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Association of Gene Mutations with Response to Arsenic-Containing Compound Qinghuang Powder (复方青黄散)in Patients with Myelodysplastic Syndromes
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作者 ZHAO Pan LIANG Jun-bin +4 位作者 DENG Zhong-yang WANG Ming-jing QIN Jia-yue CHEN Chong-jian HU Xiao-mei 《中国结合医学杂志:英文版》 SCIE CAS CSCD 2019年第6期409-415,共7页
Objective: To in vestigate the relati on ship betwee n gene mutations and resp onse to Compo und Qinghuang Powder (复方青黄散,CQHP) in patients with myelodysplastic syndrome (MDS). Methods: Forty-three MDS patients af... Objective: To in vestigate the relati on ship betwee n gene mutations and resp onse to Compo und Qinghuang Powder (复方青黄散,CQHP) in patients with myelodysplastic syndrome (MDS). Methods: Forty-three MDS patients after treatment with CQHP for 6 months were genotyped by ultra-deep targeted sequencing and the clinical data of patients were collected and the relationship between them was analyzed. Results: Up to 41.86% of patie nts harbored genet mutations, in most cases with more than one mutation. The most comm on mutations were in SF3B1, U2AF1, ASXL1, and DNMT3A. After treatment with CQHP, about 88.00% of patients no longer required blood transfusion, or needed half of prior transfusions. Conlusion: CQHP is an effective treatment for patients with MDS, especially those with gene mutations in SF3B1, DNMT3A, U2AF1, and/or ASXL1. 展开更多
关键词 MYELODYSPLASTIC SYNDROMES arsenic next-generation sequencing REALGAR
Early Detection of Myelodysplastic Syndrome/Leukemia-associated Mutations Using NGS Is Critical in Treating Aplastic Anemia 预览
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作者 Xiang LI Yao-hui WU +3 位作者 Si-si CAI Wei-ming LI Yong YOU Min ZHANG 《当代医学科学(英文)》 SCIE CAS 2019年第2期217-221,共5页
Distinguishing between aplastic anemia(AA)and hypoblastic myelodysplastic syndrome(hMDS)with a low percentage of bone marrow(BM)blasts(<5%)can be difficult due to the overlap in clonality and a spectrum of genetic ... Distinguishing between aplastic anemia(AA)and hypoblastic myelodysplastic syndrome(hMDS)with a low percentage of bone marrow(BM)blasts(<5%)can be difficult due to the overlap in clonality and a spectrum of genetic alternations between the two subtypes of diseases.However,due to recent advances in DNA sequencing technology,both spectnim and frequency of mutations can be accurately determined and monitored by next-generation sequencing(NGS)at initial diagnosis and during immunosuppressive therapy(1ST)in patients with AA or hMDS.This improvement in acquiring a patient's genetic status and clonal evolution can provide more proper,precise,and on-time information to guide disease management,which is especially helpful in the absence of traditional morphologic/cytogenetic evidence. 展开更多
关键词 APLASTIC ANEMIA hypoblastic MYELODYSPLASTIC syndrome IMMUNOSUPPRESSIVE therapy next-generation sequencing
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More Benefits of Oral Administration of Arsenic-containing Qinghuang Powder Compared with Decitabine for High/Very-high Risk Myelodysplastic Syndrome 预览
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作者 朱千赜 肖海燕 +9 位作者 刘为易 全日城 唐旭东 吕妍 刘驰 李柳 王洪志 郭小青 麻柔 胡晓梅 《世界中西医结合杂志(英文)》 2019年第2期11-19,共9页
