Don’t pay attention to oral health and prone to tongue cancer!

1. The little meat ball was originally a tongue cancer. Mr. Chen, in his 50s, has a history of smoking for many years, but he is very careless in cleaning and protecting his teeth. Dark and thick tartar and calculus are obviously visible on the teeth. By chance six months ago, a friend took him to the hospital for an ultrasonic dental cleaning. The doctor discovered that two teeth on his right side had been decayed and had a broken crown, and there was a soybean-sized piece of meat growing on the edge of the adjacent tongue. ball. The doctor reminded him to check the meat ball, but Mr. Chen didn’t care. However, a few months later, Mr. Chen suddenly discovered that the small meat ball had grown up and was ruptured. It was very painful, and it was very painful. Slobber. Only then accompanied his family to the hospital’s stomatology department. The doctor carefully asked the medical history and performed histopathological biopsy for him. He was diagnosed with tongue cancer. 2. The addiction to tobacco and alcohol is the cause of tongue cancer and local trauma (mostly disabled). Roots and sharp teeth) are related to tobacco and alcohol habits. The prevention of tongue cancer should pay attention to the following common causes: 1. Chronic infection of the tongue and body inflammation or long-term unhealed 2. Poor oral hygiene 3. Mechanically stimulated tooth residual crown and root, sharp gum edge, poor denture restoration, especially metal Dentures stimulate the tongue mucosa to produce ulcers for a long time, and finally lead to cancer. 4. Chemical factors. Aromatic hydrocarbons in tobacco have carcinogenic effects, especially those who smoke cigars or use pipe smokers, and those who drink hard alcohol for a long time are 15 times more likely to suffer from oral cancer. 5. Malnutrition Vitamin A and Vitamin B deficiency are prone to cancer. 3. Tongue pain is alert to tongue cancer. Early tongue cancer can manifest as ulcer, protrusion and infiltration. In some cases, the first symptom is only tongue pain, which can sometimes reflect to the face or ears. Ulcerative and invasive cancers are often accompanied by spontaneous pain and different degrees of tongue movement limitation; protruding general tongue dyskinesia is not obvious, and less spontaneous pain. Tongue cancer can directly exceed the midline or invade the floor of the mouth when it enters the advanced stage. Infiltrate the jaw bone. It can extend to the base of the tongue or the lateral wall of the pharynx. At this time, the tongue movement may be severely restricted and fixed, and saliva will increase and overflow; eating, swallowing, and speech are all difficult, and the pain is severe, which can be reflected to half of the head. Tongue cancer often occurs with lymph node metastasis, which can be as high as 40% to 80% reported in the literature. 4. Biopsy can accurately diagnose tongue cancer. Tongue cancer is generally easier to diagnose. However, we must be vigilant for early tongue cancer, especially invasive cancer. For the diagnosis of tongue cancer, palpation is more important than inspection. In order to confirm the diagnosis, a biopsy should be performed. If the ulcer is not improved after removing the irritation factor and active local treatment in clinical practice, a biopsy should be performed in time for early diagnosis. Early treatment should be based on comprehensive treatment with surgery. Perform primary source resection and neck lymph node dissection, combined with radiotherapy or chemotherapy before or after surgery 5. Reduce oral irritation and prevent tongue cancer 1. Pay attention to oral hygiene, brush your teeth every morning and night, rinse your mouth after meals 2. Grind Change the sharp non-functional cusps and edge ridges to make the cusps and edge ridges of the occlusal surface of the crown become rounded and blunt to prevent damage to the lingual edge tissues 3. Quit smoking, alcoholism and other bad habits 4. Strengthen physical exercise ; Supplement nutrition, eat more fresh fruits rich in vitamins and anti-cancer and anti-cancer effects, and eat less irritating food

Adult T cell leukemia classification

The clinical manifestations of adult T-cell leukemia patients are diverse, including acute leukemia-like, lymphoma with lymphocytic proliferation, chronic with better prognosis, and smoking state (invasive).  Almost all patients have lymphadenopathy. Many patients have extensive lymphadenopathy, most have retroperitoneal lymphadenopathy. But mediastinal masses are rare. The bone marrow is often infiltrated with leukemia cells. Other common sites involved are the lungs, liver, skin, gastrointestinal tract, and central nervous system. ATL is related to several histological subtypes of lymphoma, such as diffuse, poorly differentiated small cell type, mixed large and small cell type, and large immunoblast type.  About two-thirds of patients can develop skin involvement, and most patients with skin infiltration can see focal ATL cell infiltration or Pautrier microabscesses. The main difference between skin T-cell lymphoma and skin T-cell lymphoma is: most ATL has an acute onset and no chronic early course. Skin T-cell lymphoma has nothing to do with HTLV-I infection.   There is no obvious correlation between clinical course and lymph node morphology. Secondary infections are common, mainly including Pneumocystis carinii infection and bacterial and fungal infections.  The main clinical and laboratory characteristics of each type:   (1) The median age of patients with rapid progress is 40 years old. The typical performance is: white blood cell count 5×109-10×109/L, malignant lymphocytes can be seen in peripheral blood, and anemia and thrombocytopenia are not common at the onset. The onset is very urgent, mainly due to rapidly progressing skin damage, hypercalcemia, or both. There are many kinds of skin damage, such as scattered tumor masses, small fusion nodules, plaques, papules, and non-specific erythema. Patients with hypercalcemia often manifest as fatigue, apathy, confusion, polyuria, and polydipsia.  (2) Chronic type may have lymphadenopathy, hepatosplenomegaly, skin and lung infiltration, no hypercalcemia, no central nervous system, bone, gastrointestinal infiltration, no ascites and pleural effusion. Absolute value of peripheral blood lymphocytes>3.5×109/L, abnormal lymphocytes>5%. Lactate dehydrogenase is more than twice the normal value.  (3) Lymphoma-type lymph node histology proved to be lymphadenopathy. No leukemia cell infiltration. Peripheral blood lymphocytes &lt.4.0×109/L, abnormal T lymphocytes &lt.1%.  (4) Smoky skin damage is its characteristic, which can be manifested as erythema, papules, and nodules. There may be lung infiltration. Generally, there is no hypercalcemia, lymphadenopathy, hepatosplenomegaly, and bone marrow infiltration are mild. No central nervous system infiltration. The percentage of ATL cells in peripheral blood is low (generally less than 5%). The chromosomes are mostly normal karyotypes. Lactate dehydrogenase is more than 1.5 times the normal value.

