Shi Shurong: How to reduce or delay the conversion of MDS patients to acute leukemia?

   Studio Shi Shurong WeChat xyk261MDS is the disease name officially confirmed in the 1970s. Its clinical manifestations are refractory anemia, bleeding, infection and high-risk conversion to leukemia. It is a malignant clonal disease, a disease in which normal hematopoietic cells become morbid and ineffective hematopoietic cells, that is, the characteristics of benign hematopoiesis and malignant hematopoiesis coexisting at the same time. Therefore, how to reduce or delay the conversion of MDS patients to acute leukemia becomes a difficult point of treatment.  Most of them die of infection or bleeding before they become rushed leukemia. Age is an independent risk factor for infection. This is due to the decline of the elderly’s own body resistance, coupled with the deterioration of nutritional status and the decline of absorption capacity. It is easy for hospital infection to occur after a disease. After chemotherapy, the level of white blood cells is reduced, which inhibits bone marrow and immune regulation, and causes damage to the skin, mucous membranes, especially the respiratory tract and digestive tract mucosa. Bacteria can easily enter the human blood through the mucosal barrier and cause endogenous hospital infections. .   Therefore, the corresponding preventive measures need to be implemented:    1. Open windows regularly every day to keep the environment clean and hygienic;    2. Standardize the rational use of antimicrobial drugs, increase the rate of pathogenic bacteria culture inspection, use antimicrobial drugs according to the results of drug sensitivity, and reduce fungal infections.   3. If undergoing surgical treatment, pay attention to postoperative review, preferably once every 6 months, to check for complications such as infection after surgery. In terms of treatment, due to the different treatment strategies for different types of MDS, RA and RAS are mainly anemia. At this time, the use of Chinese and Western drugs to stimulate bone marrow hematopoiesis is mainly used, and can also be treated with inducers; RAEB Treated with low-dose chemotherapy plus inducing differentiation agents, RAEB-t should be treated with conventional combined chemotherapy similar to acute leukemia. Individualized treatment measures should be adopted for MDS.

Thank you for your consultation appointment: I am diagnosed with slow-grain after pregnancy. Can I give birth and then treat?

Chronic leukemia can occur in anyone, including women in pregnancy. Pregnancy is a good thing, but what should I do if I find that I have chronic myeloid leukemia? Mr. Child or cure first? Director Shi Shurong’s WeChat consultation platform: zkxk9999 cases of chronic myeloid leukemia diagnosed after pregnancy are rare, but not uncommon, but fortunately, the progress of chronic myeloid leukemia is relatively slow, especially for patients who are still in the chronic phase, and my child will be treated again. Not impossible! However, during the illness, whether it will affect the growth and development of the child or whether it will delay the optimal treatment time, this is a question everyone wants to know! Under what circumstances can pregnant women diagnosed with “slow grains” be treated later? Slow granules were obtained during pregnancy. If the condition is chronic, and the results of routine blood tests show that the white blood cells are less than 100×109/L, and the platelets are less than 500×109/L, they can be temporarily untreated and wait for the treatment after delivery. However, it should be noted that no treatment does not mean that the patient will do nothing. Regular review and monitoring of the condition is indispensable, especially in the case of abnormal changes in the blood, it is necessary to consult a hematologist in time to find a solution. What should I do if the white blood cells of slow-grain patients are greater than 100 and the platelets are greater than 500 during pregnancy? The first is to improve blood performance. White blood cells can be filtered regularly to prevent blood viscosity. For patients with high platelets, anticoagulants can be used to prevent them from forming a thrombus. If the patient is not tolerated by the above method or is not effective, he can be injected with interferon alpha after the patient is six months pregnant. Interferon α is not easy to enter the fetus, and the fetus that has been formed at this time is the least harmful. At the same time, even after six months of pregnancy, try to avoid taking tyrosine kinase inhibitors and hydroxyurea, so as not to cause fetal malformations. Under what circumstances is it not recommended for patients to continue pregnancy? If the patient’s condition is already in an accelerated phase or a sudden change period, it is not recommended to continue pregnancy, especially in the acute change period. The condition progresses rapidly, and powerful chemotherapy drugs are often needed to control the condition to avoid threatening the patient’s life. Although chronic myeloid leukemia is not a hereditary disease, the baby will not be inherited, but the diagnosis of chronic leukemia will have a great impact on the patient’s body and psychology. The rapid progress of the disease in the acute change period will also endanger the life of the pregnant woman, let alone Say kid. Therefore, for whether to continue pregnancy, it is necessary to carefully choose according to the actual situation of the patient. More patient communication assistance can follow the WeChat public account: Slow Grain Patient Association

Shi Shurong Consultation Appointment: What is the difference between slow granules (CMML) and chronic myeloid leukemia?