OBJECTIVE: To evaluated the benefits of oral administration of arsenic-containing Qinghuang Powder(QHP)compared with decitabine for patients with high/very-high(H/VH) risk myelodysplastic syndrome(MDS) according to th... OBJECTIVE: To evaluated the benefits of oral administration of arsenic-containing Qinghuang Powder(QHP)compared with decitabine for patients with high/very-high(H/VH) risk myelodysplastic syndrome(MDS) according to the Revised International Prognostic Score System. METHODS: The OS(mOS) rate, annual OS rate and progression to acute myeloid leukemia(AML) in patients with H/VH MDS treated with QHP(QHP group, n = 27) and decitabine(decitabine group, n = 20) were retrospectively analyzed. The effects of prognostic factors of age, proportion of bone marrow blast,peripheral blood cell count, karyotype and Charlson Comorbidity Index(CCI) on OS were further analyzed. RESULTS: The m OS rate of QHP group(29 months) was signi?cantly longer than that of the decitabine group(18 months)(P = 0.043). The OS rates of 1, 2, and 3 years were signi?cantly higher in the QHP group(88.9%, 59.3%, 29.6%) than that in the decitabine group(70%, 25%, and 5%)(P = 0.01). There was no signi?cant difference of 5-year OS rate between the 2 groups(P = 0.133).The effects of prognostic factors on mOS were further analyzed, and it was found that there was no signi?cant difference of m OS rate between the QHP group(29 months) and the decitabine group(21 months) in the patients with age 65 years old(P = 0.673). The mOS rate was signi?cantly longer in QHP group(28.5 months) than that in decitabine group(18 months) in the patients with age of < 65 years old(P = 0.04). The proportions of bone marrow blast cells with 10% or < 10% had no signi?cant effects on the mOS rate of patients in the 2 groups(P = 0.429, P = 0.183). In patients with HGB 80 g/L, mOS rate was signi?cantly longer in the QHP group(57 months) than that in the decitabine group(21 months)(P = 0.047), while in patients with HGB < 80 g/L, there was no signi?cant difference of mOS rate between the 2 groups(P = 0.265). In the patients with PLT < 50×10~9/L, the mOS rate was signi?cantly longer in the QHP group(33 months) than that in the decitabine group(16 months)(P = 0.028). In the patients wi 展开更多
关键词 MYELODYSPLASTIC syndrome Qinghuang Powder REALGAR ARSENIC DECITABINE Survival period
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Relation of Blood Arsenic Concentration with Effect and Safety of Arsenic-Containing Qinghuang Powder (青黄散)in Patients with Myelodysplastic Syndrome
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作者 DENG Zhong-yang ZHU Shi-rong +10 位作者 WANG Ming-jing FANG Su ZHAO Pan ZHU Qian-zhe WANG Hong-zhi GUO Xiao-qing XU Yong-gang YI Bo-wen SHANG Xiao-hong MA Rou HU Xiao-mei 《中国结合医学杂志:英文版》 SCIE CAS CSCD 2019年第7期497-501,共5页
Objective: To investigate the relation of blood arsenic concentration (BAC) with clinical effect and safety of arsenic-containing Qinghuang Powder (青黄散,QHP) in patients with myelodysplastic syndrome (MDS). Methods:... Objective: To investigate the relation of blood arsenic concentration (BAC) with clinical effect and safety of arsenic-containing Qinghuang Powder (青黄散,QHP) in patients with myelodysplastic syndrome (MDS). Methods: Totally 163 patients with MDS were orally treated with QHP for 2 courses of treatment, 3 months as 1 course. The BACs of patients were detected by atomic fluoresce nee