- ISSN 1008-5734
- CN 11-4015/R
- 1999年创刊
- 主管: 中国科学技术协会
- 主办: 中华医学会
ObjectiveTo evaluate the operating quality of adverse events following immunization (AEFI) surveillance system and analyze the reported cases in Beijing during 2011 in order to provide the basis for further improvement of monitoring AEFI. Methods The data of individual cases of AEFI in Beijing during 2011 were collected through the AEFI information system of China, analyzed by descriptive epidemiological methods and evaluated according to the AEFI monitoring index. The diagnostic quality of cases of AEFI was investigated by quantitative questionnaire and qualitative group interview. ResultsEight hundred and sixty cases of AEFI were reported in Beijing during 2011. The reporting rate was 9.60 per 100 000 doses. Six of seven state indicators (report coverage rate in districts, reporting rate within 48 hours, investigation rate, input rate of questionnaire within 3 days, upload rate of investigation report within 7 days, and classification rate) were up to the standard of AEFI system except the integrality rate of key project in questionnaire. CDC of Beijing and districts held a total of 27 AEFI expert meetings during 2011. Ninety-five cases of AEFI were discussed and, among them, rare adverse reactions were 55, serious rare adverse reactions were 8, and 7 cases were excluded due to abnormal reactions. There were some differences in working condition among expert groups in different districts. Of 860 cases of AEFI, common adverse reactions were 526 (61.2%), abnormal reactions were 209 (24.3%), coincidental events were 117 (13.6%), psychogenic reactions were 8 (0.9%). The main biological products associated with AEFI were diphtheria, tetanus and acellular pertussis combined vaccine adsorbed (DPT) and measles and rubella combined vaccine, live. The main clinical presentations of AEFI were allergic rash (79.5%) and angioneurotic edema (90%). Allergic rash was mainly caused by measles rubella combined vaccine (37.7%). No accidents of vaccine quality and vaccination were reported. ConclusionThe operating quality of AEFI surveillance system in Beijing during 2011 is at higher level. However, the standardized management of AEFI expert group should be improved. The incidence of rare adverse reactions due to measles and rubella combined vaccine, live is higher, the further investigation and analysis should be performed.
ObjectiveTo study the effect of cytochrome C on accumulation of etimicin in rat kidney and its renal tubular toxicity. Methods Forty-eight specific pathogen free male Wistar rats were divided into 8 groups according to random number table, including the vehicle control group, the cytochrome C group, the etimicin 10 mg/kg group, the etimicin 10 mg/kg plus cytochrome C group, the etimicin 30 mg/kg group, the etimicin 30 mg/kg plus cytochrome C group, the etimicin 100 mg/kg group, and the etimicin 100 mg/kg plus cytochrome C group; each group contained 6 rats. Rats in the vehicle control group received intraperitoneal injection of normal saline solution. Rats in the cytochrome C group received intraperitoneal injection of cytochrome C 100 mg/(kg·d). Rats in the etimicin alone groups received intraperitoneal injection of etimicin 10, 30, 100 mg/(kg·d), respectively. The rats in the three groups receiving etimicin plus cytochrome C initially received intravenous injection of cytochrome C 100 mg/(kg·d) via a tail vein and, about 30 minutes later, received intraperitoneal injection of etimicin 10, 30, 100 mg/(kg·d), respectively. The rats in each group continuously received drugs for three days and, 24 hours after the last injection, they were sacrificed and their bilateral kidneys were removed. The amount of etimicin accumulated in the kidney was measured using high-performance liquid chromatography, renal tubular epithelial cell apoptosis was detected by terminal-deoxynucleotidyl transferase mediated nick end labelling technique, and the positive number density of apoptotic cell was calculated by computer map analysis system. ResultsThe etimicin concentration in the tissue of rat kidneys was as follows: in the etimicin 10, 30, and 100 mg/kg groups, the contentration was (69.3±16.9), (221.8±66.8), and (305.9±35.5) μg/g, respectively; in the etimicin plus cytochrome C groups, the concentration was (39.0±18.4) (P<0.05), (121.5±34.2) (P<0.05), and (266.7±43.7) μg/g, respectively. The positive number density of apoptotic renal tubular epithelial cells in rats was as follows: in the etimicin 10, 30, and 100 mg/kg groups, the density was (266.8±15.4)/mm2, (527.7±208.7)/mm2, and (528.8±145.3)/mm2, respectively; in the etimicin plus cytochrome C groups, the density was (97.2±15.4)/mm2 (P< 0.01), (162.4±36.6)/mm2 (P< 0.01), and (472.5±70.1)/mm2, respectively. ConclusionCytochrome C can inhibit etimicin-induced renal tubular toxicity by inhibiting accumulation of etimicin in kidney.
