2011 Volume 13 Issue 2 Published: 28 April 2011
  

  • Select all
    |

    论著

  • 论著
    Lin Na;Li Tianzuo
    2011, 13(2): 69-4.
    Abstract ( ) PDF ( )
    Objective: To summarize the effectiveness and safety of general anesthesia with sevoflurane inhalation during phacoemulsification and intraocular lens implantation for cataracts in children. Methods: The clinical data from 145 children (84 boys and 61 girls, aged 3 to 8 years, ASA physical statusⅠorⅡ) who underwent the phacoemulsification and intraocular lens implantation under general anesthesia with sevoflurane inhalation in Beijing Tongren Hospital during the period from May 2009 to August 2010 were collected and analyzed, retrospectively. Anesthetic induction was performed with 8% sevoflurane and oxygen (5 L/min) via a face mask. The venipuncture was performed after the children became unconscious, and a laryngeal mask airway (LMA) was inserted when the bispectral index scale (BIS) was <60 and the lower jaw relaxed. Anesthetic maintenance was performed with 3% 4% sevoflurane and oxygen (2 L/min) via a LMA and the spontaneous respiration was maintained, the artificial ventilation was performed intermittently during the operation. The BIS value, heart rate (HR) and respiratory rate (RR) were recorded before anesthetic induction (T1), at the time point of the lowest BIS after being unconscious (T2), before insertion of a LMA (T3), and during anesthetic maintenance (T4), respectively. The adverse reactions, such as cough, breath holding, laryngospasm, vomiting, increased secretions and hypoxemia were monitored during the induction and maintenance of anesthesia. Results: Before anesthetic induction, the children’s BIS value was 9498 (98±2) and the HR was (111±10)beats/min. Unconsciousness appeared 1534 (20±3)s after inhalation of 8% sevoflurane, meanwhile the BIS value decreased to 1238 (23±7), the HR increased to (160±12) beats/min, and the maximum HR was 180 beats/min. In comparison with the BIS value and HR before anesthetic induction, the differences were statistically significant (all P<0.01). At the lowest BIS value, jerking movements occurred in the limbs and the body in 73.1% cases (106/145) lasting for 510 s and then disappeared. When BIS value increased to 2442 (35±4) and the children’s lower jaws relaxed, the LMA could be inserted smoothly. The differences in HR was statistically significant (P<0.01) between T3 [(97±10)beats/min] and T1[(111±10)beats/min]. The differences in average RR among the duration of anesthetic induction[(21.6±34)/min], the duration of anesthetic maintenance[(29.0±3.8)breath/min], and before the anesthetic induction[(24.6±3.6)breath/min] were statistically significant (all P<0.01). There were no breath holding, laryngospasm, cough, increased secretions, vomiting, hypoxemia and other severe adverse reactions in 145 children during anesthesia and their operations were completed uneventfully. Conclusion: The general anesthesia with sevoflurane inhalation is effective and safe during cataract surgery in children but, during anesthetic induction, they should be carefully monitored in order to avoid the accident injury due to jerking movements of the limbs and the body.
  • 论著
    Chen Xin;Yang Li;Zhai Suodi
    2011, 13(2): 73-5.
    Abstract ( ) PDF ( )
    Objective: To systematically evaluate the risk of cardiovascular events with rosiglitazone and pioglitazone treatment in over 65yearold patients with type 2 diabetes mellitus. Methods: A search of Cochrane Library (1996 to 2010), PubMed (1966 to 2010), Embase (1966 to 2010), CJFD (1979 to 2010), CBM (1978 to 2010) and VIP (1989 to 2010) were conducted using keywords “rosiglitazone”,“pioglitazone”,“cardiovascular events”,“cardiovascular risk”,“elderly population”,“65 years old”,and “cohort study”. Retrospective cohort studies in comparison of cardiovascular events between rosiglitazone and pioglitazone in over 65yearold patients with type 2 diabetes mellitus were collected. According to the inclusion criteria, the literature was selected and assessed. The metaanalysis of data was conducted using RevMan 5.0 software. The relative risk ratio (RR) and 95% confidence interval (CI) of myocardial infarction, heart failure, and allcause mortality due to rosiglitazone or pioglitazone treatment in over 65yearold patients with type 2 diabetes mellitus were calculated. Results: Seventyfour related articles were obtained and, after detailed screening, three retrospective cohort studies from 2008 to 2010 were located, with a total of 295 668 patients (including 104 479 receiving rosiglitazone and 191 189 receiving pioglitazone). The metaanalysis revealed the following results: the incidence rates of myocardial infarction, heart failure and total mortality in the patients receiving rosiglitazone were higher than those in the patients receiving pioglitazone, their RR (95%CI) were 1.05(0.98-1.13,P=0.17),1.22(1.05-1.40,P=0.007) and 1.14(1.08-1.21,P<0.000 01),respectively. Conclusion: The risk of heart failure and allcause mortality is higher in rosiglitazone treatment than in pioglitazone treatment in over 65yearold patients with type 2 diabetes mellitus.