“Infiltrating manifestations” of leukemia

1. Anemia    often appears earlier and gradually worsens. Paleness, weakness, dizziness, palpitations, anorexia and edema, etc. The degree of anemia in patients is often out of proportion to the amount of bleeding.  2, bleeding   About half of the cases have bleeding to varying degrees. Bleeding usually occurs later than anemia, but it often awakens patients to seek medical advice and do blood tests. Common bleeding includes skin bleeding, purple spots, epistaxis, gums and oral mucosal bleeding, menstruation, etc. In severe cases, hematuria, gastrointestinal bleeding (hee blood, blood in the stool) can occur, retinal bleeding can cause visual disturbance, and even cranial Internal bleeding is often life-threatening.  3. Fever and infection    More than half of patients start with fever, which can be low or high fever. Whether fever before or during treatment, I mostly mean co-infection. Infection can occur in any part of the body, but angina and stomatitis are the most common. Upper respiratory tract and lung infections, perianal inflammation, paraanal abscess and gastroenteritis become more common. If combined with sepsis, it will cause death One of the main reasons. Some acute leukemia fever may have no obvious infection foci (especially when neutrophils &lt.0.2×109/L), but infection cannot be ruled out. On the contrary, patients whose body temperature is &lt.38.5℃ and the fever subsides automatically after chemotherapy starts, indicating fever Related to leukemia itself (tumor fever). Of course, there is no lack of clinical cases where tumor fever and infection coexist.   The common pathogens of infection are Escherichia coli, Pseudomonas aeruginosa, Klebsiella, Staphylococcus aureus and other conditional pathogens, anaerobic bacteria, etc. Infiltration manifestations (1) Bone and joint pain. Leukemia infiltration of bone and periosteum causes bone pain (children are more common than adults, and ALL is more common than AML), which can be diffuse pain in the limbs or back, or confined to joint pain, often leading to movement Difficult and easily misdiagnosed as osteomyelitis or rheumatism. More than one third of patients have sternal tenderness, which is helpful for the diagnosis of this disease. A few severe bone pains are caused by bone marrow necrosis.  (2) Enlarged liver, spleen and lymph nodes&nbsp. Mild to moderate hepatosplenomegaly is more common, generally no more than 4 to 6 cm below the ribs. ALL has a higher incidence of hepatosplenomegaly than AML, and the degree of enlargement is more obvious. Lymph node enlargement ALL is also more common than AML. It can involve superficial or deep lymph nodes such as the mediastinum, mesenteric, retroperitoneum, etc., but the degree of enlargement is generally mild, usually ≤3.0cm in diameter. Swollen lymph nodes of the liver and spleen are generally more obvious in T-ALL and B-ALL.   (3) Central Nervous System Leukemia (CNSL) CNSL often appears in the remission period of ALL, and it is relatively rare in newly diagnosed patients. The infiltration site mostly occurred in the arachnoid and dura mater, followed by brain parenchyma, choroid or cranial nerve. Severe patients have typical manifestations of increased intracranial pressure such as headache, vomiting, strong nape, papilledema, and even convulsions and coma. Similar to intracranial hemorrhage. Mild cases only complain of mild headache and dizziness. Cranial nerves (VI and VII are the main cranial nerves) involved can cause visual impairment and facial paralysis. (4) Infiltration of other tissues and organs. ALL skin infiltration is less common than AML, but testicular infiltration is more common. Testicular leukemia also often appears in remission of ALL, manifested as painless swelling of unilateral or bilateral testes, and the texture persists. Tenderness is the root cause of extramedullary recurrence of leukemia second only to CNSL. Leukemia infiltration can also affect various tissues and organs such as lung, pleura, kidney, digestive tract, heart, brain, uterus, ovary, breast, parotid gland and eye, and show the dysfunction of corresponding organs, but it can also be asymptomatic. .

