Objective: To explore the possibility of using traditional Chinese medicine (TCM) in treating β thalassemia, its clinical effect and molecular mechanism of the action.Methods: According to the TCM theory of“Shen pro...Objective: To explore the possibility of using traditional Chinese medicine (TCM) in treating β thalassemia, its clinical effect and molecular mechanism of the action.Methods: According to the TCM theory of“Shen producing marrow”, the composite recipe, Yisui Shenxueling Granule (YSSXL), consisting of Chinese drugs for nourishing Shen and supplementing marrow (NS&SM) was given orally to 7 8 patients with β thalassemia (49 of the severe type and 29 of moderate type ), 3 times a day, 10 g each time (for children, the dose would be reduced proper ly), with 3 months as one therapeutic course, and no blood transfusion used in t he course. The clinical therapeutic efficacy and hematologic parameters in patie nts were observed, and systemic gene analysis was conducted with PAGE, PCR, PCR SSCP, RT PCR and DNA sequences analysis and mRNA detection, in order to s tudy the molecular mechanism from the relationships between genetic mutation and clinical efficacy, gene expression and its regulation. Results: YSSXL showed obvious therapeutic effect in treating β thalassemia. Gene analysis revealed that it did not change the genetic mutatio n type, but could obviously increase hemoglobin, fetal hemoglobin (HbF), γ/(β+ γ) globin ratio, γ globin mRNA expression and GM CSF mRNA expression in patients, as well as the GM CSFmRMA in marrow of mice after 60 Co radia tion. Conclusion: YSSXL has a remarkable therapeutic effect on β tha lassemia, and its possible mechanism is its action in unlocking γ gene, in creasing the γ globin expression and enhancing HbF synthesis so as to compe nsate for the gene defect. This study has opened a new path for the treatment of β thalassemia with TCM.展开更多
In this Editorial,we highlight the possible role that metabolism dysfunction-associated steatotic liver disease(MASLD)may play in the future,regarding liver disease in patients with transfusion-dependent β-thalassemi...In this Editorial,we highlight the possible role that metabolism dysfunction-associated steatotic liver disease(MASLD)may play in the future,regarding liver disease in patients with transfusion-dependent β-thalassemia(TDBT).MASLD is characterized by excessive accumulation of fat in the liver(hepatic steatosis),in the presence of cardiometabolic factors.There is a strong correlation between the occurrence of MASLD and insulin resistance,while its increased prevalence parallels the global epidemic of diabetes mellitus(DM)and obesity.Patients with TDBT need regular transfusions for life to ensure their survival.Through these transfusions,a large amount of iron is accumulated,which causes saturation of transferrin and leads to the circulation of free iron molecules,which cause damage to vital organs(primarily the liver and myocardium).Over the past,the main mechanisms for the development of liver disease in these patients have been the toxic effect of iron on the liver and chronic hepatitis C,for which modern and effective treatments have been found,resulting in successful treatment.Additional advances in the treatment and monitoring of these patients have led to a reduction in deaths,and an increase in their life expectancy.This increased survival makes them vulnerable to the onset of diseases,which until recently were mainly related to the non-thalassemic general population,such as obesity and DM.There is insufficient data in the literature regarding the prevalence of MASLD in this population or on the risk factors for its occurrence.However,it was recently shown by a study of 45 heavily transfused patients with beta-thalassemia(Padeniya et al,BJH),that the presence of steatosis is a factor influencing the value of liver elastography and thus liver fibrosis.These findings suggest that future research in the field of liver disease in patients with TDBT should be focused on the occurrence,the risk factors,and the effect of MASLD on these patients.展开更多