spectrophotometry at 1, 3, and 6 months during the treatment, and the effective rate, hematological improvement and safety in patients after treatment with QHP were analyzed. Results: After 2 courses of treatment, the total effective rate was 89.6%(146/163), with 31.3%(51/163) of hematological improvement and 58.3%(95/163) of stable disease. The hemoglobin increased from 73.48 ± 19.30 g/L to 80.39 ± 26.56 g/L (P<0.05), the absolute neutrophil count increased from 0.81 ±0.48 × 10^9/L to 1.08 ±0.62 × 1O^9/L (P<0.05), and no significant changes were observed in platelet counts (P>0.05). Among 46 patients previously depended on blood transfusion, 28.3%(13/46) completely got rid of blood transfusion and 21.7%(10/46) reduced the volume of blood transfusion by more than 50% after treatment. The BACs were significantly increased in patients treated for 1 month with 32.17 ± 18.04 jig/L (P<0.05), 3 months with 33.56 ±15.28 μg/L (P<0.05), and 6 months with 36.78 ±11.92 μg/L (P<0.05), respectively, as compared with those before treatment (4.08 ±2.11 ag/L). There were no significant differences of BACs among the patients treated for 1, 3 and 6 months (P>0.05). The adverse reactions of digestive tract during the treatment were mild abdominal pain and diarrhea in 14 cases (8.6%), and no patients discontinued the treatment. The BACs of patients with gastrointestinal adverse reactions were significantly lower than those without gastrointestinal adverse reactions (22.39 ±10.38 vs. 37.89 ± 11.84,μg/L, P<0.05). The BACs of patients with clinical effect were significantly higher than those failed to treatment (40.41 ± 11.69 vs. 23.84 ± 展开更多
关键词 MYELODYSPLASTIC syndrome REALGAR ARSENIC Qinghuang Powder Chinese medicine
Effect of Qinghuang Powder(青黄散) Combined with Bupi Yishen Decoction(补脾益肾方) in Treating Patients with Refractory Cytopenia with Multilineage Dysplasia through Regulating DNA Methylation
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作者 ZHOU Qing-bing YANG Xiao-hong +5 位作者 WANG Hong-zhi WANG De-xiu XU Yong-gang HU Xiao-mei XU Feng-qin MA Rou 《中国结合医学杂志:英文版》 SCIE CAS CSCD 2019年第5期354-359,共6页
Objective: To explore the effect of Qinghuang Powder(QHP, 青黄散) combined with Bupi Yishen Decoction(BPYS, 补脾益肾方)on myelodysplastic syndromes(MDS) patients with refractory cytopenia with multilineage dysplasia(R... Objective: To explore the effect of Qinghuang Powder(QHP, 青黄散) combined with Bupi Yishen Decoction(BPYS, 补脾益肾方)on myelodysplastic syndromes(MDS) patients with refractory cytopenia with multilineage dysplasia(RCMD) and determine the change of DNA methylation in MDS-RCMD patients after the treatment of Chinese medicine formula. Methods: All 308 MDS-RCMD patients were treated with QHP combined with BPYS for 2 months at least, absolute neutrophil count(ANC), hemoglobin(Hb), platelets(PLT), primitive bone marrow cells and chromosome karyotype were chosen as the main evaluation indexes to analyze the treatment effect according to criteria from the MDS International Working Group. Then 43 bone marrow samples from 15 MDS-RCMD patients and 28 healthy donors were obtained for the examination of DNA methylation.Gene Ontology(GO) and Pathway analysis were applied to analyze the methylation data. Results: The overall MDS response rate to QHP was 61.68%(190/360) including hematologic improvement-neutrophil(HI-N) or hematologic