  • 论著
    Li Yan;Liu Yongjun;Qin Chao;Chen Wei;Xu Meng;Liu Guangyang;Zhu Delin;Gao Hong
    2011, 13(2): 78-7.
    Abstract ( ) PDF ( )
    Objective: To investigate the immune toxicity of human umbilical cord mesenchymal stem cells (UCMSC) on Wistar rats. Methods: One hundred and twelve SPF grade Wistar rats were randomly divided into 4 groups: the solvent group (a dose of solvents 5 ml/kg), the lowdose group (a dose of 1×107 human UCMSC/kg), the highdose group (a dose of 5×107 human UCMSC/kg) and the control group (a dose of 1×107 rat UCMSC/kg). Each group comprised 28 rats (14 males and 14 females). UCMSC once every 2 weeks was given via the caudal vein for 4 doses. The graft versus host diseases (GVHD) scores were evaluated every week after the UCMSC injection start. The IgG and IgM levels and the numbers of T cell subtypes (CD3+, CD4+, and CD8+) were measured. The pathological changes in lymphonode, thymus and spleen were observed and organ coefficients were calculated 1 and 13 weeks after the final dose of UCMSC. Results: The GVHD scores were 0 after injection of UCMSC in all groups. One week after the final dose of UCMSC, the IgG and IgM levels of female rats in the lowdose group[ (0.65±0.12) and (0.63±0.14)g/L, respectively]and the highdose group[ (0.06±0.01) and (0.06±0.01) g/L, respectively] increased markedly than those in the solvent group [(0.41±0.17) g/L and (0.04±0.01) g/L, P<0.05 and P<0.01, respectively]. Thirteen weeks after the final dose of UCMSC, the IgM level of the male rats in the highdose group [(0.05±0.01) g/L] increased markedly than that in the solvent group [(0.03±0.01) g/L, P<0.05]. The IgM levels of male and female rats in the control group [(0.06±0.02) and (0.05±0.02) g/L, respectively]increased markedly than those in the solvent group [(0.05±0.02) g/L, both P<0.05]. There were no statistically differences in the IgG and IgM levels of male and female rats among groups 13 weeks after the final dose of UCMSC (all P<0.05). One week after the final dose of UCMSC, the spleen coefficient of female rats in the lowdose group[(0.274±0.016) %] and the highdose group [(0.294±0.019) %] increased markedly than that in the solvent group [(0.232±0.012)%, P<0.01]. The spleen coefficient of male rats in the highdose group [(0.242±0.027)%] increased markedly than that in the solvent group [(0.202±0.012)%, P<0.01]. The spleen coefficient of male and female rats in the control group [(0.261±0.019)% and (0.236±0.014)%, respectively] increased markedly than that in the solvent group (P<0.01). There were no statistically differences in the spleen and thymus coefficients among groups 13 weeks after the final dose of UCMSC (all P>0.05). The percentage of CD3+, CD4+, and CD8+ T cells and ratio of CD4+/CD8+ in all groups were within the normal range. The histopathological examination of thymus, lymphonode and spleen showed no abnormal changes. Conclusion: Human umbilical cord mesenchymal stem cells can induce elevation of immunoglobulin level and spleen coefficients in Wistar rats, and this effect is transient and reversible.
  • 论著
    Huang Jina;Liu Jingb;Zhou Mina;Ji Xiaoli;Qiao Aizhenb;Xue Meib;Zhu Lingb;Wang Hengxiangb
    2011, 13(2): 85-5.
