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Objective:To investigate the effect of IA10 regimen induction therapy on newly diagnosed adult acute myeloid leukemia (AML) patients without allogeneic hematopoietic stem cell transplantation (allo-HSCT) and the influencing factors of prognosis.Methods:The clinical data of 99 adult patients with newly diagnosed AML treated with IA10 regimen and without allo-HSCT in the Third Hospital of Yuncheng City in Shanxi Province from January 2007 to April 2017 were retrospectively analyzed. The baseline disease characteristics, relapse and survival status and minimal residual disease (MRD) levels were obtained. The influencing factors of prognosis were evaluated by Cox regression model.Results:All the 99 patients did not undergo allo-HSCT after achieved morphologic leukemia-free state (MLFS), the blood cells of 84 cases (84.8%) recovered to complete remission (CR) when reaching MLFS, 8 cases (8.1%) had CR with incomplete recovery of platelet count (CRp), 7 cases (7.1%) had CR with incomplete recovery of blood cell count (CRi). The median relapse time, median disease-free survival time, and median overall survival time were 35 months (6-54 months), 22 months (4-49 months) and 39 months (9-73 months). Multivariate analysis showed that FLT3-ITD was an independent risk factor for relapse, disease-free survival and overall survival in all patients and patients with consolidation therapy ≥1 course (all patients: HR=3.46, 95% CI 2.03-5.97, HR=2.49, 95% CI 1.40-5.47, HR=2.70, 95% CI 1.86-5.90; patients with consolidation therapy ≥1 course: HR=2.14, 95 CI 1.67-5.64, HR=2.63, 95 CI 1.54-5.03, HR=2.06, 95 CI 1.12-4.34; all P < 0.05); the high risk group of South West Oncology Group (SWOG) was an independent risk factor for relapse and disease-free survival in all patients ( HR=2.54, 95% CI 1.16-5.30; HR=2.57, 95% CI 1.38-5.10; both P < 0.05); CRi when achieving MLFS was an independent risk factor for disease-free survival and overall survival in all patients and patients with consolidation therapy ≥ 1 course (all patients: HR=5.71, 95% CI 2.66-11.03, HR=4.46, 95% CI 2.51-9.14; patients with consolidation therapy ≥ 1 course: HR=3.87, 95% CI 1.56-9.83, HR=4.67, 95% CI 2.33-11.59; all P < 0.05), and it was an independent risk factor for relapse in all patients ( HR=3.37, 95 CI 1.26-8.91, P < 0.01); the proportion of peripheral blood primitive cells ≥ 0.50 and the positive MRD after 1 course of consolidation therapy were the independent risk factors for relapse and disease-free survival in patients with consolidation therapy ≥ 1 course (proportion of peripheral blood primitive cells ≥ 0.50: HR=1.96, 95% CI 1.25-3.41, HR=1.56, 95% CI 1.02-2.94; positive MRD after 1 course of consolidation therapy: HR=2.21, 95% CI 1.37-4.05, HR=2.46, 95% CI 1.51-4.23; all P < 0.05). There were significant differences in cumulative relapse, disease-free survival and overall survival of patients without and with 1, 2 and 3 prognostic risk factors (all P < 0.05). Conclusions:IA10 regimen is effective in the induction therapy of newly diagnosed adult AML patients without allo-HSCT. The poor molecular genetic characteristics and CRi when achieving MLFS at the first diagnosis are risk factors for the prognosis of patients, and the high proportion of peripheral blood primitive cells, the combination of monokaryotype and positive MRD after 1 course of consolidation therapy are also closely related to the poor prognosis of patients.
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Objective To study the correlation of EMMPRIN and VEGF-C expression with invasion and metastasis of breast carcinoma. Method The expression of EMMPRIN and VEGF-C was detected by immunohistochemical technique in 21 cases hyperplasia of mammary glands, 10 cases of in-tubule carcinoma and 68 cases invasive carcinoma. Results The positive rate of EMMPRIN expression in hyperplasia of mammary glands, in-tubule carcinoma and invasive carcinoma were 4. 76% (1/21), 40. 00% (4/10)73.53% (50/68), respectively;Significant difference was found among three groups ( P < 0.01 ). The positive rate of VEGF-C expression in hyperplasia, in-tubule carcinoma and invasive carcinoma were14. 29% (3/21) ,60. 00 (6/10) ,77.94% (53/68), respectively. The positive rates of VEGF-C expression in situ and invasive ductal carcinoma were remarkably higher than that of hyperplasia of mammary glands ( P <0. 01 ). The expression of EMMPRIN significantly correlated with the expression of VEGF-C in breast tubule carcinoma ( rs =0. 390, P <0. 01 ), Lymph nod metastasis and the number axillary Lymph nod metastasis were related to EMMPRIN and VEGF-C ( P < 0. 01 ). Conclusion The over-expression of EMMPRIN and VEGF-C were important elements to promote the invasiveness and metastasis of breast carcinoma. Synergistic effect between EMMPRIN and VEGF-C may take place in lymph node metastasis of breast carcinoma.
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Objective To strengthen the management of contaminated area of sterilization and supply center, increase the cleaning quality of instruments and control nosocomial infection. Methods We executed the following measures: paying attention to the decontamination work, changing concepts, refining regulations, establishing programmed decontamination process, specification of work, thinning pest responsibility, strengthening infection mangement of contaminated area, effect examination and training and checking. Results The bacteria removing rate reached 95.3%. Conclusions Refining management could result in perfect cleaning effect which was applicable in the management of contaminated area of sterilization and supply center.
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Objective To observe effect of abdomen compression on improvement of anal exsufflation for patients after abdomen operation. Methods Patients in the department of general surgery( 120 cases )after abdomen operations were randomly divided into the experimental group and the control group with 60 cases in each group.The control group adopted routine postoperative nursing,The experimental group received abdomen compression baaed upon routine nursing. Anal exsufflation time was compared between the two groups. Sults Anal exsufflation time of the experimental group undergoing different operations was earlier than that of the control group(P < 0.01 ). Conclusions Abdomen compression can bring forward anal exsufflation time,fa-cilitate the recovery of gastrointestinal function and normal diet, thus improve the rehabilitation of patients