Intravenous arsenic trioxide (ATO) has been adopted as the first‐line treatment for acute promyelocytic leukemia (APL). Another arsenic compound named the Realgar‐Indigo naturalis formula (RIF), an oral traditional Chinese medicine containing As4S4, has been shown to be highly effective in treating adult APL. In the treatment of pediatric APL, the safety and efficacy of RIF remains to be confirmed. This randomized, multicenter, and noninferiority trial was conducted to determine whether intravenous ATO can be substituted by oral RIF in the treatment of pediatric APL. From September 2011 to January 2017, among 92 patients who were 16 years old or younger with newly diagnosed PML‐RARa positive APL, 82 met eligible criteria and were randomly assigned to ATO (n = 42) or RIF (n = 40) group. The remaining 10 patients did not fulfilled eligible criteria because five did not accept randomization, four died and one had hemiplegia prior to arsenic randomization due to intracranial hemorrhage or cerebral thrombosis. Induction and consolidation treatment contained ATO or RIF, all‐trans‐retinoic acid and low intensity chemotherapy. End points included event‐free survival (EFS), adverse events and hospital days. After a median 3‐year follow‐up, the estimated 5‐year EFS was 100% in both groups, and adverse events were mild. However, patients in the RIF group had significantly less hospital stay than those in the ATO group. This interim analysis shows that oral RIF is as effective and safe as intravenous ATO for the treatment of pediatric APL, with the advantage of reducing hospital stay. Final trial analysis will reveal mature outcome data.
A quadratic trigonometric B-spline curve analogous to the standard quadratic uniform B-spline curve, with a shape parameter, is presented in this work. The shape of the proposed curve can be adjusted by altering the value of the shape parameter while the control polygon is kept unchanged. With the shape parameter, the quadratic trigonometric B-spline curve can be closer to given polygon than the standard quadratic uniform B-spline curve. The proposed curve can be used to accurately represent the ellipse.
To study the effects of the nonhomogeneous material properties on the stress in an induction quenched crankshaft, the FEM model considering the nonhomogeneous material properties was established to simulate the stress in the crankshaft under the explosion pressure. Results showed that the nonhomogeneous properties almost didn’t vary the Mises stress distribution rule in the crankshaft. The maximum Mises stress, the ratio of the elastic modulus of the surface layer and the matrix followed a linear rule nearly. Moreover, the maximum Mises stress increased with the ratio. Besides, effect of elastic modulus distribution in the transition layer on the maximum stress could be ignored. To simplify the establishment of the FEM model, the elastic modulus could be set to either equal to the surface layer’s or the matrix’s.
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