Is it necessary to reexamine allergic purpura?

Xiebeilu studio WeChat add369456    Henoch-Schonlein purpura is a common capillary pathologically reactive disease, which increases the permeability and fragility of the blood vessel wall, causing a beginner situation. What is the cause of allergic purpura? Henoch-Schonlein purpura is also known as hemorrhagic chronic vascular poisoning, and an allergic reaction in our microvessels. The most common season for allergic purpura is in spring and autumn. Patients will find some spots and ecchymosis on their skin. The spots may be large or small, and the distribution is not very uniform. There is pain, let’s talk about the cause of the disease.   So, if allergic purpura relapses, is it necessary to review? The symptoms of recurrence of anaphylactoid purpura are somewhat similar to the initial symptoms. If the rash completely disappears and reappears, or is accompanied by abdominal pain and joint swelling and pain, it can also cause kidney damage. The recurrence is the same as the original symptom. However, anaphylactoid purpura is a chronic process, so recurrence must be related to early treatment and follow-up, as well as life adjustment.  Children with allergic purpura after initial treatment, such as the disappearance of rash, gastrointestinal symptoms relief, joint swelling and pain disappear, long-term follow-up in the outpatient clinic, regular urine check, because urine changes often indicate kidney damage. Kidney damage is prone to appear within 6 months of onset, so urine should be checked frequently and rechecked to see if there is edema or proteinuria. If there is any of the above conditions, active treatment should be taken.  If the kidney has no problem after 6 months, you can stop the review. However, some symptoms may reappear after 6 months, and there may be recurrence of the disease. It is necessary to actively find the cause of recurrence. Most of them are infections, strenuous exercise, and stimulation of the external environment. It may cause recurrence of the disease, which is relapse. Be sure to go to the hospital to check if there are induced factors, and then give re-treatment.   Therefore, in order to prevent recurrence, it is necessary to pay attention to infection. Most patients with purpura are associated with upper respiratory tract infection or throat discomfort about one or two weeks before the onset of the disease. Bacteria, viruses, mycoplasma, parasitic infections, etc. may cause the recurrence of this disease, we must pay attention to prevention. There is also the restriction of exercise or even bed rest. In fact, during the acute attack period, proper bed rest is necessary to restrict exercise. However, if you are bedridden every day, even the child must carry it on the back of the toilet. It is completely unnecessary.

MDS patients, don’t let immunosuppressants kill you

Shi Shurong’s studio WeChat xyk261 immunosuppressant has a wide range of types, each of which has a different mechanism of action, but their common characteristics are able to suppress immune cells and reduce inflammatory factors. There are several types of immunosuppressants commonly used in clinical practice. Specialists will select the appropriate immunosuppressant according to the characteristics of each drug and the actual situation of the patient.   Glucocorticoids are also called steroidal anti-inflammatory drugs, that is, people often say “hormones”. The names of such drugs often carry a word “pine” or “dragon” at the end, such as prednisone, dexamethasone, methylprednisolone, etc. Hormones have a wide range of functions, such as anti-inflammatory, anti-rheumatic, anti-allergic, and immune system. It can effectively reduce inflammatory factors and suppress various immune cells.   Clinically, for those patients with strong immune response and severe inflammation, the use of hormones will have an immediate effect. However, it is precisely because the hormone has too much effect, so it is a “double-edged sword.”  Osteoporosis, necrosis of the femoral head, increased blood sugar, increased blood pressure, body fat, peptic ulcer, etc., are common adverse reactions of hormones. These adverse reactions often occur in patients who use hormones for a long time. Therefore, when the specialists use hormones, they will closely observe the condition, and once the condition is controlled, they will begin to reduce or stop the hormones in time. It is often accompanied by calcium supplementation and stomach protection during treatment to reduce side effects.  Recommend everyone to be very careful when using hormones. I once met an old woman who bought prednisone for a long time in a pharmacy. When the joint hurts, I took a few capsules, just like we usually eat sugar pills. After several years, not only the disease has not been cured, but bone Loose, severely deformed joints. There is also a patient with lupus erythematosus. After treatment in many hospitals and long-term use of large doses of hormones, the femoral heads were necrotic on both sides, and the femoral heads were changed at a young age. Many people have infections due to the use of hormones, and they may even be in danger of life.   Therefore, as a patient with MDS, in the treatment, do not blindly increase the amount due to the use of medicine, and you must consult a professional doctor to take medicine according to different personal conditions to avoid harm to your health.

Want to contain leukemia, take a look at these “signs”!

Xiebeilu studio WeChat add369456 In recent years, the number of people suffering from leukemia has been increasing, and the prevention and control situation is still grim. With the continuous development of medical standards, the survival rate of leukemia patients has increased significantly, but at the same time, it has also become a hidden health risk for cancer survivors.   Cancer cell damage is often irreversible, so early screening, early warning, and timely intervention have become one of the important cores of leukemia.   So how to contain leukemia, take a look at these leukemia markers! In the early stage of leukemia, symptoms of pain in the bones and joints of the extremities often occur, and there may be spot bleeding, dry bleeding such as nose bleeding, gum bleeding, but because the symptoms are not obvious, many people ignore it, but this situation is best Go to the hospital for examination early. If you often feel nausea and vomiting or headache is one of the symptoms of leukemia, especially persistent, this situation should be more vigilant, go to the hospital as soon as possible, do not blindly take pain medicine To avoid affecting inspection and treatment. In conjunction with the treatment, we must ensure adequate rest and maintain a stable mood.   Leukemia is best detected and treated early, so as to reduce the damage to the body. With current medical methods, the most important thing is to treat it with drugs, or choose the appropriate treatment method according to the specific situation of the patient.

Falling into the abyss of blood transfusion, it happens once a week. Where do the patients with aplastic anemia go?