    Abstract ( ) PDF ( )
    Objective: To evaluate the safety of two bortezomibbased chemotherapy regimens in treatment of patients with multiple myeloma (MM). Methods: The adverse reactions occurring in patients with multiple myeloma while receiving PAD or VMP regimens were retrospectively analyzed using Common Terminology Criteria for Adverse Events v3.0. PAD regimen(bortezomib+epirubicin hydrochloride+dexamethasone) included 4 courses, the first course was 18 days, the second, third and fourth courses were 11 days,respectively. PAD regimen was used for patients with MM who were younger and in relatively good physical condition. VMP regimen(bortezomib+melphalan+prednisone) included 4 courses, each course was 11 days. VMP regimen was used for patients with MM who were elder and in relatively poor physical condition. Results: From March 2008 to December 2010, 16 inpatients with MM in AirForce General Hospital received chemotherapy. Twelve patients (7 males and 5 females with median age of 61 years) received PAD regimen. Four patients (3 males and 1 female with median age of 67 years) received VMP regimen. The main adverse reactions induced by PAD or VMP regimen were thrombocytopenia, neutropenia, peripheral neuropathy, infection, and gastrointestinal reactions. (1)Thrombocytopenia was occurred in 9 patients receiving PAD regimen during courses 2-4, including 7 cases of gradesⅠⅡ thrombocytopenia, 1 case of grade Ⅲ thrombocytopenia , and 1 case of grade Ⅳ thrombocytopenia. Thrombocytopenia was occurred in 2 patients receiving VMP regimen, including 1 case of gradeⅡ thrombocytopenia and 1 case of grade Ⅳ thrombocytopenia. The PAD or VMP regimen was continued uninterruptedly in patients mentioned above. The platelet count in patients with grades Ⅲ and Ⅳ thrombocytopenia returned to normal level after platelet transfusion.(2) Neutropenia occurred in 8 patients receiving PAD regimen during courses 2-4, including 5 cases of gradesⅠ-Ⅱ neutropenia, 1 case of grade Ⅲ neutropenia , and 2 cases of grade Ⅳ neutropenia. Neutropenia occurred in 2 patients receiving VMP regimen during courses 2-4, including 1 case of grade Ⅱ neutropenia and 1 case of grade Ⅳ neutropenia. In the patients with grades Ⅰ-Ⅱneutropenia, the PAD or VMP regimen was continued uninterruptedly. In the patients with grade Ⅲ neutropenia receiving PAD regimen, the chemotherapy was temporarily discontinued and the patients received symptomatic treatment; after neutrophil count returned to normal level, the chemotherapy was continued. In patients with grade Ⅳ neutropenia receiving VMP regimen, the chemotherapy was not discontinued, and the patients received SC recombinant human granulocyte stimulating factor.(3) Peripheral neuropathy occurred in 4 patients receiving PAD regimen, including 3 cases of gradesⅠ-Ⅱ peripheral neuropathy and 1 case of gradeⅢ peripheral neuropathy. Grade Ⅰperipheral neuropathy occurred in 1 patient receiving VMP regimen. In a patient with grade Ⅱ peripheral neuropathy, symptoms improved after adjustment of bortezomib dose decreasing from 1.3 mg/m2 to 1.0 mg/m2. In a patient with grade Ⅲ peripheral neuropathy, PAD regimen was repeated after drug withdrawal and symptomatic treatment.(4) Infection and fever occurred in 4 patients receiving PAD regimen during courses 2-4, 1 patient died from septic shock secondary to pulmonary infection. (5) Loss of appetite, nausea, vomiting, and diarrhea or constipation occurred in 16 patients; regimens were not withdrawn, but they received symptomatic treatment. Conclusion: PAD and VMP regimens are relatively safe in treating patients with MM, and most adverse reactions are mild and tolerable. The withdrawal or dose adjustment of bortezomib should be conducted in patients having relatively serious adverse reactions.
  • 安全用药

  • 安全用药
    Ji Liwei;Li Kexin
    2011, 13(2): 90-5.
    Abstract ( ) PDF ( )
    Combined oral contraceptives are the most widely used contraceptives preparations, they contain two sex hormone: progestogen and estrogen. COC may cause cardiovascular diseases. Epidemiological evidence suggests that the dyslipidemia may be associated with these diseases. The mechanism of this phenomenon is not entirely clear; the elevation of blood triglyceride levels may be related to a decrease in lipolytic activity of liver and triglyceride removed as well as an increase in blood insulin levels. Different preparations of COC should be alternated if possible for a longterm use of the contraceptives in women of childbearing age, and blood lipid levels should be monitored during the period of COC use.
