2011 Volume 13 Issue 3 Published:
  

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    论著

  • 论著
    Study on tolerance of Yanshen oral solution in phase Ι clinical trials
    Yan Benyong;Zhang Feng;Sun Li;Liang Juncheng;Fan Huaying;Shi Jie;Xu Guozhu;Deng Yanping
    2011, 13(3): 137-5.
    Abstract ( ) PDF ( )
    Objective: To study the tolerance of Yanshen oral solution and to determine its safe dosage. Methods: A total of 38 healthy volunteers (aged 18-32 years) entered the tolerance study and received a single-dose regimen or a multi-dose regimen in clinical trials. The single-dose regimen was an open study, 26 subjects were divided into 5 groups: the 5 ml dose group (n=4), the 10 ml dose group (n=4), the 20 ml dose group (nn=6), the 30 ml dose group (n=6), and the 40 ml dose group (n=6). The multiple-dose regimen was a randomized, double-blinded, and placebo-controlled study, 12 subjects were divided into 2 groups: the Yanshen group (n=6) and the placebo group (n=6). The ratio of male to female in each group was 1 to 1. During the study period，the subjects’vital signs and adverse events were observed and recorded; routine blood, urine, and stool tests, blood biochemical tests (including the levels of K+, Na+, Ca2+, Cl-, glutamic-pyruvic transaminase, aspartate aminotransferase, total bilirubin, alkaline phosphatase, urea nitrogen, creatinine, etc.) , and electrocardiogram (ECG) were performed and all the results were statistically analyzed. Results: There were no differences in the age, gender, body weight and height among the 4 single-dose groups (the 40 ml dose group was canceled because of intolerance) and between the 2 multiple-dose groups. The maximum tolerance dose was 30 ml in the single-dose regimen and 20 subjects completed the study. A dose of 20 ml thrice daily for 7 consecutive days was selected for the multiple-dose regimen study. There were no statistically significant changes in vital signs, the routine blood, urine, and stool tests, and blood biochemical tests in all subjects after receiving the single-dose or multiple dose regimens. In the single-dose regimen study, sinus bradycardia occurred in 1 subject each in the 20 ml dose and 30 ml dose groups. All subjects receiving the multi-dose regimen had normal ECG. The main adverse reactions after drug administration were mild nausea and vomiting. In the single-dose regimen study, nausea occurred in 1 subject in the 5 ml dose group and 3 subjects in the 20 ml dose group, vomiting occurred in 1 subject in the 5 ml dose group and 2 subjects in the 20 ml dose group; in addition, all 6 subjects in the 30 ml dose group developed nausea and vomiting. In the multiple-dose regimen study, mild nausea and vomiting occurred in 2 subjects in the Yanshen group; however, the symptoms improved 30 min after developing adverse reactions. Conclusion: Yanshen oral solution could be well tolerated in a dose of 20 ml thrice daily with no severe adverse reactions.
  • 论著
    Effects of low-dose midazolam and ketamine on postoperative agitation induced by sevoflurane in non-hospitalized children
    Xi Chunhua;Wang Yanhua;Li Tianzuo
    2011, 13(3): 142-5.
    Abstract ( ) PDF ( )
    ABSTRACT Objective: To explore the effectiveness and safety of low-dose midazolam or ketamine on prevention of postoperative agitation induced by sevoflurane in non-hospitalized children. Methods: The children who underwent strabotomy under general anesthesia with sevoflurane entered a prospective randomized study.The children were divided into the midazolam group, the ketamine group and the control group by using ballot method. Anesthesia was induced with 8% sevoflurane and oxygen (5 L/min) via a face mask in all children. The laryngeal mask airway was inserted and the spontaneous respiration was maintained after the children became unconscious and jaw relaxed. Anesthesia was maintained with 2.0%-2.5% sevoflurane in an oxygen-nitrous oxide mixture. The children in the control,midazolam and ketamine groups were administered 0.9% sodium chloride 5 ml,midazolam 0.02 mg/kg (diluted with 0.9% sodium chloride to 5 ml), and ketamine 0.2 mg/kg (diluted with 0.9% sodium chloride to 5 ml) by slow intravenous push 10 minutes before the end of surgery, respectively. The laryngeal mask airway was removed, the children were transferred to the post anesthesia care unit(PACU) and the agitation was scored. If the child’s score was≥4, an IV push of propofol 2.0 mg/kg was given. The anesthesia time, recovery time from the anesthesia, the situation of postoperative agitation, whether receiving propofol, PACU length of stay, and the adverse reactions in children in the three groups were recorded. Results: A total of 61 children (aged 3-6 years, ASA physical status Ⅰ-Ⅱ)entered this study from May to November 2010.The control group comprised 11 boys and 9 girls with average age of (5.0±0.8) years and body weight of 14-27 kg; the midazolam group comprised 13 boys and 8 girls with average age of (5.0±0.4) years and body weight of 13-24 kg; the ketamine group comprised 10 boys and 10 girls with average age of (5.0±0.9) years and body weight of 15-30 kg. There were no statistically significant differences between the three groups in the gender, age, body weight, and the ratio of surgery for single or both eyes (P>0.05). The recovery time from the anesthesis in the midazolam and ketamine groups［(32.8±6.5) and (286±8.6) min, respectively］were longer than that in the control group［(19.8±5.0)min, P<0.01］, the incidence of postoperative agitation in the midazolam and ketamine groups［19%(4/21), 15%(3/20)］were lower than that in the control group［55%(11/20), P<0.05］. No statistically significant differences were observed between the three groups in regards to anesthesia time, whether receiving propofol, PACU length of stay, and the adverse reactions (P>0.05). Conclusion: Low-dose midazolam or ketamine is safe and effective in preventing postoperative agitation induced by sevoflurane.
