Perioperative corticosteroids for reducing postoperative complications following esophagectomy: an updated systematic review and meta-analysis.

BACKGROUND: This updated systematic review and meta-analysis aims to evaluate the efficacy and safety of perioperative corticosteroid administration versus placebo for esophageal cancer patients following scheduled esophagectomy. METHODS: We searched databases through June 30, 2023. We included articles on randomized controlled trials (RCTs) comparing perioperative corticosteroid administration with placebo in esophageal cancer patients with esophagectomy. The outcomes were the death rate during hospitalization, length of hospital stay, and short-term complications. Risk ratios (RRs) and corresponding 95% confidence interval (CIs) for each estimated effect size were applied for dichotomous outcomes, and the mean difference (MD) and corresponding 95% CIs for each estimated effect size were applied for continuous outcomes. We used GRADE to evaluate the quality of each of the outcome and the level of recommendations. RESULTS: Nine RCTs with 508 participants were included in this study. Severe outcomes, including the length of hospital stay, leakage, mortality during the hospitalization period in the corticosteroid group was comparable to that in the control group, but positive effects of corticosteroid administration were observed on the length of intensive care unit stay (MD -3.1, 95% CI - 5.43 to - 0.77), cardiovascular disorders (RR 0.44, 95% CI 0.21-0.94) and other general complications (RR 0.49, 95% CI 0.29-0.85). CONCLUSIONS: Peri-operative intravenous corticosteroid administration may reduce cardiovascular disorders, other general complications and the length of ICU stay without carrying severe outcomes. More high quality RCTs are warranted to further investigate the effects of corticosteroids on postoperative mortality and complications for esophageal cancer patients with esophagectomy. SYSTEMATIC REVIEW REGISTRATION: Cochrane, registration number: 196.

Integrative genomic and transcriptomic profiling reveals distinct molecular subsets in adult mixed phenotype acute leukemia.

Mixed phenotype acute leukemia (MPAL) is a subtype of leukemia in which lymphoid and myeloid markers are co-expressed. Knowledge regarding the genetic features of MPAL is lacking due to its rarity and heterogeneity. Here, we applied an integrated genomic and transcriptomic approach to explore the molecular characteristics of 176 adult patients with MPAL, including 86 patients with T-lymphoid/myeloid MPAL (T/My MPAL-NOS), 42 with Ph+ MPAL, 36 with B-lymphoid/myeloid MPAL (B/My MPAL-NOS), 4 with t(v;11q23), and 8 with MPAL, NOS, rare types. Genetically, T/My MPAL-NOS was similar to B/T MPAL-NOS but differed from Ph+ MPAL and B/My MPAL-NOS. T/My MPAL-NOS exhibited higher CEBPA, DNMT3A, and NOTCH1 mutations. Ph+ MPAL demonstrated higher RUNX1 mutations. B/T MPAL-NOS showed higher NOTCH1 mutations. By integrating next-generation sequencing and RNA sequencing data of 89 MPAL patients, we defined eight molecular subgroups (G1-G8) with distinct mutational and gene expression characteristics. G1 was associated with CEBPA mutations, G2 and G3 with NOTCH1 mutations, G4 with BCL11B rearrangement and FLT3 mutations, G5 and G8 with BCR::ABL1 fusion, G6 with KMT2A rearrangement/KMT2A rearrangement-like features, and G7 with ZNF384 rearrangement/ZNF384 rearrangement-like characteristics. Subsequently, we analyzed single-cell RNA sequencing data from five patients. Groups G1, G2, G3, and G4 exhibited overexpression of hematopoietic stem cell disease-like and common myeloid progenitor disease-like signatures, G5 and G6 had high expression of granulocyte-monocyte progenitor disease-like and monocyte disease-like signatures, and G7 and G8 had common lymphoid progenitor disease-like signatures. Collectively, our findings indicate that integrative genomic and transcriptomic profiling may facilitate more precise diagnosis and develop better treatment options for MPAL.

