Acute myeloid leukemia (AML) is a group of heterogeneous malignant diseases inhematological system, with significant differences in morphology, immunology, genetics, molecular biology and clinical manifestations. Cytogenetics detection has become one of the main bases for the accurate diagnosis, treatment options and prognosis judgement of AML. However, the high heterogeneity at the molecular level leads to low detection rate by conventional cytogenetics detection technology. Clonal chromosome aberrations in 40 %ˉ50 % of patients with AML could not be detected by using standard chromosomal banding, which might be called normal karyotype AML (NK-AML). The common molecular genetic changes in non-M3 AML includes FLT3, NPM1, DNMT3A and IDH mutations. This paper mainly reviews the characteristics of the above four genes, pathogenesis and prognosis of non-M3 AML.

Objective:To investigate the impact of butylphthalide on homocysteine, CRP and nerve function in the patients with a-cute progressive cerebral infarction. Methods:Totally 122 cases of patients with acute cerebral infarction were randomly divided into the observation group (n=60) and the control group (n=62). The control group was treated with the routine treatment, and the ob-servation group was treated with butylphthalide additionally. The treatment course was two weeks. The total effective rate, blood Hcy, the level of plasma CRP and the changes of neurological function deficits scale in both groups before and after the treatment were ob-served and compared. Results:The overall response rate in the observation group (81. 67%) was significantly higher than that in the control group (64. 52%). After the treatment, the blood Hcy and CRP in both groups were significantly lower than that before the treatment(P<0. 05), and that of the observation group was significantly lower than that of the control group(P<0. 05). The neuro-logical function deficits scale in both groups were significantly lower than that before the treatment(P<0. 05), and that of the observa-tion group was significantly lower than that of the control group at the same period. The two groups during the treatment showed no sig-nificant adverse reactions. Conclusion: The effect of butylphthalide in the patients with acute cerebral infarction is effective, which can reduce blood Hcy, the level of plasma CRP and the neurological function deficits scale, and improve the neurological function with-out obvious adverse reactions during the treatment course.

Objective:To explore the effect of continuous pumping normal saline at same infusion speed before flushing or sealing the tube on the hemodynamics of patients with hypovolemic shock receiving norepinephrine.Methods:A total of 56 cases of hypovolemic shock patients receiving norepinephrine via micro-pump were randomly assigned to the observation group and the control group (28 cases in each group). Patients in the control group received conventional operation method to flush or seal the tube, while patients in the observation group continued pumping normal saline at the same infusion speed, followed by flushing or sealing the tube based on the control group. The changes of hemodynamics after flushing or sealing the tube was compared between two groups.Results:After 30 s, 1 min, 2 min, 3 min, 5 min of flush or seal the tube, the systolic blood pressure were (105.4±17.4) mmHg, (106.3±21.3) mmHg, (102.1±14.5) mmHg, (100.6±16.9) mmHg, (101.0±14.3) mmHg (1 mmHg=0.133 kPa), mean arterial blood pressure were (81.1±8.6) mmHg, (82.4±9.9) mmHg, (78.6±7.3) mmHg, (76.9±6.7) mmHg, (75.7±6.5) mmHg in the observation group, lower than those in the control group [(150.6±26.7) mmHg, (151.8±30.1) mmHg, (139.7±29.8) mmHg, (125.3±25.3) mmHg, (114.4±21.6) mmHg and (107.4±11.6) mmHg, (106.1±11.5) mmHg, (98.1±11.1) mmHg, (88.9±9.6) mmHg, (79.5±8.0) mmHg], the differences were statically significant ( P<0.05). After 30 s, 1 min, 2 min, 3 min of flush or seal the tube, the diastolic blood pressure were (69.0±10.50)mmHg, (70.5±10.7)mmHg, (66.9±8.3)mmHg, (65.1±6.2)mmHg in the observation group, lower than those in the control group [(85.9±11.6) mmHg, (83.3±8.7) mmHg, (77.3±7.4)mmHg, (70.7±7.2) mmHg], the differences were statically significant ( t value was 10.199-18.464, P<0.05). Conclusions:Before flushing or sealing the tube, continue pumping normal saline at same infusion speed can reduce the risk of abnormal hemodynamics for the hypovolemic shock patients receiving norepinephrine via micro-pump.

