Siblings Research Articles

SAT-086 Pituitary Volume as a Diagnostic Measure for Determining the Etiology of Short Stature in Children: Receiver Operating Characteristic Curve Analysis and Cutoff Values

Background: It is speculated that pituitary volume (PV) is a marker of chronic growth hormone (GH) secretion. In previous studies, we determined that children with GH deficiency (GHD) and idiopathic short stature (ISS) had significantly smaller PVs than normal controls (NCs). Cutoff values for small PVs are needed to improve the clinical utility of PV in determining children who qualify for GH therapy.Objective: To define the cutoff between pathologic and nonpathologic PV in prepubertal and pubertal children with short stature (SS). Patients and Methods: The SS group was selected from the database of a pediatric endocrinology center, which was queried for siblings (SBs) aged 6–18 yrs who underwent a GH stimulation test and MRI between 2013–2019. All 77 SBs had SS, defined as 2 SDs below mean height for age, subnormal growth velocity for at least 6 months, or predicted height at least 2 inches discrepant from midparental height. The NC group was selected from the database of a neuroradiology center; these NCs consisted of 170 randomly selected subjects aged 6–18 yrs. Patients with MRI abnormalities were excluded. PVs were calculated using the ellipsoid formula (LxWxH/2). ROC curve analysis was utilized to generate cutoff values. The diagnosis of short stature was the dependent variable and PV was the independent variable. The PV with the highest Youden index was selected as the definitive cutoff for a small PV. Results: The mean (MN) and median (MD) age of SBs was 11.6 ±2.2 and 11.9 yrs, respectively, and the MN and MD age of the NCs was 12.6 ±3.4 and 13.2 yrs, respectively. The MN and MD age of prepubertal SBs (n=29) and NCs (n=58) were 9.3 ±1.2 and 9.7, and 8.6 ±1.4 and 8.6 yrs, respectively. The MN and MD age of pubertal SBs (n=48) and NCs (n=112) were 13.0 ±1.4 and 12.7, and 14.7 ±1.9 and 14.6 yrs, respectively. The difference in MN age between SBs and NCs was significant (p<0.05). For prepubertal subjects, sensitivity was 86.21% and specificity was 68.97%. The distance to corner was 0.3396, and the highest Youden index was 0.5517, corresponding to a PV of 215.02 mm3. The Area Under the Curve (AUC) was 0.8395 with a standard error of 0.0426 (p<0.001). For pubertal subjects, sensitivity was 81.25% and specificity was 79.46%. The distance to corner was 0.2781, and the highest Youden index was 0.6071, corresponding to a PV of 315.0 mm3. The AUC was 0.8460 with a standard error of 0.0337 (p<0.001). Conclusion: To our knowledge, we present the first study on the sensitivity and specificity of PV in determining the etiology of SS. Our data suggest that prepubertal patients with a PV<215.02 mm3 and pubertal patients with a PV<315.00 mm3 have small pituitary glands. Statistically calculated cutoffs are necessary to accurately diagnose pituitary hypoplasia and should be utilized to determine the etiology of SS. Future studies should include children with Tanner staging and height SDs to generate more accurate PV cutoffs.

Cases of two siblings diagnosed as chorea-acanthocytosis

Cases of two siblings diagnosed as chorea-acanthocytosis

Network failures: When incentives trigger impulsive responses.

Adequate control of impulsive urges to act is demanded in everyday life but is impaired in neuropsychiatric conditions such as stimulant use disorder. Despite intensive research it remains unclear whether failures in impulse control are caused by impaired suppression of behavior or by the over invigoration of behavior by stimuli associated with salient incentives such as drugs, food, and money. We investigated failures in impulse control using functional magnetic resonance imaging (fMRI) to map the neural correlates of premature (impulsive) responses during the anticipation phase of the Monetary Incentive Delay (MID) task in healthy controls (HC), stimulant‐dependent individuals (SDIs), and their unaffected first‐degree siblings (SIB). We combined task‐based fMRI analyses with dynamic causal modeling to show that failures of impulse control were associated with interactions between cingulo‐opercular and dorsal striatal networks regardless of group status and incentive type. We further report that group‐specific incentive salience plays a critical role in modulating impulsivity in SDIs since drug‐related incentives specifically increased premature responding and shifted task modulation away from the dorsal striatal network to the cingulo‐opercular network. Our findings thus indicate that impulsive actions are elicited by salient personally‐relevant incentive stimuli and those such slips of action recruit a distinct fronto‐striatal network.

