目的了解中国血液病患者中性粒细胞缺乏（粒缺）伴发热的发生率、临床和微生物学特征及危险因素。方法前瞻性研究2014年10月20日至2015年3月20日来自全国11家血液病中心发生粒缺伴发热的连续血液病患者发热情况及危险性因素。结果1 139...目的了解中国血液病患者中性粒细胞缺乏（粒缺）伴发热的发生率、临床和微生物学特征及危险因素。方法前瞻性研究2014年10月20日至2015年3月20日来自全国11家血液病中心发生粒缺伴发热的连续血液病患者发热情况及危险性因素。结果1 139例患者共发生784例次粒缺伴发热，粒缺持续21 d时发热的累积发生率为81.9%。多因素分析显示中心静脉置管（P〈0.001，HR= 3.407，95% CI 2.276-4.496 ）、胃肠道黏膜炎（P〈0.001，HR=10.548, 95% CI 3.245-28.576）、既往90 d内暴露于广谱抗生素（P〈0.001，HR=3.582，95% CI 2.387-5.770）和粒缺持续时间〉7 d （P〈0.001，HR= 4.194，95% CI 2.572-5.618）是粒缺伴发热的危险因素。无任何危险因素、具备1项、2项、3-4项危险因素患者发热的累计发生率依次增加（35.4%、69.2%、86.1%及95.6%，P〈0.001）。784例次粒缺伴发热中，不明原因发热253例次（32.3%），临床证实的感染429例次（54.7%），微生物学证实的感染102例次（13.0%）。最常见的感染部位依次为肺（388例次，49.5%）、上呼吸道（159例次，16.0%）、肛周组织（77例次，9.8%）、血流（60例次，7.7%）。最常见的病原菌为革兰阴性菌（44.54%），其次为革兰阳性菌（37.99%）和真菌（17.47%）。发热与未发热患者相比，两组之间总体病死率差异无统计学意义（9.2%对4.8%，P=0.099）。多因素分析显示年龄〉40岁（P=0.047 ，HR=5.000 ，95% CI 0.853-28.013 ）、血流动力学不稳（P=0.001，HR=13.185, 95% CI 2.983-54.915）、既往耐药菌的定植或感染（P=0.005 ，HR=28.734， 95% CI 2.921-313.744）、血流感染（P=0.038 ，HR=9.715, 95% CI 1.110-81.969）和肺部感染（P=0.031， HR=25.905, 95% CI 1.381-507.006）是与总体死亡相关的危险因素。展开更多
Helicobacter pylori(H. pylori) infection is very common and affects approximately half of the world population. It causes gastric diseases, but some authors have reported an association of H. pylori infection with oth...Helicobacter pylori(H. pylori) infection is very common and affects approximately half of the world population. It causes gastric diseases, but some authors have reported an association of H. pylori infection with other systemic manifestations beginning in 1994. The list of potential effects of H. pylori outside the stomach includes a number of extragastric manifestations and we focused on neurological, dermatological, hematologic, ocular, cardiovascular, metabolic, allergic, and hepatobiliary diseases. This review discusses these important reported manifestations that are not related to the gastrointestinal tract.展开更多
Chinese arsenic drugs have been applied in Chinese medicine for several centuries. Beginning from 1970s, arsenic containing drugs have been generally used for the treatment of malignant hematologic diseases including ...Chinese arsenic drugs have been applied in Chinese medicine for several centuries. Beginning from 1970s, arsenic containing drugs have been generally used for the treatment of malignant hematologic diseases including acute promyelocytic leukemia, myelodysplastic syndrome, and multiple myeloma. No matter what ingredients of arsenic drugs were applied, either arsenic trioxide, arsenic disulfide, or arsenic containing Chinese herbal compositions including Qinghuang Powder （青黄散） and Realgar-lndigo naturalis formula （复方黄黛片）, they all provided the distinct approaches for the management of malignant hematologic diseases, and good clinical efficacy was obtained with mild adverse reactions. Moreover, the mechanisms of action have been continuallv elucidated.展开更多
文摘目的了解中国血液病患者中性粒细胞缺乏（粒缺）伴发热的发生率、临床和微生物学特征及危险因素。方法前瞻性研究2014年10月20日至2015年3月20日来自全国11家血液病中心发生粒缺伴发热的连续血液病患者发热情况及危险性因素。结果1 139例患者共发生784例次粒缺伴发热，粒缺持续21 d时发热的累积发生率为81.9%。多因素分析显示中心静脉置管（P〈0.001，HR= 3.407，95% CI 2.276-4.496 ）、胃肠道黏膜炎（P〈0.001，HR=10.548, 95% CI 3.245-28.576）、既往90 d内暴露于广谱抗生素（P〈0.001，HR=3.582，95% CI 2.387-5.770）和粒缺持续时间〉7 d （P〈0.001，HR= 4.194，95% CI 2.572-5.618）是粒缺伴发热的危险因素。无任何危险因素、具备1项、2项、3-4项危险因素患者发热的累计发生率依次增加（35.4%、69.2%、86.1%及95.6%，P〈0.001）。784例次粒缺伴发热中，不明原因发热253例次（32.3%），临床证实的感染429例次（54.7%），微生物学证实的感染102例次（13.0%）。最常见的感染部位依次为肺（388例次，49.5%）、上呼吸道（159例次，16.0%）、肛周组织（77例次，9.8%）、血流（60例次，7.7%）。最常见的病原菌为革兰阴性菌（44.54%），其次为革兰阳性菌（37.99%）和真菌（17.47%）。发热与未发热患者相比，两组之间总体病死率差异无统计学意义（9.2%对4.8%，P=0.099）。多因素分析显示年龄〉40岁（P=0.047 ，HR=5.000 ，95% CI 0.853-28.013 ）、血流动力学不稳（P=0.001，HR=13.185, 95% CI 2.983-54.915）、既往耐药菌的定植或感染（P=0.005 ，HR=28.734， 95% CI 2.921-313.744）、血流感染（P=0.038 ，HR=9.715, 95% CI 1.110-81.969）和肺部感染（P=0.031， HR=25.905, 95% CI 1.381-507.006）是与总体死亡相关的危险因素。
文摘Helicobacter pylori(H. pylori) infection is very common and affects approximately half of the world population. It causes gastric diseases, but some authors have reported an association of H. pylori infection with other systemic manifestations beginning in 1994. The list of potential effects of H. pylori outside the stomach includes a number of extragastric manifestations and we focused on neurological, dermatological, hematologic, ocular, cardiovascular, metabolic, allergic, and hepatobiliary diseases. This review discusses these important reported manifestations that are not related to the gastrointestinal tract.
文摘Chinese arsenic drugs have been applied in Chinese medicine for several centuries. Beginning from 1970s, arsenic containing drugs have been generally used for the treatment of malignant hematologic diseases including acute promyelocytic leukemia, myelodysplastic syndrome, and multiple myeloma. No matter what ingredients of arsenic drugs were applied, either arsenic trioxide, arsenic disulfide, or arsenic containing Chinese herbal compositions including Qinghuang Powder （青黄散） and Realgar-lndigo naturalis formula （复方黄黛片）, they all provided the distinct approaches for the management of malignant hematologic diseases, and good clinical efficacy was obtained with mild adverse reactions. Moreover, the mechanisms of action have been continuallv elucidated.
