Objective To investigate the clinical characteristics and efficacy of acute myeloid leukemia (AML) with NPM1 and FLT3 mutations.Methods NPM1 and FLT3 mutations were detected in 67 patients with newly diagnosed AML by PCR-capillary electrophoresis.The relationship was analyzed between the mutations and efficacy.Results The incidence of NPM1 mutation was 10.4％ (7/67) in total AML patients and 26.1％ (6/23) in normal karyotypes AML patients.The incidence of FLT3-ITD mutation was 10.4％ (7/67) in total AML patients and 17.4％ (4/23) in normal karyotypes AML patients.The characteristics of 60 NPM1 wild type patients vs that of 7 NPMl mutation patients was as follow,platelet count (BPC) (54× 109/L vs.27.5 × 109/L,P ＜ 0.01),proportion of AML-M5 (57.1％ vs.27.3％,P ＜ 0.01),incidence of CD34+ (28.6％ vs.63.3％,P＜0.01),normal karyotypes (85.7％ vs.28.3％,P＜0.01),cases with particular fusion gene (0 vs.48.3％,P ＜ 0.01),incidence of FLt3-1TD-mutations positive (28.6％ vs.8.3％,P ＜ 0.01),and the differences were significant (P＜0.01).No statistic difference was found in white blood cell(WBC) counts,percentage of blasts in bone marrow,sex,median age and complete remission rate between the two groups (P ＞0.05).The WBC counts (26.9 × 109/L vs.8.1 × 109/L,P =0.013),percentage of blastsin in bone marrow (90％ vs.76％,P=0.014) in the FLT3-ITD mutationg positive patients were clearly higher than those in the FLT3-ITD negative patients.If not associated with FLT3-ITD mutations,mutant NPM1 appears to identify patients with improved response toward treatment.Conclusion It is necessary to detect NPM1 mutation and FLT3-ITD mutation in newly diagnosed AML patients,especially in patients with normal karyotype,which might help to molecular classification and treatment.

Objective To investigate the diagnostic performance of acoustic radiation force impulse (ARFI) imaging in assessing liver cirrhosis preoperatively in infants with biliary atresia (BA).Methods A total of 64 consecutive infants with BA who underwent ARFI imaging in 3 days before Kasai surgery were recruited.Virtual Touch Quantification mode was used to measure shear wave speed (SWS),All infants with BA underwent liver biopsy during the surgery.The mean SWS of infants with and without liver cirrhosis were compared and analyzed.The diagnostic efficacy of SWS was observed using ROC curves.Results Liver cirrhosis was found in 8 of 64 infants.The mean SWS in infants with cirrhosis was significant-ly higher than that in infants without cirrhosis ([2.51±0.50]m/s vs [1.74±0.31]m/s,t=6.039,P＜0.001).The cutoff value of SWS for predicting liver cirrhosis was 2.16 m/s,the area under ROC curve was 0.930 (P＜0.001),and the diagnostc sensitivity and specificity was 87.50％ and 92.86％,respectively.Conclusion ARFI imaging is helpful to predic tion of liver cirrhosis in infants with BA preoperatively.It may be an effective method for clinical management and prognosis prediction in infants with BA.