Objective:To study the prevalence of anemia,the proportion of hemoglobin(Hb)levels,the treatment methods,and the influencing factors of Hb levels in maintenance hemodialysis(MHD)and peritoneal dialysis patients.Method...Objective:To study the prevalence of anemia,the proportion of hemoglobin(Hb)levels,the treatment methods,and the influencing factors of Hb levels in maintenance hemodialysis(MHD)and peritoneal dialysis patients.Methods:In this study,602 patients with maintenance hemodialysis and continuous ambulatory peritoneal dialysis were enrolled from December 2020 to December 2022 in our hospital,and their medical records were collected and summarized.The main contents included the patient’s gender,age,primary disease,dialysis duration,dialysis method,the use of erythropoietic stimulating agents(ESA),intravenous iron,and laboratory tests.A Hb index exceeding 110 g/L was set as the standard for the prevalence of anemia.Results:The rate of anemia in patients undergoing blood purification was 83%.The proportion of ESA use was 84.1%,and the proportion of iron use was 76.7%,of which the proportion of intravenous iron used was 17.0%,and the proportion of folic acid used was 28.3%.Conclusion:The incidence of anemia in MHD patients was relatively high,with a low proportion of patients reaching the standard Hb levels.Risk factors include albumin(ALB)levels,iron storage,white blood cells,C-reactive protein,cholesterol,etc.Nutritional support,iron supplementation,and prevention of micro-inflammatory reactions can effectively promote the improvement of Hb indicators in dialysis patients to prevent anemia.展开更多
To our knowledge,patients with immunoglobulin G4-related sclerosing cholangitis(IgG4-SC)associated with autoimmune hemolytic anemia(AIHA)have not been reported previously.Many patients with IgG4-SC have autoimmune pan...To our knowledge,patients with immunoglobulin G4-related sclerosing cholangitis(IgG4-SC)associated with autoimmune hemolytic anemia(AIHA)have not been reported previously.Many patients with IgG4-SC have autoimmune pancreatitis(AIP)and respond to steroid treatment.However,isolated cases of IgG4-SC are difficult to diagnose.We describe our experience with a patient who had IgG4-SC without AIP in whom the presence of AIHA led to diagnosis.The patient was a73-year-old man who was being treated for dementia.Liver dysfunction was diagnosed on blood tests at another hospital.Imaging studies suggested the presence of carcinoma of the hepatic hilus and primary sclerosing cholangitis,but a rapidly progressing anemia developed simultaneously.After the diagnosis of AIHA,steroid treatment was begun,and the biliary stricture improved.IgG4-SC without AIP was thus diagnosed.展开更多
APLASTIC anemia(AA) is a bone marrow failure disease caused by abnormal activation of T lymphocytes,resulting in the apoptosis of hematopoietic cells and bone marrow failure.1 Currently,hematopoietic stem cell transpl...APLASTIC anemia(AA) is a bone marrow failure disease caused by abnormal activation of T lymphocytes,resulting in the apoptosis of hematopoietic cells and bone marrow failure.1 Currently,hematopoietic stem cell transplantation(HSCT),immunosuppressive therapy(IST),and supportive care(e.g.transfusion adjuvant therapy,hematopoietic展开更多
目的:探讨补血生髓方对肿瘤相关性贫血(cancer related anemia, CRA)小鼠的改善作用及可能的作用机制。方法:C57BL/6雌性小鼠腹腔注射苯肼(50mg/kg),并且皮下接种肺癌LLC细胞建立CRA模型,随机分成模型组、EPO组(1365IU/kg)、补血生髓方...目的:探讨补血生髓方对肿瘤相关性贫血(cancer related anemia, CRA)小鼠的改善作用及可能的作用机制。方法:C57BL/6雌性小鼠腹腔注射苯肼(50mg/kg),并且皮下接种肺癌LLC细胞建立CRA模型,随机分成模型组、EPO组(1365IU/kg)、补血生髓方组(60.67g/kg),每组10只,另取10只正常小鼠作为空白组,给药2周。ELISA检测促红细胞生成素、血清干扰素-γ(interferon-γ,IFN-γ)水平,流式细胞术检测外周血Tregs细胞比例,Real time-PCR及免疫荧光检测缺氧诱导因子-1α(hypoxia inducible factor-1α,HIF-1α)、程序性死亡-配体1(programmed cell death ligand 1,PD-L1)mRNA及蛋白的表达。结果:与模型组相比,补血生髓方组小鼠的肿瘤体积、肿瘤质量均显著降低(P<0.01)。与空白组相比,模型组血红蛋白、促红细胞生成素、IFN-γ水平显著下调(P<0.01),外周血Tregs细胞比例显著升高(P<0.05)。与模型组相比,补血生髓方组血红蛋白、促红细胞生成素、IFN-γ水平显著上调(P<0.01),外周血Tregs细胞比例显著下降(P<0.01),HIF-1α、PD-L1mRNA和蛋白表达显著降低(P<0.01)。结论:补血生髓方能够改善CRA小鼠的贫血状态,通过下调HIF-1α/PD-L1通路调节CRA小鼠的免疫功能,从而抑制肿瘤的生长。展开更多