Xiebeilu studio WeChat add369456 Aplastic anemia is generally very long and will recur. Therefore, it is necessary to take medicine to maintain, but long-term use produces drug dependence, which in turn hurts the liver and kidneys. And some patients are also prone to bleeding, often need continuous blood transfusion, trapped in the abyss of blood transfusion, what should I do? Long-term use of hormone drugs, common adverse reactions can be seen in Cushing’s syndrome, hyperlipidemia, hypertension, hyperglycemia, atherosclerosis, gastrointestinal ulcers, bleeding, weakened immunity, easy infection, delayed skin wound healing , Erythema, perioral dermatitis, femoral necrosis, muscle atrophy, osteoporosis, cataracts, glaucoma, sodium water retention, hypokalemia, hypogonadism, delayed puberty, oligomenorrhea or amenorrhea.   In fact, in order to treat patients, some doctors will abuse antibiotics. Not only does it not improve, but it has a negative effect on the patient’s condition and affects the recovery of the condition. Therefore, while using conventional Western medicine, Chinese medicine can be used as an auxiliary. Many Chinese herbal medicines have the effects of nourishing kidney and filling essence, benefiting marrow and blood, strengthening spleen and qi, clearing heat and detoxifying. The treatment of aplastic anemia can reduce the toxic and side effects of Western medicine on the body and regulate Liver and kidney, better cure aplastic anemia.

Not every MDS patient is suitable for hematopoietic stem cell transplantation

Hu Guisheng Assistant WeChat: dd326751 Source: Transferred from WeChat public account [Hu Guisheng Studio] MDS, which is myelodysplastic abnormal syndrome, is a disease that is not easily cured by the blood system and has the characteristics of high-risk to acute leukemia. The simplicity can be mainly manifested as anemia, or anemia, leukopenia and the reduction of platelets, the prognosis is also different. According to the different somatic cell products invaded, the number of primitive cells and their karyotypes are different, MDS is divided into low risk, medium risk and high risk. For low-risk patients, the mean survival period is around 5 years, and for medium-risk patients, the mean survival period is around 2 years. However, for high-risk patients, the mean survival period is less than half a year.  When MDS is at high risk, hematopoietic stem cell transplantation is still recommended. If hematopoietic stem cell transplantation is successful, it is a good message. In fact, it can continue its own life. However, after getting sick, it will not become more and more physically and mentally healthy as before. Therefore, even if hematopoietic stem cell transplantation is successful , Also depends on their own situation.   Generally speaking, the current MDS treatment should be based on the risk group to decide the treatment plan and strategy. Treatment of MDS patients in the relatively low-risk group includes supportive therapy (component blood transfusion, hematopoietic factor therapy), immunomodulators, demethylation therapy, and traditional Chinese medicine therapy. Chemotherapy and hematopoietic stem cell transplantation are generally not recommended. Patients in the relatively high-risk group require high-intensity treatment, including combination therapy, demethylation, chemotherapy, and hematopoietic stem cell transplantation, but high-intensity treatment, such as chemotherapy transplantation, has higher treatment-related complications and mortality, and is not suitable for all patients. .   In addition, there is another very important point, that is, the age span of MDS is relatively large. In my country and Asia, the age of onset tends to be younger. There are a small number of children and adolescents with MDS in clinical practice, and some adults have MDS, but most of them are still sick for the elderly. Therefore, when formulating treatment plans and measures, in addition to the prognostic scores of MDS patients, a comprehensive assessment should be made based on the patient’s age, physical condition, comorbidities and accompanying diseases, treatment willingness and compliance, etc., and select an individual treatment plan. To suit every patient and prevent over-treatment and under-treatment.

Hu Guisheng: Will leukemia be transmitted through blood?

Assistant Hu Guisheng WeChat: dd326751 Source: Transferred from WeChat public account [Hu Guisheng studio] Leukemia is a malignant tumor caused by blood disease, which brings great harm to our health. But leukemia is not contagious. Here we analyze whether there is a possibility of infection from the onset factors and blood infection. Also study how to diagnose leukemia.  Analysis of pathogenic factors is not infectious. The etiology of leukemia is mainly related to viral infection, ionizing radiation, genetic factors, and chemical factors. Judging from the therapeutic factors of leukemia, leukemia is not infectious, and leukemia will not get sick because of infection. The etiology of its onset is diverse, and there is no possibility of infection. Therefore, it is necessary to stay away from radiation and chemical pollution in daily life and pay attention to life safety to prevent leukemia.  Leukemia does not spread through blood. This is because the body has a certain repelling effect on foreign substances. Even if a small amount of leukemia cells enter the body, the body can quickly remove them and destroy them. Foreign leukemia cells cannot continue to grow and reproduce in the body. Therefore, leukemia cannot be transmitted through the blood.   At present, no leukemia is listed as a member of infectious diseases worldwide. In daily diagnosis and treatment, it is not necessary to take isolation measures for patients, and different blood patients (including leukemia patients) are admitted in the blood ward, and there is no mutual infection. The medical staff who usually have long-term contact with leukemia patients have not been infected with leukemia.  Through the above analysis, we made it clear that leukemia is not contagious. So if there are leukemia patients around, don’t be afraid to contact them, care more about them, and give them more care. But leukemia can be transmitted to the next generation by genetic methods, so couples need to do a marriage check before giving birth. Leukemia is a disease that is difficult to treat. Most of this disease will be treated by bone marrow transplantation, otherwise it will affect the safety of patients.

Hu Guisheng: What are the symptoms of baby thalassemia?

