Chronic Thromboembolic Pulmonary Hypertension and ChronicThromboembolic Pulmonary Disease / 罕见病研究

Chronic thromboembolic pulmonary hypertension (CTEPH) and chronic thromboembolic pulmonary disease (CTEPD) are diseases that occur after acute pulmonary embolism resulting from residual and organized intra-pulmonary thrombus, with or without pulmonary hypertension(PH). The prognosis of these diseases has been dramatically improved with the continuous progress of treatment and the updated concept of the comprehensive treatment strategy. However, there is a lack of awareness of these diseases among medical practitioners, and a lack of epidemiological data in China, with unknown pathogenesis and non-specific clinical manifestations. Therefore, it is easy to misdiagnosis, underdiagnosis and delay diagnosis in clinical practice. To enhance the understanding of medical personnel, this paper summarizes the definition, epidemiology, pathology, pathogenesis, diagnosis and treatment of CTEPH and CTEPD.

Chinese Guideline for Diagnosis and Management of Drug ⁃ induced Liver Injury (2023 Version) / 胃肠病学

Drug⁃induced liver injury (DILI) is an important adverse drug reaction that can lead to acute liver failure or even death in severe cases. Currently, the diagnosis of DILI still follows the strategy of exclusion. Therefore, a detailed history taking and a thorough and careful exclusion of other potential causes of liver injury is the key to correct diagnosis. This guideline was developed based on evidence⁃based medicine provided by the latest research advances and aims to provide professional guidance to clinicians on how to identify suspected DILI timely and standardize the diagnosis and management in clinical practice. Based on the clinical settings in China, the guideline also specifically focused on DILI in chronic liver diseases, drug ⁃ induced viral hepatitis reactivation, common causing agents of DILI (herbal and dietary supplements, anti⁃tuberculosis drugs, antineoplastic drugs), and signal and assessment of DILI in clinical trials.

Research progress in drug treatment of chronic obstructive pulmonary disease with pulmonary hypertension / 国际生物医学工程杂志

Chronic obstructive pulmonary disease (COPD) is well known as a chronic lung disease. In recent years, with the deepening of its understanding, various complications of COPD, especially pulmonary hypertension(PH) have received more and more attention. COPD patients with PH have an increased fatality rate and a poor prognosis, which seriously affects the quality of life of the patients, and the treatment of the disease lacks effective drugs. In order to fully understand the current status of the treatment of the disease, the research progress of the drug treatment of COPD combined with PH was reviewed. The results show that for patients with COPD and PH, the best treatment should be given to their underlying diseases. The use of statins and fasudil may be beneficial, but the effect of targeted drugs is still controversial. In the future, more large randomized controlled trials need to be carried out to further clarify the efficacy of various drugs on COPD.

Diagnosis and Differential Diagnosis of Drug-induced Liver Injury: A Challenge in Clinical Practice / 胃肠病学

Diagnosis and differential diagnosis of drug-induced liver injury (DILI) is still a challenge in clinical practice due to lack of specific diagnostic biomarkers and the fact that drugs can cause all known types of liver injuries. Currently, the diagnosis of DILI is still based on an exclusive strategy. The Roussel Uclaf Causality Assessment Method (RUCAM) has been recommended by major guidelines as a standard method for assessing DILI causality in clinical practice. However, due to the defects of RUCAM and the complex clinical phenotypes of DILI, it is still unable to fully meet the needs of complex clinical problems. Therefore, further research should focus on development of new assessment scales and specific diagnostic biomarkers.

Strengthening the scientific research and supervision of drug-induced liver injury based on big data / 临床肝胆病杂志

Drug -induced liver injury (DILI) is one of the most important drug -induced diseases and has complex clinical phenotypes ,which leads to its unpredictability.The involvement of many types of drugs and complex population heterogeneity pose great challenges to the supervision of scientific research on DILI.Most of our knowledge of DILI comes from the international databases of long -term follow -up.However, there are still many unmet clinical needs in the field of DILI .Strengthening the scientific research on drug -induced liver injury based on big data helps us to understand DILI better and it is the premise for scientific supervision .

Important issues in protocol design of exploratory and confirmatory clinical trials of new drugs for nonalcoholic steatohepatitis / 临床肝胆病杂志

The research and development of new drugs for nonalcoholic steatohepatitis (NASH) is a research hotspot in the field of liver diseases. Confirmatory clinical trials are the key clinical trials for new drug registration, while exploratory clinical trials usually provide a basis for confirmatory clinical trials. Due to different objectives of clinical trials in different phases, there are different requirements and strategies for protocol design. Trial design should take into account both ethics and scientificity. Good protocol design needs to consider the methodology of clinical trials, the overall strategy for drug research and development, new drugs under research and their target indications, and clinical epidemiology, diagnosis, and evaluation of NASH.

