Adverse Drug Reactions Journal

Objective To evaluate anesthetic effect and safety of lumbar anesthesia combined with intravenous dexmedetomidine(DMT) in elderly patients.Methods The elderly patients(aged 65 to 75 years) undergoing prostate electrocision through urethra from January 2012 to May 2013 in Logistics College Hospital of Chinese People's Armed Police Forces were enrolled into this study and were divided into DMT group and control group using a random number table.The patients in the two groups received bupivacaine(5.0 mg/ml) 2.0 ml for lumbar anesthesia.The patients in the DMT group received a slow intravenous bolus of DMT(0.5 μg/kg) before anesthesia and pumped DMT continuously at a rate of 0.5 μg/(kg ? h) until the end of operation.The patients in the control group received the same volume of 0.9%sodium chloride solution for injection at the same rate.The anesthetic effects(maximal sensory block plane and regression time,sedation score),adverse reactions and the residence time in post anesthesia care uint were compared between the two groups.Results A total of 86 patients were enrolled into this study.DMT group comprised 43 cases with the average age of(69±5) years and the control group comprised 43 cases with the average age of(71±6) years.There were no significant differences in the systolic pressure, diastolic pressure,heart rate,pulse oxygen saturation(SpO_2) and maximal sensory block plane of patients during the operation between the two groups.The differences of regression time of maximal sensory block plane,sedation score during operation,incidence of hypotension,incidence of bradycardia,and the residence time in post anesthesia care unit between DMT group and the control group were(223±38) min vs.(155±26) min,(4.2±1.9) vs.(2.1±1.3),20.9%(9 cases) vs.2.3%(1 case),44.2%(19 cases) vs.4.7%(2 cases),and(245±43)min vs.(195±38) min,respectively.The differences were statistically significant(all P0.05).The difference in incidence of excessive sedation between DMT group and the control group[9.3%(4 cases) vs.0]was not statistically significant,the incidence of low pulse oxygen saturation[14.0%(6 cases) vs 0]was statistically significant(P0.05).The patients who developed hypotension,bradycardia and low pulse oxygen saturation received ephedrine,atropine and oxygen,respectively.The patients' above-mentioned symptoms were improved after the treatment. Conclusions Lumbar anesthesia combined with intravenously DMT may enhance the effects of analgesia and sedation,and is relatively safe for elderly patients.The clinician should pay attention to the adverse reactions such as hypotension,bradycardia and low pulse oxygen saturation.The monitoring of adverse reactions should be intensified.Once adverse[reactions develop,the symptomatic treatment should be given.

Chu Jin

Yaowu buliang fanying zazhi

Anaesthetic effect and safety of lumbar anesthesia combined with intravenous dexmedetomidine in elderly patients

老年患者腰麻联合静脉右美托咪定麻醉效果及安全性研究

Objective To report the epidemiological investigation of a poisonous mushroom poisoning event occurring in Tengchong County,Yunnan Province in order to provide reference for preventing and controlling similar poisonous mushroom poisoning.Methods After receiving the report of poisoning event,the specialists in local Center for Disease Control and Prevention(CDC) hastened to the scene and they conducted epidemiological investigations,identification of poison and analysis of the results.Results Around 3 o'clock in the afternoon on June 30,2012,six members of a family comprising a grandfather(case 1,56-year-old ),a grandmother(case 2,47-year-old ),and four granddaughters(case 3,4,5,and 6 aged 8,8,7,and 1.5 years,respectively) ate a dish containing  malijun for lunch,which was picked by the grandfather at that day.Around 4-6 o'clock the next morning, two granddaughters(cases 3 and 5 ) and the grandparents developed nausea,vomiting,and diarrhea successively and then presented to a local health center.They were treated with symptomatic therapy and then returned home.Case 4 experienced diarrhea only without seeking medical advice and case 6 just drank a little juice of the dish and she had no marked symptoms.On July 2,cases 3 and 5 developed lethargy and coma.All the six patients presented to the People's Hospital of Tengchong County and were diagnosed with group poisonous mushroom poisoning which was reported to local CDC.Case 3 died despite resuscitation attempts in the emergency department.Case 1 was admitted to hospital and case 2 was staying treatment in emergency department and both of them recovered on days 26 and 19 after poisoning, respectively.The other three kids were transferred to provincial medical institutions in the same day and recovered on days 10 to 13 after poisoning.The fresh sample of malijun,which was picked by specialists of CDC at the location,was identified as Galerina sulciceps rather than the edible mushroom Laccaria vinaceoavellanea which was commonly called  malijun by local people.This event was determined as a sudden acute poisonous mushroom poisoning event caused by picking and eating Galerina sulciceps by mistaken.Conclusions The appearance of Galerina sulciceps may be easily confused with that of Laccaria vinaceoavellanea,thus,the poisoning may occur due to picking and eating by mistaken. Management of the information on poisoning should be enhanced,and the spectrum of poisonous mushrooms in different districts should be controlled by professional institutes.Medical staff should be trained to reinforce knowledge of diagnosis and treatment of poisonous mushrooms,and popular science education in the prevention of common poisonous mushrooms poisoning to general public should be conducted.

