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This paper reported a case of severe COVID-19 in the recovery stage with acute lymphoblastic leukemia treated by integrated traditional Chinese and western medicine， with the intention of shedding light on the clinical diagnosis and treatment of similar conditions. The patient， who had acute lymphoblastic leukemia， developed COVID-19 infection during the bone marrow suppression period after chemotherapy. Treatment with western medicine was mainly anti-infection， symptomatic management， and supportive care. During the recovery stage， considering the patient's chemotherapy history and disease progression， the overall syndrome was identified as deficiency of both qi and yin and binding of phlegm and blood. Based on the “state-target” combined treatment strategy， herbal prescriptions were selected and modified to address the “deficiency state”， “disease target”， and “symptom target”. In addition to western medicine， the patient was administered with Shengmai Powder （生脉散） and Compound Zhebei Granules （复方浙贝颗粒） in its modifications to boost qi， nourish yin， and reinforce healthy qi， nourish and cool the blood， ultimately achieving satisfactory therapeutic effects.
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Objective To study the relationship between the positive expression of human leukocyte antigen B27 (HLA-B27) in different age groups and genders in Uygur and Han nationality in Xinjiang,and explore the clinical value of HLA-B27 in different ethnic groups.Methods From January 2013 to November 2016,1 416 cases of Uygur and Han patients with positive expression of HLA-B27 were detected by flow cytometry.There were 369 cases of Uygur and 1 047 cases of Han.Results Independent samples t-test showed that the positive expression of HLA-B27 in Uygur and Han population was statistically significant (165.22±8.262 vs 163.99±8.113,t=2.479,P=0.013).In male,there was a significant difference in the positive expression of HLA-B27 between Uygur and Han population (165.40 ± 8.237 vs 163.99 ± 8.164,t =2.187,P =0.029).In the age of 41～60 years old and ＞60 years old,the positive expression of HLA-B27 in Uygur was higher than that in Han nationality (166.18 ± 7.650 vs 164.53 ± 8.018,t =2.215,P =0.027;171.63 ± 8.134 vs 167.40 ± 9.469,t =2.126,P=0.035).There was no significant difference in the positive expression of HLA-B27 between Uygur and Han nationality in women,as well as in the age of 20 years and 21～40 years (t=-0.029～1.257,all P＞0.05).Conclusion The investigation showed that the positive expression of HLA-B27 in Uygur was higher than that in Han nationality.The content of HLA-B27 positive expression has racial difference.
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Objective To evaluated the application value of mean corpuscular volume(MCV) and red blood cell volume distribu-tion width(RDW) in predicting early treatment responses of non-severe aplastic anemia(NSAA) .Methods 101 cases of patients who were newly diagnosed with non-severe aplastic anemia and were treated with Cyclosporine (CsA)combined androgen therapy . Treatment before baseline MCV ,RDW value were measured ,treatment for 3 months ,6 months test routine blood ,reticulocyte indi-cators and treatment results were statistically analyzed and receiver operating characteristic (ROC) curve was used to estimate the sensitivity and specificity of MCV ,RDW in predicting early treatment results .Results The level of MCV and RDW in non-severe aplastic anemia were significantly higher than normal reference .the responded patients had significantly higher pretreatment base-line MCV value than those non-responded .especially at 6 month ,baseline MCV were 105 .10 fl and 98 .30 fl respectively (P=0 .025) .the responded patients had significantly lower pretreatment baseline RDW value than those non-responded .especially at 3 month .baseline RDW were 14 .60% and 16 .60% respectively(P=0 .001) .The cutoff level of MCV (100 fL) and RDW (15 .55% ) for the predicting 3 and 6 month treatment responses were established based on the ROC curve ,with degree of accurancy of MCV was 62 .4% ,61 .4% and RDW 70 .3% ,63 .4% respectively .compared the treatment efficacy acuity MCV ≥100 fL/RDW <15 .55%group was significantly better than MCV < 100 fL/RDW≥15 .55% group .Multivariate analysis showed that pretreatment RDW and absolute reticulocyte value was the early prognostic factor of NSAA treatment effect .84 patients with ARC ≥ 20 × 109/L , through RDW cutoff Layered compare treatment response :RDW<15 .55% group was significantly better than the RDW≥15 .55%group(P=0 .000) .Conclusion MCV can not serve as of a significant predictor of early treatment response in non-severe aplastic a-nemia .RDW can serve as of the bone marrow failure severity indicators and a significant predictor of early treatment response in non-severe aplastic anemia .The joint reticulocyte absolute value parameters ,which can more accurately predict treatment efficacy .
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Discuss the pathogenesis and treatment strategy of idiopathic thrombocytopenic purpura from the view of insidious pathogenic factors.The invasion,remission and recurrence of ITP implicated the theory model of insidious pathogenic factors,and it applied new thread for syndrome differentiation and treatment.
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The study process of TCM syndrome spectra of hemopathy is the process to recognize the syndrome characteristics of the onset, development of hemopathy, it bases on norm of TCM symptoms and syndrome. In this course, it could not only find common feature of syndrome,but also analyze distribution regularity of TCM syndrome. Thus to establish sequence of hemopathic syndrome, and to provide the basis for clinic determination of treatment based on syndrome differentiation, and provide the foundation for finding correlation of TCM syndrome and target tests.