Hu Guisheng Assistant WeChat: dd326751 Source: From WeChat public account [Hu Guisheng Studio] Pediatric thalassemia is referred to as pediatric thalassemia, also known as marine anemia. Because it is caused by a defect in the globin gene, it is professionally called “globin production disorder anemia.” The disease is hereditary, and the cause of the disease is simply a genetic defect in Hb’s globin, which leads to obstacles in the synthesis of the corresponding globin chain, resulting in changes in the composition of hemoglobin and ultimately anemia. The clinical condition of most patients is chronic progressive hemolytic anemia. The regions with higher incidence rates abroad are Southeast Asia and the Mediterranean coast, and the southern provinces of China are Gui, Yue, Qiong, Shu, and Chongqing, while the incidence rates in the north are lower.  Baby is a child just born, can be called a baby. It can be said that the parents of the baby are caring, and they are afraid of falling in their mouths and holding them in their hands, and they are afraid of falling. The kind of love is more powerful than loving yourself. The baby will attach great importance to a little problem. The disease, that is, what will happen to the baby of thalassemia.   Thalassaemia is different from general anemia. General anemia is only occasionally dizzy, but thalassemia will affect the baby’s growth and development. If the baby has had thalassemia just after birth, it is mainly due to genetic factors, so it will cause thalassemia. Babies with thalassemia need to receive treatment in time, otherwise it will have a great impact on the baby.   1. The first symptom of a baby with thalassemia is anemia, which is the most common symptom. Babies with thalassemia will look pale and malnourished. In the future life, parents should take good care of the baby, otherwise the baby’s physical health will be greatly affected.   2. The baby’s body will be weaker. Compared with other normal babies, the baby with thalassemia will be weaker. Once cold, there will be symptoms of cold and fever.   2. The baby will have abnormal digestive system. The baby with thalassemia has a different digestive system than other babies. The baby with thalassemia often suffers from abdominal pain and diarrhea, mainly because the patient’s digestive system is affected.   3. Thalassaemia babies will also have developmental delay, and the absorption ability of thalassemia babies will also be affected. Mainly because anemia affects the patient’s growth and development, once this happens, it still needs to be treated with drugs, otherwise the child’s physical health will be greatly affected.  These are some of the symptoms related to thalassemia. Once a thalassemia baby is born, the body will be greatly affected, and the immunity will be relatively low. The problem of thalassemia is more complicated and requires treatment for a longer time, which may be accompanied by the child for life. It is recommended that couples check their bodies before preparing for pregnancy, so as to prevent the appearance of thalassemia.

Shi Shurong Medical Talk: How to treat chronic myeloid leukemia complicated with myelofibrosis?

Now, the treatment of many patients with chronic myeloid leukemia requires long-term use of targeted drugs to control the disease. Some patients have a significant therapeutic effect and the disease has been stable. Some patients may have some complications, such as bone marrow fibrosis. Director Shi Shurong’s WeChat consultation platform: zkxk9999 Disease description: The patient is 43 years old, diagnosed with chronic myeloid leukemia for three years, and treated with imatinib. During this period, the disease control effect is good. Later, the patient was found to have severe anemia, somatosensory weakness, weight loss, and the hospital review found “bone “Slim”! Now the patient has swollen legs, weight loss, splenomegaly, and severe anemia, how to treat? Doctor: In the case of no obvious effect of Western medicine treatment, it is recommended to combine Chinese and Western medicine. Oral targeted drugs are used to control the disease. If the splenomegaly is significant and the compression is obvious, the spleen can be cut for treatment. In addition, it cooperates with syndrome differentiation treatment of traditional Chinese medicine, strengthens the spleen and kidneys, promotes blood circulation, improves symptoms and relieves the disease, and at the same time, the effect of reducing the spleen is also obvious. In summary, chronic myeloid leukemia complicated with bone marrow fibrosis should be treated with integrated traditional Chinese and western medicine as early as possible. The combination of the two advantages will help the treatment of the disease, reduce the side effects of western medicine, and improve the microenvironment of the patient’s bone marrow hematopoiesis and enhance the patient. Quality of life and prolonged survival. More patient communication help can pay attention to WeChat public account: Slow Grain Patient Association

Xie Bie Lu medical words: the interaction between imatinib and commonly used drugs, it is recommended to collect!

Most patients with chronic myeloid leukemia have a long course of disease, and they need to take targeted drugs for a long time to control the disease. However, in the process of medication, chronic patients may encounter the need to take other drugs. So, what impact do other drugs have on targeted drugs? Director Shi Shurong’s WeChat consultation platform: zkxk9999 Let me share with you the effects of some common medications on imatinib: 1. Acetylphenol-Imatinib can cause abnormal liver function tests. A patient who took a large dose of acetaminophen and imatinib at the same time developed liver failure and died. Therefore, patients taking imatinib should limit the use of acetaminophen. That is, for most patients, the dose of acetaminophen should be ≤1300mg/d. 2, aprepitant-aprepitant inhibits CYP4503A4 activity and increases the plasma concentration of imatinib. 3. Carbamazepine-Carbamazepine induces CYP4503A4 activity and reduces the plasma concentration of imatinib. It is usually necessary to increase the dose of imatinib. 4. Clarithromycin-Clarithromycin inhibits the activity of CYP4503A4 and increases the plasma concentration of imatinib. 5. Cyclosporine-Imatinib inhibits the activity of CYP4503A4 and increases the plasma concentration of cyclosporine; due to the narrow therapeutic window of cyclosporine, this interaction is worthy of attention. 6. Dexamethasone-Dexamethasone induces CYP4503A4 activity and reduces the plasma concentration of imatinib. It is usually necessary to increase the dose of imatinib. 7. Erythromycin-Erythromycin inhibits the activity of CYP4503A4 and increases the plasma concentration of imatinib. 8. St. John’s wort-St. John’s wort induces CYP4503A4 activity and can reduce the plasma concentration of imatinib. Patients receiving St. John’s wort treatment may need to increase the dose of imatinib. 9. Itraconazole—Itraconazole inhibits the activity of CYP4503A4 and increases the plasma concentration of imatinib. 10. Ketoconazole-Ketoconazole inhibits the activity of CYP4503A4 and increases the plasma concentration of imatinib. 11. Phenobarbital-Phenobarbital induces CYP4503A4 activity and reduces the plasma concentration of imatinib. It is usually necessary to increase the dose of imatinib. 12. Phenytoin-Phenytoin induces CYP4503A4 activity and reduces the plasma concentration of imatinib. It is usually necessary to increase the dose of imatinib. 13. Pimozide-Imatinib inhibits the activity of CYP4503A4 and increases the plasma concentration of pimozide. Due to the narrow therapeutic window of pimozide, this interaction is worthy of attention. 14. Rifabutin-Rifabutin induces CYP4503A4 activity and reduces the plasma concentration of imatinib. It is usually necessary to increase the dose of imatinib. 15. Rifampicin-Rifampicin induces CYP4503A4 activity and reduces the plasma concentration of imatinib, usually increasing the dose of imatinib. 16. Rifapentine-Rifapentine induces CYP4503A4 activity and reduces the plasma concentration of imatinib. It is usually necessary to increase the dose of imatinib. 17. Simvastatin-Imatinib inhibits the activity of CYP4503A4 and increases the plasma concentration of simvastatin. The dosage of simvastatin may need to be adjusted. 18. Warfarin-Warfarin is metabolized by CYP450 isoenzymes CYP2C9 and CYP3A4, and the simultaneous application of warfarin and imatinib may lead to increased utilization of warfarin. To sum up, in the course of treatment, patients with slow-grained patients should choose carefully for other drugs that may affect the therapeutic effect. If you need to take the above drugs at the same time, you need to consult a professional doctor first. Do not use the drugs yourself to avoid adverse reactions. More patient communication assistance can follow the WeChat public account: Slow Grain Patient Association

