2009 Volume 11 Issue 3 Published: 28 June 2009
  

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    临床论著

  • 临床论著
    Sun Lidong;Zhang Mei;Tang Xin
    2009, 11(3): 153-5.
    Abstract ( ) PDF ( )
    Objective: To evaluate the efficacy and safety of compound famotidine chewable tablets in treatment of symptoms in gastric acidrelated diseases. Methods: Sixty patients with gastric acidrelated diseases from September 2005 to March 2006 were randomly divided into two groups: the compound famotidine group and the famotidine group (30 cases in each group). The compound famotidine group comprised 12 men and 18 women with average age (45.50±10.09) years. The famoditine group comprised 14 men and 16 women with average age of (49.72±9.54) years. The patients in compound famotidine group received 1 compound famotidine chewable tablet (each tablet contains famotidine 10 mg, calcium carbonate 800 mg, magnesium hydroxide 165 mg) once daily when gastric acidrelated symptoms occurred on day 1; and on day 2, 1 tablet once or twice daily when symptoms occurred or 1 tablet at bed time if no symptoms occurred; the maximum daily dosage was 2 tablets. The patients in the famotidine group received 1 famotidine 20 mg capsule when gastric acidrelated symptoms occurred on day 1, and the administration were the same as those in the compound famotidine group on day 2; the maximum daily dosage was 2 capsules. The duration of treatment was 7 days in both groups. Observations included immediate symptom relief rate and complete symptom relief time 10, 30, 60, and 120 minutes after the first administration, symptom scores before treatment and after treatment completion, symptom relief rate after treatment completion, adverse reactions, routine blood tests, blood calcium level, liver and renal function, and changes in electrocardiogram. Results: The complete symptom relief time after the first administration in the compound famotidine and famotidine groups was (64.31±39.64) min and (72.75±51.41) min, respectively; there was no significant difference (P>0.05). The immediate symptom relief rate 10 and 30 minutes after the first administration in the compound famotidine and famotidine groups was 53.57% vs 82.14% and 22.22% vs 5556%, respectively; the differences were statistically significant (all P<0.05). The immediate symptom relief rate 60 and 120 minutes after the first administration was 89.29% vs 92.86% and 81.48% vs 92.59%, respectively; there was no significant difference (all P>0.05). The immediate symptom relief rate after treatment completion in both groups were 92.86% and 96.30%; there was no significant difference (P>0.05). The symptom scores in the compound famotidine and famotidine groups were (3.70±1.18) and (4.39±1.27) before treatment, and (2.93±1.12) and (2.72±1.26) after treatment completion, respectively; the difference between before treatment and after treatment was statistically significant (all P<0.01), but there was no significant difference between the two groups (P>0.05). The incidence of adverse reactions was 3.57% (one case of dry mouth) in the compound famotidine group and 7.41% (one case of dizziness and one case of nausea) in the famotidine group, there was no significant difference between the two groups (P>0.05). No abnormal changes were found in routine blood tests, liver and renal function, and blood calcium level (all P>0.05). Conclusion: Compound famotidine chewable tablets can rapidly relieve heartburn and acid regurgitation, it is a safe and effective medical preparation in treatment of symptoms in gastric acidrelated diseases.
  • 临床论著
    Zhang Jianxin;Shang Lan
    2009, 11(3): 158-3.
    Abstract ( ) PDF ( )
    Objective: To observed the effects of risperidone on electrocardiogram (ECG) in drugnaive patients with firstepisode schizophrenia. Methods:Ninetyfive drugnaive inpatients with firstepisode schizophrenia between January 2004 and December 2008 were enrolled in the study. The patients comprised 40 men and 55 women with average age of (33.85±10.80)years. Seventytwo patients’age was < 40 years and 23 patients’age was 40-70 years. The disease duration was ≥5 years in 32 cases (33.68%) and <5 years in 63 cases (66.32%).The patients started receiving risperidone at an initial dose of 1 mg once daily that was gradually increased to 2-6 mg daily within 2 weeks for a total of 3 months; of them, 32 patients received lowdose risperidone (<4 mg/d) and 63 patients received high-dose risperidone (≥4 mg/d). The patients’ECG was performed before and 1, 2, and 3 months after administration. The relationship among sex, age, disease duration, dosage and ECG changes was observed. Results: Risperidone-induced abnormal ECG mainly was sinus arrhythmia including sinus tackycardia, sinus bradycardia, and sinus irregularity, and