AIM: To investigate the influence of Sijunzi Decoction(Radix et Rhizoma ginseng,Rhizoma atractylodis macrocephalae,poria,Radix et Rhizoma glycyrrhizae) on the pharmacokinetics of Levofloxacin(LVFX) in rats with deficiency of spleen. METHODS: Twenty-four rats were randomly divided into four groups: NS(normal rats given 0.9% saline solution),NS+SJZT(normal rats given 0.9% saline solution and Sijunzi Decoction),R(rats pretreated with Reserpine) and R+SJZT(rats pretreated with Reserpine and then cured with Sijunzi Decoction).After a single oral administration of LVFX 20 mg/kg,blood samples were collected at different intervals.The concentrations of LVFX plasma were determined by HPLC.Pharmacokinetic parameters were determined from the plasma concentration-time data. RESULTS: Reserpine led to the syndromes similar to the deficiency of spleen,a traditional Chinese medicine syndrome.The pharmacokinetic parameters of LVFX in NS,NS+SJZT,R and R+SJZT groups were as follows: AUC_((0-∞))=(8.55 ?0.99),(7.41?1.39),(4.68?0.95) and(7.89?1.41)mg/(L?h),respectively and C_(max)=(3.31?0.63),(2.38?1.15),(1.29?0.45) and(3.35?1.15) mg/L,respectively.Compared with the parameters of LVFX in NS group,Reserpine markedly decreased AUC_((0-∞)) and C_(max) of LVFX(P

Objective:To optimize the preparation technology of compound sodium lactate injections for the improvement of clari-ty. Methods:The orthogonal test was adopted to screen the best preparation conditions using four influencing factors including the de-carburization temperature of the concentrated solution (A), pH value of the concentrated solution (B), decarburization time of the concentrated solution ( C) and the filling temperature of the injections ( D) with 3 levels for each, and the clarity of the injections as the index. Results:The best preparation conditions were as follows:the decarburization temperature was 60℃, pH value of the con-centrated solution was 6. 5, the decarburization time was 20minute and the filling temperature was 50℃. Conclusion: The optimal process can improve the clarity of compound sodium lactate injections.

Objective To study the moderate hypothermia with iced saline given intravenously with ice cap and ice sheet used in patients with severe stroke or craniocerebral trauma in order to clarify its clinical therapeutic effect and recovery of neurologic function for providing reliable clinical data.Methods A total of 84 patients suffered severe stroke (cerebral hemorrhage or cerebral infarction) or traumatic brain injury with GCS (Glascow Coma Scale) ＜8 admitted within 24 hours after onset were enrolled for study.The exclusion criteria were functional decompemsation of heart,liver,kidney and lung as cardiovascular complications of hypertension,hematological and other diseases,and craniocerebral trauma with multiple injuries of thorax,abdomen and extremities.Patients were divided into observation group and control group (n =42 in each group).The patients of two groups were managed to maintain respiratory tract patent,prevention of infection,dehydration,reduction of intracranial pressure and treated with Cytidine Diphosphate Choline,piracetam,ganglioside sodium and other conventional therapy.In control group,patients treated with ice cap and ice sheet,whereas in observation group,patients were treated with iced saline injected intravenously in addition to ice cap and sheet.At admission,the GCS score of patients was assessed and 6 months later,GCS score and Glascow Outcome Scale,(GOS) score of patients were determined,and 12 months after the treatment,quality of life score were evaluated by KPS.Results The time from onset of stroke or from trauma accident occurred to initiation of hypothermia treatment and time from initiation of hypothermia therapy to the target temperature reached in observation group were (8 ±4) hours and (3± 1 )hours respectively,and in control group,they were ( 16± 5) hours and (6 ± 2) hours,and there were significant differences between two groups ( P ＜ 0.05 ).The mean GCS score of patients at 6 months in the observation group and in the control group were (7.01 ± 1.12) and (4.02 ± 1.11 ) respectively (P ＜0.05 ) ; whereas the GOS score at 6 mouths of patients was categorized into good outcome,disabled outcome and poor outcome,and the good outcome in the observation group was significantly better than that in the control group (P ＜ 0.05 ),and no statistically significant difference in disabled outcome was found between two groups (P ＞ 0.05),and the poor outcome of GOS score was significantly lower in observation group than that in control group ( P ＜0.05 ).Twelve months after the treatment,the long-term quality of patients'life assessed by KPS score in observation group was significantly better than that in control group ( P ＜ 0.05).Conclusions The moderate hypothermia therapy by using iced saline administered intravenously combined with ice cap and ice sheet for severe stroke and head trauma patients conferred better therapeutic effects than the treatment with ice cap and ice sheet.

ObjectiveTo evaluate the inhibitive effect of Photodynamic therapy (PDT) with different parameters on dental caries formation in rats.MethodsWistar rats were infected with S.mutans to establish the rat caries mode 1.The rat's teeth were treated with 0.9% NS and 0.2% NaF as controls;laser,photosensitizer and laser plus photosensitizer,respectively as treated groups.Hematoporyrin monomethyl ether(HM ME) was used as photosensitizer and laser as the light source.The rats were sacrificed after five weeks.Keyes count was used to measure the inhibitory effect of PDT on dental caries.The surface morphology of the teeth was evaluated by scan electronic microscopy(SEM).Results The PDT-treated group and NaF-treated group showed significantly reduced Keyes scores compared with the negative controls (P＜0.05).The laser-treated group,photosensitizer-treated group and NS-treated group showed no significantly reduced Keyes scores compared with the negative controls (P＜0.05).The differences of Keyes scores between various parameter PDT treated groups were significant (P＜0.05).Additionally,Keyes scores reduced gradually with the increasing of laser power.The outcome of SEM showed that the teeth treated with different laser powers exhibited different changes in morphology.Conclusion HMMEPDT had significant inhibitive efficacy on caries development in rats and its inhibitory effect presented close correlation with the power of laser,which indicates that it is important to apply appropriate power in clinical treatment.

