RESUMO
Objective:To investigate the effect of chemotherapy combined with sorafenib on the prognosis of FLT3 internal tandem duplication (FLT3-ITD)-positive acute myeloid leukemia and to find a more effective treatment.Methods:The clinical data of 60 patients who were newly diagnosed with acute myeloid leukemia and who received treatment in The Second Affiliated Hospital of Qiqihar Medical University from January 2015 to January 2017 were retrospectively analyzed. The patients were divided into three groups according to whether they were positive for FLT3-ITD and the treatment method they used. The observation group (FLT3-ITD-positive, n = 19) were treated with sorafenib based on routine chemotherapy. The control group 1 (FLT3-ITD-positive, n = 21) was treated only with routine chemotherapy. The control group 2 (FLT3-ITD-negative, n = 20) was treated only with routine chemotherapy. After the first and fourth courses of treatment, clinical efficacy was compared among the three groups. Results:After the first course of treatment, the complete remission rate in control group 2 was 50.0% (10/20), which was significantly higher than 15.8% (3/19) in the observation group and 4.8% (1/21) in the control group 1 ( H = 13.39, P < 0.05). After the fourth course of treatment, the complete remission rate in the observation group, control group 2, and control group 1 was 63.2% (12/19), 60.0% (12/20), and 4.8% (1/21), respectively, and the differences were statistically significant ( H = 19.21, P < 0.05). Four-year follow-up results showed that the median survival time in the observation group, control group 1, and control group 2 was 36.63, 24.15, and 45.00 months respectively. The event-free survival in the observation group, control group 1, and control group 2 was 18.00, 9.82, and 24.90 months, respectively. The median survival time and the event-free survival in the control group 2 were significantly longer than those in the observation group and control group 1 ( χ2 = 19.93, 23.04, both P < 0.001). Conclusion:Chemotherapy combined with sorafenib for treating newly-diagnosed FLT3-ITD-positive acute myeloid leukemia can provide comprehensive benefits and have advantages for survival over chemotherapy without sorafenib and chemotherapy alone.
RESUMO
Anatomy, materials science, engineering, bio-mechanics, electrical machinery, remote control and computer technology, etc, have generally reflected the development of modem artificial joint surgery, and computer technology plays a particular role. Computer-assisted surgery system can be manipulated to combine space three-dimensional navigation technology, computer image processing and visualization technology with clinical operations, and to calculate the signal transmission and reception of transmitter location points using computer, So as to work out all kinds of curves and angles, which transform the invisible and virtual human parameters directly into animated images, and at the same time enabling the location of surgical instruments to show real-time updates at intraoperative imaging. This will let the doctor know, at any time, the relationship between the location of surgical instruments and the anatomical structure of patients, thus avoiding the important anatomical structure to ensure a safe operation. It simulates surgical instruments' forward and backward as well. Storage surgery route and measuring the angle, length and diameter of implant will make the operation more convenient for doctors in an objective manner, so as to facilitate surgeries. The prosthesis's location, the angles of slope and rotation, master of power line, and the location of osteotomy all need a precise positioning in the process of artificial joint replacement. With the promotion of computer-guided surgery of joint surgery, artificial joint replacement, with the help of computer navigation surgery, can control error at a distance of 1 mm and angle of 1° so as to ensure the accuracy of the location of prosthesis, match it exactly and strictly, thereby reducing the chance of loosening, wear and osteolysis, extending the life of artificial joints, and providing a better joint function.