Serious hypoglycemia, lactic acidosis and pancytopenia caused by Linezolid in elderly patients: a case report and literature review / 中华老年医学杂志

Objective:To analyze and summarize adverse reactions such as hypoglycemia, lactic acidosis and pancytopenia caused by Linezolid in elderly patients, in order to enhance clinicians' awareness of adverse reactions of Linezolid.Methods:One case with Linezolid-induced lactic acidosis, pancytopenia and hypoglycemia was reported in a patient receiving long-term and repeated use of Linezolid for recurrent urinary tract infections(RUTI)in Beijing Hospital.National and international literature on the three severe and rare adverse reactions caused by Linezolid before December 2018 was reviewed, and the risk factors, clinical characteristics and prognosis of the three severe adverse reactions caused by Linezolid were summarized and analyzed.Results:A total of 86 cases with Linezolid-induced adverse reactions such as hypoglycemia, lactic acidosis and pancytopenia were analyzed.Among them, the ratio of males to females was 1.8∶1.0, the median age was 64.5 years, and 44 cases were over 65 years, accounting for 51.2%.Among the 57 patients with lactic acidosis, 25 lactic acidosis cases were combined with liver and kidney diseases, which were the most commonly involved organs(43.9%, 25/57). The time of onset for lactic acidosis was 4 h-109 d, with a median value of 32 d, and the peak values of blood lactate were 2.6-38.1 mmol/L, with a median value of 13.3 mol/L.Pancytopenia occurred 4 h-120 days after the treatment, and the median value was 21 days.The time of onset for hypoglycemia was 8 h-26, and the median time was 10.3 days.The lowest value of blood glucose was 0.2 mmol/L.Of the 86 cases, 61(70.9%)patients improved, and 12 cases of 51 patients with lactic acidosis died, with a mortality rate of 23.5%.Conclusions:Clinicians should be aware of serious adverse reactions including hypoglycemia, lactic acidosis and pancytopenia during Linezolid treatment in elderly patients.It is recommended to monitor changes in blood glucose, blood lactate and blood cell count during Linezolid treatment, and to avoid long-term use of Linezolid, so as to maximize the benefits for patients.

The relationship between the TSLC1 silencing and DNA methylation in human lung cancer cells / 中国肺癌杂志

<p><b>BACKGROUND AND OBJECTIVE</b>The expression of TSLC1 is downregulated or abrogated in many kinds of tumors, and its downregulation is highly associated with DNA hypermethlyation. The aim of this study is to explore the relationship between TSLC1 silencing and DNA methylation of its promoter region in lung cancer cells.</p><p><b>METHODS</b>We detected the expression pattern of TSLC1 in human normal lung tissue and three lung cancer cell lines (A549, NCI-H446 and Calu-3) by semi-quantitative RT-PCR and Real-time PCR. Then we detected the status of DNA methylation in TSLC1 promoter region with bisulfite sequencing in above normal lung tissue and lung cancer cell lines. After treatment of above cell lines with the inhibitor of DNA methyltransferase 5-Aza-2-deoxycytidine (5-Aza-dC), we detected the expression change of TSLC1 by Real-time PCR before and after the treatment of 5-Aza-dC.</p><p><b>RESULTS</b>There was no methylation in TSLC1 promoter region in normal lung tissue and A549 cell line in which TSLC1 expressed; while there was DNA hypermethylation in TSLC1 promoter region in NCI-H446 and Calu-3 cell lines in which TSLC1 was abrogated, also the expression of TSLC1 in NCI-H446 and Calu-3 cell lines could be restored after treatment of 5-Aza-dC.</p><p><b>CONCLUSION</b>The silencing of TSLC1 in lung cancer cells is due to the hypermethylation of its promoter region.</p>

