Metastatic renal cell carcinoma prognosis is extremely poor and the survival time of patients in general more than a year. There was no significant effect of their chemotherapy. To IL-2 and interferon α-based immunotherapy can only make a small part of the lives of patients and to extend treatment response rate of less than 20%.
Has confirmed that allogeneic bone marrow transplantation can have a powerful effect of graft-versus-leukemia (graft-versus-leukemia effect), blood system for tumor treatment can produce better results. Another person of interest is confirmed in a number of solid tumors such as metastatic breast cancer can also occur in patients with graft-versus-tumor effect. Immunotherapy for renal cell carcinoma and a higher degree of sensitivity, so that scholars have different gene through cell transplantation for the treatment of renal cell carcinoma.
University of California at San Diego, a scholar of peripheral blood stem cell transplantation in the treatment of advanced kidney cancer effects were observed, and the results of the study published in the "New England Journal of Medicine."
To study the age of 18 to 75-year-old study by the Organization for renal biopsy confirmed, and through the imaging method for the adoption of advanced renal cell carcinoma can no longer radical resection surgery patients; at the same time there is a requirement in patients with HLA typing the same There is only one site or a different brothers and sisters.
Before transplantation cyclophosphamide, fludarabine and / or ATG to carry out pre-and at the same time before and after transplantation in the application of intravenous or oral cyclosporine to prevent graft rejection or graft-versus-host reaction.
For stem cells in the peripheral stem cell collection prior to acceptance of granulocyte colony stimulating factor (G-CSF) treatment in order to collect sufficient number of stem cells.
According to the transplant donor stem cells into the speed and extent of deciding whether to disable cyclosporine as well as lymphocyte infusion.
Complete remission is defined as able to detect the disappearance of all tumor metastasis; partial remission is defined as the transfer of cancer to reduce the diameter of at least 50% of the time to maintain at least 30 days.
Application of PCR method of evaluation of the micro-satellite for the district to determine - were set by the state of the extent of the formation; according to the International Bone Marrow Transplant Registry to determine the standard graft-versus-host reaction of the extent of the problem.
The results showed: A total of 19 patients with advanced renal cell carcinoma patients to participate in the study, the average age was 48 years old. Follow-up period, 19 patients received peripheral blood stem cell transplant after the 9 cases of survival 287-831 days (average follow-up time of 402 days). 3 cases of complete remission in patients with post-transplant 27,25 and 16 months was to maintain the state of complete remission; 7 cases of partial remission of 4 cases of patients in the transplant after 9-19, when the tumor has been no progress. 2 transplant patients because of complications related to the death; 8 cases of patients with tumors progress. A total of 10 cases (53%) of patients with metastatic renal cell carcinoma there have been varying degrees of improvement in metastasis (including lymph nodes, adrenal gland, liver, subcutaneous tissue, bone, lung, abdominal, pelvic and chest wall of metastasis, etc.) There have been dissipated. 19 cases of patients in complete remission for 3 and the remaining 7 cases of partial remission for patients. Transfer of cancer regression occurred later, at an average of 129 days after the transplant, and are usually out in the cyclosporine as well as the formation of complete donor chimerism after the T cells.
Multivariate analysis showed that only acute graft-versus-host reaction tumor regression is the only predictor. The results of this and graft-versus-tumor effect with. At the same time, also found that the only clear-cell kidney cancer treatment should have a response.
Although this study has some limitations, but without the traditional treatment of immune response in patients with metastatic renal cell carcinoma, non-allogeneic bone marrow transplantation of peripheral blood stem cell transplantation can renal cell carcinoma metastatic to achieve long-term subsided.
Nov 2, 2008
Early detection of lung cancer can do?
Central lung cancer: primary in the central parts of the lung. It's irritating symptoms of cough, sputum blood (blood may show symptoms, blood and sputum point, or mixed). Gradually increased after the tumor can develop fever, chest tightness, feeling feel suffocated and so on. Because lung cancer is located in the central parts, which are often the shadow of the heart and major blood vessels to cover up the shadow, so rely on chest X-ray examination easily lead to misdiagnosis. Check the best method of fine Sputum examination chest, trachea, bronchi of the tomography, CT examination, bronchoscopy contrast, inflation mediastinal contrast, fiberoptic bronchoscopy.