Clinical trials of investigational new drugs for nonalcoholic steatohepatitis:challenges in design and practice / 临床肝胆病杂志

Research and development of investigational new drugs for nonalcoholic fatty liver disease is now a research hotspot in the field of liver disease. However,there are still great challenges in protocol design and implementation in phase Ⅱ/ Ⅲ clinical trials. Since there are still controversies over the exact histological definition of nonalcoholic steatohepatitis in the academic world and a lack of long - term large -scale studies on the natural history and clinical pathology of nonalcoholic fatty liver disease/ nonalcoholic steatohepatitis,we still face a lot of challenges in the selection and definition of study population,selection of study endpoints,and interpretation of true clinical value. In addi-tion,such clinical trials often have various confounding factors,which should be controlled as much as possible in protocol design and imple-mentation,in order to minimize the bias in research conclusions.

Risk factors of Syncope Symptom in Patients with Pulmonary Embolism by unconditioned logistic regression / 实用医学杂志

Objective To investigate the risk factors of syncope symptom in patients with pulmonary embolism (PE).Methods 457 patients with confirmed pulmonary embolism were recruited in the study.They were divided into two groups:the syncope group (44 patients) and the group without syncope (413 patients).The clinical manifestation,laboratory examination,physical examination,imagingof all patients were analyzed by unconditional logistic regression.Results (1) Single factor analysis,prevalence of syncope was 9.6％ (44/457) in these patients with PE.Those with syncope had some higher risk factors,including age over 60,coronary heart disease,hypertension,stroke and lower limb vein thrombosis history.The proportion of falling pressure chest painand centricity thrombus in syncope group were increasing compared with the groupwithout syncope.Pulmonary embolism severity index (sPESI) score was higher than groupwithout syncope.(2) Multivariate analysis showed that hypertension coronary heart disease and Centricity thrombus were the independent correlates of the presence of syncope in the patients with PE.Conclusions Patients who had histories of hypertension and coronary heart disease may have the higher risk factors of syncope.Blood pressure falling and central localization may be more likely to happen in PE patients with syncope.

Clinical observation of enteral nutrition support in patients with acute exacerbation of chronic obstructive pulmonary disease / 肠外与肠内营养

Objective:To investigate the clinical effect of enteral nutrition (EN) on patients with acute exacerbation of chronic obstructive pulmonary disease (COPD).Methods:96 cases of acute exacerbation of COPD patients admitted to our hospital from January 2015 to December 2016 were randomly divided into observation group (48 cases) and control group (normal diet,48 cases).The patients in two groups were given anti-infection and other symptomatic treatments equally.The serum protein levels and pulmonary function in the two groups were compared after 2 weeks.Furthermore,antibiotic use durations,hospitalization days and the re-admission rates within 3 months were observed and compared between two groups.Results:The serum albumin and pre-albumin levels,FEV1 and FEV1/FVC in the observation group were significantly elevated in comparison with those in the control group.And the antibiotic use durations,hospitalization days and the re-admission rates within 3 months remarkably decreased in the observation group (P ＜ 0.05).Conclusion:Enteral nutrition could improve the nutritional status and pulmonary function in patients with acute exacerbation of COPD,shortening the length of hospital stay and the durations of antibiotic use and reducing the rates of re-admission.Enteral nutrition may be worth applying widely in clinical COPD patients in future.

Pulmonary hypertension in patients with chronic obstructive pulmonary disease: clinical characteristics and risk factors / 中华内科杂志

