- ISSN 1008-5734
- CN 11-4015/R
- 1999年创刊
- 主管: 中国科学技术协会
- 主办: 中华医学会
A 48 yearold man with psoriasis had been treated for one year with Ciguyinxie capsules No.1 (four capsules daily in the morning), Ciguyinxie capsules No.3 (four capsules daily at night), and Cigukangfubao patches（The main ingredient of the three preparations is pseudobulb of appendiculate cremastra）. The patient was hospitalized with aggravated psoriasis. Blood routine test revealed a WBC count of 3.2×109/L, a PLT count of 50×109/L, and a HB level of 90 g/L. On the second hospital day, a reexamination showed that his WBC count, PLT count, and HB level were decreased to 2.6×109/L, 19×109/L, and 82 g/L, respectively. Ciguyinxie capsules and Cigukangfubao patches were discontinued and the patient received recombinant human granulocyte stimulating factor, dexamethasone and platelet suspension. Three days later, his blood routine values returned to normal limits.
A 56yearold man with right scapula comminuted fracture received cervus and cucumis polypeptide 32 mg dissolved in 500 ml of sodium chloride 0.9% by intravenous infusion on day 14 after the surgery of open reduction and internal fixation. After about 2 ml of initial infusion, he suddenly developed chest distress, palpitation, blushing, hidrosis, and vomiting. His blood pressure dropped from 130/76 mmHg to 80/50 mmHg. The infusion was stopped immediately and the patient received antishock therapy. One hour later, his symptoms were relieved.
A 72yearold woman with rheumatoid arthritis took methotrexate 2.5 mg twice daily. One week later, she developed abdominal pain and diarrhea. Methotrexate was discontinued, and the patient was given treatment with norfloxacin and berberine, however, her symptoms did not resolve. A blood routine test after hospitalization showed the following levels: WBC 1.6×109/L, RBC 2.7×1012/L, Hb 86 g/L, and PLT 51×109/L. Despite administration of granulocyte colonystimulating factor and levofloxacin, her peripheric blood cell counts decreased progressively. Watery stools turned to mucus bloody stools. Petechia and ecchymosis appeared on her skin. She received calcium folinate 15 mg thrice daily by intramuscular injection. On the fourth hospital day, her WBC count was 0.5×109/L, her Hb level was 73 g/L, and her PLT count was 11×109/L. Platelet and packed red cells were given by intravenous infusion, and treatment with fluid infusion, hematischesis, and antiinfection continued. One week later, the patient's abdominal pain and diarrhea relieved. A reexamination of blood routine showed a WBC count of 4.9×109/L, a Hb level of 76g/L, and a PLT count of 70×109/L. At follow-up 2 years later, her blood routine test showed normal findings.
Objective:To investigate the adverse reactions induced by cefoperazone (CPZ) and cefoperazone/sulbactam (CPZ/SB).Methods: Two hundred and twenty case reports of adverse reactions induced by CPZ and CPZ/SB were collected from database of PLA ADRM Centre between January 2001 and December 2006. The 220 cases were divided into following two groups: the CPZ group (115 cases) and the CPZ/SB group (105 cases). The patients in the CPZ and CPZ/SB groups were administered with CPZ 1 g and CPZ/SB (CPZ:SB=1:1) 2 g dissolved in 100200 ml of glucose 5% or sodium chloride 0.9% by intravenously two times daily, respectively. The time of infusion was 30～60 minutes. The clinical types and manifestations, severity, outcome, the effects on patients' original diseases, and the time of onset to adverse reactions were compared between the CPZ group and the CPZ/SB group.Results: The main adverse reactions in the two groups were the same, ie, skin and appendages disorders, allergic reactions, gastrointestinal disorders, and their differences of incidence rate were no statistically significant (P>0.05). The incidence rate of the fatal or serious (sequelae occurring) adverse reactions was higher in the CPZ group than in the CPZ/SB group (0.9% vs. 0, 2.6% vs. 0). The time of onset of adverse reactions was slower in the CPZ/SB group than in the CPZ group [(2.9±4.1) days vs. (1.9±2.1) days]. The vision abnormality (4 cases), hyperglycemia (1 case), and aphasia (1 case) occurred in the CPZ/SB group.Conclusion: The cefoperazone/sulbatan is safer than cefoperazone, but it may induce some special adverse reactions, which should be paid more attention in clinical practice.