First detection of the hemizygote frameshift variant of the DMD gene in a 13-year-old patient affected by dystrophinopathy (Duchenne DMD and Becker BMD) at Saint Camille Hospital of Ouagadougou, Burkina Faso: Case report

Genetic diseases are poorly reported in sub-Saharan Africa, especially in Burkina Faso. The reasons for this reality are multifactorial including, the difficulty of diagnostic confirmation, financial accessibility and even the difficulty with referral of cases by medical staff. Genetic diseases, although relatively rare, exist in families and deserve special attention in our paraclinical assessments. Few cases can be diagnosed in sub-Saharan Africa. The clinical case we are reporting here is a dystrophynopathy by mutation of the Duchenne muscular dystrophy (DMD) gene. This is the first confirmed detection of a frameshift mutation in the DMD gene in a boy received at Saint Camille Hospital in Ouagadougou, Burkina Faso. This is a 13-year-old MR boy, from a family of four siblings, all male, from the eastern region of Burkina Faso. The boy had a clinical picture of myopathy with difficulty in walking, frequent falls, myogenic syndrome with stool sign, Gowers sign and scapula alata, all leading to a suspicion of dystrophinopathy with a request for genetic analysis. The DMD gene responsible for the disease is located on the X chromosome (Xp21.2-p21.1). The study of the dystrophin gene (DMD) was done using three methods, namely MLPA, high throughput sequencing and Sanger sequencing. The results led to the identification of a frameshift mutation of exon 71 in the DMD gene: it is a hemizygotic variant with ribosomal shift of the DMD gene NM_004006.2 (DMD): c.10258del p.(Ser3420Leufs*25). This clinical case led for the first time in Burkina Faso to the confirmed diagnosis of hereditary muscular dystrophy resulting from a mutation with a frameshift in exon 71 of the DMD gene in the hemizygotic state in a 13-year-old boy, a student and the eldest sibling of 4 boys, three of whom have myopathy. Key words: Mutation, Duchenne muscular dystrophy (DMD) gene, dystrophinopathy, duchenne versus becker, case report.

A rare case of immune hydrops in an “Elevated D” pregnancy

The D-/-phenotype is a rare variant of the Rh system, in which red blood cells express only D antigen. Sensitized D-/-women carry a risk of hemolytic disease of fetus and newborn (HDFN) and pose a challenge in management due to nonavailability of antigen negative blood for intra-uterine/exchange-transfusion. A 23y old G2P1L1A0, blood group “A” Rh D+C-c-E-e- presented at 20 weeks' period of gestation (POG) with a positive indirect antiglobulin test. Cordocentesis at 23 weeks' POG revealed fetal's blood group as “B” Rh D+, Direct Coombs Test 4+, Hemoglobin 2.8 g/dL. USG with MCA-PSV indicated rapid development of fetal anemia and hydrops. Patient's sibling had D-/-phenotype, but was ABO-incompatible with the fetus. Rapidity of progression of case resulted in intrauterine fetal demise at 27 weeks' POG. HDFN, in rare blood groups, leads to problems in arranging compatible units in developing countries due to lack of centralized rare donor registries.

Elimination of Acute GvHD with Three Doses of Abatacept Prophylaxis Combined with Post-Transplant Cyclophosphamide after Myeloablative Treosulfan-Based Conditioning in the HLA Identical Sibling and Unrelated (10-12/12) Peripheral Blood Stem Cell Donor Setting: Improved Safety and Efficacy Compared to Alemtuzumab Prophylaxis