[Development of Vital Signal Monitoring System Based on Accelerometer].

OBJECTIVE: Reduce the number of false alarms and measurement time caused by movement interference by the sync waveform of the movement. METHODS: Vital signal monitoring system based on motion sensor was developed, which collected and processed the vital signals continuously, optimized the features and results of vital signals and transmitted the vital signal results and alarms to the interface. RESULTS: The system was tested in many departments, such as digestive department, cardiology department, internal medicine department, hepatobiliary surgery department and emergency department, and the total collection time was 1 940 h. The number of false electrocardiograph (ECG) alarms decreased by 82.8%, and the proportion of correct alarms increased by 28%. The average measurement time of non-invasive blood pressure (NIBP) decreased by 16.1 s. The total number of false respiratory rate measurement decreased by 71.9%. CONCLUSIONS: False alarms and measurement failures can be avoided by the vital signal monitoring system based on accelerometer to reduce the alarm fatigue in clinic.

Ginsenoside Rh2 Ameliorates Neuropathic Pain by inhibition of the miRNA21-TLR8-mitogen-activated protein kinase axis.

Ginsenoside Rh2 is one of the major bioactive ginsenosides in Panax ginseng. Although Rh2 is known to enhance immune cells activity for treatment of cancer, its anti-inflammatory and neuroprotective effects have yet to be determined. In this study, we investigated the effects of Rh2 on spared nerve injury (SNI)-induced neuropathic pain and elucidated the potential mechanisms. We found that various doses of Rh2 intrathecal injection dose-dependently attenuated SNI-induced mechanical allodynia and thermal hyperalgesia. Rh2 also inhibited microglia and astrocyte activation in the spinal cord of a murine SNI model. Rh2 treatment inhibited SNI-induced increase of proinflammatory cytokines, including tumor necrosis factor-α, interleukin (IL)-1 and IL-6. Expression of miRNA-21, an endogenous ligand of Toll like receptor (TLR)8 was also decreased. Rh2 treatment blocked the mitogen-activated protein kinase (MAPK) signaling pathway by inhibiting of phosphorylated extracellular signal-regulated kinase expression. Finally, intrathecal injection of TLR8 agonist VTX-2337 reversed the analgesic effect of Rh2. These results indicated that Rh2 relieved SNI-induced neuropathic pain via inhibiting the miRNA-21-TLR8-MAPK signaling pathway, thus providing a potential application of Rh2 in pain therapy.

[Clinical Investigation of Key Parameter Range of AMG Muscle Relaxant Monitor].

The accelerometry(AMG) muscle relaxant monitor is the most widely used quantitative muscle relaxant monitor to assess the degree of neuromuscular at present. In this study, the ulnar nerve was stimulated by using train of four stimulation(TOF) mode of the AMG muscle relaxant monitor, and the movement of the adductor pollicis muscle was monitored. In this way, the distribution range of key parameters (acceleration peak value, response time, and TOF ratio) of the adductor pollicis muscle during the use of muscle relaxant in clinical practice is analyzed and will provide a practical basis for the development and improvement of the muscle relaxant monitor.

Results of surgery on adults with functional single ventricle without prior cardiac surgery in childhood.

OBJECTIVES: Patients with unoperated functional single ventricle (FSV) rarely survive into adulthood with good functional status and there are few reports about surgical results of adult patients with FSV. This study retrospectively reviews our experience with surgery in adult patients with FSV. METHODS: From January 2008 to September 2017, 65 adult patients with FSV underwent surgery in our hospital. Twenty underwent Blalock-Taussig shunt or bidirectional Glenn procedures in other hospitals prior, and four were lost to follow-up. Finally, 41 patients were included in this study. RESULTS: The early postoperative mortality was 7.3% (3/41). Postoperative systemic arterial oxygen saturation (SpO2 , 83.7% ± 4.8%) was significantly higher than preoperative SpO2 (77.9% ± 10.1%, P < .01). The mean follow-up time was 3.9 ± 3.1 years (range 1-11 years). There was only one case of late mortality and massive hemoptysis was the cause of death. Right ventricular morphology and severe atrioventricular valve regurgitation (AVVR) were the risk factors of postoperative death for patients with pulmonary stenosis(PS). There was no death case in patients who received Fontan procedure. In a follow-up, we found the grade of AVVR was reduced and the grade of heart function (New York Heart Association) was improved. CONCLUSIONS: Adult patients with FSV can also undergo surgery. The mortality was acceptable and late results were satisfactory. After surgery, oxygen saturations increased, grades of AVVR decreased and the heart functions improved. Right ventricular morphology and severe AVVR were risk factors for patients with PS.

