Leukemia patients have new drugs

Gleevec is the use of molecular biology developed one of the few successful drugs.

A confrontation of the new leukemia drug has been available, leukemia patients no longer need to rely on chemotherapy or radiotherapy for cancer treatment.

By the Novartis pharmaceutical company that invented the new anti-cancer drug called Gleevec, or STI-571, is to use molecular biology developed one of the few successful drugs.

Traditional chemotherapy or radiotherapy for cancer treatment in the removal of cancer cells at the same time, will cause harm to normal cells, prone to side effects or cause resistance to reduce vulnerability to infection. Directly attack cancer cells in the abnormal protein molecular biological drugs would be no such problems.

Gleevec is the main effect of confrontation with chronic myeloid leukemia (chronic myeloid leukemia).

Can not automatically send messages of cancer death

Chronic myeloid leukemia is a bone marrow hematopoietic tissue caused by too many white blood cell count each of 4,500 Americans were diagnosed with chronic myeloid leukemia. Gleevec is through attacking chronic myeloid leukemia cancer cells, known as BCR-ABL abnormal protein, such treatment of cancer.

Cell protein plays for the “communication”. Gleevec was originally goal is to stop the abnormal protein, leading to cancer cells can not convey the “cancer tumor growth,” the message. However, the researchers surprise that, owing to excessive dependence on these messages cancer cells, cancer cells can not convey the message was automatically die.

A short period of time allowed to review drug

The study also showed that 54 chemotherapy invalid chronic myeloid leukemia patients, 53 taking Gleevec, the number of white blood cell count in the blood return to normal.

Significant effect, the federal Food and Drug Administration last month on the 10th an unprecedented rapid approval of this as a miracle drug. General fastest in the six-month drug can be approved, Gleevec, in a short span of two and a half months was approved.

Help to relieve patients with gastrointestinal stromal tumor

Gleevec was approved a few days later, the researchers also revealed that drug use in gastrointestinal stromal tumors (Gastrointestinal Stromal Tumour) has also been a significant effect. Gastrointestinal stromal tumor is a very serious cancer, patients often died within a year. Each of the gastrointestinal stromal tumor of Americans about 10,000 people.

83 taking Gleevec of gastrointestinal stromal tumor patients, 51 were in condition to reduce the phenomenon, even for such chemotherapy and radiation are generally ineffective for cancer, is a big achievement.

The researchers now are exploring whether to Gleevec and other drugs combined, used to treat other types of cancer.

One of every five patients have side effects

However, Gleevec also has potentially serious side effects, every five patients, there is a hemorrhage in such serious side effects, they have to change the weight or suspend drug use, has not yet been killed because of side effects.

Since the drug is new, some cancer experts also questioned its long-term effectiveness. Gleevec is really whether the treatment of cancer, or merely to delay worsening condition only » Gleevec cancer cells can control how long » Why some patients will be invalid after taking » These issues are yet to be researchers found that on January 1.

Gleevec may cheaper prices, the monthly amount needed 2,000 to 2,400 U.S. dollars. In order to help the poor patients, Gleevec invention of the pharmaceutical company Novartis plans for those who are less than the annual salary of 43,000 yuan to provide free drug patients, those annual salary of less than 200,000 yuan or no medical insurance patients can also get allowances.

Although Gleevec for the treatment of many types of cancer do not have help, but the invention of drug research in molecular biology research staff, is a strong-arm. As long as one day, mankind can find various types of cancer cells in the abnormal protein, and confrontation of these protein drugs, have become all the cancer can be treated.