Chronic myelomonocytic leukemia (CMML) is a clinically rare blood disease. Its clinical manifestations, survival time, and blood routine tests are diverse. Most of them develop after 60 years of age, CMML has obvious pathological hematopoiesis, and the hematopoietic function is mostly poor. Director Shi Shurong’s WeChat consultation platform: Similarities between zkxk9999 and chronic myeloid leukemia: CMML can be divided into chronic phase, accelerated phase, and acute phase. The patients in the chronic phase are relatively stable, asymptomatic, or have only low fever and fatigue, and rarely have enlarged liver and spleen lymph nodes, which is very similar to chronic myeloid leukemia. At the same time, many patients with chronic myeloid leukemia have myeloproliferative characteristics, the same is true of “slow granulocytes”. Differences: ① The slow-grained single is not only characterized by myeloproliferative characteristics, but also accompanied by morbid bone marrow hematopoiesis, which often occurs due to abnormal bone marrow hyperplasia and thrombocytopenia, manifested as fatigue, palpitations, paleness, low fever, infection or bleeding. ② The characteristic of myeloproliferative hyperplasia is abnormal mononuclear cell hyperplasia, especially when the disease progresses rapidly after entering the accelerated phase. At this time, the mononuclear cell can be significantly increased, the condition is extremely serious, and most of them die from bleeding, infection or dirty before the acute change Organ failure. ③The main treatment of slow-grain monotherapy is mainly chemotherapy. On the basis of chemotherapy, it cooperates with traditional Chinese medicine syndrome differentiation treatment to reduce side effects and relieve pain. The doctor said that the median survival time of CMML patients is about 20 months, and about 15-20% of them progress to acute myeloid leukemia; the survival time may be related to the proportion of bone marrow blasts. But the prognosis will also be significantly different due to the heterogeneity of the disease. More patient communication assistance can follow the WeChat public account: Slow Grain Patient Association

Shi Shurong: The most common symptom of blood disease is also often misdiagnosed because of this symptom

Shi Shurong studio WeChat xyk261    bone pain is the most common symptom in life. The cause of bone pain is due to bone hyperplasia, joint degeneration, chronic strain, cold and cold, dampness and wind, acute sprain, injury, infection, tumor, tuberculosis, bone development deformity and other factors.  Clinically, patients with bone pain may be due to leukemia, multiple myeloma, lymphoma, and bone marrow necrosis.   1. Leukemia: Patients with acute and chronic leukemia will have bone pain, because the capacity of the bone marrow cavity is limited, and the bones around the bone marrow cavity are hard and inelastic, and the leukemia cells in the patient’s bone marrow proliferate a lot, making the bone marrow cavity tension increase, causing pain.   In addition, the phenomenon of bone pain may also be caused by the infiltration of leukemia cells to damage the cortex and periosteum of the bone, causing the disease to increase bone pain. Bone pain occurs in patients with leukemia, and the following situations are common:   Bone pain is more common in the ribs, and sternal tenderness is one of the characteristics of leukemia;   Most leukemia patients have hidden pain, and dull pain is common, and a few patients have severe bone pain , And unbearable;   Children with acute leukemia often have severe pain in the long bones of the limbs, and the analgesic is ineffective. Although the child had severe bone pain, the physical examination was normal and no other symptoms changed.   2. Multiple myeloma:    bone and joint pain is the main symptom of multiple myeloma. The cause of bone pain in patients with this disease is different from leukemia, mostly caused by bone destruction. Multiple myeloma is a malignant tumor disease caused by the malignant transformation of plasma cells in the bone marrow. Malignant plasma cells, also known as myeloma cells, can secrete a cytokine called osteoclast activation factor, which destroys and stimulates osteoclasts, leading to bone loss. Calcium, osteoporosis, and stubborn destruction.  Multiple myeloma patients with bone pain are most common in the lumbosacral region, followed by the thoracic ribs, and bone pain in the extremities is rare. The degree of pain varies, and it is often mild and temporary in the early stage. Activity can induce or make the pain worse, and it can become persistent and serious as the disease progresses. This pain analgesic is difficult to work together. Noridine does not relieve pain.   In addition, multiple myeloma is prone to pathological fractures due to bone destruction. If a fracture occurs, bone pain suddenly increases and the pain is severe. When a patient is diagnosed with multiple myeloma, sometimes a mass in the bone may be found, and the local bone may be tender.   3. Lymphoma:    Lymphoma cells can cause bone pain when they invade the bone. The pain is generally limited to the lesion, and local tenderness can be obvious. The main bones invaded by lymphoma are thoracic spine, lumbar spine, ribs, pelvis, femur and cervical spine. It is usually hidden pain and dull pain, and there can also be severe pain attacks.   4. Bone marrow necrosis:    is relatively rare. Due to the unclear etiology, the cells in the bone marrow dissolve and necrosis in a large amount in the short term, resulting in severe bone pain, which is very severe and makes it unbearable. All painkillers are difficult to relieve. Bone marrow necrosis is mostly secondary to other malignant tumors, and some cannot find a clear cause.

Hu Guisheng, Beijing Institute of Hematology: Careful use of drugs will kill you!

