2008 Volume 10 Issue 5 Published: 28 October 2008
  

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    病例报告

  • 病例报告
    Wang Shaobing;Xiao Houping
    2008, 10(5): 0-0.
    Abstract ( ) PDF ( )

    A 58-year-old woman, who has a history of penicillin allergy, was treated with an IV infusion of enoxacin glyconate 0.4 g once daily for hemorrhoids infection. On days 1 and 2 of therapy, the woman developed nausea and anorexia. On day 3, the patient experienced visual loss, reduced hearing, trembling limbs, and dysphoria about 30 minutes after treatment. Her symptoms resolved after promethazine and calcium gluconate were administered. Enoxacin was stopped and the abovementioned symptoms did not reappear.

  • 调查研究

  • 调查研究
    Zhao Chen;Zhu Wei;Lian Shi
    2008, 10(5): 0-0.
    Abstract ( ) PDF ( )

    Objective: To understand the types of drug eruptions and their causative agents in order to help clinicians to diagnose and treat drug eruptions. Methods: The clinical data from outpatients between January 2002 and December 2007 were collected. The latent period, causative agents, type, treatment, and outcome of drug eruptions were analyzed retrospectively. Results: A total of 341 patients[165 men and 176 women aged 3~90 years, average age (45.67±19.98) years ] were enrolled in a study. Two hundred and ninety-eight patients of them had a certain latent period. The latent period from exposure to onset of symptoms was ≤1 week in 247 cases (82.89%),~2 weeks in 28 cases (9.40%) and >2 weeks in 23 cases (7.71%). Two hundred and ninetythree patients (85.92%) received monotherapy. The common agents causing drug eruptions were β-lactam antibiotics (68 cases, 32.2%), analgesicantipyretic agents (49 case, 16.72%), quinolones (32 cases, 10.92%), Chinese patent medicines (30 cases, 10.24%), and sulfonamides (29 cases, 9.90%). Other causative agents included cardiovascular agents, antiepileptics, biological products, sedatives and hypnotics. The types of drug eruptions were morbilliform or scarlatiniform exanthema (exanthematous eruption) (147 cases), urticaria (71 cases), fixed drug eruption (60 cases), erythema multiform (7 cases), purpuric eruption (4 cases), eczematid (2 cases), severe erythema multiform (1 case), and acneiform eruption (1 case). Exanthematous eruption is mainly caused by β-lactam antibiotics (49 cases), quinolones (18 cases), analgesic-antipyretic agents (18 cases) and Chinese patent medicines (16 cases). Urticaria is mainly caused by quinolones (10 case) . Fixed drug eruption is mainly caused by sulfonamides (28 cases) and analgesic-antipyretic drugs (22 cases). All the patients fully recovered after receiving antihistamines, corticosteroids and symptomatic and supportive treatment. Conclusion: The most common drug eruptions are exanthematous eruption, followed by urticaria and fixed drug eruption. The most common drugs that cause drug eruptions are β-lactam antibiotics, analgesic-antipyretic agents, quinolones, Chinese patent medicines, and sulfonamides.

  • 安全合理用药

  • 安全合理用药
    Xia Peiyuan
    2008, 10(5): 0-0.
    Abstract ( ) PDF ( )

    The term hazardous drugs refer to the drugs that have carcinogenicity, teratogenicity, reproductive toxicity, genotoxicity, organ toxicity at low doses, including antineoplastic agents, antiviral agents, hormones, immunosuppressive agents, and so on. A large number of studies have showed that healthcare workers who prepare or administer hazardous drugs may have the risks for occupational exposure to these drugs. Exposures to hazardous drugs may occur through inhalation of respiratory tract, skin contact, skin absorption, ingestion of alimentary tract, and so on. Inhalation and skin contact/absorption are the most likely routes of exposure to hazardous drugs. Occupational exposure to hazardous drugs can lead to decrease in immunity, increase in risk for cancer occurring, and potential reproductive damage. The common adverse effects of hazardous drugs are dizziness, fatigue, alopecia, cough, nausea, vomiting, abnormal menstruation, and skin rash. In addition, chronic liver damage may occur after long-term exposure to hazardous drugs. In order to diminish the risk of exposure to hazardous drugs to healthcare workers, the following safe protective procedures should be included: Good work practice should be formulated; The health care workers who have potential contact with these hazardous drugs should receive a safety education and training; Preparation should be carried out in designated area; Use of biological safety cabinets; Personnel protective equipment (including gloves, isolation gowns, safety glasses, face shields, and respirators) should be worn; Adequate care should be taken in the disposal of waste material; Acute exposure to hazardous drugs should be managed promptly.