“Tackling” leukemia, each has its own advantages

1. Although CNS-L complicated by AML is lower than ALL, it is still common for patients with M4, M5 and hyperleukocytoemia to develop CNS-L.   2. The disease is similar to meningitis, with manifestations of intracranial hypertension, such as headache, vomiting, and optic nerve head edema. Lumbar puncture increases the pressure of the cerebrospinal fluid, the number of white blood cells and protein in the cerebrospinal fluid increases, and the sugar decreases, and leukemia cells can be detected. Infringement of cranial nerves can cause corresponding symptoms, such as visual impairment, pupil changes, and facial nerve paralysis. Leukemia cells entering the central nervous system can be caused by blood flow dissemination, skull bone marrow leukemia cell infiltration, or intracranial spot hemorrhage.   3. It is difficult for general chemotherapy drugs to pass through the blood-brain barrier, and the central nervous system becomes a “shelter” for leukemia cells, which is one of the reasons for the recurrence of leukemia. Therefore, the above clinical types of AML should be prevented. 4. Western medicine treatment: After the disease appears, it is difficult for some drugs to pass through the blood-brain barrier, so it is difficult to achieve good therapeutic effects. Western medicine treatment is currently widely used in HD or ID-Ara-C intracranial concentration to kill leukemia cells s level. Intrathecal medication has better effects. However, the problem of relapse and drug resistance is still a clinical problem.  What is the occurrence of green tumors in acute leukemia?   1. Green tumors are myeloid leukemias, a limited infiltration of abnormal white blood cells under the periosteum or soft tissues. Because of its light green color, the lumps are round and raised like tumors, hence the name.   2. Patients with this disease are mostly healthy-looking children, and it is more common in men than women. There are often changes in the blood and bone marrow of leukemia, the course of the disease is rapid and the development is rapid, and it can die within months or even weeks.   3. The disease is noticeable with prominent eyeballs, because the orbital periosteum is the most common site for localized infiltration of leukemia. Lymph nodes in front of the ears and submandibular are often enlarged. There is also green pigmentation on the surface of the skin of the bump. In the later stage of the disease, all important organs and limbs are involved. In the later stage, death is often caused by anemia, infection and failure.   Fourth, treatment measures:    The disease should be treated as early as possible, and biopsy or surgical resection should be avoided to avoid uncontrollable bleeding. Mainly systemic chemotherapy, active symptomatic treatment. Combination of Chinese and Western medicine is used to reduce the side effects of chemotherapy.  What should I do if there is bone and joint pain in acute leukemia?   1. Bone and joint pain: Bone and joint pain is one of the important symptoms of leukemia. The main reason is the infiltration of leukemia cells to cause bone and joint synovitis. Long-term pain and torment have a great deal of mental devastation to patients and seriously affect the quality of life of patients.   2. Western medicine treatment: comprehensive systemic chemotherapy, active symptomatic treatment, antibiotics to control infection. Combined with Chinese medicine comprehensive treatment.

Uncover the mystery of leukemia

1. Onset    leukemia has rapid or slow onset, and many children and adolescents have rapid onset. Common first symptoms include: fever, progressive anemia, significant bleeding tendency, or bone and joint pain. The slow onset is mostly elderly and some young patients, and the condition gradually progresses. Most of these patients have progressive fatigue, pale complexion, shortness of breath after fatigue, lack of appetite, weight loss, or unexplained fever as the first symptoms. In addition, a small number of patients may have convulsions, blindness, toothache, gingival swelling, pericardial effusion, and paraplegia of the lower limbs as the first symptoms.  2, fever and infection   A, fever is one of the most common symptoms of leukemia, which can occur in different stages of the disease and have different degrees of fever and fever. The main cause of fever is infection, among which angina, stomatitis, and perianal inflammation are the most common, and pneumonia, tonsillitis, gingivitis, and perianal abscess are also common. Ear inflammation, enteritis, carbuncle, pyelonephritis, etc. can also be seen, and severe infections can also cause sepsis and sepsis.   B. The pathogens of infection are more common with bacteria. In the early stage of the disease, gram-positive cocci are the main ones. Viral infections are rare but often more dangerous. Cytomegalovirus, measles or varicella virus infections are prone to pneumonia, so be careful.  3, hemorrhage    hemorrhage is also a common symptom of leukemia. The bleeding site can be all over the body, with skin, gums, and nasal bleeding most common. There can also be bleeding in the retina, ears, and intracranial, digestive tract, respiratory tract and other internal organs. Menorrhagia is also common in women and can be the first symptom. The bleeding of M3 and M5 subtypes of AML is more serious, especially M3 patients are prone to death due to diffuse intravascular coagulation (DIC) and intracranial hemorrhage.  4, anemia    can appear in the early stage, a few cases may develop refractory anemia months or years before diagnosis, and then develop into leukemia. Patients are often accompanied by symptoms such as fatigue, pale complexion, heart palpitations, shortness of breath, and lower extremity edema. Anemia can be found in all types of leukemia, but it is more common in elderly AML patients, and many patients often have anemia as the first symptom. 5. Leukemia cell infiltration signs A, liver and spleen enlargement, lymphadenopathy B, nervous system: the main lesions are bleeding and leukemia infiltration C, bones and joints: bone and joint pain is one of the important symptoms of leukemia, and ALL is more common . D. Skin. There can be two types of specific and non-specific skin damage. The former manifests as maculopapular rash, pustules, masses, nodules, erythroderma, exfoliative dermatitis, etc., which are more common in adult monocytic leukemia, while the latter is Mostly manifested as skin ecchymosis, spots and so on.  E. Oral: gingival swelling, bleeding, and leukemia infiltration are more common in AML-M5. In severe cases, the entire gingiva can be extremely hyperplastic, swelling like a spongy, and the surface is ulcerated and easy to bleed.   F. Heart: Most of the manifestations are myocardial leukemia infiltration, hemorrhage and epicardial hemorrhage, pericardial effusion, etc.  G, kidney: more than 40% of leukemia patients have kidney disease.  H, gastrointestinal system: manifested as nausea and vomiting, lack of appetite, abdominal distension, diarrhea, etc.   I. Lung and pleura: Mainly infiltrate the alveolar wall and lung space, but also infiltrate the bronchi, pleura, blood vessel wall, etc.  J, others: uterus, ovaries, testes, prostate, etc. can be infiltrated by white blood cells. Female patients often have vaginal bleeding and menstrual cycle disorders. Male patients may have decreased libido.

