ABSTRACT
OBJECTIVE@#To summarize the clinical and laboratory characteristics of patients with acute myeloid leukemia (AML) with inv(16)/t(16;16) (p13.1;q22), and to analyze the risk factors affecting the prognosis of the patients.@*METHODS@#AML patients with inv(16)/t(16;16) (p13.1;q22) and/or CBFβ-MYH11+ admitted to the Department of Hematology, The First Affiliated Hospital of Soochow University from January 1, 2008 to October 30, 2019 were retrospective analyzed, the clinical and laboratory indicators, as well as treatment plans and efficacy evaluations of the patients were all recorded. Furthermore, related factors affecting the overall survival (OS) and event-free survival (EFS) of the patients were analyzed.@*RESULTS@#Among 151 AML patients with inv(16)/t(16;16) (p13.1;q22) and/or CBFβ-MYH11+, the percentage of additional chromosomal abnormalities was about 27.8%, and the most common additional chromosomal abnormality was +22 (33/151, 21.8%), followed by +8 (11/151, 7.3%). There were 112 patients with perfect NGS examination, and the result showed the most common accompanying gene mutations were KIT mutation (34/112, 30.4%) and FLT3 mutation (23/112, 20.5%). Univariate analysis showed that factors affecting EFS included: NE≤0.5×109/L (P=0.006) and combined K-RAS mutation (P=0.002); Factors affecting OS included: Age≥50 years old (P<0.001) and NE≤0.5×109/L (P=0.016). Multivariate analysis showed that NE≤0.5×109/L (P=0.019) was the risk factors affecting OS. The proportion of bone marrow eosinophilia (BME)≥10.00% (P=0.029) was the risk factors affecting EFS.@*CONCLUSION@#The prognosis for those newly diagnosed AML patients who were of advanced age, the high proportion of bone marrow eosinophils, K-RAS mutations, and agranulocytosis is poor. The treatment plans can be adjusted in the early stage to improve the prognosis of such patients.
Subject(s)
Humans , Middle Aged , Chromosome Inversion , Leukemia, Myeloid, Acute/genetics , Myosin Heavy Chains/genetics , Oncogene Proteins, Fusion , Prognosis , Retrospective StudiesABSTRACT
OBJECTIVE@#To summarize the clinical and Laboratory characteristics of patients with multiple myeloma (MM) and analyze the prognostic factors.@*METHODS@#Two hundred MM patients were retrospectively analyzed for the following parameters, including peripheral blood, bone marrow morphology, cytogenetics, clinical staging, and response to the chemotherapy in order to summarize related factors affecting overall survival (OS). The prognostic factors were also analyzed.@*RESULTS@#200 patients with MM were divided into 3 groups according to bone marrow plasma cell percentage (BMPC%) in bone marrow smears: ＜10% group (74 cases, 37.0%), 10%-50% group (75 cases, 37.5%), ＞50% group (51 cases, 25.5%). Compared with the other two groups, patients in BMPC%<10% group were characterized by lower clinical staging levels, lower rates of 13q14 deletion and t(11;14) positive, better response to chemotherapy and favorable three-year OS rate. The univariate analysis showed that prognostic factors indicating favorable outcome as evaluated by OS included age≤55 years old, BMPC%＜10%, WBC＜7.5×10@*CONCLUSION@#The clinical characteristics are different among MM patients with different BMPC% in bone marrow smears at initial diagnosis, and prognostic analysis shows that the BMPC% in bone marrow smears has an effect on OS rate. BMPC% in bone marrow smears at initial diagnosis, age, WBC, Hb, response to the fourth chemotherapy are also the main factors impacting the prognosis of patients.
Subject(s)
Humans , Middle Aged , Disease-Free Survival , Hematopoietic Stem Cell Transplantation , Multiple Myeloma/therapy , Prognosis , Retrospective Studies , Transplantation, Autologous , Treatment OutcomeABSTRACT
@#AIM:To investigate the risk factors of diabetic retinopathy(DR)in diabetic patients and the influence on the biological structures of anterior segment.<p>METHODS: This was a cross-sectional study. Patients with type 2 diabetes who had been treated in ophthalmology department of Shanghai Tongren Hospital were invited to participate in this study during January 2018 to September 2018. To evaluate clinical characteristics, each subject completed diabetes related history questionnaire, laboratory examination(blood glucose, glycosylated hemoglobin, blood lipid), eye examination(vision, intraocular pressure, slit lamp examination, corneal topography, fundus photography, OCT). According to the severity of retinopathy, patients were classified to three groups: group 0: none DR, group 1: mild and moderate NPDR, group 2: severe NPDR and PDR. Chi-square test, <i>t</i>-test and variance analysis were used to analyze the differences between groups, and risk factors of DR were studied through Logistic regression analysis. Then analyzed whether these risk factors would affect the biological structures of the anterior segment, such as refractive index, corneal thickness, corneal curvature and anterior chamber depth.<p>RESULTS: Totally 219 diabetic patients participated in the survey, and 56 patients(25.6%)were diagnosed with DR. The age of DR patients \〖(66.84±15.13a)(group 1)/(65.45±12.83a)(group 2)\〗 was higher than that of patients without DR(59.59±14.61a)(<i>P</i><0.05). The course of diabetes in DR patients \〖(13.69±10.22a)(group 1)/(15.23±8.22a)(group 2)\〗 was higher than that in patients without DR(9.21±7.92)a(<i>P</i><0.05).The proportion of diabetic nephropathy in DR patients \〖(28.0%)(group 1)/(32.3%)(group 2)\〗 was higher than that those without DR(14.1%)(<i>P</i><0.05).The proportion of DR patients treated with insulin \〖(64.0%)(group 1)/(83.9%)(group 2)\〗 was higher than those without DR(44.2%)(<i>P</i><0.05). Logistic regression analysis showed that the course of diabetes, diabetic nephropathy and insulin were the risk factors of DR(<i>OR</i>>1, <i>P</i><0.05). All of the above risk factors will significantly reduce the corrected vision of DR patients.The corneal thickness of patients with DR(550.82±34.73)μm was greater than those without DR(542.37±33.32)μm(<i>P</i><0.05). The anterior chamber depth of patients with diabetes over 10a(2.49±0.43)mm was less than those with diabetes less than 10y(2.68±0.40)mm(<i>P</i><0.05).<p>CONCLUSION: The course of diabetes, diabetic nephropathy and insulin use were the risk factors for DR. Patients with long duration of diabetes had a shallower anterior chamber depth.