  • 滥用误用

  • 滥用误用
    Yu Yinjiao
    2008, 10(5): 0-0.
    Abstract ( ) PDF ( )

    Smoking is one of major causes leading to death and more than five million people die from smoking each year worldwide. It has become a serious public health problem. Studies have been identified that there are more than 4000 compounds in tobacco and tobacco smoke. Among them at least 43 compounds are carcinogens. Regular smoking can cause a number of diseases like cancer, emphysema, heart disease, organ damage as well as dependence (addiction). The dependence is mainly caused by nicotine containing in tobacco. Most regular smoking are addicted to nicotine. So regular smokers stopping smoking may induce nicotine withdrawal symptoms including irritability, restlessness, dizziness, headache, difficulty sleeping, and inability to concentration. Most smokers who fail to succeed in quitting smoking is mainly related to the nicotine addiction. In view of this fact, a nicotine replacement therapy (NRT) was advanced. NRT is a way of getting nicotine slowly into the body without smoking. This help people not only to stop or reduce the symptoms of nicotine withdrawal, but also avoid the hazards from smoking. The results from the various studied have showed that NRT increase the rate of success in quitting smoking, and the risk for dependence to NRT product is small. NRT medicines are available as gums, patches, inhalers, sprays, and so on. All dosage forms of NRT medicines have adverse reactions. The severity of adverse reactions are generally mild, but their types differ across NRTs. The common adverse reactions are dizziness, headache, nausea, vomiting, and gastrointestinal discomfort. NRT can safely used for pationts with cardiovascular disease. NRT is not recommended for pregnant women, nursing mothers, and adolescents. In a word, nicotine replacement therapy is safe and effective in helping smokers stop using cigarettes. NRT products have been used in many countries worldwide as OTC. It is worthy of recommendation.

  • 论著

  • 论著
    Han Ming;Wu Yan;Sun Xianchang;Liu Rulin
    2008, 10(5): 0-0.
    Abstract ( ) PDF ( )

    Objective: To study the efficacy of ligustrazine in prevention of cisplatininduced ototoxicity . Methods: Eighty guinea pigs with normal hearing and the weight of 250~350 g were randomly divided into four groups (20 guinea pigs in each group): the normal saline group, the cisplatin group, the ligustrazine group, and the ligustrazine plus cisplatin group. The first three groups were intraperitoncally injected with normal saline 4 ml/kg daily, cisplatin 4 mg/kg daily, and ligustrazine 140 mg/kg daily, respectively. The fourth group was intraperitoncally injected with ligustrazine 140 mg/kg daily on day 1 and 2; and from day 3, cisplatin 4 mg/kg daily was given 30 minutes after ligustrazine administration for 6 days. Changes in auditory brain stem response (ABR) threshold were determined before medication and after the last medication. In addition, the SOD activity and malondialdehyde(MDA) content in the cochlea tissues of 10 guinea pigs in each group were measured and morphologic changes in cochlea hair cells of other 10 guinea pigs in each group were observed under transmission electron microscope after the last medication. Results: The ABR thresholds in the normal saline group, the cisplatin group, the ligustrazine group, and the ligustrazine plus cisplatin group were (55.652±6.562) dB, (40.556±4.532) dB, (42.321±5.362)dB, and (45.639±6.069) dB, respectively. The ABR thresholds in the cisplatin group were markedly higher than in the other three groups (P<0.01). The SOD activities in the normal saline group, the cisplatin group, and the ligustrazine plus cisplatin group were (33.30±5.89) U/mg, (21.44±6.42) U/mg, and (29.69±4.47) U/mg, respectively. The SOD acitivities in the cisplatin group were significantly lower than in the normal saline group (P<0.01). And there was no statistically significant difference in the SOD activities between the ligustrazine plus cisplatin group and the normal saline group (P>0.05). The MDA contents in the normal saline group, the cisplatin group, and the ligustrazine plus cisplatin group were (10.34±1.74) nmol/mg, (15.72±2.04) nmol/mg, and (11.07±1.56) nmol/mg, respectively. The MDA contents in the cisplatin group were significantly higher than in the normal saline group (P<0.01). And there was no statistically significant difference in the MDA contents between the ligustrazine plus cisplatin group and the normal saline group (P>0.05). The body and nucleus of hair cells remained basically normal in the ligustrazine plus cisplatin group, while the pyknosis, agglutination of nucleus chromatin, vacuolar degeneration, and the damage of ultra structure were marked in the cisplatin group.Conclusion:Ligustrazine has protective effects for cisplatininduced ototoxicity.