  • 论著
    Non-fatal heart failure risk occurring in type 2 diabetic patients receiving rosiglitazone therapy: a metaanalysis
    Wu Shanshan;Zhang Yuan;Sun Feng;Zhan Siyan
    2011, 13(3): 147-6.
    Abstract ( ) PDF ( )
    Objective: To systematically evaluate the non-fatal heart failure risk occurring in type 2 diabetic patients receiving rosiglitazone therapy. Methods: Medline, ClinicalTrials.gov website and GlaxoSmithKline(GSK) website were searched using “rosiglitazone”,“randomized clinical trial” and “human”as the keywords from the inception to 31 August, 2010. The randomized controlled trials (RCT) to compare non-fatal heart failure risk of rosiglitazone and other hypoglycemic drugs in patients with type 2 diabetes mellitus were collected and meta-analysis were conducted. According to the treatment course, diabetes duration, therapeutic model and type of control, all RCT were divided into different subgroups to undergo meta-analysis; and sensitivity analysis and cumulative meta-analysis were conducted further. Results: A total of 678 related articles were searched and 170 trials were obtained according to the inclusion and exclusion criteria. Of the 170 trials, 99 were openly published on Medline or the website of ClinicalTrials.gov and 71 were published on the website of GSK. The results of meta-analysis showed that the odds ratio (OR) for non-fatal heart failure in the rosiglitazone group was 1.24 (95% CI: 0.99-1.55, P=0.065), compared with the control group. The results of meta-analysis in subgroups showed that the OR for non-fatal heart failure in the rosiglitazone group were 1.42 (95% CI: 1.06-1.90, P=0.019) and 1.01 (95% CI: 0.71-1.44, P=0.958) in the 99 openly published studies and the 71 studies published on the website of GSK, respectively; the OR for non-fatal heart failure in the rosiglitazone group was 1.62 (95% CI: 1.17-2.23, P=0.004) in the 30 studies with the treatment course of ≥52 weeks. In the 21 openly published studies with the treatment course of ≥52 weeks and the 33 studies with the duration of diabetes of ≥5 and＜10 years, the OR for non-fatal heart failure in the rosiglitazone groups were 1.79 (95% CI：1.22-2.64，P=0.003) and 1.55 (95% CI: 1.06-2.26, P=0.025), respectively. The results of cumulative meta-analysis showed that the OR value was influenced by the results of the large scale RCT (RECORD) 2009, and there was a positive turning point in 2009. The results of a meta-analysis of the 43 trials with a JADA score of ≥3 showed that the OR for non-fatal heart failure was 1.62 (95% CI：1.17-2.23，P=0.004); of them, the OR values for the 16 trials with the treatment course of ≥52 weeks, the 13 trials with the duration of diabetes of ≥5 and＜10 years, and the 19 trials with combined drug therapy were 1.79 (95% CI: 1.24-2.57，P=0.002), 1.76 (95% CI：1.15-2.71，P=0.010), and 1.68 (95% CI：1.11-2.53，P=0.014), respectively. Conclusion: Rosiglitazone may increase the non-fatal heart failure risk in the patients with type 2 diabetes mellitus, particularly in those with long duration of diabetes, receiving long-term medication use and combined drug therapy.
  • 论著
    Improved hemolysis test method for detecting hemolytic reaction induced by puerarin injection
    Li Geng;Peng Shaozhong;Cai Dake;Lai Xiaoping;Su Ziren
    2011, 13(3): 153-4.