Cloning and identification of the core promoter of human TSLC1 gene / 基础医学与临床

Objective To clone and to identify the core promoter of human TSLCI used for exploring of transcrip-tion regulatory mechanism.Methods A series of different fragments located in the upstream of translation start site of TSLC1 were amplified from human genomic DNA by PCR,and then constructed into pGL3-Basic luciferase re-porter vector.The activity of different fragments in A549 and NCI-H446 cells was examined by a dual-luciferase as-say after transient transfection,and then the core promoter of TSLC1 was identified.Results Among the different constructs,the fragment of -68 ～ -329 bp located in the upstream of ATG showed the strong activity both in A549 cells and NCI-H446 cells,which played an important role in the transcription of TSLC1.Conclusion The fragment of -68 ～ -329 bp located in the upstream of translation start site of TSLC1 might be the core promoter region.

Clinical characteristics of pulmonary embolism and thrombolytic therapy in elderly patients / 中华老年医学杂志

Objective To explore the elinical characteristics and the effects of thrombolytic and anti-coagulation therapy on pulmonary embolism(PE)in over 60-year-old patients. Methods The clinical findings,diagnostic techniques,effects of thrombolytic and anti coagulation therapy in 72 patients with PE aged over 60-year were analyzed retrospectively. Results Each one of 72 patients in this study suffered from two or more chronic diseases.Hypertension(56.9%)and deep venous thrombosis(DVT)in lower limbs(53.6%)were the most common thrombosis risk factors in the study.The clinical findings were atypical in elderly patients with PE.Different degree of dyspnea was the main characteristics(91.7%).Other findings were cough(30.6%),chest pain(27.8%),cyanosis (18.1%),faint(13.9%)and emptysis(12.5%).The objective signs showed edema of lower extremity (44.4%),moist rales(31.9%),P2 accentuation(18.1%),vascular murmur(5.6%).Blood gas analysis in 61 cases showed that 53 patients suffered from hypoxemia(86.9%)along with 37 cases of hypocapnia(60.7%).The alveolar-arterial oxygen gradient was increased in 27/31 cases(87.1%)and blood D-dipolymer was positive in 50/61 cases(82.0%).Spiral CT pulmonary angiogram(CTPA)in 62 cases and radioactive nuclear ventilation perfusion scan in 16 cases demonstrated PE in 58(93.5%) and 16(100%)patients respectively.The cure rate of thrombolytic therapy combined with anti-coagulation versus anti-coagulation therapy alone was 86.2%versus 30.2%(P=0.000).There was no haemorrhagia phenomenon during thrombolytic and anti-coagulation therapy. Conclusions The most common risk factors of PE in the elderly are hypertension and DVT in Iower limbs.The clinical symptoms are atypical and variable.Dyspnea is the main characteristics.Thrombolytic with anti-coagulation therapy is safe and effective,but anti-coagulation therapy alone has no benefit.

Deep cerebral venous thrombosis in adults / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the pathogenesis, clinical features, radiographic findings and therapeutic outcomes of non-acute intracranial deep venous thrombosis in adults.</p><p><b>METHODS</b>Five patients who presented with increased intracranial pressure were examined with computed tomography, magnetic resonance and angiography, diagnosed as having non-acute intracranial deep venous thrombosis, and treated with thrombolytic therapy. They were reviewed retrospectively.</p><p><b>RESULTS</b>There were 3 men and 2 women, aged from 22 to 49 years. Symptom duration ranged from 1 month to 7 months, and 4 of the 5 patients were associated with venous sinus thrombosis. Two patients developed cold and fever before the onset of disease, and 3 patients had no evident predisposing factors. After the infusion of thrombolytic and systemic anti-coagulant therapy, the neurological symptoms and signs of the patients were alleviated.</p><p><b>CONCLUSIONS</b>Digital subtraction angiography (DSA) is more sensitive and accurate than MRI on diagnosing intracranial deep venous thrombosis. It may play an important role in the assessment of the treatment of intracranial deep venous thrombosis. Thrombolysis and anticoagulation of intracranial deep venous thrombosis appears to be a safe and efficacious treatment not only in the acute stage but also in the non-acute stage.</p>