Cancer related anemia (CRA) is a common side effect in patients with tumors, the incidence of which is related to tumor type, treatment regimen, the duration of chemotherapy, etc. The pathogenesis of CRA has not been fully defined. CRA may lead to chemotherapy dose reduction or may even delay chemotherapy. Patients with CRA require red blood cell transfusion, thus increasing the treatment cost, reducing the efficiency of chemotherapy and the patient's quality of life, and shortening the survival time. The main treatments of CRA include red blood cell transfusion, iron supplements, erythropoietin, and so on. Based on recent literature and clinical studies, the expert committee of the China Anti-Cancer Association drew up the consensus on the diagnosis and treatment of anemia related to tumor in China (2023 edition). The 2023 consensus incorporates the latest evidence-based medicine evidence and Traditional Chinese Medicine related content and aims to provide more reliable diagnosis and treatment plans for Chinese oncologists to help improve CRA and the quality of life in patients with cancer.
Humans ; Consensus ; Quality of Life ; Anemia/prevention & control* ; Neoplasms/therapy* ; China/epidemiology*

Introduction: As the younger female generation, female adolescents should understand anaemia prevention. This study examined the effects of animated educational videos on the knowledge of anaemia prevention among female adolescents using the Health Belief Model (HBM). Methods: A quasi-experimental method with a randomised pre-test and post-test control group design was applied. Animated educational videos about anaemia prevention were used as the intervention. One hundred sixty-one female adolescents were recruited through multistage random sampling and divided into intervention (n=78) and control (n=83) groups. The intervention group received education via animated educational videos. The HBM questionnaire was used to measure the nine HBM indicators (r=0.8); the item categories were valid and reliable. Descriptive analyses, independent t-tests and repeated-measures ANOVA were used to analyse the data. Results: The animated educational videos played thrice significantly increased the knowledge of the intervention group (mean score: pre-test, 94; post-test one, 99; post-test two, 102). The scores for anaemia examination barriers (P=0.001), anaemia susceptibility (P=0.001), anaemia severity (P=0.001), anaemia prevention benefits (P=0.001), anaemia examination benefits (P=0.001), self-efficacy for obtaining iron tablets (P=0.001), self-recognition of anaemia signs and symptoms (P=0.001), signs of anaemia prevention (P=0.001) and health motivation (P=0.001) significantly changed. Meanwhile, the knowledge of the control group did not significantly increase (pre-test, 93; post-test one, 94; post-test two, 97). The intervention group had significantly higher mean scores in both the first and second measurements than the control group (P=0.05). Conclusion Animated educational videos significantly increased the knowledge of anaemia prevention, including the nine HBM indicators.
Video-Audio Media [Publication Type] ; Anemia ; Prevention and control ; Health Belief Model

Objective: To Evaluate the efficacy and safety of posaconazole as primary prevention of invasive fungal disease (IFD) in patients with severe aplastic anemia (SAA) treated with anti-thymus/lymphocyte immunoglobulin (ATG/ALG) combined with cyclosporine intensive immunosuppressive therapy (IST). Methods: A retrospective analysis of clinical data of 58 SAA patients who received IST of anti-thymocyte immunoglobulin combining cyclosporine and antifungal prophylaxis during April 2013 to May 2017 in Peking Union Medical College Hospital was performed. The patients were divided into posaconazole prophylaxis group and the control group (itraconazole or fluconazole). The disease characteristics, IFD prevention effect and adverse drug reaction, curative effect and prognosis of the two groups were compared. Results: Posaconazole was used to prevent fungal infection in 20 patients. The other 38 patients were used as the control group. Retrospective analysis showed comparable characteristics (gender, age, disease severity, etiology, interval between the onset of disease to treatment, ATG/ALG type) of both groups. The incidence of IFD were 0 and 15.8% in posaconazole prophylaxis group and the control group, respectively (P=0.084). In the control group, there were 6 cases diagnosed as IFD. Of them, 2 were confirmed, 2 suspected and 2 not identified. Five of the 6 cases were pulmonary infection, 1 bloodstream infections. Of the 6 IFD cases, 5 were very severe aplastic anemia (VSAA). There was no obvious adverse reaction in posaconazole prophylaxis group. Conclusion: Posaconazole is safe and effective for primary prevention of fungal infection of SAA patients receiving IST, especially for the VSAA.
Anemia, Aplastic ; Cyclosporine ; Humans ; Immunosuppressive Agents ; Mycoses/prevention & control* ; Primary Prevention ; Retrospective Studies ; Treatment Outcome ; Triazoles/therapeutic use*

Adult ; Anemia, Iron-Deficiency ; epidemiology ; prevention & control ; China ; epidemiology ; Cost-Benefit Analysis ; Female ; Food, Fortified ; Health Education ; methods ; Health Knowledge, Attitudes, Practice ; Health Promotion ; methods ; Humans ; Middle Aged ; Outcome Assessment (Health Care) ; Pilot Projects ; Soy Foods ; Young Adult

INTRODUCTIONEnteric fever is a multisystemic infection which largely affects children. This study aimed to analyse the epidemiology, clinical presentation, treatment and outcome of paediatric enteric fever in Singapore.