    Abstract ( ) PDF ( )
    Objective: To evaluate the improved hemolysis test method for detecting a hemolytic reaction induced by puerarin injection. Methods: Twenty-four Beagle dogs (body weight 6-8 kg，the ratio of male to female was 1∶1) were obtained and 50% and 2% fresh erythrocyte suspensions were prepared. The standard hemolysis test method in the 2005 edition of the Chinese Pharmacopoeia and improved hemolysis test method established by our laboratory were used in this study. The features of the improved method were increase in puerarin concentration and incubation time. Beagle dog erythrocytes were incubated with different concentrations of puerarin injection and/or propylene glycol, and the hemolytic reaction was observed. In addition, the normal saline and the distilled water served as the negative and positive control, respectively. The incidence of hemolysis was calculated and all results were analyzed statistically. Results: When using the standard hemolysis test method in the pharmacopoeia, no hemolysis occurred in Beagle dog erythrocytes within 3 hours following application of propylene glycol 3.3-16.7 ml/L and puerarin 0.33-1.67 mg/ml. When using improved hemolysis test method, hemolytic phenomenon occurred in 4 Beagle dogs’erythrocytes following application of propylene glycol 100 ml/L, and the incidence of hemolysis was 16.6%; compared with the negative control, the difference was statistically significant (P<0.05); in addition, hemolytic phenomenon occurred in 16 Beagle dogs’erythrocytes following application of propylene glycol 100 ml/L and puerarin 10 mg/ml, the incidence of hemolysis was 66.7%; the difference was statistically significant, compared with the negative control (P<0.01). Correlation analysis showed that the incidence of hemolysis was not correlated with the concentration of propylene glycol (r=0.571, P>0.05), and significantly correlated with the concentration of puerarin(r=0.952, P<0.01). Conclusion: The improved hemolysis test method appeared to be more effective than the standard hemolysis test method in detection of a hemolytic reaction induced by puerarin injection.
  • 论著
    Efficacy and safety of different doses of clopidogrel therapy in patients with left maincoronary artery disease undergoing percutaneous coronary intervention
    Wang Mei;Ai Hui;Wang Chunmei;Zu Xiaolin;Wang Chenggang;Zhu Xiaoling
    2011, 13(3): 157-4.
    Abstract ( ) PDF ( )
    Objective: To evaluate the short-term efficacy and safety of different doses of clopidogrel therapy in patients with left main coronary artery disease undergoing percutaneous coronary intervention (PCI). Methods: The ≤75-year-old patients with left main coronary artery disease (a>75% stenosis in the left main stem) undergoing PCI were hospitalized in Emergency Department of Beijing Anzhen Hospital from January 2006 to January 2010 and served as the subjects. All clinical data from the subjects were collected and retrospective analysis was conducted. Patients were divided into the 75 mg dose group (oral administration of 75 mg/d on days 1-30 after PCI) and the 150 mg dose group (oral administration of 150 mg/d on days 1-30 after PCI) according to the doses of clopidogrel use. Maximal platelet aggregation rate and time was measured and recorded before PCI and 1, 7, 14 and 30 days after PCI, and adverse events were observed during hospitalization. Results: A total of 120 hospitalized patients undergoing PCI were enrolled in this study. Of them, 46 were male and 18 were female with mean age of (52±7) years in the 75 mg dose group and 35 were male and 21 were female with mean age of (50±8) years in the 150 mg dose group. The maximal platelet aggregation rates and time before PCI and 1, 7, 14, 30 days after PCI were 84%±18% and (240±48)s, 81%±14% and（238±44)s, 59%±12% and (210±42)s, 48%±10% and (199±40)s, 43%±10% and (184±30)s in the 75 mg dose group, and 86%±16% and (244±46)s, 77%±16% and (239±46)s, 51%±11% and (180±41)s, 40%±10% and (166±33)s, 38%±9% and (159±35)s in the 150 mg dose group. The results of maximal platelet aggregation rate and time showed a decreasing trend after PCI in both groups and the values of the 2 indexes in the 150 mg dose group were lower than those in the 75 mg dose group (all P<0.01). In a comparison of the two platelet aggregation index values 7, 14 and 30 days after PCI with those before PCI or one day after PCI in both groups respectively, the differences were statistically significant (all P<0.05). A comparison of maximal platelet aggregation rate 14 and 30 days after PCI with those 7 days after PCI in both groups showed that the differences were statistically significant (all P<0.05). In the 150 mg dose group, a comparison of maximal platelet aggregation rate one day after PCI with that before PCI revealed that the difference was statistically significant (P<0.05). There were no cardiovascular events such as severe bleeding, myocardial reinfarction and stroke in patients in both groups. No statistically significant between-group difference was found in the incidence ［12 cases (18.7%) in the 75 mg dose group, 13 cases (23.1%) in the 150 mg dose group］of adverse reactions, including mild bleeding, abdominal pain, dyspepsia, constipation, rash , dizziness, and headache (χ2=1.046，P=0.593). Conclusion: The dose of clopidogrel 75 mg/d or 150 mg/d is effective and safe in the treatment of patients with left main coronary artery disease undergoing PCI. However, compared with the dose of 75 mg/d, clopidogrel 150 mg/d could significantly inhibit the platelet aggregation and not increase the risk of bleeding, so it might be more beneficial to reduction of the ocurrence of thrombosis after PCI.