Objective To investigate the clinical characteristics of pulmonary hypertension(PH) in patients with chronic obstructive pulmonary disease (COPD) and study the related risk factors.Methods Patients with stable COPD enrolled in this study,undergoing examinations including full pulmonary function tests (PFT),6-minute walk distance (6MWD),Exercise Oxyhemoglobin,Saint.George's respiratory questionnaire (SGRQ) and transthoracic echocardiography.Pulmonary artery systolic pressure (sPAP) ≥ 36 mmHg(1 mmHg =0.133 kPa) was defined as PH.Results A total of 251 patients were finally evaluable in this study.The frequency of PH was 55.4％ (139/251) in patients with stable COPD.Significant differences were seen between patients with PH and without PH respectively in the following factors (mean P ＜0.05):proportion of age ≥ 60 years (69.8％ vs 57.1％),forced expiratory volume in one second (FEV1)(％ predicted) [(47.5±8.2)％ vs(61.2±10.2)％ and(49.8±7.9)％ vs(66.4±11.3)％],sPAP [(41.9 ± 9.1) mmHg vs (28.2 ± 3.2) mmHg],exercise oxyhemoglobin desaturation [(-5.5 ± 3.2) ％ vs(-2.2 ± 1.2) ％],6MWD [(316.0 ± 55.2) m vs(390.0 ±75.2) m].The following variables were negatively correlated with sPAP:6MWD (r =-0.330,P =0.003),FEV1 (％ predicted) (r =-0.210,P =0.024 and r =-0.130,P =0.012,respectively).The following variables were positively correlated with sPAP:age(r =0.560,P =0.031),exercise oxyhemoglobin desaturation ＞ 3％ (r =0.540,P =0.001).Logistic regression test has showed that age≥ 60 years,exercise oxygen desaturation ＞ 3％,FEV1 (％ predicted) ＜ 50％,6MWD ＜ 350 m were risk factors for PH in COPD.Conclusion The incidence of PH in COPD increases with age,yet the performance of lung function and the activity of endurance decrease in elder patients.Sixty years or older,exercise oxygen desaturation ＞ 3％,FEV1 (％ predicted) ＜ 50％,6MWD ＜ 350 m are risk factors of PH in COPD.Echocardiography or right heart catheterization when needed should be considered to confirm the diagnosis.

Thoracoscope-assisted internal fixation for treatment of rib fracture / 中华创伤杂志

Objective To discuss the clinical efficacy of internal fixation assisted by thoracoscope in treatment of rib fractures.Methods The study enrolled 180 patients with rib fractures associated with thoracic deformity hospitalized from July 2010 to June 2013.Ninety out of the patients were operated on by thoracoscope-assisted internal fixation (operation group),and the remaining 90 fractures were treated non-operatively (non-operation group).Clinical markers recorded were duration of pain,time of ventilator use,hospital length of stay and complications.Patient mental health was measured with self esteem scale (SES).Patient mobility was evaluated at follow-up.Results Between operation and non-operation groups differences were observed in duration of pain [(3.1 ± 1.0)d vs (8.9 ± 1.2) d],time of ventilator use [(3.0 ± 1.0) d vs (4.8 ± 1.0) d] and hospital length of stay [(10.0 ± 1.1) d vs (15.8 ± 1.0) d] (P ＜ 0.01).SES in operation group was (28.3 ± 2.1) versus (24.4 ± 3.3) points in non-operation group (P ＜ 0.01).No major complications occurred in operation group,but there were 20 pleural effusion,15 severe thoracic collapse or deformity,14 lung infection,10 refractory chest pain and 2 upper limb dysfunction in non-operation group (P ＜0.01).Two patients presented mobility limitation in operation group,but 12 had evident loss of mobility in non-operation group (P ＜0.01).Conclusions Thoracoscope-assisted internal fixation is effective to accelerate the pace of recovery,relieve pains,reduce complications and thus can be a priority method for treatment of rib fractures.

Understanding of ACG Clinical Guideline:Diagnosis and Management of Idiosyncratic Drug-induced Liver Injury / 胃肠病学

The American College of Gastroenterology( ACG)released the first clinical guideline for drug-induced liver injury( DILI)in June,2014:the diagnosis and management of idiosyncratic drug-induced liver injury( IDILI), which includes all aspects of IDILI,such as risk factors,diagnosis,differential diagnosis and treatment. The guideline discusses especially the issues on herbal and dietary supplements( HDS)induced liver injury and DILI in patients with chronic liver disease. The guideline is of great value for standardizing the clinical diagnosis and treatment,providing the best recommendations for management of the patients with DILI. Since the evidence of research in the field of DILI is relatively weak at this moment,the clinicians should consider the possible individual difference of the patients under the frame of guideline for making the best clinical decision.