Ethylene glycol is the main ingredient in antifreeze. Ethylene glycol undergoes enzymatic metabolism principally in the liver, and converses to glycoaldehyde, glycolate, glycoxylate, and oxalate successively. These metabolites can cause metabolic acidosis. The typical clinical features of ethylene glycol poisoning are drowsiness, coma, elevated blood pressure, tachycardia, and hyperventilation. Many paiblished case reports described three stages of ethylene glycol poisoning: a neurological stage (30 minutes to 12 hours after injection), central nervous system depression occurs; followed by a cardiopulmonary stage (12～24 hours after ingestion), metabolic acidosis and cardiopulmonary disorders occur; and finally, a renal stage (24～72 hours after ingestion), tubular necrosis and renal failure occur. The lethal dose of ethylene glycol is usually 1.4～1.6 ml/kg[about 100 ml in an about (70 kg)]. The diagnosis is based on history of exposure, clinical features, and determination of ethylene glycol and the major acidic metabolite, glycolate, concentrations in blood and urine. The general principles of treatment include emptying the stomach, correction of acidosis, antidotes (ethanol or fomepizole) administration, haemodialysis, and supportive therapy. This paper reports 3 cases of ethylene glycol poisoning. Three male patients aged 48 years ingested about 150 ml of ethylene glycol each. The patients were presented with headache (2 cases), abdominal discomfort and restlessness (1 case). The three patients developed unconsevousness 9 hours after ingestion, metabolic acidosis 12 to 18 hours after ingestion, and hematuria 24 hours after ingestion. The patients were treated with gastric lavage, haemodialysis, famotidine 40 mg, 20 ml of IV calcium gluconate 10%, IV sodium bicarbonate 4%, oral administration of 200 ml of spirit (containing ethanol 38%), and vitaminB6. And then two patients were perfectly recovered from their illness. One patient died 29 hours after ingestion of ethylene glycol.
A 58yearold man who had a history of cholelithiasis, renal lithiasis, prostatic hypertrophy, type 2 diabetes mellitus, and hypertension was prescribed with ceftriaxone (dosage not stated) for management of cholecystitis. After 3 days of treatment, he presented with generalized erythema morbilliforme and oedema of the eyelids and lower extremities. On day 12, an urine routine test showed the following values: RBC (++) to（+++）,PRO (+++). After admission, the renal function tests revealed the following levels: BUN 43.20 mmol/L, Cr 1 268.0 μmol/L, and UA 855 μmol/L. The patient was diagnosed with acute interstitial nephritis and acute renal failure. Combination therapy with haemodialysis, antiinfection, corticosteroid, diuretics, and fluid replacement was administered. One month later, erythema and oedema disappeared completely, and all biochemical values returned to normal ranges.
A 55yearold man received omeprazole magnesium entericcoated capsules 20 mg once daily for treating duodenobulbar ulcer seven years ago. Fifteen days after administration, he presented with eczema on the medial skin of left leg. The skin lesion resolved after symptomatic therapy. During the subsequent 7 years, he experienced a relapse of eczema following each treatment with the drug. And eczema became chronic. Omeprazole was discontinued due to the aggravation of eczema and replaced with Kuaiwei tablets. Later, eczema was cured after symptomatic therapy. The patient had no a relapse of eczema in the recent two years.
