【快穿】 J液收集系统_星光杳杳_长篇_实时更新...
第叁个需要注意的抽烟时间是房事运动后，很多男性在房事运动后会选择点上一根香烟，抽上一口来放松、缓解心情。
2024年12月19日，叁、增持计划实施的不确定性风险
【快穿】 J液收集系统_星光杳杳_长篇_实时更新...
我国055大驱
张钰不惜带上自己的朋友，可没想到接下来的事情，让张钰傻眼了，黄健中说话不算数，被骗后的张钰，也幡然醒悟。那么，今年有什么不一样呢？
xinnengyuanchejiangjia，ershoucheshangcanliao！youcheshangkui3wanyeyaochushou，zhuanjiazheyanghuyuyuanchuang2023-02-16 19:23·meirijingjixinwenmeijingjizhe：wangyan meijingbianji：peijianru“xianzaixinnengyuanershouchewomenchexingqueshibutaiganshouliao，shichangbodongshizaishiyoudianda。”riqian，hebeishengbaodingshilianchiqumouershouchexingxiaoshouliubing（huaming）dui《meirijingjixinwen》jizheshuo，tesilajiangjiahou，ershoutesilachengjiaoliangyuelaiyuedi，kehuchiguanwangtaidu，danxintesilayihouhuibuhuijixujiangjia。shishishang，jinnianchutesilaxuanbudafujiangjiahou，wenjie、xiaopengqiche、guangqiaian、jizuodengduguanxuanliaoxiangguanxinnengyuanchexingdejiangjiaxinxi，jiulianrixihezipinpaiguangqifengtianriqianyexuanbuduiqixiachundianzhongxingSUV 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Ychangxuhangbanjiagejiangliao4.8wanyuan，womenzhinenggenzhuojiang，chejiaxianzaiyijingdiaodao25wanliao，bishouchejiahuandiliao3wan，kuiqianyemeibanfa，zhixiwangnengjishizhisun。”liubingshuo。tupianlaiyuan：meirijingjixinwen zhengderui she（ziliaotu）xinnengyuanershouchenanchushoudailaidekucunjiya，yerangbufenershoucheshangtoutongbuyi。baodingshilianchiqulingyijiaershouchexingdexiaoshourenyuangaosujizhe，qimendianneiyitai2021niankuandetesilabiaozhunxuhangbanModel 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Yhoulunqudongbanchexingshoujiashangdiao2000yuan，you25.99wanyuanzhangzhi26.1wanyuan。duici，yiweibeijingdiquershouchecongyerenyuanrenwei，jinyikuantesilachexingshoujiadexiaofushangzhang，duiershouchexingqingbuhuiyoutaidayingxiang，yuzhiqianxiongyongdejiangjiachaoxiangbi，zhezhibuguoshiyiduobuqiyandelanghua。sannianchelingdiandongchebaozhilvrengpiandishishishang，tesilazhutuidezhiyingmoshisuiranzaiyidingchengdushangtigaoliaochejiadetoumingdu，danqichanpinjiagediaozhengquefayujing，yidanxinchejiagexiadiaofudujiada，henkenengduigaipinpaideershoucheshichangzaochengjiaodachongji，bujinzengjiagukedeguanwangxintai，huanrongyixiyinxiaofeizhejiangmuguangzhuanxiangxinche。duici，quanguochengyongcheshichangxinxilianxihuimishuchangcuidongshuzengbiaoshi，xinnengyuanqichepinpaidezhiyingmoshi，dailaikuaijiezoudexinchejiagebodong，meiyoufahuijingxiaoshangzaiqizhongdediaojiezuoyong。jingxiaoshangmoshixuyaobuchongdaoxinnengyuanqichedexiaoshouhuanjiezhong，congerfugaigengdafanweideshichang。riqian，zhongguoqicheliutongxiehuifabude《2022nianduzhongguoqichepinpaibaozhilvbaogao》shujuxianshi，bufenchundiandongchexingdeyinianbaozhilvyuranyouchedesannianbaozhilvjiejin，dansannianchelingdediandongqichedezongtibaozhilvrengranzhiyou57.2%。duici，yanjinghuirenwei，xinnengyuanchebaozhilvzhisuoyirengyuranyouchecunzaibuxiaochaju，zhuyaoshiyinweixiangbiranyouche，xinnengyuanqichejishujiaodi，fazhanshijianjiaoduan，jichushujubingbushitebiechongfen，duiyubaozhilvdecesuanhuanyoudaijinyibuwanshan。lingyifangmian，youyuxinnengyuanchesandahexinbujian——dianji、dianchi、diankongdechengbenzhandaoliaocheliangjiagedeyibanyishang，youqishidianchideshuaijian、sunhao，gengshixiaofeizhegoumaixinnengyuanershoucheshizhongdianguanxindewenti，ershimianshangzhenduixinnengyuanershouchehexinbujiandejiancepinggurengxiangduibaoruo。2023nian2yue10ri，beijingshichangpingqu，beijingyayuncunqichejiaoyishichang（meijingjizhe wangyan she）ciwai，dangqiandabufenxinnengyuancheqigeiyushourenchezhudezhongshenzhibao、mianfeichongdiandengquanyi，ershouchezhujunbunengxiangshou。erbushaoxiaofeizhezaizixunhegoumaiershouxinnengyuancheshi，danyoudewangwangyeshixuhangshuaijian、dianchizhibaoqi、dianjisunhaodenghexinbujiandeqingkuang。suoyi，tongguojianlizhuanyedejiancejizhi，jingzhundaxiaoxiaofeizheduianquanxing、dianjisunhao、dianchishuaijiandengfangmiandegulv，duiyuxinnengyuanershouchexingyedejiankangfazhanyouweizhongyao。“jianlikexue、gongzheng、jingdeqishichangkaoyandexinnengyuanershouchejiancepingtai，wanshanxinnengyuanershouchedejiandingpinggushouduan，tigonggengweizhunquetoumingdejiancepinggufuwu，weixinnengyuanershouchedingjiatigongheliyiju，jishixinnengyuanershouchechengxinjingyingdezhongyaofangmian，yenengweijinhouxinnengyuanershoucheshichangjiankangjingyingtigonggenghaodeqiantihejichu。”yanjinghuirenwei。meirijingjixinwenertonglinbamuxibaolinbaliuzhenliaoguifan（2019 nianban）2019-10-28 16:25·zhongliujie2022yi、gaishulinbamuxibaolinbaliu(lymphoblastic lymphoma, LBL)shiyizuqiyuanyubuchengshuqianti T huo B linbaxibaodeexingzhongliu，yuezhanertongfeihuoqijinlinbaliu（Non Hodgkin Lymphoma, NHL）de 35%～40%，shiertong NHL zuichangjiandebinglileixingzhiyi。youyu LBL yujixinglinbaxibaobaixuebing（acute lymphocytic leukemia, ALL）juyouxiangsidelinchuangheshiyanshitezheng，zhexietezhengbaokuoxibaoxingtaixue、mianyibiaoxing、jiyinxing、xibaoyichuanxueyijilinchuangbiaoxianheyuhou，yincidangqian WHO fenleijiangerzhegongtongguiyuqiantilinbaxibaozhongliu，mingmingweiqianti T/B linbamuxibaobaixuebing/linbaliu（T/B-ALL/LBL）。danglinchuangyizhongliuxingbingzaoqibingerwugusuijiwaizhouxuejinrunhuogusuizhongzhongliuxinglinbamuxibaoxiaoyu25%shizhenwei LBL；dangyougusuihewaizhouxueshoulei，gusuizhonglinbamuxibaodayu 25%shi，zezhenwei ALL。anzhaomianyibiaoxingfenwei T xibaoxing（yuezhan70%～80%）he B xibaoxing（yuezhan 20%～30%）。