Background. Acute graft versus host disease (GvHD) remains a major cause of treatment failure post allogeneic stem cell transplantation (HSCT). CD28-CD80/CD86 axis T cell co-stimulation blockade with CTLA4-Ig using abatacept (AB) is an emerging acute GvHD prophylaxis strategy1. After myeloablative conditioning (MAC), together with methotrexate and calcineurin inhibition, four doses of AB commencing day (d)-1 is being investigated in the unrelated HLA 7/8 and 8/8 mismatched/matched donor settings, mostly in children2. It is unknown if AB can be de-escalated in adults to three doses for HLA matched sibling (SIB) or unrelated 10-12/12 donors (MUD), or combined with post-transplant cyclophosphamide (PT-CY) GvHD prophylaxis3, or combined with treosulfan (TREO)-based MAC4, which are other emerging transplant strategies. We investigated the safety and efficacy of this combination, and compared outcomes to a standard anti-CD52 directed IgG1 alemtuzumab (CH) prophylaxis regimen5 in a reduced intensity conditioning (RIC). Methods. We report a single centre consecutive cohort study using peripheral blood stem cells from SIB or HLA 10-12/12 MUDs, for HSCT in adults with blood cancer indications (intuitional registration: 1920-31). One group received AB GvHD prophylaxis while the other group received CH. During 2018-2019, the AB cohort received MAC with IV fludarabine 150 mg/m2, IV TREO 42 mg/m2, and 2 Gy total body irradiation (TBI). GvHD prophylaxis comprised three doses of IV AB 10 mg/kg on d+5, +14, and +28. This was combined with IV PT-CY 50 mg/kg on d+3 and +4, IV tacrolimus 0.03 mg/kg/d infusion from d+5, and IV mycophenolate mofetil 15 mg/kg tds from d+53. The MAC AB cohort was compared to a RIC CH cohort, chosen to be biased against AB. During 2017-2018 the CH cohort received RIC with IV fludarabine 150 mg/m2and IV melphalan 140 mg/m2. GvHD prophylaxis comprised IV CH 10 mg on d-7 to d-3, and IV ciclosporin 1.5 mg/kg bd from d-1. The primary outcome measure was the incidence of acute GvHD6 at d100 and 180 post HSCT. Secondary outcomes measures were the incidence of graft failure, mixed donor chimerism, donor lymphocyte infusion (DLI), CMV reactivation, relapse, overall survival, at d100 and 180. The AB and CH cohorts were indirectly compared. Results. A total of 39 patients were included in this study, with 15 consecutive patients in the AB group (Table). The AB group had a median Karnofsky score of 70% and HCT-CI of 6; significant comorbidity greater than other reports1,2. The major cancer indications were acute leukaemia and myelodysplastic syndrome (MDS). The AB and CH groups were largely balanced. There were no AB related infusion reactions. As expected for MAC, the AB group had a numerically but not clinically significantly slower time to engraftment relative to the RIC CH group. There was no AB group graft failure. Remarkably, the AB group did not experience acute GvHD compared to the CH group by d100 (P=0.03) and d180 (P&lt;0.01). In contrast, by d100, 29% in the CH group experienced acute GvHD after a median of 59 days post HSCT. No AB group patients experienced mixed donor chimerism (P&lt;0.01), nor required a DLI (P&lt;0.01) compared to the CH group, where all had &lt;99% T cell or whole blood values at d100. Consequently, 45% of the CH cohort without acute GvHD were treated with DLI, with all patients experiencing acute GvHD at a median of 39 days post DLI (Table). Other secondary outcomes were similar. The AB group experienced a CMV reactivation rate of 67% in IgG seropositive patients. Unfortunately, 93% of CMV IgG positive patients in the CH group experienced CMV reactivation. No relapses were observed by d180 in the AB group, whereas in the CH group, 8% of patients experienced relapse. Mortality at d180 was 20% in the MAC AB group, and 21% in the RIC CH group. Conclusions. Acute GvHD prophylaxis with only three doses of AB and PT-CY post TREO-based MAC appears to be safe and efficacious in the SIB and MUD settings, in a highly co-morbid adult blood cancer population. This AB approach seems favourable compared to CH despite RIC, where acute GvHD without DLI or post DLI remains significant. A prospective multicentre clinical trial with AB in this setting seems warranted to confirm these remarkable findings of patient benefit. References. 1. Biol Blood Marrow Transplant (BBMT) 2013;19:1638-49. 2. NCT01743131. 3. Lancet Haematol 2019;6:e132-43. 4. Cancer 2017;123:2671‐79. 5. BBMT 2017;23:805-12. 6. BBMT 2016;22:4-10. Table Disclosures No relevant conflicts of interest to declare. OffLabel Disclosure: Abatacept, alemtuzumab, cyclophosphamide all the for the indication of graft versus host disease (GvHD) prophylaxis.

