Haemorrhagic cystitis following the administration of voriconazole in the treatment of central nervous system aspergillosis: a case report

Central nervous system aspergillosis (CNS-A) is a rare and fatal fungal infection. Voriconazole is the recommended treatment for CNS-A. The therapeutic effect of voriconazole is good, but its use is limited due to adverse reactions. This case report describes a 37-year-old male patient that had previously been diagnosed with acute lymphoblastic leukaemia. He had received immunosuppressive agents for 1 year following a haematopoietic bone marrow transplant. He presented with a 1-month history of left limb weakness as well as recurrent fever. Brain magnetic resonance imaging showed that he had multiple cerebral infarctions. Subsequently, he was diagnosed with CNS-A by metagenomic next-generation sequencing. Voriconazole was added to his treatment regimen, but it resulted in severe haemorrhagic cystitis and possibly bladder rupture. The dose of voriconazole was adjusted and reparative bladder surgery was undertaken immediately. Eventually, the patient was successfully treated with voriconazole and there was no recurrence of symptoms after 1 year of follow-up. Haemorrhagic cystitis is a rare adverse drug reaction associated with voriconazole use. Based on the experience with this current case, physicians should be aware of urinary tract complications with voriconazole including haemorrhagic cystitis.     

2014—2018年广州周边地区圆斑蝰蛇咬伤流行病学分析

目的了解圆斑蝰蛇咬伤患者在广州周边地区的流行病学特征,为防治圆斑蝰蛇咬伤提供依据。 方法对广州医科大学附属第一医院急诊科2014年1月1日至2018年12月31日收治的圆斑蝰蛇咬伤事件的流行病学特征进行描述性分析。采用线性相关分析的方法分析咬伤后就诊时间与咬伤后出现急性肾损伤时间的相关性。 结果5年共收治毒蛇伤1481例,死亡3例,其中43例圆斑蝰蛇咬伤,死亡2例,占毒蛇伤总死亡率的66.7%（2/3）;患者分布以广州珠三角地区（肇庆、云浮、佛山、江门）伤者居多,占74.4%,9~11月是咬伤高发月份,占44.2%（19/43）,被咬伤者以农民为主,占53.5%（23/43）,50~69岁为主要高发年龄,下肢咬伤占67.4%（29/43）,蛇伤严重程度评分重度病例占74.4%（32/43）。咬伤后就诊时间与咬伤后出现急性肾损伤的时间存在显著相关性（r=0.719,P<0.01）。 结论圆斑蝰蛇咬伤是广州周边地区毒蛇伤的主要死亡原因,应对高发月份、高发地区、高发人群及高发部位进行重点监测和干预,提高公众的自我保护能力,一旦发生圆斑蝰蛇咬伤,应立即到正规医院接受针对性诊治,必要时接受血液净化治疗。     

心肌脂质过氧化反应程度对糖尿病大鼠缺血再灌注损伤的影响

目的测定链脲佐菌素(STZ)诱导的不同周期精尿病大鼠对心肌缺血／再灌注(I／ R)损伤的影响及其与心肌脂质过氧化反应程度及血浆一氧化氮(NO)变化的关系。方法阻断和开放左冠状动脉前降支建立大鼠急性心肌I／R模型。用TTC染色测定大鼠心肌 I／R后梗死面积;用T／BARS法测定脂质过氧化反应程度;用硝酸还原酶法测定NO含量结果 STZ处理后2周,糠尿病组(2WD)心肌梗死面积比对照组(2WC)明显缩小,STZ处理后16周(16WD),梗死面积比对照组(16WC)增加;心脏组织的脂质过氧化物反应产物 2WD组较2WC组低,但是在16WD组中较16WC组显著增加;血浆NO水平2WD组较 2WC组增高,但是16WD组较16WC组显著减少。结论 STZ诱导的大鼠急、慢性期糖尿病对心肌I／R损伤呈现相反的作用。这可能是由于大鼠急、慢性期糖尿病相反的心肌脂质过氧化反应程度及NO改变而引起。     

苓桂术甘汤对肺动脉高压致右心衰大鼠心功能、神经内分泌因子水平及心脏组织NF-κB蛋白表达的影响

目的:探讨苓桂术甘汤对野百合碱所致肺源性心力衰竭大鼠的疗效及可能的作用机制.方法:将60只雄性SD大鼠随机分为空白对照组、 模型组、 呋塞米组及苓桂术甘汤高、 低剂量组,每组12只.除空白对照组外,其余各组采用野百合碱诱导肺动脉高压致右心心力衰竭模型.苓桂术甘汤高、低剂量组给药剂量分别为12 g/(kg·d)和2.5 ...