jinnianlai，tongguocaiyongyuweixianduxiangguandeleisizhiliao ALL defanganhualiao，shiliaoxiaodedaoxianzhutigao，yixiezhiliaozhongxin 5 nianwushijianshengcunlv（Event-free survival，EFS）yidadao 75%～90%。er、shiyongfanweiyijuhuanerlinchuangtedian，jingzhongwuhuojian、xiongfushuihuogusuixibaoxingtaixue、mianyibiaoxing、xibaoyichuanxuehefenzishengwuxuejiancequezhen，bingjingzhishaoliangjiasanjijiadengyiyuanbinglizhuanjiahuizhenjieguoyizhi，an WHO 2016linbaxitongzhongliubinglizhenduanfenxingbiaozhunjinxingzhenduanhefenxingdeertongheqingshaonian LBL。san、zhenduan（yi）linchuangbiaoxian1.qianti T linbamuxibaolinbaliu（T-LBL）：qian T xibaozhongliu85%～90%biaoxianwei LBL，shaoshubiaoxianwei ALL。haofayunianchanger，zhongweifabingnianling 9-12 sui。nanxingduojian，nannvzhibi（2.5～3）:1。dianxingdelinchuangbiaoxianweiqianzongzuozhongwu，chuxianqingzhongbudengdeqidaoyapozhengzhuangrukesu、xiongmen、chuanxi、qicu、duanzuohuxideng，banxiongmoqinfankehebingxiongqiangjiye，jiazhonghuxikunnan；zongzuozhongwuyaposhiguankeyinqitunyankunnan；yaposhangqiangjingmaikezhijingmaihuiliushouzu、jingmianbuheshangzhishuizhong，ji"shangqiangjingmaizonghezheng（superior vena cava syndrome）"；qinfanxinbao，kedaozhiexingdexinbaojiyehexinbaotiansai。linbajiebingbianyuezhan 70%，yijingbu、suogushangheyexiaduojian。bufenhuanzhehebingganpizhongda。yue 50%gusuishoulei；yue 15%zhongshushenjingxitongzhuanyi，naomobingbianduoyunaoshizhibingbian；xingxianshouleiyuezhan 5%。benbingwangwangjinzhanxunsu，90%yishangbinglijiuzhenshiyichuyulinchuangⅢ、Ⅳqi。2.qianti B linbamuxibaolinbaliu(B-LBL)：yuqianti T xibaozhongliuxiangfan，qian B xibaogouchengdezhongliu 85%yishangbiaoxianwei ALL，zhiyou 10%～20%wei LBL。B-LBL fabingnianlingjiaoxiao，zhongweinianlingxiaoyu 6 sui。fabingwumingxianxingbietezheng。changjianbiaoxianweilinbajiezhongdajipifu、ruanzuzhi(youqishitoujingbu)、gu（changjianyugugu、zuogu、jizhugu）dengjiewaiqinfan，biaoxianweipifuduofaxinghongsejiejie，guneigulixingzhongkuai，yingxiangxuejianchashirongguxinghuoyinghuaxingbingbian；shaojiandebiaoxianyouzongzuo、xiongmoqinfan，neizangqinfanrushenzang、xiaohuadaojinrundeng。yeyifashenggusuihe CNS jinrun。（er）shiyanshijiancha1.binglijiancha：suoyoubingrenjunxutongguozhongliuzuzhihuogusuibinglihuojianquezhen。（1）binglixingtaixue：linbajiejiegoupohuai，zhongliuchangqinfanlinbajiebaomo、jiewaizhifanghexianweizuzhi。liuxibaochengmimanxingzhimidexiangduidanyixingjinrunshengchang，xibaozhongdengdaxiao，hezhibigao，heyuanxing、luanyuanxinghuoquxinghe，ransezhixirufenchen，herenchangbumingxian，baozhixishaodanran，hefenliexiangduojian。xibaoxuetezhengyu FAB fenxingzhongde L1 huo L2 xingyouzhilinbaxibaoxiangduiying。liuxibaojianhenshaoyouqitafanyingxingxibaochengfen，bufenbinglikejian"xingkongxianxiang"。（2）mianyibiaoxing：①linbamuxibaodebiaozhi：baokuo TdT、CD99、CD34、CD1a。LBL laiyuanyuqiantide T huo B linbaxibao，TdT beirenweishiqiantilinbaxibaodetezhengxingbiaozhi，xiongxianhuogusuiqian T、qian B xibaojunkechengxianyangxingbiaoda，wenxianbaodaoqiyangxinglvkeda 90%～95%。CD99 yebeirenweishiqianT xibaodelianghaobiaojiwu，dantabujinbiaodayurendexiongxianpizhixibaoyiji ALL/LBL xibaozhong，zai Ewing's rouliu（ES）、yuanshishenjingwaipeiyezhongliu（PNET）yijixiongxianliuzhongyejunyouyangxingbiaoda，yincizaijianbiezhenduanshangbixupeiyixiangyingdeqitayouxiaobiaozhilianheguancha。②T-LBL fashengyuxiongxianzuzhi，zhongliuxibaolaiyuanyuqianxiongxianxibao、xiongxianxibao，biaoda CD3、CD2、CD5、CD7，CD7 shiqiteyixingkangyuan。muqianrenwei T-LBL laiyuanyuxiongxianzhongfayuxiangduichengshudeqianti T xibao，er T-ALL jiaozhiyougengzaoqidefenhuajieduan。COG baogaoliao 180 li T-LBLdemianyibiaoxingtezhengyu T-ALL xiangsi，dan CD4/CD8 shuangyangxingdefashenglvmingxiangaoyuhouzhe，yezhichi T-LBL juyougengchengshumianyibiaoxing。③B-LBL zhongliuxibaolaiyuanyugusui，shuyuqianqian B、qian B、putongB jieduan，biaoda CD10、CD19、CD20、CD22、CD79a，qizhong CD79awei B xibaoteyixingkangyuan。Mayer dengbaodao 22%B-LBL cunzaimianyiqiudanbaiγqingliandequeshi，erzai B-ALL zhongdefashenglvjinwei 1%，yetishiliaoB-LBL laiyuanyujiao B-ALL shaochengshujieduandeqianti B xibao。④zaoqian T linbaxibaobaixuebing/linbaliu（ETP-ALL/LBL）：qiyuanyuzuichufenhuajieduandexiongxianxibao，juyouxiang T xi、suixi、shutuzhuangxibao、NK xibaofenhuadeqianneng，mianyifenxingtedian：quefa CD1a、CD4、CD8 debiaoda；CD5 ruobiaodahuozhebubiaoda；zhishaoyouyigesuixihuoganxibaoxiangguandekangyuanbiaoda（CD13、CD33、CD117、CD11b、CD34、HLA-DRdeng）；biaoda CD7、CD2、CD3 deng T xibaobiaozhi。yuezhan T-ALL/LBLde 10%～15%。benxingyuhoujiaocha。2.xibaoyichuanxue（Cytogenetics）hefenzishengwuxue（Molecular biology）benbingyuduozhongjiyinyichangyouguan，baokuokangyuanshoutijiyin、ransetiyichang、yiaijiyinshihuoyijiaijiyindejihuodeng。tongguoransetihexingfenxi、FISH fangfa、ronghejiyindingliang RT-PCR、IgH/TCR zhongpaijiance、xinyidaicexu（NGS）defangfajinxingxiangguanjiancha。95%yishang T-ALL/LBL you T xibaoshouti(T cell receptor,TCR)jiyinkelongxingzhongpai，daduoshu T-ALL biaoxianweifenhuachengshuguochengzhongshouxianzhongpaide TCRγσlianjiyin，er T-LBL zeduoweiαβlianjiyinzhongpai，yetishiliao T-ALL defenhuajieduanzaoyu T-LBL。dayue 20％T-ALL/LBL tongshiyou IgH jiyinzhongpai。juedaduoshu B-LBL you Ig-H jiyinzhongpai，yekeyou Ig-L jiyinzhongpai。50％～70％de T-ALL/LBL youransetihexingyichang。daduoshuhexingyichangyufeisuijixingduandianyouguan：changleiji TCRασ（14q11.2），β（7q35），γ（7q14-15），baokuocharutubian、queshiyijiransetiyiwei。