Hu Guisheng Assistant WeChat: dd326751 Source: From WeChat public account [Hu Guisheng Studio] Cold is a common disease and frequent disease, which can occur all year round, and the late autumn to winter and spring are the high season. Having a cold, many people buy their own medicines and conduct “self-treatment”. There are many misunderstandings in the use of medicines. There are hundreds of cold medicines, and their ingredients are mostly similar, and their effects are similar. If two or more cold medicines are taken at the same time, that is, “repetitive medication”, it is equivalent to increasing the dose of the drug, and the risk of adverse reactions will increase exponentially. “It is a drug that divides into three,” it is well known. While drugs escort our health, their side effects can also cause considerable damage. The most common ones are cold medicines. Improper use of these drugs can cause some diseases, and blood diseases are one of the common diseases caused by them. Which drugs can induce blood diseases?    1. Antipyretic analgesics Many people still don’t know much about antipyretic analgesics. Common antipyretic analgesics are: acetaminophen, ibuprofen, nimesul Li et al. Commonly used cold medicines are also often encountered, such as: Sanjiu Ganmao Ling particles. Therefore, when choosing a cold medicine, you must choose carefully and apply it under the guidance of a doctor. These ingredients are easy to cause blood diseases. 2. Chemotherapy drugs are well known. When chemotherapy drugs are used to treat non-leukemia tumors or as immunosuppressants to treat immune diseases, acute non-lymphocytic leukemia can be secondary. This is one of the long-term serious complications of tumor chemotherapy. Most of the drugs used in chemotherapy It is a cytotoxic drug. Studies have confirmed that patients treated with chemotherapy have an increased incidence of leukemia.  3. Non-chemotherapeutic drugs such as baotaisong, chloramphenicol, chloroquine, etc.; long-term application of these drugs may induce hematological diseases, and there are related clinical reports. It is generally manifested as a poor state of bone marrow regeneration, and the type of leukemia induced is mainly acute myeloid leukemia.  In addition to paying more attention to medication, usually pay attention to prevent the occurrence of colds. For example, do not use cold water to punch or take a cold shower when you are hot and sweaty. Don’t stop blowing at the fan while you sleep, otherwise you will easily catch a cold when you wake up. Do not turn on the air conditioner for too long, and pay attention to the temperature difference between indoor and outdoor. At home, try not to use air conditioning as much as possible. Be careful not to eat only light foods in the diet, and reduce protein intake. If you stay at home with the TV all day, or are too busy, long hours of continuous work or excessive fatigue will cause the body’s immune function to be reduced, resulting in the occurrence of a cold. Therefore, it is recommended that when morning and evening sunshine is not strong, people should insist on outdoor exercise to enhance the body’s resistance to cold viruses.

Shi Shurong: Which blood diseases are more common in children? These signs help you identify!

Shi Shurong’s studio WeChat xyk261  blood disease, many people will think of leukemia, because it belongs to cancer, and more and more children have leukemia. In fact, there are many types of blood diseases, benign and malignant, so which blood diseases are more common in children? These signs help you identify!   1. Anemia    Anemia is a very common phenomenon in many people, and if children have anemia, the general parents will give the child some nutritious food to supplement the body. But in many cases, it will be misdiagnosed and miss the opportunity for treatment.   This is the most common blood disease that will not be valued by everyone. Children, especially young children, often have anemia during the rapid growth and development of their bodies. There are many types of anemia, iron-deficiency anemia and genetic thalassemia. In blood diseases, anemia is one of the first symptoms. There are diseases such as aplastic anemia and myelodysplastic syndrome, so as parents, they should be treated in time.   2. Thrombocytopenic purpura   Immune thrombocytopenic purpura is mainly affected by children and adult women, especially children of this age group, because the body’s immune mechanism is not perfect, it is easy to suffer from thrombocytopenia. The disease is a hemorrhagic disease caused by thrombocytopenia. Patients often show skin bleeding points, bruises or unstoppable bleeding, and women have prolonged menstrual time and large amounts. Low. Acute thrombocytopenic purpura is more common in children, and the condition is in the acute stage, and the possibility of cure is greater, but some children will have repeated illnesses or even develop chronic due to lack of timely and effective treatment, or improper treatment. In the period, refractory thrombocytopenia, and the condition persists repeatedly. 3. Aplastic anemia in children with aplastic anemia is also relatively common in the clinic of hematology. This is a type of bone marrow hematopoietic failure syndrome caused by multiple causes. Although the condition is benign, the incidence is high and the condition is dangerous. Severe aplastic anemia is called “soft cancer”.   Any disease has a development process. For children, parents should pay attention to observe the child’s situation. For some common anemia, bleeding and repeated fever infections, we must be vigilant and pay attention.   4. Leukemia    Leukemia is a type of malignant clonal disease of hematopoietic stem cells, and it is also the first malignant disease among children in this group. The most common of this age group is mainly acute lymphoblastic leukemia, and most children can have a good prognosis through chemotherapy, bone marrow transplantation and syndrome differentiation treatment of traditional Chinese medicine.   5. Lymphoma   Lymphoma is a malignant tumor of the lymphatic hematopoietic system, and this group of children is also more common. It is one of the hematological malignancies! Seeing the above common blood diseases of children, parents may feel “terrified”. In fact, as long as the child’s physical and mental health is maintained, the probability of any disease occurring is relatively small. At the same time, even if unfortunately sick, as long as the disease is discovered as soon as possible, take it as soon as possible. Treatment measures, most children can get a good prognosis, and even normal living conditions.