  • 安全用药
    Liu Xiao;Zhou Ying;Cui Yimin
    2011, 13(2): 95-4.
    Abstract ( ) PDF ( )
    Fluoroquinolone antibacterials levofloxacin, ciprofloxacin, gatifloxacin and moxifloxacin have been reported to cause torsades de pointes (TdP). Clinical manifestations of TdP are dizziness, fainting, or even cardiac arrest. QT interval prolongation and TdP are visible on the electrocardiogram (ECG). The mechanism of TdP is unclear, it may be associated with inhibition of cardiac K+ channels and blocking of K+ outflow. The risk factors for causing TdP are female, advanced age, underlying organic heart disease (especially congestive heart failure, QT interval prolongation and bradycardia), liver and kidney dysfunction, hypokalemia, and hypomagnesemia, as well as combined use with other drugs that can cause QT interval prolongation. Once a patient develops to QT interval prolongation and TdP, the causative agent should be discontinued immediately. Potassium and magnesium supplements are given to inhibit the early afterdepolarization. Artificial temporary cardiac pacing or isoprenaline is used to maintain normal heart rate. For the unconscious patient with ventricular fibrillation, external electrical cardioversion could be carried out.
  • 安全用药
    Wang Boya;Yan Suying
    2011, 13(2): 99-4.
    Abstract ( ) PDF ( )
    Linezolid is an oxazolidinone antibacterial used for the treatment of Grampositive infection of the respiratory tract and skin, including those due to vancomycin resistant enterocooci. The common adverse reactions are diarrhea, nausea, vomiting, headache, and rash. Linezolid may cause thrombocytopenia, and the risk factors for thrombocytopenia are prolonged use of linezolid, advanced age, and renal insufficiency. The mechanism of thrombocytopenia induced by linezolid might be linked to bone marrow suppression or immunemediated platelet decrease. The measures for prevention and treatment of thrombocytopenia are as follows: highdose and prolonged use of linezolid should be avoided; platelet count should be closely monitored during linezolid therapy; linezolid combined with drugs that produce bone marrow suppression should be avoided; linezolid therapy should be discontinued in patients who developed thrombocytopenia, and transfusion of platelets should be considered in patients having severe thrombocytopenia.
  • 滥用误用

  • 滥用误用
    Li Hong;Ren Aimin
    2011, 13(2): 103-2.
    Abstract ( ) PDF ( )
    A 19yearold man with infectious mononucleosis was prescribed an IV infusion of aciclovir 600 mg in 10% glucose 250 ml but, due to a medication error, he received an IV infusion of aciclovir 3.0 g in 10% glucose 250 ml. Nine hours after infusion completion, he developed marked lumbago, oliguria, 2+ urine protein, and 2+ urine occult blood followed by a 24hour anuria period. On day 3, his renal function tests revealed a serum creatinine level of 557 μmol/L and a urea level of 9.2 mmol/L. Renal ultrasonography showed diffuse bilateral renal lesion. He received blood purification and an IV infusion of methylprednisolone 40 mg/d for 2 days. His renal function improved and urine volume increased. On day 15, both his renal function and routine urine tests returned to normal and he was discharged with complete recovery.
    KEY WORDSaciclovir; acute renal failure
  • 病例报告

  • 病例报告
    Li Jie;Li Yang
    2011, 13(2): 110-3.