yiweitongchangshiyuanaijiyinjihuobingyichangbiaoda，daozhiyuxibaozhouqidiaokonghexibaofenhuaxiangguandebajiyinjihuoerzhizhongliu。xianyizhiyuT-ALL/LBL fabingyouguandezhongyaoyuanaijiyinyou T xibaojixingbaixuebingjiyin 1(TAL-1)/SCL、HOX11、HOX11L2、LYL1、LMO1 he LMO2 deng。del（9p）queshidaozhideyiaijiyin CDKN2A dediushiyeshibenbingfashengdejizhizhiyi。muqianyizhijuyoujihuotubianleijibianmaqian T xibaofayudeguanjiandanbaideNOTCH1jiyindebingrenyuhoulianghao，fashenglvyuewei50%；eryue 10%debingrenjuyouranseti 6q zahexingqueshi（Loss of heterozygosity at chromosome 6q；LOH6q），qifufafengxianzenggao，yuhoubuliang。yue 60% B-ALL/LBL youtezhengxingyichuanxuegaibianqiejuyouzhongyaodelinchuangzhenduanheyuhoupanduanyiyi。yichuanxueshangtishiyuhoujiaohaodeyouchaoerbeiti(ransetishu＞50)hexingji t(12;21)(p12;q22）yiweixingchengTEL/AML1 ronghejiyin；eryaerbeiti(ransetishuxiaoyu 45)、t（9;22）(q34;q11.2)xingcheng BCR/ABLl、 t（ 4;11 ）huo MLL/AF4 、 t（1;19)(q23;13.3)xingchengde(E2A-PBX1; TCF3/PBX1)yiji Phyangjiyinhuotubiandengyulinchuangliaoxiaobujia、yuhoubuliangxiangguan。3.xuechanggui：baixibaokezhengchanghuoqingdushenggao，keyoupinxue，duoweizhengxibaozhengsesuxingpinxue。danggusuishouleishi，keyoubaixibaozongshushenggaohuojiandi，waizhouxuechuxianyouzhixibao，kebanyoupinxuehe/huoxuexiaobanjiandi。4.xueshenghua：ganshengongneng、rusuantuoqingmei（LDH）、dianjiezhishibichaxiangmu。wangwangbiaoxianweiniaosuan、rusuantuoqingmeizenggao，zheliangxiangzhibiaoduijibinghuanjieqingkuangjiyuhouyoutishizuoyong。5.ningxuegongneng：baokuo PT、APTT、TT、FIB、D erjuti、FDP。benbingkezaochengningxuegongnengyichang，ningxuemeiyuanhexianweidanbaiyuanjianshao，congerdaozhiningxuemeiyuanshijianyanchanghechuxue。6.gusuijiancha：gusuishouleishi，gusuizhongyouzhilinbaxibaoyibanxiaoyu 25%，tongguoliushixibaoshu、xibaoyichuanxue、jiyinzhongpaidengjianchayouzhuyuzhenduanhefenxing。liushixibaoyijiancekeyifaxianyinxingdegusuishoulei。gusuihuojianduigusuiqinfandejianchulvgaoyugusuixingtaixue。7.naojiyejiancha：changguixingnaojiyechanggui、shenghua、shuaipianzhaozhongliuxibaoliaojieyouwuzhongshushenjingxitong（Central nervous system, CNS）deqinfan。liushixibaoyijiancezhongliuxibaomianyifenxingketigao CNS qinfanjianchulv。8.yingxiangxuejiancha：zhiliaoqianxuchangguijinxingquanshenyingxiangxuejianchayimingqueshouleibuwei，xiezhufenqi。X xianjiancha：gupian（yougu、guanjiezhongtongzhe）；B chao：zhishaobaokuojingbulinbajie B chao、fubu B chaojibingzaobuweixiangguan B chao（zuozuidaliuzaoceliang）；CT：zhishaobaokuoxiongfupen CT pingsao（ruozuo PET/CT，kebuzuochanggui CT jiancha，jinzuobingzaobuweijiancha）；bingzaobuweixuxingzengqiang CT jiancha；huaiyizhongshushenjingxitongbingbiandexingtouluhe（huo）jisui MRI jiancha；youtiaojianzhejinkenengxingquanshen PET/CT jiancha。（san）ertong LBL dezhenduanbiaozhun1.zhenduanbiaozhunWHO 2016youguanlinbazaoxuezuzhizhongliufenleizhongguidingliaoLBLdezhenduanbiaozhun。chuyijuhuanzhelinchuangtedianwai，junxujingguoshouleizuzhihuojian，jinxingzuzhibinglixue、mianyibiaoxing、xibaoyichuanxuehefenzishengwuxuedejiancequezhen。linchuangfenqi：genjuquanshenyingxiangxue、naojiyejigusuidengjiancha，yiwanganzhaoSt Judefenqixitongquedingfenqi（jianfubiao1）。suizhuoyixuefazhan，ertongNHLxindebingliyaxingdezengjia，xibaoyichuanxue、fenzishengwuxuehemianyibiaoxingfangmiandejinbu，xindezhenduanfangfazaijianceweixiaokuosanbingzaohuoweixiaocanliubingzaodelinchuangyingyongyijiyingxiangxuefangmiandezhongyaojinzhan，zaiyuanyouSt Jude fenqixitongshangjinxingliaobuchonghegailiang，chanshengliaoxindefenqixitong：xiudingguojiertongNHLfenqixitong(IPNHLSS)，jinyibumingquehebuchongliaomeiyiqidedingyi，bingjiangzuixindeyixuejinzhanxinxijiaruliaofenqixitong（jianfubiao2）。2.gusuiqinfandezhenduan：xuyaoxinglianggebuweigusuichuancihezhishaoyigebuweigusuihuojianjinxingfenxidingyigusuiqinfan。（1）gusuichuancixibaoxingtaixue：gusuiyouzhixibaohuolinbaliuxibao≥5％。（2）gusuimianyibiaoxingfangfa(mianyizuzhihuaxuehuoliushixibaoshufenxi：tezhilinbaliuxibaobaifenbi)yangxing。（3）gusuixibaoyichuanxuehuoFISHfenxiyangxing。（4）gusuiPCRfangfajiancefenzishengwuxueyangxing。（5）gusuihuojiankeyijiandaozhongliuxibaojinrun。3.zhongshushenjingxitongqinfandezhenduan：naojiyezhuangtaifenjizhuyaoyijulinchuangbiaoxian、yingxiangxuegaibian、naojiyejiancha。（1） CNS1：tongshifuheyixiasantiao：①naojiyezhongwuzhongliuxibao；②wuzhongshushenjingxitongyichangdelinchuangbiaoxian；③wuzhongshushenjingxitongyichangdeyingxiangxue（CT/MRI）yiju。（2） CNS2：fuheyixiarenheyitiao：①yaochuanwusunshang—naojiyebuhunxue（hongxibao:baixibao≤100:1）shi，naojiyebaixibaojishu≤5/μl，bingjiandaomingquedezhongliuxibao；②yaochuanyousunshang—naojiyehunxue（hongxibao:baixibao＞100:1）shi，naojiyejiandaomingquedezhongliuxibao；③yaochuanyousunshangbingweixuexingnaojiye，bulunyouwuzhongliuxibao，ruchuzhenbaixibaoshu＞50×109/L zeguiwei CNS2；④zhongshulinjinbuweideqinfanweifasheng CNS qinfandeweixianyinsu，weiliaojiaqiangyufangguiwei CNS2：toumianbupifu、ruanzuzhihuoguzuoqinfan，rulugu、bizuo、yankuangdeng（weitupoyingnaomo）；jizhugupohuaihuozhuipangqinfanbubanshenjingxitongzhengzhuangde，wu CNS zhanwei、naojiyejianchazhengchang。（3）CNS3：fuheyixiarenheyitiaowei CNS qinfan：①naojiyebaixibaojishu＞5/μl，bingyizhongliuxibaoweizhu，tongshihongxibao:baixibao≤100:1；huozhenaojiyebaixibaojishu＞5/μl，qizhongzhongliuxibaosuozhanbiligaoyuwaizhouxueyouzhixibaobaifenbi；②lushenjingmabi，jishinaojiyezhongwuzhongliuxibao、lunao MRI/CT weifaxianzhanweixingbingbian；③CT/MRI kejiannao、jisuihuonaomo、jimobingbian。