Xie Bielu medical words: What do the three important “reactions” of chronic myeloid leukemia mean?

During the entire treatment of chronic myeloid leukemia, in addition to taking medication regularly, it is necessary to monitor regularly to do a good evaluation of the therapeutic effect. The three responses of the therapeutic effect include: hematological response, cytogenetic response and molecular response. Director Shi Shurong’s WeChat consultation platform: zkxk9999 In fact, these three “responses” belong to three levels, or the depth of efficacy, and are also classified according to the sensitivity of the corresponding three tests, corresponding to peripheral blood testing, chromosome testing and Quantitative PCR genetic testing. First of all, hematological reactions include blood routine, peripheral blood smears, spleen palpation, and patient’s symptoms and other common or superficial indicators. A complete hematological response is blood routine, with normal peripheral blood smears and no clinical symptoms such as splenomegaly associated with slow granules. The hematological response detection level is the lowest, that is, the sensitivity is the lowest, and most patients who are under effective control of their regular medications have basically normal blood tests. Secondly, the cytogenetic response, or chromosome detection, is determined according to the proportion of Philadelphia chromosomes and is divided into three stages: complete cytogenetic response: the proportion of Philadelphia chromosomes is 0, which means that the chromosome turns negative; some cytogenetic reactions: Philadelphia chromosome ratio is 1-35%; secondary cytogenetic response: Philadelphia chromosome ratio is 36-65%; microcytogenetic response: Philadelphia chromosome ratio is 66-95%; cytogenetic non-response: Philadelphia The proportion of chromosomes is more than 96%. Furthermore, molecular response (MR) is the deepest quantitative PCR gene detection, which is an order of magnitude concept, such as MR3.0 (also known as: MMR), that is, leukemia cells have dropped by 3 logarithms, and the residual quantity is thousands One-half. MR4.5 means that the leukemia cells have dropped by 4.5 logarithms and the residual amount is 0.0032%. MR5, that is, the leukemia cells have dropped by 5 logarithms and the residual number is 0.001%. Does genetic testing turn negative, does it mean that the leukemia cells are gone? it’s not true! Genetic testing turned negative, that is, molecularly undetectable, that is, a completely molecular reaction. For this “negative”, two points need to be understood: First, it is not that the leukemia cells have been completely eliminated, and the leukemia cells have burned. No molecular detection! Second, the extent to which this leukemia cell is small also depends on the detection sensitivity of the laboratory, which means that the detection sensitivity of a certain laboratory can only reach MR3 (MMR), then, “negative” can only indicate the leukemia cell’s The residual amount is less than one-thousandth. If MR4.5 can be reached, the residual amount of leukemia cells is less than 0.0032%. Experts remind that residual leukemia cells are the root cause of leukemia recurrence. Even if the residual amount is less than one thousandth, once the control of the drug is lost, it is easy to relapse and increase. Therefore, do not stop the medicine too quickly, you should follow the doctor’s advice to stabilize the medicine and avoid the relapse. More patient communication assistance can follow the WeChat public account: Slow Grain Patient Association

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.

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.

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

Why do doctors like to give routine blood tests? What disease can be ruled out? What disease is detected?