  • 病例报告

  • 病例报告
    Wu Rongrong;Chen Hongge;Wei Zhenman;Han Jin
    2008, 10(5): 0-0.
    Abstract ( ) PDF ( )

    A 64-year-old woman with breast cancer developed jaundice and abnormal liver function after chemotherapy. A liver CT scanning was performed to determine whether there were liver metastases after admission. The woman suddenly developed dizziness, chest distress, and dyspnea after administration of IV iopamidol 30 mg. Subsequently, unconsciousness and generalized convulsion occurred. Her blood pressure was unrecordable. The patient was diagnosed with iopamidolinduced anaphylactic shock. Her symptoms recovered gradually following antianaphylactic and antishock treatment.

  • 病例报告
    Li Lina;Bie Junb
    2008, 10(5): 0-0.
    Abstract ( ) PDF ( )

    A 60-year-old man with small cell lung cancer was treated with a chemotherapy regimen consisting of IV cisplatin 30 mg on days 1~3 and IV irinotecan 240 mg on day 3 in 28-day cycles. He took sodium bicarbonate 0.5 g thrice daily while starting chemotherapy. On day 5 of chemotherapy, the patient experienced diarrhea with 10 watery stools and more a day. The volume of watery stool was 40~50 ml each time. He presented with mild dehydration. Loperamide, norfloxacin,and fluid replacement were given immediately. His diarrhea was relieved.

  • 安全合理用药

  • 安全合理用药
    Zhang Haiying;Lv Xin;Li Yuzhen
    2008, 10(5): 0-0.
    Abstract ( ) PDF ( )

    Microecology is a branch of vital science for research in the relationship of microorganisms with the hosts. Recently, microecological preparations are emerging in large numbers with the advance of microecology. The microecological preparations can regulate microecosystem dysbiosis, maintain microecosystem balance, and confer a health benefit on the host. The microecological preparations can be classified into three types: probiotics (live microorganisms), prebiotics (nondigestible food ingredient), and synbiotics (a mixture of probiotics and prebiotics). The indications for microecological preparations are diarrhea (including diarrhea in children, antibioticassociated diarrhea, and traveller's diarrhea), irritable bowel syndrome, inflamematory bowel disease, Helicobacter pylori infections, constipation, cirrhosis, allergy, and female genital urinary tract infections. The microecological preparations are relatively safe. However, the microecological preparations containing live microorganisms should be used in caution in patients with hypoimmunity or impaired intestinal mucosal barrier in order to avoid opportunistic infections occurring. General precautions for the use of microecological preparations are as follows: the tablet/capsule should be swallowed with warm water (at a temperature under 40℃); bismuth preparations, tannic acid, activated charcoal, tincture, and certain antibiotics in combination with microecological preparations comprising live microorganisms should be avoided; the microecological preparations should be preserved in lightprotected containers and kept in cool place.

  • 中毒救治

  • 中毒救治
    Wei Zhaofu
    2008, 10(5): 0-0.
    Abstract ( ) PDF ( )

    Aluminium phosphide is a pesticide. It reacts with the wet, water or acid to form hydrogen phosphide(PH3),a very toxic gas, which produces inhibition of the cytochrome oxidase, blocking the electron transfer chain and oxidative phosphorylation producing an energy crisis in the cells. The latent period of acute aluminium phosphide poisoning is within 24 hours, and in most patients it is 1~3 hours. Symptoms of exposure to hydrogen phosphide gas include headache, dizziness, nausea, vomiting, and difficulty breathing. Severe exposure may damage liver, kindneys, lungs, nervous and circulatory systems, and may cause death. Diagnosis of aluminium phosphide poisoning is made from exposure history and clinical presentations. Treatments include gastric lavage, oxygen supplementation, blood purification, administration of intravenous dopamine, corticosteroids, and magnesium sulfate. This paper presents a patient died from hydrogen phosphide gas inhalation. A 19-yearold woman, who lived in a room which had aluminium phosphide and the wet floor, was hospitalized with upper abdominal pain, nausea, vomiting, dizziness, and fatigue. The next day, she presented with incontinences of feces and urine, unconsciousness, cyanosis, wet rale in both lung, a heart rate of 40 heats/min, a blood pressure of 70/40 mmHg, a respiration rate of 10~12 breaths/min. Her ECG showed bradycardia. Laboratory testing revealed the following values: WBC 12.3×109/L, BUN 15.3mmol/L, SCr 171 μmol/L, CPK 260~710 U/L, LDH 240~695 U/L, AST 463 U/L, ALT 398 U/L, ALP 230 U/L, TBil 36.3 μmol/L, phosphate 1.68 mmol/L, calcium 1.6 mmol/L, and magnesium 0.45 mmol/L. She was diagnosed with aluminum phosphide poisoning. Despite treatment with oxygen, vasoactive substances, and other protective and symptomatic therapy, the patient died from multiorgan failure.

