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Although bone destruction and hypercalcemia without acute peripheral blast BCR-ABL-positive acute lymphoblastic leukemia (ALL) have been reported in children, they are rare in adults. Herein, we describe a case of BCR-ABL positive ALL with a triploid karyotype, WT1, and CDKN2A mutations with hypercalcemia and bone destruction as the first manifestations. Complete remission (CR) was achieved by induction chemotherapy. BCR-ABL turned negative after treatment with dasatinib. However, computed tomography and whole-body bone scan showed extensive bone destruction. Additionally, bone biopsy showed leukemic infiltration. After treatment with dasatinib and VMCP, leukemia recurred with positive BCR-ABL. The T315I mutation occurred. The patient was surgically diagnosed with calculous cholecystitis and achieved CR2 by postoperative orebatinib and VP regimens. Later, the patient died due to a severe pulmonary infection. BCR-ABL-positive ALL with bone destruction is rare and difficult to control using tyrosine kinase inhibitor chemotherapy alone. Therefore, further exploration of more effective treatments is needed.
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Objective To observe the effect of transcranial direct current stimulation (tDCS) with mirror neuronal rehabilitation training system (MNST-V1.0) in post-traumatic unconscious patients after severe craniocerebral injury. Methods A prospective, self controlled and open-label method was used. Thirty-six post-traumatic unconscious patients with severe craniocerebral injury from January 2016 to July 2017 were selected. Four cases of the patients did not complete the treatment and the last 32 cases completed the study. All patients were given routine wake-up therapy, and tDCS combined with MNST-V1.0 (20 min/time, 1 time/d, 6 times/week, a total of 8 weeks) was given at the same time. The Glasgow coma scale (GCS), JFK coma recovery scale and Four coma rating scale before treatment and 2, 4, 8 weeks after treatment were recorded. Results The scores of open reaction, language and motor response score of GCS 2, 4, 8 weeks after treatment were significantly higher than those before treatment:(1.56 ± 0.82), (2.06 ± 1.01) and (3.11 ± 1.45) scores vs. (1.00 ± 0.45) scores, (2.23 ± 1.06), (2.56 ± 1.08) and (3.02 ± 1.04) scores vs. (1.00 ± 0.61) scores, (2.79 ± 1.12), (3.22 ± 1.33) and (4.44 ± 1.07) scores vs. (1.00 ± 0.54) scores, and there were statistical differences (P ＜ 0.01 or ＜0.05). The scores of hearing, vision, movement, speech response, communication and arousal of JFK coma recovery scale 2, 4, 8 weeks after treatment were significantly higher than those before treatment, and there were statistical differences (P＜0.01). The scores of open reaction, sport reaction, brainstem response of Four coma rating scale 2, 4, 8 weeks after treatment were significantly higher than those before treatment, and there were statistical differences (P＜0.05); there was no statistical difference in respiratory score of Four coma rating scale before and after treatment (P＞0.05). Conclusions The tDCS combined with MNST-V1.0 can improve the consciousness level in post-traumatic unconscious patients with severe craniocerebral injury, and have the effect of promoting awakening.
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Objective To explore the relationship between the rs1611115 and rs739398 polymorphism of dopamine-β-hydroxy-lase genes and violent behavior in adolescents .Methods Adolescent male offenders were divided into violent group (107 samples) and nonviolent group (107 samples) .Besides ,107 male adolescents in vocational school were served as normal controls .The rs1611115 and rs739398 polymorphisms of DβH gene were measured by used SNaPshot SNP technology in 321 samples .Chi-square test was used to compare the distribution difference between three groups of each gene type and the allele frequency distribution . Results There was statistically significant difference among violent group ,nonviolent group and normal control group in the geno-type and allele frequencies of DβH gene rs1611115 polymorphism(P0 .05) .There was no statistically significant difference among violent group ,nonvio-lent group and normal control group in the genotype and allele frequencies of rs739398 polymorphism(P>0 .05) .Conclusion No association was found between the rs739398 polymorphism of DβH gene and adolescents with violent behavior .But the rs1611115 polymorphism of DβH gene was related to adolescent criminals with violent and nonviolent behavior .
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Objective To explore the relationship between the rs3785143 polymorphism of norepinephrine transporter gene,and investigate the influence of interaction effect between NET gene polymorphism and childhood abuse in adolescents with violent behavior.Methods Adolescent male offenders were divided into violent group (124 samples) and nonviolent group (120 samples).The rs3785143 polymorphisms of NET gene were measured by used SNaPshot SNP technology in 244 samples.Chi-square test was used to compare the distribution difference between three groups of each gene type and the allele frequency distribution.Results ①There was no statistically significant difference among violent group and nonviolent group in the genotype and allele frequencies of rs3785143 polymorphism (x2=0.753,0.022; all P＞0.05).②64.5％ violent adolescents have experience of childhood abuse,and 35.5％ had no history of abuse ;48.3％ nonviolent adolescents have experience of childhood abuse,and 51.7％ had no history of abuse(x2=6.50,P＜0.05).③There was not significant interaction between NET gene polymorphism and childhood abuse((OR=0.386,P＞0.05) 95％ CI (0.457-4.739)).Conclusions The NET gene polymorphism is not associated with violent behavior in male adolescents,and there was not interaction between NET gene polymorphism and childhood abuse.