Chronic disease anemia

In some chronic infections such as tuberculosis, lung abscess, inflammation such as rheumatoid arthritis, systemic lupus erythematosus and Yanxingchangbing, tumors such as breast cancer, malignant lymphoma, and other surgical trauma and continued on after the 1-2 By the associated with anemia, characterized by low serum iron, total iron binding capacity is low, and increase the storage of iron known as chronic anemia disease anemia. With other systemic diseases secondary to the different anemia, such as liver disease, kidney and endocrine diseases of the secondary anemia. Its mechanism is still not very clear, that includes three areas: (1) to shorten the life span of red blood cells (2) bone marrow anemia status of the response of obstacles (3) the release and use of iron barriers. Clinical performance was mainly for mild to moderate anemia, hemoglobin little less than 90 g / L, HCT not less than 32 percent, are being pigment cell anemia, about 1 / 3 to 1 / 2 patients with low performance for the pigment or small cell Anemia. Serum iron and total iron binding capacity were lower than normal, iron saturation of lower than normal or less, increased serum ferritin, free erythrocyte protoporphyrin also increased. David iron tablets in the bone marrow cells and macrophages to reduce the increase in iron storage. For the treatment of major diseases. Generally do not need special treatment. Iron supplement invalid, added EPO can improve the anemia, subcutaneous injection. Three times a week.

Bone marrow disease anemia

The disease is malignant tumor metastasis to bone marrow substantive, so that the normal bone marrow hematopoietic inhibited, the interference caused hematopoietic function of anaemia. In addition to its characteristics as anemia, peripheral blood cells in a naive and childish RBC tablets. Common diseases due to this disease are: prostate cancer, breast cancer, gastric cancer, lung cancer and neuroblastoma, and other diseases.

[Symptoms of disease]

1. Signs and symptoms depend on the incidence. 2. Anemia, myelocytic reduction and thrombocytopenia. 3. Lymph nodes, hepatosplenomegaly. 4. Pathological fracture.

[Diagnosis]

1. Most positive cell anemia, with WBC and thrombocytopenia. 2. Smears of blood that marked the deformed red blood cells and red blood cell size increased. This shows that naive tablets tablets blood cells and red blood cells naive. 3. Smears and bone marrow biopsy can be found the performance of the original disease. Cancer metastasis can be found in the trailers, the cancer cells into college. 4.X line skeleton radiography, radionuclide scans may find cancer bone metastases source of the disease.

[Treatment of]

1. Control the disease. 2. Anemia, a serious infusion of red blood cells. 3. Support therapy.

[Evaluation]

Turn for the better: the incidence ease, reduce the symptoms of anemia. Invalid: the incidence and symptoms of anemia did not change or increase further.

[Expert Tips

The disease is not a single disease but a group of diseases, clinical manifestations. Because of different causes, the treatment should be the primary disease. Treatment of this disease are not effective. Especially for tumors cause bone marrow infiltration, the hope of cure is very little of.

Bone cancer

All in all kinds of organizations, such as the skeletal system of bone, cartilage, fibrous tissue, fat, blood, nerve tissue and undifferentiated reticuloendothelial caused by the structure of the tumors are primary bone tumors. Through a direct invasion, revascularization or lymphatic system in the transfer of bone tissue formation in the transfer of secondary bone cancer tumor. Apart from a benign bone tumor, malignant particularly, there are some of the bone tissue lesions not sure whether the true nature of their bone tumors, such as fibrous dysplasia, isolated bone cyst, eosinophilic granuloma of bone, bone症等disorder of lipid metabolism, tumor-like lesions (bone tumor-like lesions).

Bone tumors that have not been the cause of the past, especially the chronic injury that minor injuries, chronic infection can cause bone tumors. In recent years, such as through the experimental study has used Harvey Fujinaga and Moloney made of the large number of mouse sarcoma virus osteosarcoma model, Finkel has used different types of isotopes and osteosarcoma virus into animal models, some with radioactive substances such as radium, strontium and other manufactured Osteosarcoma animal model. These pathogenic factors have been identified by many scholars. Bone tumor incidence for men age 15 to 24 years old, female, 5 ~ 14 years old, may be related to gender bone growth and development of endocrine and duration of the morning.

Benign bone tumor

Benign Osteoblastoma (benign osteoblastoma) is a rare benign bone tumor.

[Pathological changes:

This tumor is as osteoid osteoma, but larger, the largest diameter of up to 10 cm. Expansion bone tumor destruction of bone from the outer membrane or new bone parcels. Dual cut through the bone cortex, a soft tissue tumors. Tumor vascular rich and difficult surgery to stop bleeding. Histological characteristics of a large number of bone cells in the bone-like tissue or bone ridge arranged in clusters on the surface, the surface of bone-like tissue packets to vary and the new bone calcification. In the matrix of connective tissue often rich in blood vessels.

