS 5: 7%]. The imaging histological concordance was ascertained for each lesion. In cases of discordance, repeat biopsy or surgical excision were recommended; in cases of benign lesions, we urged a follow-up of at least 6 months and for borderline and malignant lesions a surgical excision. We also evaluated concordance between VAB results and subsequent examinations (surgical excision or followup). RESULTS: VAB demonstrated 123 (54%) benign lesions (with six cases of imaging-histological discordance), 26 (11.4%) borderline lesions and 79 (34.6%) malignant lesions. We obtained a suitable post-VAB mammographic or histological evaluation for 78 benign lesions, 17 borderline lesions and 76 malignant lesions, with one (1.3%) false negative (FN) case, two (11.8%) underestimations of borderline lesions, 14 (18.4%) underestimations of malignant lesions and no (0%) false positive cases. We did not observe any postbiopsy complications or scars. CONCLUSIONS: Percutaneous histological VAB with an 11-gauge needle proved to be, as reported in previous studies, a reliable method for diagnosing nonpalpable, mammographically detectable only breast lesions, with an underestimation rate lower than core biopsy and a FN rate similar to that of surgical biopsy, without any significant complications.     

适时"误解"一下宝宝吧

小丫头澄澄妹妹,对于我的"教诲"通常都是忽视的.小时候,她哭闹时,随你怎么好言相劝,她该往地上躺还是往地上一躺,根本不理你的好言相劝.慢慢地,我发现,教育孩子有时不一定要正面去教育,适当"误解"孩子一下或许会更有效.     

儿子的护齿经验谈

因为老公是牙医,儿子出生后我们首先想到的,就是把儿子的小牙从小护理好。 如今孩子4岁半了,身体结实,能说会道。特别值得一提的就是他的一口洁白整齐的小牙,没有一点黄,没有一个牙洞,漂亮得都可以做广告了。     

Genetic variation and decreased risk for obesity in the Atherosclerosis Risk in Communities Study

AIM: To investigate the effects of variation in the leptin [LEP (19A>G)] and melanocortin-4 receptor [MC4R (V103I)] genes on obesity-related traits in 13 405 African-American (AA) and white participants from the Atherosclerosis Risk in Communities (ARIC) Study. METHODS: We tested the association between the single-locus and multilocus genotypes and obesity-related measures [body mass index (BMI), body weight (BW), waist-hip ratio, waist circumference and leptin levels], adjusted for age, physical activity level, smoking status, diabetic status, prevalence of coronary heart disease, hypertension, stroke or transient ischaemic attack. RESULTS: AA and white female carriers of the MC4R I103 allele exhibited significantly lower BW than non-carriers of this allele (p < 0.05 and p < 0.01 respectively). AA female carriers of both the LEP A19 allele and the MC4R I103 allele were 63% [odds ratio (OR) = 0.37, 95% confidence interval (CI) (0.18-0.78)] less likely to be obese, and white female carriers of the same two alleles were 46% [OR = 0.54, 95% CI (0.32-0.91)] less likely to be obese, than non-carriers of the variant alleles. Female carriers of both the LEP A19 and MC4R I103 alleles had significantly lower BW (p < 0.05), BMI (p < 0.05) and plasma leptin (p < 0.01) than the non-carriers of both the alleles. Carriers of the two variant alleles had lower BMI over the 9-year course of the ARIC study and significantly lower weight gain from age 25 years. No significant joint effect of these two variants was observed in males. CONCLUSION: These results suggest that variation within the LEP and MC4R genes is associated with reduced risk for obesity in females.     

乳头溢液病人行MRI:我们是否应该建议?

目的比较增强MRI(CEMRI)、乳腺X线摄影和超声成像对乳头溢液(ND)病人的敏感性。方法回顾性评估2007年3月—2009年7月间行乳腺X线摄影、超声和1.5TCEMRI的38例ND女性病人。比较影像发现、病理诊断和随访数据(平均随访时间20个月)。计算敏感度和特异度数值。     

英国爸爸为孩子想放弃工作

我家老二出生后,猪爸公司正提升他,只是要经常出差。为了能天天在家跟孩子“腻歪”着。猪爸居然递交了辞呈!谁知这金融危机说来就来,好多行业里的同事开始面临失业,猪爸才赶快去找工作。     

量身定制育儿方案:让您成为好爸爸

虽说越来越多的人开始意识到父亲在育儿中的重要地位,然而真正身体力行将育儿责任落实到实处的爸爸们还不算太多。很多时候,爸爸们因为有着这样那样的理由和难处,加上不知道该从哪些方面入手,     

让你的孩子也来“混”厨房

把孩子领进厨房的好处远比你想象中要多,再加上一些简重的厨房注意事项,相信你家的小大厨一定能好好享用一番快乐的厨房时光。