伴NPM1基因突变的成年人急性髓系白血病临床研究

Objective To evaluate the clinical feature of adult acute myeloid leukemia with nucleophosmin (NPM1) cytoplastic positive (NPMc+AML), and to investigate the significance of the NPM1 gene mutations regularly in detecting the early relapse. Methods The NPM1 gene mutations was screened by the PCR-capillary electrophoresis in 95 newly diagnosed adult AML patients. 5 complete remission AML patients were selected to detecte the NPM1 gene mutations regularly. Results In 95 cases of adult AML patients, the incidence of the NPM1 mutations was 9.5 % (28/95). The incidence of the NPM1 mutations in patients (≥40-year-old) was higher clearly than it' s in pazients (40-year-old) (λ 2= 6.963, P = 0.012). That in the AML patients with normal karyotype (51.1%) was higher than that in the patients with abnormal karyotype (8.3 %) (λ2= 20.860, P= 0.0000). NPM1 mutations occured with a considerate percentage in AML patients with M5/M2 subtype. In AML with recurrent genetic abnormalities the NPM1 mutations wasn' t found.The white blood cell count, platelet count, lactate dehydrogenase in the NPMc+AML patients were clearly higher than that in the NPMc-AML patients (t were individually 4.132, 4.603, 4.069, P ＜0.05). The rate of complete remission, relapse-free survival and overall survival in the NPMc+AML patients were also higher than that in the N PMc-AML patients (λ 2 were individually 10.448, 4.146, 4.384, P ＜0.05). In cases detected regularly NPM1 mutations preceded the hematological relapse about 1.5-2 months. Conclusion NPM1 gene mutations has a higher incidence in adult AML, particularly in normal karyotype AML. The clinical manifestations are older, and higher in white blood cell count, platelet count, and lactate dehydrogenase. The NPM1 mutations in adult AML is a good factor for prognosis. The regular detection of NPM1 mutation could find relapse early.     

伴NPM1基因突变的成年人急性髓系白血病临床研究

Objective To evaluate the clinical feature of adult acute myeloid leukemia with nucleophosmin (NPM1) cytoplastic positive (NPMc+AML), and to investigate the significance of the NPM1 gene mutations regularly in detecting the early relapse. Methods The NPM1 gene mutations was screened by the PCR-capillary electrophoresis in 95 newly diagnosed adult AML patients. 5 complete remission AML patients were selected to detecte the NPM1 gene mutations regularly. Results In 95 cases of adult AML patients, the incidence of the NPM1 mutations was 9.5 % (28/95). The incidence of the NPM1 mutations in patients (≥40-year-old) was higher clearly than it' s in pazients (40-year-old) (λ 2= 6.963, P = 0.012). That in the AML patients with normal karyotype (51.1%) was higher than that in the patients with abnormal karyotype (8.3 %) (λ2= 20.860, P= 0.0000). NPM1 mutations occured with a considerate percentage in AML patients with M5/M2 subtype. In AML with recurrent genetic abnormalities the NPM1 mutations wasn' t found.The white blood cell count, platelet count, lactate dehydrogenase in the NPMc+AML patients were clearly higher than that in the NPMc-AML patients (t were individually 4.132, 4.603, 4.069, P ＜0.05). The rate of complete remission, relapse-free survival and overall survival in the NPMc+AML patients were also higher than that in the N PMc-AML patients (λ 2 were individually 10.448, 4.146, 4.384, P ＜0.05). In cases detected regularly NPM1 mutations preceded the hematological relapse about 1.5-2 months. Conclusion NPM1 gene mutations has a higher incidence in adult AML, particularly in normal karyotype AML. The clinical manifestations are older, and higher in white blood cell count, platelet count, and lactate dehydrogenase. The NPM1 mutations in adult AML is a good factor for prognosis. The regular detection of NPM1 mutation could find relapse early.     

成人遗传性纤维蛋白原缺乏症1例报道并文献复习

目的 探讨遗传性纤维蛋白原缺乏症的临床特点,以提高临床医师对该病的认识.方法 回顾性分析报道1例成人遗传性纤维蛋白原缺乏症临床诊疗经过,并对相关文献进行复习.结果 结合患者及其弟、其子血凝相关检查,诊断为遗传性纤维蛋白原缺乏症,予以冷沉淀输注后顺利手术,复习文献该病多于成年前出现出血表现而诊断.结论 遗传性纤维蛋白原缺乏症较少见,多于婴幼儿及儿童出现程度不同的出血表现,该病的诊断应强调详细的家族遗传史调查及出凝血实验室检查.活动性出血时或外科手术前应予以替代治疗.     