Shi Shurong’s Medical Talk: Summary of Inventory: TCM Classification and Medication for Chronic Aplastic Anemia!

At present, for the treatment of aplastic anemia, the intervention of traditional Chinese medicine has obvious advantages. Applying Chinese medicine to treat aplastic anemia can help patients adjust the immune system, improve the micro-hematopoietic condition, and repair hematopoietic stem cells. Director Shi Shurong’s consultation with WeChat zkxk9999 Chinese medicine believes that the essence of chronic aplastic anemia is “kidney deficiency”. During clinical diagnosis and treatment, the syndrome is further differentiated into kidney yin deficiency type, kidney yang deficiency type, kidney yin and yang deficiency type according to the patients’ symptoms of partial yin and yang. . For chronic aplastic anemia, traditional Chinese medicine is based on syndrome differentiation and treatment. The specific methods and medications are as follows: Yin deficiency and fire exuberance, blood pressure and delirium type: Syndrome characteristics: dizziness, paleness, two cheeks flushing, five upset fever, night sleep and dreams , Waist and knees are sore, hot flashes and night sweats, thirst and drink, skin petechiae, bleeds, fresh bleeding color, tender purple red moss thin shaojin or less moss, pulse count. Remedy: Nourishing Yin and reducing fire, cooling blood to stop bleeding Prescription: Buffalo horn tablets, raw peony, white peony root, Phellodendron chinense, Rehmannia glutinosa cornus, Huaishan medicinal herbs, Xiejiang turtle, Biloba root, Agrimonia spp., and bleeding if obvious: according to different bleeding parts Echinacea purpurea, white gerbera, small thistle, raw ground elm, arborvitae leaves, pistil, etc. Kidney-yin deficiency type: Syndrome characteristics: hot flashes and night sweats, hot hands and feet, white cheeks and red face, less sleep and more dreams, soft back and legs, palpitations, panic, fresh bleeding, tender red tongue and thin moss or less moss, pulse count. Governing Law: Nourishing Yin and Kidney, Yiqi and Regenerating Marrow. Prescription: Rehmannia glutinosa, Cornus officinalis, Huaishan medicine, Radix Polygonum, Ligustrum lucidum, Ligustrum lucidum, Dodder, Psoralen, Poria cocos, Angelica, Heliotrope, Hedyotis, Astragalus, Radix, Chia, Hawthorn, Astragalus, Astragalus, Lycium chinense, Ejiao (Xiang), Kidney-yang deficiency type: Syndrome characteristics: pale complexion, cold limbs, pale lips, shortness of breath, lazy breath, soft waist and legs, soft bowel movements, pale bleeding, pale tongue and white fur with dents and weak pulse. Governing Law: Warm the kidney and aphrodisiac, benefit Qi and regenerate the marrow Prescription: Radix Cornus officinalis, Huaishan medicine, Radix Polygonum, Radix, Dodder, Psoralen, Radix Sinensis, Morinda officinalis, Radix Angelicae, Radix Angelicae, Hedyotis sibiricum, Coriander, Hawthorn, Cinnamon, Raw Radix Astragalus, Ginseng, Antler Gum (Closed). If the appetite is weak: add orange peel, pinellia, radish seed, chicken inner gold, Jiao Liuqu and other kidney yin and yang deficiency type: syndrome characteristics: pale complexion, cold and hot, spontaneous sweating, sweating and sweating Sour and soft, nocturnal emission is slippery, pale tongue with thin white or no coating, pulse thin and weak or thin. Governing Law: nourishing yin and aphrodisiac, replenishing qi and regenerating marrow. Prescription: Radix Rehmanniae Preparata, Radix Cornus officinalis, Ligustrum lucidum, Prunus sibiricum, Psoralen, Antler, Cistanche, Cistanche, Spleen, Huaishan, Poria, Heliconia, Radix Angelica, Radix Angelicae, Radix Astragali, and Hawthorn. Finally, aplastic anemia is a benign blood disease. As long as the patient is detected early and actively treated, the prognosis is generally better. As for the choice of treatment method, patients should not rely too much on Western medicine, and should choose the treatment method that suits them according to their own condition. For more aplastic disease knowledge or patient help, you can follow the WeChat public account: skg120

Xie Bielu’s medical remarks: What conditions can cause the suppression of bone marrow hematopoiesis and cause aplastic anemia?