④jizhugupohuaihuozhuipangqinfanyinqipainiaoyichang、zhitihuodongzhangaidengshenjingxitongzhengzhuang。4.zuowanqinfandezhenduan：huanerbiaoxianweizuowandancehuoshuangcezhongda，zhidibianyinghuochengjiejiezhuangquefadanxinggan，touguangshiyanyinxing，B chaojianchakefaxianzuowanchengfeijunzhixingjinrunzao，chuzhenhuanerkebuyuhuojian。zaiquanshenhualiaohuanjiedehuanerchuxianzuowanzhongdazhe，yingjinxinghuojianyiquedingshifouzuowanfufa。（si）jianbiezhenduan1.jixingsuixibaixuebinghelixibaorouliu：xingtaixueshangchengsuixibaoyuLBL delinbamuxibaonanyiqubie。danchengsuixibaoxingtaijiaobuyizhi，xibaozhijiaoduo，baozhineikejianhongranbangzhuang Auer shixiaoti。mianyibiaoxing MPO、CD13、CD14、CD15 he CD64 chengyangxingfanying；TdT yiji T huo B linbaxibaobiaozhiweiyinxing。2.Burkitt's linbaliu：xingtaixueshangerzheyouxiangsizhichu，junweizhongdengdaxiaodedanxingxingzhongliuxibaogoucheng，dukechuxian"xingkongxianxiang"。danLBL oujianzaoxing"xingkongxianxiang"，er Burkitt's linbaliu"xingkongxianxiang"changchangguanchuanyuzhenggeliuzuzhi。liuxibaobiaoda sIgM、CD10、EBER1/2 yuanweizajiaoyangxing。xibaoyichuanxuexianshiyoutezhengxing t（8;14）（q23;q21)huo c-myc jiyinzhongpai。3.feilinbazaoxuexitongxiaoxibaoxingexingzhongliu：zhuyaobaokuoyouwenshirouliu、yuanshishenjingwaipeiyezhongliu、shenjingmuxibaoliu、xiaoxibaoweifenhuaaideng。youqishifashengyulinbajiewaidexiaoyuanxibaozhongliu，youyuqimuxibaohuatezheng，qieertongyiweihaofanianlingzu，yincidang CD99（+），er LCA、CD3、CD20 junyinxingshiyiwuzhenweicileijibing。kexuanyongduozhongkangyuan，baokuoshenjingneifenmibiaojiwu（CgA、Syn）dengkezijianbie。4.xiongxianliu：yibanweiyuqianshangzongge，jishaofashengyuertongjiqingshaonian。congbinglishangliangzhejunbiaoxianweilinbaxibaomimanxingshengchang，TdT junchengyangxing。xiongxianliuliuzuzhichengfenyezhuang，jianmingxiandexianweibaomojicudadexianweijiange；sanzaidedifenzizhiliangjiaodanbai（CK）yangxingxibaoguanchuanyuzhenggeliuzuzhi。er LBL zhong，youyuliuxibaodejinrunxingshengchang，zaicancundexiongxianzuzhizhongkechuxianshaoliangzaoxingfenbude CK yangxingxibao。5.jitailiu：zonggeneikenengfashengliangxingheexingjitailiu，yeduofashengyuqianzongge，zhongliuneihanyougaomidudewuzhirugaihuaruangu、gu、chidengzuzhishi，X xianjianchachangkequedingzhenduan；xuezhongjiataidanbaizenggaozheduoweiexing。6.qitazonggezhongliu：rushenjingyuanxingzhongliu、xianweiliu、zhifangliu、linbaguanliudeng，junxutongguolinchuangbiaoxian、zhongliuzaizonggezhongdeweizhi、yingxiangxuetedianjibinglijianchajinxingjianbie。（wu）linchuangzhiliaofanyingpinggubiaozhun、pinggushijiandianjineirong1. pinggubiaozhun（1）liuzaohuanjieqingkuang①wanquanhuanjie（CR）：tongguochatiheyingxiangxuejianchazhengshisuoyouliuzaoquanbuxiaoshi。CT xianshiyuanzhongdadelinbajiehezhongkuaiyisuoxiaozhizhengchangfanwei（zuidajingxian＜ 1.5 cm），geqiguanyingxiangxuekejiandaodesuoyouliuzaojunyixiaoshi。PET saomiaoyiwuyangxingfaxian。gusuitupian/huojianzhengchang；liushixibaoshujinxing MRD jianceweiyinxing。②weiquedingdewanquanhuanjie（Unconfirmed complete response）：suiranbingzaozuidajing＞1.5cm，danzongtishangbingzaosuoxiao＞75%（xianghuchuizhiliangtiaozuidahengjing）。congyingxiangxueshangwufaquedingshifouweicanliudezhongliuxingbingzao，yingxingbinglihuojianqueding，eryoudebingzaoyoukenengbushiyushoushuhuojianqueding。③bufenhuanjie (PR)：liuzaozuidajingxiansuoxiao≥ 50% ，meiyouxinfaliuzao。④wufanying(NR)(jibingwending)：pingguxianshimeiyoudadao PR， danyemeiyouxinfaliuzao。⑤jibingjinzhan (PD)：renheliuzaozengda≥ 25% huochuxianxinfaliuzaohuogusuifufa。（2）fenzishengwuxuehuanjie（MCR）：jiancefenzishengwuxuebiaoji，lirutongguo PCR fangfajiancegusuironghejiyincongyangxingzhuanweiyinxing。（3）fenzishengwuxuefufa（huoyinzhuanyang）：ruyoufenzishengwuxuebiaoji，zhiliaohouzhuanweiyinxingdejiyinhuoqitaronghejiyinzaicijianceweiyangxing。2.hualiaoqijianpinggushijiandian（1）qiangdesongyuzhiliao d8：pingguwaizhouxueyouzhixibaoshujizhuyaoliuzao；（2）VDLPfanganyoudaozhiliao d15jinzuogusuichangguiji MRDpinggu；（3）VDLP fanganyoudaozhiliao d33；（4）CAM2 fanganhualiaohou：chengweizhongqipinggu；（5）yanchiqianghuaⅠkaishiqian；（6）yanchiqianghuaⅡkaishiqian；（7）weichizhiliaoqijian：weichizhiliaokaishishi：baokuozhongjianweichijidaweichikaishiqian；weichizhiliaoqiansigexunhuanmei 8 zhoupingguyici（baokuogusuijianchajiliuzaopinggu），yihoumei 8 zhouxiaopingguyici（jiandanyingxiangxuejiancha，wuguchuanheyaochuan），mei 16 zhoudapinggu 1 ci（baokuonaojiyehegusuijiancha）。3.hualiaoguochengzhongpingguneirong（1）qiangdesongyuzhiliao d8：jinxingwaizhouxueyouzhixibaopinggujizhuyaoliuzaopinggu，yizuozhuyaoliuzaode B chaojianchaweizhu，zongzuozhanweikexingCT jiancha，bingxingzhongliujingxianceliang，zhongliuhuisuodayu 25%、waizhouxueyouzhixibaoxiaoyu 1000/mm3weiduiqiangdesongmingan；（2）VDLP fangan d15：yougusuiqinfandebingrenfuchagusuixingtai，bingtongguoliushixibaoyijiancegusui MRD；（3）qitashijiandianpinggu：baokuo①gusuihuanjieqingkuang：gusuixingtaiheliushixibaoyijiancegusui MRD；gusuironghejiyinyangxingzhexufuchagusuijiyinzhuanyin。②liuzaoqingkuang：liuzaobuweixiangguanyingxiangxuejiancha。si、linchuangweixiandufencengLBL weixiandufencengshangwutongyibiaozhun，yuanzeshangshizonghelinchuangfenqi、zhongliuxibaoyichuanxuetezhengyijizhiliaofanyingdengjiayiqueding。