用蔗糖铁注射液治疗缺铁性贫血的疗效探讨

目的：探讨用蔗糖铁注射液治疗缺铁性贫血的临床效果。方法：对2012年3月～2014年3月期间我院收治的100例缺铁性贫血患者的临床资料进行回顾性研究。我们将这100例患者随机分为研究组和对照组,每组各有50例患者。我们对对照组患者使用琥珀酸亚铁片进行治疗,对研究组患者使用蔗糖铁注射液进行治疗。治疗结束后,比较两组患者的临床效果。结果：治疗结束后,研究组患者治疗的总有效率为94.0%,对照组患者治疗的总有效率为80.0%,研究组患者治疗的总有效率明显高于对照组患者,二者相比差异具有显著性（P<0.05）;对照组患者平均治疗的时间和平均纠正贫血的时间分别为：（78.3±10.6）d和（34.7±10.2）d;研究组患者平均治疗的时间和平均纠正贫血的时间分别为：（16.7±4.3） d和（19.8±5.4）d。研究组患者平均治疗的时间和平均纠正贫血的时间明显少于对照组患者,二者相比差异具有显著性(P<0.05)。研究组患者不良反应的发生率为4.0%,对照组患者不良反应的发生率为14%。研究组患者不良反应的发生率明显低于对照组患者,二者相比差异具有显著性（P<0.05）。结论：用蔗糖铁注射液治疗缺铁性贫血疗效确切,可有效地改善患者的临床症状,且无明显不良反应。此疗法值得在临床上推广使用。     

单孔腹腔镜治疗小儿腹股沟斜疝的临床分析

目的对患有腹股沟斜疝的小儿患者采用单孔腹腔镜的手术治疗方法进行治疗,根据治疗结果观察其治疗疗效。方法采用回顾分析法对我院收治的100例病患采用单孔腹腔镜的手术治疗结果进行资料分析,并观察其治疗疗效。结果我院收治的小儿患者手术治疗时长短,平均时长为13min,并且未出现睾丸萎缩、阴囊水肿、感染以及医源性隐睾等并发症。结论采用单孔腹腔镜手术对小儿腹股沟斜疝进行治疗,具有安全可靠性,且用时短,缓解了患儿的痛苦,提高了我院的治疗效率,有利于临床实践与推广。     

伴NPM1基因突变的成年人急性髓系白血病临床研究

 目的　探讨我国成年伴NPM1基因突变的急性髓系白血病患者（NPMc+AML）的临床特点,初步探讨定期定性检测该突变在早期判断AML复发中的意义。方法　采用聚合酶链反应（PCR）-毛细管电泳法对95例成年初治AML患者检测NPMl突变情况,并选取其中5例完全缓解患者定期检测该突变。结果　95例成年AML患者NPM1突变发生率为29.5 %（28／95）; ≥40岁患者突变发生率[40.0 %（22／55）]明显高于＜40岁患者[15.0 %（6／40）]（χ2＝6.963,P＝0.012）;正常核型AML患者突变发生率[51.1 %（24／47）]明显高于异常核型患者[8.3 %（4／48）]（χ2＝20.860,P＝0.000）。AML患者发生NPM1突变以M5[72.7 %（16／22）]、M2[36.3 %（8／22）]常见,在具有重现性染色体异常的AML中,未发现该突变。NPMc+AML患者白细胞、血小板计数及乳酸脱氢酶水平均明显高于NPMc-AML组（t值分别为4.132、4.603、4.069,均P＜0.05）。NPMc+AML患者完全缓解率、无复发生存率及总生存率均明显高于NPMc-AML患者（χ2值分别为10.448、4.146、4.384,均P＜0.05）。定期检测的患者血液学复发前1.5～2.0个月重新出现NPM1基因突变。结论　NPM1基因突变在成年AML患者中,尤其是正常核型AML患者中有较高的发生率,临床表现为患者年龄偏大,白细胞计数、血小板计数、乳酸脱氢酶均较高,NPM1基因突变是成年AML患者预后良好的指标。定期定性监测该突变可早期判断AML复发。     

2008～2010年医院消毒灭菌质量监测分析与对策

加强医院消毒灭菌质量的监测与管理,可以有效预防、控制医院感染,提高医疗质量,保障医疗安全。为了解我院消毒灭菌的工作质量,我们总结了2008～2010年环境卫生与消毒灭菌效果的监测资料,并进行统计分析。现报告如下。