MATERIALS AND METHODSA retrospective review of children diagnosed with enteric fever in a tertiary paediatric hospital in Singapore was conducted from January 2006 to January 2012. Patients with positive blood cultures for Salmonella typhi or paratyphi were identified from the microbiology laboratory information system. Data was extracted from their case records.

RESULTSOf 50 enteric fever cases, 86% were due to Salmonella typhi, with 16.3% being multidrug resistant (MDR) strains. Sixty-two percent of S. typhi isolates were of decreased ciprofloxacin susceptibility (DCS). Five cases were both MDR and DCS. The remaining 14% were Salmonella paratyphi A. There were only 3 indigenous cases. Ninety-four percent had travelled to typhoid-endemic countries, 70.2% to the Indian subcontinent and the rest to Indonesia and Malaysia. All patients infected with MDR strains had travelled to the Indian subcontinent. Anaemia was a significant finding in children with typhoid, as compared to paratyphoid fever (P = 0.04). Although all children were previously well, 14% suffered severe complications including shock, pericardial effusion and enterocolitis. None had typhoid vaccination prior to their travel to developing countries.

CONCLUSIONEnteric fever is largely an imported disease in Singapore and has contributed to significant morbidity in children. The use of typhoid vaccine, as well as education on food and water hygiene to children travelling to developing countries, needs to be emphasised.

Adolescent ; Anemia ; epidemiology ; Anti-Bacterial Agents ; therapeutic use ; Child ; Child, Preschool ; Drinking Water ; Drug Resistance, Multiple, Bacterial ; physiology ; Enterocolitis ; epidemiology ; Female ; Food Contamination ; Health Education ; Hospitals, Pediatric ; Humans ; India ; Indonesia ; Infant ; Malaysia ; Male ; Paratyphoid Fever ; drug therapy ; epidemiology ; microbiology ; Pericardial Effusion ; epidemiology ; Retrospective Studies ; Salmonella paratyphi A ; physiology ; Salmonella typhi ; physiology ; Shock ; epidemiology ; Singapore ; epidemiology ; Tertiary Care Centers ; Travel ; Typhoid Fever ; drug therapy ; epidemiology ; microbiology ; prevention & control ; Typhoid-Paratyphoid Vaccines ; therapeutic use

OBJECTIVETo assess the effect of sodium iron ethylenediaminetetraacetate (NaFeEDTA)-fortified soy sauce on anemia prevalence in the Chinese population.

METHODSA systematic review was performed to identify potential studies by searching the electronic databases of PubMed, Cochrane Library, WHO Library, HighWire, CNKI, and other sources. The selection criteria included randomized controlled trials that compared the efficacy of NaFeEDTA-fortified soy sauce with that of non-fortified soy sauce. Anemia rates and hemoglobin levels were the outcomes of interest. Inclusion decisions, quality assessment, and data extraction were performed by two reviewers independently. A total of 16 studies met the inclusion criteria for anemia rate analysis, of which 12 studies met the inclusion criteria for hemoglobin analysis. All included studies assessed the effect of NaFeEDTA-fortified soy sauce on anemia rates and hemoglobin concentrations.

RESULTSAfter the intervention, the hemoglobin concentration increased and anemia rates decreased significantly as compared with the non-fortified soy sauce groups. For anemia rates, data from 16 studies could be pooled, and the pooled estimate odds ratio was 0.25 (95% CI 0.19-0.35). For hemoglobin concentrations, data from 12 studies could be pooled, and the pooled weighted mean difference was 8.81 g/L (95% CI 5.96-11.67).

CONCLUSIONNaFeEDTA-fortified soy sauce has a positive effect on anemia control and prevention in the at-risk population.