  • 中毒救治
    Wu Na;Wang Dixin
    2008, 10(5): 0-0.
    Abstract ( ) PDF ( )

    A 5-month-old female infant with eczema was externally applied with Yisaoguang ointment which contains red lead (Pb3O4), ceruse and some other traditional Chinese mineral medicines. Ten days later, she developed listlessness, dysphoria, and mild anaemia. Laboratory tests revealed that her ALT, AST, and lead level were 61 U/L, 81 U/L, and 342.3 μg/L, respectively. Acute lead poisoning was suspected. Yisaoguang ointment was discontinued. After dimercaptosuccinate and symptomatic treatment, her symptoms were relieved. Subsequently, she was given methionine. Half a month later, her lead level and other laboratory values returned to normal range.

  • 病例报告

  • 病例报告
    Wang Yanhui
    2008, 10(5): 0-0.
    Abstract ( ) PDF ( )

    A 41-year-old hypertension. One week later, the man developed hyposmia, which was aggravated gradually. Three months later, his dosage of nifedipine was changed to 20 mg twice daily. Meanwhile, enalapril and carvedilol were added to his regimen. He developed a complete loss of olfaction on day 3 after receiving the dosage regimen. An examination of nasal cavity showed nasal mucosa congestion and both inferior turbinate hypertrophy. Obstructive anosmia was suspected. His olfaction returned to normal status on day 6 after discontinuation of sustainedrelease nifedipine tablets. The other antihypertensive drugs were continued. The olfactory disturbance did not reappear.

  • 病例报告
    Xie Xiaoju;Sun Jing
    2008, 10(5): 0-0.
    Abstract ( ) PDF ( )

    A 75-year-old woman was administered with an IV infusion of gatifloxacin 0.4 g dissolved in 500 ml of glucose 5% after undergoing cholecystectomy. On the second day, she presented with visual illusion, hallucination, excitement, restlessness, and persecutory delusion about five hours and a half after the infusion. Twelve hours later, her symptoms gradually resolved. On the third day, gatifolxacin was discontinued and her psychiatric symptoms did not reappear.

  • 病例报告
    Wu Shuyun;Hou Zhiwen;Li Yan
    2008, 10(5): 0-0.
    Abstract ( ) PDF ( )

    A 30-year-old pregnant woman was hospitalized with chronic hepatitis B. After treatment with liverprotective medications, her liver function improved. In order to reduce transaminase levels further, bifendate 15 mg thrice daily was added to her regimen. Two weeks later, her liver function worsened. Laboratory investigations revealed the following: ALT 24.9 U/L,AST 328.9 U/L,TBil 32.0 μmol/L,DBil 20 μmol/L. The bifendate was stopped, and other liverprotective medications were continued. Her liver function returned to normal limits.

  • 病例报告
    Xu Yuhua
    2008, 10(5): 0-0.
    Abstract ( ) PDF ( )

    A 65-year-old woman took reserpine 0.5 mg/d for hypertension three years ago. After two weeks of treatment, she developed dark urine, yellowish of sclera and skin with pruritus. Laboratory investigation revealed the following:ALT 1 859 U/L,AST 1 441 U/L,total bilirubin 306.71 μmol/L,direct bilirubin 279.6 μmol/L,AFP 157.5 μg/L; HBsAb was positive and serologic test for hepatitis A, C, E were negative. Her CT examination showed cholecystitis. The patient had no history of hepatobiliary diseases. Various types of viral hepatitis and hepatic tumor were excluded by examination, and no evidence showed bacterial infection, so reserpineinduced reactions were suspected. After resepine was withdrawn and reduced glutathione and diammonium glycyrrhizinate were administered for 1 month, her symptom improved gradually; her liver function normalized; her cholecystitis disappeared. One month later, her AFP level also returned to normal range. One year ago, the woman took 1 tablet of compound reserpine and triamterene (containing 0.1 mg of reserpine per tablet) once daily for poorly controlled hypertension. After three weeks of therapy, similar symptoms reappeared and liver function test values and AFP increased again. In addition, CT scanning revealed cholecystitis again. Compound reserpine and triamterene was stopped. Liver-protective and anti-infective treatment were given. One month later, her liver function normalized and her cholecystitis disappeared again. The above-mentioned symptoms did not recur during one year of follow-up.

