Prognostic significance and treatment strategies for IKZF1 deletion in pediatric B-cell precursor acute lymphoblastic leukemia.

BACKGROUND: The predictive importance of IKZF1del in pediatric B-cell precursor acute lymphoblastic leukemia (BCP-ALL) has shown variability across different studies. Thus, the optimal treatment approach for children with IKZF1del BCP-ALL remains contentious, with the ongoing debate surrounding the use of IKZF1del-based high-risk stratification versus a minimal residual disease (MRD)-guided protocol. METHODS: IKZF1 status was reliably determined in 804 patients using multiplex ligation-dependent probe amplification (MLPA) data obtained from four hospitals in Fujian, a province of China. In the Chinese Children Leukemia Group (CCLG)-ALL 2008 cohort, IKZF1 status was included in the risk assignment, with all IKZF1del patients receiving a high-risk regimen. Conversely, in the Chinese Children's Cancer Group (CCCG)-ALL 2015 cohort, IKZF1del was not incorporated into the risk assignment, and patients were treated based on an MRD-guided risk stratification protocol. RESULTS: IKZF1del was found in 86 patients (86/804, 10.7%) overall and in 30 (30/46, 65.2%) BCR::ABL1-positive patients. Overall, IKZF1del was a poor prognostic predictor for patients, though the significance diminished upon age adjustment, white blood cell (WBC) count at diagnosis, treatment group, and MRD status. In the CCLG-ALL 2008 cohort, IKZF1del conferred a notably lower 5-year overall survival (OS) and event-free survival (EFS) and a significantly higher 5-year cumulative incidence of relapse (CIR) than IKZF1wt. In the CCLG-ALL 2015 cohort, IKZF1del conferred a lower 5-year OS and EFS and a higher 5-year CIR than IKZF1wt, but the differences were insignificant. The IKZF1del patients treated with higher intensity chemotherapy (CCLG-ALL 2008 high-risk regimen) had a markedly lower 5-year OS and EFS compared with those treated with the MRD-guided protocol (CCCG-ALL 2015 protocol). Furthermore, patients treated with the CCLG-ALL 2008 high-risk regimen experienced a higher frequency of serious adverse events (SAEs), especially infection-related SAEs, compared with those treated with the CCCG-ALL 2015 MRD-guided protocol. CONCLUSIONS: The prognostic effect of IKZF1del may vary in different protocols. Compared with higher intensity chemotherapy, the MRD-guided protocol may be a more effective approach to treating BCP-ALL with IKZF1del in children.

Long-term outcome of children with acute promyelocytic leukemia: a randomized study of oral versus intravenous arsenic by SCCLG-APL group.

Realgar-Indigo naturalis formula (RIF), an oral traditional Chinese medicine mainly containing Realgar (As4S4), is highly effective in treating adult acute promyelocytic leukemia (APL). However, the treatment efficacy and safety of RIF have not been verified in pediatric patients. SCCLG-APL group conducted a multicenter randomized non-inferiority trial to determine whether intravenous arsenic trioxide (ATO) can be substituted by oral RIF in treating pediatric APL. Of 176 eligible patients enrolled, 91 and 85 were randomized to ATO and RIF groups, respectively. Patients were treated with the risk-adapted protocol. Induction, consolidation, and 96-week maintenance treatment contained all-trans-retinoic acid and low-intensity chemotherapy, and either ATO or RIF. The primary endpoint was 5-year event-free survival (EFS). The secondary endpoints were adverse events and hospital days. After a median 6-year follow-up, the 5-year EFS was 97.6% in both groups. However, the RIF group had significantly shorter hospital stays and lower incidence of infection and tended to have less cardiac toxicity. All 4 relapses occurred within 1.5 years after completion of maintenance therapy. No long-term arsenic retentions were observed in either group. Substituting oral RIF for ATO maintains treatment efficacy while reducing hospitalization and adverse events in treating pediatric APL patients, which may be a future treatment strategy for APL.

Effect of climate and ecological restoration on vegetation changes in the "Three-River Headwaters" region based on remote sensing technology.