[Note: Diagnosis

The main symptoms are pain and tenderness. Each is a result of local muscle pain and spasm of the limited physical activity. Spinal lesions can be a result of violations to the spinal cord or spinal nerve compression. Low back pain in children should consider the disease.

X-ray photographs showed expansion of the lesions increased transparency, more than 2 cm diameter, and some up to 7 ~ 10 cm. Lesions are ripe calcification, the density increased. Bone tumor around the hardening of osteoid osteoma not obvious.

[Note: treatment

Should be held tumor resection. Neural arch bone plate involvement, such as nerve compression, decompression of Eastern. Surgical resection difficult position, the middle of available X-ray radiation, and calcified lesions healing.

Imatinib studies have shown that inhibition of tumor growth in mice

Study in mice preliminary findings show that a therapy for leukemia future anti-cancer drugs will one day be used to treat Ewing’s sarcoma. Ewing’s sarcoma is a very difficult treatment of bone tumors. From the University of Oregon Cancer Institute Brian J. Druker in a comment on the study, said: “Ewing’s sarcoma in children with primary bone tumor incidence in second place. Although this has not been transferred to other tumor site, the cure rate is relatively high. generally require joint surgery, chemotherapy and radiation therapy. ”

In this study, from the National Cancer Institute’s Melinda S. Merchant, and others in vivo implantation of Ewing’s sarcoma in mice and dish Ewing’s sarcoma cells were studied to evaluate imatinib (Gleevec in the United States known as the , and in Europe as Glivec) inhibited the growth of cancer cells is effective. Researchers in the latest issue of the “Journal of the National Cancer Institute,” the report said, the drug can kill about 50 percent of the cancer cells, or tumor is shrinking around 50 percent. For those of the existing chemotherapy drug known to exist resistant cell lines, the use of such drugs can still effectively kill the cancer cells. Merchant, who wrote in a research report: “The current observation of chemotherapy drugs for those who have been resistant to recurrence of Ewing’s sarcoma is more important.” However, the researchers also pointed out that compared with other cancer cells, kill Ewing’s sarcoma Cells need a higher concentration of the drug. Druker wrote in a research report: “According to preliminary results of the clinical study, imatinib can be slowed Ewing’s sarcoma cell growth. Another in the future in the study is expected to confirm that the use of imatinib may increase Ewing’s sarcoma cells to chemotherapeutic drug sensitivity. “Gleevec is in the last year the United States Food and Drug Administration approval for the treatment of chronic myeloid leukemia.

Humble renal cysts

Renal cysts including single renal cysts, congenital polycystic kidney disease and congenital multiple renal cysts, and other. Patients usually no symptoms, only the B-scan found on a kidney or a few months cyst. Few people can be more than a long cyst, but the existence of bilateral cysts are rare at the same time. This cyst wall thin, intracapsular to clarify with yellow liquid, mostly cyst the size of walnut. Is not the cause of renal cyst is very clear, generally considered to belong to kidney degeneration, which are more disease for the elderly. Small cyst not cause any symptoms. The recent B-inspection carried out extensive, found that renal cysts were also increased.