Almost all in-patients and patients in the outpatient clinic who only need to draw blood will check a blood routine. What disease can be detected by massage this little blood routine? If the blood routine is normal, what diseases can be ruled out? Although the blood routine is called a project, it actually includes many sub-projects. In the simplest way, the blood routine can find out whether we have anemia, whether there is bacterial infection, and whether there is an increase in thrombocytopenia. So the doctor doubts whether we have anemia or inflammation, we will take a blood routine check. 1. Hemoglobin to see if anemia is the main component of red blood cells, and bears the function of the body transporting oxygen and carbon dioxide to organs and tissues. Hemoglobin can better reflect the degree of anemia. Reference value of hemoglobin Male 120~160g/L Female 110~150g/L Newborn 170~200g/L Hemoglobin reduction is anemia, anemia can be divided according to severity: severe anemia, Hb in 31~60g/L; moderate anemia, Hb is between &gt.61-90g/L; mild anemia, Hb is between &gt.90g/L and below the lower limit of normal reference. Increased hemoglobin is more common in hypoxia, severe dehydration, pulmonary heart disease, congenital heart disease, residents in high mountain areas, severe burns, shock, etc. 2. Red blood cell count of red blood cells Children: (4.2~5.2)×1012/L Adult male: (4.0~5.5)×1012/L Adult female: (3.5~5.0)×1012/L Red blood cell increase: non-disease increase: impulse, Excitement, fear, cold water bath stimulation, hypoxia stimulation; long-term blood donation. Decrease: pregnancy, infants and young children grow rapidly. Increased disease: frequent vomiting, excessive sweating, extensive burns, blood concentration, chronic pulmonary heart disease, emphysema, altitude sickness, tumors, and polycythemia vera. Reduction: leukemia, acute hemorrhage, iron deficiency, vitamin B12 deficiency, etc. 3. We have a fever with white blood cells, or suspect inflammation. As soon as we arrive at the hospital, we will draw blood to see if the white blood cells are high or not. If the white blood cells are high, it may be caused by inflammation or infection. Normal reference range: adult (4.0~10.0)×109/L newborn (15.0~20.0)×109/L non-disease leukocyte increase: strenuous exercise, after eating, pregnancy, newborn. Disease white blood cell increase: acute suppurative infection, uremia, leukemia, tissue damage, acute bleeding, etc. Disease leukopenia: aplastic anemia, certain infectious diseases, liver cirrhosis, hypersplenism, radiotherapy and chemotherapy. White blood cells are a preliminary judgment of whether there is a bacterial infection, and the increase can be seen in bacterial infections, bleeding, leukemia, and poisoning. In the clinic, what kind of disease is specific depends on the classification of white blood cells, clinical manifestations, and other tests. White blood cells are divided into several types: neutrophils N0.5 ~ 0.7 (50% ~ 70%) play an important role in acute infection, the clinical significance of the increase and decrease is the same as the white blood cell count. Eosinophil E0.01-0.05 (1%-5%) reduces typhoid fever, paratyphoid fever, major surgery, severe burns, and long-term use of adrenocortical hormones. Increased allergic diseases, skin diseases, parasitic diseases, some blood diseases and tumors, such as chronic myelogenous leukemia, nasopharyngeal cancer, lung cancer and cervical cancer. B0 ~ 0.01 (0 ~ 1%) decrease of basophils: sensitized shock, medication is seen in excessive use of adrenocortical hormones, etc. Increase: Blood diseases such as chronic myeloid leukemia, trauma and poisoning, malignant tumors, allergic diseases, etc. Lymphocyte L0.20~0.40 (20%~40%) decrease: acute phase of infectious diseases, radiation sickness, cellular immunodeficiency disease, long-term application of adrenal cortex hormones or exposure to radiation, etc. Increase: infectious lymphocytosis, tuberculosis, malaria, chronic lymphocytic leukemia, pertussis, certain viral infections, etc. Monocytes M0.03~0.08 (3%~8%) increase: infectious diseases or parasitic diseases, active period of tuberculosis, mononuclear leukemia, malaria, etc. 4. Normal reference range of platelet (100~300)×109/L increase: acute massive blood loss and acute infection after hemolysis; polycythemia vera, hemorrhagic thrombocytosis, multiple myeloma, chronic myelogenous leukemia and

Don’t take the tooth extraction too seriously, resulting in a variety of health problems, acute death is one of them

A recent report-a 26-year-old man with wisdom teeth bleeds and dies after more than 10 days, has caused heated discussion. The protagonist of this story, 26-year-old Liu Guofan, wanted to remove wisdom teeth because his wisdom teeth were infected. He went to a local stomatological hospital for a few days after the teeth extraction. He still had a lot of bleeding, and appeared dizzy and nausea symptoms, but he did not see the doctor. The doctor received a WeChat reply, and the situation turned sharply. Finally, the traffic police sent him to the hospital intensive care unit (ICU). His admission diagnosis was: suspected oral and maxillofacial space infection, suspected left lower limb cellulitis, suspected acute osteomyelitis, suspected acute Leukemia, sepsis, lung infection, thrombocytopenia, moderate anemia, hypokalemia, and unfortunately passed away a few days later. For most of us, pulling wisdom teeth is a simple matter, but for Liu Guofan, it triggers the acceleration of his death. Finally, the experts analyzed the incident and considered that it may have leukemia. The secondary sepsis, cerebral hemorrhage and other factors promoted his death. We couldn’t help but sigh, but one of the rare trivial things of wisdom teeth was finally killed. In fact, tooth extraction is still an invasive operation, which can also cause many complications, such as syncope, allergies, broken roots, fractures, bleeding, secondary infections, facial paralysis and so on. Bleeding is a common complication of tooth extraction, but it is sometimes a symptom of leukemia. In clinical practice, some people have leukemia detected because of tooth extraction bleeding. So what are the symptoms of leukemia? Leukemia is a type of malignant clonal disease of hematopoietic stem progenitor cells. These progenitor cells cannot differentiate into normal white blood cells, and even infiltrate bone marrow and other hematopoietic organs to inhibit normal hematopoiesis, resulting in partial or complete loss of anti-inflammatory ability of white blood cells. Suppression, resulting in symptoms of anemia, bleeding and fever infections, so clinically more common with high fever, skin purpura, menorrhagia, bleeding after tooth extraction is diagnosed as leukemia not only from the doctor, which is consistent with Liu Guofan’s later symptoms and diagnosis. These symptoms are also the clinical manifestations of many other diseases. It can be seen that the atypical symptoms are difficult to diagnose. In addition to some of the above symptoms, leukemia can also include swollen lymph nodes, swollen gums, joints, bone pain, protruding eyeballs, swelling, or blindness. The diagnosis of leukemia is the most common blood test that we do at the time of our visit. Leukemia patients often have an increase in white blood cells, which can be increased by more than 10×10^9/L. Of course, some white blood cells are less than 1.0×10^9/L or normal , Red blood cells, platelets are often reduced. The gold standard for diagnosis is to find the original cells by bone marrow aspiration. In addition, some immunological, cytochemical and other tests can further provide a basis for diagnosis and classification. In fact, such a report of the occurrence of tragedy, tracing back to the source, except that the patient lacked some medical knowledge, the doctor did not conduct relevant examinations in advance, and the understanding of the complication was insufficient, the incident also existed by chance. As doctors, we have begun our adventure since we entered this industry. We need to equip ourselves to avoid risks. Of course, in the process of practicing medicine, the patient’s cooperation is also very important. For example, do not bargain for necessary examinations and trust the doctor a little more. Of course, I believe that with the advancement of medical reform, the future medical industry can make doctors and patients get along with the environment more friendly. It is hoped that in the recent college entrance examination and when volunteering will be reported, this incident should not be a hindrance for candidates to join the medical profession.