secondly was ST-T changes. Abnormal ECG occurred respectively in 37 cases (38.95%), 28 cases (29.47%), and 31 cases (32.63%) 1,2, and 3 months after administration. Of them, male and female patients were respectively 19 cases (47.5%), 14 cases (35.0%), 12 cases (30.0%) and 18 cases (32.7%), 14 cases (25.5%), 19 cases (345%); the patients with age of 4070 years and < 40 years were respectively 5 cases (21.7%), 5 cases (21.7%), 6 cases (26.1%) and 32 cases (44.4%), 23 cases (31.9%), 25 cases (34.7%); the patients with disease duration of ≥5 years and < 5 years were respectively 12 cases (37.5%), 9 cases (28.1%), 6 cases (18.8%) and 25 cases (39.7%), 19 cases (30.2%), 25 cases (39.7%); the patients receiving low-dose and highdose risperidone were respectively 8 cases (25.0%), 7 cases (21.9%), 8 cases (25.0%) and 29 cases (46.0%), 21 cases (33.3%), 23 cases (36.5%). There were no differences in ECG changes in different time points among the patients with different sex, age, disease duration, and doses(all P>0.05). Conclusion: The effects of risperidone on ECG in drugnaive patients with firstepisode schizophrenia are mild. It is a less cardiotoxic antipsychotic drug.
  • 临床论著
    Fan Long;Xue Jixiu;Wang Tianlong
    2009, 11(3): 161-4.
    Abstract ( ) PDF ( )
    Objective: To observe the changes in serum amyloid-beta (1-40) [Aβ(1-40)]and zinc levels in elderly patients receiving general anesthesia with isoflurane during perioperative period. Methods: From June 2007 to March 2008, forty patients planning to undergo laparatomy were enrolled in the study. The patients were divided into following two groups based on age: the elderly patient group (20 cases) and the nonelderly patient group (20 cases). The elderly patient group comprised 12 men and 8 women with average age of (72.39±4.11) years. The nonelderly patient group comprised 11 men and 9 women with average age of (48.15±5.62)years. After transferring to the operation room, the patients in both groups received anesthesia induction and endotracheal intubation, followed by isoflurane 1 to 1.5 minimal alveolar concentration (MAC) for anesthesia maintenance. Three ml of blood was taken from the patients’cubital vein before anesthesia and 2, 4, and 24 hours after anesthesia, respectively. Serum Aβ(1-40) and zinc levels were measured with ELISA and biochemical analysis, respectively. Results: Average serum Aβ(1-40) level before anesthesia in the elderly patient and nonelderly patient groups were (5.03±1.96)μg/ml and (3.92±0.46) μg/ml, respectively. The difference was statistically significant (P<0.05).Average serum Aβ(1-40) levels 2,4, and 24 hours after anesthesia in the elderly patient and nonelderly patient groups were increased: (7.95±1.66) μg/ml, (7.63±1.51) μg/ml, (6.94±1.43) μg/ml and (5.15±0.72) μg/ml, (6.34±0.99) μg/ml, (4.81±0.81) μg/ml, respectively. The differences in Aβ(1-40) level in both groups between before anesthesia and after anesthesia, as well as at different time points after anesthesia between the two groups, were statistically significant (all P<0.05). Average serum zinc levels before anesthesia in the elderly patient and non-elderly patient groups were (14.36±1.38) μg/ml and (14.64±1.75)μg/ml, respectively. Serum zinc levels 2,4 and 24 hours after anesthesia in the elderly patient and nonelderly patient groups were (12.71±1.36) μg/ml, (10.64±1.83) μg/ml, (8.07±1.61) μg/ml and (13.10±1.68) μg/ml, (11.16±1.74) μg/ml, (9.40±1.99) μg/ml, respectively. The differences in serum zinc levels in both groups between before anesthesia and after anesthesia, as well as 24 hours after anesthesia between the two groups, were statistically significant (all P<0.05). Conclusion: Markedly increased serum amyloid-beta (1-40) levels and decreased serum zinc levels occur in elderly patients receiving general anesthesia with isoflurane during perioperative period.
  • Zhang Huifang
    2009, 11(3): 164-2.
    Abstract ( ) PDF ( )
    A 38-year-old man took 3 metamizole sodium 0.5 g tablets himself for a cold. About 30 minutes later, the patient developed dizziness, chest distress, asthenia, and red petechiae and ecchymoses on his face, neck, trunk, and extremities. Three hours later, the patient was hospitalized with aggravated symptoms. An examination revealed a temperature of 37.2℃, a heart rate of 118 beats/min, a respiratory rate of 32 breaths/min, and a BP of 30/0 mm Hg. She experienced agitation, unconsciousness, general clamminess, incontinence of urine, and bilateral mydriasis. Routine blood tests revealed the following: WBC count 12.6×109/L with 80% neutrophils, platelet count 136×109/L. An ECG showed tachycardia and sinus arrhythmia. Despite treatment with adrenaline, dexamethasone, promethazine, and sodium bicarbonate, the resuscitation was unsuccessful and he died.
  • 临床论著