ACUTE GRAFT Versus Host Disease 1990-2017: Reduced Incidence and Predictive Factors

Alessandra Di Francesco1 , Anna Maria Raiola2 , Alida Dominietto2 , Carmen Di Grazia2, Francesca Gualandi2, Maria Teresa Van Lint2, Patrizia Chiusolo1, 3, Luca Laurenti1, 3, Federica Sora'1, 3, Sabrina Giammarco1 , Elisabetta Metafuni1 , Emanuele Angelucci2 , and Andrea Bacigalupo ,3 1Istituto di Ematologia, Fondazione Policlinico Universitario A Gemelli IRCCS, Roma Italy 2IRCCS Policlinico San Martino, Genova, Italy 3Universita' Cattolica del Sacro Cuore, Roma, Italy; Background: Acute Graft versus Host Disease (GvHD) is a major complication of allogeneic HSCT, and prophylaxis has significantly changed in time . Aim of th study: we wanted to determine the cumulative incidence of GvHD and its outcome, in 3 periods :&lt;2000; 2000-2010; &gt;2010, together with predicting factors. Methods: we analyzed 3126 patients allografted in 2 transplant Centers between 1976 and 2018. Median age increased over the 3 periods from 32 (1-66) to 42 years (9-71) to 50 years (range13-74) (&lt;0.00001). Results GvHD timing : The median day of onset of GvHD before year 2000 was day +14 (2-90), between 2001 and 2010 it was day +19 (2-98) and beyond year 2010 it was day +33 (2-98) (p&lt;0.0001). There were 237 patients developing GvHD before day 14 before year 2000, 71 patients between 2001 and 2010 and only 8 patients beyond 2010 (p&lt;0-0001). GvHD cumulative incidence. The cumulative incidence (CI) of GvHD grade II-IV was 47% before 2000, 24% between 2000 and 2010, and 16% after 2010 (p&lt;0.00001). The CI of GvHD grade III-IV was 13%, 5%, 4% respectively in the three periods (p&lt;0.001). Survival at 5 years of patients with GvHD grade II has remained unchanged in the 3 periods (52%, 44%, 55%, respectively , p=0.2); survival of patients with GvHD grade III-IV has improved from 15%, to 30% and 23% respectively (p=0.003). GvHD and donor type. The incidence of GvHD grade II-IV in HLA identical siblings (SIBS) was 25%, 19% and 14% in the 3 periods (p=0.0005), and for alternative donors, these figures were 43%, 34%, 21% (p&lt;0.00001). Transplant related mortality (TRM). The CI of TRM for patients with grade II GvHD has not changed significantly (27%, 25%, 20%, p=0.1) whereas TRM for patients with GvHD grade III-IV has been reduced from 70% (&lt;2000) to 49% (2001-2010) to 26% beyond year 2010 (p=0.002). Multivariate analysis on survival for patients with grade II GvHD . Significant predictors of survival, for patients with GvHD grade II, were the day of onset of acute GvHD (&lt;/&gt;day 14), advanced phase of the disease, transplant year before year 2000, patients age over 60, and a donor other than an HLA identical sibling. When adding together these negative predictors , the 5 year survival was 28% for patients with 3-5 negative predictors, as compared to 56% for patients with 0-2 negative predictors Conclusions. We show a very significant reduction of the CI of GvHD with time, together with a very significant delay of the onset of the disease. TRM has been reduced in patients with grade III-IV GvHD, less so in patients with GvHD grade II. In the latter significant clinical predictors may allow the identification of patients at high risk, eligible for treatment protocols. Disclosures No relevant conflicts of interest to declare.