Objective:To observe the efficacy and safety of telbivudine for preventing mothertoinfant HBV vertical transmission in five HBVinfected pregnant women.Methods: From March to August 2007, 5 chronic HBVinfected women with a high risk for infecting their newborn infants by vertical transmission entered the study. Their HBV DNA levels were ≥1×107 copies/ml. The women were treated with oral telbivudine 600 mg once daily between 28 weeks after pregnancy and 1 month after labour. The changes in the HBV DNA level, liver function, and adverse reactions were observed in the five women. The neonates’ HBV DNA and HBsAg levels were measured. The neonates’developmental status was observed and Apgar scores were performed.Results: Of the 5 pregnant women, 4 pregnant women’s HBV DNA levels were not detected (＜5×102 copies/ml). One pregnant woman’s HBV DNA level was 4.56×103 copies/ml. The five neonates were normally developed, and Apgar score was 10. The neonates’HBV DHA levels were ＜5×102 copies/ml, and their HBsAg tests were negative. Conclusion: Telbivudine seems to be effective in the preventing of mothertoinfant HBV vertical transmission and no influence on infant’s development.
3.4-methylenedioxyme thamphetamine (MDMA, ecstasy) is a synthetic amphetamine derivative, which is used as a recreational substance and is widely abused among young people. MDMA targets the serotonergic system and can cause serotonin neuronal damage. The mechanism responsible for the neurotoxicitg of MDMA is probably associated with hydroxyl radical formation. MDMA abuse commonly occurs in combination with ethanol, and ethanol can increase hydroxyl radicals formation and serotonin neuronal damage.
A 40yearold woman with hyperthyrosis took methimazole 10 mg thrice daily. More than 1 month later, she developed a high fever, pain around the anus. Laboratory test revealed leucopenia. Methimazole was stopped immediately. Despite of administration with metronidazole and cefuroxime for antiinfection, her symptom did not resolve. She also developed palpitation, chest distress, anorexia, and oliguria. Five days later, she was hospitalized. She had a body temperature of 40 ℃, a pulse rate of 140 beats/min, a respiratory rate of 30 breaths/min, and a BP of 60/30 mmHg. Physical examination showed sporadic petechia on her limbs, a 1.5 cm×1.5 cm perianal ulcer with purulent secretion. Her WBC count was 0.4×109/L with 0.16 neutrophils. Her haemoglobin level was 94 g/L, and her platelet count was 11×109/L. A bone marrow biopsy revealed hypoplasia with a myeloid to erythroid cell ratio of 0.5:1, few leucocytes and erythrocytes, non megacaryocyte, less platelets, lymphocytes 0.51, plasmocytes 0.13, and reticulocytes 0.345. The blood biochemical test revealed the following levels: K+ 2.9 mmol/L, Na+ 134 mmol/L, Ca 2+ 1.6 mmol/L, AST 53 U/L, ALT 207 U/L, albumin 20 g/L, and total protein 48 g/L. A thyroid function examination showed that her free T3 and free T4 levels were 38.43 pmol/L and 38.36 pmol/L, respectively, and her thyrotropin level was undetected. Despite symptomatic, supportive, and anti-infective treatment, her thyroid crisis remained so. The next morning, she suddenly developed unconsciousness. The resuscitation failed of success, and then she died.
Objective:To develop a mobile pharmacy service system（MPSS）for enhancement of medication compliance and safety to patients.Methods: A mobil pharmacy service system (MPSS) was formed through developing the pharmacy service database, applied database system, and transmitting and receiving installation for short message. One hundred patients (57 men, 43 women, median age 55 years) discharged from hospitle while receiving continued drug therapy entered the pilot trials of the MPSS. Of the 100 patients, 60 suffered from hematological disorders, 24 osteopathy, and 16 dermopathy. The short message containing the information of administration, dosage, precaution, and adverse reactions of drugs were transmited to the patient's mobile through the MPSS for the medication instruction and communication between medical staffs and patients.Results: Each patient received the service time of 12.06 days and the instruction of 3.52 different agents on average. The investigation and feedback from the patients showed that the overall evaluation to the MPSS was good, and the quality of service was scored 92.3. Conclusion: The MPSS has the advantages of convience, rapidness, reliance, and higher coverage. It is of practical value to medication compliance and safety to patients.