  • 病例报告
    Hao Shijun;Xie Zhuomin;Li Yunsheng;Gao Xiafen;Cheng Yongjun;Chen Xiaoli
    2008, 10(5): 0-0.
    Abstract ( ) PDF ( )

    A 22-year-old man had a 3-year history of nephrotic syndrome. He was treated with prednisolone 40 mg and azathioprine 50 mg twice daily for recurrence of the disease. The patient's routine blood and liver function levels were normal before treatment. Two months after the therapy, his ALT level increased to 110 U/L. Subsequently, the dosage of azathioprine was changed to 50 mg once daily, and the previous dosage of prednisolone was maintained, and he was also given liverprotective treatment, but his abnormal liver function persisted. Three months later, the patient developed hyperpyrexia, headache, mild jaundice, pancytopenia and worsening liver function. His routine blood test showed a WBC count of 1.40×109/L with 96.57% lymphocytes, a RBC count of 1.09×1012/L,a Hb level of 35 g/L,a PLT count of 19.20×109/L. His liver function tests revealed the following values: ALT 386 U/L,AST 303 U/L,GGT 147 U/L,total bilirubin 102 μmol/L,and direct bilirubin 78 μmol/L. Azathioprine was stopped. Antiinfective,liverprotective therapy and blood transfusion were given. Thirty days later, his symptoms improved, his jaundice subsided gradually, his routine blood and liver function levels normalized and he was discharged.

  • 综述

  • 综述
    Zhang Li;Chen Haiping
    2008, 10(5): 0-0.
    Abstract ( ) PDF ( )
    Objective: Peroxisome proliferatoractivated receptor gamma (PPAR-γ)agonist mainly includes thiazolidinediones and novel nonthiazolidinediones PPAR-γ agonist. The commonly used thiazolidinediones are troglitazone, pioglitazone, and rosiglitazone. One of the common adverse reactions to PPAR-γ agonist is edema, which may worsen or precipitate congestive heart failure (CHF). The incidence of edema is 3%~28.9%. PPAR-γ agonist combined with other oral antihyperglycemic agents or insulin can increase the incidence of edema. The mechanisms of edema induced by PPAR-γ agonist involve watersodium retention, blood vessel dilation and increased vascular permeability, particularly associated with the deregulation of renal salt and water transport proteins distribution over distal tubes and collecting ducts which plays an important role in development of watersodium retention. PPAR-γ agonistinduced edema is often mild, and it subsides gradually after drug discontinuation. PPAR-γ agonist should be avoided in patients with moderate to severe CHF [New York Heart Association (NYHA) class Ⅲ~Ⅳ], and should be used with caution in patients with mild CHF (NYHA classⅠ~Ⅱ). PPAR-γ agonists should be given as low dosage as possible. The dosage should be gradually increased, if necessary. PPAR-γ agonists combined with diuretics may be given. The patients' weight and edema should be closely monitored. Strategies for prevention and management of edema include the use of novel and selective PPAR-γ moderators, specific inhibitors of protein kinase C-β or epithelial sodium channel, and PPAR-γ antagonists.
  • 病例报告

  • 病例报告
    Chen Minjianga;Ye Wenlingb;Li Xuemeib
    2008, 10(5): 0-0.
    Abstract ( ) PDF ( )

    A 29-year-old woman was hospitalized with chronic renal insufficiency and hyperthyroidism. She was given propranolol 10mg thrice daily for treating sinus tachycardia. Her blood potassium level was 4.64 mmol/L before propranolol therapy, and increased to 6.41mmol/L on day 9 of treatment,but his urinary volume did not decrease and no evidence showed that his renal function deteriorated. Her blood potassium level still remained elevated after treatment with low potassium diet, intravenous injection of hypertonic glucose, insulin,and furosemide. The blood potassium level returned to normal range after reducing dosage of propranolol, and elevated once more after increasing dosage again. Propranolol was discontinued and changed to metoprolol. His blood potassium level normalized.