The “invisible period” of leukemia

About 20% of AML experienced months or even years of anemia, bleeding tendency, various blood cell reductions, and pathological hematopoiesis of the hematopoietic cells of various bone marrow lines, and then gradually evolved into acute leukemia. This course of disease became pre-leukemia. 1. Leukemia infiltration (1) Lymph node, spleen, liver enlargement (2) Bone and joint pain (3) Central nervous system leukemia (4) Skin damage (5) Myelocytoma (6) Mediastinal mass (7) Gum hyperplasia ( 8) Infiltration of other parts: Heart involvement is rare. Leukemia cells can infiltrate the conduction system or the wall of tubular arteries. Lung infiltration is rare, and clinical pulmonary symptoms are mostly caused by concurrent infection. In a few cases, the ileocecal intestinal wall was infiltrated by leukemia, leading to necrosis of the intestinal wall, and clinical signs of intestinal obstruction may appear. Leukemia can also infiltrate the fundus. Leukemia infiltrates the inner ear, causing dizziness, tinnitus, hearing loss, and often accompanied by bleeding. Testicular infiltration is rare in AML. Occasionally, leukemia infiltrates the penis.  2. Bleeding tendency: Clinically, spontaneous skin and mucous membrane bleeding are the most common, such as bleeding spots on the skin, ecchymoses, nose bleeding, bleeding under the eyes, menorrhagia, and even dripping. Severe cases may be accompanied by visceral bleeding, with gastrointestinal and urinary tract bleeding more common.  3. Anemia: Decreased red blood cell production and ineffective production of red blood cells are the main causes of anemia in AML. Studies on the conversion of radioactive iron in plasma and red blood cells have shown that the iron conversion rate is normal or increased, but the iron uptake of mature red blood cells is significantly reduced. At the same time, it has been observed that some patients with AML have abnormal proliferation of bone marrow red blood cells and megaloblastic changes, both It suggests that there is invalid production of red blood cells.  4. Infection and fever: The myelogenous progenitor cells are replaced by leukemia cells, and the inhibitory factors produced by AML leukemia cells interfere, resulting in a significant decrease in neutrophils.

“Tackling” leukemia, each has its own advantages

Can central system leukemia be relieved? How to deal with it effectively?   1. Although CNS-L complicated by AML is lower than ALL, it is still common for patients with M4, M5 and hyperleukocytoemia to develop CNS-L.   2. The disease is similar to meningitis, with manifestations of intracranial hypertension, such as headache, vomiting, and optic nerve head edema. Lumbar puncture increases the pressure of the cerebrospinal fluid, the number of white blood cells and protein in the cerebrospinal fluid increase, and the sugar decreases, and leukemia cells can be detected. Infringement of cranial nerves can cause corresponding symptoms, such as visual impairment, pupil changes and facial nerve paralysis. Leukemia cells entering the central nervous system can be caused by blood flow dissemination, skull bone marrow leukemia cell infiltration, or intracranial spot hemorrhage.   3. It is difficult for general chemotherapy drugs to pass through the blood-brain barrier, and the central nervous system becomes a “shelter” for leukemia cells, which is one of the reasons for the recurrence of leukemia. Therefore, the above clinical types of AML should be prevented. 4. Western medicine treatment: After the disease appears, it is difficult for some drugs to pass through the blood-brain barrier, so it is difficult to achieve good therapeutic effects. Western medicine treatment is currently widely used in HD or ID-Ara-C intracranial concentration to kill leukemia cells s level. The effect of intrathecal medication is better. However, the problem of relapse and drug resistance is still a clinical problem.  What is the occurrence of green tumors in acute leukemia?   1. Green tumors are myeloid leukemias, a kind of localized infiltration of abnormal white blood cells under the periosteum or soft tissues. Because of its light green color, the lumps are round and raised like tumors, hence the name.   2. Patients with this disease are mostly healthy-looking children, and it is more common in men than women. There are often changes in the blood and bone marrow of leukemia, the course of the disease is rapid and the development is rapid, and it can die within months or even weeks.   3. The disease is noticeable with prominent eyeballs, because the orbital periosteum is the most common site for localized infiltration of leukemia. Lymph nodes in front of the ears and submandibular are often enlarged. There is also green pigmentation on the surface of the skin of the bump. In the later stage of the disease, all important organs and limbs and bones are involved. In the later stage, death is often caused by anemia, infection and failure.   Fourth, treatment measures:    The disease should be treated with internal medicine as soon as possible, and biopsy or surgical resection should be avoided to avoid uncontrollable bleeding. Mainly systemic chemotherapy, active symptomatic treatment. Combination of Chinese and Western medicine is used to reduce the side effects of chemotherapy.  What should I do if there is bone and joint pain in acute leukemia?   1. Bone and joint: Bone and joint pain is one of the important symptoms of leukemia. Synovitis of bone and joint is mainly caused by leukemia cell infiltration. Long-term pain and torture have a great deal of mental devastation to patients and seriously affect the quality of life of patients.   2. Western medicine treatment: comprehensive systemic chemotherapy, active symptomatic treatment, antibiotics to control infection. Combined with Chinese medicine comprehensive treatment.