ABSTRACT
·AIM: To compare the influence of endolaser or cryotherapy on capsule contraction syndrome (CCS) following phaco - vitrectomy and intraocular lens implantation in patients with rhegmatogenous retinal detachment. ·METHODS: A total of 244 eyes were enrolled in this retrospective analysis. The surgical approach was standard vitrectomy combined with phacoemulsification and intraocular lens (IOL) implantation simultaneously. There were 198 eyes underwent endolaser and 46 eyes underwent cryotherapy during the surgery. The main outcome measures were postoperative clinical outcomes including anatomical position of retina, the capsules and the position of IOLs and best corrected visual acuity (BCVA) at 1d,1wk,1,2,3,6mo and 1a. ·RESULTS: There were 6 eyes (3.0%) of CCS occurred in endolaser group and 5 eyes (10.9%) of CCS occurred in cryotherapy group. The different procedures during the surgery were significantly associated with the incidence of CCS (odds ratio:0.256,P=0.021,95% Cl:0.075-0.880). ·CONCLUSION: Different procedures during phaco -vitrectomy surgery are significantly associated with the incidence of CCS. Endolaser is more beneficial than cryotherapy in preventing CCS following phaco -vitrectomy and intraocular lens implantation.
ABSTRACT
Objective · To evaluate the effect of phacoemulsification combining with intraocular lens (IOL) implantation in cataract patients with Fuchs endothelial corneal dystrophy (FECD) and high myopia. Methods · Five patients (9 eyes) diagnosed with FECD and high myopia were collected retrospectively at Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine from January 2015 to February 2016. All the 9 eyes underwent phacoemulsification combining with IOL implantation. Visual acuity, intraocular pressure, corneal endothelial cell density (CD) and central corneal thickness (CCT) were evaluated. Paired t-test was performed to evaluate the differences. Results · 88.89% (8/9) of the vision of the patients was improved, the best corrected visual acuity improved at least 2 lines. The intraocular pressure had no statistically significant difference before and after the operation (t=-1.066, P=0.318). The preoperative and postoperative CDs were (2184.25±196.44) cells/mm2 and (1910.0±83.41) cells/mm2 (t=2.876,P=0.064). The preoperative and postoperative CCTs were (546.83±33.74) μm and (566.67±24.66) μm (t=1.971, P=0.106). The loss rate for endothelial cells was (12.10±7.84)%. Only one patient was observed corneal edema and the CD could not be determined, so he underwent penetrating keratoplasty.Conclusion · Phacoemulsification combining with IOL implantation is safe and effective for patients with FECD and high myopia. Preoperative evaluation of corneal endothelium is necessary. Some measures should be taken into consideration to reduce the loss of endothelial cells during in surgery.
ABSTRACT
Objective · To evaluate the effect of phacoemulsification combining with intraocular lens (IOL) implantation in cataract patients with Fuchs endothelial corneal dystrophy (FECD) and high myopia. Methods · Five patients (9 eyes) diagnosed with FECD and high myopia were collected retrospectively at Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine from January 2015 to February 2016. All the 9 eyes underwent phacoemulsification combining with IOL implantation. Visual acuity, intraocular pressure, corneal endothelial cell density (CD) and central corneal thickness (CCT) were evaluated. Paired t-test was performed to evaluate the differences. Results · 88.89% (8/9) of the vision of the patients was improved, the best corrected visual acuity improved at least 2 lines. The intraocular pressure had no statistically significant difference before and after the operation (t=-1.066, P=0.318). The preoperative and postoperative CDs were (2184.25±196.44) cells/mm2 and (1910.0±83.41) cells/mm2 (t=2.876,P=0.064). The preoperative and postoperative CCTs were (546.83±33.74) μm and (566.67±24.66) μm (t=1.971, P=0.106). The loss rate for endothelial cells was (12.10±7.84)%. Only one patient was observed corneal edema and the CD could not be determined, so he underwent penetrating keratoplasty.Conclusion · Phacoemulsification combining with IOL implantation is safe and effective for patients with FECD and high myopia. Preoperative evaluation of corneal endothelium is necessary. Some measures should be taken into consideration to reduce the loss of endothelial cells during in surgery.