  • 临床论著
    Jiang Beiqi;Li Zhengdong;Zhuang Zhigang
    2009, 11(3): 165-5.
    Abstract ( ) PDF ( )
    Objective: To observe docetaxel-related adverse reactions to TAC regimen (docetaxel plus epirubicin and cyclophosphamide) and AC-T regimen (epirubicin plus cyclophosphamide followed by docetaxel) in treatment of breast cancer in order to evaluate their clinical safety. Methods: From July 2004 to June 2008, 110 patients with confirmed breast cancer were enrolled in the study and divided into two groups: the TAC regimen group and the AC-T regimen group. The TAC regimen group comprised 72 patients; patient age ranged from 28 to 55 years [average age (45±7.2) years]. The AC-T regimen group comprised 38 patients; patient age ranged from 35 to 66 years [average age (48±6.4) years]. The patients in the TAC regimen group received an IV push of epirubicin 60 mg/m2, an IV push of cyclophosphamide 500 mg/m2, and an IV infusion of docetaxel 75 mg/m2 on day 1 of every 21-day cycle for 6 cycles. The patients in the AC-T regimen group received an IV push of epirubicin 75 mg/m2 and an IV push of cyclophosphamide 500 mg/m2 on day 1 of every 21-day cycle for 4 cycles, followed by an IV infusion of docetaxel 75mg/m2 on day 1 of every 21day cycle for 4 cycles. Docetaxelrelated adverse reactions were observed during treatment with the two regimens. Results:Neutropenia in the TAC regimen and AC-T regimen groups was 72 cases (100%) [64 cases (88.9%) of grade 3/4 neutropenia] and 32 cases (84.2%) [16 cases (42.1%) of grade 3/4 neutropenia], respectively; granulocytic fever was 62 cases (86.1%) and 6 cases (15.8%), respectively. The differences in grade 3/4 neutropenia and granulocytic fever between the TAC regimen and AC-T regimen groups were statistically significant (all P<0.01). Anaphylaxis was 10 cases (13.9%) and 5 cases (13.2%), respectively; watersodium retention was 3 cases (4.17%) and one case (2.63%), respectively; peripheral neurotoxicity was 33 cases (45.8%) and 12 cases (31.6%), respectively; changes in skin and nail were 28 cases (38.9%) and 13 cases (34.2%), respectively. There were no significant differences in incidence of anaphylaxis, water-sodium retention, peripheral neurotoxicity, and changes in skin and nail between the TAC regimen and AC-T regimen groups (all P>0.05). Conclusion: AC-T regimen is a relatively safe chemotherapy regimen.
  • 临床论著
    Wang Zhiying;Liang Biyun;Fu Zhuo
    2009, 11(3): 170-4.
    Abstract ( ) PDF ( )
    Objective: To observe the influence of atropine on anesthetic effect and safety of propofol during enteroscopy.Methods: Between March 2008 and July 2008, eighty patients planning to undergo enteroscopy were enrolled in the study and divided into two groups: the test group and the control group (40 cases in each group).The test group comprised 23 men and 17 women with average age (53±19) years. The control group comprised 26 men and 14 women with average age ( 50±22) years. The patients in the test group received an slow IV push of 0.250.5 ml of atropine 0.1mg/ml diluted in sodium chloride 0.9% to total of 5 ml, and slow IV push of propofol 1.52.5 mg/kg in not less than 30 seconds.The patients in the control group received propofol alone, the dosage and administration were the same as those in the test group.The patients’heart rate, blood pressure, and blood oxygen saturation before and 5, 10 minutes after administration, limb movement, period of consciousness, dosage of propofol, and adverse reactions were observed and recorded. Results:The heart rate of patients in both groups decreased 5 minutes after administration compared with before administration: (77.2±8.9) beats/min vs (73.5±9.1) beats/min, respectively, in the test group; (79.7±7.2) beats/min vs (68.4±12.3) beats/min, respectively, in the control group. The different in heart rate was statistically significant (all P<0.01). The systolic pressure and blood oxygen saturation in both groups decreased 5 minutes after drug administration compared with before drug administration: (136±12.5) mm Hg vs (123.2±14.3) mm Hg and (97.5±0.8)% vs (95.2±0.7)%, respectively, in the test group; (138±14.6) mm Hg vs (108±12.2) mm Hg and (97.8±0.7)% vs (90.3±0.8)%, respectively, in the control group. Systolic pressure and blood oxygen saturation markedly decreased in the control group compared with the test group, the differences were statistically significant (all P < 0.01). In the test and control groups, the total scores of limb movement was 22 and 46, the consciousness period was (2.8±1.3) min and (4.8±2.1) min, and the total dosage of propofol was (124±16) mg and (138±20) mg, respectively; the differences between the two groups were statistically significant (all P < 001). The incidence of adverse reactions in the test and control groups were 65% and 87.5%, respectively, including blood oxygen saturation <80% (2.5% vs 10.0%), bradycardia (0% vs 12.5%), and allergic erythema (7.5% vs 12.5%). Conclusion: Propofol combined with atropine is an effective and safe anesthetic regimen for painless enteroscopy.
  • 病例报告