  • 论著
    Experimental study on skin irritation and sensitization of Toxicodendron vernicifluum leaf
    Xie Lijing;Zhang Lixia;Zhou Jing;Sun Chengye
    2011, 13(3): 161-4.
    Abstract ( ) PDF ( )
    Objective: To study the skin irritation and sensitization of Toxicodendron vernicifluum (T.vernicifluum) leaf in animals. Methods: Flesh leaves (free of rachises) of T.vernicifluum were collected, frozen, and ground. Ground T .vernicifluum leaves were prepared into a paste with distilled water at room temperature; the ratio of the leaf to distilled water was 1 to 1. Skin irritation testing was conducted in 6 New Zealand white rabbits. A patch (3 cm×3 cm) of fur of each rabbit was shaved from both sides of its back. The paste 1.0 g was applied to the bare skin on the left side of the back and maintained for 4 hours and then cleaned off. Distilled water 0.5 ml was applied to the bare skin on the right side of the back as control. Skin responses in the part applied with the paste were observed and scored 1, 24, 48 and 72 hours after cleaning. Skin sensitization testing was conducted in 50 albino guinea pigs. These pigs were divided into 3 groups: the experiment group (10 males and 10 females), the positive control group (10 males and 10 females) and the negative control group (5 males and 5 females). A patch (2 cm×2 cm) of fur of each pig was shaved from both sides of its back. On the beginning of experiment and on days 7 and 14 of experiment, the paste 0.8 g, 2.5% 2,4-dinitro-chlorobenzene 0.2 g and distilled water 0.4 ml were applied to the bare skin on the left side of each pig’s back in the experiment, positive control and negative control groups and maintained for 6 hours and then cleaned off, respectively. On days 28 of experiment, the paste 08 g was applied to the bare skin on the left side of each pig’s back in the experiment and negative control groups, 1.0% 2,4-dinitro-chlorobenzene 0.2 g was applied to the bare skin on the left side of each pig’s back in the positive control group and maintained for 6 hours and then cleaned. The rate and severity of sensitization were calculated and assessed 24 and 48 hours after cleaning, respectively. Results: In the skin irritation testing, 3 rabbits developed erythema after applying the paste to their skin. The average irritation score was 0.67 and the irritation severity was mild. In the skin sensitization testing, the guinea pigs in the experiment and negative control groups did not develop erythema and edema 24 and 48 hours after applying the paste to their skin. The average sensitization score was zero, sensitization rate was zero, and sensitization severity was mild. The guinea pigs in the positive control group developed erythema and edema and the average sensitization score was 3.65 and sensitization rate was 100% 48 hours after applying the paste to their skin. The sensitization severity was severe. Conclusion: The skin irritation of T .vernicifluum leaf is mild and there is no skin sensitization in the experimental animals.

    • 安全用药

  • 安全用药
    Gefitinib-induced interstitial lung disease：prevention and treatment
    Gao Xuan;Li Zhiping
    2011, 13(3): 165-4.
    Abstract ( ) PDF ( )
    Gefitinib is a selective inhibitor of the tyrosine kinase activity of the epidermal growth factor receptor, which is used in the treatment of non-small-cell lung cancer. Gefitinib can cause interstitial lung disease (ILD). The mean time to gefitinib-induced ILD onset is 24-42 days. The incidence of ILD is 0.44%-2.0%, and the mortality rate of ILD is 0.12%-0.5%. The clinical manifestations are dyspnea, respiratory distress, dry cough, and cyanosis. Diffuse infiltration shadow and alveolar interstitial shadow were seen on chest imagine studies. Advanced age, male, smoking history, a previous history of ILD, and the long duration of treatment are th risk factors for gefitinib-induced ILD. During gefitinib therapy, chest imaging should be performed regularly. Once ILD occur, gefitinib should be discontinued, and high-dose IV glucocorticoid, oxygen inhalation therapy, and anti-infective therapy should be administered. The prognosis is generally good.