Distribution and similarity of allergens in children in the same family

Objective To investigate and analyze the similarities of allergens in children of the same family with susceptibility to the same genetic background and environmental factors. Methods From January 2013 to December 2017, a total of 142 pairs of children with allergic diseases aged 0-15 years and their siblings (284 cases) were collected from the outpatient or hospitalized treatment of Pediatrics and otolaryngology department of the First People′s Hospital of Foshan City, the Third Affiliated Hospital of Sun Yat-sen University.The elder group was brother or sister (142 cases), and the younger group was brother or sister (142 cases). The serum allergen sIgE was tested by Allergy Screen allergen detection system (developed by Germany MEDIWISS Company) and the similarity of allergens was analyzed. Results A total of 142 siblings (284 cases) had systemic symptoms of allergic diseases in varying degrees, including respiratory symptoms (cough (47 cases in the old group, 32 cases in the young group), χ2=3.946, P=0.047), nasal obstruction (41 cases in the old group, 19 cases in the young group, χ2=10.227, P=0.001), runny nose (46 cases in the old group, 26 cases in the young group, χ2=7.442, P=0.006), gastrointestinal symptoms (abdominal pain (11cases in the old group, 7 cases in the young group, χ2=4.63, P=0.031), skin symptoms(urticaria (18 cases in the old group, 8 cases in the young group, χ2=4.234, P=0.037)) and so on, the difference was statistically significant.Some children have multiple organ system symptoms at the same time.There was no significant difference between the old group and the young group in the early use of antibiotics, mode of production and feeding mode within 6 months (all P>0.05). Among the two groups, house dust mite and cockroach (r=0.831, P<0.05), dog hair and house dust (r=0.717, P<0.05), cypress, elm, willow, birch, oak, maple, walnut, sycamore, poplar and Dianqing, branching, yanqu, and heiqu (r=0.683, P<0.05). Conclusion With the same genetic background and the same environmental factors, the allergens in siblings are similar. Key words: Siblings; Allergen; Similarity

Multivariate classification of schizophrenia and its familial risk based on load-dependent attentional control brain functional connectivity.

Patients with schizophrenia (SCZ), as well as their unaffected siblings (SIB), show functional connectivity (FC) alterations during performance of tasks involving attention. As compared with SCZ, these alterations are present in SIB to a lesser extent and are more pronounced during high cognitive demand, thus possibly representing one of the pathways in which familial risk is translated into the SCZ phenotype. Our aim is to measure the separability of SCZ and SIB from healthy controls (HC) using attentional control-dependent FC patterns, and to test to which extent these patterns span a continuum of neurofunctional alterations between HC and SCZ. 65 SCZ with 65 age and gender-matched HC and 39 SIB with 39 matched HC underwent the Variable Attentional Control (VAC) task. Load-dependent connectivity matrices were generated according to correct responses in each VAC load. Classification performances of high, intermediate and low VAC load FC on HC-SCZ and HC-SIB cohorts were tested through machine learning techniques within a repeated nested cross-validation framework. HC-SCZ classification models were applied to the HC-SIB cohort, and vice-versa. A high load-related decreased FC pattern discriminated between HC and SCZ with 66.9% accuracy and with 57.7% accuracy between HC and SIB. A high load-related increased FC network separated SIB from HC (69.6% accuracy), but not SCZ from HC (48.5% accuracy). Our findings revealed signatures of attentional FC abnormalities shared by SCZ and SIB individuals. We also found evidence for potential, SIB-specific FC signature, which may point to compensatory neurofunctional mechanisms in persons at familial risk for schizophrenia.