Aplastic anemia is a group of syndromes in which the total volume of red bone marrow is reduced due to bone marrow hematopoietic failure caused by various causes and replaced by fatty marrow. The occurrence of aplastic anemia is often caused by certain factors. Director Shi Shurong’s consultation on WeChat zkxk9999 At present, the main causes of aplastic anemia caused by the suppression of bone marrow hematopoiesis in common life are mainly as follows: tuberculosis: In addition to showing symptoms such as dyspnea, cough, bronchopneumonia and lymphadenopathy, the patient gradually loses weight, Bone marrow hematopoietic function is suppressed, showing aplastic anemia. Necrosis: The patient gradually loses weight, the hematopoietic function of the bone marrow is suppressed, and aplastic anemia occurs. According to the characteristic symptoms of various types of burkholderia, the burkholderiac test and the positive complement binding reaction can be identified. Arsenic poisoning: there is a life history of exposure to arsenic-containing pesticides (diarsenic trichloride, etc.), and the illness often occurs when the arsenic-containing pesticides are swallowed for several hours. The main symptoms are severe gastrointestinal symptoms and neurological symptoms, such as severe diarrhea, or alternating diarrhea and constipation, chronic cases such as visual impairment, ataxia, and blood changes in aplastic anemia. Liver and kidney arsenic content exceeding 10-15ppm can be used as reference for diagnosis. Mercury poisoning: Chronic mercury poisoning can inhibit bone marrow hematopoietic function and cause aplastic anemia. There is a life history of exposure to organic mercury pesticides. Gastrointestinal and neurological symptoms such as persistent diarrhea and ataxia appear. Renal mercury increased, and mercury repelling treatment was effective. Chloramphenicol poisoning: there is a history of long-term application of chloramphenicol, especially excessive application. The first is to inhibit erythropoiesis, and then other bone marrow cell lines are also suppressed, inducing aplastic anemia. Sulfa poisoning: It can cause aplastic anemia, which can be identified based on the history of long-term use of sulfonamides. In summary, some poisoning phenomena or diseases in life may cause aplastic anemia. For these causes, remind everyone to stay away from toxic and harmful substances, ionizing radiation, viruses and other factors. If the above symptoms occur, diagnose as soon as possible. Clarify the condition and treat symptomatically. For more aplastic disease knowledge or patient help, you can follow the WeChat public account: skg120

Shi Shurong’s Medical Talk: What should I do if hormones treat thrombocytopenia and the body is severely swollen?

Many patients who have just been diagnosed with thrombocytopenia, especially those with lower values, will be treated with hormonal drugs, but the rapid increase of hormonal drugs will also bring many side effects. How should patients respond? Director Shi Shurong consulted Ms. Qi, a patient on WeChat zkxk9999: I am 25 years old, and my physical examination found that the blood routine platelet value is only 26, but the body has no discomfort symptoms, no bleeding, and only a slight bump is prone to bruising. After a bone marrow aspiration examination, the bone marrow hematopoietic function was normal. The doctor gave oral hormone therapy. Later, the platelet rose to 85, but after using the hormone for a month, the body was severely swollen and I dared not eat it again. Excuse me, is there any good treatment? ? Hematologist: Thrombocytopenia is a relatively common benign disease. The cause of the disease involves autoimmune disorders. In short, the patient spontaneously produces an anti-platelet growth antibody that destroys platelet growth. Commonly used therapeutic drugs have certain side effects. The most common side effects of hormones are: centripetal obesity, gastric mucosal damage, hypertension and elevated blood glucose; blood product infusions are only short-term effective, and their side effects are minor, but there are infections related to blood transfusion-related diseases Risk; while the spleen is removed for treatment, the spleen is an important immune organ of the human body, and the ability to resist infection will be reduced after resection, which needs to be evaluated by a specialist clinic. At present, for the treatment of targeted thrombocytopenia, the timely intervention of Chinese medicine and traditional Chinese medicine has made more and more patients see a more obvious increase in platelets. At the same time, compared with hormone therapy, traditional Chinese medicine will not let patients be affected by side effects. At the same time, after the patient’s platelet lifts and stabilizes, the chance of recurrence is also greatly reduced. Because thrombocytopenia is mostly related to the imbalance of the patient’s autoimmune function, even if the patient recovers and the platelet returns to normal, it is necessary to pay close attention, regularly review the blood routine, and monitor the platelet value. To emphasize, the lower the platelet value, the higher the risk of bleeding. Therefore, regardless of bleeding symptoms, patients should be actively treated to increase the platelet value and avoid serious bleeding. In addition, cold infections are also likely to cause relapse or exacerbation of thrombocytopenia, pay attention to prevention in life. For more thrombocytopenia disease knowledge or patient help, please pay attention to WeChat public number: xxbjs75

Xie Bielu medical words: Patient question: How can thrombocytopenia no longer recur?

Thrombocytopenia is a common hemorrhagic disease, but some patients have a low value, but they are accidentally found due to a bleeding point caused by a cold, which confirms the diagnosis of thrombocytopenic purpura. How to treat this situation? Director Shi Shurong consulted with WeChat zkxk9999 Hebei patient Mr. Wang: I found a skin bleeding spot to go to the hospital for a cold and was diagnosed with idiopathic thrombocytopenic purpura. Bone marrow aspiration showed megakaryocyte maturation disorder. Blood routine examination of platelet value 9. 2016 3 He was admitted to the hospital on the 24th of the month. He was checked for platelet 122 on the 29th of the month. He was discharged from the hospital on May 27. PLT8 was admitted to the hospital again. Intravenous infusion of dexamethasone 40mg, medication for four days, prednisone suspension, platelets 41, 3 mg of prednisone orally to stop after stopping the meter, in conjunction with eating Chinese medicines for platelet ascending, such as platelet decline to continue a large dose shock. After that, the condition was repeated twice, and each time required hospitalization, which was expensive. I don’t know how to treat it, so that thrombocytopenic purpura will not recur? Hematologist: According to the data, the diagnosis of idiopathic thrombocytopenic purpura is clear. The disease is humoral immune-mediated destruction of platelets. The traditional treatment methods include: hormone, splenectomy and immunosuppressive therapy. From the point of view of platelet values, platelets can be elevated after hormone shock treatment, indicating that the hormone is still effective. However, when taking oral hormones, the reduction and withdrawal should not be too fast. At the same time, since the effects of hormone drugs on increasing platelet value are mostly temporary, in order to avoid the occurrence of side effects and improve the efficacy of hormones at the same time, it can be combined with traditional Chinese medicine and conditioning. At present, the treatment of thrombocytopenic purpura is mostly based on the combination of traditional Chinese medicine and western medicine. Traditional Chinese medicine uses medicine based on syndrome differentiation. Western medicine treatment can prevent patients from severe bleeding and avoid life worries. Complementary treatment of traditional Chinese medicine and western medicine can stabilize the patient’s condition. , No more. For more thrombocytopenia disease knowledge or patient help, please pay attention to WeChat public number: xxbjs75