    • 中毒救治

  • 中毒救治
    Liver failure induced by overdose of paracetamol, pseudoephedrine hydrochloride and dextromethorphan hydrobromide tablets Ⅱ/paracetamol,pseudoephedrine hydrochloride, diphenhydramine hydrochloride and dextromethorphan hydrobromide tablets
    Wang Kailia;Xu Changjiangb;Jin Jinga;Gao Dengliana;Xing Hanqiana;Yan Lia;Zhao Juna
    2011, 13(3): 169-2.
    Abstract ( ) PDF ( )
    A 22-year-old man developed nausea and vomiting following suicide attempt taking 120 paracetamol, pseudoephedrine hydrochloride and dextromethorphan hydrobromide tabletsⅡ/paracetamol, pseudoephedrine hydrochloride, diphenhydramine hydrochloride and dextromethorphan hydrobromide tablets (total dose of paracetamol 39 g). He was hospitalized about 13 hours after ingesting the drug. Laboratory tests revealed following levels and values: ALT 7385 U/L, TBil 26.5 μmol/L, DBil 15.4 μmol/L, PTA 23.1%, and lactate 3.9 mmol/L. Druginduced acute liver failure were diagnosed. He received treatment with liverprotective drugs, molecular adsorbent recirculating system (MARS) , and plasma exchange. On day 13 after admission, the patient nearly recovered to normal condition. Repeat liver function tests showed the following levels: ALT 146 U/L, TBil 16.7 μmol/L, and DBil 8.3 μmol/L; and then he was discharged.

    • 误用滥用

  • 误用滥用
    Narcolepsy induced by Magu withdrawal
    Chen Shaoyuan
    2011, 13(3): 171-2.
    Abstract ( ) PDF ( )
    A 41-year-old man took a amphetamine-type stimulant Magu (mainly containing methamphetamine and caffeine) intermittently for more than 2 years. One year ago, he began to reduce the dose of Magu himself and then to stop taking Magu completely 4 weeks before he presented himself to clinic. Fifty days after Magu withdrawal, he developed daytime sleepiness, which occurred frequently; each episode occurred within 10-20 min and lasted for a few minutes to tens minutes. He experienced “nightmare” phenomenon several times. Polysomnography revealed that a mean sleep latency decreased to 80 seconds. Narcolepsy was diagnosed, which was considered to be induced by Magu withdrawal. The patient was encouraged to insist on the drug withdrawal and to enhance physical activities as well as audio-visual stimuli for avoiding daytime sleep. He was given oral amitriptyline 25 mg before going to sleep at night. Two weeks later, the patient’s sleep disturbances disappeared.

    • 病例报告

  • 病例报告
    Osteonecrosis of the jaw associated with pamidronate disodium
    Lu Mina;Wang Weib;Zhou Yinga;Liang Yana;Cui Yimina;Guo Xiaohuib
    2011, 13(3): 180-2.
    Abstract ( ) PDF ( )
    A 60-year-old man with type 2 diabetes mellitus received an IV infusion of pamidronate disodium 60 mg dissolved in 0.9% sodium chloride 500 ml, which was given within 4-5 hours via an infusion pump, for bone metastasis of small cell lung cancer. The dosing interval was once every 1-3 months. He received pamidronate 10 times within 17 months. Subsequently, the patient received head radiotherapy for brain metastasis. Two days before radiotherapy, he was given prednisone 10 mg thrice daily for 37 days. After radiotherapy completion, the patient was retreated with pamidronate disodium therapy, and the dosage and administration were the same as the previous regimen. He received pamidronate 5 times within one year. During this year, the patient experienced recurrent gingival swelling, pains and pyorrhea. Osteonecrosis of the jaw (ONJ) was diagnosed by dentists. ONJ was considered to be associated with pamidronate disodium, or both bisphosphonates and radiotherapy.
  • 病例报告
    Interstitial pneumonitis due to long-term amiodarone use
    Ren Xiaolei;He Zhen;Li Yuzhen
    2011, 13(3): 182-2.
    Abstract ( ) PDF ( )
    A 62-year-old woman presented with cough, expectoration, and fever after receiving amiodarone 300 mg/d for 4 years for atrial fibrillation. A chest CT scan revealed bilateral pulmonary diffuse interstitial infiltrations. Drug-induced interstitial pneumonitis was considered to be related to amiodarone. Amiodarone was discontinued, and prednisone was given. Her condition gradually improved.
  • 病例报告
    Iopromide-induced acute renal failur
    Hu Yunzhen;Lu Xiaoyang
    2011, 13(3): 183-2.