Amiodarone is a class III antiarrhythemic. It is used in the control of ventricular arrhythmias and atrial fibrillation. Amiodarone can induce a varity of adverse reactions. The one of the common serious adverse reactions to amiodarone is pulmonary toxicity. The reported incidence of amiodarone pulmonary toxicity(APT) is variable, but appears to be between 1% and 17%. Most of the patients develop interstitial pneumonitis or hypersensitivity pneumonitis after 3～12 months of amiodarone therapy. The pathogenesis of amiodarone pulmonary toxicity is uncertain. The possible mechanisms include direct cytotoxicity, hypersensitivity, inflammatory or immune response. The related factors inducing APT are preexisting lung disease and high dosage or longterm use of amiodarone. The clinical presentations of APT are nonspecific, and main symptoms are nonproductive cough, dyspnea, weakness, weight loss, and fever. The alveolar and interstitial inflammation is frequent on the chest roentgenogram. The clinical diagnosis of APT should be considered when a patient develops the following findings: new or worsened symptoms, new abnormalities or worsening on the chest roentgenograms and a 15 percent decrease in the CO or total lung capacity. It is recommended that the benefitrisk ratio be evaluated before start of amiodarone therapy, the smallest effective dosage be used for longterm treatment, and the pulmonary function be examined at regular intervals. Once the clinical diagnosis of APT is made, the most common option is to decrease the dosage or discontinue amiodarone. Most patients’ signs and symptoms resolve after the cessation of amiodarone. The patient with severe pulmonary toxicity may be administered with shortterm corticosteroid therapy.
Risperidone is widely used atypical antipsychotic drug in clinical practice, which has antagonistic actions at dopamine type 2 (D2), serotonin type 2 (5-HT2), α1 and α2 adrenergic, and histamine H1 receptors in varying degrees. Blockade of dopamine D2 receptor results in extrapyramidal effects and hyperprolactinemia. Blockade of 5-HT2 and histamine H1 receptors leads to weight gain and hyperglycemia. Other common adverse reactions are insomnia, anxiety, headache, drowsiness, concentration difficulties, constipation, nausea, vomiting, blurred vision, rash, orthostatic hypotension, hypertension, tachycardia, and sexual dysfunction.
A 65yearold woman with right glaucoma was instilled with 0.1 ml of latanoprost eye drops. Two hours after administration of the first drop, she developed dyspnoea, cyanosis, and hidrosis. Physical examination showed that her heart rate was 120 beats/min, her blood pressure was 160/100 mmHg, and the wheezing heard from her lungs. The patient was given salmeterol xinafoate and fluticasone propionate powder for inhalation immediately. Her symptoms resolved after ten minutes. Later, latanoprost eye drops was replaced with 1% brinzolamide eye drops. Bronchial asthma did not recur.
Reversible posterior leukoencephalopathy syndrome (RPLS) is a group of signs and symptoms mainly associated with posterior cerebral white matter lesions. It is characterized clinically by headache, visual disturbances, confusion, altered mental status, motion disturbances, and seizures. The characteristic abnormalities on neuroimges are often seen in the white matter of parietaltemporaloccipital lobes, as a lowdensity change on CT and as a high signal change on T2 weighted and ADC. The occurrence of RPLS is usually associated with hypertension, renal failure, and medications. The drugs that may induce RPLS are antineoplastic agents, bevacizumab, ciclosporin, diclofenac, human immunoglobulin for intravenous injection, linezolid, tacrolimus, thalidomide, and measles vaccine. The mechanisms of druginduced RPLS remain unclear. Early diagnosis and treatment are rather important because delayed or inadequate therapy could lead to irreversible damage. However, with timely and appropriate management, RPLS is reversible in the majority of cases. Treatment strategies for druginduced RPLS include the withdrawal of suspected drugs, control of blood pressure and seizures, and dehydration.