Introduction: Sickle cell disease and thalassemia are the most frequent hemoglobinopathies. During their evolution, they present certain complications, among which are two neurosurgical emergencies, namely spontaneous...Introduction: Sickle cell disease and thalassemia are the most frequent hemoglobinopathies. During their evolution, they present certain complications, among which are two neurosurgical emergencies, namely spontaneous cranial epidural hematoma and non traumatic radiculo-medullary compression, with some particularities for each. Method: In order to highlight these particularities, we compared the characteristics of these two complications, from a number of publications reported between 2000 and 2021. Results: Sickle cell disease was complicated by spontaneous cranial epidural hematoma. Forty-two cases were reported, the mean age was 14.7 years (2 - 21 years) and the sex ratio was 6.4. The clinical presentation combined, in a non-traumatic context, signs of intracranial hypertension with those of neurological focalization. Neuroimaging showed epidural-type collection, often frontal and parietal in location. The incriminating mechanisms were ischemia, hemorrhage and extra medullary hematopoiesis. The treatment was surgical. Non traumatic radiculo-medullary was the complication of thalassemia. Of the 77 cases reported, the mean age was 27.5 years (9 - 66 years) and the sex ratio was 4.1. The lesions were epidural with a clear thoracic predominance and resulted from extra marrow hematopoiesis. Treatment included: hypertransfusion, radiotherapy, hydroxyurea and surgery. Vital and functional prognosis were globally satisfactory when the management was rapid. Conclusion: Cranial and spinal epidural lesions, respective complications of sickle cell disease and thalassemia, result from similar mechanisms. Their prognosis depends on the rapidity of management. .展开更多
Thalassemia syndrome is a genetic blood disorder induced by the reduction of normal hemoglobin production,resulting in a drop in the size of red blood cells.In severe forms,it can lead to death.This genetic disorder h...Thalassemia syndrome is a genetic blood disorder induced by the reduction of normal hemoglobin production,resulting in a drop in the size of red blood cells.In severe forms,it can lead to death.This genetic disorder has posed a major burden on public health wherein patients with severe thalassemia need periodic therapy of iron chelation and blood transfusion for survival.Therefore,controlling thalassemia is extremely important and is made by promoting screening to the general population,particularly among thalassemia carriers.Today Twitter is one of the most influential social media platforms for sharing opinions and discussing different topics like people’s health conditions and major public health affairs.Exploring individuals’sentiments in these tweets helps the research centers to formulate strategies to promote thalassemia screening to the public.An effective Lexiconbased approach has been introduced in this study by highlighting a classifier called valence aware dictionary for sentiment reasoning(VADER).In this study applied twitter intelligence tool(TWINT),Natural Language Toolkit(NLTK),and VADER constitute the three main tools.VADER represents a gold-standard sentiment lexicon,which is basically tailored to attitudes that are communicated by using social media.The contribution of this study is to introduce an effective Lexicon-based approach by highlighting a classifier calledVADERto analyze the sentiment of the general population,particularly among thalassemia carriers on the social media platform Twitter.In this study,the results showed that the proposed approach achieved 0.829,0.816,and 0.818 regarding precision,recall,together with F-score,respectively.The tweets were crawled using the search keywords,“thalassemia screening,”thalassemia test,“and thalassemia diagnosis”.Finally,results showed that India and Pakistan ranked the highest in mentions in tweets by the public’s conversations on thalassemia screening with 181 and 164 tweets,respectively.展开更多