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

Treatment of leukemia focuses on primary disease

[Overview]    Leukemia response is a response response of the hematopoietic system after the body is stimulated, which is manifested by a marked increase in the number of peripheral blood leukocytes, and the appearance of immature cells, similar to leukemia.  【Diagnosis】   1. Medical history and symptoms    (1) Medical history Question: Note: ① Are there bacterial, fungal and parasitic infections.  ②Is there autoimmunity&nbsp. disease&nbsp.(rheumatoid arthritis, sarcoidosis, etc.) and neoplastic disease (kidney tumor, leukemia, etc.).   ③ Whether to use glucocorticoid, epinephrine, lithium chloride and other drugs.   ④ Whether there is severe burn, crush injury, electric shock injury. Poisoning. Acute hemolysis or massive blood loss. Whether it is in the recovery period of bone marrow suppression, etc.  ⑵Clinical symptoms: Depending on the original disease, the corresponding clinical symptoms appear.   Second, physical examination found:    is mainly the corresponding signs of primary disease.   3. Auxiliary blood test: red blood cells and hemoglobin can be normal (except acute hemolysis, massive blood loss and leukemia), and platelet count is normal. The number of white blood cells increased significantly> 25×109/L, up to 200×109/L The proportion of granulocytes increased. Classification shows naive cells, toxic granules and vacuoles often appear in the neutrophil cytoplasm.   2. Bone marrow elephants: hyperplasia is active or obviously active, and there is no obvious increase in primitive cells, and there is no abnormal cell morphology of leukemia. The erythroid and megakaryocyte cell lines are normal.   3. Cytochemical staining: The neutrophil alkaline phosphatase score is significantly increased.   4.&nbsp. Genetic examination: no Ph1 chromosome.   Fourth, differential diagnosis    Leukemia-like reactions often have clear incentives, but when the original disease is more concealed, attention should be paid to differentiate from leukemia.  【Therapeutic measures】  The leukemia reaction itself does not require treatment, and can be quickly recovered after the original cause is removed. Therefore, we should carefully look for the primary disease and actively treat it.

Shi Shurong medical words: Why do you have chronic myeloid leukemia? What should be paid attention to in treatment?

Patients with chronic myeloid leukemia and their families have a question: why do they have chronic myeloid leukemia? It is generally believed that the incidence of chronic granules is related to these factors: ionizing radiation, chemical pollution, and genetic factors. However, in the same living environment, only a few people have been diagnosed with chronic granules. What is the pathogenesis of this group of people? Director Shi Shurong consulted WeChat zkxk9999 slow granulogenesis: non-genetic, mostly chromosomal variation. In previous research, it has been found that chronic myeloid leukemia is caused by the translocation and exchange of the 9th and 22nd pair of chromosome end gene loci in humans. The formation of a new bcr-abl fusion gene, encoded into a specific protein, a tyrosine kinase, which leads to disease, causing a rapid rise in white blood cells and splenomegaly. The cause of the chromosomal mutation is not yet clear, but what can be determined is that it has nothing to do with inheritance. Based on the pathogenesis of slow granules, the curative effect of targeted drugs is “gratifying”. Targeting drugs for fusion genes of slow granule patients, namely tyrosine kinase inhibitors, have a clear effect and a significant effect, allowing the quality of life and survival of slow granule patients. The period has been significantly extended. However, during the treatment period, due to individual differences, it is necessary to constantly adjust the medication plan according to the patient’s condition, medication response and efficacy. Therefore, patients with slow-grain must carefully review and monitor in order to pass the medication to make the fusion gene The expression reached the expected goal, and even received withdrawal. In addition, some patients with slow-grained drugs have had various degrees of side effects during the treatment, which may even affect the final efficacy. Therefore, it is recommended that slow-grain patients can intervene in traditional Chinese medicine to increase the effectiveness and reduce toxicity! For more knowledge about chronic myeloid leukemia disease or patient help, you can pay attention to WeChat public number: mbxb120

