The Relationship between Body Mass Index and Adult Acute Myeloid Leukemia / 中国实验血液学杂志

OBJECTIVE@#To analysis the relationship between different BMI (body mass index) and the clinical characteristics, laboratory examination indexes of newly diagnosed adult patients with acute myeloid leukemia (AML), so as to investigate the effects of BMI to the efficacy of first induction chemotherapy.@*METHODS@#The clinical data of 145 newly diagnosed adult AML patients treated in the First Hospital of Lanzhou University from August 2015 to August 2019 were retrospective analyzed. According to the guidelines for prevention and control of overweight and obesity in Chinese adults, the BMI (kg/m@*RESULTS@#Among the 145 newly diagnosed adult AML patients, there were 71 males and 74 females. The median age was 50 years old(range 18 to 82 years old). There were 21 patients in underweight group (14.5%), 79 patients in normal weight group (54.5%), and 45 patients in overweight and obese group (31.0%). The patients with higher BMI level showed the older in age（P=0.018）. There were significant differences in sex between the patients in each group(P=0.035). In overweight and obese patients, the number of male was significantly higher than female. There were no statistical differences in AML classification, comorbidities(Diabetes, hypertension, coronary heart disease), hospital days, whether secondary AML and FLT3 gene mutation among the patients in different BMI groups. There were significant differences in TG of the patients in the different groups, the overweight and obese patients were higher (P=0.007). There were no significant differences in WBC and Hb counts, ALB, TC, HDL, LDL, or LDH between the patients in each BMI group at newly diagnosed. The complete remission rate of the patients in the low body mass group or overweight and obese group were lower than that in the normal body weight group (P=0.035). The rate of documented infection during the first induction chemotherapy were significantly higher for the patients in low body mass group than those in normal weight group or overweight and obese group (P=0.038). There was no statistical difference in chemotherapy regimens, the number of chemotherapy until CR, febrile neutropenia, bleeding, and the time of neutropenia, liver and kidney toxicity among each BMI group. Multivariate analysis showed that overweight and obese (P=0.012) , FLT3 mutation (P=0.015) were the risk factors affecting the CR rate of the patients. And the patients with secondary AML, high-risk type, and newly diagnosed WBC ≥50×10@*CONCLUSION@#In newly diagnosed adult patients with AML, low body mass, overweight and obesity, and FLT3 mutations were the factors reducing the early efficacy of AML patients. There were more adverse reactions induced by chemotherapy in the low body mass group. Therefore, inappropriate BMI level can be a risk factor for assessing the prognosis of adults with newly diagnosed AML.

Effect of epidural labor analgesia on the prolactin levels of parturient / 新乡医学院学报

Objective To explore the effect of epidural labor analgesia on the prolactin (PRL) levels of parturient.Methods Sixty primipara who delivered in the First Affiliated Hospital of Xinxiang Medical University from October 2016 to May 2017 were selected as research object.The parturient were divided into observation group and control group,with 30 cases in each group.The parturient in observation group were given ropivacaine combined with sufentanil for epidural block labor analgesia;the parturient in control group took natural production method without any analgesia method.The pain score,duration of labor,milk yield,serum PRL level before analgesia and 24,48 h postpartum and the number of initial lactation at 30 rmin,24 h,48 h postpartum of maternal were compared between the two groups.Results The active period of the first stage of labor of parturient in the observation group was significantly shorter than that in the control group (P ＜ 0.05);there was no statistic difference in the latent period of the first stage of labor,the second stage of labor and the third stage of labor of parturient between the observation group and the control group(P ＜ 0.05).There was no statistic difference in the pain score of parturient between the two groups before analgesia(P ＜ 0.05);the pain score of parturient in observation group was significantly lower than that in the control group at the time point of uterine orifice open 3 cm,uterine orifice full dilatation and fetal disengagement(P＜ 0.05).There was no statistic difference in the PRL levels of parturient between the two groups before analgesia (P ＜ 0.05);the PRL level of parturient in observation group was significantly higher than that in the control group at 24,48 h postpartum(P ＜0.05).The condition of initial lactation of maternal in the observation group was significantly better than that in the control group(P ＜ 0.05).The milk yield of parturient in observation group was significantly more than that in the control group at 24,48 h postpartum (P ＜ 0.05).Conclusion Epidural analgesia can reduce the pain of parturient,shorten the active stage of the first stage of labor,increase the level of PRL and increase the milk yield of the postpartum.