improvement-erythroid(HI-E) or hematologic improvement-platelet(HI-P). Patients with anemia had a better response rate than patients with neutropenia or thrombocypenia(55.88% vs 31.54% or 55.88%vs. 36.9%). The DNA methylation microarray analysis disclosed that 4,257 hypermethylated genes were demethylated upon the treatment with QHP and BPYS. GO analysis and Pathway analysis showed that these demethylated genes were involved in a lot of tumor-related pathways and functions. Conclusions: QHP combined with BPYS could effectively treat MDS-RCMD patients through hematologic improvement(HI-N, HI-P or HI-E)and PLT and RBC transfusion independence due to the demethylation, thereby providing another choice for the treatment of patients with MDS-RCMD. 展开更多
关键词 Qinghuang Powder Bupi Yishen Decoction MYELODYSPLASTIC SYNDROMES DEMETHYLATION Chinese medicine
Clinical Practice Guideline of Sui Du Lao (Myelodysplastic Syndrome) 预览
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作者 Hu Xiaomei 《世界中西医结合杂志(英文)》 2019年第4期10-15,共6页
This paper developed a guideline for clinical practice of Sui Du Lao (myelodysplastic syndrome).It covers the traditional Chinese medicine (TCM) disease names,syndrome differentiation,prognostic scores,treatment accor... This paper developed a guideline for clinical practice of Sui Du Lao (myelodysplastic syndrome).It covers the traditional Chinese medicine (TCM) disease names,syndrome differentiation,prognostic scores,treatment according to the syndrome differentiation,and efficacy evaluation,and the relationships between dose,efficacy,mechanism,and toxicity of Realgar and emergency plans in patients treated orally with TCM preparation containing Realgar . 展开更多
关键词 SUI Du Lao MYELODYSPLASTIC syndrome STANDARDS GUIDELINE REALGAR TRADITIONAL Chinese medicine
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低剂量地西他滨联合rhG-CSF治疗骨髓增生异常综合征临床观察
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作者 舒华娥 方腾 《社区医学杂志》 2019年第14期838-840,共3页
目的 骨髓增生异常综合征(myelodysplastic syndrome,MDS)是一类以骨髓增生活跃伴有病态造血和外周血细胞减少的疾病,地西他滨为该疾病的治疗方法之一。本研究观察低剂量地西他滨联合粒细胞集落刺激因子(granulocyte colony stimulating... 目的 骨髓增生异常综合征(myelodysplastic syndrome,MDS)是一类以骨髓增生活跃伴有病态造血和外周血细胞减少的疾病,地西他滨为该疾病的治疗方法之一。本研究观察低剂量地西他滨联合粒细胞集落刺激因子(granulocyte colony stimulating factor,rhG-CSF)治疗MDS的临床疗效与安全性。方法 选择开州区人民医院2015-10-07-2017-08-23收治的18例MDS患者作为研究对象,地西他滨皮下注射5~7mg/(m2·d)×5d,28d为1个周期;第1~10天,粒细胞集落刺激因子150~300μg/d,皮下注射,1次/d,地西他滨前24h开始至白细胞计数>20×109 L-1暂停使用。接受地西他滨治疗3个周期后评价治疗反应,中位起效周期数为5,中位治疗≥6周期(范围为3~21周期)。结果 在18例患者中,9例(50%)完全缓解;2例(11%)部分缓解并脱离成分血输注;3例(17%)血液学改善;2例转化为急性髓细胞白血病;2例(11%)患者属于极高危,原始细胞均在>10%合并复杂染色体异常,并发严重感染在3个月内死亡。总有效率为78%。血液学不良反应:白细胞和血小板减少;Ⅰ~Ⅱ级占61.1%,Ⅲ级占16.7%,Ⅳ级占11.1%,Ⅲ~Ⅳ级感染率为22.2%;无Ⅲ~Ⅳ级出血、恶心呕吐和肝功能损伤。结论 低剂量地西他滨联合粒细胞集落刺激因子预激方案治疗MDS疗效较好,毒副作用小。 展开更多
关键词 地西他滨 低剂量 粒细胞集落刺激因子 骨髓增生异常综合征
Minimal residual disease-directed immunotherapy for high-risk myelodysplastic syndrome after allogeneic hematopoietic stem cell transplantation
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作者 Xiaodong Mo Xiaohui Zhang +9 位作者 Lanping Xu Yu Wang Chenhua Yan Huan Chen Yuhong Chen Wei Han Fengrong Wang Jingzhi Wang Kaiyan Liu Xiaojun Huang 《医学前沿:英文版》 CAS CSCD 2019年第3期354-364,共11页