This new drug for leukemia can play a preventive role!

Many drugs used in the treatment of leukemia are for preventive purposes. Among them are-compound sulfamethoxazole (compound sulfamethoxazole). British leukemia group study-this medicine can achieve preventive effect! Although this drug is not a chemotherapy drug, it plays an irreplaceable role in the chemotherapy of leukemia. This is because most patients with leukemia, especially children with leukemia, suffer from severe damage to the body’s immune system during chemotherapy, and the immune system will be very weak, and various types of infections are prone to occur. One of the fatal infections is pneumonia caused by “Pneumocystis carinii”. Although the incidence of this pneumonia is very small, it is terrible once it is infected! Fuxin Xinming can play a preventive role! Co-trimoxazole is taken twice a day, for 3 consecutive days a week, and stopped for 4 days. You can choose which three days of medication to take according to convenience, such as Monday, Tuesday, and third, and the rest of the day, or Wednesday, Thursday, and Friday, and the rest of the day. Because there are reports that co-trimoxazole can increase the toxicity of MTX, it is best not to use it on the same day as MTX. Emphasis-from the beginning of chemotherapy, we must continue to take co-trimoxazole until the drug is stopped, and if necessary, continue to take it for 3-6 months after the drug is stopped. If you have any questions about this article or the disease, you are welcome to follow us on WeChat and search for leukemia patients: dxbby120

Shi Shurong’s medical words: Chronic leukemia is not so terrible, and reasonable medicine can survive for a long time!

Chronic myeloid leukemia is a malignant tumor that affects the blood and bone marrow. It is characterized by the production of a large number of immature white blood cells. These white blood cells accumulate in the bone marrow to inhibit the normal hematopoiesis of the bone marrow; and can spread through the blood through the body, causing anemia in patients , Easy bleeding, infection and organ infiltration. Director Shi Shurong’s consultation on WeChat zkxk9999 mentioned leukemia, everyone will be afraid, thinking that leukemia is a “fatal disease” that is not cured, in fact, chronic leukemia is not the case! At present, with the continuous improvement of the diagnosis and treatment of chronic myeloid leukemia, this type of leukemia is no longer a “fatal disease”, as long as the drug is properly controlled, it can be treated as a chronic disease! Reasonable medication, slow-grain patients can survive for a long time! With the advent of first-line and second-line target drugs, the progress of slow-grain patients has been greatly slowed down, and the survival rate of slow-grain has been greatly improved. Many slow-grain patients who survive with cancer still live a wonderful life, and slow-grain treatment has gradually Turn into a chronic disease treatment. However, the course of slow granules is divided into chronic phase, accelerated phase and acute change phase. Only when the disease progresses to the acute change phase will the patient face the threat of death. Therefore, the key to slow-grain therapy is to delay the progression of the disease as much as possible to achieve the goal of long-term survival. At present, the main treatment methods for slow granules are: targeted therapy, interferon therapy, and hematopoietic stem cell transplantation therapy. Targeted therapy The current internationally recommended slow-grain treatment plan. Although the treatment technology for leukemia is constantly developing and the drugs are being updated, there are still patients who develop drug resistance or intolerance, and the problem of drug resistance and intolerance is increasingly becoming Slow-grain treatment is a serious obstacle on the road. In response to these problems, experts suggest that slow-grain patients can cooperate with traditional Chinese medicine conditioning, while reducing the toxic and side effects of targeted drugs, it can also improve the patient’s physique, so as to achieve the effect of improving efficacy! For more knowledge about chronic myeloid leukemia disease or patient help, please pay attention to WeChat public account: mbxb120

