MDS group: “Relidamide” mainly has these seven points!

“Lelidomide”-This drug has the effect of inhibiting the proliferation of malignant cloned cells and promoting their apoptosis in clinical medical applications, and has a certain effect evaluation on MDS. The main functions are the following seven points! 1. Inhibit tumor necrosis factor a; 2. Interleukin-6 and IL-123, induce Caspase-8-mediated apoptosis; 4. Inhibit cell adhesion and angiogenesis; 5. By inducing interleukin-2; 6. Interferon г Stimulates the proliferation of T and NK cells; 7, inhibits Akt phosphorylation, etc.; … This drug has therapeutic value for MDS, but it also has drawbacks. Sufficient attention needs to be paid to safety to avoid affecting the quality of life of patients and the high risk of complications. To learn more about “disease knowledge” or “MDS patient group communication” and other WeChat search public number: gsby120

Cyclosporine should be used to treat aplastic anemia, especially in patients with impaired renal function!

Assistant Hu Guisheng WeChat: dd326751 Article source: Reposted from the WeChat public account [Hu Guisheng Studio] In the treatment of aplastic anemia, cyclosporine plays a very important role. Combined with ATG therapy, it is the main immunosuppressant treatment for severe aplastic anemia The method has been sought after and accepted by many patients with aplastic anemia.   But as the saying goes, “It’s three-point medicine.” While cyclosporine acts on the body to treat diseases, its drug toxicity is also accumulating in the body.  Because the substance has a strong effect on T cell-dependent immune response. It forms a complex with the T cell cytoplasmic receptor protein cyclophilin, and then binds to calcineurin to inhibit the activity of the enzyme, thereby inhibiting the response of T cells to specific antigen stimulation and reducing the production of cytotoxic T cells. Reduce the release of inflammatory cytokines, inhibit interferon production and natural killer cell function. In addition to inhibiting T cell activation, this product can also interfere with the growth and function of a variety of cells.  Also, because the drug is mainly metabolized in the liver, most of it is excreted in bile, and 6% is excreted in urine from the kidney. Therefore, long-term use may cause chronic kidney damage, elevated glutathione aminotransferase, cholestasis, and high total bilirubinuria. Liver function tests are required during the medication period, and liver protection drugs are taken if necessary. When abnormal liver function occurs, reduce the use of cyclosporine according to doctor’s advice or temporarily stop using cyclosporine. In addition, care should be taken to prevent the combined use of other drugs that also have kidney-hazard side effects to increase the risk of kidney damage. In order to reduce the risk of kidney damage, after the treatment process, the drug should be slowly reduced and the use of cyclosporine should be stopped after the treatment process.   For this reason, in the treatment of aplastic anemia, doctors often recommend that patients with aplastic anemia can be treated with integrated traditional Chinese and western medicine, combined with traditional Chinese medicine, to reduce toxicity and increase efficiency, and effectively alleviate the adverse effects of drugs on patients!

Children’s thrombocytopenic purpura, do not overuse drugs!