zaizhiliaozaoqixugenjuweixianyinsu，quedingweixiandufenzuweidiweizu、zhongweizu、gaoweizu。（yi）diweizuanzhaoxiudingdeguojiertong NHL fenqixitong，bujuyougaoweiyinsudeⅠ、Ⅱqibingren（cunzaizaoqizhongliuzifarongjiehuojudaliukuaideⅡqibingrenchuwai）。（er）zhongweizubujuyougaoweiyinsudeⅢ、Ⅳqibingren。（san）gaoweizuxutongguoliuzao、gusui、waizhouxuepingguliaojiezhiliaofanying。1.qiangdesongyuzhiliao d8，waizhouxueyouzhixibaodayu 1000/mm3。2.youdaozhiliao d15 gusuiyouzhixibao＞25%。3.youdaozhiliao d33 zhongliucancun＞25%huogusuiyouzhixibao＞5%；gusui MRD≥10-2；naojiyezhongchixucunzaiyouzhixibao（zhisanciqiaozhuhounaojiyezhongrengyouzhongliuxibao）。qizhongrenyixiang。4.gongguzhiliaoqian（CAM2 hualiaohou）pinggurengyoucanliubingzaozhejinliangxinghuojian，rengweizhongliuzuzhi（ruguomeiyoutiaojianzuoercihuojiankeshitiaojianxing PET／CT xiezhujianbie）；gusui MRD≥10-3。qizhongrenyixiang。5.juyoubuliangyichuanxuetezheng：t(9;22)huo BCR/ABL，t(4;11)huoMLL/AF4jiqitaMLLjiyinzhongpai、PhyangALLxiangguanjiyinruIKZF1、CRLF2、JAK2 deng。wu、zhiliao（yi）xitonghualiao1.hualiaoyuanze：jiyu LBL shengwuxuetexingleisiyu ALL，jinnianlaiguojishangcaiyongleisi ALL dehualiaofanganhouxianzhugaishanliaoyuhou，bijiaoguojijingdianfangan，yi BFM90 liaoxiaozuijia，benjianyitigongdezhiliaofanganshiyi BFM90 weijichudegailiangfangan，geyiyuankegenjugeziqingkuangxuanzeyingyong。yunxuduisuocaiyongdefanganjinxingweidiao，quyuzhongxinhuodadeyiliaozhongxinkezaiyuanzebubiandejichushangtichuhelixiugai。2.hualiaoqianzhunbei（1）quezhenjiancha：jinkenengzaizuirongyiqucaidebuweiqudebiaobenxunzhaozhongliuxibao，baokuo：gusui、xiongfushui、qianbiaolinbajie、pifukeyiliuzao、shenbulinbajiechuancihuohuojian、xiongfuqiangliuzaochuancihuoshoushuquhuojian。ranhouwanshanzhongliuxibaode MICM fenxing；wanchengzhongxinbinglihuizhen（zhishaoliangjiasanjiayiyuanbinglizhuanjiahuizhen）。（2）jianyixionggujizuogulianggebuweigusuichuancihuohuojian：yingxinggusuixibaoxingtaixue、liushixibaomianyibiaoxingfenxi、xibaoyichuanxuehejiyinjiancha。（3）changguijiancha：baokuoquanxuexibaofenxi、baixibaofenlei、ganshengongneng、xueqingrusuantuoqingmei、xiongfushuijiqitatiyedexibaoxuejianchadeng。（4）naojiyejiancha：xibaolixinfazhaoliuxibao、liushifangfajianceweiliangxibao。（5）yingxiangxuejianchajinxingfenqi：xingkeyilinbajiejifubu B chao、keyishouqinbuweideguzuopian、CT dengyingxiangxuejianchayibianliaojiebingbianfanwei。huaiyizhongshushenjingxitongbingbianshikexingnaojijisuicigongzhen（MRI）jiancha。youtiaojiandexing PET/CT jiancha。（6）hualiaoqianjiancha：liaojiezangqigongneng、mianyizhuangkuang、bingduganran、chuanranbingdengzhuangkuang。3.changguihualiao：yi BFM90 weijichudezhiliaofanganbaokuo VDLP+CAMyoudaohuanjiezhiliao、4 liaocheng HD-MTX（jiaandiezuo）huo 6 liaochenggaoweifangandehuanjiehougongguzhiliao、VDLD+CAM yanchiqianghuazhiliao、6-MP+MTXdeweichizhiliaodenghuanjie。butongyu ALL，LBL zhongⅠ、ⅡqihuanzhewuyanchiqianghuaⅡzhiliao，yanchiqianghuaⅠzhiliaohouzhijiejinruweichizhiliao。yuqitaleixing NHL butong，LBL zaidadaowanquanhuanjiehou，huanxujinxingweichizhiliao，qimudeshiyoudaozhongliuxibaofenhua、diaowang，dadaochediqingchucanliubingzaodemude。zongliaochengyuewei 24 geyue。zhiliaoguochengzhongxudingqijinxingpinggu，baokuogusuichanggui、gusui MRD dejiancejiliuzaodepinggu，liaojiehuanjiezhuangtai，jishidiaozhengzhiliaofangan。4.zhongshushenjingxitongjinrundeyufangjizhiliao：yuanzeshangquchuliaolunaofangliao（baokuo CNS3 bingren），yijiaqianghualiao、zengjiaqiaozhujiaqiang CNS qinfandeyufanghezhiliao。（1）CNS1 dezhiliao：suoyoubingrenjunjieshouyufangxingsanlianqiaozhuji 4liaochengdajiliang MTX hualiao，qizhong T-LBL 5 g/m2；B-LBL 3 g/m2。zhenggehualiaoguochengzhong，B-LBL zhishao IT 20 ci，T-LBL 22 ci。（2）CNS2 dezhiliao：zaiyoudaohuanjie VDLP fanganzhong（di 8、22tian）zengjia 2 cisanlianqiaozhu，jimeizhouyici，gong 5 ci。quanchenggong 22～24 ci。（3）CNS3 dezhiliao：zaiyoudaohuanjie VDLP fanganzhong（di 8、22tian）zengjia2cisanlianqiaozhu，jimeizhou1ci，gong5ci。yanchiqianghuaⅠ VDLD（di 1、15 tian）zengjia 2 ciqiaozhu。quanchenggong 26～30 ci。（4）weichizhiliaoqijiande CNS zhiliao：CNS2（baokuozhongshulinjinbuweiqinfanzhe）、CNS3 bingrenweichizhiliaoqijianzengjialiangciqiaozhu。T-LBLweichizhiliaoqijianmei 4 zhouqiaozhu 1 ci，gong 12 ci；B-LBL mei 8 zhouqiaozhu1 ci，gong 8 ci。zhu：annianlingsanlianqiaozhujiliang（jianfubiao 3）。5.zuowanjinrundezhiliaoyuanze（1）dangzhenduanshicunzaizuowanwutongxingzhongdadengdianxingzuowanjinrundezhengzhuangshi，buyidingbixuxinghuojian，ketongguo B chaoquezhen。ruojingguoyoudaojigongguzhiliaohouzuowanzhongwuxiaoshi，B chaojianchazuowanshizhihuishenghuifuzhengchangkebufangliao。（2）ruojingguoyoudaojigongguzhiliaohourengyouchixucunzaidezuowanzhongwu，xuxinghuojian。jingbinglizhengshirengcunzaizuowanjinrunzhe，yugongguzhiliaoM houxuxingshuangcezuowanfangliao，jiliangwei 18-24Gy。（er）hualiaofangan1.chushiyoudaohualiaofangan：VDLP fangan+liangliaocheng CAM fangan。（1）VDLP fanganyoudaozhiliao：changchunxinjian（VCR）1.5 mg/(m2·d)，meizhou 1 ci，gong 4 ci，meicizuidajueduiliangbuchaoguo 2 mg，d8、d15、d22、d29，gong 4 ci；rouhongmeisu（DNR）25 mg/(m2·d)，jingmaidizhu 6 xiaoshiru，meizhou 1 ci，d8、d15、d22、d29，gong 4 ci；zuoxuanmendongzuoanmei（L-Asp）5000 u/(m2·d)，d8、d11、d14、d17、d20、d23、d26、d29，Q2d，gong 8 ci，jirouzhushe；ruo L- ASP guominkeyupeimendongmei（PEG-ASP）2500 IU/m2，jirouzhushe，d9，d23，gong 2 ji；ponisong（PDN）60 mg/(m2·d)，d1～d28，koufu，di 29～35 tiandijianzhiting。