Uncover the mystery of leukemia

1. Onset    leukemia has rapid or slow onset, and children and adolescents often have rapid onset. Common first symptoms include: fever, progressive anemia, significant bleeding tendency, or bone and joint pain. The slow onset is mostly elderly and some young patients, and the condition gradually progresses. Most of these patients have progressive fatigue, pale complexion, shortness of breath after fatigue, lack of appetite, weight loss, or unexplained fever as the first symptoms. In addition, a small number of patients may have convulsions, blindness, toothache, gingival swelling, pericardial effusion, and paraplegia of the lower limbs as the first symptoms.  2, fever and infection   A, fever is one of the most common symptoms of leukemia, which can occur at different stages of the disease and have different degrees of fever and fever. The main cause of fever is infection, among which angina, stomatitis, and perianal inflammation are the most common, and pneumonia, tonsillitis, gingivitis, and perianal abscess are also common. Ear inflammation, enteritis, carbuncle, pyelonephritis, etc. can also be seen, and severe infections can also cause sepsis and sepsis.   B. The pathogen of infection is more common with bacteria, and in the early stage of the disease, gram-positive cocci are the main ones. Viral infections are rare but often more dangerous. Cytomegalovirus, measles or varicella virus infections are prone to pneumonia, so be careful.  3, hemorrhage    hemorrhage is also a common symptom of leukemia, the bleeding site can be all over the body, with skin, gums, nasal cavity bleeding most common, there can also be retina, ear bleeding and intracranial, digestive tract, respiratory tract and other internal organs bleeding. Menorrhagia is also common in women and can be the first symptom. The bleeding of M3 and M5 subtypes of AML is more serious, especially M3 patients are prone to death due to diffuse intravascular coagulation (DIC) and intracranial hemorrhage.  4, anemia   can appear in the early stage, a few cases may develop refractory anemia months or years before diagnosis, and then develop into leukemia. Patients are often accompanied by symptoms such as fatigue, pale complexion, heart palpitations, shortness of breath, and lower extremity edema. Anemia can be found in all types of leukemia, but it is more common in elderly AML patients, and many patients often have anemia as the first symptom. 5. Leukemia cell infiltration signs A, liver and splenomegaly, lymphadenopathy B, nervous system: the main lesions are bleeding and leukemia infiltration C, bones and joints: bone and joint pain is one of the important symptoms of leukemia, and ALL is more common . D. Skin. There can be two kinds of specific and non-specific skin damage. The former manifests as maculopapular rash, pustules, masses, nodules, erythroderma, exfoliative dermatitis, etc., which are more common in adult monocytic leukemia, while the latter is Mostly manifested as skin ecchymosis, spots and so on.  E. Oral: gingival swelling, bleeding, and leukemia infiltration are more common in AML-M5. In severe cases, the entire gingiva can be extremely hyperplastic, swelling like a spongy, and the surface is ulcerated and easy to bleed.   F. Heart: Most manifested as myocardial leukemia infiltration, hemorrhage and epicardial hemorrhage, pericardial effusion, etc.  G, kidney: more than 40% of leukemia patients have kidney disease.  H, gastrointestinal system: manifested as nausea and vomiting, lack of appetite, abdominal distension, diarrhea, etc.   I. Lung and pleura: Mainly infiltrate the alveolar wall and lung space, but also infiltrate the bronchi, pleura, blood vessel wall, etc.  J, others: the uterus, ovaries, testes, prostate, etc. can be infiltrated by white blood cells. Female patients often have vaginal bleeding and menstrual cycle disorders. Male patients may have decreased libido.

Thank you for recording medical words: fatigue, night sweats, weight loss…the development of chronic myelogenous leukemia will occur

The common symptoms of chronic myelogenous leukemia include fatigue, low fever, weight loss, hyperhidrosis and other symptoms. In addition, with the development of chronic myelogenous disease, the course of the disease can be divided into three stages: chronic phase, accelerated phase and blast phase. In these three stages, the human body exhibits different symptoms, so what are the symptoms in these three stages? Shi Shurong/Xie Bielu Director WeChat consultation platform zkxk9999 fatigue, night sweats, weight loss… What symptoms will occur in the development of chronic myelogenous leukemia? One: Common symptoms in the chronic phase include fatigue, dizziness, abdominal discomfort, etc., accompanied by symptoms related to increased basal metabolism, such as fever, night sweats, hyperhidrosis, weight loss, low fever, heart palpitations, and mental stress. Related symptoms caused by spleen enlargement are common, such as abdominal distension, heaviness or pain in the left upper abdomen, and a feeling of fullness after eating. Bleeding symptoms are rare. Bone pain and arthralgia are rare symptoms at the initial diagnosis, and can be manifested as acute left lower chest or left upper abdomen due to perisplenic inflammation or splenic infarction. The incidence of peptic ulcer is higher than normal, which may be related to excessive release of histamine. Rare symptoms include gouty arthritis, which is often associated with hyperuricemia; priapism, which may be caused by leukemia infiltration or cavernous thrombosis. Two: Accelerated phase This stage of chronic myelogenous leukemia is in a period of intensified progression, which is a turning point for the patient’s condition to deteriorate. Its clinical manifestations are a gradual and gradual process, and it is difficult to absolutely separate. The accelerated progression stage is clinically characterized by unexplained low-grade fever, fatigue, anorexia, night sweats, and increased weight loss, accompanied by rapid spleen enlargement and tenderness disproportionate to white blood cells, sudden swelling of lymph nodes, obvious sternum tenderness, and bone lysis Sex changes, bone pain and other physical signs, anemia often worsens, and it is ineffective to the traditional medicine busulfan or hydroxyurea treatment. Three: In addition to the above symptoms, when entering the blast phase, it is also manifested as general bone pain, liver, spleen, and lymphadenopathy, extramedullary infiltration manifestations such as skin nodules, testicular infiltration, priapism, and orbital infiltration and green tumors. Severe neutrophil deficiency often leads to uncontrollable bacterial and fungal infections, manifested by persistent high fever, and even sepsis. Severe platelet deficiency causes aggravation of bleeding tendency and even death due to cerebral hemorrhage. For patients with chronic particles, the most typical and prominent manifestations include splenomegaly, pale complexion, sternum tenderness, swollen lymph nodes, and skin purpura in addition to the above discomfort. Once CML disease enters the blast phase, the limited survival period requires immediate treatment. The key lies in early prevention and treatment, taking medicine on time, regular work and rest, and controlling the condition as much as possible in the chronic and stable stage, so as to achieve the purpose of prolonging the survival time of patients. For more patient communication and help, please follow the WeChat public account [Chronic Myelopathy Association]mbxb120