Objective To evaluate feasibility and reliability of using Simplified Acute Physiology Score Ⅱ (SAPS Ⅱ)in predicting mortality in critically ill patients with neurological diseases.Methods All 653 patients hospitalized in neurological intensive care unit (N-ICU) from Jan 2005 to Dec 2007 were retrospectively studied.SAPSⅡ scores were scaled upon admission at 24,48 and 72 h,and possibility of hospital mortality (PHM) was calculated based on SAPS Ⅱ score.Neurological diseases diagnosis made initially at time of hospitalization was classified into five categories:intracranial hemorrhage,cerebral infarction,neurologic infection,neuromuscular diseases and other neurologic diseases.At each of four time points,the SAPSⅡscores were compared between the survival group and death group,and the relationship of SAPS Ⅱ score and prognosis were analyzed.The calibration of the SAPS Ⅱ were accessed with the Hosmer-Lemeshow goodness-of-fit chi-squared statistic and the discrimination with area under the receiver operating characteristic curve (AUROC).Multivariate logistic regression was used to analyze the relationship between disease category and prognosis.Results SAPS Ⅱ scores in the death group (46.53±12.22,47.28±13.84,48.58±14.18 and 49.06±14.61)at each time point were significantly higher than those in the survival group (34.70±11.78,30.28±12.24,29.79±12.36 and 29.69±12.96;t=11.12,14.02,14.43 and 13.49 at 0,24,48 and 72 h,respectively,P＜0.01).Furthermore,univariate logistic regression analyses demonstrated that SAPS Ⅱ score was correlated with prognosis (OR=1.080,1.100,1.109,1.100 at 0,24,48 and 72 h,respectively,P＜0.01).The scores at 48 and 72 h were more accurate in predicting mortality.SAPS Ⅱ had good calibration at each time points (x2=5.305,7.557,6.369 and 8.540,P＞0.05),however,the consistency of expected mortality with observed mortality was satisfactory only at 48 and 72 h(82.6%,83.4%),so was the discrimination ( AUROC=0.825,0.847 respectively).There was no correlation between disease categories and outcome.Conclusion SAPS Ⅱ scoring,best evaluated at 48 and 72 h after hospitalization,can be used as a reliable predictor of probability of mortality in patients hospitalized in N-ICU and prediction can be applied in these patients with all different neurology diseases.

Objective To study the causes and nursing points of re-operation after orthotopic liver transplantation (OLT). Methods The clinical data of 241 patients who underwent OLT in the past three years were analyzed, and the causes and nursing of re-operation were summarized. Results In the 241 patients,30 cases underwent re-operation. The incidence of re-operation was 12.4%. The causes included: intra-abdominal bleeding in 14 cases with the incidence of 46.7%, biliary complications in 8 cases with the incidence of 26.6%, 4 cases infection in different organs with the incidence of 13.3%, wound dehiscence in 2 cases with the incidence of 6.7% and recurrence of carcinoma in 2 cases with the incidence of 6.7%. 7 patients died after re-operation with the mortality rate of 13.3%. Conclusions The causes of re-operation after OLT were various, intra-abdominal bleeding and biliary complications were the main factors. Knowing the causes and taking rational nursing helped to raise the survival rate and quality of life after OLT.

Objectives To investigate the clinical features of clomiphene citrate (CC) resisitant in patients with the polycystic ovary syndrome(PCOS). Methods A total of 145 women with PCOS were analyzed in the center for reproductive medicine of our hospital. According to the responses to CC ,patients were divided into two groups:(1)the CC resistant group(n = 32),(2)the CC response group(n = 113). The clinical features were compared between these two groups. Results (1)Body weight,body mass index(BMI),blood pressure and F?G scores were significantly higher in the CC resistant group than those in the CC response group (P < 0.05, respectively).(2)Basic antral follicle counts(AFC),C reaction protein(CRP),fasting insulin(FI)and HOMA?IR in the CC resistant group were significantly higher than those in the CC response group (P < 0.05, respectively),however,no significant difference was observed in sex hormones between these two groups. Conclusion PCOS patients with CC resistant are more likely to have higher body weight,BMI,blood pressure, insulin resistant?indexes and basic AFC ,the clinical doctors should consider these features before the treatment of ovulation induction.