简介:Astodeterminetheeffectofpost-remissiontherapyinprolongingsurvivalanddurationofremissionaftercompleteremission,50patientswithAPLIncompleteremissionInducedbyretinolcacid(RA)weredividedintothreegroupsrandomly:(A)30cases,treatedbyalternatechemotherapywithRA;(B)10cases,withRAalone;(C)10cases,onlywithchemotherapy.ThesurvivalcurvesshowedmatGroupAhadthesurvivaltimemorethan1yearIn87.4%,morethan2yearin80.7%.26/30casesweresurvivalandstillinremission,thesurvivalcurvetendtobeaplateauat16months.InGroupBmorethan1yearin45.7%.InGroupC,morethan1yearIn50%.(Keplan-Melerx2=8.93P<0.01).ThisresultshowedthatthealternatechemotherapywithRAforpost-InductionremissiontherapycouldbeusefultoImprovelong-termsurvivorsandtoprolongthedurationofremission.
简介:目的:观察推拿和呼吸体操治疗对缓解期慢性阻塞性肺病患者肺功能、呼吸困难、运动能力和生活质量的影响.方法:缓解期慢性阻塞性肺病患者66例,随机数字表法分为2组,推拿组(n=33)和对照组(n=33),治疗3个月.治疗前后进行呼吸困难、生活质量评分和肺功能、6min步行测试.结果:推拿组,肺功能观察指标显著改善;对照组,肺功能改善不明显.两种方法对生活质量均有提高,但推拿疗法优于呼吸体操.两种方法均能增加患者6min步行距离,均能改善呼吸困难,但两者差异无显著意义.结论:两种治疗方法显示对缓解期慢性阻塞性肺病患者呼吸困难、生活质量、运动耐受能力和肺功能有着较好的治疗效果,特别是推拿治疗对缓解期慢性阻塞性肺病的肺功能和生活质量的影响优于对照方法.
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简介:全身的corticosteroids与联系IgG4的胆管炎为自体免疫的胰腺炎代表标准治疗。为类固醇依赖者疾病,azathioprine被用于宽恕的维护。Mycophenolatemofetil被用于最近为自体免疫的肝炎移植免疫力的抑制和更多;然而,没有案例报告与自体免疫的胰腺炎在成年病人在mycophenolatemofetil的使用上标明日期。有调停IgG4的自体免疫的胰腺炎和对类固醇倔强、azathioprine偏狭的联系IgG4的胆管炎的一个病人与mycophenolatemofetil被对待,它禁止denovoguanosine合成和B和T淋巴细胞生产的封锁。到用在4瞬间的治疗经期上两次每日的嘴的1000mg的mycophenolatemofetil和uptitration的介绍在病人精力水平和血葡萄糖控制与改进被联系并且没与任何不利事件被联系。没有胆汁的stent,病人被管理。然而,当泼尼松剂量每天到达了11mg时,有症状,黄疸,transaminases的增加,和hyperbilirubinemia的回来。在在有联系IgG4的自体免疫的胰腺炎和联系IgG4的胆管炎的一个成年病人的mycophenolatemofetil使用的第一份报告,mycophenolatemofetil的介绍没有不利事件安全、容忍得好,但是它没启用类固醇的中止。Mycophenolatemofetil和另外的immunomodulatory治疗应该继续与倔强或周期性的自体免疫的胰腺炎在病人的大子集为宽恕的维护学习。
简介:AbstractImportance:Graves’ disease (GD) is rare in children under the age of 7 years. Children with this disease exhibit greater thyrotoxicity at diagnosis and require a longer course of medical therapy, compared with pubertal and postpubertal children and adults.Objective:To investigate the clinical features and identify predictors of remission in children under the age of 7 years with GD.Methods:This retrospective study included 77 children who were diagnosed with GD under the age of 7 years and were treated in the Department of Endocrinology, Beijing Children’s Hospital from 2010 to 2018. Clinical manifestations, laboratory data, and follow-up records were collected for all patients. Children who achieved remission of treatment with methimazole were compared with those who had persistent disease to identify which variables were associated with remission; multiple logistic regression and Cox regression analyses were used to evaluate interactions among predictive variables.Results:Sixty-three boys and 14 girls were included; the median age at diagnosis was 4.2 years (interquartile range: 3.2-5.3 years). Forty-six (56.7%) patients had no family history of thyroid disease, 17 patients had family history of thyroid disease and 14 patients with unknown family history. Of the 77 patients, 18 (23.4%) patients achieved remission of treatment with methimazole and 59 patients did not; moreover, 51 (66.2%) had Graves’ ophthalmopathy. Univariate analyses revealed no significant differences between the remission group and non-remission group in terms of age at diagnosis, sex, initial goiter size, or initial thyroid hormone concentration. However, there were a trend of correlation between the initial level of thyroid peroxidase antibody (TPOAb) and remission status (univariate analysis OR 1.002, P = 0.038; multivariate analysis OR 1.004, P = 0.019). Similar results were observed in univariate analysis of the initial thyrotropin receptor antibody (TRAb) level, but this association was not significant in multivariate analysis. Cox regression analyses revealed that children with high TRAb level required longer duration of remission, compared with low TRAb level (OR 0.950, 95% CI 0.904-0.997, P = 0.037).Interpretation:Initial TRAb level was an independent predictor of remission outcome in young children under the age of 7 years with GD. Initial TRAb level may predict the likelihood of remission in patients with young-age-of-onset GD.
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简介:AbstractBackground:The role of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in children with high-risk (HR) T-cell acute lymphoblastic leukemia (T-ALL) in first complete remission (CR1) is still under evaluation. Moreover, relapse is the main factor affecting survival. This study aimed to explore the effect of allo-HSCT (especially haploidentical HSCT [haplo-HSCT]) on improving survival and reducing relapse for HR childhood T-ALL in CR1 and the prognostic factors of childhood T-ALL in order to identify who could benefit from HSCT.Methods:A total of 74 newly diagnosed pediatric T-ALL patients between January 1, 2012 and June 30, 2018 were enrolled in this retrospective study. Patients were stratified into the low-risk chemotherapy cohort (n = 16), HR chemotherapy cohort (n = 31), and HR transplant cohort (n = 27). Characteristics, survival outcomes, and prognostic factors of all patients were then analyzed.Results:Patient prognosis in the HR chemotherapy cohort was significantly worse than that in the low-risk chemotherapy cohort (5-year overall survival [OS]: 58.5% vs. 100%, P = 0.003; 5-year event-free survival [EFS]: 54.1% vs. 83.4%, P = 0.010; 5-year cumulative incidence of relapse [CIR]: 45.2% vs. 6.3%, P = 0.011). In HR patients, allo-HSCT improved the 5-year EFS and CIR compared to that of chemotherapy (5-year EFS: 80.1% vs. 54.1%, P = 0.041; 5-year CIR: 11.6% vs. 45.2%, P = 0.006). The 5-year OS was higher in the HR transplant cohort than that in the HR chemotherapy cohort (81.0% vs. 58.5%, P = 0.084). Minimal residual disease re-emergence was an independent risk factor for 5-year OS, EFS, and CIR; age ≥10 years was an independent risk factor for OS and EFS; and high white blood cell count was an independent risk factor for EFS and CIR.Conclusion:Allo-HSCT, especially haplo-HSCT, could effectively reduce relapse of children with HR T-ALL in CR1.