Evolution Characteristics of Electromagnetic Power Radiated in Lightning Discharge Processes.

Combining the spectra of could-to-ground lightning discharge processes obtained by a slit-less spectrograph with synchronous electric field information, the temperature, the conductivity, the current peak, electromagnetic power peak and the luminance of the discharge channel are calculated. The values are in a normal range reported by references. The correlation among cut-off time before a subsequent return stroke, the luminance and electromagnetic power peak of the channel is discussed. The change trends of the conductivity, the current peak and electromagnetic power peak are also investigated. The results show when cut-off time is long, neutralized charges will grow, the current will rise and electromagnetic power radiated from the channel will increase. When the conductivity and the peak of the electric field change increase simultaneously, the current in the channel will rise and electromagnetic power radiated from the channel will be greater. This work will provide some references for calculating optical and electromagnetic energy radiated by lightning discharge processes.

Combined treatment of rituximab, idarubicin, dexamethasone, cytarabine, methotrexate with radiotherapy for primary central nervous system lymphoma.

The overall response rates and long-term survival of primary central nervous system lymphoma (PCNSL) are still significantly inferior to the results achieved in similar subtypes of extranodal non-Hodgkin's lymphoma. It is clearly necessary to investigate new therapeutic methods on PCNSL. We encountered three patients histologically documented PCNSL as diffuse large B-cell lymphoma (DLBCL). They were treated with R-IDARAM which comprised rituximab, idarubicin, dexamethasone, cytarabine and methotrexate. Patient 1 received stereotactic brachytherapy (SBT) prior to chemotherapy performed with iodine-125 seeds (cumulative therapeutic dose 50 Gy). After six cycles of R-IDARAM at 3-weekly intervals, radiotherapy was applied at a dosage of 2000-4000 cGy in conventional schedule (180 or 200 cGy/day) to whole brain or spinal cord in all patients. Complete remission (CR) was achieved after first two cycles of R-IDARAM in all patients. All three patients remained in CR at the time of this report with a median duration of follow-up of 23 months (ranging from 13 to 41 months). Three patients have been alive for 41, 13, 16 months respectively until now. The patient with the longest survival time was the one given SBT prior to chemotherapy. This study suggests that R-IDARAM combining with radiotherapy maybe a high effective regimen in PCNSL patients especially those with primary central nervous system DLBCL. A comprehensive treatment combining internal radiotherapy by SBT, modified R-IDARAM and followed reduced external radiotherapy may be a new treatment concept for PCNSL with higher efficiency and lower toxicity.

Hypothalamic transcriptome profile from laying period to incubation period of Changshun green-shell laying hens.

Incubation behavior in chickens is closely associated with hypothalamus. Here, RNA sequencing of hypothalamus from Changshun green-shell laying hens, an indigenous chicken breed from China, in egg-laying period (LP) and incubation period (BP) was conducted to identify critical pathways and candidate genes involved in controlling the incubation behavior in hypothalamus. A total of 637 up-regulated and 305 down-regulated differently expressed genes (DEGs) were identified in chicken hypothalamus between LP and BP groups. Gene ontology term (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis further revealed that neuroactive ligand-receptor interaction, hippo signaling pathway, and focal adhesion were significantly enriched. Five candidate genes (POMC, IGF1R, CHAD, VCL, and MYL9) were suggested to play crucial roles in the regulation of chicken incubation behavior. Our results further indicated the complexity of reproductive behavior of different chicken breeds.