Peripheral lung cancer: primary pulmonary peripheral, so very few have a cough, hemoptysis, and other symptoms, a small number of patients have chest pain, dull pain or intermittent pain, but when the tumor increased, and pleural invasion, when the chest wall, Have a position of sustained chest pain or irritation. As the peripheral lung cancer in the lung periphery, it can easily be found in chest X-ray, the diagnosis is by chest X-ray, CT and pathology for local puncture seized. However, peripheral lung cancer at an early stage is still a lack of characteristic X-ray findings, many patients may be misdiagnosed as tuberculosis, long-term or lung inflammation and delayed treatment. In order to avoid misdiagnosis, all over the age of 40 suddenly appeared round the shadow of the lungs, can not be diagnosed with tuberculosis, should be taken early surgery or to make one or two months to observe the dynamic, if a circular shadow or increasing drug treatment There was no significant change, should not further delay, but quickly, please check thoracic surgeon, at an early date for surgery.
In addition to the above-mentioned lung cancer patients with pulmonary symptoms, there are a host pulmonary symptoms, such as male breast increased the feminization of men, phlebitis, clubbed fingers and hypertrophic osteoarthropathy, endocrine disorders, and so on, the most Is a common clubbed fingers and hypertrophic osteoarthropathy. As a result, there are unexplained clubbed fingers, toes, as well as hypertrophic osteoarthropathy should be carried out chest X-ray examination to rule out the possibility of lung cancer.
Peripheral lung cancer: primary pulmonary peripheral, so very few have a cough, hemoptysis, and other symptoms, a small number of patients have chest pain, dull pain or intermittent pain, but when the tumor increased, and pleural invasion, when the chest wall, Have a position of sustained chest pain or irritation. As the peripheral lung cancer in the lung periphery, it can easily be found in chest X-ray, the diagnosis is by chest X-ray, CT and pathology for local puncture seized. However, peripheral lung cancer at an early stage is still a lack of characteristic X-ray findings, many patients may be misdiagnosed as tuberculosis, long-term or lung inflammation and delayed treatment. In order to avoid misdiagnosis, all over the age of 40 suddenly appeared round the shadow of the lungs, can not be diagnosed with tuberculosis, should be taken early surgery or to make one or two months to observe the dynamic, if a circular shadow or increasing drug treatment There was no significant change, should not further delay, but quickly, please check thoracic surgeon, at an early date for surgery.
In addition to the above-mentioned lung cancer patients with pulmonary symptoms, there are a host pulmonary symptoms, such as male breast increased the feminization of men, phlebitis, clubbed fingers and hypertrophic osteoarthropathy, endocrine disorders, and so on, the most Is a common clubbed fingers and hypertrophic osteoarthropathy. As a result, there are unexplained clubbed fingers, toes, as well as hypertrophic osteoarthropathy should be carried out chest X-ray examination to rule out the possibility of lung cancer.
Oct 29, 2008
Allow people to a comprehensive understanding of hepatitis B
Medical patients in general feel that the abnormal symptoms such as nausea, liver pain, and so on; doctors will be visible and tangible signs of that, such as swelling of the liver, ascites, and so on. Clinical signs and symptoms collectively referred to the performance. Like many diseases like hepatitis B clinical manifestations are very different too. According to the clinical manifestations, hepatitis B virus infection often divided into several types.
As a result of this disease may be misdiagnosed as flu or some patients have no symptoms, with the result that many cases of hepatitis not be diagnosed, common symptoms of hepatitis are:
1, decreased appetite; 2, weak; 3, low-grade fever; 4, muscle or joint pain; 5, nausea, vomiting; 6, and abdominal pain.
Signs:
1 mild swelling of the liver, soft texture can be touched or medium hardness of the liver, or tenderness, pain knock. Some cases may have no signs.