  • 病例报告
    Guo Lai;Zhang Gaihua
    2008, 10(5): 0-0.
    Abstract ( ) PDF ( )
    A 62-year-old woman with a suspected pulmonary infection developed chill, chest distress, short breath and hyperpyrexia two hours and a half after receiving an IV infusion of azithromycin 0.5 g, and then dysphoria and delirium occurred. ECG examination showed fast atrial fibrillation. Her symptoms resolved after anti-anaphylactic and symptomatic treatment. Azithromycin was withdrawn and changed to amoxicillin. The above-mentioned symptoms did not recur.
  • 病例报告
    Liu Haiyana;Luo Hongwenb;Wang Yafengc
    2008, 10(5): 0-0.
    Abstract ( ) PDF ( )

    A 58-year-old woman with upper respiratory infection started receiving an IV infusion of cefotaxime sodium 4.0 g dissolved in 250 ml of glucose 5% and sodium chloride 0.9%, followed by an IV infusion of asarone 8 mg in 250 ml of glucose 5%. No adverse reactions occurred during cefotaxime sodium infusion, but after receiving 20 ml of asarone infusion, the patient experienced dizziness, nausea, abdominal pain, vomiting, unconsciousness, and decreased blood pressure. Her BP was 85/42 mmHg, and her HR was 60 beats/min. The infusion was stopped immediately, and then oxygen, calcium gluconate, adrenalin, and promethazine were given. Five minutes later, her blood pressure normalized. The patient was treated with cefotaxime sodium several times before and no adverse reactions were found. Therefore, the anaphylactic shock was considered to be associated with asarone injection.
    KEY WORDSasarone; anaphylactic shock; adverse reaction

  • 病例报告
    Chen Hui;Zhu Wei;Lian Shi
    2008, 10(5): 0-0.
    Abstract ( ) PDF ( )

    A 24-year-old man with symptomatic epilepsy received an intermittent therapy of sodium valproate for 16 years. On admission, his ALT and AST levels were 41 U/L and 56 U/L, respectively. The patient's ALT and AST levels increased to 224 U/L and 99 U/L respectively 9 days after undergoing epileptogenic focus resection. He was given an IV infusion of diammonium glycyrrhizinate 150 mg mixed with 5% Glucose injection 250 ml once daily. Four days later, the man developed bilateral erythema and blister with pruritus in his extremities. Subsequently, his erythema progressed to involve his neck, axillary fossa, cubital fossa, groin, and popliteal fossa. These lesions consisted of a central maculopapule and papulovesicle surround by erythematous ring. Druginduced eczematid was diagnosed. Diammonium glycyrrhizinate was stopped, and cetirizine and vitamin C were given. Three days later, skin eruption and pruritus subsided. According to his history, he experienced generalized erythema with pruritus after treatment of an IV infusion of diammonium glycyrrhizinate one year ago.

  • 病例报告
    Mao Wanheng;Shang Qianhui;Jiang Qianfeng
    2008, 10(5): 0-0.
    Abstract ( ) PDF ( )

    A 63-year-old man had a history of epilepsy and hypertension. In recent 3 years, he has been receiving one tablet of sustainedrelease nifedipine 10 mg twice daily. Enalapril was added to his treatment two months ago due to poorly controlled hypertension. The patient developed gross hematuria with a small amount of blood clots 8 hours after administration of enalapril. Urinalysis showed occult blood (++++). Renal, urethra or bladder stones and tumors were not determined by B-scan ultrasound. Enalapril was stopped. Symptomatic therapy was given and hematuria disappeared. Sustainedrelease nifedipine tablets were continued. Above-mentioned symptoms did not recur.

  • 论著

  • 论著
    Xu Juan;Ji Bingxin;Su Li;Sun Xuejing;Liu Congyan
    2008, 10(5): 0-0.
    Abstract ( ) PDF ( )

    Objective: To investigate the efficacy and safety of hematopoietic stem cell mobilization by granulocyte colony-stimulating factor (G-CSF) in patients with progressive multiple sclerosis (MS). Methods: Thirtyfour patients with secondary progressive MS were enrolled in a study. G-CSF 5 μg/kg daily for 4~6 days was used for mobilization of autologous hematopoietic stem cells. Mononuclear cells (MNCs) after mobilization were collected by blood cell separator. The absolute numbers of CD34+ cells and mononuclear cells were detected by flow cytometry. The type and incidence of adverse reactions were observed after G-CSF therapy. The expanded disability status scale (EDSS) was used to evaluate the condition of the patients before and after G-CSF therapy. Results: The numbers of collected CD34+ cells and MNCs cells were (2.68±0.89)×106/kg and (2.98±1.19)×108/kg, respectively. After transplantation, the median time of neutropil returning to >0.5×109/L and platelet returning to >50×109/L was 13 days (range 9-17 days) and 16 days (range 11-21 days), respectively. Transplantationrelated mortality was zero. Seventeen patients (50%) presented with muscle pain and fatigue, but the symptoms resolved without medication. Two patients experienced an increase in 0.5 points on the EDSS after mobilization by G-CSF, but no statistically significant difference was observed compared with before mobilization (P=0.16). Conclusion: The efficacy and safety of mobilization by G-CSF alone can meet the clinical requirement for autologous hematopoietic stem cell transplantation in treating patients with progressive MS.

