4.The expression and its clinical significance of granulocyte colony-stimulating factor receptor in acute myelocytic leukemia
Lin FU ; Zonghong SHAO ; Rong FU ; Yong LIANG ; Wen ZHAI ; Guojin WANG ; Huaquan WANG ; Limin XING ; Yuhong WU ; Hong LIU ; Jia SONG ; Jing GUAN ; Jun WANG ; Lijuan LI ; Yue REN ; Hui LIU ; Xiaoming WANG ; Erbao RUAN
Chinese Journal of Practical Internal Medicine 2001;0(06):-
Objective To investigate the expression of granulocyte colony-stimulating factor receptor(G-CSFR,CD114)in acute myelocytic leukemia(AML)bone marrow CD34+cells and evaluate G-CSF's secutiy of applying to the patients of AML after chemotherapy.Methods From March 2008 to January 2009,62 AML patients[33 deno-vo or relapsed AML patients,29 AML patients in complete remission(CR)]and 16 normal controls in the General Hospital,Tianjin Medical University were detected for the expression of G-CSFR in CD34+cells by Fluorescence-activated cell sorer(FCM)and Semi-quantitative reverse transcription-polymerase chain reaction(RT-PCR).Results The ratio of CD114+CD34+/CD34+ in the deno-vo or relapsed group,CR group and the control group were(11.69?2.91)%,(31.84?8.62)%,(32.87?8.44)% respectively(P0.05),G-CSFR mRNA expression in BMNNCs of the deno-vo or relapsed group,CR group and the control group were(30.52?6.21)%,(85.13?21.25)%,(91.57?18.64)% respectively(P0.05).13 AML patients were followed up.The ratio of CD114+CD34+/CD34+ before treatment and in CR were(12.58?2.00)% and (30.13?7.09)% respectively.The ratio before treatment was lower than that in CR(P
5.Study and management for issues about patients with lupus nephritis after pregnancy
Chinese Journal of Practical Internal Medicine 2001;0(06):-
Systemic lupus erythematosus(SLE)is an autoimmune disease that affects primarily women,commonly in their reproductive years but does not influence fertility.More recent prospective studies indicate that pregnancy is safe for the majority of mothers if it is planned when SLE is quiescent.In pregnant women with lupus nephritis,the outcome of the fetal and maternal is strongly correlated with lupus activity,kidney function and the presence of aPL at the time of conception.To prevent renal complications,prednisone is given after conception,and reinforcement for a few days before the estimated delivery and for a week after delivery or miscarriage with rapid tapering to maintenance levels may be suggested.Treatment of flares includes corticosteroids,hydroxychloroquine,azothioprine and cyclosporin A.Blood pressure is controlled with methyldopa,labetalol nifedipine or hydralazine.
6.Lupus nephritis patients complicated with infection during the therapy
Chinese Journal of Practical Internal Medicine 2001;0(06):-
Infection is a major complication in lupus nephritis patients,and also remains a major cause of morbidity and mortality in LN.The most common infected sites are respiratory tract,skin soft tissue,urinary system,et al.Immunological abnormity,use of glucocorticoid and immunosuppressive agents,renal insufficiency and hypoproteinemia are involved in the susceptibility of LN patients' infections.A wide variety of infectious pathogens are recognized in LN and bacterial infection is the most.Virus,fungi and tubercle bacillus also can be identified.The clinical manifestations of the infections are atypical,including fever,cough,headache,twitch,abnormity of spirit and action,et al and often confused with the multiplicity clinical manifestations of SLE activity.It is necessary to carry out clinical observation and pathogeny examination for diagnosis.All patients must receive effective anti-infective therapy in time,and adjust their glucocorticoid and immunosuppressive dosage.In order to avoid infection,it is necessary to strictly control the indication and dosage of glucocorticoid and immunosuppressers.
7.Thromboembolism and anticoagulant therapy in patients with lupus nephritis
Chinese Journal of Practical Internal Medicine 2001;0(06):-
Patients with systemic lupus erythematosus,especially lupus nephritis,are often accompanied by arterial and venous thrombus at various sites.Thrombosis is associated with the extrinsic and intrinsic coagulation pathway activated by inflammation and endothelium injury.Anticoagulant therapy can interrupt the cycle between inflammation and thrombus,which not only prevents and treats the thrombotic disease but also lessens the inflammatory reaction in kidney and attenuates the renal injury.
8.Immunosuppressive agents in the treatment of lupus nephritis
Chinese Journal of Practical Internal Medicine 2001;0(06):-
Renal involvement is common in systemic lupus erythematosus(SLE).Treatment of lupus nephritis includes immunosuppressive and supportive therapy.The intensity of immunosuppressive therapy depends on the clinical and renal pathological disease activity.The long-term targets of treatment are to prevent lupus nephritis relapse and protect renal function.Complete remission is the goal in the induction phase,and long-term treatment is necessary in the maintenance phase.Individualization therapy and the side effects of immunosuppressive agents should be paid more attention.
9.The rational use of corticosteroids in the treatment of lupus nephritis
Chinese Journal of Practical Internal Medicine 2001;0(06):-
Active systemic lupus erythematosus(SLE)and lupus nephritis(LN)are often treated with corticosteroids combined with various immunosuppressives.For the critical patients the methylprednisolone plus intensive therapy should be also used on the basis of above-mentioned routine treatment in order to abort the severe activity of SLE/LN rapidly.In this paper the sorts,the routine and intensive therapeutic regimens,the side-effects and the treatment targets of corticosteroids will be reviewed in detail.
10.The relationship between renal histology,its mechanism and the treatment of Lupus nephutis
Chinese Journal of Practical Internal Medicine 2001;0(06):-
This paper emphasizes the importance of the mechanism of renal tissue damage in conducting treatment of lupus nephritis in addition to the renal histology.There are at least 4 kinds of mechanisms related to the renal tissue damage of LN including circulating immune complex deposition,in situ immune complex formation,vasculitic change and thrombotic mircoangiopathy.Treatment according to the mechanisms of tissue damage will give rise to a much better result as compared with the classic treatment based on morphology alone.Multi-target immune theapy has been recommended for treatment of those severe and complicated LN.