2 can occur in some cases face liver disease, the performance An Hei looking for, Malacosoma Wu Hua, rough, and so on Chunseanzi; can also cause facial telangiectasia, spider palm liver, some patients have splenomegaly.
3 yellow skin or into the sclera, gastrointestinal symptoms later.
The signs and symptoms of hepatitis B
As a result, many people do not know what the symptoms of hepatitis B, often uncomfortable, what can be called hepatitis B in the head. Some v. Ren Zhu, but after the medical examination is normal; some people put too much effect until the emergence of ascites, upper gastrointestinal bleeding before medical treatment, delays in diagnosis and treatment when asked. Hepatitis B know the common symptoms and signs, we can understand the severity of their condition and change. Can reduce the number of unnecessary psychological burden.
Medical patients in general feel that the abnormal symptoms such as nausea, liver pain, and so on; doctors will be visible and tangible signs of that, such as swelling of the liver, ascites, and so on. Clinical signs and symptoms collectively referred to the performance. Like many diseases like hepatitis B clinical manifestations are very different too. According to the clinical manifestations, hepatitis B virus infection often divided into several types.
1. Hepatitis B virus carriers: If there are no symptoms and signs. Normal liver function, only the surface antigen positive, either, "Dasan Yang" or "Xiao Sanyang." Either Hl (v DNA positive or negative, that are carriers of hepatitis B virus. It accounted for hepatitis B-infected people in the majority. It is worth noting that although some people symptoms did not even have normal liver function, but there is chronic inflammation of the liver, if left untreated, can eventually develop into cirrhosis, who is not a real carrier. As a result, the absence of liver histological examination of the evidence, it is necessary to carry out long-term, dynamic observation, in order to make an accurate diagnosis.
2. Acute hepatitis B: In the course of six months, said acute hepatitis B, a general acute onset, severity of symptoms ranging, and most of the surface antigen in more than six months away, a small number of hepatitis B can become chronic.
3. Chronic Hepatitis B: The course of chronic hepatitis B, said more than half a year, may have different severity of the symptoms, Buyu persistent, recurrent. If there is no history of hepatitis B, there is no recent test results for the first time is sometimes difficult to determine the incidence of acute chronic hepatitis B or hepatitis B.
4. Heavy B: the rapid development of the disease, the symptoms are very heavy, if not actively rescue can be life-threatening.
In addition to the hepatitis B virus carriers, other various types of hepatitis B have a different severity of symptoms and signs, can be summarized, including the following.
1, full-body symptoms: hepatitis B patients often feel Tilibuzhi, fatigue,打不起精神, which may be due to impaired liver function, reduce consumption, the Food and digestion closed mock obstacles, lack of nutrient intake. On the other hand, is due to inflammation, increased consumption, people have taken the material as a result of damage to liver function, metabolism can not fully meet the needs of the body. The third aspect may be caused by the hepatitis B and psychological pressure on the rest and sleep, insomnia, and so on, the dream may be more relevant.
2, digestive symptoms were: the liver is an important digestive system, liver bile secretion is necessary to digest food. Hepatitis, bile secretion decreased, affecting the digestion and absorption of food. Inflammation of the liver may also cause obstacles to the flow of the sinus, resulting in congestion and edema of the gastrointestinal tract, affecting the digestion and absorption of food. As a result, hepatitis B is often loss of appetite, nausea, tired of oil, abdominal discomfort, and so on.
3, jaundice: bilirubin metabolism in the liver is the hub of the serious illness, due to the uptake of BIL, the combination of secretion, excretion, and other barriers to increased concentration of bilirubin in the blood. When the increased concentration of bilirubin in the blood, urine bilirubin from the discharge, so that the urine become darker in color. It is the first jaundice. But the hot days sweating lack of drinking water, some drugs can cause changes in urine color should pay attention to the distinction. When the concentration of bilirubin in the blood to continue to increase. Which can cause eye, skin jaundice. As the discharge of bile acids obstacles, the concentration of bile acids in the blood increased, too much bile acid deposition in the skin. To stimulate peripheral nerves, causing itching skin.