Background: Although systemic hypertension is rarely seen in steady state sickle cell disease (SCD), relative hypertension has been reported to be associated with an increased risk of cardiovascular and renal complica...Background: Although systemic hypertension is rarely seen in steady state sickle cell disease (SCD), relative hypertension has been reported to be associated with an increased risk of cardiovascular and renal complications. Objective: To determine the prevalence of BP patterns and assess factors associated with relative hypertension insickle cell anemia (SCA) adult patients. Methods: Clinical data and office BP were obtained from 103 consecutive steady-state SCA adult patients (mean age 26 ± 7.9 years, 66% females, 22.3% on hydroxyurea) attending four healthcare centers providing SCD-specific care in Kinshasa. Seated BP was measured using an automated electronic device. Three consecutive blood pressure measurements were taken with 2 minutes interval between readings and the average of the 2 last readings was considered for the analyses. Normal BP, relative hypertension and systemic hypertension were defined as BP 120/70 mmHg, 120 - 139/70 - 89 mmHg and ≥140/90 mmHg, respectively. Results: Normal BP, relative hypertension and systemic hypertension were observed in 56 (54%), 43(42%) and 4 (4%) of SCA patients, respectively. In multivariate analysis, factors associated with relative hypertension were leg ulcer (aOR 2.05;95%CI 1.77 - 5.18;p = 0.016), central obesity (aOR 3.32;95%CI 1.28 - 6.24;p = 0.001), smoking (aOR 5.02;95%CI 1.51 - 9.50;p = 0.017), and microalbumiuria (aOR 3.44;95%CI 1.44 - 5.76;p = 0.035). Conclusion: Relative hypertension was a common finding in the present case series and associated with traditional cardiovascular risk factor as well as factors specific to SCD highlighting the need for measures to prevent its progression towards systemic hypertension and associated cardiovascular and renal disease.展开更多
目的对肿瘤相关性贫血(cancer related anemia,CRA)患者进行输血治疗后,分析通过血浆D-二聚体水平的检测对患者进行评估的临床应用价值。方法将太仓市中医医院于2020年6月—2022年6月收治的48例恶性肿瘤伴C R A患者作为研究对象,所有患...目的对肿瘤相关性贫血(cancer related anemia,CRA)患者进行输血治疗后,分析通过血浆D-二聚体水平的检测对患者进行评估的临床应用价值。方法将太仓市中医医院于2020年6月—2022年6月收治的48例恶性肿瘤伴C R A患者作为研究对象,所有患者均进行输血治疗。检测输血前、后患者血浆D-二聚体水平,比较不同输血前血浆D-二聚体水平、不同输血治疗效果、不同单次输血量及不同输血次数患者输血后的血浆D-二聚体水平。结果输血治疗后血浆D-二聚体水平均高于输血前,差异均有统计学意义(P<0.05)。单次输血量<2 U的患者输血前后血浆D-二聚体水平比较差异无统计学意义(P>0.05),输血量≥2 U的患者输血后血浆D-二聚体水平明显升高,差异有统计学意义(P<0.05)。不同输血次数输血3 U患者输血后血浆D-二聚体水平均明显升高,差异均有统计学意义(P<0.05)。结论恶性肿瘤伴CRA患者进行输血治疗后,血浆D-二聚体水平会出现变化,将其作为评估治疗贫血效果的指标是有临床意义的,也能够为肿瘤患者制定合理的输血方案提供依据和参考。展开更多
文摘Objective:To study the prevalence of anemia,the proportion of hemoglobin(Hb)levels,the treatment methods,and the influencing factors of Hb levels in maintenance hemodialysis(MHD)and peritoneal dialysis patients.Methods:In this study,602 patients with maintenance hemodialysis and continuous ambulatory peritoneal dialysis were enrolled from December 2020 to December 2022 in our hospital,and their medical records were collected and summarized.The main contents included the patient’s gender,age,primary disease,dialysis duration,dialysis method,the use of erythropoietic stimulating agents(ESA),intravenous iron,and laboratory tests.A Hb index exceeding 110 g/L was set as the standard for the prevalence of anemia.Results:The rate of anemia in patients undergoing blood purification was 83%.The proportion of ESA use was 84.1%,and the proportion of iron use was 76.7%,of which the proportion of intravenous iron used was 17.0%,and the proportion of folic acid used was 28.3%.Conclusion:The incidence of anemia in MHD patients was relatively high,with a low proportion of patients reaching the standard Hb levels.Risk factors include albumin(ALB)levels,iron storage,white blood cells,C-reactive protein,cholesterol,etc.Nutritional support,iron supplementation,and prevention of micro-inflammatory reactions can effectively promote the improvement of Hb indicators in dialysis patients to prevent anemia.
