RESUMEN
Objective:To investigate the value of artificial intelligence (AI) cytomorphologic analysis system in the cytomorphological diagnosis and therapeutic evaluation of acute myeloid leukemia (AML).Methods:Bone marrow smear samples were collected from 150 patients with newly diagnosed and treated acute myeloid leukemia who were inpatients and outpatients at the Department of Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College from June 1, 2021 to July 31, 2022 for retrospective analysis. Among them, there were 50 patients in the newly diagnosed group, including 28 males and 22 females, with the onset age of 43.5(32.3,58.8)years. There were 100 patients in the post-treatment group, including 36 males and 64 females, with the onset age of 34.5(23.0,47.0)years. The results from cytomorphology expert were used as the gold standard and the Python 3.6.7 was used for analysis to evaluate the accuracy, sensitivity, and specificity of the AI cytomorphologic analysis system for blast cell recognition in AML diagnosis and treatment.Results:The proportion of blasts in AI analysis of 50 samples in the newly diagnosed group was≥20%, which met the diagnostic criteria of AML. AI analysis of blasts had an accuracy of 90.3%, sensitivity of 85.5%, and specificity of 98.0%. The correlation coefficient between AI and the proportion of blasts analyzed by experts was positively correlated( r=0.882, P<0.001). Meanwhile, in the post-treatment group, the sensitivity and specificity of AI analysis of blasts were 89.7% and 99.2%, respectively. The correlation coefficient between AI and the proportion of blasts analyzed by experts was positively correlated( r=0.957, P<0.001). According to AI analysis data, there are 8 samples in this group whose AI efficacy evaluation results on AML are inconsistent with expert analysis. Conclusion:AI cytomorphologic analysis system has high accuracy, sensitivity and specificity for blast cell recognition in AML morphological diagnosis and therapeutic evaluation.
RESUMEN
The main progress in international critical care medicine in 2020 are: the reflections on the mandatory of implementation of the 1-hour cluster treatment strategy for sepsis are still continuing; the "metabolic resuscitation" therapy, represented by large dose of vitamin C, failed to yield positive results; the global epidemic of coronavirus disease 2019 (COVID-19) continues to spread, with evidences indicating Dexamethasone, Remdesivir or interferon β-1b (IFNβ-1b), Lopinavir/Ritonavir and ribavirin as promising therapy; conservative oxygen therapy did not exert positive effects neither for mechanical ventilated patients nor for acute respiratory distress syndrome (ARDS) patient; the concept of lung- and diaphragm-protective mechanical ventilation illuminates a new opportunity to potentially improve clinical outcomes for critically ill patients; there was no positive evidence for stress ulcer prophylaxis and timing of endoscopy for severe acute upper gastrointestinal bleeding; early initiation of renal-replacement therapy (RRT) for critically ill patients with acute kidney injury (AKI) has not shown positive effect. At last, artificial intelligence (AI) has shown good potential in identifying ARDS phenotypes and early predicting sepsis.
RESUMEN
Acute lymphoblastic leukemia(ALL)is the most common childhood malignancy.As an essential component of multiagent chemotherapy, asparaginase(ASP)has significantly improved the remission rate and event-free survival rate of children with ALL since its application in clinical practice.However, there are many adverse events due to ASP, including asparaginase-associated pancreatitis(AAP). The mechanisms behind and the risk factors predisposing AAP are unknown.This review summarizes the latest research progresses on AAP.
RESUMEN
Objective To investigate the laparoscopic feature and its relationship with clinical manifesta-tions in infertile patients with endometriosis. Methods From Jan.2013 to Jan.2017,infertile patients who received hysteroscopy and hysteroscopy combination surgery in Ganzhou People′s Hospital were enrolled in this ret-rospective study.The basic clinical data and the distribution of endometriotic lesions were recorded and analyzed in patients with endometriosis simultaneously. Analysis was performed about the clinical manifestations and the rAFS stage of the patients. Results 204 patients are totally enrolled in the study. Among them,120 patients(58.8%) had endometriosis. The presence of menorrhea,dyspareunia,tenesmus,chronic pelvic pain,hypermenorrhea, adnexal mass,restricted uterine mobility,tenderness of adnexa,and tenderness nodules of posterior vaginal fornix are clinically statistically significant.In addition,the presence of ovarian endometrioma is also a significant clinical factor that is close related with the rAFS stage of infertile patients with endometriosis. Moreover,uterosacral liga-ment,rectovaginal septum,vagina and bowel were more common infiltrated in stage Ⅲ and stage Ⅳ endometrio-sis. Conclusions For infertile patients,detailed case history,overall bimanual examination and trans-vaginal ultrasound examination are very important to help diagnosis endometriosis preoperatively and provide evidence for the selection of individualized treatment strategies.