Improved moth-flame algorithm based on cat chaotic and dynamic cosine factor.

The moth-flame algorithm shows some shortcomings in solving the complex problem of optimization, such as insufficient population diversity and unbalanced search ability. In this paper, an IMFO (Improved Moth-Flame Optimization) algorithm is proposed to be applied in solving the optimization problem of function. First, cat chaotic mapping is used to generate the initial position of moth to improve the population diversity. Second, cosine inertia weight is introduced to balance the global and local search abilities of the algorithm. Third, the memory information in the particle swarm algorithm is introduced into the iterative process of the algorithm to speed up the convergence of the population. Finally, Gaussian mutation strategy is used in the current optimal solution to avoid the algorithm from falling into the local optimum. Simulation experiments are conducted on 11 benchmark test functions, compared with other improved MFO (Moth-Flame Optimization) algorithms and classical optimization algorithms. The results show that the IMFO has higher accuracy and stability in solving the above-mentioned test functions. The proposed algorithm is experimented and verified by optimizing the KELM (Kernel Extreme Learning Machine) in an engineering example and exhibits a better optimization performance.

[Changes of transcription factors Bcl-6, Foxp3 and RORγt in CD4(+) cells in bone marrow of immuno-related hematocytopenia].

OBJECTIVE: To evaluate the possible mechanism of transcription factors B cell lymphoma 6 (Bcl-6) , forkhead/winged helix transcription factor 3 (Foxp3) and retinoic acid related orphan receptor (RORγt) in CD4(+) T cells for immuno-related hematocytopenia (IRH). METHODS: CD4(+) T cells were harvested from 40 IRH patients, 38 aplastic anemia subjects and 25 normal controls and separated by magnetic activated cell sorting (MACS). Then the expressions of transcription factors of Foxp3, RORγ and Bcl-6 in CD4(+) T cells were measured by real time fluorescent quantitative-polymerase chain reaction (QRT-PCR). RESULTS: Auto-antibody was detected on CD34(+) cells (67.5% (27/40) ), CD15(+) cells (65.0% (26/40)), GlyA(+) cells (75.0% (30/40) ), auto-antibody involving three, two or one myeloid cell were detected in 27.5% (11/40), 52.5% (21/40), 20.0% (8/40) of IRH patients. Compensatory increase of Foxp3 mRNA was found in IRH (0.124 (0.073-0.198) vs 0.071 (0.046-0.118), P < 0.05). The expression of Bcl-6 was higher (2.243 (0.854-4.544) vs 1.211 (0.131-2.816), P < 0.05). Compared to aplastic anemia, the expression of RORγt was lower in IRH (0.133 (0.068-0.189) vs 0.290 (0.138-0.480), P < 0.01) and the ratio of Treg/Th17 shifted to Th17 in patients with aplastic anemia (Foxp3/RORγt ratio,0.500 (0.240-0.795) vs 0.975 (0.483-1.416), P < 0.01). CONCLUSION: As one kind of bone marrow failures caused by autoantibody to bone marrow cells, IRH may occur due to a high expression of Bcl-6 in CD4(+) T cells, its immunopathogenesis is different from that of aplastic anemia.

[Study on the conductivity properties of lightning channel by spectroscopy].

Combining the spectra of cloud-to-ground lightning return obtained by a slit-less spectrograph with the transport theory of air plasma, the electrical conductivity in one discharge channel was calculated with different methods. The results show that the conductivity of the lightning channel core is of the order of 10(4) S m-1; the conductivity goes down with the increase in the channel height in the same channel; the contributions of the collisions between electron and first or second degree ionized atoms, and electron-electron as well as ion-ion collisions to the electrical conductivity of the lightning channel core can not be neglected; the collision integrals method is more reasonable for calculating the conductivity of the lightning channel core. Based on the conductivity, the discharge current was estimated and compared with the peak current of every return stroke, and the results are in the reasonable range, further, the correlation between the channel temperature and the discharge characteristics is discussed, which provides a practical way for this aspect.

