Investigation of anaplasmosis in Yiyuan County,Shandong Province,China

Objective:To investigate the situation of anaplasmosis in Yiyuan county.Shandong Province. Methods:A total of 26 blood samples from febrile patients suspected of anaplasmosis,48 blood samples from healthy farmers,8 from dogs,and 10 from goats and 170 ticks were collected in the same area during 2005-2007,and detected by serological and molecular methods.Results: Eight confirmed cases and 6 probable cases were determined using serologic and molecular methods.The seroprevalence of Anaplasma phagocytophilum(A.phagocytophilum) was 26.7% in healthy cases.Nine out of 10 sheep samples and 7 out of 8 dog samples reacted positively to the A.phagocytophilum antigen.PCR amplification and sequencing of the 16SrRNA of,4. phagocytophilum gene showed that some samples from patients,goats and ticks were 100% identical.The seroprevalence of Rickettsia typhi was 22.9%,Orientia tsutsugamushi 6.3%, Rickettsia sibirica 27.1%,Coxiella burnetii 18.8%,Bartonella henselae 31.3%,and Borrelia burgdorferi 41.6%.Conclusions:It is important to make differential diagnosis of febrile patients and to apply treatment with specific antibiotics.It is needed to enforce essential prevention and control measures including tick control and to improve sanitation conditions.

一项有关来那度胺联合低剂量地塞米松治疗中国复发/难治性多发性骨髓瘤患者的多中心、开放性Ⅱ期临床试验:MM-021试验(全译文)

目的：在中国,复发/难治性多发性骨髓瘤（RRMM）的治疗方案不能满足患者的需求。来那度胺联合低剂量地塞米松可有效治疗白种人RRMM患者,并且通常具备良好的耐受性,但是过去的研究并未评估该疗法对中国RRMM患者的疗效。方法：MM-021是一项多中心、单治疗组、开放性Ⅱ期临床试验,旨在评估来那度胺联合低剂量地塞米松治疗中国RRMM患者的疗效、安全性和药物代谢动力学特征。既往接受过≥1种抗骨髓瘤疗法治疗的患者服用来那度胺＋低剂量地塞米松,直至疾病进展或停止用药。存活患者需在入选后接受≥1年的随访。来那度胺剂量为25mg/d,并根据基线肾功能进行调整。大多数受试者均为晚期病患（85.6%为Durie-SalmonⅢ期）,并且既往接受过大量治疗（56.7%既往接受过≥4种抗骨髓瘤治疗;69.5%既往接受过沙利度胺治疗;63.1%既往接受过硼替佐米治疗）;5.3%患者为免疫球蛋白D型（IgD）。结果：安全性研究群体共有199例入选患者。在疗效研究群体187例患者中,疾病控制率（至少疾病稳定）为94.7%,总缓解率（至少部分缓解）为47.6%,患有肾功能损害及IgD型的患者亦取得高缓解率。至15.2个月中位随访期后,中位缓解持续时间为8.8（0.4-18.8）个月,中位无进展生存期为8.3个月（95%CI6.5-9.8）。最常见3-4级不良事件（AE）为贫血（26.1%）、中性粒细胞减少（25.1%）、血小板减少（14.6%）、肺炎（13.1%）、白细胞减少（9.5%）和中性粒细胞计数减少（8.5%）。AE导致40.2%的患者减少来那度胺剂量和（或）暂停使用,并导致约9.0%的患者停止用药。来那度胺药物代谢动力学特征与白种人和日本患者报道的结果相似。结论：既往接受过多次治疗的中国RRMM患者（包括肾功能损害和IgD亚型患者）对来那度胺联合低剂量地塞米松治疗方案具有可接受的安全性和高缓解率。这些研究发现显示了此治疗方案对于目前治疗方案均无效的中国RRMM患者具有临床应用潜力。