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Objective:To improve the recognition of bleeding risk in the anticoagulant process by analyzing one case of senior patient with deep vein thrombosis occurred severe bleeding during the anticoagulant therapy.Methods:The possible causes of hemorrhage were analyzed after the brief introduction of medical history,lab test report and treatment process of the patient.Results:The reasons of hemorrhage might be as follows:① the combination of warfarin and dalteparin induced the adverse drug reaction;② albumin decreased during the treatment process resulting in the effect enhancement of warfarin;③ the clearance of warfarin decreased resulting from the low creatinine clearance of the elderly patient.Conclusion:Clinical anticoagulant practice should be more careful in senior patients.The frequency of related laboratory tests should be increased in order to find potential risks timely.
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OBJECTIVE:To observe clinical efficacy and safety of compound α-ketoacid tablet in the treatment of type 2 dia-letic mellitusc(T2DM)complicated with early diabetic nephropathy. METHODS:A total of 180 T2DM patients with early nephrop-athy during Jan. 2013-Dec. 2015 selected as research objects were divided into group A,B,C according to random number table, with 60 cases in each group. Group C was given basic symptomatic treatment. Group A was additionally given Compound α-ketoac-id tablets 2.52 g orally,tid,on the basis of group C. Group B was additionally given Compound α-ketoacid tablets 5.04 g orally, tid,on the basis of group C. Three groups were treated for consecutive 24 weeks. The renal function indexes (BUN,Cr,GFR, urine ALB),blood glucose indexes (FPG,PPG,HbA1c),blood pressure indexes (SBP,DBP) and nutritional indexes (serum ALB,PA,Hb) were observed in 3 groups before and after treatment. The occurrence of ADR was recorded in 3 groups. RE-SULTS:Before treatment,there was no statistical significance in renal function indexes,blood glucose indexes,blood pressure in-dexes or nutritional indexes among 3 groups(P>0.05). After treatment,urine levels of ALB,HbA1c and SBP were decreased sig-nificantly in 3 groups;the group B was significantly lower than the group A;the group A was significantly lower than the group C. The levels of serum ALB,PA and Hb were decreased significantly in group A and C;the group B was significantly higher than the group A;the group A was significantly higher than group C,with statistical significance (P<0.05). The incidence of ADR in 3 groups were 8.3％,10.0％ and 6.7％ respectively,without statistical significance(P>0.05). CONCLUSIONS:Compound α-keto-acid tablet can significantly improve renal function,control blood glucose and blood pressure levels and complete necessary nutri-ents in T2DM patients with early nephropathy patients with good safety. High dose are more effective.
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Objective:To investigate the breakthrough points and methods of pharmaceutical care performed by clinical pharma-cists for chemotherapy-induced Ⅳ degree myelosuppression. Methods: One advanced lung adenocarcinoma patient suffering from IV degree myolosuppression after being treated with pemetrexed combined with nedaplatin was selected as the example, and the chemother-apy regimen, the cause and treatment of IV degree myolosuppression and the pharmaceutical service could be carried out were ana-lyzed. Results: With the help of clinical pharmacists, the patient conquered chemotherapy-induced myelosuppression, and clinical pharmacists enhanced the awareness of pharmaceutical care and played a positive role in the safe and effective drug use. Conclusion:The participation of clinical pharmacists in clinical pharmaceutical care through providing pharmaceutical service is beneficial to safer and more effective drug therapy.
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Objective To investigate CT findings,of the non-epithelial benign tumors of the larynx and their value in diagnosis and treatment.Methods Thirty-nine patients with non-epithelial benign tumors of larynx were examined with CT before treatment.Results Twenty-two cases with hemangioma displayed phebolithes in 9 cases,plain CT in 8 cases showed isodensity with respect to muscle near them and enhanced CT in 14 cases showed moderate to marked enhancement(9 cases)and no contrast enhancement(5 cases). Among 6 cases of neurogenic tumor,neurilemmoma(5 cases)presented as low to intermediate density on plain CT scan(1 case)and enhancement with homogeneous or inhomogeneous after enhanced CT,another case of neurofibroma presented as low density with homogeneous on plain CT imaging.Chondroma(3 cases) showed enhancement with inhomogeneous on enhanced CT scan.Pleomophic adenoma(3 cases)showed moderate to marked enhancement and one of the three cases presented as marked cystic degeneration. Lipoma(2 cases)demonstrated low density with no contrast enhancement.Lymphangioma,leiomyoma and fibroma(each has 1 case)displayed no contrast enhancement(lymphangioma)and moderate to marked enhancement(leiomyoma and fibroma)on enhanced CT scans.Conclusion CT can definitely display the shape,range and density of the tumors in larynx and provide information for diagnosis and treatment.