A fault diagnosis method for building electrical systems based on the combination of variational modal decomposition and new mutual dimensionless.

The fault diagnosis of building electrical systems are of great significance to the safe and stable operation of modern intelligent buildings. In this paper, it has many problems, such as various fault types, inconspicuous fault characteristics, uncertainty of fault type and mode, irregularity, unstable signal, large gap between fault data classes, small gap between classes and nonlinearity, etc. A method of building electrical system fault diagnosis based on the combination of variational mode decomposition and mutual dimensionless indictor (VMD-MDI) and quantum genetic algorithm-support vector machine (QGA-SVM) is proposed. Firstly, the method decomposes the original signal through variational modal decomposition to obtain the optimal number of Intrinsic Mode Function(IMF) containing fault feature information. Secondly, extracts the mutual dimensionless indicator for each IMF. Thirdly, the optimal penalty coefficient C of the support vector machine and the parameter gamma ([Formula: see text]) in the radial basis kernel function are selected by the quantum genetic algorithm. Finally, SVM optimized by the QGA is used to identify and classify the faults. By applying the proposed method to the experimental platform data of building electrical system, and compared with the traditional feature extraction method Empirical Mode Decomposition (EMD), Singular Value Decomposition(SVD), Local Mean Decomposition(LMD). And compared with traditional SVM, Genetic Algorithm optimized Support Vector Machine (GA-SVM), One-Dimensional Convolutional Neural Network (1DCNN) for fault classification methods. The experimental results show that the method has better effect and higher accuracy in fault diagnosis and classification of building electrical system. Its average test accuracy can reach 91.67[Formula: see text].

Evaluation of the Anti-Inflammatory Pain Effect of Ginsenoside-Conjugated O-Carboxymethyl Chitosan Particles.

Nanoparticle delivery of functional molecules or vaccines is an effective method for the treatment of many diseases. This study aims to design ginsenoside Rh2-conjugated O-carboxymethyl chitosan (O-CMC/Rh2) as a drug delivery system and explore its anti-nociceptive effects. O-CMC/Rh2 was synthesized with an esterification reaction, and its chemical composition and morphology were evaluated using proton nuclear magnetic resonance (1H NMR), the attenuated total reflectance-Fourier transform infrared (ATR-FTIR) spectroscopy, and scanning electron microscopy (SEM). In addition, the in vitro cumulative release of Rh2 from the O-CMC/Rh2 was also evaluated under different pH conditions. The results showed that the ginsenoside Rh2 was successfully conjugated to the O-CMC matrix and exhibited a highly porous structure after conjugation, facilitating the release of Rh2 from O-CMC. Complete Freund's adjuvant (CFA) and burn injury-induced pain models were used to evaluate the anti-nociceptive effects of O-CMC/Rh2 on inflammatory pain. O-CMC/Rh2 reduced CFA-induced pain hypersensitivity in a dose-dependent manner and had a longer analgesic effect than Rh2. In addition, O-CMC/Rh2 also relieved the chronic pain induced by bury injury. These results indicated that O-CMC/Rh2 could be useful in reducing inflammatory pain, thus possessing a potential medicinal application in pain therapy.

A Comparative Assessment of Different Aerogel-Insulated Building Walls for Enhanced Thermal Insulation Performance.