A 36yearold woman with facial rash received antianaphylactic treatment with tranilast capsules 0.1 g thrice daily for 20 days. During this period, she also took loratadine, cetirizine, etc. She continued to use tranilast for 8 days after her skin rash faded. However, within the last 4 days of tranilast administration, the patient developed urinary frequency, urgency, odynuria, gross hematuria, and mild lethargy. After admission, laboratory tests revealed the following levels: ALT 716 U/L, AST 263 U/L, TBIL 41.1 μmol/L, DBIL 20.0 μmol/L, IBIL 21.1 μmol/L, GGT 246 U/L, ALP 372.3 U/L. A blood routine test showed eosinophile granulocyte count of 0.66×109/L. An urinalysis revealed RBCs filled per highpower field. On the second hospital day, the patient developed a fever (T 38.5 ℃), anorexia, nausea, jaundice, mild pruritus, discomfortableness on percussion at her right renal region. She was treated with liverprotective, antiinfective, and intravenous fluid therapy. Ten days later, the patient's condition started to improve. After 24 days of treatment, all laboratory values were within normal limits.
Mercury poisoning is usually misagnosed because of insidious onset, nonspecific signs and symptoms, and lack of knowledge within the medical profession. This paper reported a prolonged misdiagnosed case of mercury poisoning to bring attention of it in clinical practice. A 10yearold girl presented with a loss of consciousness secondary to seizure attack. An Examination showed that she has red painful hands with blood pressure 150/90 mmHg. There were audible (grade Ⅲ/Ⅵ) machinery murmurs along the left sternal margin in the 2nd to 3 rd intercostal spaces. Abnormal high signal change was found within subcortical regions of the frontal, partietal, temporal, and occipital lobes on FLAIR image . Her plasma rennin angiogenesis and aldosterone levels were obviously elevated. Her mercury concentration in the urine was 0.17 mg/L before treatment. After treatment with dimercaprol, the girl's blood pressure returned to normal limits, seizures and other symptoms diappeared. Tracing her history, she was exposed to elemental mercury for playing with her classmates in the last 2 months.
A 64yearold woman with malignant pleural mesothelioma received the second injection of IV pemetrexed 0.5 g under chemotherapy. Two to six days after the therapy, she developed anorexia, nausea, vomiting, and diarrhea. The symptoms were not relieved after she took berberine hydrochloride. On admission, her body temperature was 38.5 ℃, her heart rate was 130 beats/min, and her blood pressure was 75/40 mmHg. An ECG showed frequent atrial premature beats and occasional ventricualr premature beats. A blood routine test showed a WBC count of 2.4×109/L, a RBC count of 2.14×1012/L, a Hb level of 65 g/L, and a PLT count of 13×109/L. A stool analysis detected 02 RBCs per highpower field and 47 WBCs per highpower field, and an occult blood test was positive. Blood biochemistry examination revealed the following values: LDH 204 U/L, TBil 39.4 μmol/L, BUN 24.0 mmol/L, and Cr 239 μmol/L. Her prothrombin time (PT) was 19.5 seconds, her prothrombin activity (PTA) was 41%, and her activated partial thromboplastin time (APTT) was 58.7 seconds. Arterial blood gas analysis revealed a pH of 6.91 and a paCO2 of 37 mmHg. She received tracheal intubation and mechanical ventilation immediately. Supplement of albumin and plasma, and antiinfective therapy, antishock, and antiarrhythmia treatment were given. On day 2 after admission, the patient's condition worsened. She presented with deep coma, oliguria, and a great quantity of ascites. It was hard to maintain adequate blood pressure. Sustained hemofiltration and rhG-CSF were administered. On day 3, the patient died of multiorgan failure.
A 60yearold woman with diabetes was instilled with compound tropicamide eye drops for mydriasis before examination of ocular fundus. She developed a markedly decreased auditory acuity with tinnitus. An examination showed a bilateral sensorineural deafness. After treatment with hyperbaric oxygen and puerarin, her hearing recovered obviously. The patient was instilled with the eye drops again for examination of eye, and then her markedly decreased auditory acuity recurred. Deafness occurred after the fourth instillation of tropicamide eye drops. Despite more than 1 month's treatment, her hearing did not recover.
