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Objective: To compare the value of digital breast tomosynthesis (DBT) and flly-field digital mammography (FFDM) in evaluating breast architectural distortion (AD) lesions, and the value of DBT and ultrasound in differentiating benign and malignant breast AD. Methods: DBT, FFDM and ultrasound data of 58 patients with AD lesions detected with DBT were retrospectively analyzed. Taken pathological outcomes as standards, the sensitivity, specificity and accuracy of DBT and FFDM in evaluating breast AD were compared and analyzed. The consistency of results of DBT and ultrasound in differentiating benign and malignant breast AD with pathological results was analyzed. ROC curve of DBT and ultrasound for differentiating benign and malignant breast AD were drawn, and the diagnostic efficacies were compared. Results: All patients underwent FFDM, and 41 of them also underwent ultrasound examination. Among 58 cases of breast AD detected with DBT, only 23 AD were found with FFDM (χ2=33.03, P0.05). Median consistency of DBT and ultrasound results was observed in differentiating benign and malignant breast AD and pathological results (Kappa=0.65, 0.71, both P0.05). Conclusion: The sensitivity and accuracy of DBT in evaluating breast AD are higher than FFDM. DBT is comparable to ultrasound in differentiating benign and malignant breast AD. AD detected with DBT has relatively high malignancy, so it is recommended to conduct timely biopsy for correct diagnosis.
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Objective@#To evaluate the efficacy and prognostic factors in core binding factor (CBF) acute myeloid leukemia (AML) under current therapy modalities, therefore optimizing the treatment strategies.@*Methods@#Standard cytological and immune methods including next generation sequencing (NGS) were used for risk stratification. Complete remission (CR) rate, disease-free survival (DFS) and overall survival (OS) were assessed by multivariate Logistic and Cox regression models in a total of 206 adults (aged 16-65 years) with CBF-AML, including 152 AML patients with t(8;21) and 54 with inv(16).@*Results@#The CR rate of inv(16) patients after first course was 54/54(100%), significantly higher than that of t(8;21) patients [127/147(86.4%), P=0.005]. The fusion transcript level and KIT mutation were independent factors related to CR rate in t(8;21) patients (P=0.044 and 0.027; respectively). DFS and OS in inv(16) patients tended to be more superior than that in t(8;21) patients (P=0.066 for DFS; P=0.306 for OS; respectively). Multivariate Cox identified negative expression of CD19 and female gender the independent predictors of inferior DFS in t(8;21) patients (P=0.000 for CD19; P=0.006 for sex; respectively). Analysis of combining CD19 with gender indicated that females/CD19-subpopulation had significantly poor DFS than did males/CD19+ ones (Bonferroni-P<0.000 01). The number of mutations in each patient, FLT3-ITD and additional karyotype abnormalities did not affect CR rate and DFS (all P>0.05).@*Conclusions@#Patients with inv(16) have better induction response than those with t(8;21). High level of fusion transcripts and positive KIT mutation are associated with low CR rate in t(8;21) patients. Negative CD19 expression and female gender are independent predictors of inferior DFS in t(8;21) patients.
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Objective To observe the rate of iris vessels exposure and analyze its relevant factors in normal full-term neonates.Methods A retrospective study.1855 normal full term neonates,including 947 boys and 908 girls,were enrolled.The mean gestational age (GA) was (38.84±1.10) weeks and mean birth weight (BW) was (3 396.52±402.08) g.There were 1235 neonates from normal term vaginal delivery,402 cases of cesarean delivery and 218 cases of forceps delivery.All neonates were examined with hand-held portable slit lamp biomicroscopy within 1 to 3 days after birth by two trained ophthalmologist respectively.Iris vessels exposure was defined as radial red blood vessels along iris fibers.Infants were divided into iris vessels exposure group and iris vessels unexposed group according to the findings of slit lamp biomicroscopy.78 infants with iris vessels exposure were followed up for 42 days after birth till the iris vessels can't be seen under microscope.The differences between the two groups were compared for gender,mode of delivery (MOD),GA,BW and body length (BL).Multiple logistic regressions were used to determine the factors related to iris vessels exposure.Results There were 298 neonates with iris vessels exposure among 1855 neonates and the rate was 16.1％.1557 neonates (83.9％) had unexposed iris vessels.There were no different in gender (x2=0.551) and MOD (x2=3.036) between iris vessels exposure group and unexposed group (P＞0.05),while the differences in GA (x2=47.216),BW (t=4.603) and BL (t=3.936) between the two groups were statistically significant (P=0.000).Multiple logistic regression analysis revealed that only GA (β=-0.291,odds ratio=0.747,95％ confidence interval:0.656-0.85 1,P=0.000) was correlated to iris vessels exposure significantly.The iris vessels couldn't be seen in 77 of 78 infants with iris vessels exposure when followed up to 42 days.Conclusions The iris vessels exposure in normal full-term neonates is frequently observed.There is a significant inverse correlation between GA and iris vessels exposure.