  • 病例报告
    Wang Linghang
    2009, 11(3): 173-2.
    Abstract ( ) PDF ( )
    A 7-month-old male infant was hospitalized with hand, foot and mouth disease. Nystatin one million units dissolved in 10 ml of 0.9% sodium chloride injection was applied to the oral mucosa of the infant for complication of mycotic stomatitis. Meanwhile, an IV infusion of Tanreqing injection was given. Subsequently, the infant presented with crying and noise, convulsion of extremities, skin cyanosis, and high fever; his BP was 80/55 mm Hg and his heart rate was 160 beats/min. His symptoms relieved after treatment with anti-allergic drugs. Two days later, Tanreqing injection was withdrawn and nystatin was continued. Cyanosis and peripheral coldness recurred; his BP was 70/50 mm Hg. Nystatin was stopped and changed to fluconazole. The above symptoms did not recur.
  • 实验论著

  • 实验论著
    Yuan Weili;Wang Xukai;Liu Dongjuan
    2009, 11(3): 174-5.
    Abstract ( ) PDF ( )
    Objective: To investigate the effect of different pingyangmycin concentrations on normal rabbit lip tissue. Methods:Thirtyone rabbits were randomly divided into three group: the 8 mg/5 ml dose group (15 rabbits), the 8 mg/3 ml dose group (15 rabbits), and the control group (one rabbit). The rabbits in both dose groups were redivided into 5 subgroups (3 rabbits in each subgroup), respectively. The rabbit right upper lip in the each subgroup was injected with 0.5 ml of pingyangmycin 8 mg/5 ml and pingyangmycin 8 mg/3 ml,respectively. The rabbit right upper lip in the control group was injected with same volume of normal saline. The changes in the rabbit lip were observed every day. The repeated injection was performed on week 2 after the first injection. Three rabbits in each subgroup of both dose groups were sacrificed on days 21,28,35,60, and 90 after the first injection and the rabbit in the control group was sacrificed on day 90 after the first injection. Adverse reactions at the local injection site were observed, and the lip thickness was measured at the different time points after injection. The pathological changes in the rabbit lip tissue were observed under light microscope and transmission electron microscope. Results: In the 8 mg/5 ml dose group, asymmetric changes in the rabbit bilateral upper lip were not found and the thickness of injection site of the rabbit lip was respectively(4.18±0.04)mm,(4.16±0.06)mm,(4.16±0.03)mm,(4.14±0.05)mm, and(4.12±0.02)mm on days 21, 28, 35, 60, and 90 after the first injection. In 8 mg/3 ml dose group, swelling of injection site of the rabbit upper lip, mild atrophy of upper lip, and sclerosis of local mucous membrane occurred, and the thickness of injection site of the rabbit lip was respectively (3.48±0.01)mm,(3.36±0.02)mm,(2.64±0.11)mm,(1.56±0.14)mm, and(1.38±0.18)mm at different time points after the first injection. The differences in the thickness of injection site of the rabbit lip at different time points between the 8 mg/5 ml dose group and the 8 mg/3 ml dose group were statistically significant (all P< 0.01). On day 28 after injection, light microscopic examination of the rabbit lip tissue from injection site in the 8 mg/3 ml dose group revealed vacuolar degeneration of vascular endotheliocyte, intravascular thrombosis and obstruction, hyperplasia and degeneration of collagenous fibers, and a replacement of a part of muscle fibers by collagenous fibers. On day 90 after injection, electron microscopic examination revealed normal mitochondria, clear mitochondrial cristae, regular arrangement of muscle fibers in the 8 mg/5 ml dose group, as with the control group; and dissolution of a part of muscle fibers, swelling of myofilaments, rupture of mitochondrial outer membrane, dissolution of mitochondrial cristae, and vacuolar degeneration of some mitochondria in the 8 mg/3 ml dose group.Conclusion: Local injection of pingyangmycin 8 mg/5 ml in the normal rabbit lip tissue is safer than that of pingyangmycin 8 mg/3 ml.
  • 调查研究

  • 调查研究
    Zhang Renlinga;Qi Yingb;Wang Yuqingc
    2009, 11(3): 179-4.
    Objective: To investigate the clinical features of oedema and the changes in liver and renal function and thyrotropin level in type 2 diabetic patients following the addition of pioglitazone. Methods:Eight type 2 diabetic patients receiving hypoglycemic agents plus pioglitazone from January to December in 2008 were enrolled in the retrospective investigation. The 8 patients comprised 2 men and 6 women with age of 5268 years \[average age (58.62±5.65) years\]. All patients received more than 2 hypoglycemic agents (metformin, gliquidone, nateglinide, insulin, repaglinide, and acarbose), followed by pioglitazone 1530 mg daily. The time of oedema onset and disappearance and its clinical features were investigated in patients following the addition of pioglitazone. Before and during pioglitazone administration and 2 weeks after oedema disappearance, the urinary analysis, liver and renal function tests were performed. In addition, the TSH level was measured after oedema onset and 2 weeks after oedema disappearance. Results: All patients developed oedema 510 days after pioglitazone start, and its features were bilateral pitting oedema in both feet and legs. The oedema subsided 27 days after pioglitazone withdrawal. The laboratory tests before and during pioglitazone administration and 2 weeks after oedema disappearance revealed that urinary protein was negative; the median serum urea level was 6.20 mmol/L, 6.36 mmol/L, and 5.90 mmol/L, respectively; the median SCr level was 83.5 μmol/L, 87.0 μmol/L, and 78.0 μmol/L, respectively; the median ALT level was 31.5 U /L, 32.0 U /L, and 33.0 U /L, respectively. The TSH level after oedema onset and 2 weeks after oedema disappearance was 7.1 mU/L and 6.9 mU/L, respectively. Conclusion: Type 2 diabetic patients receiving hypoglycemic agents may develop pitting oedema in both feet and legs following the addition of pioglitazone, but there is no effect on liver and renal function and thyrotropin level, and oedema rapidly resolved after pioglitazone discontinuation.
  • 安全用药