The efficacy of minimal residual disease (MRD)-directed immunotherapy,including interferon-α (IFN-α) treatment and chemotherapy plus granulocyte colony-stimulating factor-primed donor leukocyte infusion (chemo-DLI),... The efficacy of minimal residual disease (MRD)-directed immunotherapy,including interferon-α (IFN-α) treatment and chemotherapy plus granulocyte colony-stimulating factor-primed donor leukocyte infusion (chemo-DLI),was investigated in patients with high-risk myelodysplastic syndrome (MDS) who were MRD-positive after allogeneic hematopoietic stem cell transplantation (allo-HSCT).High-risk MDS patients who received non-T-cell-depleted allo-HSCT at the Peking University Institute of Hematology and were MRD-positive after ailo-HSCT were studied (n =47).The MRD-positive status was considered if leukemia-associated aberrant immune phenotypes or Wilms' tumor gene 1 expression is present in a single bone marrow sample.The cumulative incidence of the relapse and non-relapse mortality 2 years after immunotherapy were 14.5% and 21.4% (P=0.377)and 9.1% and 0.0% (P=0.985) for patients in the IFN-α and chemo-DLI groups,respectively.The probability of disease-free and overall survival 2 years after immunotherapy were 76.4% and 78.6% (P =0.891) and 84.3% and 84.6% (P=0.972) for patients in the IFN-α and chemo-DLI groups,respectively.Persistent MRD after immunotherapy was associated with poor survival.Thus,the MRD-directed immunotherapy was effective for patients with high-risk MDS who were MRD-positive after alIo-HSCT,and the efficacy was comparable between chemo-DLI and IFN-α treatment. 展开更多
关键词 donor LEUKOCYTE infusion HEMATOPOIETIC stem cell transplantation INTERFERON-Α minimal residual disease MYELODYSPLASTIC syndrome
Characteristics of Clostridium difficile infection in patients hospitalized with myelodysplastic syndrome or acute myelogenous leukemia 预览
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作者 Kamini Shah Bryan F Curtin +3 位作者 Christopher Chu Daniel Hwang Mark H Flasar Erik von Rosenvinge 《世界临床肿瘤学杂志》 2017年第5期398-404,共7页
AIM To evaluate factors associated with Clostridium difficile infection(CDI)and outcomes of CDI in the myelodysplastic syndrome(MDS)and acute myeloid leukemia(AML)population.METHODS After IRB approval,all MDS/AML pati... AIM To evaluate factors associated with Clostridium difficile infection(CDI)and outcomes of CDI in the myelodysplastic syndrome(MDS)and acute myeloid leukemia(AML)population.METHODS After IRB approval,all MDS/AML patients hospitalized at the University of Maryland Greenebaum Comprehensive Cancer Center between August 2011 and December 2013 were identified.Medical charts were reviewed for demographics,clinical information,development of CDI,complications of CDI,and mortality.Patients with CDI,defined as having a positive stool PCR done for clinical suspicion of CDI,were compared to those without CDI in order to identify predictors of disease.A t-test was used for comparison of continuous variables and chisquare or Fisher’s exact tests were used for categorical variables,as appropriate.RESULTS Two hundred and twenty-three patients(60.1%male,mean age 61.3 years,13%MDS,87%AML)had 594 unique hospitalizations during the study period.Thirtyfour patients(15.2%)were diagnosed with CDI.Factors significantly associated with CDI included lower albumin at time of hospitalization(P<0.0001),prior diagnosis of CDI(P<0.0001),receipt of cytarabine-based chemotherapy(P=0.015),total days of neutropenia(P=0.014),and total days of hospitalization(P=0.005).Gender(P=0.10),age(P=0.77),proton-pump inhibitor use(P=0.73),receipt of antibiotics(P=0.66),and receipt of DNA hypomethylating agent-based chemotherapy(P=0.92)were not significantly associated with CDI.CONCLUSION CDI is common in the MDS/AML population.Factors significantly associated with CDI in this population include low albumin,prior CDI,use of cytarabine-based chemotherapy,and prolonged neutropenia.In this study,we have identified a subset of patients in which prophylaxis studies could be targeted. 展开更多