RESUMEN
Objective@#To evaluate the therapeutic efficacy and safety of immunosuppressive therapy (IST) combined with recombinant human thrombopoietin (rhTPO) for severe aplastic anemia (SAA) in pediatric patients.@*Method@#A retrospective case-control study was conducted and the clinical data of 45 pediatric patients with de novo SAA admitted to the Anemia Diagnosis and Treatment Center of Chinese Academy of Medical Sciences & Blood Disease Hospital during the period from December 2009 to December 2014 were analyzed. Among them, 15 patients were treated with the regimen of IST together with rhTPO and 30 patients were given IST treatment only. The variation characteristics of the peripheral blood routine as well as the transfusion of blood products was dynamically observed, and the therapeutic efficacy was assessed respectively after 3, 6 and 12 months after the treatment. In the meantime, adverse effects related to rhTPO application were recorded. Thereafter, the statistics of the two groups were compared by non-parametric rank sum test.@*Result@#Among 45 pediatric patients, there were 26 male and 19 female, and the median age was 11 years (6-14). The number of patients received good hematological response(complete remission (CR) plus good partial response (GPR)) in the combinatory group versus vs. the IST group was 6 vs. 3 patients (χ2=3.906, P=0.048) at the 3rd month, 7 vs. 7 patients (χ2=1.568, P=0.210) at the 6th month, and 13 vs. 14 patients (χ2=6.667, P=0.01) at the 12th month respectively. For those achieved good hematological response at the 3rd month, the amount of platelets transfusion and red blood cells transfusion of the combined group were both less than that of the IST group during the period from the 10th to the 12th weeks (platelets transfusion: 1.4 U vs. 2.9 U, t=-3.523, P=0.002; red blood cells transfusion: 0.8 U vs. 2.6 U, t=-2.392, P=0.026). No serious adverse effect related to rhTPO application was observed in the IST combined with rhTPO group.@*Conclusion@#Application of rhTPO can improve the short-term therapeutic efficacy of IST for pediatric SAA, alleviate transfusion dependence, and has a good safety profile.
RESUMEN
Objective To compare the dissolution behavior between domestic trepibutone tablets and original reference product, and provide a basis for evaluating the quality consistency of generic drugs. Methods Four dissolution media recommended by Japanese Orange Book and a domestic standard dissolution media were selected to determined the dissolution profile,and f2 factor was calculated to investigate the consistency of stripping curves. Results In water,pH 4.0 and pH 1.2,the f2 of domestic formulation and reference formulation was under 50,and the dissolution profile was inconsistent.Dissolution behavior of domestic preparations of different manufacturers was dissimilar.In water,the f2 of domestic preparations of different batches of the same manufacturer was over 99.9,and the dissolution behavior was similar. Conclusion The dissolution method of existing domestic standard can not distinguish the dissolution behavior of different products,and it should be revised and completed.There is still great difference in quality between the domestic preparations and reference preparations.
RESUMEN
Objective The purpose of the study was to identify the most frequently used nursing diagnoses,interventions,outcomes and linkages using standardized nursing terminologies for elderly patients with abdominal external hernia surgery.Methods For this study a descriptive design was used.The frequently used NANDA-Ⅰ,NIC,NOC,and NNN linkages were identified through 38 elderly patients with abdominal external hernia surgery who were admitted in hospital from March to August in 2014.Data were analyzed by SPSS17.0.Results The finding showed the most frequently used 5 nursing diagnoses were activity intolerance,impaired tissue integrity,deficient knowledge,chronic pain,and risk for falls,the frequency were 15.51％(38/245),15.51％(38/245),15.10％(37/245),14.69％(36/245) and 14.69％(36/245),the most frequently used 5 nursing outcomes were activity tolerance,ambulation,tissue integrity (skin and mucous membranes),wound healing (primary intention) and knowledge (diet) the frequency were 10.05％(38/378),10.05％(38/378),10.05％(38/378),10.05％(38/378) and 9.79％(38/378); the most frequently used 5 nursing interventions were environmental management (comfort),positioning,exercise therapy (ambulation,) incision site care and environmental management the frequency was all 6.96％(38/546).The most frequently used top 10 NNN linkages were also identified in this study.Conclusions The most frequently used NANDA-Ⅰ,NIC,NOC,and NNN linkages for patients with abdominal external hernia surgery from this study not only offer new knowledge to nurses but also provide scope of evidence-based nursing research in abdominal external hernia clinics.
RESUMEN
Objective To investigate the status of cancer pain and the usage of complementary and alternative medicine among gynecological cancer pain patients.Methods Thirty-one patients with cancer pain were investigated with self-designed questionnaire in the Gynecology Department of the First Hospital of Lanzhou University.Results The average score of age was (51.23 ± 11.34) years old,the youngest patient was 23 years old.During the period of cancer,54.84％ (17/31) of the average degree of cancer pain was mild,77.42％ (24/31) of the most severe degree of cancer pain was severe,51.61％ (16/31) of the patients experienced two or more parts of the pain,75.47％ (40/53) of the cancer pain was pelvic pain,72.72％ (24/33) was dull pain.The higher the degree of cancer pain was,the worse the subjective sleep quality was.Merely 25.81％ (8/31) of the patients used complementary and alternative medicine methods to treatment cancer pain,6 cases of them considered that the methods were effective.Conclusions Patients with gynecological cancer became younger and younger,their cancer pain was severe and mostly was pelvic pain and dull pain.Patients' subjective sleep quality was affected by cancer pain.Complementary and alternative methods might mitigate cancer pain but their usage frequency was low,which was anticipated to be more used in clinic.