    Abstract ( ) PDF ( )
    A 66yearold man with myocardial infarction was hospitalized and underwent percutaneous transluminal coronary angioplasty and stenting immediately. The day after surgery, he received clopidogrel 75 mg once daily, intial dose of aspirin 300 mg followed by 100 mg per day, fluvastatin 20 mg once daily, and fosinopril sodium 10 mg once daily. One month later, the patient developed chills and high fever. Routine blood tests revealed the following values: white blood cell count 1.1×109/L with neutrophils 0.034, absolute value of neutrophils 0.037×109/L, red blood cell count 3.6×1012/L, hemoglobin 113 g/L, and platelet count 119×109/L. Bone marrow aspiration and biopsy showed nonsevere aplastic anemia. He received symptomatic treatment, his routine blood tests showed marked decreases in his complete blood count. On day 44 of hospitalization, routine blood tests revealed the following values: white blood cell count 2.6×109/L with neutrophils 0.367, absolute value of neutrophils 0.954×109/L, red blood cell count 3.6×1012/L, hemoglobin 113 g/L, and platelet count 84×109/L. Clopidogrel and aspirin were withdrawn immediately and switched to warfarin 2.5 mg once daily and cilostazol 100 mg twice daily,other medicines continued also. Subsequently, the routine blood tests were performed, and complete blood count gradually increased after reaching the lowest values. Bone marrow aspiration was repeated two times and results showed that bone marrow picture gradually returned to normal. On day 102 of hospitalization, routine blood tests revealed the following values: white blood cell count 5.8×109/L with neutrophils 0.552, absolute value of neutrophils 3202×109/L, red blood cell count 4.2×1012/L, hemoglobin 140 g/L, and platelet count 170×109/L. He was prescribed clopidogrel 50 mg once daily, aspirin 100 mg once daily. One week later, his routine blood tests showed marked decreases in complete blood count and, two weeks later, routine blood tests revealed the following values: white blood cell count 3.4×109/L with neutrophils 0.349, absolute value of neutrophils 1.187×109/L, red blood cell count 4.0×1012/L, hemoglobin 133 g/L, and platelet count 176×109/L. Subsequently, clopidogrel alone was stopped and changed to cilostazol 100 mg thrice daily. After one week, his blood picture normalized.
  • 病例报告
    Li TongyunLiu Haiyan
    2011, 13(2): 112-2.
    Abstract ( ) PDF ( )
    A 22yearold female patient was given progesterone 40 mg thrice daily, methyltestosterone 5 mg once daily, nifuratel 0.4 g thrice daily, and 2 Luohuazizhu tablets thrice daily for irregular menstruation and vaginitis. Three days later, the patient developed jaundiced skin and sclera, and teacolored urine. Laboratory tests showed the following values: red blood cells 3.02×1012/L with reticulocytes 0.034, total bilirubin 141.3 μmol/L, direct bilirubin 9.7 μmol/L, and indirect bilirubin 131.6 μmol/L. Progesterone, methyltestosterone, and nifuratel were stopped, Luohuazizhu tablets was continued, and treatment with a variety of drugs was given. Her jaundice gradually subsided. The color of urine gradually returned to normal . Eleven days after the withdrawal of the medicines, jaundice disappeared completely. Laboratory tests revealed the following levels: red blood cells 2.94×1012/L with reticulocytes 0.021, total bilirubin 15.2 μmol/L, direct bilirubin 5.8 μmol/L, and indirect bilirubin 9.4 μmol/L.
  • 病例报告
    Ouyang Hua
    2011, 13(2): 113-2.
    Abstract ( ) PDF ( )
    A 61-year-old male patient with small cell lung cancer received SC recombinant human interleukin -11(rhIL-11) 3 mg once daily for thrombocytopenia which occurred during chemotherapy. On day 5 of drug therapy, the patient presented with mild edema in his lower extremities, which progressed to a severe edema on day 7. The edema was considered to be related to rhIL-11.The drug was discontinued immediately. The man received diuretic therapy with hydrochlorothiazide and spironolactone. Two days after drug withdrawal, his edema gradually diminished and then subsided. Two months later, his thrombocytopenia recurred. SC rhIL-11 3 mg/day was readministered. Five days after initiation of rhIL-11, mild edema in his lower extremities recurred. His edema subsided two days after discontinuation of rhIL-11.
  • 病例报告
    Yu Dongwei;Gu Qinhua
    2011, 13(2): 114-2.
    Abstract ( ) PDF ( )
    A 69yearold woman with type 2 diabetes suddenly developed slurred speech and mouth distortion and then was hospitalized. Before admission, the patient received gliclazide 80 mg twice daily and aspirin 0.1 g once daily. A blood glucose test showed a glucose level of 1.7 mmol/L. An IV injection of 50% glucose 100 ml was administered. One hour later, her blood glucose level increased to 20 mmol/L, and her symptoms relieved. Gliclazide was discontinued and replaced with 1 tablet of sustainedrelease glipizide 5 mg once daily. The next day, her fasting blood glucose level was 1.7 mmol/L and her postprandial blood glucose level was 2.7 mmol/L.She also had palpitation, dizziness, and so on. Her symptoms improved after receiving an IV infusion of 10% glucose 250 ml. On days 35 of admission, the hypoglycemic agent was withdrawn, her blood glucose levels were then maintained between 82 mmol/L(fasting) and 10.1 mmol/L(postprandial).On day 6, 1 tablet of sustainedrelease glipizide 5 mg once daily was readministered. Her blood glucose level was maintained within 5.56.5 mmol/L. Two days later, she was discharged and continued taking sustainedrelease glipizide tablets. On day 12 after discharge, the patient suddenly redeveloped unconsciousness and no response to verbal stimuli, and then she was readmitted. A blood glucose test showed a glucose level of 1.6 mmol/L. On day 3 of admission, she started received metformin therapy,and her 2hour postprandial blood glucose level was maintained at approximately 8.7 mmol/L. On day 9, she was discharged.