Advances in allogeneic hematopoietic stem cell transplantation in treatment of acquired severe aplastic anemia

Acquired severe aplastic anemia (SAA) is a life-threatening bone marrow failure syndrome. Immunosuppressive therapy (IST) and allogeneic hematopoietic stem cell transplantation (allo-HSCT) are the main treatments for acquired SAA. Matched sibling donor (MSD)-hematopoietic stem cell transplantation (HSCT) is the best treatment for acquired SAA patients who are younger than 40 years old. Outcomes of unrelated donor (URD)-HSCT, haploidentical hematopoietic stem cell transplantation (haplo-HSCT) and umbilical cord blood transplantation (UCBT) have improved in the recent decade, and provide more options with respect to the clinical treatment of acquired SAA. In order to improve clinicians′ understanding of allo-HSCT for acquired SAA, this article reviews the research progress of acquired SAA treated by allo-HSCT in recent years. Key words: Anemia, aplastic; Hematopoietic stem cell transplantation; Donor selection; Transplantation conditioning; Graft vs host disease; Transplantation, haploidentical; Cord blood stem cell transplantation

Number of Siblings in Childhood, Social Outcomes in Adulthood:

In many parts of the world, fertility has declined in important ways in the past century. What are the consequences of this demographic change? Our study expands the empirical basis for understandi...

The Value of Family Screening After Sudden Cardiac Death in a Child

The sudden death of a child is traumatic for all and often leads to screening of siblings and even cousins for underlying cardiac disease. In fact,

Women Protection and Decision of Customary Justice on The Ride of Cross Action (Women Protection Based On Law And Customary Justice In Atambua)

Rape can be occured in all women from all side of life, occupations, age, and marital status, which was done alone or abuzz. The perpetrators of violence also come from various circles, work, age, social class and marital status. In this case, the number of women violence against in Atambua is quite high. Sexual abuse cases and sexual harassment turned out most of the perpetrators are still related to blood with victims, such as biological father, siblings, uncle and neighbors. The cases of sexual assault against women in Atambua are resolved in customary. However, any form of resolution, the act of violence of rape against viewed from various aspects still must be responded as a criminal act, for example the custom settlement of tallitan tafani still apply penal sanction in the form of penalty as one of the effort of restoration of good name, and also dignity for the victim.

Exploring trauma and attachment style over the lifespan using secondary data: A single case study of two sisters

Le interviste sul ciclo di vita forniscono ricche informazioni contestuali sul trauma infantile e adulto e sui rischi di disturbi clinici. Le interviste a sorelle possono dare informazioni sulla concordanza e sulle differenze individuali in relazione a un’esperienza. Esaminare i report di sorelle riguardanti le loro esperienze infan-tili comuni e le differenti esperienze durante l’eta adulta puo essere illuminante. Due sorelle selezionate per uno studio su esperienze infantili avverse, stile di attaccamento e depressione, sono state utilizzate per illustrare le esperienze chiave dell’area di indagine in questione. Prese da un campione di donne londinesi, le sorelle adulte cresciute in una famiglia di 13 bambini in Irlanda, riportano una comune trascuratezza emotiva. Una delle due sorelle riporta di aver vis-suto inversione di ruolo, dato dall’aspettativa che lei educasse la sorella minore; l’altra sorella riporta abuso fisico da parte di un fratello. Entrambe le sorelle esperiscono in eta adulta uno stile di attaccamento insicuro, una di loro declinato in uno stile ansioso-spaventante e l’altra declinato in uno stile evitante-ritirato. Entrambe presentano depressione clinica con Disturbo d’Ansia Generalizzato (GAD). Le interpretazioni combinano sia uno stile socio-ecologico (problemi relativi allo stato di deprivazione infantile e all’immigrazione) sia fattori relativi allo stile di attaccamento conseguente alle avversita infantili con implicazioni nell’adattamento in eta adulta.

Familial graves’ disease in a mother and two daughters

Familial Graves’ disease in a mother and two daughtersGraves’ disease is characterized by primary hyperthyroidism, diffuse goitre, and possibly exophthalmos and pretibial myxedema along with autoantibodies. Familial Graves’ disease has been infrequently described in the literature and is underreported in the nation. This report describes an instance of familial Graves’ disease in a mother and two siblings, as well as their findings and treatment using Nuclear medicine techniques. Keywords: Thyrotoxicosis, hyperthyroidism, Graves’ disease, thyroid hormones, Nuclear Medicine

Efficacy analysis of haploidentical allogeneic hematopoietic stem cell transplantation combined with third-party umbilical cord blood infusion in treatment of high-risk lymphoblastic malignancies