  • 安全用药
    Nan Fei;Dang Haihong
    2009, 11(3): 183-5.
    Abstract ( ) PDF ( )
    Hepatitis C is an infectious disease caused by hepatitis C virus. Treatment of hepatitis C viral infection is mainly to use interferon or interferon plus ribavirin. Depression may occur in the patients with hepatitis C following treatment with interferon. The time of depression onset is 1-8 weeks after starting interferon. The prevalence rate of interferon-induced depression is 17%-82%. The risk factors for depression occurring include patients' heredity, neuropsychic condition before interferon treatment, hepatitis C itself, and the dosage, duration, administration route, and formulations of interferon. The mechanisms of interferoninduced depression are decreased 5-HT levels, hypothalamic-pituitary-adrenocortical (HPA) axis activation, proinflammatory cytokine activation, increased intercellular adhesion molecule-1, increased nitric oxide levels, and decreased dipeptidyl peptidase levels. Treatment and prevention of depression include assessment of patient condition before treatment and appropriate choice of anti-depression drugs after depression occurring.
  • 安全用药
    Wen Yingqi
    2009, 11(3): 188-3.
    Sorafenib is a multikinase inhibitor, which is used in the treatment of advanced renal cell carcinoma and many other types of solid tumors. One of the most common adverse reactions to sorafenib is handfoot skin reaction (HFSR). The incidence of HFSR is 33.8%. The clinical manifestations of HFSR are numbness, tingling, erythema, swelling, blister, dry skin, chap, and desquamation on the hands and feet. The mechanisms of sorafenibinduced HFSR is unclear, but may be related to inhibition of VEGF, PDGF, c-kit, RET, and FLT3. Prevention and treatment of HFSR include dosage adjustment according to the intensity of HFSR and symptomatic treatment.
  • 药源性疾病

  • 药源性疾病
    Lei Zhaobao
    2009, 11(3): 191-5.
    Abstract ( ) PDF ( )
    The term of drug-induced taste disorders refers to agusia, dysgusia, and hypogusia due to drugs. More than one hundred drugs can cause taste disorders. The main drugs causing taste disorders are anti-infectives, cardiovascular drugs, drugs used in neuropsychopathy, and antineoplatics. One of the plausible mechanisms of druginduced taste disorders is the reduction of zinc concentration in human body. Drug-induced taste disorders can negatively influence appitite, food intake, quality of life, emtional state, and importantly, medication compliance. Therefore, doctors should care for the druginduced taste disorders occurring in clinical practice.
  • Wu Jinglin;Sun Yanbing
    2009, 11(3): 195-2.
    Abstract ( ) PDF ( )
    A 46-year-old woman with uremia and anemia received an IV infusion of iron dextran 100 mg twice a week while undergoing hemodialysis. The patient experienced headache every time 30 minutes after infusion initiation. She presented with generalized myalgia and arthralgia after the seventh infusion. Iron dextran injection was stopped and switched to an oral iron preparation. Her symptoms relieved one week later.
  • Ling Yilan
    2009, 11(3): 196-2.
    Abstract ( ) PDF ( )
    A 39-year-old woman with mania received lithium carbonate 0.5 g at noon and 0.75 g in the evening as well as clozapine 12.5 mg at noon and 62.5 mg in the evening for 10 years and more. About one year ago, the patient developed dizziness, asthenia, low extremeities shiver, and hands tremor. On examination, lithium poisoning was suspected. Laboratory test revealed that her serum lithium concentration was 2.4 mmol/L . Lithium carbonate was stopped. An IV infusion of 1000 ml of sodium chloride 0.9% once daily was given, and clozapine was continued. Seven days later, her serum lithium concentration decreased to 0.33 mmol/L and her symptoms gradually improved.
  • Du Guantao;Chen Guilin
    2009, 11(3): 197-2.
    Abstract ( ) PDF ( )
    A 67-year-old man with chronic obstructive pulmonary disease and infection received 2 compound methoxyphenamine capsules (each capsule contains aminophylline 25 mg) thrice daily and an IV infusion of enoxacin 0.2 g once daily. After five days of therapy, he developed chest distress, nausea, short of breath, and several times of vomiting. Enoxacin was stopped. Three days later, his serum theophylline concentration was 19.06 μg/ml. Compound methoxyphenamine capsules were continued. His symptoms mentioned above relieved.
  • 药物滥用