Aerogel is widely recognized as a superinsulating material with great potential for enhancing the thermal insulation performance of building walls. It can be applied in various forms such as aerogel plasters (AP), aerogel fibrous composites (AFC), and aerogel concrete (AC) in practical engineering applications. This study aims to investigate the most efficient application form for maximizing building insulation performance while minimizing the amount of aerogel used. To predict the thermal insulation performance of aerogel-insulated walls, a resistance-capacitance network model integrating the aerogels' effective thermal conductivity model was developed and was validated by comparing it with Fluent simulation software results in terms of surface temperature. Using the validated models, the thermophysical parameters, transient thermal properties, and transmission load were predicted and compared among AP, AFC, and AC walls. The results indicate that using AFC can result in approximately 50% cost savings to achieve the same thermal resistance. After adding a 20 mm thickness of aerogel to the reference wall without aerogel, the AFC wall exhibited the highest improvement in thermal insulation performance, reaching 46.0-53.5%, followed by the AP wall, and then the AC wall, aligning with considerations of microstructural perspectives, thermal resistance distributions, and thermal non-uniformity factors. Therefore, giving priority to AFC use could reduce the required amount of silica aerogel and enhance economic efficiency. These results provide valuable insights for theoretical models and the application of aerogel-insulated walls in building engineering insulation.

Construction of Polypyrrole-Coated CoSe2 Composite Material for Lithium-Sulfur Battery.

Lithium-sulfur batteries with high theoretical energy density and cheap cost can meet people's need for efficient energy storage, and have become a focus of the research on lithium-ion batteries. However, owing to their poor conductivity and "shuttle effect", lithium-sulfur batteries are difficult to commercialize. In order to solve this problem, herein a polyhedral hollow structure of cobalt selenide (CoSe2) was synthesized by a simple one-step carbonization and selenization method using metal-organic bone MOFs (ZIF-67) as template and precursor. CoSe2 is coated with conductive polymer polypyrrole (PPy) to settle the matter of poor electroconductibility of the composite and limit the outflow of polysulfide compounds. The prepared CoSe2@PPy-S composite cathode shows reversible capacities of 341 mAh g-1 at 3 C, and good cycle stability with a small capacity attenuation rate of 0.072% per cycle. The structure of CoSe2 can have certain adsorption and conversion effects on polysulfide compounds, increase the conductivity after coating PPy, and further enhance the electrochemical property of lithium-sulfur cathode material.

Effectiveness of human mesenchymal stem cells derived from bone marrow cryopreserved for 23-25 years.

OBJECTIVE: To evaluate long-term cryopreserved human bone marrow cells (BMCs) as a source of functional mesenchymal stem cells (MSCs). METHODS: Samples of human BMCs that were cryopreserved for 23-25 years (n=20) were thawed to obtain an initial culture and a primary culture (P(0)) that was propagated through five passages (P(1)-P(5)) to obtain MSCs. Freshly collected human bone marrow samples (n=20) were used as controls for comparison of efficiency of recovery and growth characteristics of MSCs. P(3) cultures were tested for their capacity to differentiate into osteoblasts, adipocytes, and neuronal cells. Appropriate staining, immunohistochemical and biochemical methods were employed to ascertain cell type identities at different stages of culturing. RESULTS: In the initial culture, the cell adherence rate of the cryopreserved cells was significantly lower than that of controls (19.7% vs. 38.2%, p<0.05) while the relative rate of recovery of MSCs was only 48.5±8.6% in P(0). At the end of P(3), fibroblast-like cells accounted for about 95% of cells in both cryopreserved and control groups (p>0.05). These cells were positive for essential MSC surface molecules (CD90, CD105, CD166, CD44, CD29, CD71, CD73) and negative for haematopoietic and endothelial cell markers (CD45, CD34, HLA-DR). The cell growth and cell cycle patterns were similar for both groups. MSCs at P(3) from both groups had similar capacities to differentiate in vitro into osteoblasts, adipocytes, and neuronal cells. CONCLUSION: Using the methods described here, long-term (23-25 years) cryopreserved human BMCs can be successfully cultivated to obtain MSCs that have good differentiation capabilities.

Finite-time generalized synchronization of non-identical fractional order chaotic systems and its application in speech secure communication.