Infiltrating manifestations in patients with acute leukemia

Symptoms of infiltration of acute leukemia are commonly seen in medicine, such as fever, bleeding, and anemia. Many leukemia patients lacked relevant knowledge and did not go to the hospital in time after discovery, thus missing the best time for treatment. Now I will not talk to you about the infiltration performance of acute leukemia patients. The symptoms of acute leukemia are mainly in the following aspects: 1. Lymph nodes and hepatosplenomegaly: rush is more common than rush and non-lymph, and the degree of swelling is also significant. Mediastinal lymphadenopathy is mostly seen in T-cell leaching, which is a very important point in the symptoms of acute leukemia. 2. Bone and joint pain: The symptoms of acute leukemia often have tenderness at the lower end of the sternum. 3. Skin and mucosal lesions: acute single and acute myelomonocytic leukemia are more common. Specific skin damage manifested as diffuse maculopapular rash, purple-blue skin nodules or lumps are all very important symptoms of acute leukemia. 4. Central nervous system leukemia With the improvement of leukemia remission rate and prolonged survival, central nervous system leukemia has become a more prominent problem. The symptoms of acute leukemia are more common than acute and non-leaching, and acute promyelocytic leukemia is also more common. The vast majority of patients have fever, which is manifested as low or high fever, and most of them are repeated irregular fever. Although most leukemia patients have a large number of white blood cells in the peripheral blood, most of these cells do not have the anti-infective effect of normal white blood cells. At the same time, medical experts also pointed out that due to the different physical conditions of patients, the infiltration performance of acute leukemia patients is also different. Therefore, it cannot be generalized. As a patient with acute leukemia, you should still go to the hospital for a comprehensive examination to better understand your condition.

Expert guidance: treatment of acute leukemia

Acute leukemia is a malignant proliferative disease of the hematopoietic system, which is characterized by the proliferation of a certain blood cell system in the hematopoietic tissue, which enters the bloodstream and infiltrates various tissues and organs, thereby causing a series of clinical symptoms and signs, such as fever, anemia, bleeding, Signs of organ and tissue infiltration such as liver, spleen, lymphadenopathy, bone and joint pain, and signs of central nervous system and testicular infiltration. The fundamental purpose of    leukemia treatment is to make patients survive for a long time until they are cured. The main treatments of leukemia include chemotherapy, radiotherapy, target therapy, and traditional Chinese medicine. Some high-risk patients require bone marrow transplantation. In the past 10 years, with the progress of molecular biology and biogenetics, the prognosis of leukemia has been greatly improved. “Leukemia is an incurable disease” is a thing of the past. Regular and systematic treatment can make most leukemia patients survive for a long time without disease, or even heal. For the treatment of acute leukemia, Lin Jianfen, director of the National Medical Hematology Center, guides us: acute leukemia should follow the principle of selecting a plan according to the classification of acute leukemia in the treatment, and select the best chemotherapy plan at home and abroad to improve the complete remission The quality, and timely and effective treatment after complete remission and prevention and treatment of central nervous system leukemia, and strive to cure as many patients as possible.   (1) Administration by type: Different types of leukemia have different treatment schemes and should be treated by type.   (2) Adequate administration: During the induction and consolidation phase, sufficient medication is used to kill as many leukemia cells as possible, so that the bone marrow can quickly reach a state of suppression, which is extremely important for reducing relapse in the future.   (3) Combined medication: It can synergistically increase the effect, reduce relapse, improve remission and long-term survival rate.   (4) Long-term treatment: It can prevent relapse and improve long-term survival rate. In the chemotherapy for several years, chemotherapy can be summarized into two basic procedures:   ①Induction remission therapy (including induction differentiation therapy);  ②Post-remission therapy (including consolidation therapy, intensive therapy, maintenance therapy and prevention of extramedullary leukemia) .   (5) Intermittent chemotherapy: There should be an interval between the two courses of treatment to facilitate the recovery of normal hematopoietic cells and allow leukemia cells in the resting phase to enter the proliferation cycle, which is easy to be killed in the next chemotherapy.   Editor’s conclusion: In addition to the above points, the focus of leukemia treatment is to quickly select a combination chemotherapy plan according to the type of leukemia cells, control the progression of the disease and strengthen supportive therapy to ensure the smooth progress of chemotherapy, and prevent and treat the occurrence of extramedullary leukemia.