关键词 CLOSTRIDIUM DIFFICILE Acute myeloid leukemia Cytarabine-based chemotherapy MYELODYSPLASTIC syndrome NEUTROPENIA
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沙利度胺+环孢素+EPO3联用药治疗骨髓增生异常综合征临床研究 被引量:1
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作者 李艳玲 《湖南师范大学学报:医学版》 2016年第2期93-95,共3页
目的 :研究沙利度胺+环孢素+epo 3联用药治疗骨髓增生异常综合征临床效果。方法:收治60例mdS患者,将60例患者分成三组,a组给予沙利度胺,B组给予沙利度胺+环孢素,C组给予沙利度胺+环孢素+epo三种药物。结果 :三组患者病情改善效果、治... 目的 :研究沙利度胺+环孢素+epo 3联用药治疗骨髓增生异常综合征临床效果。方法:收治60例mdS患者,将60例患者分成三组,a组给予沙利度胺,B组给予沙利度胺+环孢素,C组给予沙利度胺+环孢素+epo三种药物。结果 :三组患者病情改善效果、治疗后预后有差异,并发症比较无差异。结论 :沙利度胺+环孢素+epo 3联用药治疗mdS可减轻病症,提高患者临床疗效和生存质量,延长生存期限,增加治愈疾病的可能性,可在临床推广。 展开更多
关键词 沙利度胺 环孢素 EPO 骨髓增生异常
Insights into myelodysplastic syndromes from current preclinical models 预览
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作者 Shuh Ying Tan Monique F Smeets +4 位作者 Alistair M Chalk Harshal Nandurkar Carl R Walkley Louise E Purton Meaghan Wall 《世界血液学杂志》 2016年第1期1-22,共22页
In recent years,there has been significant progress made in our understanding of the molecular genetics of myelodysplastic syndromes(MDS).Using massively parallel sequencing techniques,recurring mutations are identifi... In recent years,there has been significant progress made in our understanding of the molecular genetics of myelodysplastic syndromes(MDS).Using massively parallel sequencing techniques,recurring mutations are identified in up to 80%of MDS cases,including many with a normal karyotype.The differential role of some of these mutations in the initiation and progression of MDS is starting to be elucidated.Engineering candidate genes in mice to model MDS has contributed to recent insights into this complex disease.In this review,we examine currently available mouse models,with detailed discussion of selected models.Finally,we highlight some advances made in our understanding of MDS biology,and conclude with discussions of questions that remain unanswered. 展开更多
关键词 MYELODYSPLASTIC SYNDROMES MOUSE models GENETIC MUTATIONS
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Advances and perspectives on cellular therapy in acquired bone marrow failure diseases 预览
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作者 Xiao-Shen Sun Xin Liu +3 位作者 Kai-Lin Xu Allshine Chen Witold B Rybka Jeffrey J Pu 《世界血液学杂志》 2016年第1期31-36,共6页
Acquired bone marrow failure diseases(ABMFD)are a class of hematopoietic stem cell diseases with a commonality of non-inherited disruption of hematopoiesis that results in pancytopenia.ABMFDs also are a group of heter... Acquired bone marrow failure diseases(ABMFD)are a class of hematopoietic stem cell diseases with a commonality of non-inherited disruption of hematopoiesis that results in pancytopenia.ABMFDs also are a group of heterogeneous diseases with different etiologies and treatment options.The three most common ABMFDs are aplastic anemia,myelodysplastic syndrome,and