  • 药物滥用
    Zhang Kaigao
    2009, 11(3): 198-3.
    Abstract ( ) PDF ( )
    The term of chronic non-cancer pain refers to a painful condition which is caused by various kinds of diseases and not associated with cancer lasting more than six months.Recently, prescription opioid use for treatment of chronic noncancer pain is increasing. Prescription opioid abuse has been a health problem and caused widespread concern. Risk factors for prescription opioid abuse are mainly non-opioid substance abuse and mental disorders. The patient with non-cancer pain and behaviors of non-opioid substance abuse or mental disorders is prone to develop prescription opioid abuse.
    KEY WORDS
  • Liu Chunyu;Xie Zhiyi;Qin Long
    2009, 11(3): 201-3.
    Abstract ( ) PDF ( )
    A 26yearold man was hospitalized with myalgia in his lower extremities, chest distress and palpitation. On admission, he had oliguria, dark urine, a BP of 80/50 mm Hg, and a heart rate of 120 beats/min. Laboratory test results were as follows: CK 906 U/L, CK-MB 100 U/L, ALT 310 U/L, AST 369 U/L. Urinalysis revealed the following results: WBC count 1493.2/μl, RBC count 193.1/μl, cast 65/μl, pathologic cast (+), bilirubin (++), occult blood (++), protein (++), specific gravity 1.030. Blood gas analysis revealed a pH of 6.9 and a PO2 of 64 mm Hg, which was considered to be metabolic acidosis. An IV infusion of sodium bicarbonate 5% was given. A review of his medical history showed that he had a history of chronic hepatitis B and received telbivudine 600 mg once daily for 11 months and more. Laboratory test showed his blood myoglobin level was more than 500 ng/ml. The man was diagnosed with telbivudineassociated rhabdomyolysis and treated with hemofiltration, methylprednisolone, and symptomatic therapy. Telbivudine was discontinued and changed to entecavir. The second day of hospitalisation, he had a peak CK level of 1300 U/L, a CKMB level of 61 U/L, a ALT level of 512 U/L, and a AST level of 579 U/L. Four days later, his urine volume normalized, renal function gradually returned to within normal ranges. On day 12 of hospitalisation, his myalgia in the lower extremities markedly improved and his muscle strength recovered to grade Ⅳ; he had a CK level of 144 U/L, a CK-MB level of 15.1 U/L, a ALT level of 57 U/L, a AST level of 34 U/L, and normal electrolyte levels.
  • Liu Yu;Zhang Yuanyuan;Wu Yimei;Zhao Xiuli;Zhang Xiaoshu
    2009, 11(3): 203-3.
    Abstract ( ) PDF ( )

    An 18-year-old man with epilepsy received carbamazepine treatment for 3 months, but no effects were observed, then carbamazepine was changed to sodium valproate 0.2 g daily for 40 days and more. Subsequently, the patient suddenly developed convulsion on limbs with unconsciousness, then he was hospitalized. His consciousness recovered after management. He presented with dizziness, diplopia, nausea, vomiting, and tinnitus. Examination revealed dysarthria, nystagmus and ataxia. On day four after admission, his blood ammonia level was 117.6 μmol/L. Routine blood testing and liver and renal function examination were normal. A brain MRI found no marked abnormalities. His symptoms improved after discontinuation of sodium valproate and his dizziness recurred after readministration of sodium valproate. Sodium valproate was stopped immediately and switched to clonazepam. His symptoms disappeared. His blood ammonia level decreased to 66 μmol/L.

  • 病例报告

  • 病例报告
    Cheng Sheng
    2009, 11(3): 205-2.
    Abstract ( ) PDF ( )
    A 55yearold woman, who had no previous history of liver disease, received nimesulide 0.1 g twice daily for prolapse of lumbar intervertabral disc. Twenty days later, the patient developed epigastric distention and pain, nausea, and anorexia. Liver function examination showed the following values: ALT 377 U/L, AST 105 U/L, TBil 13.72 μmol/L. She had negative serology for HBsAg and hepatitis A, C, E antibodies. Ascites were evident on an ultrasonography, an abdominal paracentesis was performed, and 180 ml of turbid yellow ascitic fluid were drained off. Routine tests revealed that her ascitic fluid contained WBC 1 720×106/L; a Rivata test was positive. Nimesulide was stopped, and polyene phosphatidylcholine, compound glycyrrhizin, glucurolactone, and levofloxacin were given. On day 10 after hospitalization, her ascitic fluid was disappeared. Then her liver function gradually improved and he was disoharged. Two months after discharge, her liver function returned to within normal ranges.
  • Li Xueqinga;Suo Lixiab;Shao Yajunc;Yin Jinhuab
    2009, 11(3): 206-2.
    Abstract ( ) PDF ( )

    Three patients with diabetes mellitus (1 man and 2 women aged 42~65 years) received repaglinide 0.5~2 mg thrice daily. Their liver functions were normal before repaglinide administration. About 12 months of therapy, the patients presented with yellowish skin and sclera. Liver function tests revealed the following values: ALT 205~1 350 U/L, AST 183~835 U/L, γ-GT 155~585 U/L, TBil 52.8~158.8 μmol/L. Repaglinide was stopped and liver-protective treatment was given. Their symptoms subsequently improved.

  • 病例报告

  • 病例报告
    Zhou Xin;Liu Ruining;Li Hongjie
    2009, 11(3): 208-2.
    Abstract ( ) PDF ( )

    An 84-year-old woman was hospitalized with marked emaciation and anorexia. On admission, her liver function examination revealed the following values: ALT 10.0 U/L, AST 20.2 U/L, and γ-GT 16.3 U/L. An IV infusion of alany1 glutamine 20 g plus compound amino acid (18AA-Ⅱ) 500 ml was given. Three days later, her ALT level was 98.7 U/L, her AST level was 172.3 U/L, and her γ-GT level was 16.0 U/L. On day 5 after admission, the infusion was stopped; and on day 16, her liver function normalized. An IV infusion of alany1 glutamine plus compound amino acid (18AA-Ⅱ) was readministered. Four days after administration, her ALT and AST levels increased to 149.8 U/L and 129.5 U/L, respectively. The infusion was stopped again and her liver function normalized gradually.