    Abstract ( ) PDF ( )
    A 65-year-old man with type 2 diabetes mellitus was hospitalized with slow response to stimuli and slurred speech. Cranial magnetic resonance imaging showed cerebral infarction (acute phase). He was treated with enteric-coated aspirin 0.1 g once daily, edaravone 30 mg once daily, methylcobalamin, etc. He received the contrast medium iopromide 100 ml (equivalent to 30 g iodine) once daily for two days for undergoing contrast-enhanced CT scans of lung and abdomen. On day 3, he developed lower extremity edema, his 24 hour urine volume was 400 ml and then anuria occurred. An IV push of furosemide was given, but his symptoms did not improve. A repeat test showed a serum creatinine level of 475 μmol/L and a serum urea nitrogen level of 24.5 mmol/L. Acute renal failure was diagnosed and considered to be related to iopromide. After five days of continuous hemodialysis, the patient’s urine output increased and his serum creatinine level decreased to 284 μmol/L. Seventeen days later, his serum creatinine level dropped to 231 μmol/L and his serum urea nitrogen level was 14.4 mmol/L. Lower extremity edema significantly improved, and then he was discharged.
  • 病例报告
    Thrombocytopenia induced by intravenous infusion of cefuroxime
    Wu Zhiheng;Yang Bo
    2011, 13(3): 185-1.
    Abstract ( ) PDF ( )
    A 70-year-old woman was planned to undergo meningeoma resection and received an IV infusion of cefuroxime 2 g dissolved in 250 ml of 0.9% sodium chloride once daily for a lung infection before operation. Her platelet count was 166×109/L before drug administration and, on day 2 of treatment, her platelet count rapidly dropped to 40×109/L, but no evidence of clinical bleeding. It was considered to be associated with cefuroxime, so the drug was withdrawn and switched to ofloxacin. One day after change to ofloxacin, her platelet count rose to 160×109/L. Thereafter, the pulmonary infection improved and the operation completed uneventfully.
  • 病例报告
    Heparin-induced thrombocytopenia: two case reports
    Zu Xiaolin;Zhang Haibo;Zhu Xiaoling;Ma Linan
    2011, 13(3): 186-2.
    Abstract ( ) PDF ( )
    Patient 1, a 24-year-old man, received aspirin 300 mg, clopidogrel 300 mg, and an IV push of heparin 10 000 U ,then he underwent coronary arteriography, percutaneous transluminal angioplasty and stenting for acute myocardial infarction. His platelet count was 228.0×109/L before surgery. One hour after surgery, his platelet count decreased to 36.2×109/L. Heparin-induced thrombocytopenia was considered. Subsequently, heparin was discontinued, and an IV infusion of argatroban 0.5-2 μg·kg-1·min-1 was given. On day 3, the patient’s platelet count increased to 101×109/L and, on day 4, the platelet count returned to normal range.Patient 2, a 69-year-old man, with coronary atherosclerotic cardiopathy received an IV push of heparin 3000 U during coronary arteriography. Subsequently, he underwent coronary bypass. SC low-molecular-weight heparin 1 mg·kg-1·12 h-1 was given for 7 days before surgery and an IV infusion of heparin 7000 U was given during surgery. His platelet count was 197×109/L before surgery and decreased to 19.2 ×109/L after surgery. Heparin was stopped and an IV infusion of argatroban 0.5-1.5 μg·kg-1·min-1 was given. His platelet count increased to 146.0×109/L.
  • 病例报告
    Increased myohemoglobin due to loxoprofen
    Zhang Haiying;Ren Xiaolei;Li Yuzhen
    2011, 13(3): 188-2.
    Abstract ( ) PDF ( )
    A 79-year-old woman with rheumatoid arthritis was administered loxoprofen 60 mg. Two hours later, she developed generalised weakness, polyhidrosis, and red urine. Her blood myohemoglobin was 938 μg/L and urinary myohemoglobin was 2102 μg/L. Meanwhile the patient developed hematuria and her leukocyte count increased. Increased myohemoglobin was considered to be induced by loxoprofen. Loxoprofen was discontinued and the patient received anti-infective and supportive treatments. On day 7 of drug discontinuation, the blood myohemoglobin was 24 μg/L and urinary myohemoglobin was 174 μg/L. But her infection of urinary system did not improve and therapy was continued.
  • 病例报告
    Pericardial effusion and atrial fibrillation associated with imatinib
    Wang Xinyu;Xu Xinye;Sun Chao;Niu Jie;Gao Wei
    2011, 13(3): 189-2.
    Abstract ( ) PDF ( )
    A 68-year-old woman with malignant gastric stromal tumor received imatinib 400 mg once daily after surgery. Half a year later, ultrasonic cardiogram showed a mild pericardial effusion. Five years later, the patient developed mild edema in both lower extremities and atrial fibrillation, and ultrasonic cardiogram showed a moderate pericardial effusion. Imatinib was discontinued and, two weeks later, pericardial effusion decreased. Three weeks later, pericardial effusion subsided completely, atrial fibrillation did not recur, and her lower limbs edema significantly improved. Imatinib was readministered according to the above-mentioned dosage. Two weeks later, a little pericardial effusion appeared and, on months 3 and 6, ultrasonic cardiogram revealed no pericardial effusion and she did not present with atrial fibrillation.