paroxysmal nocturnal hemoglobinuria.Stem cell transplantation is the only treatment that can cure these diseases.However,due to high therapy-related mortality,stem cell transplantation has rarely been used as a first line treatment in treating ABMFD.With the advance of personalized medicine and precision medicine,various novel cellular therapy strategies are in trial to increase the efficiency and efficacy of ABMFD treatment.This article aims to review current available stem cell transplantation protocols and promising cellular therapy research in treating ABMFD. 展开更多
关键词 Bone marrow failure DISEASES APLASTIC anemia Cellular therapy Stem cell transplantation PAROXYSMAL NOCTURNAL HEMOGLOBINURIA MYELODYSPLASTIC syndrome
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沙利度胺联合环孢素A及泼尼松治疗骨髓增生异常骨髓增殖性肿瘤临床研究 被引量:1
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作者 李莉娟 张连生 +8 位作者 柴晔 曾鹏云 吴重阳 岳玲玲 胡婉丽 陈红鹰 白俊 郝正栋 李亮亮 《中国实用内科杂志》 CAS CSCD 北大核心 2014年第10期1015-1016,共2页
骨髓增生异常/骨髓增殖性肿瘤(MDS/MPN)属于克隆性髓性肿瘤,临床表现为同时具有MDS和MPN的特点,即病态造血、血细胞升高、肝脾肿大等重叠表现。尽管对该类疾病的认识取得了长足进展,但治疗还限于对症和延用MDS有效的药物如免疫抑制剂... 骨髓增生异常/骨髓增殖性肿瘤(MDS/MPN)属于克隆性髓性肿瘤,临床表现为同时具有MDS和MPN的特点,即病态造血、血细胞升高、肝脾肿大等重叠表现。尽管对该类疾病的认识取得了长足进展,但治疗还限于对症和延用MDS有效的药物如免疫抑制剂环孢素A(CsA)、去甲基化药物等,疗效不甚理想,单药有效率在20%左右。沙利度胺及雷那度胺等作为抗血管新生和免疫调节剂,在原发性骨髓纤维化(PMF)中取得了较好疗效(40%~50%),CSA在低危MDS也取得了30%~50%的临床反应率。 展开更多
关键词 骨髓增生异常 骨髓增殖性肿瘤 沙利度胺 环孢素A 治疗效果 免疫学反应
Emerging immunological concepts in the pathogenesis of myelodysplastic syndromes 预览
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作者 Claudio Fozza 《世界血液学杂志》 2013年第2期13-15,共3页
The involvement of T-lymphocytes in the pathogenesis of myelodysplastic syndromes(MDS)is now well documented by relevant clinical and experimental findings.This brief review will focus on the T-cell repertoire pattern... The involvement of T-lymphocytes in the pathogenesis of myelodysplastic syndromes(MDS)is now well documented by relevant clinical and experimental findings.This brief review will focus on the T-cell repertoire pattern typical of MDS patients as well as on the potential role exerted by specific T-cell subsets in this context.Future investigations should further explore the specific role played by different T-cell subsets in the bone marrow milieu typical of MDS,further clarifying which of the described changes represent either an epiphenomenon or rather a real causative factor in the pathogenesis of these disorders. 展开更多
关键词 MYELODYSPLASTIC SYNDROMES T-CELLS T-CELL receptor REPERTOIRE Regulatory T cells Immunotherapy
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从正虚瘀结论治骨髓增生异常/骨髓增殖性疾病初探 预览 被引量:2
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作者 黄中迪 邱仲川 +4 位作者 陈佩 应平平 赵琳 胡晓莹 朱小勤 《山东中医杂志》 2009年第7期447-449,共3页
根据骨髓增生异常/骨髓增殖性疾病(MD/MPD)的特性以及临床表现的双重性,认为其病机为邪毒与营血相抟,结成瘢瘕,终成正虚瘀结之虚实夹杂证,表现既有因虚劳而致的脾肾精气之不足,又有血实瘀结之盛候,治疗总以补虚化瘀为主旨。
关键词 骨髓增生异常(MD) 骨髓增殖性疾病(MPD) 正虚瘀结
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环孢素A对骨髓增生异常综合征的干预评价 预览
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作者 吴斌 姚红霞 林丽娥 《海南医学》 CAS 2004年第6期 42,77,共2页
目的了解环孢素A(CsA)联合治疗骨髓增生异常综合征难治性贫血(MDS-RA)的疗效.方法:所有患者按CsA 3mg~5mg.kg-1.d-1口服3~6个月,联合罗钙全,维生素B6或加用达那唑、维甲酸.结果所有病例的总有效率为71.4%,CR28.6%(2/7),PR42.8%(3/7),... 目的了解环孢素A(CsA)联合治疗骨髓增生异常综合征难治性贫血(MDS-RA)的疗效.方法:所有患者按CsA 3mg~5mg.kg-1.d-1口服3~6个月,联合罗钙全,维生素B6或加用达那唑、维甲酸.结果所有病例的总有效率为71.4%,CR28.6%(2/7),PR42.8%(3/7),进步1例,无效1例.结论CsA联合治疗MDS-RA是较有效的方法之一. 展开更多