4, liver pain: lack of liver nerve pain, acute hepatitis B generally do not have the pain. However, the liver surface layer of thin film, said the envelope liver, liver capsule on the distribution of nerve pain there is, when the inflammation of the liver enlargement, liver coated tension, pain by stimulating nerve, so some patients may have a right upper quadrant And the right quarter of the ribs does not apply, secret anguish. Tiao, such as severe pain, but also pay attention to the disease biliary tract, liver, gastrointestinal diseases, the possibility to avoid misdiagnosis.
5, hepatosplenomegaly: Due to inflammation, congestion, swelling, cholestasis, hepatitis B often swelling of the liver. If the chronic inflammation Buyu period, recurrent. Intrahepatic fibrous connective tissue proliferation, hard texture of the liver. Due to a large number of advanced liver cell destruction, fibrous tissue contraction, the liver can be narrowed. Acute or chronic hepatitis C early, no more swelling of the spleen, after the spleen may reticuloendothelial system proliferation, as well as portal hypertension. Congestion spleen, enlarged spleen caused. Continuing to carry out liver and spleen enlargement tips.
6, demonstrated outside the liver: a lot of chronic hepatitis in patients with liver cirrhosis in particular, looked dull complexion, face, said liver disease, which may be due to endocrine disorders, skin pigmentation. Or because of recurrent or persistent jaundice, biliverdin in the skin calm Letter. The palm of your hand, hypothenar significant congestive liver, said Zhang. , Chengfangshezhuang clusters of skin capillary expansion, said spider with a diameter of a few millimeters to a few centimeters, the pressure of bleaching, commonly found in the face, neck,
As a result of this disease may be misdiagnosed as flu or some patients have no symptoms, with the result that many cases of hepatitis not be diagnosed, common symptoms of hepatitis are:
1, decreased appetite; 2, weak; 3, low-grade fever; 4, muscle or joint pain; 5, nausea, vomiting; 6, and abdominal pain.
Signs:
1 mild swelling of the liver, soft texture can be touched or medium hardness of the liver, or tenderness, pain knock. Some cases may have no signs.
2 can occur in some cases face liver disease, the performance An Hei looking for, Malacosoma Wu Hua, rough, and so on Chunseanzi; can also cause facial telangiectasia, spider palm liver, some patients have splenomegaly.
3 yellow skin or into the sclera, gastrointestinal symptoms later.
The signs and symptoms of hepatitis B
As a result, many people do not know what the symptoms of hepatitis B, often uncomfortable, what can be called hepatitis B in the head. Some v. Ren Zhu, but after the medical examination is normal; some people put too much effect until the emergence of ascites, upper gastrointestinal bleeding before medical treatment, delays in diagnosis and treatment when asked. Hepatitis B know the common symptoms and signs, we can understand the severity of their condition and change. Can reduce the number of unnecessary psychological burden.
Medical patients in general feel that the abnormal symptoms such as nausea, liver pain, and so on; doctors will be visible and tangible signs of that, such as swelling of the liver, ascites, and so on. Clinical signs and symptoms collectively referred to the performance. Like many diseases like hepatitis B clinical manifestations are very different too. According to the clinical manifestations, hepatitis B virus infection often divided into several types.
1. Hepatitis B virus carriers: If there are no symptoms and signs. Normal liver function, only the surface antigen positive, either, "Dasan Yang" or "Xiao Sanyang." Either Hl (v DNA positive or negative, that are carriers of hepatitis B virus. It accounted for hepatitis B-infected people in the majority. It is worth noting that although some people symptoms did not even have normal liver function, but there is chronic inflammation of the liver, if left untreated, can eventually develop into cirrhosis, who is not a real carrier. As a result, the absence of liver histological examination of the evidence, it is necessary to carry out long-term, dynamic observation, in order to make an accurate diagnosis.