  • 病例报告
    Pseudohyperaldosteronism assiociated with glycyrrhizinic acid preparations
    Liang Ji;Su Tao
    2011, 13(3): 190-2.
    Abstract ( ) PDF ( )
    A 62-year-old man with actinic dermatitis received a 4-day treatment with an IV infusion of compound glycyrrhizin 20 ml/d (containing 40 mg of glycyrrhizin) , oral ebastine, and oral cetirizine, followed by a 10-day treatment with traditional Mongolian medicine (specific composition not stated). Because his skin symptoms did not significantly improved, he was administered 2 compound glycyrrhizin tablets (containing 50 mg of glycyrrhizin) twice daily. One week later, the patient developed edema in his eyelids and lower extremities. His blood pressure was 180/100 mm Hg. The drug was discontinued immediately. Laboratory tests revealed the following levels and values: serum potassium 3.1 mmol/L, serum sodium 151 mmol/L, SCr 82 μmol/L, renin 0.40 pg/L, angiotensin II 98 ng/L, and aldosterone 164 ng/L. He was treated with oral triamterene 50 mg twice daily and oral nifedipine 20 mg twice daily. After one day, his edema disappeared and blood pressure was maintained at 140-160/90-100 mm Hg. A repeat laboratory testing showed a serum potassium level of 4.7 mmol/L and a serum sodium level of 141 mmol/L.However, his SCr level increased to 129 μmol/L and the highest level was 144 μmol/L. Two days after triamterene withdrawal, the laboratory results showed the following levels: SCr 86 μmol/L, serum potassium 3.7 mmol/L, serum sodium 141 mmol/L, and normal levels of renin, angiotensin II, and aldosterone. Pseudohyperaldosteronism was diagnosed and considered to be related to glycyrrhizinic acid.
  • 病例报告
    Colchicine-induced hypoglycemia
    Du Jinming;Liu Baoping
    2011, 13(3): 192-2.
    Abstract ( ) PDF ( )
    A 76-year-old man self-medicated oral colchicine 3 mg/15 h in divided doses for his acute gouty arthritis. The next day, he developed confusion, no response to verbal stimuli, profuse sweating, and no spontaneous activity of his limbs. Laboratory tests showed a blood glucose level of 26 mmol/L, and his liver function, electrolytes and serum creatinine were in normal range. Hypoglycemia was diagnosed. An IV push of 50% glucose 20 ml was given immediately and, about 2 minutes later, he regained consciousness, and then it was changed to an IV infusion 10% glucose 500 ml. One hour later, he gradually returned to normal. The next morning, he redeveloped profuse sweating, confusion accompanied with a blood glucose level of 3.2 mmol/L. After administration of an IV push of 50% glucose 20 ml, the patient improved. He was observed for 4 days, and then he was discharged without discomfort.
  • 病例报告
    Abnormal hepatic function caused by citalopram
    Jiang Saiping;Lu Xiaoyang
    2011, 13(3): 193-2.
    Abstract ( ) PDF ( )
    A 70-year-old man received cefoperazone sodium/sulbactam sodium, vancomycin, and omeprazole for worsened cough and expectoration accompanied by a fever and short of breath. On day 8, he was given citalopram 10 mg once daily for depression. On day 9, his ALT and AST levels increased from 47 U/L and 52 U/L to 139 U/L and 145 U/L, respectively. The dosage of citalopram was increased to 20 mg once daily due to poor control of depression. Subsequently, his hepatic enzyme levels increased markedly and, on day 19, the laboratory tests revealed a ALT level of 529 U/L and a AST level of 256 U/L. Abnormal hepatic function was considered to be induced by citalopram, so citalopram was stopped and other drugs were continued. Then his hepatic function gradually returned to normal.
  • 病例报告
    Ceftriaxoneinduced anaphylactic shock resulting in a vegetative state
    Jiang Lianhua
    2011, 13(3): 195-1.
