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In order to further standardize the diagnosis and treatment of long-term systemic complications in kidney transplant recipients, Branch of Organ Transplantation of Chinese Medical Association initiated the formulation of “Clinical Diagnosis and Treatment Guidelines for Long-term Systemic Complications in Kidney Transplant Recipients in China”. Experts on organ transplantation were organized to summarize and integrate the latest progress in this field based on existing clinical guidelines, systematic evaluations, case studies, expert consensus. The guideline was formed after multiple rounds of discussion and reaching a consensus which included complications of hematological system, central nervous system，cardiovascular system, ocular, cutaneous and osteoporosis disorders. The full text focuses on 27 clinical problems and forms 40 recommendations, mainly involving the risk factors, classification, diagnosis, treatment and prevention of various complications. This guideline graded the quality of evidence and the strength of recommendation for each clinical issue using 2009 Oxford Centre for Evidence-Based Medicine (OCEBM) Grading and Strength of Recommendation criteria, so as to provide reference for the diagnosis and treatment of late complications, comprehensively improve the management capacity of clinicians to benefit kidney transplant recipients.
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In recent years, with the wide use of antimicrobial agents, the adverse reactions related to antimicrobial agents have attracted more and more attention.Among them, the adverse reactions in hematological system induced by antibacterial agents seriously affect patient′s health and doctor′s selection for antibiotics.For example, some beta lactam antibiotics can cause dysfunction of coagulation and hemolytic anemia.Chloramphenicol and sulfonamides can cause aplastic anemia.Linezolid can cause thrombocytopenia and anemia.It is important to understand the adverse reactions in hematological system caused by antibiotics.In this paper, the antibiotic induced adverse reactions in hematological system and their mechanism were summarized in order to provide information for the rational use of antimicrobial agents.
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ObjectiveTo discuss the hematological adverse reactions of oral omeprazole administration with convention dosage and treatment course in aged patients.MethodsFour hundred and nine cases of reflux esophagitis by endoscopic diagnosis from Beijing Hospital during January 2000 to December 2010 were divided into three groups according to their ages: group A ( 168 cases) aged from 60 to 69 years,group B ( 152 cases) aged from 70 to 79 years and group C (89 cases) aged equal to or above 80 years.Each group of patients was randomly divided into three subgroups,A 1 ( 56 cases),B 1 ( 51 cases) and C 1 ( 30 cases ) were administered with oral omeprazole,20 mg,bid; A2 ( 56 cases ),B2 ( 51 cases ) and C2 ( 30 cases ) were administered with oral famotidine,20 mg,bid; A3 ( 56 cases),B3 ( 50 cases),C3 ( 29 cases ) and all above subgroups were administered with oral sucralfate,10 ml,tid.The treatment course lasted for one month.The clinical efficacy,WBC count,RBC count,the Hemoglobin level,platelet count,as well as the prothrombin time,thrombin time,activated partial thromboplastin time,fibrinogen,Plasma fibronectin and serum D-Dimer were tested and compared after 10-days and 30-days treatment.ResultsAfter the treatment,all the patients had alleviated symptoms,to varied extend,especially in subgroups treated with oral omeprazole and sucralfate.After 30 days' treatment,blood WBC counting in B1 subgroup declined to lower than normal values in two cases; PLT counting drops in 1 case; blood WBC dropped in 6 cases and PLT dropped in4 cases of the C1 subgroup;blood WBC counting dropped in 1 case and PLT dropped in 2 cases of the C2 subgroup.Hemoglutination did not show significant change in all groups (P ＞ 0.05 ).Conclusion The hematological adverse reactions of oral omeprasole in aged patients,under convention dosage and treatment course,occured with age increase,especially for blood WBC and platelet counting.