  • 病例报告

  • 病例报告
    Cai Shaoping;Chang Xiujuan;Liu Ze
    2008, 10(5): 0-0.
    Abstract ( ) PDF ( )

    A 54-year-old man with hepatitis B and posthepatic cirrhosis was administered with an IV infusion of ademetionine 1,4-butanedisulfonate 1 000 mg dissolved in 250 ml of glucose 5% for hyperbilirubinemia. Five minutes later, the man developed chest distress, short breath, dyspnea, cyanosis of lips, and bilateral wheezing. He had a body temperature of 37.0 ℃, a respiratory rate of 30 breaths/min, a heart rate of 120 beats/min, and a BP of 125/82 mmHg. Ademetionine 1,4-butanedisulfonateinduced anaphylactic reaction was suspected. The medication was withdrawn immediately. His condition improved after nasal oxygen supplementation and adrenalin administration. Author comment: anaphylaxis induced by ademetionine 1,4-butancdisulfonate is uncommon, and care should be taken in clinical use of the drug.

  • 中药不良反应

  • 中药不良反应
    Yin Anning;Wang Ruhua
    2008, 10(5): 0-0.
    Abstract ( ) PDF ( )
    A 36yearold woman presented herself to the clinic with fatigue and worsening lumbago. Urinalysis revealed 35 RBCs/high power filed and 2+ proteinuria. Laboratory investigations also revealed a BUN level of 10.1 mmol/L and a SCr level of 176 μmol/L. Chronic nephritis was diagnosed. The patient was given an IV infusion of Shenkang injection 60 ml plus 5% glucose 250 ml. She presented with difficulty breathing, marked asthma, tearing, runny nose, tinnitus, conjunctival congestion, and wheezing in both lungs about 5 minutes after administration of the infusion. Her symptoms were relieved after treatment with oxygen, adrenaline, and dexamethasone.
  • 期刊评价

  • 期刊评价
    Li Yanqiong;Sun Yanmin;Feng Yaping;Zhang Jing;Li Jiajia
    2008, 10(5): 0-0.
    Abstract ( ) PDF ( )

    Objective: To examine the frequency and type of citations of articles published in Adverse Drug Reactions Journal and to reveal the characteristics of citations in this journal. Methods: The citations of articles published in Adverse Drug Reactions Journal from 2003 to 2007 were collected. The frequency and type of the citations, Price index, and the top cited journal were statistically analyzed with bibliometris methods. Results: From 2003 to 2007, Adverse Drug Reactions Journal contained 385 articles, and 354 of them had a total of 4 849 references, for an average of 12.6 references per article. The citation rates were 91.9%. Of the 4 849 references, 89.3% were from journals, and 7.5% were from books. The Price index was 62.9%. The citations in the top 20 cited journals in citation frequency were 22.8% of the total citations. Conclusion: The citation of articles published in Adverse Drug Reactions Journal has characteristics of a large number and a wide range. The journal is one of the important sources in drug safety information.

  • 病例报告

  • 病例报告
    Long Sen
    2008, 10(5): 0-0.
    Abstract ( ) PDF ( )

    A 30-year-old man was treated with antipsychotic drugs for depression. The patient had no history of hypertension and his blood pressure was normal before therapy. He started receiving monotherapy with clozapine 150 mg at noon and 225 mg in the evening, and his blood pressure was normal. On day 13 of clozapine treatment, fluoxetine 20 mg in the morning was added to his regimen. On day 2 of combination therapy, he experienced dizziness and a BP of 150/105 mmHg. After clozapine dosage was reduced to 125 mg at noon and 200 mg in the evening and fluoxetine dosage was increased to 40 mg, his blood pressure increased further to 160/110 mmHg. Therefore, fluoxetine was stopped and clozapine dosage was further reduced to 100 mg at noon and 175 mg in the evening. Two days later, his blood pressure normalized.