PDN duiyuzhongliufuhedadehuanzheqishijiliang[(0.2～ 0.5mg/(kg·d)]kaishiyizhouneizhujianzengzhi 60mg/(m2·d)，yimianfashengzhongliurongjiezonghezheng。danlian MTX qiaozhu，d1；sanlianqiaozhu（TIT），CNS1：d15、d33；CNS2、CNS3：d8、d15、d22、d33。（2）CAM fangan：ruohuanerwufare、wuyanzhongganran；ANC≥0.5×109/L，PLT≥50×109/L shi，keyu d36 kaishidiyilun CAM fangan。gong 2 geliaocheng CAM fangan，jutiyaowujianxia：huanlinzuoan（CTX）1000 mg/(m2·d)，1 ci，d1，shuihuajianhua 3 tian；meisina 400mg/(m2·ci)，yujingmaidizhu CTX de 0h、4h、8h，d1；atangbaozuo（Ara-C）75 mg/(m2·d) ，d3～d6，d10～d13,gong 8 tian；6-zuojizuozuo（6-MP）60 mg/(m2·d)，gong 14 tian。sanlianqiaozhu，d10。xiuliao 1-2 zhou；ANC≥0.5×109/L，PLT≥50×109/L；wufarejiyanzhongganran；kaishidi 2 lun CAM。2.huanjiehougongguzhiliao（1）diweizuhezhongweizugongguzhiliao M fangan：CAM2 jieshuhou 1-2 zhou，wufare、wuyanzhongganran；jizuoqingchulvzhizhengchang；gangongneng ALT/AST≤10 beizhengchangshangxianzhi；danhongsu≤3 beizhengchangshangxianzhi，ANC≥0.5×109/L，PLT≥50×109/L shikeyikaishigongguzhiliaofangan M。CAM2 houxuexianghuishengjifuchaguchuan，bingxingliuzaopinggu，weijianmingquecanliubingzao，keyikaishi M fanganhualiao。jutiyaowuruxia：dajiliangjiaanzuozuo（MTX）3～5 g/(m2·d),meiliangzhou 1 ci，gong 4 ci[T-LBL:5 g/(m2·ci)；B-LBL:3g/(m2·ci)]，d8、d22、d36、d50；siqingyesuangai（CF）15 mg/m2，6 xiaoshi 1 ci，3～8 ci，genju MTX xueyaonongdugeiyudiaozheng。6-MP 25 mg/(m2· d)，buchaoguo 56 tian，genju WBC diaozhengjiliang。sanlianqiaozhu：d8、d22、d36、d50。yingyongdajiliang MTX qijianxuyaojinxingshuihua、jianhua，bingjiance MTXxueyaonongdu。45 xiaoshicha MTX nongduxiaoyu 0.25μmol/L weizhengchang。ruoMTX gaoyuzhengchang，genjunongdudiaozheng CF yonglianghecishu（jianfubiao 4）。（2）gaoweizugongguzhiliaofangan：CAM2 houxuexianghuishengjifuchaguchuan，bingxingliuzaopinggu，anzhaoweixiandufenzujinrugaoweizubingrenkeyijinrugongguzhiliaogaowei（HR）fanganhualiao。CAM2 jieshuhou 1～2 zhou，wufare、wuyanzhongganran；jizuoqingchulvzhizhengchang；gangongneng ALT/AST≤10 beizhengchangshangxianzhi；danhongsu≤3beizhengchangshangxianzhi；ANC≥1×109/L，PLT≥100×109/L shikeyikaishi HR fangan，shuncibaokuo HR-1、HR-2、HR-3 fangan。① HR-1 fangan：DXM 20mg/(m2·d)，koufuhuojingmaituizhu，d1～d5；VCR 1.5 mg/m2/ci（zuida 2 mg），jingmaituizhu，d1，d6；HD-MTX 5 g/(m2·ci)，jingmaidizhu，d1；CF 15 mg/(m2·ci)，6 xiaoshi 1 ci，3～8 ci，genju MTX xueyaonongdudiaozheng；CTX 200 mg/(m2·ci)，12 xiaoshi 1 ci，jingmaidizhu，d2～d4，gong 5 ci，HD-MTX jieshuhou 7h kaishiyu；meisina 70 mg/(m2·ci)，yujingmaidizhu CTX de 0h、4h、8h；Ara-c 2000 mg/(m2·ci)， 12 xiaoshi 1 ci，d5，gong 2 ci；L-ASP 25000 u/(m2·d)jingmaidizhu 2 xiaoshiyishang，d6、d11；ruguo L-ASP guomin PEG-ASP 2500 u/(m2·ci)，jirouzhushe，d6；TIT d1。② HR-2 fangan：DXM 20 mg/(m2·d)，koufuhuojingmaituizhu，d1～d5；changchundixin（VDS）3 mg/(m2·ci)，jingmaituizhu，d1，d6；HD-MTX 5 g/m2/ci，jingmaidizhu，d1；CF 15mg/(m2·ci)，6 xiaoshi 1 ci，3～8 ci，genju MTX xueyaonongdudiaozheng；yihuanlinzuoan（IFO）800 mg/(m2·ci)，jingmaidizhu，12 xiaoshi 1 ci，d2～d4，gong 5 ci，HD-MTX jieshuhou 7h kaishiyu；meisina 300 mg/(m2·ci)，jingmaidizhu，IFO 0h、4h、8h；DNR 30 mg/(m2·ci)，jingmaidizhu，d5；L-ASP 25000 u/(m2·ci)，jingmaidizhu 2 xiaoshiyishang，d6、d11；ruguo L-ASP guomin PEG-ASP 2500 u /(m2·ci)，jirouzhushe，d6；TIT d1。③ HR-3 fangan：DXM 20 mg/(m2· d)，koufuhuojingmaituizhu，d1～d5；Ara-c 2000 mg/(m2·ci)，jingmaidizhu，12 xiaoshi 1 ci，d1～d2；yituobozuo（VP-16）100 mg/(m2·ci)，jingmaidizhu，12 xiaoshi 1 ci，gong 5 ci，d3～d5；L-ASP 25000 u/(m2·ci)，jingmaidizhu 2 xiaoshiyishang，d6、d11；ruguo L-ASP guomin PEG-ASP 2500 u/(m2·ci)，jirouzhushe，d6；TIT d5。3 liaocheng HR fanganhouxinggusuiheliuzaopinggu，CR debingrenzhihouzaizhongfu HR-1、HR-2、HR-3 fangan，jiyu MTX nongdujiancedesiqingyesuanjiejiujianfujian 3。ruguoyouliuzaojinzhanhuochuxianxinfaliuzaoxuchuzu，gaiyongerxianfanganzhiliao。3.yanchiqianghua I zhiliao（1）VDLD fangan：danggonggufanganjieshuhouyue 2 zhou，wufare、wuyanzhongganran；ANC≥1×109/L，PLT≥100×109/L shikekaishicifanganhualiao。benliaochenghualiaoqianfuchagusui，bingxingliuzaopinggu。jutiyaowuruxia：VCR 1.5 mg/(m2· d)，meizhou 1 ci，diweizuhezhongweizugong 3ci，D1、8、15；gaoweizugong 4 ci，d1、d8、d15、d22，meicizuidajueduiliangbuchaoguo 2 mg；DNR huoameisu（ADR）25 mg/(m2· d)，meizhou 1 ci，diweizuhezhongweizugong 3 ci，d1、d8、d15；gaoweizugong 4 ci，d1、d8、d15、d22；L-asp 10000 u/(m2·d)，jirouzhushe，Q2d，d1、d4、d7、d10，gong 4 ci；L-ASP guominkeyupeimendongmei（PEG-ASP）2500 IU/(m2· ci)，jirouzhushe，d4，gong 1 ji。DXM 8～10mg/(m2· d)，d1～d7，d15～d21；sanlianqiaozhu：d1、d15（jin CNS3 zhezengjia 2 ci IT）。(2)CAM fangan: xiuliao 1～2 zhou；ANC≥1×109/L，PLT≥100×109/L；wufarejiyanzhongganran；jizuozhizhengchang；kaishi CAM fanganhualiao。jutiyaowuruxia：huanlinzuoan（CTX）1000 mg/(m2· d)，1 ci，d1，shuihuajianhua 3 tian；meisina 400 mg/(m2·ci)，yujingmaidizhu CTX de 0h、4h、8h，d1；atangbaozuo（Ara-C）75 mg/(m2· d)，d3～d6，d10～d13,gong 8 tian；6-zuojizuozuo（6-MP）60 mg/(m2· d)，gong 14 tian。sanlianqiaozhu，d3。xiuliaoyue 2 zhou，wufarejiyanzhongganran；ANC≥0.2×109/L，PLT≥50×109/L；kekaishiweichizhiliao。4.zhongjianweichizhiliao。zhongweizubingrenwanchengyanchiqianghuaＩhoujinru 8zhouzhongjianweichizhiliao（jiyong 8 zhou 6-MP+MTX/VD fangan，jutifanganwei：6-MP 50 mg/(m2·d)，chixushuiqiankongfukoufugong 8zhou；MTX 20 mg/m2，meizhou 1 ci，gong 8 ci，koufuhuojirouzhushe，genju WBC diaozhengfanganzhong6-MP dejiliang。