减低剂量地西他滨治疗骨髓增生异常综合征伴单系发育不良患者的疗效观察深圳罗湖区人民医院 龚 辉 陈 姣 杜 芳 周凌云 刘丹波 康春香1

目的 探讨减低剂量地西他滨治疗骨髓增生异常综合征伴单系发育不良(MDS-SLD)患者的临床疗效和安全性。方法 评价深圳市罗湖区人民医院2016年1月至2018年12月使用减低剂量地西他滨[15 mg /( m₂.d),连续 5d]治疗的12例MDS-SLD患者的疗效和不良反应。结果 2例(16.6%)获完全缓解,1例(8.3%)获部分缓解,5例(41.6％)达血液学改善,总反应率达66.6％。在5例可行细胞遗传学评估的患者中,1例(20.0%)获PR。Ⅳ级血液学毒性发生率 50.0%, Ⅲ～Ⅳ级感染发生率33.3%,无Ⅲ～Ⅳ级出血,无Ⅲ～Ⅳ级恶心呕吐和Ⅲ～Ⅳ级肝功能损伤。中位随访时间16(2～32月),随访期间无患者死亡。结论 减低剂量地西他滨治疗骨髓增生异常综合征完全缓解及部分缓解率高,药物不良反应发生率低。     

Sensitive and accurate identification of PNH clones based on ICCS/ESCCA PNH Consensus Guidelines—A summary

Paroxysmal nocturnal hemoglobinuria (PNH) is a rare hematopoietic stem cell disorder resulting from the somatic mutation of the X‐linked phosphatidyl‐inositol glycan complementation Class A (PIG‐A) gene. Depending on the severity of the mutation in the PIG‐A gene, there is a partial or absolute inability to make glycosylphosphatidyl‐inositol (GPI)‐anchored proteins including complement‐defense structures such as CD55 and CD59 on RBCs and WBCs. Flow cytometric detection of PNH clones has become the gold standard and has played an increasingly important role in the diagnosis, monitoring, and clinical management of patients with PNH. Recently, a 4‐part set of Consensus Guidelines have been published by flow experts in the field to address the key assay‐specific considerations for the identification of PNH clones in RBC and WBC, how to report such data and a full validation document for the assays described. Below, we have summarized the most significant aspects of this International effort.     

The Smoker’s Paradox Revisited: A Patient-Level Pooled Analysis of 18 Randomized Controlled Trials

ObjectivesThis study examined the smoker’s paradox using patient-level data from 18 prospective, randomized trials of patients undergoing percutaneous coronary intervention (PCI) with stent implantation.BackgroundStudies on the effects of smoking and outcomes among patients undergoing PCI have reported conflicting results.MethodsData from the RAVEL, E-SIRIUS, SIRIUS, C-SIRIUS, TAXUS IV and V, ENDEAVOR II to IV, SPIRIT II to IV, HORIZONS-AMI, COMPARE I and II, PLATINUM, and TWENTE I and II randomized trials were pooled. Patients were stratified by smoking status at time of enrollment. The 1- and 5-year ischemic outcomes were compared.ResultsAmong 24,354 patients with available data on smoking status, 6,722 (27.6%) were current smokers. Smokers were younger and less likely to have diabetes mellitus; hypertension; hyperlipidemia; or prior myocardial infarction (MI), PCI, or coronary artery bypass grafting. Angiographically, smokers had longer lesions, more complex lesions, and more occlusions, but were less likely to have moderate or severe calcification or tortuosity. At 5 years, smokers had significantly higher rates of MI (7.8% vs. 5.6%; p < 0.0001) and definite or probable stent thrombosis (3.5% vs. 1.8%; p < 0.0001); however, there were no differences in the rates of death, cardiac death, target lesion revascularization, or composite endpoints (cardiac death, target vessel MI, or ischemic target lesion revascularization). After multivariable adjustment for potential confounders, smoking was a strong independent predictor of death (hazard ratio [HR]: 1.86; 95% confidence interval [CI]: 1.63 to 2.12; p < 0.0001), cardiac death (HR: 1.68; 95% CI: 1.38 to 2.05; p < 0.0001), MI (HR: 1.38; 95% CI: 1.20 to 1.58; p < 0.0001), stent thrombosis (HR: 1.60; 95% CI: 1.28 to 1.99; p < 0.0001), and target lesion failure (HR: 1.17; 95% CI: 1.05 to 1.30; p = 0.005).ConclusionsThe present large, patient-level, pooled analysis with 5-year follow-up clearly demonstrates smoking to be an important predictor of adverse outcomes after PCI.     

RPS14基因重组慢病毒载体的构建及其在MUTZ-8细胞中的表达

目的 构建携带人RPS14基因重组慢病毒载体获得稳定产毒的细胞,并观察其在人MDS细胞株MUTZ-8细胞中的表达.方法 通过反转录方法,获得目的基因RPS14;将目的基因克隆入慢病毒表达质粒pGC-FU Vector,构建含有RPS14基因的重组慢病毒载体pGC-FU RPS14,经PCR、酶切及测序鉴定其正确性;在...     

浅议六经表证的辨证论治

《伤寒论》六经为病,都有一个发病部位的问题,辨清病位,治疗才能有的放矢。本文主要针对六经表证的辨证治疗加以论述,以期丰富表证的辨证治疗体系。     

Analysis of Clinical Syndromes in 47 Patients with Pancreatic Cancer at Late Stage

Objective:To analyze the law governing the distribution of traditional Chinese medicine(TCM) syndromes of pancreatic cancer.Methods:The authors used retrospective study to statistically analyze TCM syndromes of patients,separated complex syndromes and calculated the frequency of appearance of single syndromes.Results:The patients mainly suffered from 4 syndromes:blood stasis syndrome,qi stagnation syndrome,qi(yang) deficiency syndrome,and phlegm dampness syndrome.The distribution of syndromes is rarely rela...     

精神分裂症中医狂证证候标准第二轮专家咨询问卷分析

目的探讨精神分裂症(狂证)常见中医证型的证候标准。方法根据第一轮专家咨询问卷结果设计第二轮问卷,向全国专家进行问卷征询,用专家咨询法进行统计分析。结果专家积极系数为89.7%;权威程度为0.776;在各证型中,符合均数>1.5,满分比>50%,变异系数<40%,等级和>90的证候指标痰火内扰证有14个;气滞血瘀证共9个;阴虚火旺证共11个,痰结血淤证共9个,阳明热结证共9个,气阴两虚证共6个,肝胆火盛证共13个。结论证候指标中具有上述条件者可作为精神分裂症(狂证)上述中医证型的主症。