Assistant Hu Guisheng WeChat: dd326751 Article source: Reposted from WeChat public account [Hu Guisheng Studio] Acute thrombocytopenic purpura in children is a common disease in hematology department, because of its sudden onset, skin bleeding, ecchymosis, nasal bleeding, gum oozing, etc. The bleeding is prominent, and the parents are panicked and anxious. They go to the hospital and ask the doctor to find ways to relieve the child’s condition as soon as possible. Faced with parents who are eager to seek treatment for their children, the doctor in charge and the attending physician will give large doses of corticosteroids and large doses of intravenous gamma bulbs. Protein, cyclosporin A, and even vincristine, cyclophosphamide, etc. are all given to patients, and I want to stabilize and alleviate the condition as soon as possible. The eager desire and mood of the children’s parents is understandable, and the doctor’s original intention is also good.   However, any disease has its own rules, and acute thrombocytopenic purpura is no exception. Some biological factors (such as viral infections, bacterial infections, etc.) and chemical factors (such as certain drugs, benzene, etc.) affect the body, causing the body’s immune function disorder, producing anti-self-platelet antibodies or other mechanisms that destroy platelets, so that platelets can quickly If it is destroyed, the platelets in the blood circulation are reduced, the normal hemostatic function is destroyed, and bleeding is easy to occur, and the bleeding is not easy to stop. In the face of certain external factors, the body’s immune function is temporarily disturbed, which is the result of the body’s stress response.   In other words, the body itself or moderately interfered by drugs can recover from stress after a certain period of time. The use of a large amount of hormonal drugs and a large amount of gamma globulin can reduce the destruction of platelets and increase platelets quickly, but this is not the result of the body’s immune function recovery, but the result of the body’s entire human immune system being suppressed. When the medicinal value of this medicine fades, the body’s immune function has not recovered, and the platelets will still be destroyed, and the platelets will continue to decline. The efficacy of immunosuppressive agents such as cyclosporin A, vincristine, and cyclophosphamide is about the same. Hormonal drugs, large amounts of gamma globulin, cyclosporin A, vincristine, cyclophosphamide and other immunosuppressants, or inhibit B lymphocytes, or inhibit the effect of reticulum endothelial cells, or inhibit the effect of T somatic cells , A large amount of use and a long course of treatment are applied to the human immune system and other children whose organs are not fully developed. The medium- and long-term effects are unpredictable.  The human body’s immune system is more complicated. The relationship between immune cells and cellular immunity, the relationship between cellular immune subgroups, how the body adjusts various immune functions, and the balance among various cellular immune subgroups, is not very clear at this stage, let alone the human immune system of children The growth and development are not completely perfect, and the immune function is still in a sound link. Obviously, in such a link, it is not suitable to give obvious or long-term immunosuppressive treatment. Although it can suppress abnormal immunity, the suppression of all normal immunity cannot be ignored. It is hard to imagine that the body will harmonize the relationship between immune cells, cellular immunity, and cellular immune subgroups under immunosuppression, and achieve all normal balance. The immunosuppressive treatment of subacute thrombohypopurpura in adolescents and children should be treated with caution.

MDS Club: How to solve the problem of thrombocytopenia after chemotherapy?