Renal cysts the main clinical symptoms
The vast majority of renal cysts and asymptomatic. Some patients may cyst itself and increased intraluminal pressure, infection and the following symptoms:
① lumbar, abdominal pain or discomfort: The reason is because of kidney enlargement and expansion so that the renal capsule Tension increased by renal pedicle traction or pressure from the neighbouring organs. In addition, polycystic kidney lead to kidney water, become heavy, fall traction, and will lead to the waist pain. The characteristics of pain for pain, Duntong fixed in unilateral or bilateral, the Department of lumbar back downward radiation. For intracystic hemorrhage or secondary infection, the pain will suddenly intensified. If the merger stones or urinary tract obstruction clot after bleeding can be a renal colic.
② hematuria: for the performance of microscopic hematuria or gross hematuria. Attack cyclical. Low back pain often exacerbated attack, strenuous exercise, trauma, infection may induce or aggravate. Bleeding reason is because there are many arterial wall below, as with infection or increased pressure to vascular wall stretch and due to excessive bleeding.
③ abdominal mass: sometimes the main reason for attending patients, 60% to 80% of the patients can be touched enlarged kidney. Generally speaking, the greater the kidney, renal function worse.
④ proteinuria: general level is low, 24-hour urine, does not exceed 2 g. More nephrotic syndrome will not happen.
⑤ hypertension: Solid oppression kidney cyst, causing renal ischemia, increased renin secretion caused hypertension. In normal renal function, have more than 50 percent of patients with hypertension, renal dysfunction, the higher the incidence of hypertension.
⑥ renal dysfunction: As cyst placeholder, oppression, so that normal renal tissue significant decrease in renal function of the decline.

Renal cysts screening method
More reliable methods of X-ray angiography, kidney B-mode ultrasonography examination, radionuclide scan and CT scan. In the renal cysts, urinary tract X-ray angiography may have pyelonephritis and renal calyceal compression deformation, but smooth edge, no damage. Renal cysts are not cancer, but easily confused with the tumor, renal cysts and renal cancer differential important. Identification of the two methods can be used PET or renal parenchymal renal angiography. Parenchymal tomography, cyst site imaging shallow, deep imaging tumor site; renal angiography, vascular sparse cyst site, no contrast agent concentration, renal vascular rich due to malignant tumors, a contrast agent concentration. Suspected malignant cyst, the cyst could puncture, allantoic fluid out of a routine inspection and exfoliated cells checks to the cyst can also be injected contrast agents to check whether tumor wall. B-mode ultrasonography and CT it is easy to renal parenchymal renal cysts and tumors separately, therefore, is the ideal method.

The treatment of renal cysts
The current level of medical treatment of renal cysts no effect method. For small renal cysts, asymptomatic, no need for any treatment, but should be reviewed regularly, it will continue to increase observation cyst. Asymptomatic should be regular urine checks, including urine, urine culture, every six months to one year to conduct a renal function test, including the creatinine clearance rate. Because of the deterioration of the infection is an important reason, if necessary, to refrain from urinary tract trauma of the inspection. Renal cyst puncture of little use, not only vulnerable to infection, easy to relapse, and the long-term observation, the operation can not delay the occurrence of renal damage. Surgical resection cyst is not an easy task, because the surface of renal cysts can be cut off, but to cut off buried deep in the kidney cyst on the very difficult. Malignant tumors larger and there is possible, surgical exploration can be carried out, if confirmed to be a benign cyst, renal surface can be wall resection edge with catgut suture and the renal parenchyma consecutive residual wall covered with iodine. Broad side of renal parenchymal damage, the contralateral normal renal function, viable nephrectomy.

Hydronephrosis diagnosis based on clinical manifestations

1. Symptoms of the disease, such as pain stones, tumors hematuria, a urethral stricture voiding difficulties.

2. Water side of the waist pain.

3. Infection with chills, fever, pyuria.

4. Side waist cystic mass.

5. Bilateral obstruction in chronic renal insufficiency, and uremia.

Diagnosis

1. Low back pain, waist cystic mass.

2.B super: kidney volume increased cortical thinning, the real size of the dark areas.

3.X line Intravenous urography showed hydronephrosis.