    Abstract ( ) PDF ( )
    A 40-year-old woman received an IV infusion of ceftriaxone sodium 2.0 g dissolved in 0.9% sodium chloride 250 ml for her upper respiratory tract infection (gastrointestinal type). About 5 minutes after infusion start, the patient experienced chest tightness, dyspnea, followed by convulsions, foam at mouth and no response to verbal stimuli. The medicine was discontinued immediately, and her blood pressure was undetectable. She received endotracheal intubation and anti-shock therapy. Two hours later, her BP increased to 138/68 mm Hg, but she remained in a moderate coma. The patient was hospitalized and then she received anti-shock therapy and the treatment for the correction of acid-base disturbances. On day 2 of admission, a head CT showed diffuse swelling in the brain tissue. During 3 weeks in hospital, the patient was still in a coma. Nine months after discharge, the patient remained in a vegetative state.
  • 病例报告
    Anaphylactic reactions due to intravesical instillation of epirubicin and pirarubicin in one case each
    Zong Huantaoa;Liang Xingjiana;Wu Jichunb;Zhang Yonga
    2011, 13(3): 196-2.
    Abstract ( ) PDF ( )
    Two patients developed anaphylactic reactions during treatment with intravesical instillation of epirubicin or pirarubicin after surgery for bladder cancer. Patient 1, a 60-year-old man, received intravesical instillation of epirubicin 50 mg in 0.9% sodium chloride 50 ml. Ten minutes after starting intravesical instillation, the patient experienced itching of both hands and feet, redness of his face and limbs, and a heart rate of 100 beats/min. Twenty minutes later, the symptoms worsened and he could not tolerate this drug. Therefore, the drug was evacuated from his bladder, and his symptoms gradually subsided. Subsequently, the patient received the second intravesical instillation of epirubicin, and the above symptoms with nausea and vomiting occurred, and then subsided again after evacuation of the drug. Patient 2, a 54-year-old man, received chemotherapy with intravesical instillation of pirarubicin 40 mg in 5% glucose 50 ml. Thirty minutes after starting intravesical instillation, the patient presented with blurry vision, generalized pruritus with wheal. The drug was evacuated from his bladder immediately and IM diphenhydramine and IM dexamethasone were given. Thirty minutes later, his symptoms improved and, one hour later, subsided.
  • 病例报告
    Cefodizime sodium-induced epidermolysis bullosa
    Liu Haiyan;Li Tingting
    2011, 13(3): 197-2.
    Abstract ( ) PDF ( )
    An 80-year-old male patient received an IV infusion of cefodizime sodium 1.5 g dissolved in 0.9% sodium chloride 250 ml for pulmonary infections. While receiving about 10 ml of the infusion, the patient developed palpitation, chest distress, cold intolerance, generalized pruritus, and high fever. Physical examinations showed a temperature of 39.6 ℃, red lamella appearing on generalized skin, especially on his limbs. The infusion was discontinued immediately and he received symptomatic treatment and supportive therapy. Then palpitation and cold intolerance were subsided and his temperature decreased. However, his skin symptoms did not improve. The next day, some flaccid vesicles appeared on his back and limbs, which later progressed to erosion. Skin symptoms due to cefodizime sodium were considered and the drug was not readministered. He received hydrocortisone, chlorphenamine, and other anti-allergic therapy. Meanwhile, fusidic acid was given for anti-infection. Subsequently, his skin symptoms and pulmonary infections improved gradually.
  • 病例报告
    Anaphylactoid reactions induced by trastuzumab
    Jia Rongdi;Xu Yao
    2011, 13(3): 198-2.
    Abstract ( ) PDF ( )
    A 52-year-old woman received an IV infusion of trastuzumab 220 mg dissolved in 0.9% sodium chloride 250 ml at a rate of 50 drops/min for adjuvant chemotherapy after breast cancer surgery. About 30 minutes after infusion initiation, the patient developed chills, chest tightness, lips numbness, and short of breath. Her heart rate was 165 beats/min and blood pressure was 199/99 mm Hg. The infusion was stopped immediately and symptomatic treatment was given. Fifty minutes later, the above symptoms disappeared and her heart rate and blood pressure returned to normal. Twenty-one days later, she received a second chemotherapy with an IV infusion of trastuzumab 110 mg in 0.9% sodium chloride 250 ml at a rate of 30 drops/min. Five minutes later, she presented with anaphylactoid symptoms again and, 10 minutes after drug discontinuation, her symptoms disappeared.
  • 病例报告
    Severe diarrhea attributed to dasatinib
    Gao Xihua
    2011, 13(3): 200-1.
    Abstract ( ) PDF ( )
    A 55-year-old male patient with accelerated phase of chronic granulocytic leukemia received dasatinib 70 mg twice daily due to poor control with nilotinib therapy. On the day of drug administration, the patient developed diarrhea with frequent watery stools. Dasatinib was withdrawn, smectite powder was given, and then his diarrhea improved. Three days later, diarrhea recurred after readministration of dasatinib. And the symptoms of diarrhea subsided after discontinuation of dasatinib.
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