Thrombocytopenia is one of the serious adverse reactions to linezolid. The risk factors for linezolid-induced thrombocytopenia are advanced age, female, long-term treatment, combined use of 3 kinds or more of antibiotics, lower baseline platelet count and renal insufficiency. Local symptoms of linezolid-induced thrombocytopenia are gingival bleeding, epistaxis, purpura and, in severe cases, gastrointestinal bleeding may occur. The most commonly seen general symptoms are fever, chills, generalized aching pain, nausea, vomiting, abdominal pain and arthralgia. The mechanism of thrombocytopenia induced by linezolid may be associated with bone marrow suppression, immune mediation or oxidative stress. Vitamin B6 might be effective in treating linezolid-induced thrombocytopenia, but the mechanism is presently unknown.
Paraquat can do human body harm by digestive tract, skin and mucosa, and some other routes. Clinical manifestations of acute paraquat poisoning include single or multiple organs damage of skin and mucosa, lung, liver, kidney, and so on. Patients may develop asymptom or mild local irritant symptoms and, after a latent period of several hours to several days, the conditions may become aggravated suddenly. At present, no specific effective method can be used for treating acute paraquat poisoning and the long latency is an important “time window” for clinical management. There is still ongoing controversy surrounding the effect of blood purification for acute paraquat poisoning; nevertheless, part of patients may be saved by early and repeated blood purification. Blood concentration of paraquat is closely related to clinical manifestation and prognosis of poisoning and the higher concentration can cause the greater harm to human body and the higher fatality.
A 57-year-old man with chronic hepatitis B received adefovir 10 mg daily orally. About three years after the start of the drug therapy, the patient developed bilateral lower limb swelling and pain in the morning and an elevation of serum alkaline phosphatase. After 4 years of the drug therapy, the patient was admitted to Xuanwu Hospital of Capital Medical University due to worsening pain in his lower limbs, and asthenia. Physical examination showed grade 4 muscle strength of the both lower limbs, weakened tendon reflexes, and hypalgesia in extremities. Laboratory test revealed a markedly reduced serum phosphate level of 0.59 mmol/L and electromyogram showed neurogenic injury. X-ray and ultrasonic examination showed osteoporosis. The patient was diagnosed with hypophosphatemic osteopathia and peripheral neuropathy related to adefovir. So adefovir was stopped and his therapy was changed to entecavir. The symptoms gradually improved. One month later, the serum phosphate level returned to normal (0.99 mmol/L) and, 3 months later, his bilateral lower limb pain disappeared completely, muscle strength was normal, and osteoporosis improved markedly.
An 89-year-old female patient received an IV infusion of clindamycin 1.35 g dissolved in 0.9% sodium chloride 250 ml once daily for bronchitis. Ten minutes after infusion started, drug extravasation occurred and the dorsum of hand of the patient became swollen. The needle was pulled out immediately and her lesion was treated with applying compound sodium aescinate gel and receiving wet dressing with magnesium sulfate. The next day, she presented with a blister of 2 cm in diameter at the infusion site and then the blister ruptured. Skin ulceration and necrosis occurred and progressed to black crusts. Dressing change and other treatment were given and, about one month later, her skin ulceration gradually healed.
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