Clinical manifestations and treatment of bladder tumors

Yesterday I talked about bladder tumors. In fact, some scholars often use auxiliary examination methods. What about his clinical manifestations and treatment? Did you really smell cancer? Today we will talk about it. Other auxiliary examinations 1. Cystoscopy: is the most important method for diagnosing bladder tumors. Can directly observe the relationship between tumor growth site, size, number, morphology, basal condition and ureteral opening, bladder neck, and can simultaneously perform tumor biopsy and random biopsy of bladder mucosa to determine tumor differentiation and the presence of carcinoma in situ. 2. X-ray examination: excretory urography can understand whether the renal pelvis and ureter have tumors and renal function. If there is a tumor in the upper urinary tract, the bladder tumor may be implanted. Hydrops or unclear visualization of the kidneys and ureters, indicating that the tumor has infiltrated the ureter orifice and caused obstruction. Cystography showed filling defects, and the irregular rigidity of the bladder wall showed deep tumor infiltration. CT and MRI examinations can show the depth of tumor invasion and pelvic metastasis. 3. B-mode ultrasound: B-mode ultrasound is getting more and more attention. It can display bladder tumors of more than 0.5 cm, and can be dynamically observed. Transurethral ultrasound scanning can accurately show the depth and extent of tumor infiltration into the bladder wall. The direct acoustic image of a bladder tumor can appear as bulging into the bladder cavity or infiltrating into the bladder wall. 3. Clinical manifestations The early and most common symptoms of bladder tumors are intermittent, painless, and gross hematuria throughout. It is usually hematuria during the whole course, which is worse at the end. There are also very few patients with microscopic hematuria or only a small amount of terminal hematuria. The degree of hematuria is inconsistent with the size, number, and malignancy of the tumor. Non-epithelial tumors have mild hematuria. Patients with bladder tumors with necrosis, ulcers, co-infection, or large tumors (especially in the triangular area) may have symptoms such as frequent urination, urgency, and dysuria. Difficulty urinating and urinary retention may occur when the tumor is located near the bladder neck or when the tumor is large. When the pelvis is extensively infiltrated, there is lumbosacral pain and edema of the lower extremities. Squamous cell carcinoma and adenocarcinoma are highly malignant and the course of the disease is short; children with rhabdomyosarcoma often have dysuria as the main symptom. Because most patients with lumps in the lower abdomen are already in the late stage of the disease. Fourth, the treatment is mainly surgical treatment. Surgical treatment is divided into transurethral surgery, bladder incision tumor removal, partial bladder resection and total bladder resection. Different treatment methods should be selected according to the location of the tumor, the depth of invasion, the number, the degree of malignancy, and the patient’s general condition. Radiation and chemotherapy are adjuvant treatments. The latest surgical methods in our hospital: transurethral resection of bladder tumor (TURBt), transurethral bladder tumor holmium laser enucleation; laparoscopic total cystectomy + ileal bladder replacement, laparoscopic total cystectomy + in situ new bladder Surgery. &nbsp.

Learn about bladder tumor in 1 minute

Bladder tumors are common tumors in the urinary system and abnormal growth of the bladder wall. Papillary tumors and squamous cell carcinomas are more common, showing painless gross hematuria. After tumor necrosis and infection, bladder irritation appears. 1. The etiology of bladder tumors is very complicated and not completely clear. However, it is mainly affected by the following substances: 1. Chemical carcinogens: At present, β-naphthylamine, benzidine, 4-aminobiphenyl, etc. have been confirmed as bladder cancer substances. These substances are widely used in the dye, textile, printing, rubber and plastic industries. Long-term exposure to such carcinogens is extremely prone to bladder cancer. However, due to individual differences, the incubation period of bladder cancer is very long. And smoking is 1.5 to 4 times more dangerous than non-smokers (benzopyrene in smoke is also a carcinogen). 2. Oncogenes and tumor suppressor genes: Molecular biology research believes that certain factors can cause the activation of cancer genes or the inactivation of tumor suppressor genes, which can cause cancer. 3. Other: Abnormal metabolism of tryptophan and niacin can be the cause of bladder cancer. Schistosomiasis Egypt, leukoplakia of the bladder, glandular cystitis, urolithiasis, urinary retention, etc. may also be the cause of bladder cancer. Second, auxiliary examination laboratory examination 1. Urine examination: hematuria or terminal hematuria, and urine P53 test was positive. 2. Urine shed cytology test: It is an important screening diagnostic method, simple and easy to perform. Tumors with high malignant degree and poor cell differentiation have a high positive rate, which is also an effective method for monitoring cancer recurrence and high-risk population screening. Quantitative fluorescence image analysis is more sensitive. 3. Nuclear matrix protein 22 (NMP22): It is a new type of inspection method that has just appeared in recent years, mainly to check the content of nuclear matrix protein in tumor shed cells in urine. 4. Hyaluronidase (HA) and hyaluronidase determination (HAase): Increased HA and HAase can be found in urine. 5. Bladder tumors and ABO antigen, flow cytometer, tumor chromosomes, salivary enzymes, oncogenes, tumor suppressor genes can have a deeper understanding of biological characteristics such as tumor malignancy, infiltration trend and prognosis. Other auxiliary examinations 1. Cystoscopy: is the most important method for diagnosing bladder tumors. Can directly observe the relationship between tumor growth site, size, number, morphology, basal condition and ureteral opening, bladder neck, and can simultaneously perform tumor biopsy and random biopsy of bladder mucosa to determine tumor differentiation and the presence of carcinoma in situ. 2. X-ray examination: excretory urography can understand whether the renal pelvis and ureter have tumors and renal function. If there is a tumor in the upper urinary tract, the bladder tumor may be implanted. Hydrops or unclear visualization of the kidneys and ureters, indicating that the tumor has infiltrated the ureter orifice and caused obstruction. Cystography showed filling defects, and the irregular rigidity of the bladder wall showed deep tumor infiltration. CT and MRI examinations can show the depth of tumor invasion and pelvic metastasis. 3. B-mode ultrasound: B-mode ultrasound is getting more and more attention. It can display bladder tumors of more than 0.5 cm, and can be dynamically observed. Transurethral ultrasound scanning can accurately show the depth and extent of tumor infiltration into the bladder wall. The direct acoustic image of a bladder tumor can appear as bulging into the bladder cavity or infiltrating into the bladder wall. 3. Clinical manifestations The early and most common symptoms of bladder tumors are intermittent, painless, and gross hematuria throughout. It is usually hematuria during the whole course, which is worse at the end. There are also very few patients with microscopic hematuria or only a small amount of terminal hematuria. The degree of hematuria is inconsistent with the size, number, and malignancy of the tumor. Non-epithelial tumors have mild hematuria. Patients with bladder tumors with necrosis, ulcers, co-infection, or large tumors (especially in the triangular area) may have symptoms such as frequent urination, urgency, and dysuria. Difficulty urinating and urinary retention may occur when the tumor is located near the bladder neck or when the tumor is large. When the pelvis is extensively infiltrated, there is lumbosacral pain and edema of the lower extremities. Squamous cell carcinoma and adenocarcinoma are highly malignant and the course of the disease is short; children with rhabdomyosarcoma often have dysuria as the main symptom. Because most patients with lumps in the lower abdomen are already in the late stage of the disease. Fourth, the treatment is mainly surgical treatment. Surgical treatment is divided into transurethral surgery, bladder incision tumor removal, partial bladder resection and total bladder resection. Different treatment methods should be selected according to the location of the tumor, the depth of invasion, the number, the degree of malignancy, and the patient’s general condition. Radiation and chemotherapy are adjuvant treatments. The latest surgical methods in our hospital: transurethral resection of bladder tumor (TURBt), transurethral bladder tumor holmium laser enucleation; laparoscopic total cystectomy + ileal bladder surgery,