Age Factors ; Anemia, Iron-Deficiency ; epidemiology ; prevention & control ; China ; epidemiology ; Edetic Acid ; Ferric Compounds ; Food, Fortified ; Hematocrit ; Humans ; Prevalence ; Randomized Controlled Trials as Topic ; Soy Foods

OBJECTIVETo explore the apoptosis and its mechanisms of spleen CD4⁺ CD25⁺ regulatory T (Treg) cells in severe aplastic anemia (SAA) mouse model induced by interferon (IFN-γ) in combination with busulphan (BU).

METHODSThe BALB/c female mice SAA model was induced by intraperitoneal injection with IFN-γ and intragastric administration with BU (combined group, n=16), with BU group (n=16), IFN-γ group (n=16) and normal group (n=16) as controls. Spleen Treg cells were purified by using of immunomagnetic beads. Apoptosis was detected by flow cytometry. AKt and TGF-β expression was measured by Western blot.

RESULTSApoptosis of spleen Treg cells in combined group [(33.21±0.65)%] was significantly higher than that in BU group [(21.58±0.64)%], IFN-γ group [(17.62±1.05)%], and control[(27.38±1.89)%] (P<0.05). A significantly lower expression of AKt and TGF-β protein was also seen in combined group (0.30±0.05 and 0.17±0.05), as compared to the other three groups (P<0.05).

CONCLUSIONExcessive apoptosis of Treg cells was found in SAA mouse model, which may be a cause of Treg cells decrease in patients with AA. The down-regulated expression of AKt and TGF-β could play a role in increased apoptosis of Treg cells. Our data may provide a new treatment strategy in AA.

Anemia, Aplastic ; prevention & control ; Animals ; Apoptosis ; Disease Models, Animal ; Female ; Mice ; Mice, Inbred BALB C ; Spleen ; cytology ; T-Lymphocytes, Regulatory ; cytology

Children have been identified as the most nutritionally vulnerable group when disaster happens. The most common nutritional risks include protein-energy malnutrition, iron-deficiency anemia, and trace element deficiency in children after earthquake. During the disaster relief, effective nutritional interventions should be performed according to the nutritional conditions of children in the affected area, so as to prevent the common nutritional risks. Timely diagnosis and treatment should be provided for children at a high risk of malnutrition.
Anemia, Iron-Deficiency ; epidemiology ; prevention & control ; Child ; Earthquakes ; Humans ; Malnutrition ; epidemiology ; prevention & control ; Prevalence ; Protein-Energy Malnutrition ; epidemiology ; prevention & control ; Risk Factors ; Vitamin A Deficiency ; epidemiology ; prevention & control ; Zinc ; deficiency

OBJECTIVETo evaluate the efficacy and safety of iron protein succinylate (IPS) oral solution in preventing and treating anemia of prematurity (AOP).

METHODSSixty premature infants less than 35 weeks of gestation were randomly divided into IPS (n=30) and polysaccharide iron complex (PIC) groups(n=30). Treatment began at two weeks after birth. The infants received IPS or PIC in addition to recombinant human erythropoietin. On days 14, 28, 42, and 60 after treatment, hemoglobin (Hb), red blood cell count(RBC), hematocrit (HCT), percentage of reticulocytes, serum iron, and serum ferritin were determined. Liver and renal functions were evaluated before and after treatment.

RESULTSThere were significant differences in the changing trends of RBC and HCT between the two groups (P<0.05). In the IPS group, RBC and HCT gradually decreased after birth, but began to rise gradually on days 28 and 42 of treatment; in the PIC group, RBC and HCT kept decreasing from birth to day 60 of treatment. On day 60 of treatment, the IPS group had significantly higher levels of Hb, RBC, HCT, serum iron, and serum ferritin than the PIC group (P<0.05). No notable adverse events occurred in either group.

CONCLUSIONSIPS oral solution has good efficacy and tolerability in preventing and treating AOP.

Administration, Oral ; Anemia, Neonatal ; blood ; drug therapy ; prevention & control ; Erythrocyte Count ; Female ; Hematinics ; therapeutic use ; Hematocrit ; Humans ; Infant, Premature ; Iron ; metabolism ; Male ; Metalloproteins ; adverse effects ; therapeutic use ; Solutions ; Succinates ; adverse effects ; therapeutic use

Anemia, Aplastic ; mortality ; pathology ; therapy ; Child ; Disease-Free Survival ; Graft vs Host Disease ; prevention & control ; Hematopoietic Stem Cell Transplantation ; methods ; Humans ; Immunosuppressive Agents ; therapeutic use ; Risk Factors ; Severity of Illness Index ; Tissue Donors ; Transplantation Conditioning ; methods ; Transplantation, Homologous ; Unrelated Donors