VCR 1.5 mg/(m2· d)，1 ci，d1，meicizuidajueduiliangbuchaoguo 2 mg；DXM 6mg/(m2· d)，d1～d5。sanlianqiaozhu，d1。5.yanchiqianghuaⅡzhiliao（1）VDLD fangan：zhongweizubingrenwanchengzhongjianweichizhiliaohoufuchagusui，bingxingliuzaopinggu，chuyuwanquanhuanjiezhuangtai，jinruyanchiqianghuaⅡzhiliao。danghuanerwufare、wuyanzhongganran；ANC≥1×109/L，PLT≥100×109/L shikekaishicifanganhualiao。jutiyaowuruxia：VCR 1.5 mg/(m2· d)，meizhou 1 ci，gong 3 ci，d1、d8、d15，meicizuidajueduiliangbuchaoguo 2 mg；DNR huoameisu（ADR）25 mg/(m2· d)，meizhou 1 ci，gong 3ci，d1、d8、d15；L-asp 10000 u/(m2· d)，jirouzhushe，Q2d，d1、d4、d7、d10，gong 4 ci；L-ASP guominkeyupeimendongmei（PEG-ASP）2500 IU/m2，jirouzhushe，d4，gong 1 ji。DXM 8-10mg/(m2· d)，d1～d7，d15～d21；sanlianqiaozhu：d1。(2)CAM fangan: xiuliao 1～2 zhou；ANC≥1×109/L，PLT≥100×109/L；wufarejiyanzhongganran；jizuozhizhengchang；kaishi CAM fanganhualiao。jutiyaowuruxia：huanlinzuoan（CTX）1000 mg/(m2· d)，1 ci，d1，shuihuajianhua 3 tian；meisina 400dmg/(m2· ci)，yujingmaidizhu CTX de 0h、4h、8h，d1；atangbaozuo（Ara-C）75 mg/(m2· d) ，d3～d6，d10～d13,gong 8 tian；6-zuojizuozuo（6-MP）60 mg/(m2· d) ，gong 14 tian。sanlianqiaozhu，d3。6.weichizhiliaofangan：diweizuhegaoweizubingrenwanchengyanchiqianghuaＩhoujinruweichizhiliaojieduan。ji 6-MP+MTX fanganqijianmei 4 zhoucharu VDfanganyici。kaishiweichizhiliaoshixingliuzaopinggu，weichizhiliaoqiansigexunhuanmei 8zhoupingguyici（baokuogusuijiancha），yihoumei 8 zhouxiaopingguyici（jiandanyingxiangxuejiancha，wuguchuan、yaochuan），mei 16 zhoudapinggu 1 ci（baokuonaojiyehegusuijiancha）。（1）6-MP+MTX fangan：6-MP 50 mg/(m2· d)，chixushuiqiankongfukoufu；MTX 20 mg/m2，meizhou 1 ci，koufuhuojirouzhushegenju WBC diaozhengfanganzhongdeyaowujiliang。（2）VD fangan：VCR 1.5 mg/(m2·d)，1 ci，meicizuidajueduiliangbuchaoguo 2 mg；DXM 6～8 mg/(m2· d)，d1～d5。- 24 -zongzhiliaoliaocheng： yue 2.5 nian。（san）LBL fufahoudezhiliaoceluedayue 10%～20%jinzhanqi LBL shunanzhihuofufabingli。huanjiehouyidanfufa，wangwangbingqingjiqixiongxian，xunsuquanshenduozangqizhuanyi，zaicihuanjiekunnan，yuhoujicha，shengcunlvjinwei 10%～30%。bujiuzhiliaozhuyaobaokuozaiciyoudaohezaoxueganxibaozhichideqianghuazhiliao。bujiudemubiaoshijinkuaidadaowendingdeercihuanjie（second complete remission， CR2），jinzaoxingzaoxueganxibaoyizhi（haematopoietic stem cell transplant，HSCT）。wanjiuhualiaochangyongdeerxianzhiliaodexibaoduleiyaowuyouyihuanlinzuoan、qujiayangrouhongmeisu、kabodeng。xianyoushujubiaomingfufa LBL weijing HSCT jihuwuzhiyudejihui，erxiangbizitiHSCT（autologous HSCT，auto-HSCT），yijiyin HSCT（allogenic-HSCT，allo-HSCT）suiyoujiaogaodezhiliaoxiangguansiwang，danjuyougenggaodewubingshengcunlv，auto-HSCT fufalvmingxiangaoyu allo-HSCT。1.T-LBL wanjiuzhiliao（1）nailabin（Nelarabine，Arranon）：shituoyangniaozuoleisiwu 9-b-D-atangzuozuotangniaozuozuo（ara-G）deqiantiyaowu，dui Tlinbamuxibaode DNA hechengjuyouxuanzexingyizhizuoyongerzhixibaosiwang。shiyizhongyouxiaode T xibaoteyixingxibaoduyaowu，yongyuzhiliaonanzhi、fufade T-LBL/ALL，takedanyaozhiliaohuoyuqitaxibaoduyaowulianyong。ertongyingyongjiliang 650 mg/(m2· d) ×5 d，21d yiliaocheng，Ⅰ/Ⅱqiertongjichengrenyanjiu，danyaofanyinglv 14%～55%。changjiandefuzuoyongweijiliangyilaixingshenjingduxing，biaoxian 2 jihuo 3 jiganjue、yundongshenjingbingbianhejirouguzuotengtong，youdebingrenbiaoxiantoutong、shishui、ganjuechidun、zuozuofazuo、gongjishidiaodeng，duoweikenixingde。qitafuzuoyongweixueyeduxing、exinoutudengxiaohuadaofanying。nailabinzhiliaofufa/nanzhi T-ALL/LBL zuichangyongdelianhehualiaoshihuanlinzuoanjiayituobozuo，Leah dengbaodao 5/7 CR，qizhong 4 lideyijinxing HSCT，danjin 1 licunhuo，qitabingrensiyujibingjinzhanhezhiliaoxiangguanhebingzheng。chuliaolianhehualiao，K Burley baodao 1 liyizhihoufufadeT-ALL caiyongnailabinjiagongzhexibaohuishudadaochixu CR。Annalisa dengtichukeyigenjubingrenjiyinbiaodapu，banailabinxuanzexingdilianhe PI3K、Bcl2、MEK yizhiji，yizengjiaqiliaoxiao。（2）daleimudankang（Daratumumab）：CD38 renyuanhuadankang，CD38kangyuanzaihualiaoqianhouhuozaifufahouT-ALL/LBLxibaoshangbiaodawending，kenengchengweilianghaodezhiliaobadian。bingkezuowei CAR-T xibaozhiliaodebadian，muqianjunzaitansuozhong。（3）qita：ru PI3K yizhiji、mTOR yizhijihuo PI3K-mTORshuangzhongyizhijilianhetangpizhijisuyongyugaowei PTEN queshidebingren；lusuolitini（ruxolitinib）：JAK/STAT tongluyizhiji，nenggoukefutangpizhijisunaiyaodengjunzaiyanjiuzhong。2.B-LBL wanjiuzhiliao（1）laoansuanjimeiyizhiji（TKI）：keyongyuzhiliaochuzhihefufade Ph+ALL / LBL，tongguobaxiangzuoyongyu BCR/ABL ronghejiyincongerfahuiliaoxiao。yimatinidanyaoyouxiaolvda 70%，lianhehualiao CR lvkeda90%。dierdaidashatiniheniluotinikeyongyuduiyimatininaiyaodebingren，juyoutouguoxuenaopingzhangdetexing，liaoxiaoyouyuyimatini。（2）CD19 teyixingqianhekangyuanshouti T xibao（CAR T xibao）：zhiliaofufa/nanzhi B-ALL/LBL CR lvdadao 70%～92%，liaoxiaoxianzhu，huanjiehoukeqiaojieyizhi，CAR-T xibaozhiliaodeduxingweixibaoyinzishifangzonghezhengheshenjingduxing。（3）qitarushuangteyixingkangti（Blinatumomab）、pengtizuomi（Bortezomib）deng，zhiliaofufa/nanzhiALL/LBLjunyouyidingliaoxiao。（si）zaoxueganxibaoyizhi1.duihualiaoguochengzhongduogepinggudianxianshiduihualiaobumingan，zhongqipingguyou mingquecan liubing zao；huo cunzaiyu houbu liangjiyin ：juyout(9;22)/BCR-ABL1、MLL zhongpaideng，keangaoweizufanganhualiao，wanchengsanliaochenggaoweifanganbaokuo HR-1、HR-2、HR-3 houxingyijiyinzaoxueganxibaoyizhi。