Renal safety of adefovir dipivoxil for two-year treatment in Chinese patients with chronic hepatitis B / 中华临床感染病杂志

Objective To assess the renal safety of adefovir dipivoxil (ADV) in Chinese patients with chronic hepatitis B (CHB).Methods A retrospective study was performed on 1 013 CHB patients from Chinese ADV multicenter clinical trials (ADF30001 and ADF106632).All patients were administrated with ADV 10 mg daily.The serum creatinine and phosphorus levels were measured in different time pointsduring 104-week treatment.Nephrotoxicity was defined as an increase ≥44.2 μ mol/L from baseline in serum creatinine or a serum phosphorus value of ＜ 0.4845 mmol/L on two consecutive occasions.Paired t test was used to analyze serum creatinine and phosphorous data before treatment and at different time points during treatment.Results At week 28,week 52,week 80 and week 104,the median levels of serum creatinine were 74.963,76.996,76.820 and 77.969 μmol/L,respectively,and there were no significant differences from baseline (t =0.91,0.23,0.59 and 0.97,P ＞ 0.05).No patient experienced a ≥ 44.2 μmol/L increase from baseline.For serum phosphorus,the median levels at week 28,week 80 and week 104 were 1.098,1.088 and 1.048 mmol/L,and there were significant decreases from baseline (t =2.34,3.06 and 4.94,P ＜0.05 or ＜ 0.01).The cumulative incidence of serum phosphorus abnormality was 0.8％ (8/104).There were no confirmed serum phosphorous decreases to ＜ 0.4845 mmol/L.Conclusion Two years treatment with ADV (10 mg/d) does not result in marked nephrotoxicity,indicating that ADV 10 mg daily is well tolerated by Chinese patients.

Intravenous Rabeprazole Sodium for Treatment of Duodenobulbar Ulcer Bleeding:A Multicenter,Randomized, Double-blind,Positive Drug Parallel-group Controlled Clinical Study / 胃肠病学

Background:To date,clinical studies on intravenous rabeprazole sodium for treatment of duodenobulbar ulcer bleeding are still lacking.Aims:To evaluate the efficacy and safety of intravenous rabeprazole sodium with different doses and times of administration in treating patients with duodenobulbar ulcer bleeding.Methods:A multicenter,randomized, double-blind,positive drug parallel-group controlled trial was performed.One hundred and five patients with duodenobulbar ulcer bleeding proved by gastroscopy were randomly divided into four groups.Patients in group A,B and C were treated with intravenous rabeprazole sodium 20 mg qd,40 mg qd and 20 mg bid for 5 days,respectively.Patients in control group received intravenous omeprazole sodium 40 mg bid for 5 days.Hemostatic rate was the primary endpoint,hemostatic time and amount of blood transfusion were the secondary endpoints.Results:Hemostatic rates in group A,B,C and control group were 96.2% (25 /26),92.6% (25 /27),100.0% (26 /26)and 100.0% (26 /26),respectively,no significant difference was seen between the four groups (P >0.05).Median hemostatic time in group A,B,C and control group were 24 (24,72)h,24 (24,72)h,24 (24,48)h and 24 (24,48)h,respectively,no significant difference was seen between the four groups (P >0.05).No patient need blood transfusion during the treatment course.Slight leucopenia was the exclusive adverse effect seen in one case in group C after accomplishment of treatment.Conclusions:Three intravenous rabeprazole sodium regimens with different doses and times of administration were all effective and safe for treatment of mild to moderate duodenobulbar ulcer bleeding.Administration with 20 mg bid seems more effective among the three regimens.

Paid Emphasis on Management of Common Digestive System Diseases during Pregnancy / 胃肠病学

Frequently,there is a lack of safety data about diagnostic method and drug therapy of digestive diseases during pregnancy. It is profitable to understand the limited evidences of safety data about diagnosis and drug therapy of digestive diseases during pregnancy,which will allow the accurate evaluation and risk assessment on diagnostic method and treatment during pregnancy. High-quality clinical study on patients with pregnancy is helpful for the management of common digestive diseases among this special population.

DNA oxidative damage of the peripheral blood mononuclear cells in pulmonary embolism patients / 中国医师进修杂志