Surface temperature and precipitation are factors effecting vegetation growth. Vegetation coverage change is one of the important factors influencing global and regional climate change. Dynamic monitoring of vegetation change can reflect the trend of climate change to a certain extent. Three-River Headwaters are located in the hinterland of the Qinghai-Tibet Plateau. It has the characteristics of "high, cold, and dry" (higher altitude, cold and dry weather) and its ecosystem is fragile. In recent years, with the global climate change, a series of eco-environmental problems such as river flow cutoff, permafrost degradation, and vegetation destruction has occurred in the headwaters area, which are closely related to climate and vegetation changes. At the same time, in order to solve the problem of ecological environment degradation in the region, various ecological restoration policies have implemented. Several uncertainties in the relationship between vegetation and climate change in the Three-River Headwaters region. This study aims to find out the uncertainties. In this study, the spatial distribution of vegetation coverage was calculated by using NDVI (normalized difference vegetation index) from the first-level product of MODIS (moderate resolution imaging spectroradiometer) remote sensing data. Combining policy factors, the relationship between rainfall, surface temperature, and vegetation growth status were analyzed. The results show that during the study period (1948-2019), the temperature rose significantly and the rainfall increased especially after the implementation of ecological restoration policy (after 2000). Vegetation coverage increased year-by-year (2000-2015). The rainfall effect on surface temperature and vegetation growth, when the summer rainfall increased, the temperature decreased, leads to vegetation coverage decreased (for example, 2001, 2003, 2008 and 2011); the dependence of vegetation on rainfall has obvious lag in Three-River Headwaters in summer. In the years with suitable rainfall and higher temperature in summer, the vegetation grows better and the vegetation coverage increases. This is mainly because the Three-River Headwaters is located in the alpine zone, and vegetation growth is more dependent on temperature. The implementation of ecological restoration policy promotes vegetation coverage. Studying the impact of climate and policy factors on vegetation cover is of great scientific significance and practical value for understanding the ecological restoration mechanism in high cold and arid regions.

The variation of rainfall runoff after vegetation restoration in upper reaches of the Yellow River by the remote sensing technology.

In history, the Yellow River has been suffering from endless floods, which has brought great damage or destruction to agriculture, cities, and people's lives and property along the river. In this study, the rainfall and runoff characteristics of the Yellow River upstream (Tangnaihai and Lanzhou) after the vegetation restoration were analyzed. With the government implementation of ecological restoration policy since 1999, the vegetation cover in this area has been greatly improved and the normalized difference vegetation index (NDVI) shows a fluctuating increase, with the maximum value of 0.323 (in 2010) and the minimum value of 0.289 (in 2008). The trend of rainfall from 1948 to 2019 was increased, with an average increase of 1.747mm per 10 years. Before the implementation of ecological policy (1948 to 1999), the rainfall decreased by an average of 0.953mm per 10 years, and then increased by an average of 16.519mm per 10 years (2000 to 2019). From 1998 to 2017, the runoff increased by 11.13×108m3 per 10 years (Tangnaihai) and 30.517×108 m3 (Lanzhou) per 10 years, which was due to the increase in rainfall. Annual sediment discharge and annual average sediment concentration decreased by 0.002×108t and 0.103 kg/m3 per 10 years in Tangnaihai, 0.081×108t and 0.395kg/m3 per 10 years in Lanzhou respectively. The decreasing intensity of Lanzhou station was greater. The sediment runoff modulus of Tangnaihai and Lanzhou decreased by 1.4875 km2·year and 4.9439 km2·year respectively. The increase of vegetation has a decreasing effect on sediment discharge. The implementation of ecological restoration policy reduces the amount of sediment into the Yellow River and plays an important role in the protection of ecological environment in the Yellow River Basin.

Quantifying the effect of ecological restoration on soil erosion in China's Loess Plateau region: an application of the MMF approach.

Land degradation due to erosion is one of the most serious environmental problems in China. To reduce land degradation, the government has taken a number of conservation and restoration measures, including the Sloping Land Conversion Program (SLCP), which was launched in 1999. A logical question is whether these measures have reduced soil erosion at the regional level. The objective of this article is to answer this question by assessing soil erosion dynamics in the Zuli River basin in the Loess Plateau of China from 1999 to 2006. The MMF (Morgan, Morgan and Finney) model was used to simulate changes in runoff and soil erosion over the period of time during which ecological restoration projects were implemented. Some model variables were derived from remotely sensed images to provide improved land surface representation. With an overall accuracy rate of 0.67, our simulations show that increased ground vegetation cover, especially in forestlands and grasslands, has reduced soil erosion by 38.8% on average from 1999 to 2006. During the same time period, however, the change in rainfall pattern has caused a 13.1% +/- 4.3% increase in soil erosion, resulting in a net 25.7% +/- 8.5% reduction in soil erosion. This suggests that China's various ecological restoration efforts have been effective in reducing soil loss.

Waves on Louisiana Continental Shelf Influenced by Atmospheric Fronts.