A 27yearold female patient received oral Shaofuzhuyu granules 1.6 g thrice daily for menoxenia after artificial abortion. Two months after administration, the patient developed yellowish of the skin and dark urine. She continued to take Shaofuzhuyu granules for more than 1 month, and her symptoms were worsen accompanied by asthenia, nausea, and vomiting. Examination showed her liver function was abnormal. Shaofuzhuyu granules were discontinued. Despite liverprotective treatment for two weeks, her symptoms were not relieved. The patient was then admitted to hospital. Liver function tests revealed the following levels: ALT 130 U/L, AST 330 U/L, TBil 141.4 μmol/L, and DBil 130.7 μmol/L. A virological examination showed that hepatic A, B, C, D, and E viruses were negative, and a immunopathologic examinatin of liver tissue revealed there was no hepatitis virus. She was diagnosed with druginduced liver damage and was treated with glutathione, compound glycyrrhizin, polyene phosphatidylcholine. Three weeks later, the patient's symptoms disappeared, her liver function returned to normal limits and she was discharged.
An 82yearold man with pulmonary infection received IV piperacillin/tazobactam 4.5 g mixed with 100 ml of sodium chloride 0.9% once every 8 hours. He developed dark red loose stools with occult blood of (++++) on the next day. Laboratory test revealed that his prothrombin time (PT) was increased from 11.3 s to 15.8 s, and his prothrombin activity (PA) was decreased from 140.9% to 76.9%. Despite treatment with IV etamsylate, IV aminomethylbenzoic and IM vitamin K1, his bloody stools remained unchanged on day 3. Piperacillin/tazobactam was discontinued and replaced with ciprofloxacin and azithromycin for antiinfective therapy. One day later, his stools almost returned to normal color. On reexamination, occult blood in stool was negative, and his PT and PA levels were within normal ranges.
A 61 yearold man with advanced gastric carcinoma received chemotherapy with IV docetaxel 40 mg/m2, IV calcium folinate 120 mg/m2, and fluorouracil 800 mg/m2 via a central vein for 24 hours, in combination with two cycles of intraperitoneal hydroxycamptothecin 15 mg and thermotherapy after the surgery. On day 5 after the chemotherapy, he developed progressive pitting oedema of the lower extremities. After 4 days of treatment with methylprednisolone and furosemide, his oedema resolved.
A 19yearold man with wound received IM tetanus antitoxin 1500 IU following a negative skin test. Half an hour later, he drank about 20 ml of spirit. He developed dizziness, generalized wheal, ear lobe and lip swelling, chest distress, palpitation, cold sweat, pallor, and dyspnoea immediately. Physical examination revealed a pulse rate of 108 beats/min, a respiratory rate of 28 breaths/min, and a BP of 60/30mmHg. After symptomatic treatment with oxygen, antianaphylaxis, and electrolyte supplements, the symptoms resolved gradually, and his vital signs returned to normal ranges.
A 5yearold girl with bronchial pneumonia received budesonide nebulising suspension 2 ml twice daily, oral ketotifen 0.5 mg and procaterol 12.5 μg twice daily, montelukast sodium chewable tablets 5 mg once daily for treating cough. The next day, she developed left knee pain. Montelukast sodium chewable tablets were withdrawn, and other drugs were continued. Knee pain resolved after two days. Two weeks later, treatment with budesonide aerosol 200 μg twice daily and montelukast sodium chewable tablets 5 mg once daily was readministered. Knee pain with muscle stiffness of the legs occurred again 3 days later. Montelukast was discontinued again. Seven days later, knee pain was relieved. Another 2 days later, his symptoms resolved.
A 57yearold woman, with a history of type 2 diabetes mellitus, hypertension, and cerebral infarction, was hospitalized with acute aggravated chronic renal failure. During hospitalization, she started receiving IV acyclovir 500 mg twice daily for herpes zoster infection. On day 3 after the IV acyclovir treatment, she developed disturbance of consciousness, disorientation, and somnolence. There was no obvious change in her serum electrolyte, serum creatinine, and haemoglobin levels, and in body temperature. An examination on nervous system revealed no positive signs. A head CT scan displayed new and old cerebral infarctions. Cinepazide was given and the dose of acyclovir was reduced to 500 mg once daily. However, the patient’s disturbance of consciousness continued to worsen. After withdrawal of acyclovir and dialysis therapy for 3 successive days, the patient regained normal consciousness rapidly.