Learn about these two chemotherapy drugs for myeloproliferative diseases!

Chemotherapy drugs are rarely used for early high-intensity treatment of myeloproliferative diseases. In clinical practice, high-intensity control is generally involved before chemotherapy is used. After all, there are pros and cons. The disadvantage is also a more prominent treatment mode. The answer to whether chemotherapy drugs can cure myeloproliferative diseases is unattainable. Mainly for the purpose of control and maintenance. A complete cure is currently not possible. The following is a summary of the last two types of chemotherapy drugs aimed at this group of patients. Can understand the popularity. Can chemotherapy drugs cure myeloproliferative diseases? What are the common medications? (3)-Piperbromide is a piperazine drug. Usage 75mg/d, oral administration in divided doses, when the hematocrit decreases, change to 50mg daily, after 2 to 3 months of administration, about 90 to 95% of patients with myeloproliferative diseases (true red) can get complete remission . Clinically, for patients who achieve remission, treatment is maintained at 25 mg daily thereafter. The side effects are lower than other alkylating agents. The main side effects are gastrointestinal reactions. There are also a certain degree of white blood cell and platelet reduction, which should be paid attention to. As for the problem of the incidence of leukemia, it still needs long-term observation. ——Anagrelide first- and second-line medicine. This medicine can inhibit platelet aggregation and reduce the number of platelets. There are no reports of chromosomal damage caused by the use of this drug. It is only used for patients with high-risk factors for thrombosis, which can be considered. In summary, it is a common medicine used in chemotherapy. Patients need to receive the most appropriate treatment according to their own conditions under the guidance of medical advice. If you have any questions about this article or the disease, please feel free to follow us on WeChat and search more about MPD patients: xejb120

A major performance affecting the recovery of allergic purpura: organ damage!

The previous popular science emphasized the rehabilitation standards for allergic purpura. Especially for the observation of the relief of skin purpura and the subsequent cure. Recently, a patient’s question is also a problem that many patients will mention-the recurrence of purpura is not as serious as the last one. Is this almost ready? What is certain is that in the treatment stage, if the number of purpura repetitions, such as purpura this time, is broader, dense, and slows down, but it is alleviated after treatment, and after the next repetition, the purpura becomes sparse, And it can alleviate and disappear on its own. This time is much shorter than the last relapse. This is the sign of recovery. A major performance affecting the recovery of allergic purpura: organ damage! Henoch-Schonlein purpura is an acute disease, but the treatment stage, even before and after, is a chronic process. The longer the course of the disease, the easier it is to cause damage to the organs. Damage to other organs. Simple skin damage generally does not have serious consequences, but kidney damage is not the same. It may cause kidney failure, nephrotic syndrome, and even a lower probability of uremia. The curative problem of allergic purpura can be recovered, mainly in choosing the right medical prescription and adding the patient’s own cognition and attitude towards the disease. Seemingly a very small disease, serious problems may occur behind it. Therefore, the repeated attacks of purpura and damage to organ complications need to be highly concerned. If you have any questions about this article or the disease, please feel free to follow us on WeChat Soyisou: gmxzd1

Shi Shurong: The signal before purpura nephritis, urinary tract infection!

Shi Shurong Studio WeChat xyk261  Children’s purpuric nephritis, also known as allergic purpuric nephritis, is a disease in which the main pathological changes of microscopic red blood cells or combined proteinuria appear in the urine test within 6 months after allergic purpura, which are more common in children with allergies, especially Children who have had eczema or asthmatic bronchitis in infants and young children, after ingestion of food or inhalation allergens, symmetrical rashes on the lower extremities occur, which are more common in the legs and necks, and they do not fade, or have abdominal pain and Arthralgia, the main cause of the disease is the deposition of immune complexes in the mesangial area or vascular loops.  Urinary tract infections are also called urinary tract infections. According to anatomical location, they can be divided into upper urinary tract infections and lower urinary tract infections. The clinical manifestations are frequent urination, urgency, dysuria, fever, headache, nausea, vomiting, hematuria. Urinary tract infections caused by different causes may behave differently, and finding the cause may be more important. If a patient with purpura nephritis develops a urinary tract infection, it means that his immune system has been damaged. So what are the symptoms?   often has symptoms of backache fatigue, urination dripping, incomplete urination, frequent urinary urgency, bloating and other symptoms. From the perspective of traditional Chinese medicine, these symptoms can be attributed to syndromes of kidney deficiency or spleen and kidney deficiency after syndrome differentiation, and may also be accompanied by evil symptoms such as bladder dampness and heat, liver and gallbladder dampness and heat. In the literature of Chinese medicine for allergic purpura, purple spots appear on the skin, which are generally classified as “spot”. Because allergic purpura often has external feelings at the beginning of the disease and is caused by allergies, its etiology is mostly related to wind and humidity. , Heat, poison and evil. The pathogenesis of purpuric nephritis can be considered as a patient who has blood heat content, exogenous wind evil or food with moving wind, wind-heat fight or heat poison, such as burning blood, causing blood pressure, causing skin to overflow, skin overflow , Intestinal gastrointestinal, and even kidney, so there are frequent skin purpura of the lower limbs, abdominal pain frequently, even blood in the stool and urine. Therefore, some conservative treatments, such as anticoagulant drugs and microcirculation-improving drugs, should not be overtreated. Can be matched with Chinese medicine at the same time of treatment, with the assistance of Chinese medicine, to achieve the effect of increasing efficacy and reducing toxicity.

