Comparison of the nephrotoxicity of vancomycin and norvancomycin on elderly patients / 中国生化药物杂志

Objective To observe vancomycin and vancomycin in elderly patients with renal toxicity.Methods 105 cases because of infection from March 2013 to October 2014 were collected and randomly divided into two groups, one had 52 patients and were given vancomycin for anti-infection treatment, another group had 53 patients and were given norvancomycin for anti-infective treatment.Changes of serum urea nitrogen and creatinine levels and adverse reactions were observed and compared between two groups.Results Creatinine levels of patients with vancomycin group after 10 days and 7 days after withdrawal were (97.86 ±8.27)μmoI/L, (82.03 ±5.72)μmoI/L, and the norvancomycin group were (98.67 ±8.34)μmoI/L, (83.47 ± 5.91)μmoI/L, the difference were not significant.Urea nitrogen levels of patients with vancomycin group after 10 days and 7 days after withdrawal were (6.71 ±1.15)mmoI/L,(6.09 ±1.09)mmoI/L, respectively, and the norvancomycin group were(6.75 ±1.17)mmoI/L,(6.15 ±1.12)mmoI/L, the difference were not statistically significant.The total effective rate of vancomycin group was 78.85%, and norvancomycin group was 75.47%, the difference was not statistically significant.Adverse reactions of vancomycin group during treatment was 13.46%, and norvancomycin group was 13.21%, the difference was not statistically significant.Conclusion Vancomycin and norvancomycinboth have anti-infective effect on renal function in patients with certain adverse effects, urea nitrogen, creatinine levels in two groups were elevated during treatment, but decreased after withdrawing medicine.

An extensive DeBakey type IIIb aortic dissection with massive right pleural effusion presenting as abdominal pain and acute anemia:particular case report / 老年心脏病学杂志（英文版）

We describe the case of a 79-year-old male presented with sudden onset of abdominal pain and mild breathlessness, and complicated acute progressive anemia with haemoglobin which declined from 120 g/L to 70 g/L within five days. An urgent computed tomography an-giography showed acute thoracic aortic dissection, DeBakey type IIIb, a dissecting aneurysm in the proximal descending thoracic aorta start-ing immediately after the origin of the left subclavian artery and extending distally below the renal arteries with evidence of rupture into the right pleural cavity for massive pleural effusion. Plasma D-dimer, brain natriuretic peptide and C reactive protein level were elevated. Our case showed that D-dimer can be used as a‘rule-out’ test in patients with suspected aortic dissection. A raised BNP may exert a protective role through anti-inflammatory endothelial actions in the systemic circulation.