1、Study On The Change Of Thyroid Function In Patients With Iron Deficiency Anemia 2、Meta-analysis Of DAS And IM For Chronic-phase Chronic Myeloid Leukemia

Objective To study the change of serum total thyroxine(T4),serum total Triiodothyronine(T3),serum free thyroxine(FT4),free iodine Thyroid three original acid(FT3),thyroid-stimulating hormone(TSH),thyroid peroxidase antibodies(TPO-Ab) of iron deficiency anemia(IDA) patients and to explore the mechanism of iron metabolism,anemia and thyroid function in relationship to guide clinical treatment.Methods Collected 176 cases IDA patients and 77 cases of healthy controls in our hospital from 2012 October to 2014 October,IDA including mild,moderate and severe anemia,respectively 28,73,75.Routine blood test,serum ferritin and thyroid hormone levels were measured.Detecting serum ferritin,thyroid hormones by Radioimmunoassay;blood routine,total iron binding capacity,Fe ions and other indicators by biochemical analyzer and blood cell analyzer.Results Compared to healthy controls and severe anemia group,there is statistical significance of serum T3,T4,FT3 and FT4(P<0.05);FT3 severe anemia group was lower than that of moderate anemia group,the difference was statistically significant(P<0.05). Moderate IDA group FT4 was lower than the control,the difference was statistically significant(P<0.05).Compared with the IDA group and the healthy control group, FT4,TPO-Ab, SF, Fe, TIBC, HCT anemia group were significantly lower than those in healthy control group(P<0.05);T3,FT3,T4,TSH,the difference was not statistically significant(P>0.05).IDA group TPO-Ab was lower than the control group,the difference has statistical significance(P<0.05),and the correlation with serum TSH positive(r=0.226,p=0.003).Three groups of anemia TIBC levels compared with controls was statistically significant(P<0.05),and with anemia aggravated increased.IDA group TPO-Ab is lower compared with health control group,the difference of TPO-Ab was statistically significant(P<0.05),and positively correlated with TSH(r=0.226,p=0.003).Compared with the IDA group and the healthy control group,the related T3,FT3,FT4 and Hb levels were positively(r=0.250,p=0.001;r=0.244,p=0.001;r=0.255,p=0.001);There was a positive correlation between T4 and HCT, SF, and TPO-Ab, TIBC was negatively correlated with T4; there was a positive correlation between TSH and TPO-Ab、 HCT,;TIBC and HCT was negatively correlated.Conclusion The metabolism of thyroid hormone changed in Severe IDA patients,even effect patients prognosis,should be early diagnosis and treatment,to avoid serious complications caused by the low level of thyroid hormone.Objective Dasatinib(DAS) as a model, multi-targets TKI, it can overcome imatinib(IM) resistance, prolong the survival time of the patients and with less adverse reactions, the treanment effect is better than imatinib.In order to further clarify the effect of DAS is better than IM in patients with chronic myeloid leukemia(CML) in chronic phase(CP), we researched the publicly related research at home and abroad for Meta-analysis and provide the choice for clinical therapy.Methods Retrieving databases including Cochrane Library,Pubmed,China National Knowledge Infrastructure(CNKI),Wan Fang database and VIP database.Meantime,references of articles were searched.The quality of randomized controlled trial(RCT) was assessed by the Cochrane collaboration’s risk tool. Meta-analysis was performed by Rev Man 5.1.If P < 0.1, the effect has heterogeneity, by using random effects; If P≥0.1,the results there is no heterogeneity, by using the fixed effects analysis;The difference was statistically significant(P < 0.05), record odds ratio(OR) and 95% confidence interval(95% CI).Results A total of 5 articles involving 2031 patients were included.Meta-analysis showed that the rate of complete cytogenetic response(CCy R) rate at 12 months in Dasatinib group was higher than imatinib group(OR=2.11,95%CI:1.59~2.80,P<0.05)and the rate of the major molecular response rate at 12 months in Dasatinib group was higher than imatinib group(OR=2.22,95%CI:1.75~2.82,P<0.05);For compared with DAS and IM imatinib group, the reducing of platelet levels is statistical significance between two groups(P ? 0.05), and neutropenia, reduced hemoglobin, rash and swelling has no statistical significance(P≥ 0.05); Sensitivity analysis results, the 12 months CCy R、MMR of DAS and IM,there is still a statistically significant difference, the(OR = 2.07, 95% CI: 1.55 ~ 2.77; OR = 2.16, 95% CI: 1.70 ~ 2.75), it explained the results is stability.Conclusion Dasatinib improve CCy R and MMR rate at 12 month in CML-CP patients.;The incidence of adverse reactions such as neutropenia, hemoglobin,edema and skin rashes between DAS and IM are the same,but thrombocytopenia that IM is high relatively than DAS.