Farewell: How long will it take to get rid of blood transfusion?

Xiebeilu studio WeChat add369456  Severe aplastic anemia is an acute and severe disease in the hematology department, which is manifested in the severe reduction of whole blood cells, and the clinical manifestation is more serious. The neutrophils are less than 0.5×10^9/L and the hemoglobin is less than 60×10^9/ L, platelet is less than 20×10^9/L, it is severe aplastic anemia. Symptoms are pale, anemia, and fatigue. Those with severe bleeding usually receive blood transfusions to maintain the bleeding. Generally, slow-acting drugs cannot quickly improve the patient’s condition. For suitable patients, anti-human thymoglobin plus cyclosporin A immunosuppressive treatment is considered. After treatment, 70%-80% of patients can get better Relief, that is, blood can reach normal levels. Allogeneic hematopoietic stem cell transplantation treatment is also effective for patients with suitable conditions, that is, patients who are younger than 40 years old and have siblings.   And for blood transfusion board, it can quickly raise blood platelets in a short time, leaving the patient with first-line vitality. However, subsequent treatment requires individualized treatment.   So how can we get rid of the blood transfusion barrier? According to the patient’s condition, blood transfusion can be used as an emergency method for the patient to temporarily relieve the bleeding. If other treatment methods are used to reduce the number of blood transfusions and adjuvant treatment, for the diseased group that is not controlled by targeted treatment, blood transfusion treatment It can last up to several years. Therefore, the traditional Chinese medicine combined with ATG/ALG method for the treatment of severe aplastic anemia, easy to obtain reticulocyte counts, easy to promote clinical, good repeatability, can effectively reduce the number of blood transfusions, from internal conditioning to aplastic anemia, to increase efficiency Attenuated effect.

Shi Shurong, Beijing Institute of Hematology: Is aplastic anemia a leukemia?

Aplastic anemia is a bone marrow hematopoietic failure caused by a variety of reasons. After hearing this, many people will think that aplastic anemia is similar to leukemia, but in fact, there is an essential difference between the two. Leukemia is a kind of Malignant neoplastic disease of the hematopoietic system, and aplastic anemia is a benign disease. Director Shi Shurong consulted WeChat zkxk9999 So, as the name implies, is it “anemia”? Hematologists tell you that whether aplastic anemia is equivalent to leukemia or anemia is anemia, this is a wrong perception. In the human body, bone marrow is equivalent to a factory for making blood cells, and its function is to make blood. Aplastic anemia refers to a disease in which bone marrow hematopoietic dysfunction caused by various causes leads to a decrease in pancytopenia to varying degrees, often manifested as paleness, dizziness, shortness of breath, bleeding from the nostrils and gums, fever and infection. Very few aplastic anemias are congenital, they are born, and most of them are acquired after birth. They are not genetic diseases and have no effect on future generations. May be caused by environmental pollution, exposure to toxic chemicals, viral infections, or the use of certain drugs, but more than 70% of patients have unknown causes, and the incidence is closely related to autoimmune disorders. The condition of aplastic anemia is serious, but it is not incurable. The current understanding of aplastic anemia by patients and relatives and friends is easy to go to two extremes-either think that the aplastic anemia is leukemia and has not been cured, or that the aplastic anemia is a general “anemia”. It doesn’t matter. According to the severity of cytopenia, the disease can be divided into severe (including very severe) aplastic anemia and non-severe aplastic anemia, which is not “untreated” or “doesn’t matter if treated slowly.” The acute and severe disease may be killed within three to six months. However, the medical community has now found a mature treatment. As long as the treatment is timely and standardized, the 10-year survival rate can reach 70%-80%. The treatment effect is better. The reason why people think that aplastic anemia is “not cured” is not only a problem of treatment difficulty, but also a restriction of treatment technology, and it has a great relationship with the high treatment cost. The high cost of medicine restricts regular or timely treatment. The treatment cost of severe aplastic anemia will be several hundred thousand yuan, some will reach 300,000 yuan, and most medicines are at their own expense. This is not something ordinary families can afford. All in all, as long as timely diagnosis and early standard treatment, aplastic anemia has the opportunity to recover a healthy body. Therefore, we must correctly recognize aplastic anemia, and choose the appropriate treatment according to their own conditions, and actively cooperate with treatment. For more aplastic disease knowledge or patient help, you can follow the WeChat public account: skg120

Shi Shurong’s medical words: The immune thrombocytopenia you want to know is here!