Diagnosed condition: clinical complications of bone marrow suppression Age and gender: 47-year-old male patient alias: Binfeng Clinically, the problem of platelet index reduction is very common in the hematology department. In addition to primary immune thrombocytopenia, many other factors can also cause secondary platelet depression. Such as neoplastic diseases. The protagonist of a real rehabilitation case shared this time is a patient with thrombocytopenia caused by osteosarcoma (the problems associated with thrombocytopenia are also very common among MDS patients, you can refer to it to understand). Osteosarcoma is a malignant bone tumor. Clinical treatment mainly involves preoperative and postoperative chemotherapy and surgical resection of the lesion. Patients who have experienced chemotherapy should be aware that one of the side effects of chemotherapy is the suppression of hematopoietic cells in the bone marrow microenvironment. Some cases will focus on the megakaryocytic effect, platelets do not rise for a long time. This is the case with the patient Bin Feng (pseudonym), when he was diagnosed with high-grade sarcoma (tumor necrosis rate of about 60%). The bone marrow suppression caused by chemoradiation is undoubtedly worse for the condition! (Test results at the time) Bin Feng’s platelet values ​​fluctuated between 90-125 before receiving chemotherapy. During the subsequent development of the treatment phase, there was a decrease in leukocyte suppression. At that time, he was discharged from the hospital after treatment with stimulating factor whitening. The follow-up treatment continued, and the blood platelet test results showed that the downward trend of platelets was only 23. At that time, the patient had followed the doctor’s advice to develop platelet transfusion and thrombopoietin treatment. Recombinant human thrombopoietin was mentioned as 35 after losing the board for another 4 days, but it suddenly dropped to 14 the next day. The unsuccessful treatment made Bin Feng and his lover’s mood down to the bottom. How can platelets be stably improved? In this way, subsequent treatment will be affected. Due to the continuous fluctuations in the situation of injection and blood transfusion, Binfeng is going to find a Beijing expert in a large hospital to see if the condition is good. If he knows the xx hospital from the Internet, he has heard about the patient’s word of mouth and finally contacted the teacher of the hospital. understand situation. (The patient himself communicated further with the teacher of the hospital) (The blood condition before treatment) At that time, after understanding the patient’s condition and considering that this was a contacted case, the problem of low platelet suppression caused by bone marrow suppression was more common. Such patients often involve blood transfusions and treatment with stimulating factor production hormones, but they often fail to restore normal hematopoietic function. The display of the curative effect is only a short-term control, and as the efficacy of the drug is lost, the value will drop again. According to the situation of Binfeng, the main therapeutic purpose needs to start to correct the abnormal hematopoietic microenvironment in order to restore the platelet value reliably! After further contact and communication, Bin Feng and his lover decided to be treated on February 25, 2020. Interviewed by the doctors in the hospital said: “The chemotherapy plan will be stronger when attacking malignant cells, but the post-disaster reconstruction after chemotherapy needs to be considered. Then the theory and practice of traditional Chinese medicine to help eliminate evils have its advantages. How to coordinate and play the Western medicine “The advantage and the strength of Chinese medicine “shou”, strong cooperation is more conducive to the treatment of the disease, and a long-term survival path of the patient, and promote healing!” In the feedback of Binfeng’s lover on March 6, we learned Bin Feng’s value improved on the sixth day after the end of chemotherapy (starting on the third day of chemotherapy), and there was no ups and downs before. After administration through treatment: April 1st re-examination combined with other blood cells, including platelet elevation 59, has been improved. Tell that you don’t need to cooperate to generate vegans. The effect will gradually increase gradually and gradually. (Patient’s lover’s feedback on treatment results) On April 27, re-examination of white blood cells 7.45, hemoglobin 138, platelets 215! (The value returned to normal after treatment) The patient himself Bin Feng felt overjoyed! From the initial platelet value of more than 20 to the current stable of more than two hundred (during the two chemotherapy has remained stable during the period)! Firmly believe in targeted treatment ideas! Thanks to both the doctor and the patient who firmly believe in each other! At the same time, it also builds a good recovery confidence for everyone in the patient society! I believe that in the near future, there will be more and more MDS patients suffering from myelosuppression to solve the dilemma! If you have any questions about this article or the disease, please feel free to follow us on WeChat and search more: gsby120

What should I do if I feel that my skin turns white

Everyone will have this kind of problem, so how can we turn white? In fact, some whitening ingredients are also added to medical skin care products. For example, like tranexamic acid, nicotinamide, etc., tranexamic acid is also called tranexamic acid, it can inhibit the tyrosinase in the process of melanin formation, thereby playing a role in inhibiting the growth of melanin. How was the role of tranexamic acid discovered? In fact, Tranexamic acid was the first to prevent postpartum hemorrhage in obstetrics and gynecology. Some people found that it can make the skin white and bright during the treatment process. Later, experiments have found that Tranexamic acid has the skin whitening treatment effect, which can inhibit the production of melanin, and finally act on Among the application fields of dermatology. Tranexamic acid not only inhibits the production of melanin, but it also inhibits the effects of vascular endothelin and redness. If there is red blood on the face or facial flushing is in a sensitive state, the whitening essence in medical skin care products is generally preferred during treatment. Just mentioned the component of nicotinamide, nicotinamide itself can play a two-way role in regulating sebum secretion. Generally speaking, it will reduce the oily skin secretion of oil. Niacinamide not only has the effect of whitening and light spots, but also has the effect of controlling oil. &nbsp.

What should I do if thrombocytopenia takes hormones for a long time to affect calcium absorption? Shi Shurong makes an appointment