Introduction: Thalassemia disorder is a genetic disease that causes the blood to have less hemoglobin than normal, the main requirement to control thalassemia’s propagation is to educate the entire society. Methodolo...Introduction: Thalassemia disorder is a genetic disease that causes the blood to have less hemoglobin than normal, the main requirement to control thalassemia’s propagation is to educate the entire society. Methodology: A descriptive survey was taken to evaluate the awareness of thalassemia among Saudi Arabia’s society, with a sample size of 384. Results: The results were written in frequencies, and it shows that most of the participants were unaware and lacking information on thalassemia syndrome. Discussion: The results of this study provide valuable insights into the awareness of thalassemia in Saudi Arabia and highlight the need to raise awareness of this disease. Conclusion: This study is not comprehensive because the survey was not disrupted evenly, but it can give us an overview of the awareness of thalassemia in Saudi Arabia, and it shows that most of the participants were unaware and lacked information on thalassemia.展开更多
BACKGROUND Iron deficiency anemia(IDA)and thalassemia trait(TT)are the most common microcytic and hypochromic anemias.Differentiation between mild TT and early IDA is still a clinical challenge.AIM To develop and vali...BACKGROUND Iron deficiency anemia(IDA)and thalassemia trait(TT)are the most common microcytic and hypochromic anemias.Differentiation between mild TT and early IDA is still a clinical challenge.AIM To develop and validate a new index for discriminating between IDA and TT.METHODS Blood count data from 126 patients,consisting of 43 TT patients and 83 IDA pa-tients,was retrospectively analyzed to develop a new index formula.This formula was further validated in another 61 patients,consisting of 48 TT patients and 13 IDA patients.RESULTS The new index is the ratio of hemoglobin to mean corpuscular volume.Its sen-sitivity,specificity,accuracy,Youden’s Index,area under the receiver operating characteristic curve,and Kappa coefficient in discriminating between IDA and TT were 93.5%,78.4%,83.3%,0.72,0.97,and 0.65,respectively.CONCLUSION This new index has good diagnostic performance in discriminating between mild TT and early IDA.It requires only two results of complete blood count,which can be a very desirable feature in under-resourced scenarios.展开更多
目的:回顾性分析2例合并双重罕见型地中海贫血基因型病例的检测及诊断过程,探究罕见地中海贫血的漏诊误诊原因提高罕见地中海贫血诊断水平。方法:结合受检者家族史、血液学表型及血红蛋白电泳分析结果,采用PCR+导流杂交法检测受检者α和...目的:回顾性分析2例合并双重罕见型地中海贫血基因型病例的检测及诊断过程,探究罕见地中海贫血的漏诊误诊原因提高罕见地中海贫血诊断水平。方法:结合受检者家族史、血液学表型及血红蛋白电泳分析结果,采用PCR+导流杂交法检测受检者α和β-地中海贫血常见基因型,DNA测序技术对受检者标本进行罕见α和β蛋白基因测序。结果:两例受检者均为合并双重罕见地中海贫血基因型,该两例罕见地中海贫血基因组合均为首次报道,一例为αα^(*53_55 del TCC)/αα杂合合并β^(IVSⅡ-2(-T))/β^(N)杂合的αβ复合地中海贫血,另一例为αα^(IVS-Ⅱ-55(T→G)inα1)/αα^(4.2-Q)双重杂合的α-地中海贫血,其中αα^(*53_55 del TCC)/αα基因型亦为首次报道。结论:本次报道的中国人群中罕见地中海贫血基因类型αα^(*53_55 del TCC)/αα及两例罕见地中海贫血基因组合案例,丰富了中国人群地中海贫血基因突变谱,为地中海贫血诊断和优生优育咨询提供更丰富的分子信息。展开更多
基金This item was supported by National Funds of Natural Sciences (No. 3017119 9) and Natural Science Foundation of Guangxi Autonomous Region (No. 014402C)
文摘Objective: To explore the possibility of using traditional Chinese medicine (TCM) in treating β thalassemia, its clinical effect and molecular mechanism of the action.Methods: According to the TCM theory of“Shen producing marrow”, the composite recipe, Yisui Shenxueling Granule (YSSXL), consisting of Chinese drugs for nourishing Shen and supplementing marrow (NS&SM) was given orally to 7 8 patients with β thalassemia (49 of the severe type and 29 of moderate type ), 3 times a day, 10 g each time (for children, the dose would be reduced proper ly), with 3 months as one therapeutic course, and no blood transfusion used in t he course. The clinical therapeutic efficacy and hematologic parameters in patie nts were observed, and systemic gene analysis was conducted with PAGE, PCR, PCR SSCP, RT PCR and DNA sequences analysis and mRNA detection, in order to s tudy the molecular mechanism from the relationships between genetic mutation and clinical efficacy, gene expression and its regulation. Results: YSSXL showed obvious therapeutic effect in treating β thalassemia. Gene analysis revealed that it did not change the genetic mutatio n type, but could obviously increase hemoglobin, fetal hemoglobin (HbF), γ/(β+ γ) globin ratio, γ globin mRNA expression and GM CSF mRNA expression in patients, as well as the GM CSFmRMA in marrow of mice after 60 Co radia tion. Conclusion: YSSXL has a remarkable therapeutic effect on β tha lassemia, and its possible mechanism is its action in unlocking γ gene, in creasing the γ globin expression and enhancing HbF synthesis so as to compe nsate for the gene defect. This study has opened a new path for the treatment of β thalassemia with TCM.