4. Radionuclide renography, obstructive kidney Fig.

5. Ureteral retrograde intubation by angiography showed hydronephrosis.

Hydronephrosis

Since the beginning of urinary tract kidney until urethra, is a continuous pipeline system. Urine from the urinary tract depends on the pipeline open, and normal urinary function. Urinary any part of the pipeline, as well as stenosis or obstruction of the normal neuromuscular dysfunction, urine through obstacles can arise, causing urinary obstruction, urinary obstruction due to the above location from the sluggish pressure gradually increased lumen expansion, which eventually led to Renal water, and expansion of renal parenchymal thinning, renal dysfunction, if bilateral obstruction, a uremia serious consequences. Lead to urinary obstruction has many causes, can be congenital, such as the kidney, ureteropelvic junction stenosis, urethral valve, horseshoe kidney, acquired diseases such as stones, tumors, benign prostatic hyperplasia, such as bladder neck contracture. It can also be a urinary tract, or the fiber with obstruction caused mass oppression, such as retroperitoneal fibrosis, such as lymphoma. It can also be a urinary tract neuromuscular obstacles, such as megaureter disease. Obstruction and the acute and chronic, acute renal obstruction to complete loss of function in a short period of time, and hydronephrosis not very obvious. Chronic obstructive hydrocephalus can kidneys than 1000 ml. Once infected with hydronephrosis, obstruction if not promptly removed and difficult to cure infection, kidney infection and speed up the destruction of a vicious circle, and even renal abscess formation.

Intravenous urography in the diagnosis of the patient what kind of assistance

Intravenous injection of contrast agent (organic iodine), the patient supine in the X-ray examination table, the next abdominal pressure (balloon or Miandian) oppression bilateral ureteral access to a clear enhancement pelvis, usually 5-10 minutes after injection 5-20 minutes to an X-ray film. Such as renal secretion, and renal calyceal, pelvis filling satisfaction, in the 30 minutes after injection with oppression can be removed so that the contrast agent filling ureter, and bladder after perturbation film. Clinical diagnosis for the following diseases:

(1) On pelvis renal calyceal images that renal dysfunction or hydronephrosis. Severely punish impaired renal function or renal pelvis Sangshizhe lights are not enhancement.

(2) chronic pyelonephritis: one or more renal calyceal top pestle-expansion, no rat-bite neat edge phenomenon of renal papillary retreat scar caused by renal calyceal unequal expansion, twisted-interference with, or in a crouched renal pelvis narrow beacon for the further development of renal scarring performance of the renal parenchyma inequality thinning, or Aoru rugged, with the latter scar compensatory cortical hypertrophy phase reflect the kidney can be increased, the normal single-or narrow side.

(3) renal tuberculosis: renal calyceal destruction, not the entire edge as wormhole-like, or because of renal calyceal narrow neck, renal calyceal disappear, deformation and to form hollow, renal calyceal no enhancement. Tuberculous abscess limitations can be oppressed pelvis renal calyceal to deformation. Renal calyceal water (due to fibrosis of stenosis or obstruction), renal calyceal “cut off” phenomenon or hydronephrosis. And see different forms of calcified plaque.

(4) nephrotic syndrome and renal vein thrombosis: sometimes that pressure ureteropelvic edge multiple tracks, adjacent to the vein compression due.

(5) papillary necrosis of inflammation: Early renal calyceal dome expanded, and the fuzzy vary cup; mid-not yet fully exfoliated nipple necrosis, nipple necrosis on contrast agent was corona-shaped nipple necrosis late detached contrast agent filling empty, a point, or altar-NECKING bottle-shaped.

(6) of hypertensive renal artery stenosis: suffering from renal, kidney and renal calyceal morphologically normal appearance. Ipsilateral renal pelvis lights initial enhancement than the contralateral desalination, but more anti-Effects of Jianshen concentration (may ischemia in the kidney tubular urine flow rate slowed, contrast agent than the full concentration). Ureteropelvic edge multi-track pressure, suggesting that collateral circulation. This shows that in real terms, as sometimes focal cortical defect, suggesting segmental renal infarction.
(7) renal congenital dysplasia: such as horseshoe kidneys, ectopic renal became kidney and renal pelvis and ureter double deformities, and others.

(8) the unilateral renal pelvis effusion diagnosis: Generally speaking, the cause of bilateral renal pelvic fluid or urine in the bladder such as: paraplegia or autonomic neuropathy, such as diabetes-induced neurogenic bladder; unilateral renal pelvis effusion Most of the causes ipsilateral ureteral diseases such as: congenital urinary off loser narrow ureteral stones, tumors or abnormal Traveling (such as retrocaval ureter), or radiation therapy after ureteral narrow.