Objective To explore the level of the oxidative stress and the DNA oxidative damage of peripheral blood mononuclear cells (PBMCs) in pulmonary embolism (PE) patients after remission and in acute exacerbation.Methods The PBMCs DNA damage in 35 PE patients (test group) after remission and in acute exacerbation respectively and in 33 healthy persons (control group) was detected by single-cell gel electrophoresissingle (Comet assay).The total antioxidative capacity (TAC) in blood plasma was measured by phenanthroline colorimetric analysis.The contents of malondialdehyde (MDA) in blood plasma was measured by thiobarbituricacid colorimetric analysis.The capacity of glutathion peroxidase (GSH-PX) in blood plasma was measured by the method of improved Hafeman direct determination method (DNTB).Results The level of TAC,GSH-PX in test group after remission were significantly higher than those in acute exacerbation[(6.86 ± 1.21) kU/L vs.(5.18 ± 1.13) kU/L,(165.25 ± 41.96) kU/L vs.(137.23 ± 38.52) kU/L] (P ＜0.01),and they were all significantly lower than those in control group [(7.85 ± 1.44),(189.92 ± 51.32) kU/L] (P ＜ 0.01).The level of MDA in test group after remission was significantly lower than that in acute exacerbation [(5.58 ± 1.89) μmol/L vs.(7.26 ± 2.25) μmol/L] (P ＜ 0.01),and they were significantly higher than that in control group [(3.71 ± 1.52) μmol/L] (P ＜ 0.01).The arbitrary units (AU) of PBMCs DNA damage in PE patients after remission (29.01 ± 6.75) was significantly lower than that in acute exacerbation (42.13 ± 8.01),and they were all significantly higher than that in control group (15.12 ± 4.36),there were significant differences (P＜ 0.01).There were negative correlations between the PBMCs DNA damage and the level of TAC in PE patients after remission and in acute exacerbation (r =-0.695,P ＜ 0.01 ;r =-0.536,P ＜ 0.01).There were positive correlations between the PBMCs DNA damage and the contents of MDA in PE patients after remission and in acute exacerbation (r =0.513,P ＜ 0.01 ;r =0.628,P ＜ 0.01).There were negative correlations between the level of TAC and the contents of MDA in PE after remission and in acute exacerbation respectively (r =-0.534,P ＜ 0.01 ;r =-0.486,P ＜ 0.05).There were positive correlation between the level of TAC and GSH-PX in PE patients after remission and in acute exacerbation (r =0.512,P ＜ 0.01 ;r =0.497,P ＜ 0.01).Conclusions There are oxidation/antioxidation imbalance,oxidative stress and the PBMCs DNA damage in PE patients.There is positive correlation between the PBMCs DNA damage and the oxidative stress.After remission,the level of the oxidative stress and the PBMCs DNA oxidative damage in the same PE patients is improved respectively.

Curative effect of lung recruitment maneuvers combined with low tidal volume technique in acute respiratory distress syndrome / 中国医师进修杂志

Objective To study the effects of lung recruitment maneuvers (RM)with different duration combined with low tidal volume (TV)ventilation in acute respiratory distress syndrome (ARDS) with pulmonary and extra-pulmonary origin(ARDSp / ARDSexp). Methods Twenty-six ARDS patients with ventilation were selected including 10 patients of ARDSp (ARDSp group) and 16 patients of ARDSexp(ARDSexp group). All patients were given intermittent high-positive end expiratory pressure (PEEP) combined with low tidal volume RM in the base of usual ventilation. Effects of different duration of RM were evaluated and compared in the patients of ARDSp / ARDSexp. Results MAP decreased and HR increased when sustaining time of RM was above 60 seconds. Significant differences were showed compared with that before treatment. MAP and HR returned to normal after RM stopped.Compared with the state before RM,Pplat and Crs increased immediately after RM (P<0.05). When RM lasted above 60 seconds, Pplat increased significantly compared with that when RM continue lasted 40-59 seconds.But Crs,OI and SpO2 didn't increase obviously. Treatment effects of RM in patients of group ARDSexp were more obviously than those in patients of ARDSp group. There were 1 case of pneumothorax and 3 cases of pneumoderma in ARDSp group and 2 cases of pneumoderma in ARDSexp group when RM lasted above 60 seconds. Conclusions RM with intermittent high-PEEP on low TV is effective to ARDS and best duration is 40～59 seconds. The patients of ARDSexp, with pulmonary interstitial edema as the main pathology, respond better to RM than patients in ARDSp with pulmonary consolidation.

Diagnostic value of me clinical grading methods in acute pulmonary embolism / 中国医师进修杂志

Objective To evaluate the significance of clinical grading methods in acute pulmonary embolism (APE). Methods Clinical data of 259 patients suspected APE were retrospectively analyzed. The clinical probability was classified into low, intermediate and high grade by the Geneva score, the Wells score and the SYSU score. The result was contrasted with gold standard. Results Through the three, methods, pa-tients were classified into low pmbability (43.9%-52.5%), intermediate probability (38.0%-42.1%) and high probability (9.5%-14.0%), and the actual frequencies of APE in each category were 6.2%-14.4% in low probability, 65.9%-76.2% in intermediate probability, 88.5%-90.5% in high probability. The SYSU score had the lowest rate of missed diagnosis in low probability (P<0.05 ).The Geneva score was the most accurate in predicting the intermediate probability (P<0.05). But in high probahility, three prediction rules had no significant difference (P>0.05). Combined with D--dimer test, the rote of missed diagnosis in low probability can be lowered. Conclusions The clinical grading methods can predict the clinical probability of APE. It exists similar accuracy, but has different scope of application. Clinical doctor should choose the ap-propriate grading methods in different patients.