文摘In this Editorial,we highlight the possible role that metabolism dysfunction-associated steatotic liver disease(MASLD)may play in the future,regarding liver disease in patients with transfusion-dependent β-thalassemia(TDBT).MASLD is characterized by excessive accumulation of fat in the liver(hepatic steatosis),in the presence of cardiometabolic factors.There is a strong correlation between the occurrence of MASLD and insulin resistance,while its increased prevalence parallels the global epidemic of diabetes mellitus(DM)and obesity.Patients with TDBT need regular transfusions for life to ensure their survival.Through these transfusions,a large amount of iron is accumulated,which causes saturation of transferrin and leads to the circulation of free iron molecules,which cause damage to vital organs(primarily the liver and myocardium).Over the past,the main mechanisms for the development of liver disease in these patients have been the toxic effect of iron on the liver and chronic hepatitis C,for which modern and effective treatments have been found,resulting in successful treatment.Additional advances in the treatment and monitoring of these patients have led to a reduction in deaths,and an increase in their life expectancy.This increased survival makes them vulnerable to the onset of diseases,which until recently were mainly related to the non-thalassemic general population,such as obesity and DM.There is insufficient data in the literature regarding the prevalence of MASLD in this population or on the risk factors for its occurrence.However,it was recently shown by a study of 45 heavily transfused patients with beta-thalassemia(Padeniya et al,BJH),that the presence of steatosis is a factor influencing the value of liver elastography and thus liver fibrosis.These findings suggest that future research in the field of liver disease in patients with TDBT should be focused on the occurrence,the risk factors,and the effect of MASLD on these patients.
文摘Introduction: Sickle cell disease and thalassemia are the most frequent hemoglobinopathies. During their evolution, they present certain complications, among which are two neurosurgical emergencies, namely spontaneous cranial epidural hematoma and non traumatic radiculo-medullary compression, with some particularities for each. Method: In order to highlight these particularities, we compared the characteristics of these two complications, from a number of publications reported between 2000 and 2021. Results: Sickle cell disease was complicated by spontaneous cranial epidural hematoma. Forty-two cases were reported, the mean age was 14.7 years (2 - 21 years) and the sex ratio was 6.4. The clinical presentation combined, in a non-traumatic context, signs of intracranial hypertension with those of neurological focalization. Neuroimaging showed epidural-type collection, often frontal and parietal in location. The incriminating mechanisms were ischemia, hemorrhage and extra medullary hematopoiesis. The treatment was surgical. Non traumatic radiculo-medullary was the complication of thalassemia. Of the 77 cases reported, the mean age was 27.5 years (9 - 66 years) and the sex ratio was 4.1. The lesions were epidural with a clear thoracic predominance and resulted from extra marrow hematopoiesis. Treatment included: hypertransfusion, radiotherapy, hydroxyurea and surgery. Vital and functional prognosis were globally satisfactory when the management was rapid. Conclusion: Cranial and spinal epidural lesions, respective complications of sickle cell disease and thalassemia, result from similar mechanisms. Their prognosis depends on the rapidity of management. .
基金The authors are thankful to the Deanship of Scientific Research at Najran University for funding this work under the Research Collaboration Funding program grant coder NU/RC/SERC/11/5.