  • 病例报告
    Jia Liu;Gao Yang;Wang Hongliang;Yu Kaijiang
    2011, 13(2): 116-2.
    Abstract ( ) PDF ( )
    A 41yearold female patient with chronic hepatitis B cirrhosis was hospitalized and received IV infusions of reduced glutathione 1.2 g once daily and IM recombinant human interferon α-2b(rhIFNα-2b)500 ×106 U once daily. One week later, laboratory tests showed the following results: white blood cell count 1.9×109/L, neutrophil count 0.48×109/ L, hemoglobin 118 g /L, erythrocyte count 3.7×1012/L, and platelet count 81×109/L. The rhIFNα-2b was stopped, other medicines were continued, and SC recombinant human granulocytemacrophage colonystimulating factor 75μg was given once daily. On day 5 of the treatment, repeated laboratory tests showed a white blood cell count of 4.8×109/L, a neutrophil count of 3.12×109/L, a hemoglobin level of 118 g /L, a erythrocyte count of 3.8×1012/L, and a platelet count of 61×109/L. RhIFNα2b once every other day was given again. Ten days after readministration, she had a persistent fever accompanied by chest tightness and vomiting. Laboratory tests showed the following values and levels: white blood cell count 0.1×109/L, undetectable neutrophil count, platelet count 20×109/L, hemoglobin 92 g/L, erythrocyte count 3.3×1012/L. RhIFNα-2b was discontinued immediately and she received symptomatic therapy. Aplastic anemia was diagnosed according to clinical symptoms and bone marrow aspiration findings. She received additional treatment with human immunoglobulin and glucocorticoid. On day 15, her platelet count decreased to 3×109/L and Klebsiella pneumoniae was detected in her blood culture. On day 17, the patient suddenly developed dyspnea, edema, petechiae and ecchymoses. On day 19, her condition worsened and, despite resuscitation attempts, she died.
  • 病例报告
    Meng Lina;Zhang Yuxiang;Su Jinwen;Yu Jinggang;Chen Ling
    2011, 13(2): 118-2.
    Abstract ( ) PDF ( )
    A 75yearold male patient with pulmonary tuberculosis was treated with rifampicin 0.6 g once daily, isoniazid 0.3 g once daily; pyrazinamide 03 g thrice daily, and levofloxacin 0.2 g twice daily for pulmonary tuberculosis. Eleven days later, the patient developed red rash accompanied with a maximum temperature of 38 ℃ and,14 days later, the symptoms worsened, so he stopped taking the medicines himself. Subsequently, he had jaundiced skin and sclera, vomiting, edema, and then he was hospitalized. Laboratory tests showed the following levels and values: ALT 652 U /L, AST 5066 U/L, ALP 66 U/L, DBil 30.9 μmol/L, TBil 53.5 μmol/L, SCr 150.0 μmol/L, BUN 13.9 mmol/L, platelet count 65×109/L. Admission diagnosis was as follows: secondary pulmonary tuberculosis; druginduced liver injury; type 1 respiratory failure; renal dysfunction; fibrillation; multiple organ dysfuction syndrome. All antitubercular drugs were discontinued, he was given amiodarone, diphenhydramine, calcium gluconate, hydrocortisone, S-adenosine-L-methionine, as well as other symptomatic and supportive treatments. Two weeks after hospitalization, the patient improved markedly. Laboratory tests showed the following results: ALT 36 U/L, AST 29 U/L, DBil 27.6 μmol/L, TBil 45.5 μmol/L, platelet count 93×109/L, SCr 51.5 μmol/L, and BUN 10.1 mmol/L. Antitubercular treatment was readministered as follows: ethambutol 075 g once daily and, one week later, pyrazinamide 0.1 g thrice daily was added and, 2 weeks later, isoniazid 0.3 g once daily was added. One month after admission, the patient’s condition was stable, and then he was discharged
  • 病例报告
    Zhang Haiying;Liu Yi;Li Yuzhen
    2011, 13(2): 120-2.