关键词 环孢素A CSA 骨髓增生异常综合征 MDS-RA 免疫抑制剂
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骨髓增生异常综合征患者骨髓血管新生初步研究 预览 被引量:3
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作者 丁伟荣 林茂芳 +2 位作者 叶锦 王丽君 丁伟 《实用肿瘤杂志》 CAS 北大核心 2003年第4期 265-267,共3页
目的探讨骨髓增生异常综合征(MDS)患者骨髓是否存在血管新生,及其与患者临床特征的关系.方法采用免疫组化法(兔抗人凝血因子Ⅷ相关抗原多克隆抗体)标记了38例MDS、15例急性非淋巴细胞白血病(ANLL)和15例正常人骨髓组织内血管内皮细胞.... 目的探讨骨髓增生异常综合征(MDS)患者骨髓是否存在血管新生,及其与患者临床特征的关系.方法采用免疫组化法(兔抗人凝血因子Ⅷ相关抗原多克隆抗体)标记了38例MDS、15例急性非淋巴细胞白血病(ANLL)和15例正常人骨髓组织内血管内皮细胞.在光学显微镜下计数骨髓切片全片中微血管数,计算平均值,表达为微血管数/×400视野,并与患者临床特征进行相关性分析.结果 MDS组骨髓微血管数(17±2支/×400视野)高于正常人对照组(7±2支/×400视野)(P<0.001),但低于ANLL组(24±4支/×400视野)(P<0.001),其中MDS低危组与高危组骨髓微血管密度差异无显著性(P>0.05).MDS患者骨髓微血管数与骨髓原始细胞百分数、外周血白细胞、血红蛋白及血小板等差异无显著性(P>0.05).结论 MDS患者骨髓存在明显的血管新生,为临床应用抗血管新生方法治疗MDS提供了实验依据. 展开更多
关键词 骨髓增生异常综合征 骨髓 微血管密度 免疫组织化学 新生血管化
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外周血指标与骨髓形态联合检验对骨髓增生异常的临床价值 预览 被引量:2
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作者 张军艳 《中国医药指南》 2015年第10期211-211,共1页
目的研究外周血指标联合骨髓形态检验应用于骨髓增生异常(MDS)的诊断价值。方法回顾分析我院近年确诊MDS患者28例,所有患者均行外周血指标联合骨髓形态学检查诊断方法分析。结果外周血指标同时减少3项11例,同时减少2项9例,只减少1项8... 目的研究外周血指标联合骨髓形态检验应用于骨髓增生异常(MDS)的诊断价值。方法回顾分析我院近年确诊MDS患者28例,所有患者均行外周血指标联合骨髓形态学检查诊断方法分析。结果外周血指标同时减少3项11例,同时减少2项9例,只减少1项8例;骨髓形态学中,骨髓增生极度活跃12例,明显活跃6例,活跃6例,减低4例。结论 MDS的外周血指标及骨髓形态学变化非常复杂,因此MDS的临床诊断中,必须将两种检查方法紧密结合起来,才能最大程度保证诊断的准确率。 展开更多
关键词 外周血指标 骨髓形态联合检验 骨髓增生异常
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305例髓系肿瘤的基因突变图谱比较分析
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作者 苟阳 唐永杰 +1 位作者 杨程 彭贤贵 《第三军医大学学报》 CAS CSCD 北大核心 2019年第21期2069-2073,共5页
目的比较分析急性髓系白血病(acute myeloid leukemia,AML)、骨髓增生异常综合征(myelodysplastic syndromes,MDS)、骨髓增殖性肿瘤(myeloproliferative neoplasms,MPN)、骨髓增生异常综合征/骨髓增殖性肿瘤(myelodysplastic/myeloproli... 目的比较分析急性髓系白血病(acute myeloid leukemia,AML)、骨髓增生异常综合征(myelodysplastic syndromes,MDS)、骨髓增殖性肿瘤(myeloproliferative neoplasms,MPN)、骨髓增生异常综合征/骨髓增殖性肿瘤(myelodysplastic/myeloproliferative neoplasms,MDS/MPN)患者的基因突变图谱。方法对本院2017年1月至2019年1月就诊的305例髓系肿瘤患者(186例AML,64例MDS,27例MPN,28例MDS/MPN)的骨髓细胞进行髓系肿瘤常见突变基因二代测序检测,绘制基因突变图谱,分析比较各髓系肿瘤基因和基因通路突变比例的差异,及各突变基因突变率的差异。结果 305例髓系肿瘤患者共检测到30个基因的606个突变,15.4%未检测到基因突变,58.0%检测到2个及以上基因突变,1人最多有7个基因突变,TET2、DNMT3A、NRAS、CEBPA、JAK2、C-KIT、U2AF1、NPM1等基因的突变比例在多个髓系肿瘤中均较高。信号通路相关基因在AML、MPN和MDS/MPN中的突变比例均>50%,在MDS中<10%;转录因子相关基因在AML中的突变比例>50%,在MPN中<5%;表观遗传学相关基因在4个髓系肿瘤中突变比例均>50%;RNA剪接相关基因在MDS和MDS/MPN中突变比例均>30%,在AML中的突变比例<5%。NRAS、C-KIT等信号通路相关基因突变更倾向于低突变率,TET2、DNMT3A等表观遗传学相关基因突变更倾向于高突变率。结论 4个髓系肿瘤的基因突变图谱具有差异性:信号通路相关基因在MDS中突变比例低,转录因子相关基因在MPN中突变比例低,RNA剪接相关基因在MDS相关疾病中突变比例高,表观遗传学相关基因在4个髓系肿瘤中突变比例均高。 展开更多
关键词 急性髓系白血病 骨髓增生异常综合征 骨髓增殖性肿瘤 骨髓增生异常综合征/骨髓增殖性肿瘤 基因突变 二代测序 信号通路
地西他滨联合中药治疗不同中医症状与体征评分MDS患者疗效分析
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作者 王萍 严峰 +3 位作者 王柏山 王思微 彭程 郭立欣 《辽宁中医药大学学报》 CAS 2019年第5期165-168,共4页
目的:探讨地西他滨(DAC)联合中药治疗不同中医症状与体征评分的骨髓增生异常综合征(MDS)患者的疗效分析。方法:诊断MDS患者中筛选30例患者,进行中医症状与体征评分分级,其标准为1级(0~9分)、2级(10~18分)和3级(19~27分),均采用中西医结... 目的:探讨地西他滨(DAC)联合中药治疗不同中医症状与体征评分的骨髓增生异常综合征(MDS)患者的疗效分析。方法:诊断MDS患者中筛选30例患者,进行中医症状与体征评分分级,其标准为1级(0~9分)、2级(10~18分)和3级(19~27分),均采用中西医结合治疗。西医方面,患者均采用地西他滨治疗,5 d为1个治疗周期,地西他滨用法为20 mg/(m^2·d),纳入患者均治疗6个周期以上。中医方面,根据评分和辨证分型的不同,采用不同的治疗方法,治疗1个月以上。结果:中西医结合治疗后,1级患者10例,有效例数3例;2级患者10例,有效例数5例;3级患者10例,有效例数6例。结论:通过中医症状与体征评分对MDS患者进行分级后治疗,发现地西他滨(DAC)联合中药治疗对1级患者的疗效较差,2级和3级患者疗效略好,其原因可能与MDS的病理本质和地西他滨的作用靶点直接相关。 展开更多
关键词 地西他滨 骨髓增生异常综合征 中医症状与体征评分 辨证分型 去甲基化
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