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Objective To explore the relationship between the impairment of hematological system and disease activity,immunological parameters,and the prognosis of systemic lupus erythematosus (SLE).Methods The clinical and laboratory data of in-patients with SLE in Jiangsu Province were investigated and all patients were hospitalized between 1999-2009.The impairment of hematological system was assessed and the relationship between hematological system damage and disease activity,immunological parameters,mortality rate of patients with SLE were analyzed.Statistic method used was X2 test.Results One thousand nine hundred and fifty eight cases of SLE were included in the study,in which,1836 were female and 122 were male.One thousand five hundred and forty nine (79.1%) patients complicated with hematological system damage,62.3% were anemia,45.5% with leucopenia and 29.4% with thrombocytopenia.There were significant differences in hematological system damage rate among patients with mild activity group,moderate activity group,severe activity group and almost no activity group,compared respectively with almost no activity group.The P values were P=0.01 and P＜0.01 respectively.The incidence of hematological system damage in elevated ESR,low complement C3 level,anti-dsDNA antibody group was higher than that in patients who had normal ESR,complement C3 level and anti-dsDNA group.(P＜0.01).During follow-up,166 patients died,of which the mortality rate(91.6%) in patients had hematological system damage,was obviously higher than those without hematological damage(8.4%)(P＜0.01 ).Among the 166 deceased patients,38.6% died of severe infection,22.9% died ofrenal failure,15.1% died ofnervous system damage,10.2% died of cadiovascular damage and 13.3% died from other causes.Conclusion Hematological system is one of the most commonly involved system in patients with SLE,of which anemia is the most common,and the incidence of leukopenia follows.The impairment of hematological system is closely related to lupus activity.Patients with abnormal immune parameters tend to have secondary hematological system damage.Severe infection is the main cause of death in patients with lupus,followed by nervous system damage and kidney damage.The mortality rate in patients with lupus that complicated hematological system damage is higher than patients who have no hematological system damage.
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Objective To study the effects of Huangqi Injection on hematological system in advanced nonsmall-cell lung cancer (NSCLC)patients after chemotherapy. Methods A total of 100 NSCLC patients were randomly recruited into a control group (40 patients) and a treatment group (60 patients). The control group was treated with MVP project (chemotherapy with mitomycin, vindesine, and platinol) and orally taken with ondansetron, batilol, and leucogen; while the treatment group was treated with Huangqi Injection on the basis of the control group. Therapeutic effect was compared between the two groups after the treatment. Results There was a significant decrease of white blood cell count and platelet count in the treatment group. The occurrence of aneamia in the treatment group was significantly lower than the control group (P＜0.05) . Conclusion Huangqi Injection has a obvious effects in reducing toxic and side effects of chemotherapy in NSCLC patients.
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OBJECTIVE:To probe into the status quo and the future tendency of the hematological system drugs used in Guangdong area.METHODS:The hematological system drugs used in over60hospitals of Guangdong area between2000and2004were analyzed statistically with respect to drug variety and amount of money.RESULTS:The amount of money of hematological system drugs increased year by year;that of the joint venture manufactured drugs and the domestic drugs in?creased year by year;filgrastim dominated the first in terms of amount of money.CONCLUSION:The domestic enterprises should strengthen the research and development of drugs and further increase their market share so as to satisfy the needs of more patients.
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OBJECTIVE:To evaluate the abnormality in hematological system induced by antituberculosis drugs so as to promote the rational use of drugs in the clinic.METHODS:The 441 case reports on abnormality in hematological system induced by antituberculosis drugs retrieved from Chinese medical science periodicals from Jan 1990 to Apr 2007 collected in CHKD periodicals knowledge base in China hospital digital library were analyzed statistically.RESULTS:A total of 15 antibuberculosis drugs were involved in the ADR cases,leading the list were rifampicin,ciprofloxacin and isoniazide,which resulted in a total of 211 ADR cases.Leukopenia was the chief clinical manifestation.CONCLUSIONS:It is essential for clinical practitioners master the distribution patterns of ADR in hematological system caused by antituberculosis drugs so as to promote medication safety.