2. Acute hepatitis B: In the course of six months, said acute hepatitis B, a general acute onset, severity of symptoms ranging, and most of the surface antigen in more than six months away, a small number of hepatitis B can become chronic.
3. Chronic Hepatitis B: The course of chronic hepatitis B, said more than half a year, may have different severity of the symptoms, Buyu persistent, recurrent. If there is no history of hepatitis B, there is no recent test results for the first time is sometimes difficult to determine the incidence of acute chronic hepatitis B or hepatitis B.
4. Heavy B: the rapid development of the disease, the symptoms are very heavy, if not actively rescue can be life-threatening.
In addition to the hepatitis B virus carriers, other various types of hepatitis B have a different severity of symptoms and signs, can be summarized, including the following.
1, full-body symptoms: hepatitis B patients often feel Tilibuzhi, fatigue,打不起精神, which may be due to impaired liver function, reduce consumption, the Food and digestion closed mock obstacles, lack of nutrient intake. On the other hand, is due to inflammation, increased consumption, people have taken the material as a result of damage to liver function, metabolism can not fully meet the needs of the body. The third aspect may be caused by the hepatitis B and psychological pressure on the rest and sleep, insomnia, and so on, the dream may be more relevant.
2, digestive symptoms were: the liver is an important digestive system, liver bile secretion is necessary to digest food. Hepatitis, bile secretion decreased, affecting the digestion and absorption of food. Inflammation of the liver may also cause obstacles to the flow of the sinus, resulting in congestion and edema of the gastrointestinal tract, affecting the digestion and absorption of food. As a result, hepatitis B is often loss of appetite, nausea, tired of oil, abdominal discomfort, and so on.
3, jaundice: bilirubin metabolism in the liver is the hub of the serious illness, due to the uptake of BIL, the combination of secretion, excretion, and other barriers to increased concentration of bilirubin in the blood. When the increased concentration of bilirubin in the blood, urine bilirubin from the discharge, so that the urine become darker in color. It is the first jaundice. But the hot days sweating lack of drinking water, some drugs can cause changes in urine color should pay attention to the distinction. When the concentration of bilirubin in the blood to continue to increase. Which can cause eye, skin jaundice. As the discharge of bile acids obstacles, the concentration of bile acids in the blood increased, too much bile acid deposition in the skin. To stimulate peripheral nerves, causing itching skin.
4, liver pain: lack of liver nerve pain, acute hepatitis B generally do not have the pain. However, the liver surface layer of thin film, said the envelope liver, liver capsule on the distribution of nerve pain there is, when the inflammation of the liver enlargement, liver coated tension, pain by stimulating nerve, so some patients may have a right upper quadrant And the right quarter of the ribs does not apply, secret anguish. Tiao, such as severe pain, but also pay attention to the disease biliary tract, liver, gastrointestinal diseases, the possibility to avoid misdiagnosis.
5, hepatosplenomegaly: Due to inflammation, congestion, swelling, cholestasis, hepatitis B often swelling of the liver. If the chronic inflammation Buyu period, recurrent. Intrahepatic fibrous connective tissue proliferation, hard texture of the liver. Due to a large number of advanced liver cell destruction, fibrous tissue contraction, the liver can be narrowed. Acute or chronic hepatitis C early, no more swelling of the spleen, after the spleen may reticuloendothelial system proliferation, as well as portal hypertension. Congestion spleen, enlarged spleen caused. Continuing to carry out liver and spleen enlargement tips.
6, demonstrated outside the liver: a lot of chronic hepatitis in patients with liver cirrhosis in particular, looked dull complexion, face, said liver disease, which may be due to endocrine disorders, skin pigmentation. Or because of recurrent or persistent jaundice, biliverdin in the skin calm Letter. The palm of your hand, hypothenar significant congestive liver, said Zhang. , Chengfangshezhuang clusters of skin capillary expansion, said spider with a diameter of a few millimeters to a few centimeters, the pressure of bleaching, commonly found in the face, neck,
Subscribe to:
Posts (Atom)