Hormone is a traditional medicine used by Western medicine to treat thrombocytopenia, and it is used to quickly increase the platelet value. For patients with low platelet count, severe bleeding can be avoided. But most patients will have the phenomenon of taking medicine as soon as it rises and stopping and then falling, and with the increase of the dosage of medication and the duration of medication, patients will show certain adverse reactions, especially it will affect the absorption of calcium. Director Shi Shurong’s micro-signal xueyeke999 interferes with the absorption of calcium and will cause the following manifestations in patients with thrombocytopenia: ① Reduced secretion of gonadotropins: weaken the secretion of pituitary gonadotropins (luteinizing hormone and follicle stimulating hormone), causing estradiol and The concentration of ketone, dehydroandrostone and progesterone decreased. The dehydroandrostenone, androstanedione, and estrogen secreted by the adrenal glands are suppressed due to adrenocorticotropic hormone and adrenal atrophy. Decreased secretion of androstanedione causes a decrease in estrone levels (under normal circumstances, estrone is aromatized from androstanedione in the surrounding adipose tissue). These anabolic hormones may play an important role in the pathogenesis of glucocorticoid-induced osteoporosis. ②Secondary hyperparathyroidism: due to the suppression of intestinal calcium absorption and negative calcium balance caused by hyperuric calcium. ③ Inhibition of intestinal calcium absorption: This effect has little to do with vitamin D, and the role of the interaction of corticosteroids and vitamin D in changes in calcium absorption caused by corticosteroids is unclear. ④Reduction of calcium reabsorption by renal tubules: fasting hypercalciuria and increased blood PTH. Hypercalciuria is caused by increased bone resorption and decreased renal tubular calcium reabsorption. Long-term use of hormone drugs requires timely calcium supplementation to prevent osteoporosis or femoral head necrosis. Corticosteroids can promote protein decomposition, inhibit protein synthesis, cause negative nitrogen balance, increase calcium and phosphorus excretion, and can also hinder calcium absorption. Inhibition of bone formation, collagen synthesis is increased during the first 24 hours in the presence of superphysiological corticosteroids, but it is clearly inhibited after 48 hours. After 48 hours of exposure, DNA synthesis decreased, and tissue sections confirmed reduced mitosis. Osteocalcin synthesis is inhibited by corticosteroids, and patients receiving corticosteroids have low levels of serum osteocalcin. Enhanced bone resorption, which involves the production of new osteoclasts by cell replication, is inhibited by high doses and prolonged exposure. Due to its anti-vitamin D effect, it can cause bone formation and lead to osteoporosis. In severe cases, spontaneous fractures can occur. Long-term use of corticosteroids should supplement vitamin D and calcium salts. In addition, when taking hormone drugs for a long time, calcium can be supplemented by diet. Milk, shrimp skin, kelp, tofu and other foods are rich in calcium and can be eaten appropriately. At the same time, drink less tea, try not to smoke, drink less alcohol and carbonated drinks. Doing more exercise and sunbathing can promote calcium absorption. If necessary, oral calcium can be taken as directed by your doctor. Welcome to pay attention to the WeChat public account of thrombocytopenia patients: xxbjs75

Which ingredients in skin care products have whitening effect?

Pigmentation, dark complexion, uneven skin tone are a common skin problem, which has a certain impact on the beauty of our appearance. I believe many fairies are very troubled by this. Smooth, white and tender skin is also beautiful in China. A sign, so what are the ingredients in the skin care products of cosmeceuticals that can whiten and lighten the pigment? I have made some conclusions for you. Arbutin, also known as arbutin, is an ingredient extracted from arbutin. The principle of arbutin whitening is that it can penetrate into the skin quickly, while inhibiting the activity of tyrosinase without affecting the cell concentration. Arbutin is to fundamentally block the synthesis of melanin, prevent the deposition of melanin in the skin, and has a good inhibitory effect on long spots and darkening. Niacinamide, also known as vitamin B3, mainly inhibits the production of melanin from the following two routes. 1. Inhibits the production of tyrosinase. 2 Accelerates keratin metabolism, controls the transport of melanin. (Gentle exfoliation) Tranexamic acid, also known as ammonia As a protease inhibitor, tranexamic acid and tranexamic acid can inhibit the activity of tyrosinase enzymes and melanocytes, prevent pigment aggregation, block and eliminate the deterioration of melanin diffusion caused by ultraviolet radiation. Make the blackboard no longer thicken, expand and increase, effectively prevent or improve skin pigmentation. In addition, azelaic acid, vitamin C, retinol, kojic acid, licorice, etc., synthesize different routes from black to inhibit the production of melanin. So as to achieve the effect of lightening melanin and whitening.