  • 论著

  • 论著
    Luo Rong;Su Yingying
    2008, 10(5): 0-0.
    Abstract ( ) PDF ( )

    Objective: To compare the efficacy and safety of two different doses of mannitol 20% for treating the patients with acute moderate-to-severe stroke. Methods: Fifty-four patients with acute moderate-to-severe stroke (massive cerebral infarction or large-volum spontaneous intracerebral hemorrhage) were randomly divided into the high-dose group (27 cases) and the low-dose group (27 cases) from march 2007 to march 2008. The patients in the highdose group were given an IV infusion of 250 ml of mannitol 20% every 6 hours for 5 days, then changed to 125 ml of mannital 20% every 6 hours for 5 days. The patients in the low-dose group were given an IV infusion of 125 ml of mannitol 20% every 6 hours for 10 days. The efficacy was evaluated by Glasgow Coma Scale (GCS) score and the incidence of brain hernia on day 1, 3, 5, 7, and 10 of therapy. No changes or no increase in GCS scores, no brain hernia, or brain hernia improvements were regarded as effectiveness. The safety was evaluated by the type and incidence of adverse reactions. The prognosis was assessed by case fatality rates on day 7 and 90 and modified Rankin Scale (mRS) score on day 90 after stroke onset. Results: The efficacy was confirmed in 20 cases (81.5%) in the highdose group and 23 cases (85.2%) in the lowdose group. There was no statistically significant difference between the two groups (P>0.05). In safety comparison of the high-dose group and the lowdose group, the incidences of acute renal damage, electrolyte abnormality, and osmolality disturbance were 11.1% versus 3.7%, 40.7% versus 44.4%, and 29.6% versus 14.8%, respectively. No acute heart failure was observed. There was no statistically significant difference in the type and incidence of adverse reactions between the two group (P>0.05). In comparison of prognosis, on day 7 after onset, the case fatality rate was 18.5% in both groups. On day 90 after onset, the case fatality rate was 22.2% in the high-dose group and 25.9% in the low-dose group. No statistically significant difference was observed in the case fatality rate between the two groups (P>0.05). On day 90 after onset, 77.8% of patients had poor prognosis (mRS 4~6 scores) in the high-dose group and 70.4% of patients in the low-dose group. There was no statistically significant difference in the prognosis between the two groups. Conclusion: Low-dose mannitol appears to be effective and safe for treating the patients with acute moderate-to-severe stroke.

  • 论著
    Xu Chuanjin;Zhang Wenzhong;Kong Suli;Cai Shanglang
    2008, 10(5): 0-0.
    Abstract ( ) PDF ( )

    Objective: To study the effects of the low-osmolality nonionic contrast media iopromide on renal function in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). Methods: One hundred and fifty-eight patients with ACS undergoing PCI were divided into two groups: the normal renal function group (88 cases) and the mild renal dysfunction group (70 cases, serum creatinine levels 120.45~232.5 μmol/L). Blood urea nitrogen (BUN) and serum creatinine (SCr) levels were measured before PCI and 24 hours, 48 hours, and 7 days after PCI. Results: The BUN levels before PCI and 24 hours, 48 hours, and 7 days after PCI in the normal renal function group were (5.45±1.65)mmol/L, (5.60±1.58)mmol/L, (5.55±1.70)mmol/L, and (5.48±1.81)mmol/L, respectively. There was no statistically significant difference in BUN levels before and after PCI (P>0.05). The BUN levels before PCI and 24 hours, 48 hours, and 7 days after PCI in the mild renal dysfunction group were (7.83±3.14) mmol/L, (8.43±3.37) mmol/L, (8.76±2.97) mmol/L,and (8.11±3.18)mmol/L, respectively; no statistically significant difference was observed in BUN levels before and after PCI (P>0.05). The SCr levels before PCI and 24 hours and 48 hours after PCI in the normal renal function group were (82.54±23.57)μmol/L, (85.48±22.47)μmol/L, and (86.51±21.72)μmol/L, respectively. The SCr levels before PCI and 24 hours and 48 hours after PCI in the mild renal dysfunction group were (176.25±28.47)μmol/L, (181.71±25.54)μmol/L, and (187.34±27.46)μmol/L, respectively. The difference in SCr levels before and after PCI was not significant between both groups (P>0.05). The renal function returned to the preoperative level 7 days after PCI. Conclusion: Low-osmolality nonionic contrast media iopromide has no marked effects on renal function in patients with ACS undergoing PCI.