Sputnik‐V vaccine‐induced panniculitis as a local reactions

Here, a case of Sputnik‐V vaccine‐induced panniculitis was reported. The patient developed erythema, induration, and local tenderness at the injection site after 13 days of the injection. Ultra‐sonography imaging showed inflammation in subcutaneous layers including fat tissue compatible with panniculitis. She received ibuprofen and warm compress, and all symptoms resolved.     

2001-2013年邯郸市他汀类药物不良反应分析

目的了解邯郸市各医院使用的他汀类药物不良反应（ADR）发生情况,为临床合理用药提供依据。方法对邯郸市药品不良反应监测机构上报的2001--2013年他汀类药物不良反应登记资料进行回顾性统计分析。结果ADR累及多个系统一器官,主要包括肝胆、胃肠、肌肉骨骼及神经系统,其他系统相对少见。严重不良反应以肝损害最常见;不同他汀类ADR有所差异,辛伐他汀主要累及肌肉骨骼、胃肠系统和肝胆系统,阿托伐他汀主要累及肝胆和神经系统,氟伐他汀主要累及胃肠系统。结论目前在临床上应用的他汀类药物在常规剂量范围内均有ADR发生,应规范降脂用药剂量和时限,减少不良反应发生。     

和胃降逆法治疗胃食管反流性咳嗽临床观察

目的:观察和胃降逆法治疗胃食管反流性咳嗽的临床疗效。方法:将120例胃食管反流性咳嗽患者,随机分为治疗组和对照组各60例。治疗组在常规治疗基础上服用和胃止嗽汤,对照组在常规治疗基础上加用兰索拉唑及枸橼酸莫沙必利分散片。两组患者均治疗4个疗程。结果:治疗结束后,治疗组总有效率为86.67%(95%CI=78.07%~95.27%),对照组为71.67%(95%CI=60.27%~83.07%),两组综合疗效比较(u=2.777 7,P=0.007 5),差异有显著性意义;两组治疗后及随访半年(ITT分析),咳嗽症状、RDQ、LCQ积分比较(P0.05或P0.01),差异有显著性意义;治疗后,治疗组不良反应发生率为10.00%(95%CI=6.28%~13.72%),对照组为26.67%(95%CI=15.48%~37.86%),两组比较(χ~2=5.565 9,P=0.020 0),差异有显著性意义;治疗后随访半年(ITT分析),治疗组复发率为23.33%(95%CI=12.69%~34.02%),对照组为41.67%(95%CI=29.20%~53.91%),两组比较(χ~2=4.596 4,P=0.034 0),差异有显著性意义。结论:治疗组临床疗效优于对照组的证据可靠,其收益为OR=0.39(95%CI=0.15~0.99),NNT=7(95%CI=3.39~212.77)。且两组不良反应发生率、复发率OR的95%CI值均1。     

简议常用中药注射剂的不良反应

近年来,随着中药注射剂的快速发展,其所引发的不良反应也逐年增加。中药注射剂大多由复方组成,有效成分尚不清楚,制备中混杂微量不纯成分,存放过程发生质量变化,导致不溶性微粒增加等而引发不良反应。     

重视妊娠期代谢性疾病的风险与防范

        妊娠期代谢性疾病（gestational metabolic disorders,GMD）是指与妊娠期代谢异常密切相关,包括妊娠期高血压及子痫前期（gestational hypertension/preeclampsia,PE）、妊娠期糖尿病（gestational diabetes mellitus,GDM）、妊娠期代谢综合征（gestational metabolic syndrome,GMS）和妊娠期超重或肥胖（gestational overweight/obesity）等在内的一组疾病。之所以将GMD作为妊娠期特殊的一组疾病,是基于这一组疾病具有共同的特点和风险：（1）与代谢异常密切相关。（2）有相同或相似的病理生理机制。（3）与不良妊娠结局有关。（4）有产后母子心血管代谢风险。跨学科共同探讨GMD风险及防范,不仅可以在“全面二胎”政策实施之后的现实挑战下,降低孕产妇、围产儿的发病率及死亡率,而且对于重大慢病的源头防控具有重要意义。     

基层药品零售企业在药品不良反应工作中存在的问题

基层药品零售企业作为药品不良反应的上报主体之一,在我国的药品不良反应监测和报告工作中发挥着重要的作用,但也存在着一些问题。通过详细阐述基层药品零售企业在药品不良反应工作中存在的问题,分析和探讨其原因,并提出相应的对策与建议,以期促进基层药品零售企业的药品不良反应工作。     

Pembrolizumab-related Immune Thrombocytopenia in a Patient with Lung Adenocarcinoma Treated by Radiotherapy: Potential Immune-related Adverse Event Elicited by Radiation Therapy

The effect of radiotherapy during immunotherapy on immune-related adverse events (irAEs) is not fully understood. We herein report a 74-year-old woman diagnosed with lung adenocarcinoma with programmed death ligand 1 expression ≥50% and treated with pembrolizumab. She developed fatal immune thrombocytopenia associated with pembrolizumab immediately following radiotherapy. A flow cytometry analysis of peripheral blood detected an increased expression of programmed death-1 (PD-1) and Ki-67 in CD4^＋ and CD8^＋ T cells after radiotherapy, compared with pre-irradiation measurements. This case suggests that radiotherapy may evoke irAEs during treatment with anti-PD-1 antibodies, which physicians should consider when using radiotherapy in patients treated with these drugs.     

Accelerated-strategy renal replacement therapy for critically ill patients: A systematic review and meta-analysis

Background:The aim of this study was to investigate the clinical effect and safety of accelerated-strategy initiation of renal replacement therapy (RRT) in critically ill patients.Methods:PubMed, Embase, OVID, EBSCO, and the Cochrane Library databases were searched for relevant articles from inception to December 30, 2020. Only RCTs that compared the clinical efficacy and safety between accelerated-strategy RRT and standard-strategy RRT among critically ill adult patients with acute kidney injury (AKI) were included. The primary outcome was 28-day mortality.Results:A total of 5279 patients in 12 RCTs were included in this meta-analysis. The 28-day mortality rates of patients treated with accelerated and standard RRT were 37.3% (969/2596) and 37.9% (976/2573), respectively. No significant difference was observed between the groups (OR, 0.92; 95% CI, 0.70–1.12; I² = 60%). The recovery rates of renal function were 54.5% and 52.5% in the accelerated- and standard-RRT groups, respectively, with no significant difference (OR, 1.03; 95% CI, 0.89–1.19; I² = 56%). The rate of RRT dependency was similar in the accelerated- and standard-RRT strategies (6.7% vs 5.0%; OR, 1.11; 95% CI, 0.71–1.72; I² = 20%). The accelerated-RRT group displayed higher risks of hypotension, catheter-related infection, and hypophosphatemia than the standard-RRT group (hypotension: OR, 1.26; 95% CI, 1.10–1.45; I² = 36%; catheter-related infection: OR, 1.90; 95% CI, 1.17–3.09; I² = 0%; hypophosphatemia: OR, 2.11; 95% CI, 1.43–3.15; I² = 67%).Conclusions:Accelerated RRT does not reduce the risk of death and does not improve the recovery of kidney function among critically ill patients with AKI. In contrast, an increased risk of adverse events was observed in patients receiving accelerated RRT. However, these findings were based on low quality of evidence. Further large-scale RCTs is warranted.