Objective To evaluate the efficacy of haploidentical allogeneic hematopoietic stem cell transplantation (Haplo-HSCT) combined with third-party umbilical cord blood (UCB) infusion in treatment of high-risk lymphoblastic malignancies. Methods The clinical data of 20 patients with high-risk lymphoblastic malignancies who received Haplo-HSCT from April 2012 to April 2015 in Shanghai General Hospital were retrospectively analyzed, which were compared with the data from 15 patients who underwent matched unrelated donor HSCT (MUD-HSCT) or 14 matched sibling donor HSCT (MSD-HSCT) during the same period. The efficacy of Haplo-HSCT combined with UCB infusion in treatment of high-risk lymphoblastic malignancies was evaluated. The preparative regimen mainly consisted of teniposide, cyclophosphamide and total body irradiation (TBI). Graft versus host disease (GVHD) preparative regimen included cyclosporine and a short term of methotrexate. The patients who received Haplo-HSCT combined with UCB infusion and MUD-HSCT were treated with antithymocyte globulin (ATG). Results After the transplantation, one patient in MUD-HSCT group and one in MSD-HSCT group died within 21 days, and other patients were engrafted successfully. The median time of neutrophil engraftment was 13 days (10-18 d), 12 days (9-16 d) and 12 days (9-14 d) in Haplo-HSCT + UCB group, MUD-HSCT group and MSD-HSCT group, respectively; the median time of platelets engraftment was 11 days (9-18 d), 12 days (10-23 d) and 12 days (9-14 d), respectively. There were 10, 3, 3 cases of grade Ⅱ-Ⅳ acute GVHD at day 100 in the three groups, respectively, and there were 6, 4, 3 cases of chronic GVHD in the three groups, respectively. The 2-year cumulative incidence of relapse was 40.6%, 66.2% and 26.7%, respectively. The predicted 2-year overall survival rate was 37.9%, 42.9% and 55.4%, respectively. All these data had no significant difference (all P > 0.05). Conclusion The efficacy of Haplo-HSCT combined with UCB infusion is similar to that of MUD-HSCT or MSD-HSCT in treatment of high-risk lymphoblastic malignancies, which should be recommended to the patients with high-risk lymphoblastic malignancies and without matched donors. Key words: Lymphoblastic malignancies; Allogeneic hematopoietic stem cell transplantation; Fetal blood

The Morality of Being Human in Family Relationships Expressed by Vietnamese Proverbs and Folk Songs

Family relationships are the foundation and sacredness of everyone. In this relationship, the question is what should people do to comply with morality? We could receive a wide range of replies for this question and the reason for this is everyone, nation and age has different concepts. In this article, the author studies morality of being human in family relationship expressed by Vietnamese proverbs and folk songs: the relationship between parents and children, between husband and wife as well as siblings to help the readers comprehend the value of traditional morality of being human notion and apply to behavior in family relationships nowadays.

Watch an ant rip apart a spiderweb to rescue a sibling

Watch an ant rip apart a spiderweb to rescue a sibling

Improving communication between parents and siblings

Improving communication between parents and siblings

Socio-Demographic and Environmental Factors in Children with Asthma: A Cross-Sectional Study from Southwestern Iran

Background: Most children with asthma start to have symptoms in early life; socio-demographic and environmental factors can play an important role in the development and clinical expression of asthma. Objectives: The aim of this study was to determine risk factors in children with asthma from southwestern Iran. Methods: This cross-sectional study included children with asthma, aged five to 15 years, who frequently referred to the allergy outpatient clinics affiliated to Shiraz University of Medical Sciences during year 2016. Information about the participants’ demographic characteristics and social and environmental factors was collected using a questionnaire during year 2016. Results: A total of 737 children (494 males and 243 females) with asthma with mean age of 8.1 ± 2.7 years were recruited. Various factors, including male gender, low birth weight, being the first child, low number of siblings, no vaccination against influenza, adenoidectomy, and young age of mother were found to be associated with an increased risk of asthma during childhood. About 50% of children ate little fish and drank too much cola in a week. Conclusions: The current study showed that influenza vaccination and consumption of fish should be encouraged; also, the rate of adenoidectomy was high in asthmatic patients. The results of this study can help plan strategies for preventing asthma.