文摘Thalassemia syndrome is a genetic blood disorder induced by the reduction of normal hemoglobin production,resulting in a drop in the size of red blood cells.In severe forms,it can lead to death.This genetic disorder has posed a major burden on public health wherein patients with severe thalassemia need periodic therapy of iron chelation and blood transfusion for survival.Therefore,controlling thalassemia is extremely important and is made by promoting screening to the general population,particularly among thalassemia carriers.Today Twitter is one of the most influential social media platforms for sharing opinions and discussing different topics like people’s health conditions and major public health affairs.Exploring individuals’sentiments in these tweets helps the research centers to formulate strategies to promote thalassemia screening to the public.An effective Lexiconbased approach has been introduced in this study by highlighting a classifier called valence aware dictionary for sentiment reasoning(VADER).In this study applied twitter intelligence tool(TWINT),Natural Language Toolkit(NLTK),and VADER constitute the three main tools.VADER represents a gold-standard sentiment lexicon,which is basically tailored to attitudes that are communicated by using social media.The contribution of this study is to introduce an effective Lexicon-based approach by highlighting a classifier calledVADERto analyze the sentiment of the general population,particularly among thalassemia carriers on the social media platform Twitter.In this study,the results showed that the proposed approach achieved 0.829,0.816,and 0.818 regarding precision,recall,together with F-score,respectively.The tweets were crawled using the search keywords,“thalassemia screening,”thalassemia test,“and thalassemia diagnosis”.Finally,results showed that India and Pakistan ranked the highest in mentions in tweets by the public’s conversations on thalassemia screening with 181 and 164 tweets,respectively.
文摘Introduction: Thalassemia disorder is a genetic disease that causes the blood to have less hemoglobin than normal, the main requirement to control thalassemia’s propagation is to educate the entire society. Methodology: A descriptive survey was taken to evaluate the awareness of thalassemia among Saudi Arabia’s society, with a sample size of 384. Results: The results were written in frequencies, and it shows that most of the participants were unaware and lacking information on thalassemia syndrome. Discussion: The results of this study provide valuable insights into the awareness of thalassemia in Saudi Arabia and highlight the need to raise awareness of this disease. Conclusion: This study is not comprehensive because the survey was not disrupted evenly, but it can give us an overview of the awareness of thalassemia in Saudi Arabia, and it shows that most of the participants were unaware and lacked information on thalassemia.
基金The study was reviewed and approved by the Shanghai Tenth People’s Hospital Institutional Review Board(Approval No.23K190).
文摘BACKGROUND Iron deficiency anemia(IDA)and thalassemia trait(TT)are the most common microcytic and hypochromic anemias.Differentiation between mild TT and early IDA is still a clinical challenge.AIM To develop and validate a new index for discriminating between IDA and TT.METHODS Blood count data from 126 patients,consisting of 43 TT patients and 83 IDA pa-tients,was retrospectively analyzed to develop a new index formula.This formula was further validated in another 61 patients,consisting of 48 TT patients and 13 IDA patients.RESULTS The new index is the ratio of hemoglobin to mean corpuscular volume.Its sen-sitivity,specificity,accuracy,Youden’s Index,area under the receiver operating characteristic curve,and Kappa coefficient in discriminating between IDA and TT were 93.5%,78.4%,83.3%,0.72,0.97,and 0.65,respectively.CONCLUSION This new index has good diagnostic performance in discriminating between mild TT and early IDA.It requires only two results of complete blood count,which can be a very desirable feature in under-resourced scenarios.
文摘目的:回顾性分析2例合并双重罕见型地中海贫血基因型病例的检测及诊断过程,探究罕见地中海贫血的漏诊误诊原因提高罕见地中海贫血诊断水平。方法:结合受检者家族史、血液学表型及血红蛋白电泳分析结果,采用PCR+导流杂交法检测受检者α和β-地中海贫血常见基因型,DNA测序技术对受检者标本进行罕见α和β蛋白基因测序。结果:两例受检者均为合并双重罕见地中海贫血基因型,该两例罕见地中海贫血基因组合均为首次报道,一例为αα^(*53_55 del TCC)/αα杂合合并β^(IVSⅡ-2(-T))/β^(N)杂合的αβ复合地中海贫血,另一例为αα^(IVS-Ⅱ-55(T→G)inα1)/αα^(4.2-Q)双重杂合的α-地中海贫血,其中αα^(*53_55 del TCC)/αα基因型亦为首次报道。结论:本次报道的中国人群中罕见地中海贫血基因类型αα^(*53_55 del TCC)/αα及两例罕见地中海贫血基因组合案例,丰富了中国人群地中海贫血基因突变谱,为地中海贫血诊断和优生优育咨询提供更丰富的分子信息。