    Abstract ( ) PDF ( )
    A 72yearold woman received combined therapy with warfarin and nadroparin calcium for suspected pulmonary embolism, and the international normalized ratio (INR) was stable at 1.23-2.81. Eight days after combination therapy, nadroparin calcium was stopped and warfarin 3 mg/d alone was given. Two days later, her INR was 3.31. A sputum culture test showed Candida albicans, and an IV infusion of fluconazole 0.4 g once daily was added to her regimen,while warfarin was adjusted to 1.5mg/d. On days one and six of combination therapy with fluconazole and warfarin, her INR was 3.91 and 7.31, respectively. Warfarin was immediately withdrawn and fluconazole was continued according to the original dose. At the same time, the patient received IM vitamin K1 40 mg. On days 1, 2, and 3 after warfarin withdrawal, her INR decreased to 4.91, 2.01, and 1.30, respectively. On day 5 after drug withdrawal, the patient was readministered warfarin 1.5 mg/d and fluconazole was adjusted to 0.2 g/d simultaneously. On day 4 of combination therapy, her INR was 1.68.
  • 病例报告
    Sun Jian;Liu Peng;Fu Dexing;Liu Zhijun
    2011, 13(2): 121-2.
    Abstract ( ) PDF ( )
    A 75yearold male patient with prostatic carcinoma received carbamazepine 0.1 g twice daily for postherpetic neuralgia. Two days later, he experienced a weak urine stream, disabling frequent urination, and stuttering urination. Five days later, carbamazepine was increased to 0.2 g twice daily. His dysuria aggravated, and then his urine was drained using a urinary catheter. The drug was discontinued. The next day, the patient urinated himself and, on day 5, he recovered completely.
  • 病例报告
    Zhang Jiali;Yu Xiaojia
    2011, 13(2): 123-2.
    Abstract ( ) PDF ( )
    A 62yearold man with type 2 diabetes mellitus was administered an IV infusion of regular insulin 10 U and 15% potassium chloride 5 ml dissolved in glucose saline 500 ml to control blood glucose. After 20 minutes of infusion, the patient developed chest distress, short breath, polyhidrosis, and diffuse wheezes in bilateral lungs. The infusion was discontinued immediately and he received oxygen inhalation and aerosol inhalation of salbutamol sulfate.Blood gas analysis revealed a PO2 level of 73 mm Hg and a PCO2 level of 41 mm Hg. About 80 minutes after infusion completion, his asthmatic symptoms improved markedly and he could sleep in the supine position. The next morning, his asthmatic symptoms subsided. His treatment was switched to subcutaneous administration of recombinant human regular insulin and protamine zinc recombinant human insulin to control blood glucose. Subsequently, the abovementioned symptoms did not recur.
  • 病例报告
    Zhao Xin;Xie Weiping;Dai Guanqun
    2011, 13(2): 124-2.
    Abstract ( ) PDF ( )
    A 77yearold male patient received an IV infusion of imipenem/cilastatin sodium 0.5 g in 0.9% sodium chloride 100 ml thrice daily, followed by an IV infusion of linezolid 0.6 g twice daily, then an IV infusion of ambroxol 0.045 g in 0.9% sodium chloride 50 ml twice daily for chronic obstructive pulmonary diseases accompanied by pulmonary infections. An IV infusion of voriconazole 0.2 g twice daily was added to his regimen due to Aspergillus infection. After the third intravenous administration of voriconazole, the patient developed yellow vision. Subsequently, his treatment was switched to oral administration of voriconazole 0.2 g twice daily and other drugs were continued. On day 2 of oral administration, his yellow vision was significantly relieved and, on day 6, his symptoms subsided completely. His yellow vision did not recur after further 9 days of oral voriconazole therapy.
  • 病例报告
    Li Ming;Long Haiyan
    2011, 13(2): 125-2.