文摘To our knowledge,patients with immunoglobulin G4-related sclerosing cholangitis(IgG4-SC)associated with autoimmune hemolytic anemia(AIHA)have not been reported previously.Many patients with IgG4-SC have autoimmune pancreatitis(AIP)and respond to steroid treatment.However,isolated cases of IgG4-SC are difficult to diagnose.We describe our experience with a patient who had IgG4-SC without AIP in whom the presence of AIHA led to diagnosis.The patient was a73-year-old man who was being treated for dementia.Liver dysfunction was diagnosed on blood tests at another hospital.Imaging studies suggested the presence of carcinoma of the hepatic hilus and primary sclerosing cholangitis,but a rapidly progressing anemia developed simultaneously.After the diagnosis of AIHA,steroid treatment was begun,and the biliary stricture improved.IgG4-SC without AIP was thus diagnosed.
基金Supported by Key Provincial Talents Program of Jiangsu(H201126)the Natural Science Fund for Colleges and Universities of Jiangsu Province (09KJB320015)+1 种基金Key Projects in the National Science & Technology Pillar Program (2008BAI61B02 and 2008ZX09312-026)the Priority Academic Program Development of Jiangsu Higher Education Institutions (PAPD)
文摘APLASTIC anemia(AA) is a bone marrow failure disease caused by abnormal activation of T lymphocytes,resulting in the apoptosis of hematopoietic cells and bone marrow failure.1 Currently,hematopoietic stem cell transplantation(HSCT),immunosuppressive therapy(IST),and supportive care(e.g.transfusion adjuvant therapy,hematopoietic
文摘Background: Although systemic hypertension is rarely seen in steady state sickle cell disease (SCD), relative hypertension has been reported to be associated with an increased risk of cardiovascular and renal complications. Objective: To determine the prevalence of BP patterns and assess factors associated with relative hypertension insickle cell anemia (SCA) adult patients. Methods: Clinical data and office BP were obtained from 103 consecutive steady-state SCA adult patients (mean age 26 ± 7.9 years, 66% females, 22.3% on hydroxyurea) attending four healthcare centers providing SCD-specific care in Kinshasa. Seated BP was measured using an automated electronic device. Three consecutive blood pressure measurements were taken with 2 minutes interval between readings and the average of the 2 last readings was considered for the analyses. Normal BP, relative hypertension and systemic hypertension were defined as BP 120/70 mmHg, 120 - 139/70 - 89 mmHg and ≥140/90 mmHg, respectively. Results: Normal BP, relative hypertension and systemic hypertension were observed in 56 (54%), 43(42%) and 4 (4%) of SCA patients, respectively. In multivariate analysis, factors associated with relative hypertension were leg ulcer (aOR 2.05;95%CI 1.77 - 5.18;p = 0.016), central obesity (aOR 3.32;95%CI 1.28 - 6.24;p = 0.001), smoking (aOR 5.02;95%CI 1.51 - 9.50;p = 0.017), and microalbumiuria (aOR 3.44;95%CI 1.44 - 5.76;p = 0.035). Conclusion: Relative hypertension was a common finding in the present case series and associated with traditional cardiovascular risk factor as well as factors specific to SCD highlighting the need for measures to prevent its progression towards systemic hypertension and associated cardiovascular and renal disease.
文摘目的对肿瘤相关性贫血(cancer related anemia,CRA)患者进行输血治疗后,分析通过血浆D-二聚体水平的检测对患者进行评估的临床应用价值。方法将太仓市中医医院于2020年6月—2022年6月收治的48例恶性肿瘤伴C R A患者作为研究对象,所有患者均进行输血治疗。检测输血前、后患者血浆D-二聚体水平,比较不同输血前血浆D-二聚体水平、不同输血治疗效果、不同单次输血量及不同输血次数患者输血后的血浆D-二聚体水平。结果输血治疗后血浆D-二聚体水平均高于输血前,差异均有统计学意义(P<0.05)。单次输血量<2 U的患者输血前后血浆D-二聚体水平比较差异无统计学意义(P>0.05),输血量≥2 U的患者输血后血浆D-二聚体水平明显升高,差异有统计学意义(P<0.05)。不同输血次数输血3 U患者输血后血浆D-二聚体水平均明显升高,差异均有统计学意义(P<0.05)。结论恶性肿瘤伴CRA患者进行输血治疗后,血浆D-二聚体水平会出现变化,将其作为评估治疗贫血效果的指标是有临床意义的,也能够为肿瘤患者制定合理的输血方案提供依据和参考。