Ocean-atmospheric dynamical processes influence the wave characteristics, and sea surface temperature (SST). The processes that affect SST in the ocean area included surface heat fluxes, wind, and precipitation. In this study, we analyzed the wave data in response to the cold front passages over Louisiana continental shelf. The data examined in this research is mainly from WAVCIS (Wave-Current-surge Information System), Coastal Ocean Estuarine Dynamics Lab at Louisiana State University and Global Precipitation Climatology Project (GPCP). With respect to the wave response to the atmospheric forcing, here we consider: (1) the connection between wave variability and atmospheric frontal passages, and (2) the influence on the SST variations during the processes. The occurrences of wind wave, precipitation, and weather processes have distinct regularities. Atmospheric cold fronts have an important influence on wave formation and associated processes over Louisiana continental shelf.

Characterizing the spatial pattern of annual urban growth by using time series Landsat imagery.

Previous studies of urbanization have largely focused on the irreversible urban growth process and the conversion of non-urban lands into impervious surfaces, but less on the conversion from impervious surfaces to green space, also referred to as deurbanization. However, urbanization and deurbanization are both typical urban renewal process, which may happen simultaneously during the urban renewal. In this study, we proposed a new method to retrieve and map annual impervious surface percentage (ISP) and to characterize urban growth patterns using time series medium- resolution images. The method is implemented by employing the Cubist tree model for annual ISP inversion (AoCubist), optimizing multi-temporal Landsat composite images to minimize the impact of phenology and inter-year climate variation, and developing the C5.0 decision tree algorithm with temporal-spatial filtering rules to improve the space-time continuity and separability of patterns derived by unsupervised K-means classification. The method was applied to investigate the urban renewal in Guangzhou, China, between 2000 and 2010. The results demonstrate that the use of ISP slope series can capture the spatial variations and temporal trends of urban growth. Validation by fieldwork and comparing with Google Earth imagery indicates that our classification yielded a reasonable overall accuracy, ranging from 88.32% to 90.85%. Annual urban expansion rate remained between 4% and 10%, while annual deurbanization rate varied from 1% to 5%. In addition, the total pixels of rapid deurbanization surpassed that of rapid urban expansion. This finding suggests that various change directions occurred in the urban renewal process and that deurbanization was a way to counter-balance the rapid urbanization. This study provides a solid methodology for ISP change detection and fresh insight into the characteristics of urban growth in terms of timing, duration, and magnitude.

Age and gender related changes in biomechanical properties of healthy human costal cartilage.

BACKGROUND AND AIMS: For repairing the ear malformation, it is recommended in China to use the over than 10-years-old rib cartilage. However, according to our clinical experience, a better post-operation effect can be found using about the 7-years-old cartilage for the operation. To shape a harvested costal cartilage and to perform it on the transplant site depend on the mechanical properties of the costal cartilage. Hence, the aim of this study is to investigate the age and gender-related biomechanical properties of the human costal cartilage. METHODS: Human costal cartilages were harvested from 25 female and 45 male donors of 5-25 years old after auricular reconstructive surgery. The specimens were divided into six groups: children (5-10 years), adolescent (11-17 years) and adult (18-25 years), respectively, in males and females. Tensile strength, stress-strain relationship, stress relaxation and creep were tested by using a material testing machine. FINDINGS: The biomechanical properties of costal cartilage are donor age and gender related. The children group has the highest tensile strengths (P<0.01) in both male and female groups. The male group relaxed and crept more than that of the female group in all three age groups (P<0.01). INTERPRETATION: These findings provide a further support for the potential age acting on the human costal cartilage. The adolescent has the lowest strength, this could be a reason that compared to using the children costal cartilage, the bigger distortion happened after using the adolescent costal cartilage in the auricular reconstruction operation.

[Biomechanical properties of the costal cartilage and its significance in the timing of ear reconstruction].

OBJECTIVE: To investigate the age-related change in biomechanical properties of the costal cartilage and its relevance to the timing of ear reconstruction with costal cartilage framework. METHODS: The patients of 5 to 25 years old were divided into three groups according to their age. The biomechanical properties of costal cartilage harvested from these patients during ear reconstruction were tested, including stree-strain relationship, stress relaxation and creep, tensile strength. All the results were analyzed statistically. RESULTS: The costal cartilage from children group had the best biomechanical properties, while the costal cartilage from the adolescent group had the worst. The difference had a statistically significance (P < 0.05). CONCLUSIONS: The biomechanical properties of costal cartilage are age-related. So it is recommended that ear reconstruction with costal cartilage framework should be performed in childhood when the costal cartilage has the best biomechanical properties.