Aim: To explore the clinical characteristics of acute myeloid leukemia(AML) with DNMT3A R882 mutation.Methods: The clinical data of 168 AML patients undergoing detection of DNMT3A R882 loci mutation were collected retrospectively.Gene sequencing after PCR was used to detect the DNMT3A R882 loci mutation,as well as CEBPA, NPM1 and FLT3-ITD mutations.The expressions of 18 antigens on leukemic blasts were assessed by 4 color flow cytometry.The prognosis was analyzed using K-M curve.Results: DNMT3A R882 mutation was detected in 24 patients(14.29%).Compared with the patients without DNMT3A R882 mutation, the patients with DNMT3A R882 mutation tended to be more older, with higher white blood and platelet counts, with higher expressions of CD33 and CD11b and poorer expression of CD34, and more companied with NPM1 and FLT3-ITD mutations.The patients with DNMT3A R882 mutation had a shorter median event-free survival time than those without(62 d vs 277 d), but there was no significant difference in complete response rate after the first course of treatment.Conclusion: The AML patients with DNMT3A R882 mutation have obvious clinical features and a poor prognosis.

左旋门冬酰胺酶(L-asparaginase,L-Asp)是治疗急性淋巴细胞白血病(acute lymphoblastic leukemia,ALL)的经典药物,其作用原理是耗竭患者体内L天冬酰胺从而阻断肿瘤细胞的蛋白质合成,抑制肿瘤细胞代谢[1-2].但因其外源性蛋白质的特性,常引发机体过敏、骨髓抑制、凝血功能异常、生化指标异常、胃肠道不适等药物相关不良反应,影响药物的继续应用[3-6].

Objective To probe into the clinical effects of treating primary liver cancer by combining irregular liver resection and hepatic artery embolism chemotherapy pump with125 I particle implantation. Methods Totally 68 patients suffering from the primary liver cancer who accepted treatment in our hospital from March 2010 to March 2011 were taken as research objects and they were divided into observation group and control group,with 34 patients in each group.In the control group,they were treated by irregular liver resection and hepatic artery embolism chemotherapy pump. In the observation group,on the basis of that in the control group,they were treated by125 I particle implantation. Then,the treatment effects,occurrence of adverse reactions and the long- term survival of two groups were observed. Results The whole effective rate of treatment in the observation group was evidently higher than that in the control group. According to the follow- up visits from 1 year to 3 years,after one year and three years,the survival rate in the observation group was evidently higher than that in the control group. The living quality in the observation group was evidently better than that in the control group and the differences had statistical significance( P < 0. 05). In addition,the occurrence rate of adverse reactions in the observation group did not have evident differences from that in the control group( P >0. 05). Conclusion The clinical effect of treating primary liver cancer by combining irregular liver resection and hepatic artery embolism chemotherapy pump with125 I particle implantation is evident,which can effectively improve the long- term survival rate of patients,improve living quality,and would not improve evidently the occurrence rate of adverse reactions. Thus,it should be promoted in clinical applications.

Objective To explored the different surgical procedure for treatment of medullary thyroid carcinoma. Methods Retrospectively to analyze the clinical data of 65 patients with medullary thyroid carcinoma. According to different operation methods,and it was divided into 3 groups.The group A underwent total thyroidectomy and central lymph node surgery. The group B was performed with thyroid subtotal resection of thyroid tissue and bilateral lymph node dissection. The group B was performed with thyroid subtotal resection of thyroid tissue and unilateral lymph node dissection.Compared surial, the cure rate, recurrence rate and complication rates. Results The survival of A, B, C three groups of patients was no statistical difference(P > 0.05). Biochemical cure rate and postoperative recurrence rate was significant differences(P < 0.05). A, B, C three groups of patients with laryngeal recurrent nerve injury and incidence of parathyroid function was significant difference(P < 0.05). Conclusion Compared with group A, group B and C has the same set of postoperative survival, but high cure rate, lower low parathyroid function and laryngeal recurrent nerve injury and lower incidence of cancer recurrence.

Objective To evaluate the efficacy of neoadjuvant chemotherapy(NACT) combined with laparoscopic surgery in treating the colorectal cancer. Methods 78 patients with colorectal cancer were randomly divided into observation group and control group, each group of 39 cases, used NACT combined laparoscopic surgery and pure laparoscopic surgery, compared the clinical efficacy of two groups of patients. Results The radical resection rate of observation group was 94.9%, higher than the 82.1% of the control group(P < 0.05);The intraoperative blood loss was less than the control group(P< 0.05);Two groups of patients with local recurrence rate, 3 year survival rate and distant metastasis rate difference was statistically significant(P < 0.05). Conclusion NACT and laparoscopic surgery for colorectal cancer patients was effective, and can improve the radical resection, reduce the bleeding reduce recurrence and metastasis and prolong the lifetime.