This paper focuses on the finite-time generalized synchronization problem of non-identical fractional order chaotic (or hyper-chaotic) systems by a designing adaptive sliding mode controller and its application to secure communication. The effects of both disturbances and model uncertainties are taken into account. A novel fractional order integral sliding mode surface is designed and its stability to the origin is proved in a given finite time. By the aid of the fractional Lyapunov stability theory, a robust controller with adaptive update laws is proposed and its finite-time stability for generalized synchronization between two non-identical fractional-order chaotic systems in the presence of model uncertainties and external disturbances is derived. Numerical simulations are provided to demonstrate the effectiveness and robustness of the presented approach. All simulation results obtained are in good agreement with the theoretical analysis. According to the proposed generalized finite-time synchronization criterion, a novel speech cryptosystem is proposed to send or share voice messages privately via secure channel. Security and performance analyses are given to show the practical effect of the proposed theories.

Fault Diagnosis of the Dynamic Chemical Process Based on the Optimized CNN-LSTM Network.

Deep learning provides new ideas for chemical process fault diagnosis, reducing potential risks and ensuring safe process operation in recent years. To address the problem that existing methods have difficulty extracting the dynamic fault features of a chemical process, a fusion model (CS-IMLSTM) based on a convolutional neural network (CNN), squeeze-and-excitation (SE) attention mechanism, and improved long short-term memory network (IMLSTM) is developed for chemical process fault diagnosis in this paper. First, an extended sliding window is utilized to transform data into augmented dynamic data to enhance the dynamic features. Second, the SE is utilized to optimize the key fault features of augmented dynamic data extracted by CNN. Then, IMLSTM is used to balance fault information and further mine the dynamic features of time series data. Finally, the feasibility of the proposed method is verified in the Tennessee-Eastman process (TEP). The average accuracies of this method in two subdata sets of TEP are 98.29% and 97.74%, respectively. Compared with the traditional CNN-LSTM model, the proposed method improves the average accuracies by 5.18% and 2.10%, respectively. Experimental results confirm that the method developed in this paper is suitable for chemical process fault diagnosis.

[Clinical Characteristics and Prognosis of Acute Myeloid Leukemia Patients with inv(16)/t(16;16)(p13.1;q22) and/or CBFß-MYH11].

OBJECTIVE: To summarize the clinical and laboratory characteristics of patients with acute myeloid leukemia (AML) with inv(16)/t(16;16) (p13.1;q22), and to analyze the risk factors affecting the prognosis of the patients. METHODS: AML patients with inv(16)/t(16;16) (p13.1;q22) and/or CBFß-MYH11+ admitted to the Department of Hematology, The First Affiliated Hospital of Soochow University from January 1, 2008 to October 30, 2019 were retrospective analyzed, the clinical and laboratory indicators, as well as treatment plans and efficacy evaluations of the patients were all recorded. Furthermore, related factors affecting the overall survival (OS) and event-free survival (EFS) of the patients were analyzed. RESULTS: Among 151 AML patients with inv(16)/t(16;16) (p13.1;q22) and/or CBFß-MYH11+, the percentage of additional chromosomal abnormalities was about 27.8%, and the most common additional chromosomal abnormality was +22 (33/151, 21.8%), followed by +8 (11/151, 7.3%). There were 112 patients with perfect NGS examination, and the result showed the most common accompanying gene mutations were KIT mutation (34/112, 30.4%) and FLT3 mutation (23/112, 20.5%). Univariate analysis showed that factors affecting EFS included: NE≤0.5×109/L (P=0.006) and combined K-RAS mutation (P=0.002); Factors affecting OS included: Age≥50 years old (P<0.001) and NE≤0.5×109/L (P=0.016). Multivariate analysis showed that NE≤0.5×109/L (P=0.019) was the risk factors affecting OS. The proportion of bone marrow eosinophilia (BME)≥10.00% (P=0.029) was the risk factors affecting EFS. CONCLUSION: The prognosis for those newly diagnosed AML patients who were of advanced age, the high proportion of bone marrow eosinophils, K-RAS mutations, and agranulocytosis is poor. The treatment plans can be adjusted in the early stage to improve the prognosis of such patients.