    Abstract ( ) PDF ( )
    A 52yearold female patient received combination treatment with levofloxacin, rifamycin sodium, isoniazid, ethambutol and pyrazinamide for pulmonary tuberculosis accompanied by tuberculous pleurisy. On day 13 of treatment, her sputum culture was positive for Enterobacter cloacae. Subsequently, an IV infusion of ceftazidime 2 g in 0.9% sodium chloride 100 ml once daily was added to her regimen. Four days later, the patient experienced confusion and delirious. Levofloxacin was stopped, but his psychiatric symptoms did not improve. Ceftazidime was withdrawn and other drugs continued, her psychiatric symptoms disappeared. Ceftazidime was not administered again and the above symptoms did not reappear. Her psychiatric symptoms did not recur after readministration of levofloxacin.
  • 病例报告
    Liu Jianfeng;Feng Qiaofei
    2011, 13(2): 127-2.
    Abstract ( ) PDF ( )
    A 44yearold woman with acute pharyngitis received an IV infusion of lomefloxacin 0.2 g dissolved in glucose 250 ml twice daily. After 2 days of treatment, she experienced asthenia and hyperhidrosis. Liver function tests showed the following levels: ALT 1076 U/L, AST 653 U/L, TBil 43.1 μmol/L,and DBil 32.3 μmol/L. She was diagnosed with acute liver damage. Lomefloxacin was discontinued immediately and she was given drugs for liver protection treatment. Four days after discontinuation of the drug, the patient’s symptoms improved, but she presented with jaundiced sclera and skin. Repeat liver function tests revealed the following levels: ALT 731 U/L, AST 420 U/L,TBil 164.8 μmol/L, and DBil 122.9 μmol/L. Fourteen days later, her jaundice subsided and her liver function returned to normal range.
  • 病例报告
    A Li Mujiang;Deng Xiaoyan
    2011, 13(2): 128-2.
    Abstract ( ) PDF ( )
    A 57yearold man with acute myocardial infarction underwent coronary artery stenting. After the surgery, he was given aspirin 100 mg once daily, clopodigrel 75 mg once daily, and simvastatin 40 mg once daily at bedtime. On day 5, he developed aching pain in his right lower limb. On day 8, his creatine kinase was 2085 U/L and serum creatine was 187 μmol/L. Meanwhile he experienced dark urine and occult blood (+). Simvastatin was withdrawn, aspirin and clopodigrel were continued, and coenzyme Q10 was administered. On day 2 of drug discontinuation, his aching pain in his right lower limb improved markedly and creatine kinase level was 1337 U/L. On day 11 of drug discontinuation, his creatine kinase level decreased to 186 U/L and his serum creatine level was 101 μmol/L, and then he was discharged.
  • 中药不良反应

  • 中药不良反应
    Zhang Xuewen
    2011, 13(2): 130-2.
    Abstract ( ) PDF ( )
    A 29yearold male patient was hospitalized for cranicerebral injury from a traffic accident. During hospitalization, the patient was given an IV infusion of compound Danshen injection 20 ml mixed in 5% glucose 250 ml once daily to improve microcirculation. On day 6 of treatment, he experienced of cutaneous purpura, followed by abdominal pain, joint pain in both lower limbs, and hematuria. Laboratory tests revealed the following levels: urinary occult blood (++), urinary protein (++), platelet count 243×109/L, prothrombin time 13 seconds, and activated partial thromboplastin time 36 seconds. Compound Danshen injection was withdrawn and he received symptomatic and supportive therapies, then his cutaneous symptoms improved. After one week, his rashes disappeared and routine urine tests normalized.
  • 中药不良反应
    Jiao Lin
    2011, 13(2): 131-2.
    A 46yearold woman selfmedicated with 2 pills (6 g) of Kudan thrice daily for her psoriatic arthritis. After 5 days, the patient developed fatigue and abdominal distension.She continued taking the drug, and her symptoms worsened. Nineteen days later, Kudan pills were stopped. On day 2 after drug discontinuation, she had markedly jaundiced skin and sclera, and then she was hospitalized. Biochemical tests revealed the following values: ALT 1384 U/L, AST 1311 U/L, TBil 91.4 μmol/L, DBil 53.5 μmol/L, IBil 37.9 μmol /L. Druginduced live damage was diagnosed and she received glycyrrhizin diammonium, reduced glutathione and other treatment. Twenty days later, her symptoms disappeared and liver function basically returned to normal, and then she was discharged.