  • Pan Yuyan
    2009, 11(3): 209-2.
    Abstract ( ) PDF ( )

    A 48-year-old woman with fatty liver and mild increase in liver enzyme level (ALT 54.2 U/L) was treated with tiopronin 02 g thrice daily. Eight days later, the patient developed asthenia, anorexia, and yellowish urine. Laboratory testing revealed the following values: ALT 562.1 U/L, AST 253.9 U/L, DBil 26.2 μmol/L, TBil 38.3 μmol/L. Serology tests for hepatitis A, C, D, E viruses were negative. Tiopronin was withdrawn immediately and an IV infusion of magnesium isoglycyrrhizinate and sodium deoxyribonucleotide was given. Subsequently, her liver function improved gradually. Eighteen days after discharge, her ALT was 27.1 U/L and her AST was 19.1 U/L.

  • Shan Wenwei
    2009, 11(3): 210-2.
    Abstract ( ) PDF ( )

    A 40-year-old man with hypertension received captopril 6.25 mg three times daily. One week later, the dosage of captopril was increased to 12.5 mg three times daily. After one month, his TBil increased from 13.6 μmol/L to 37.3 μmol/L. Captopril was discontinued. His TBil was 28.7 μmol/L one week later and 15.6 μmol/L one month later. Routine urine and blood investigations were normal, and viral serology was negative for hepatitis virus markers. Increased bilirubin was considered to be captopril-associated. Subsequently, captopril was changed to nifedipine sustained-release tablets and above-mentioned symptoms did not recur.

  • 病例报告

  • 病例报告
    Jin Zhenbo
    2009, 11(3): 211-2.
    Abstract ( ) PDF ( )
    A 36-year-old woman with hyperthyroidism was given thiamazole 10 mg thrice daily and propranolol 10 mg thrice daily. Twentythree days later, the patient presented with skin rash, loss of appetite, and nausea. Laboratory test revealed the following levels: WBC count 1.6×109/L, absolute neutrophil count 0.80×109/L, ALT 125.0 U/L, and AST 62.0 U/L. Thiamazole was withdrawn. After treatment with reduced glutathione, silibinin, loratadine, and filgrastim, the patient improved. Her WBC count was 4.30×109/L, her absolute neutrophil count was 3.1×109/L, and her ALT and AST levels were 27.0 U/L and 17.0 U/L, respectively.
  • Chen Zhongming
    2009, 11(3): 212-2.
    Abstract ( ) PDF ( )

    A 41-year-old male patient was hospitalized with peptic ulcer bleeding. After admission, the patient was treated with an IV infusion of pantoprazole 40 mg twice daily, an IV infusion of pazufloxacin 0.3 g once daily, etamsylate, aminomethylbenzoic acid, and hydroxyethyl starch. On day 3 of therapy, his WBC count decreased from 11.8×109/L to 1.7×109/L. Leukopenia was considered to be possibly pazufloxacinassociated. Pazufloxacin was stopped and switched to ceftezole, and pantoprazole was continued. His WBC count was 2.7×109/L two days later and 4.1×109/L one week later.

  • 病例报告

  • 病例报告
    Wu Xiuping
    2009, 11(3): 213-2.
    Abstract ( ) PDF ( )

    A 63-year-old man was hospitalized with angina pectoris. On admission, his blood pressure was 130/80 mm Hg. After hospitalization, he received oral administration of aspirin, simvastatin, and Tongxinluo, followed by an IV infusion of nitroglycerin 10 mg dissolved in 250 ml of glucose 5%. The patient developed increased blood pressure (150/90 mm Hg), headache, and chest distress half an hour after the first infusion start. The next day, headache, chest distress, and increased blood pressure (170/100 mm Hg) recurred 5 minutes after the second infusion start. Subsequently, nitroglycerin was stopped; all his other medications were continued. His blood pressure normalized.

  • 病例报告
    Cui Baozhu
    2009, 11(3): 214-2.
    Abstract ( ) PDF ( )

    An 87yearold man was hospitalized with lung metastasis of renal cancer complicated by lung infection. After admission, his ECG showed atrial premature beats with occasional ventricular premature beats. The patient was treatment with ceftizoxime and levofloxacin. On day 5 of hospitalization, he received an IV infusion of recombinant human interleukin-2 21 million units in 0.9% sodium chloride 100 ml. The next day, the patient developed paroxysmal atrial fibrillation. Initially, 2-3 episodes occurred every day and each episode lasted for 1-2 minutes. Four days later, multiple episodes occurred and each episode sometimes lasted for 10 minutes and more. Propafenone 100 mg thrice daily was given by mouth, but this had no obvious effect. Atrial fibrillation was considered to be possibly recombinant human interleukin-2-associated. Recombinant human interleukin-2 was stopped immediately. Subsequently, his ECG did not reveal any atrial fibrillation.