2.duiyuyuanfaliuzaofufahuogusuifufahuozhiliaozhongjinzhandebingrentongguowanjiuzhiliaonenggoudadaowanquanhuanjiehuobufenhuanjiehuodeyizhijihuizhe，xujinkuaixingyijiyinzaoxueganxibaoyizhi。liu、hebingzhengdechuli（yi）duicunzaishangqiangjingmaiyapozonghezheng、qidaogengzudebingrendechuliyuanzedayue 10%T-LBL kenengchuxianyanzhongdeqidaogengzu（banhuobubanshangqiangjingmaiyapozonghezheng），weizhenzhengzhongliujizheng。1.duicileibingrenshangweijingbingliquezhenzhe，jinjiyingyongquanshenmazuishoushuhuojian。2.kexianyuxiaohualiao（ruponisong 60 mg/m2koufuhuo VP fangan）huanjiehuxikunnan，yuyongyaohou 24～48 xiaoshineizhengzhuangkongzhihoujinzaoxingbinglijiancha，bingyingxuanzeqinxixingzuixiaodecaozuoquezhen，keyikaolvqucaishunxuwei：gusui、xiongfushui、qianbiaolinbajie、pifuhuoqitaqianbiaokeyiliuzao、shenbulinbajiehuozhongwuchuancihuojian、liuzaoshoushuquhuojian。hualiaoqianxuqianshuweiquezhenhualiaoxieyishu，gaozhijiachanghualiaokenengyingxiangbinglijieguoerwufaquezhen。3.duibanyoushangqiangjingmaiyapozonghezhengdebingrenyingbimianshangzhishuye。（er）zhongliurongjiezonghezhengdechulicunzaigaozhongliufuhede、hualiaoqianyiyougaoniaosuanxuezheng、shengongnengsunhai、shaoniaoshuizhongdebingrenweifashengzhongliurongjiezonghezhengdegaoweirenqun，xucaiqujijideyufanghezhiliaocuoshi。1.yanmijiancegexiangshengmingtizheng、churuliang、tizhong、xuedianjiezhi、ganshengongneng。2.yingyongbiezuochunjianshaoniaosuanshengcheng：10mg/(kg· d)[300mg/(m2· d)]，fen2～3cikoufu。biyaoshiyingyongniaosuanyanghuamei0.1～0.15 mg/(kg·ci)kexunsujiangdiniaosuanshuiping。3.jijishuihualiniao：3000 ml/(m2· d)[125 ml/(m2· h)]，yong1/4～1/3zhangyeti，yibanbuyonghanjiaye。geiyusuniao0.5～1mg/(kg·ci)，Q12hliniao，baozhengchurupingheng，weichiniaoliangdayuezai125 ml/(m2· h)。buchongzugouyeti，kebubijianhua，yifangjianhuatiaojianxialinsuanyanhehuangzuozuozaishenxiaoguanchenjijinyibujiazhongshensunshang。（san）duiyoushenjingxitongqinfanhuoyapodebingrenchuliyuanzejinkuaiwanshanjiancha，jinzaohualiao，yifangnao、jisuihuozhouweishenjingyapohuoqinfanguojiu，zaochengshenjingxitonggongnenghuifuyanchishenzhibukenidesunshang。bingan CNS2、CNS3 geiyuqiaozhu。qi、zhiliaozhongqitazhuyishixiang（yi）hualiaohoujiancexuechanggui，ANC ＜0.5×109/L，PLT＜100×109/L，kepixiazhushelixibaocijiyinzi（G-CSF）5μg/(kg·d)zhiANC＞1×109/Ltingyong。（er）hualiaoyaowudufufanyingdepandingbiaozhunan NCI buliangfanyingdefenjibiaozhun（CTCAE version 4.0，2009)jiance，hualiaoqianhoujunxuzhuyijiancexindiantu、chaoshengxindongtu、ganshengong、niaochanggui、xuedianfenmei、ningxuegongnengdengjiayiyufang。（san）yufangkashifeinangchongfeiyanchangguikoufufufanghuanganyizuo[25 mg/(kg· d)，meitian 2 ci]，meizhoufu 3 tianting 4tian，hualiaokaishizhidaohualiaojieshuhou 3geyue。HD-MTXyongqian 24 xiaoshidaoyong MTX houzhishao 72 xiaoshitingyongfufanghuanganyizuo。ba、tingyaohousuizhenshijianjipingguneirong（yi）shoucipinggu(tingyao 3 geyue)fuchagusuichanggui、jiyinhe MRD；liuzaopinggubaokuo B chao、CT deng，zuihaozuo PET/CT；fuchamianyigongnengjixindiantu、xinzangcaichao；fuchaganshengong、LDH。（er）tingyaodi 1、2 nianmei 3 geyue 1 cijiandanpinggu，baokuoguchuanheliuzaodeyingxiangxuejiancha（B chaohe CT pingsao）jigangonghe LDH。mei 6 geyue 1 cidapinggu，baokuoguchuanheliuzaopinggu：xiangguan B chao、zengqiang CT jianchahuo MR、mianyigongneng、gangonghe LDH deng。（san）tingyaodi 3 nianyihoumeibannianpinggu 1 ci，zhuyaozuoguchuanheliuzaodeyingxiangxue（B chaoheCT pingsao）jigangonghe LDH。shiqingkuangjiazuoneifenmijisujizhishangdengjiancha。jiu、zhuanzhentiaojian（yi）dangdiyiyuanmeiyouzhenliaotiaojian、meiyouzhiliaojingyandexujiangbingrenzhuanzhenzhiyouzhiliaotiaojiandeshangjiyiyuanyibaozhengliaoxiao。（er）juyougaozhongliufuhehuozhongliuhebingzhengdeweizhongbingrenxuzhuanzhenzhiyoujingyandeshangjiyiyuanyiwanjiushengming。（san）jingshangjiyiyuanzhiliaohouwending、dadaowanquanhuanjiedebingrenkezhuanzhenzhiyouzhiliaotiaojiandexiayijiyiyuanjixuzhiliao，liruweichizhiliaodebingren。qijianjianyidingqihuishangjiyiyuanjinxingliuzaopinggu。ruweichiqijianfashengyanzhongdehebingzheng，ruyanzhongganran，kezhuanhuishangjiyiyuanjinxingqiangjiu。fu ertonglinbamuxibaolinbaliuzhenliaoguifan（2019 nianban）bianxieshendingzhuanjiazu（anxingshibihuapaixu）zuchang：wangtianyouchengyuan：wangtianyou、sunxiaofei、zhangyonghong、tangjingyan、jinling、yangzuo、duanyanlong、zhouchunju、gaozifen、dixiaowen
心(齿颈苍)中(窜丑辞苍驳)温(奥别苍)暖(狈耻补苍)的(顿别)人(搁别苍)看(碍补苍)不(叠耻)得(顿别)这(窜丑别)种(窜丑辞苍驳)人(搁别苍)间(闯颈补苍)疾(闯颈)苦(碍耻)，孩(贬补颈)子(窜颈)有(驰辞耻)什(厂丑颈)么(惭别)错(颁耻辞)？错(颁耻辞)的(顿别)是(厂丑颈)那(狈补)些(齿颈别)没(惭别颈)长(颁丑补苍驳)大(顿补)的(顿别)大(顿补)人(搁别苍)，那(狈补)些(齿颈别)势(厂丑颈)利(尝颈)眼(驰补苍)的(顿别)人(搁别苍)们(惭别苍)。
驳耻补苍测耻辩颈苍驳蝉别诲别补颈辩颈苍驳，迟补蝉丑耻辞：锄丑颈蝉丑颈蝉丑别苍蝉丑补苍驳产别颈锄丑耻辞诲别产补辞，产耻锄丑颈飞别颈丑别迟耻谤补苍测辞耻虫颈别肠丑别苍锄丑辞苍驳。
动(Dong)力(Li)及(Ji)续(Xu)航(Hang)方(Fang)面(Mian)，翼(Yi)真(Zhen)L380入(Ru)门(Men)版(Ban)车(Che)型(Xing)，配(Pei)置(Zhi)了(Liao)前(Qian)置(Zhi)单(Dan)电(Dian)机(Ji)，最(Zui)大(Da)功(Gong)率(Lv)200kW，最(Zui)大(Da)扭(Niu)矩(Ju)343N·m，搭(Da)载(Zai)吉(Ji)利(Li)时(Shi)代(Dai)的(De)三(San)元(Yuan)锂(Zuo)电(Dian)池(Chi)，最(Zui)大(Da)续(Xu)航(Hang)570km。而(Er)，腾(Teng)势(Shi)D9 EV入(Ru)门(Men)版(Ban)车(Che)型(Xing)也(Ye)同(Tong)样(Yang)配(Pei)置(Zhi)了(Liao)前(Qian)置(Zhi)单(Dan)电(Dian)机(Ji)，最(Zui)大(Da)功(Gong)率(Lv)230kW，最(Zui)大(Da)扭(Niu)矩(Ju)360N·m，搭(Da)载(Zai)的(De)则(Ze)是(Shi)比(Bi)亚(Ya)迪(Di)的(De)磷(Lin)酸(Suan)铁(Tie)锂(Zuo)刀(Dao)片(Pian)电(Dian)池(Chi)，最(Zui)大(Da)续(Xu)航(Hang)可(Ke)达(Da)620km。
四号门：附近有海洋公园，带娃家长推荐前往。所以艾淑义为了妻子的安全，就坚决不要孩子。【快穿】 J液收集系统_星光杳杳_长篇_实时更新...
方芸跟张子健前几十年的人生轨迹完全不同