Prophylactic and therapeutic effect of oxymatrine on D-galactosamine-induced rat liver fibrosis / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the prophylactic and therapeutic effect of oxymatrine on experimental liver fibrosis and to reveal its mechanism.</p><p><b>METHODS</b>By establishing D-galactosamine-induced rat liver fibrosis model, we observed the effect of oxymatrine on serum and tissue biochemical indexes, content of liver hydroxyline, expression of TGF?1 mRNA and changes of tissue pathology.</p><p><b>RESULTS</b>There was a decline of liver hydroxyline and serum AST and ALT in oxymatrine group compared to those of the D-GalN group. The hydroxyline content in oxymatrine pretreatment group was (0.50 0.11)mug/mg compared with (0.99 0.14)mug/mg in D-GalN group (t=8.366, P<0.01). The content in oxymatrine treatment group was (0.44 0.04)mug/mg compared with 0.70 0.06 in D-GalN group (t=9.839, P<0.01). The SOD activity was (149.81 15.28) NU/mg in oxymatrine pretreatment group and (95.22 16.33) NU/mg in the model group (t=7.309, P<0.01); (157.68 19.54) NU/mg in the treatment group compared with (119.88 14.94) NU/mg in the model group (t=4.348, P<0.01). MDA in the pretreatment group was (2.06 0.17) nmol/mg, lower than (4.57 0.37) nmol/mg in the model group (t=17.529, P<0.01). In the treatment group, it was (1.76 0.24)nmol/mg, lower than (3.10 0.17) nmol/mg in the model group (t=12.697, P<0.01). TGF?1 mRNA reduced in the pretreatment and treatment groups as compared with that in the model group (0.21 0.01 vs 0.50 0.01, t=48.665, P<0.01; 0.18 0.02 vs 0.38 0.01, t=22.464, P<0.01). Electron microscopy showed that oxymatrine group had milder hepatocyte degeneration and less fibrosis accumulation than did the model group. Microscopy revealed wide septa expansion from the portal area to the central venous, piecemeal and confluent necrosis and pseudo-nodular formation in part of the lobular in the model group. While in oxymatrine group these lesions were much improved.</p><p><b>CONCLUSIONS</b>Oxymatrine shows prophylactic and therapeutic effect in D-galactosamine induced rat liver fibrosis. This is partly by protecting hepatocyte and suppressing fibrosis accumulation through anti-lipoperoxidation.</p>

The clinical study of the therapy of potassium L-aspartate injection on hypokalemia / 中国实用内科杂志

Objective Estimating clinical effects of the Therapy of Potassium L-aspartate Injection on Hypokalemia.Methods These hypolalemia patients from the Renji hospital of Shanghai Jiaotong University and Other Two Hospitals,and from March 2007 to May 2008,which were caused from various kinds of reasons.The test group (42 patients) were intravenous dripped by using three rami potassium L-aspartate injection added in 5% Glucose (or saline) 750 mL,the control group (44 patients) were gived two rami chloratum Kalium injection added in 5% Glucose (or saline) 750 mL,the Kalium were 1.10 g/d in both groups,once per day,time of therapy was 7 day.Results The test and control groups effective power after therapy were 86.67% and 91.11%,respectively,there was no significant difference (P=0.3998).The Kalium dose of test group was advanced from (3.18?0.23) mmol/L before testing to (3.73?0.37) mmol/L after therapy,the elevated average was (0.61?0.46)mmol/L,and there was no significant difference (P=0.4722).The accumulation power of Kalium recovery were (51.11?7.45)%,(77.78?6.20)%,(86.67?5.07)%,at the second,the fored and the sevened day,respectively.There was no significant difference between the two groups (P=0.1430).Conclusion The clinical effect was correspond between three rami potassium L-aspartate injection added in 5% Glucose (or saline) 750 ml and the Isodose chloratum Kalium injection,by once per day,and seven days of therapy,which can treat hypokalimeia caused from various kinds of reasons.