Immune thrombocytopenia (ITP) is an acquired autoimmune disease. It is the most common hemorrhagic disease caused by the decrease in platelet count seen clinically. Clinical manifestations of platelet count decreased to varying degrees, with or without skin and mucous membrane bleeding symptoms. ITP can occur at all ages. Generally, children are acute and adults are chronic. Director Shi Shurong consulted WeChat zkxk9999&nbsp.&nbsp. Most children with immune thrombocytopenia had a good prognosis. Here we have a comprehensive understanding of some common sense of immune thrombocytopenia: incentive: ITP: children have a history of infection before onset, which can be as high as 60%. Respiratory tract infections are common, mainly viral infections. In terms of bacteria, Helicobacter pylori infection may be one of its pathogenic factors. In children with acute ITP, the positive rate of HpIgG antibodies is 40.54%, and the positive rate of Hp IgG antibodies in children with chronic ITP is higher. There is no need to eradicate it. A unified statement of Hp infection, but a few reports show that Hp eradication can shorten the course of ITP and reduce recurrence, even if Hp eradication has no effect on the long-term treatment effect of ITP. In terms of immunization, the measles-rubella-mumps mixed vaccine (MMR) can induce the occurrence of ITP, but most of them have a good prognosis. The diagnosis has no specific diagnostic criteria and is an exclusive diagnosis. Generally, at least two blood routine tests show a platelet count of 100×109L, with or without skin bleeding, and other clinical manifestations. Excluding other secondary thrombocytopenia, such as hypoproliferative leukemia, Aplastic anemia and infection can only be diagnosed. Among them, whether a newly diagnosed ITP patient undergoes bone marrow aspiration examination to rule out other hematopoietic system diseases is currently inconclusive, and this examination is not recommended abroad, but domestic scholars recommend that those with clinical symptoms and signs and laboratory tests are not typical Before the use of glucocorticoids, refractory ITP and splenectomy before bone marrow puncture, repeat puncture if necessary. Classification New diagnosis ITP: course of disease 3 months; persistent ITP: course of disease 3-12 months; chronic ITP: course of disease 12 months. Treatment increases the number of platelets to a safe range to prevent major bleeding, without raising platelets to normal levels. It is generally believed that those with a platelet count of 30x109L and no obvious bleeding manifestations should not be treated and observed closely. Platelet count 30x109L, or with bleeding symptoms, or those with bleeding tendency can be treated regardless of the degree of platelet reduction. 1. First-line treatment (1) Prednisone, a glucocorticoid 2 mg (kg.d), can be administered intravenously at the beginning. After the platelet rebounds, it should be taken orally, and the dose should be gradually reduced to 3 to 4 weeks. If prednisone does not respond after 4 weeks of treatment, it should be rapidly reduced to discontinuation to assess whether the diagnosis is correct. (2) The common dose of gamma globulin (IVIG) is 0.4 to 1 g (kg.d) for 2 to 5 days, which can quickly increase the number of platelets. (3) Anti-D immunoglobulin 75ug (kg.d), 1 to 3 days, suitable for non-splenectomy children with Rh+, but it is not recommended for hemorrhagic anemia or autoimmune hemolytic anemia. 2. Second-line treatment (1) Glucocorticoid shock treatment of dexamethasone 1.5~2.0mg (kg.d) shock for 4 days or methylprednisolone 15~30mg (kg.d), change to prednisone 3 days after shock 1~2mg (kg.d) is taken orally. For the treatment of persistent or refractory ITP. (2) Anti-CD20 monoclonal antibody rituximab 375mgm2 intravenously, once a week, a total of 4 times, this is the standard regimen, the low-dose regimen dose was changed to 100mgm2. (3) 1mg (kg.d) of thrombopoietin recombinant TPO, used for 2 weeks, is used to treat refractory ITP. (4) Immunosuppressants such as cyclophosphamide, azathioprine, etc. (5) The indications for splenectomy are: those who are ineffective after regular medical treatment; platelet count 10X109L, those with life-threatening severe bleeding or urgent need for surgery; the course of disease is 1 year, age 5 years old; there are contraindications for the use of glucocorticoids By. Inoculation of Neisseria meningitidis, Haemophilus influenzae, and Streptococcus pneumoniae 2 weeks before surgery. Prophylactic use of penicillin after surgery can reduce the mortality of postoperative children. 3. When emergency treatment of severe ITP shows a life-threatening bleeding manifestation, methylprednisolone may be given a shock of 10-30 mg (kg.d) in combination

Beijing Academy of Hematology Xiebei Lu: slow-grain patients to improve treatment compliance is critical!

In the course of treatment, patients with chronic myeloid leukemia need long-term medication to control the disease, but the treatment effect of patients with medication is not the same. Chronic myeloid leukemia patients want to get good treatment results, they need to fully trust the doctor and follow the doctor’s instructions to standardize treatment. Director Shi Shurong consulted WeChat zkxk9999 First of all: regular curative response assessment TKI treatment regular monitoring and curative effect evaluation is the basis for optimizing TKI treatment CML. Timely discovery of problems in treatment and adjustment of the treatment plan are the prerequisites to ensure that patients get the best results. CML treatment monitoring includes three levels: hematology, cytogenetics and molecular genetics. Second: The interruption of TKI treatment and the poor compliance of patients may lead to adverse clinical results. Good medication compliance education and strict monitoring are very important to obtain the best clinical efficacy. Which conditions belong to the “poor compliance” actual medication (including dose and time) prescription medication ratio is less than 85%. According to GIPAP data, only 21% of patients who need to buy their own drugs can return to buy drugs on time the next year. Reasons why patients cannot return on time include: 30% of patients have used medications lower than the recommended dosage of the doctor and extended the duration of medication; 29% of patients discontinued medication because they feel good; some patients have insufficient knowledge of the disease and lack of follow-up; only 13.8 % Of the patients were unable to use the drug because of economic factors; 7.5% discontinued the drug because of drug resistance, intolerance or transfer to other clinical trials. Poor compliance may lead to treatment failure! The 5-year major molecular remission rate (MMR) of patients with good compliance is as high as 90%, while the number of patients with poor compliance is less than 20%; for patients who have achieved complete cytogenetic remission, patients who adhere to medication adherence are good 2 The rate of loss of complete cytogenetic remission after year is less than 5%, while patients with poor compliance are close to 40%. Of course, for patients with poor compliance, the increase in treatment costs is also inevitable. Therefore, whether it is imatinib or other medications, it is the top priority to follow the doctor’s instructions and regular regular monitoring! In addition, for patients with chronic myeloid leukemia who do not take well with targeted drugs, they can cooperate with traditional Chinese medicine treatment to effectively reduce the side effects of targeted drugs and improve the efficacy of drugs, thereby improving the quality of life of patients with chronic drugs. For more knowledge about chronic myeloid leukemia disease or patient help, you can pay attention to WeChat public number: mbxb120