How to identify acute leukemia early?

Shi Shurong’s studio WeChat xyk261 leukemia has a rapid onset. Most of them gradually progress within a few weeks to several months, and some have a sudden onset. Bad living habits, such as staying up late, long-term fatigue, and accumulation of energy, are often the triggers for the onset of leukemia and need to be improved. However, there are still many patients who cannot find obvious causes or incentives. The clinical symptoms and signs of leukemia are mainly caused by bone marrow failure or leukemia cell infiltration. They are mostly non-specific, but they are often progressively worsened and cannot be improved by the interpretation and treatment of common benign diseases. It is strongly recommended to go to the hematology department for disease screening. These symptoms that need to be vigilant include: 1. More than half of patients with leukemia take bleeding as an early manifestation, with varying degrees of severity, and the location can be throughout the body. Most manifested as spontaneous, or ecchymosis, ecchymosis, nasal bleeding, gum bleeding and menorrhagia, fundus bleeding, etc. that did not match the degree of trauma. Need to go to the hospital to check the blood routine, the local blood vessel condition of the bleeding and the function of blood coagulation factors, etc., to clarify the cause of bleeding. 2. Fever and repeated fever can also be an early manifestation of leukemia patients, mostly around 38.5 ° C, without chills, mainly fever in the afternoon, and often accompanied by severe sweating throughout the night, the use of antibiotics does not significantly affect body temperature Periodically, it is best not to use antipyretics at random, such as Analgin, Baifuning, etc., which will cover up the original condition, but should actively improve blood routines, infection-related indicators, and valuable peripheral blood cell classification tests Let’s observe the presence of naive hematopoietic cells to assess the possibility of leukemia. 3. Anemia patients often gradually appear pale and yellow, easy to fatigue and sleepiness, shortness of breath after climbing activities such as climbing, can not be explained by improper diet or fatigue, it is recommended to seek medical treatment as soon as possible to check the blood routine, clarify the degree and nature of anemia, anemia It can be the first symptom of leukemia, but it is often not an early symptom, and half of the patients have severe anemia at the time of treatment. 4. Unexplained organ painless swelling Most patients with leukemia have superficial lymph node enlargement, which is more common in the submandibular, neck, supraclavicular, axillary and groin areas, often without obvious pain; 50% of patients have physical examination Hepatosplenomegaly can be found; male young children or young people have painless enlargement of one side of the testicle, which should be considered as leukemia cell infiltration. 5. Skeletal and joint pain often has tenderness at the lower end of the sternum, which is a manifestation of the infiltration of a large number of leukemia cells. Invasion of joints, periosteum, or excessive proliferation in the medullary cavity can cause bone and joint pain, which is more common in children. It is common and significant, and severe bone pain can occur when bone marrow necrosis occurs. 6. Skin and mucosal lesions, hyperplasia or swelling of the gums, specific skin damage manifested as diffuse maculopapular rash, purple-blue skin nodules or hard nodules, etc. should also be cited | attention, leukemia in addition to the subcutaneous infiltration of the original naive cells, but also It can be accompanied by benign skin lesions, such as Sweet syndrome (acute febrile neutrophilic dermatosis) and gangrenous pyoderma, and hormone therapy is effective. 7. Central nervous system If leukemia infiltrates brain cells and meninges, it can also cause headaches, nausea, vomiting, hemiplegia, loss of consciousness, and other neurological symptoms similar to cerebrovascular disease. Cerebrospinal fluid examination can be identified by CT and lumbar puncture. If you find the above symptoms, you must go to a regular hospital to check, so as not to delay the condition and miss the best time for treatment.