Résumé
OBJECTIVE To accurately identify the rare adverse drug reactions （ADR） of vancomycin-pancytopenia in order to promote its safe use. METHODS Through a case report of a child with suppurative hip arthritis who developed pancytopenia combined with delayed drug fever caused by intravenous infusion of vancomycin，Naranjo score method and related literature were used to summarize the association between the ADR and vancomycin and its possible mechanism， and suggestions for rational use of vancomycin in pediatric patients were put forward. RESULTS & CONCLUSIONS The association of pancytopenia combined with delayed drug fever and vancomycin in this child is “very likely”. In clinical practice， it is difficult to distinguish between pancytopenia combined with delayed drug fever from fever and hematopenia caused by aggravation of infection. Medical staff should increase their awareness of vancomycin rare ADR such as pancytopenia， and pharmacists should assist medical staff in timely screening for ADR. The initial dose of vancomycin infusion for children should start from 60 mg/（kg·d），and the blood concentration should be monitored 48 h after the first infusion and the dose should be adjusted in time to maintain the valley concentration of vancomycin at 5-15 mg/L to prevent the occurrence of ADR caused by excessive blood concentration. For children who have been using vancomycin for more than one week，the blood routine should be rechecked regularly. Once pancytopenia occurs，the drug should be stopped immediately，and symptomatic treatment should be given according to the situation.
Résumé
Objective To investigate the expression of homocysteine and cystatin C in the serum of patients with different types of malignant tumors.Methods 120 patients with malignant tumors were divided into group A (gastric cancer),group B (esophageal canler),group C (liver cancer) and group D (nasopharyngeal carcinoma) according to the type of disease,25 healthy volunteers were selected as control group.Enzyme-linked immunosorbent (ELISA) was used to measure serum homocysteine and cystatin C levels in four groups of patients.Results Homocysteine level of group A,group B,group C and group D were (19.71 ± 3.40)μmol/L,(23.27 ± 9.57)μ mol/L,(21.37 ±0.38) μmol/L and (16.27 ± 1.24) μmol/L,which were significantly higher than those of the control group (all P ＜ 0.05).Cystatin C levels of group A,group B,group C and group D were (19.71 ± 3.40) mg/L,(19.71 ±3.40) mg/L.(19.71 ± 3.40) mg/L and (19.71 ± 3.40) mg/L,which were significantly higher than those of the control group (all P ＜ 0.05).Serum homocysteine and cystatin C levels of gastric cancer positively correlated with carcinoembryonic antigen (CEA) level(r =0.9643,0.9842).However,serum homocysteine and cystatin C levels of esophageal cancer,liver cancer and nasopharyngeal carcinoma had no correlation with serumCEA level.Conclusion Cystatine C and homoeysteine have potential clinical value on the diagnosis of malignant tumors.
Résumé
<p><b>OBJECTIVE</b>In order to minimize lead pollution and to protect the identified individuals with high blood lead level from lead contamination, an epidemiological study was carried on children living around the village and township-owned lead industries in Tianying town.</p><p><b>METHODS</b>Environmental monitoring: lead levels in air, soil, drinking water and crops were measured. Biological monitoring: 959 children aged 5 - 12 years were selected from villages where the lead smelters located near the residential areas and the battery disassembling was done in some families. The control children (207 pupils) were from other villages without lead exposure. Blood lead, ZnPP and teeth lead were determined. Height, weight and head circle of children and IQ scores were measured.</p><p><b>RESULTS</b>The environment was seriously polluted. The average lead concentrations in air and soils were 8.5 times and 10 times of the MACs (national health standard) respectively. Eighty-five per cent the air samples with lead concentrations higher than the national health standard. Local crops and wheat at farmers' home were also contaminated by lead dust, with. Lead content being 24 times higher than the standard. The mean blood lead and ZnPP levels of children lived in the polluted areas were 496 microgram/L and 9.41 microgram/g Hb respectively. The lead exposure caused adverse effects on children's IQ and physical development.</p><p><b>CONCLUSION</b>It is necessary to remove and reduce currently active sources of lead pollution in the community and to increase public awareness of potential health effects of lead exposure.</p>