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Objective:To investigate the clinical characteristics of pregnant women with leukemia, the condition of leukemia and the influence of clinical treatment on maternal and infant outcomes, and to explore the best clinical management method of leukemia in pregnancy.Methods:Among 79 890 pregnant and lying-in women in Qilu Hospital of Shandong University from January 2004 to December 2015, 22 cases (0.028%) were with leukemia, including 5 cases of leukemia diagnosed before pregnancy [all acute myeloid leukemia (AML)] and 17 cases of leukemia diagnosed for the first time after pregnancy [9 cases of AML, 5 cases of chronic myeloid leukemia (CML), 2 cases of acute lymphoblastic leukemia (ALL), and 1 case of chronic lymphocytic leukemia (CLL)]. According to the gestational weeks of admission and confirmed gestational weeks of leukemia, the 22 patients were divided into early-stage group (initial gestational week < 14 weeks, 5 cases), mid-stage group (newly diagnosed gestational week ≥ 14 weeks and < 28 weeks, 11 cases), and late-stage group (newly diagnosed gestational week ≥ 28 weeks, 6 cases, including 2 cases with previous diagnosis of leukemia). The final pregnancy outcomes included abortion, induced labor, premature delivery, full-term delivery and maternal and infant death. The effects of clinical treatment and obstetric treatment of leukemia on the final maternal and infant outcomes, follow-up to understand the progress of primary disease and fertility of pregnant women, and the impact of leukemia and pregnancy treatment on long-term health status of infants were analyzed.Results:Among 22 patients with leukemia in pregnancy, 14 cases (63.6%) (5 cases in early-stage group and 9 cases in mid-stage group) choosed to give up pregnancy, including 4 cases of early pregnancy abortion and 10 cases of mid pregnancy induced abortion; 12 cases of 14 cases were induced abortion or induced labor after leukemia remission induced by advanced chemotherapy. The remaining 8 patients (2 cases in mid-stage group and 6 cases in late-stage group) continued pregnancy and gave birth to live infants, of which 3 cases received chemotherapy before delivery.Conclusions:Gestational leukemia is a high-risk obstetric case, but it is still expected to achieve good pregnancy outcome under good management and treatment. On the basis of following the principles of leukemia treatment, according to the gestational weeks and patients' wishes, the individualized clinical management plan is formulated, and the accurate chemotherapy timing is conducive to the prognosis of mother and infant.
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OBJECTIVE: To investigate the changes of iron metabolism index in patients with occupational pulmonary thesaurosis induced by dust of iron or iron compounds after ending iron dust exposure for 10 years. METHODS: A total of 22 patients with occupational pulmonary thesaurosis induced by dust of iron or iron compounds were selected as study subjects.They were misdiagnosed as electric welder's pneumoconiosis in 2004-2006. After ending exposure to iron dust for 10 years,high k V X-ray photography and computed tomography of chest were conducted. Indicators of serum iron metabolism,blood routine and blood biochemical were examined. Six patients were randomly selected to detect genes of hereditary hemochromatosis. The study subjects were divided into observation group( 13 patients) and control group( 9 patients)according to the lung examination. RESULTS: The median of serum ferritin( SF) was 858. 2 μg/L. The over standard rate of SF was 77. 3%( 17/22),and the iron overload was seen in 40. 9%( 9/22) of patients. The over standard rate of serum total iron binding capacity( TIBC) was 22. 7%( 5/22). The over standard rate of serum iron was 4. 5%( 1/22).The SF level of observation group was higher than that of the control group( P < 0. 05). The SF was positively correlated with alanine aminotransferase( ALT)( P < 0. 05). The serum TIBC was positively correlated with prealbumin( P <0. 05). The serum iron were positively correlated with ALT and aspartate aminotansferase respectively( P < 0. 05). But the above 3 iron metabolism indices were not correlated with the blood routine indices,blood glucose and C-reactive protein( P > 0. 05). The six patients tested for genes of hereditary hemochromatosis were excluded from disease. CONCLUSION: There were iron metabolism abnormalities in patients with occupational pulmonary thesaurosis induced by dust of iron and iron compounds,which is related to the iron deposition in lung.
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Objective To explore the protective affect of individual earmuffs in microtia reconstruction using tissue expander.Methods 95 patients performed the implantation of tissue expander had been grouped into the experimental group(49 cases)and the control group(46 cases).Patients in the experimental group wore individual earmuffs,whereas patients in the control group wore traditional earmuffs.The survey including the information of patients' experience in wearing the earmuffs was carried out on the day when patients were given auricular reconstruction.Data collected from the two groups were analyzed to evaluate the aspects of permeability and safety.Results Patients in the experimental group complained less discomfort in sultry in permeability and tinnitus than patients in the control group.From the perspective of safety,there was no complaints of mosquitoes climbing into the earmuffs from the two groups.Because of the good adhesiveness of the individual earmuffs to the skin,the incidence of redness of skin in the experimen tal group was significantly lower than that in the control group.Conclusions Individual earmuff is a safe and comfortable nursing appliance which is practical for clinical application because of its good permeability,adhesiveness and less incidence of redness of skin.