A 56yearold man took celecoxib 200mg for rheumatic arthritis. About 2 hours later, he developed sporadic erythema multiforme on the upper limbs, and then it progressed to involve his entire body, accompanied with calor, pruritus, and effusion. The patient presented with a fever (T 38℃), chest pain, dysuresia, edema of the eyelids and upper lip, and hyperaemia of oral mucosa and urethral orifice. Laboratory test showed a WBC count of 10.5×109/L with 70.9% neutrophils and 20.1% lymphocyte. The symptoms were relieved three days after anti-anaphylactic and symptomatic treatment. One week later, erythema almost completely faded, but marked pigmentation remained in the skin lesions.
objectine:To study the mechanism of hemolysis induced by puerarin injection. Methods: Hemolysis tests in vitro and vivo were performed with puerarin injection in Beagle dogs and guinea pigs as follows: the hemolytic effects of solvent propylene glycol and pH value of the preparation on red cells of Beagle dogs; the effects of IV puerarin on the levels of SOD and MDA of guinea pigs, and hemolytic rates of red cells of sensitized guinea pigs; and the influences of puerarin injection on hemolytic effects and morphological change of red cells of Beagle dogs and guinea pigs.Results: The hemolysis of Beagle dogs’red cells occurred with puerarin in maximum concentration (10 g/L) and pH 4.48, and it did not occur with sodium chloride 0.9%, which had the same pH value as the former. The hemolysis of Beagle dogs’red cells occurred with puerarin injection containing propylene glycol 5% or 10%, and it did not occur with propylene glycol solution 5% or 10%. The level of MDA was marked decreased in the puerarin injection group compared with the sodium chloride 0.9% group (P<0.01). The hemolytic rates of red cells was not increased, and antigenantibody complex was not found in guinea pigs before and after sensitization with puerarin injection. Red cells of guinea pigs were shrunk or broken. The non-immune hemolysis tests in vitro showed that the hymolysis of red cells of Beagle dogs and guinea pigs occurred with puerarin injection, and it was related to the dosage.Conclusion: Puerarin injectioninduce hemolysis is a non-immue one, it may relate to its direct action on red cells and lead to changes in the stability of cells.
Three female patients, aged 23, 26, and 29 years, respectively, received IV clindamycin 0.9, 1.2, and 1.2 g dissolved in 250500 ml of sodium chloride 0.9% for upper respiratory tract infection. During or after the infusion, they all developed general asthenia, numbness and weakness in all extremities, and walking difficulties. Physical examination showed decreased muscular tone in the four limbs with the upper limbs muscle strength of grade 1-2 and the lower limbs muscle strength of grade 1, hypoactive patellar tendon reflex, and negative Babinski sign. An ECG revealed atrial premature beats (1 case) and sinus tachycardia (2 cases). Their serum potassium levels were 2.3 mmol/L, 2.1 mmol/L, and 2.0 mmol/L, respectively. After treatment with oral and IV potassium, the symptoms resolved completely, and their serum potassium levels returned to normal ranges.
Two male patients, aged 43 years and 81 years, had a history of type 2 diabetes mellitus, diabetic nephropathy, and hypertension. Their blood pressure and blood glucose returned to normal limits after drug therapy. Sulodexide 50 to 100 mg twice daily was added to their regimens for proteinuria. After receiving a total dosage of sulodexide 300 to 400 mg, they began to experience diarrhea with watery stools every one to two hours. Abnormalities were not found on stool examination. Treatment with sulodexide was stopped, and diarrhea resolved soon. 6 days later, sulodexide 50 mg was administered to the 81yearold patient. Diarrhea recurred 2 hours after the administration. Sulodexide was discontinued, and the symptom was relived.
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