Erythroleukemia and Its Differential Diagnosis

Acute erythroid leukemias encompass 2 main subtypes: acute erythroleukemia (erythroid/myeloid subtype) and pure erythroid leukemia. This article reviews the main clinicopathologic features of the acute erythroid leukemias and the criteria used to diagnose them. In this article, the differential diagnosis between acute erythroid leukemias and their mimics is discussed and helpful morphologic clues and diagnostic tests that help arrive at the correct diagnosis are provided. The appropriate application of diagnostic criteria, including ancillary testing, such as immunophenotyping, cytogenetics, and molecular genetic testing, is essential to categorize bone marrow erythroid proliferations.     

Acute liver failure

Acute liver failure (ALF) is a rare but life-threatening disease with varying aetiologies worldwide. Drug-induced liver injury, including paracetamol poisoning, is the main cause in Europe and the USA. Whereas in the developing world, viral hepatitis is most common. ALF is a multisystem illness that leads to development of hepatic encephalopathy, cerebral oedema, vasodilatory shock, coagulopathy, hypoglycaemia and multiple-organ failure. Early referral to a specialist liver unit is essential. The core principles of ALF management are to identify/treat the underlying cause, provide supportive care and treat any complications. Optimal management will allow time for spontaneous liver regeneration or liver transplantation, and result in improved survival rates. This article provides an overview of the key concepts in ALF diagnosis and management.     

Rho激酶抑制剂治疗短暂性脑缺血发作疗效观察

目的：分析Rho激酶抑制剂治疗短暂性脑缺血发作的效果。方法将172例短暂性脑缺血发作患者分为两组，对照组给予常规治疗，治疗组给予法舒地尔注射液治疗。结果治疗组治疗总有效率高于对照组，不良反应轻微不影响治疗。结论 Rho激酶抑制剂治疗短暂性脑缺血发作效果显著。     

Nephrotoxicity From Molecularly Targeted Chemotherapeutic Agents

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低分子肝素联合尿激酶治疗急性心肌梗死的临床研究

目的探讨低分子肝素与尿激酶在急性心肌梗死患者中的联合应用价值。方法选择急性心肌梗死患者104例，随机将患者分为研究组和对照组。对照组患者给予常规治疗，研究组患者加用低分子量肝素钠注射液与注射用尿激酶的药物联合治疗方案，比较两组患者的临床治疗情况。结果研究组患者的显著进步率和总有效率较对照组患者均明显提高，分别达到63.46％和92.31％，而无效率则明显减少，仅为7．69％，并且均呈现出统计学差异（P〈0.05）。结论低分子肝素联合尿激酶对急性心肌梗死患者临床治疗效果的改善具有极其重要的临床意义。     

急性闭塞性脑梗死介入溶栓术的护理观察

目的分析急性闭塞性脑梗死介入溶栓术的护理效果。方法运用随机抽样的方法选择治疗的急性闭塞性脑梗死患者100例,随机分为观察组和对照组各50例,对照组给予常规护理,观察组则在常规护理的基础上给予整体护理,比较2组患者的临床疗效、生活质量评分、并发症发生情况及患者满意度。结果对照组有效率为76.0%,观察组96.0%,观察组明显高于对照组,差异有统计学意义(P0.05);2组患者的生活质量评分均有所提高,且观察组生活质量改善程度明显高于对照组,差异均有统计学意义(均P0.05);对照组并发症发生率为12.0%,护理满意度为74.0%,观察组则分别为2.0%和94.0%,与对照组相比,观察组并发症发生率明显降低,护理满意度明显提高,差异均有统计学意义(P0.05)。结论在常规护理的基础上给予整体护理,能够有效提高介入溶栓术治疗急性闭塞性脑梗死的临床效果,有效降低并发症发生率,提高患者生活质量和满意度,可以在临床上推广应用。     

奥扎格雷联合法舒地尔对短暂性脑缺血发作患者脑氧代谢及炎性指标的影响研究

目的:探讨奥扎格雷联合法舒地尔对短暂性脑缺血发作患者脑氧代谢及炎性指标的影响。方法:选择采用阿司匹林进行治疗的31例短暂性脑缺血发作患者为对照组,同期采用奥扎格雷联合法舒地尔进行治疗的31例患者为观察组,将两组患者治疗前及治疗后5 d、10 d的脑氧代谢及炎性指标进行检测及比较。结果:观察组治疗后5 d、10 d的SjvO2及CjvO2均高于对照组,而Da-jvO2及CaO2均低于对照组,血清炎性指标均低于对照组,差异有统计学意义(P<0.05)。结论:奥扎格雷联合法舒地尔可显著改善短暂性脑缺血发作患者的脑氧代谢及炎性指标,可有效改善患者的疾病状态。     

Nitric oxide—mediated renal epithelial cell injury during hypoxia and reoxygenation

The potent endothelial-derived vasodilator nitric oxide (NO) has been identified as a protective agent in acute renal failure. However, some recent studies have suggested a detrimental effect of NO on rat proximal tubules exposed to hypoxia and reoxygenation. We determined whether NO metabolites cause intracellular oxidation during hypoxia and reoxygenation and whether this oxidative stress is linked to irreversible cell injury. Primary cultures of rat proximal tubular epithelial cells were studied in a subconfluent stage and subjected to 60 min hypoxia and 30 min reoxygenation. Intracellular oxidation was assessed by monitoring the conversion of nonfluorescent dihydrorhodamine 123 (DHR) to fluorescent rhodamine 123 as a probe for the long-lived oxidant peroxvnitrite. Hypoxia and reoxygenation produced a marked increase in cellular generation of oxidant species. Intracellular oxidation of DHR was reduced by approsimately 40% when cells were also exposed to the NO svnthase inhibitor L-NAME. Oxidation of DHR following hypoxia and reoxygenation was not affected by SOD or DATTU. A combination of SOD and L-NAME was no more effective than L-NAME alone. Hypoxia and reoxygenation produced substantial injury (as LDH release). There was a 40% reduction in LDH release when cells were pretreated with a NO synthase inhibitor. In summary, increased generation of NO capable of inducing intracellular oxidizing reactions and cell death occurred during renal hypoxia and reoxygenation.     

Health and Ecological Effects of Adiponitrile

Adiponitrile (ADN) has moderate acute toxicity with an oral LD₅₀ in rats of 100 to 500 mg/kg and a 4‐hr LC₅₀ in rats of 1.71 mg/L (vapor plus aerosol). ADN produced slight eye but no skin irritation in rabbits. Repeated exposures by inhalation produced changes in the hematologic profile with effects seen at 100 or 300 mg/m³. The hematologic changes were reversible upon cessation of further inhalation exposures. Dogs fed up to 500 ppm (equivalent to 12–15 mg/kg) showed no effects but 1,000 ppm produced vomiting and nausea which limited further testing at that concentration. ADN was not a genetic toxin, developmental toxin, reproductive toxin nor did it produce an increase in tumors in a 2‐yr drinking water study in rats. Human experience reports are limited to one accidental poisoning case and a few skin exposures resulting in transient irritation and inflammation. ADN is rapidly absorbed and excreted by mammals, and is metabolized to some extent although unchanged ADN is readily detected in urine, and does not bioaccumulate.