What are the symptoms of chronic lymphocytic leukemia

Chronic lymphocytic leukemia is one of the very common chronic leukemias. It has the characteristics of slow onset, long course of disease, and relatively easy treatment. Although the symptoms of chronic lymphocytic leukemia are relatively mild, if you do not take leukemia treatment in time, it is likely to cause a sudden change in the condition and the consequences will be unimaginable.   So, what are the symptoms of chronic lymphocytic leukemia?   Symptom 1: Age    Patients’ blood changes are often closely related to the symptoms of chronic lymphocytic leukemia. More than 90% of leukemia patients are over 50 years old.   Symptom 2: Sudden increase in lymphocytes    Patients with chronic lymphocytic leukemia often suffer from uncomfortable symptoms such as limb weakness, easy fatigue, and physical overdraft. Patients’ necks may also have enlarged lymph nodes and may even cause symptoms such as the abdomen or urinary system.   Symptom 3: Moderate splenomegaly    Ten percent of patients with chronic lymphocytic leukemia will have anemia, often accompanied by symptoms such as loss of appetite, thin facial muscles, and night sweats. In severe cases, patients with skin purpura and bleeding tendencies are very susceptible to infection.   Symptom 4: Damage to the gastrointestinal tract and skeletal system.  Some patients have itchy skin and leukemia skin infiltration, causing various degrees of damage to the patient’s gastrointestinal tract and skeletal system.  Chronic lymphocytic leukemia is a type of leukemia. Although the symptoms of leukemia are not very obvious, if it can not be treated in time, it may lead to a sudden change in the condition and unexpected consequences.

Leukemia care focuses on three aspects

Leukemia has become a common disease and a frequent disease, seriously endangering human health and life. The National Medical Leukemia Research Group believes that the disease belongs to the category of “medullary poison” and “deficiency tuberculosis”. In addition to being related to environmental pollution, chemical drugs, and exposure to radioactive substances, researchers have found that the occurrence of leukemia is also related to the intracellular endogenous pathogenic GYA factor and extracellular exogenous GYB pathogenic factor. The disease GYA factor destroys the homeostasis of the bone marrow, the pressure of the bone marrow increases, and the sinusoidal barrier may be ruptured, allowing immature cells at various stages to enter the bloodstream, resulting in the proliferation of immature cells and developmental arrest; the synergy of exogenous GYB pathogenic factors Leukemia cells mainly invade the liver, spleen, kidney and other organs.  One of the main causes of fever caused by leukemia is infection, followed by the application of chemotherapeutic drugs, the destruction of white blood cells can also cause fever, but the temperature of such fever is mostly below 38.0℃. According to the characteristics of leukemia patients, the following nursing measures and precautions are listed: 1. Psychological care: For patients and their families with fever, the discomfort caused by the disease and the aggravation of symptoms often cause their anxiety and anxiety. Explain to them the reason of the fever, so that they should not be impatient, and inform their doctors and nurses that they will find a way to control their condition and will come to see him at any time.   2. Environment: Keep the indoor air fresh, control the temperature at 20-40℃, the humidity at 55-60%, the bed unit is clean and dry, and change the sheets and bedding in time when there is more sweat. 3. Symptomatic care: If you have fever below 37.5℃, you can order more water, non-drug treatment such as cold towel on your forehead, reopen your temperature, and follow the doctor’s instructions for timely treatment with medication. For fever above 38.5℃, you should give medical treatment at the same time. It is best to supplement with physical cooling, there are two main methods: <1> warm water wiping bath: the whole process of wiping the bath does not exceed 30 minutes, to avoid the patient from cooling, and should pay attention to observe the patient’s tolerance and whether the skin is red and pale , Bleeding points and abnormal sensations; <2> Ice pack cold compress: You can place a water bag on the head, armpit, groin and other large blood vessels through the place, behind the pillow, auricle, scrotum, anterior heart area, plantar and abdominal cold compress. The cold compress should be no longer than 30 minutes. If the fever does not retreat, you can rest for 30 minutes before use. Give local tissue recovery time. Check the skin color every 10 minutes during the cold compress to prevent frostbite. Measure body temperature.

Do you have a bone marrow transplant if you have leukemia?

Many people think of “bone marrow transplantation” as soon as they talk about leukemia. It is believed that chemotherapy has large side effects and is easy to relapse. The late treatment is long and the time spent is higher than that of money, but bone marrow transplantation can be “quoted.” In fact, it is a misunderstanding that leukemia patients must transplant bone marrow! We often hear on the Internet that leukemia patients are looking for a suitable bone marrow matching, or because of the high cost of surgery, they cannot be operated on. Therefore, in the impression of many people, leukemia and bone marrow transplantation are closely linked. Without proper bone marrow matching, patients can only wait to die. Nowadays, in the medical research field of leukemia, modern medicine has been able to provide different treatments for different types and degrees of leukemia. With the continuous improvement of leukemia treatment research, the treatment of leukemia is becoming more standardized. Doctors can choose different treatments and different medicines for precise treatment according to the patient’s condition, age, and actual physical condition. When choosing a combined Chinese and Western medicine treatment plan, they can help the patient to a greater extent. This is also the domestic The value and significance of the existence of the integrated western medicine hospital. Regarding bone marrow transplantation, it is necessary to rationally assess the consequences. We must realize that bone marrow transplantation is not the only option. At the same time, the treatment effect is limited and there are still certain risks, because this may affect the patient’s future life, so please everyone It must be remembered: transplantation has a price, and rejection is priceless! Follow me to learn more about the science of hematology.