  • 病例报告
    Wang Yanhui
    2009, 11(3): 215-3.
    Abstract ( ) PDF ( )

    A 69-year-old woman with coronary heart disease and hypertension received captopril, atenolol, isosorbide dinitrate, and nifedipine for two years and more. After admission, enteric-coated aspirin 0.1 g once daily and SC low molecular weight heparin calaium 5 000 U once every 12 hours were added to her regimen due to unstable angina. The next day, her enteric-coated aspirin dosage was increased to 0.3 g once daily, and low molecular weight heparin calcium was changed to heparin sodium 800-1 500 U/h, which was administered via an intraveous infusion pump. Forty-eight hours later, heparin sodium was switched to SC low molecular weight heparin calcium 6 000 U once every 12 hours again. On day 5, the patient developed retroperitoneal hematoma, and the amount of bleeding was 1 000-1 200 ml. Entericcoated aspirin and low molecular weight heparin calcium were withdrawn. RBC suspension, batroxobin, and fluid expansion were given. On day 28 after hospitalization, a CT scan revealed that his hematoma was absorbed in some degree and she was discharged two days later. Two months after discharge, repeated CT scan showed that a greater part of hematoma was absorbed.

  • Zhang Fang;Chen Anjin
    2009, 11(3): 217-2.
    Abstract ( ) PDF ( )

    A 54-year-old male renal transplant recipient received allopurinol, prednisone, and sodium bicarbonate for gout in the past three years. In recent one month, his gout symptoms were exacerbated, then he was hospitalized and celecoxib 0.2 g twice daily was added to his regimen. The patient's renal function was normal and his urine protein was negative before treatment. After three days of therapy, he developed a 1+ urine protein and increased foamy urine. Celecoxib was stopped. After 3 further days, his foamy urine decreased and his urine protein became negative.

  • 病例报告

  • 病例报告
    Zhan Shengli;Cai Ming;Shi Bingyi;Li Zhouli;Wei Xing;Liang Tao;Li Pengcheng
    2009, 11(3): 218-3.
    Abstract ( ) PDF ( )

    Two man with coronary artery disease or myocardial ischemia developed priapism after receiving alginic sodium diester (dosage not stated).Patient 1, a 35-year-old man with coronary artery disease, received an IV infusion of alginic sodium diester. On day 7, the patient developed priapism, and then he was hospitalized with an erection of 32 hours duration. The man underwent blood aspiration from the corpora cavernosa and received corpora cavernosa irrigation with phenylephrine, low molecular weight heparin, and normal saline. Three days later, his priapism resolved.Patient 2, a 41-year-old man with myocardial ischemia, received an IV infusion of alginic sodium diester. On day 3, the patient developed priapism, and then he was hospitalised with an erection of 72 hours duration. Corpora cavernosa irrigation and cavernosal-glandular shunt were not successful in relieving the priapism. Subsequently, cavernosalglandular shunt plus cavernous dilation were performed again. The next day, his priapism subsided completely.

  • 病例报告
    Zhang Yan;Yao Ying
    2009, 11(3): 220-2.
    Abstract ( ) PDF ( )
    Two patients developed swelling of submandibular glands and parotid glands due to combined use of ondansetron and lappaconite via an intravenous analgesia pump after surgery. Patient 1, a 30-year-old woman with ovarian tumor and cervicitics, received IV cefodizine and IV ornidazole respectively, and ondansetron 16 mg and lappaconitine 64 mg in 100 ml of sodium chloride injection 0.9% were administered via an intravenous analgesia pump for control of vomiting and relief of pain after undergoing ovarian tumor resection. Nine hours later, swelling of bilateral submandibular glands and parotid glands occurred. The analgesia pump was removed immediately and IV dexamethasone 10 mg was given. After 5 days, her salivary glands swelling subsided. Patient 2, a 42-year-old woman with hysteromyoma and early pregnancy, received an infusion of cefuroxime and an infusion of levofloxacin, respectively, and ondansetron 8 mg plus lappaconitine 40 mg in 95 ml of sodium chloride injection 0.9% were administered via an intravenous analgesia pump for control of vomiting and relief of pain after undergoing subtotal hysterectomy. Eight hours later, the patient developed swelling of bilateral submandibular glands and parotid glands accompanied with palpitation, chest distress and dyspnea. The analgesia pump was removed immediately and IV dexamethasone 10 mg and IM promethazine 25 mg were given. The next day, her salivary glands swelling was markedly subsided and her dyspnea relieved.
  • Wu Aihuia;Zhou Rongbina;Han Juqiangb;Zhang Yuanboa;He Yanga;Chen Dongmeia
    2009, 11(3): 222-2.
    Abstract ( ) PDF ( )

    A 23-year-old man with acute purulent tonsillitis received 1 aspirin 0.5 g effervescent tablet for a fever. About thirty minutes after administration, the patient developed facial swelling, mild skin flushing over his entire body, pruritus, chest distress, short of breath, dyspnea, and cyanosis. After admission, an examination revealed a BP of 70/40 mm Hg, a heart rate of 125 beats/min, a respiratory rate of 36 breaths/min. He had popular eruption of different sizes on his entire body and wheezing over both lungs. ECG showed sinus tachycardia. Oxygen inhalation, dexamethasone, promethazine, and fluid expansion were given immediately. Half an hour later, his symptoms improved gradually.