Guo Chao

Yang ChengLiang

Li XinHe

Yang ZhuLiang

Xie LiJing

Investigation and analysis of a poisoning event caused by Galerina sulciceps

密褶盔孢伞中毒事件的调查与分析

Objective To analyze the clinical manifestations of severe adverse reactions induced by cisplatin in cancer patients and discuss the influencing factors.Methods The reports of severe adverse reactions induced by cisplatin in National Center for ADR Monitoring from January 1,2009 to December 31, 2010 were collected and analyzed retrospectively.The patients were divided into two groups;elderly group(≥60 years old) and non-elderly group(18-59 years old).The gender and age distribution,tumor location,appearance time for severe adverse reactions after treatment,clinical manifestation,cisplatin's formulation and dosage,drug combination,and patients' outcome were compared between the two groups. The elderly group was further divided into two subgroups,60-69 years old and 70-79 years old.Subgroup analysis of statistically significant factors were conducted.Results A total of 228 reports of severe adverse reaction induced by cisplatin including 228 patients were collected.There were 103 patients in the elderly group comprising 72(69.9%) males and 31(30.1%) females with an average age of(67±5)years.There were 125 patients in the non-elderly group comprising 59(47.2%) males and 66(52.8%) females with an average age of(48±9)years.Percentage of male in the elderly group was higher than that in the non-elderly group(χ~2 =11.907,P = 0.001).The proportion of respiratory system tumor was the leading ones in the list in both groups.The proportion of respiratory system tumor in the elderly group was higher than that in the non-elderly group(χ~2 =8.512,P =0.004).The proportion of urogenital tumor in the elderly group was lower than that in the non-elderly group(χ~2 =8.759,P = 0.003).The difference of appearance time for serious adverse reactions after treatment between the 2 groups was statistically significant(χ~2=_ 2.545, P = 0.011).There was no statistically significant difference in applying cisplatin powder or cisplatin solution for injection between the 2 groups.The doses of cisplatin were 10-140 mg/d and 10-420 mg/d in the elderly group and the non-elderly group,respectively.The difference was statistically significant(P = 0.011).In the elderly group cisplatin was combined with gemcitabine,etoposide,and docetaxel,the median number of drug combination was 0(interquartile:0-1).In the non-elderly group cisplatin was combined with paclitaxel,gemcitabine,and docetaxel,the median number of drug combination was 1(interquartile:1-1), the difference was statistically significant(P = 0.032).The main severe adverse reactions induced by cisplatin were myelosuppression and leukopenia.The number of cases who developed myelosuppression and leucopenia was 50(48.5%) and 24(23.3%),69(55.2%) and 24(19.2%) in the elderly and nonelderly groups,respectively.The differences were no statistically significant.Two patients in the elderly group developed renal impairment.There was no report of renal impairment in the non-elderly group.Two patients in the non-elderly group developed QT prolongation.There was no report of QT prolongation in the elderly group.After discontinuation and symptomatic treatment,the number of cases with recovery, improvement,sequelae,and death in the elderly group were 27(26.2%),72(69.9%),3(2.9%),and 1(1.0%),respectively,and in the non-elderly group were 38(30.4%),83(66.4%),3(2.4%),and 1(0.8%),respectively.The differences were not statistically significant.Percentage of male in the subgroup of 70-79 years old(87.1%) was higher than that in the subgroup of 60-69 years old(62.5%)(χ~2 =6.232,P = 0.013).Differences in dosage and number of drug combination were not statistically significant between the 2 subgroups.Conclusions The severe adverse reactions induced by cisplatin were similar in the elderly group and the non-elderly group.The elderly male,especially aged 70 to 79 years, were the high risk group of severe adverse reactions induced by cisplatin.

Liu Che

Severe adverse reactions induced by cisplatin in cancer patients:analysis of 228 reports

癌症患者中顺铂引起的严重不良反应：228例报告分析

Objective To explore the correlation between HLA-B~* 5801 allele and allopurinolinduced severe cutaneous adverse reaction(SCAR) in Han ethnic group patients in Jiangsu province. Methods The patients who developed SCAR after receiving allopurinol were enrolled in SCAR group(36 cases),the patients without any adverse reaction receiving allopurinol over 6 months were enrolled in allopurinol control group(50 cases) and 167 healthy volunteers were enrolled in healthy control group.The subjects' peripheral blood samples were taken to detect the HLA-B~* 5801 allele by sequence-specific primer polymerase chain reaction and polymerase chain reaction-sequencing based typing,in order to analyze the correlation between HLA-B~*5801 allele and allopurinol-induced SCAR.Results There were 36 cases in SCAR group comprised 22 males and 14 females with median age of 61 years(21 to 87 years).There were 50 cases in allopurinol control group comprised 42 males and 8 females with median age of 74 years(49 to 93 years).The difference of sexual distribution between 2 groups was statistically significant(P=0.02). The dose of allopurinol in two groups was 0.1-0.3 g everyday and the median dose was 0.2 daily.The subjects in SCAR group developed SCAR 5 to 47 days after receiving allopurinol.The case number of cases with drug hypersensitivity syndrome,Stevens-Johnson syndrome(SJS),toxic epidermal necrolysis(TEN) and SJS/TEN were 20,10,3 and 3,respectively.The positive rate of HLA-B ~* 5801 allele was 97.2%(35/ 36) in SCAR group,8.0%(4/50) in allopurinol control group,and 12.0%(20/167)in healthy control group.The risk of developing SCAR was significantly higher in subjects with positive HLA-B 5801 allele than those with negative HLA-B ~* 5801 allele(OR=403,95%CI:43-3761,P=0.000).The sensitivity and specificity of the HLA-B~* 5801 allele for prediction of allopurinol-induced SCAR were 97.2%and 92.0%,respectively.Conclusions The HLA-B ~* 5801 allele in Han ethnic group in Jiangsu province is highly correlated with allopurinol-induced SCAR.The patients should be received genetic screening before administration of allopurinol,which may decrease the incidence of SCAR induced by allopurinol.

Gao Ji

Correlation between HLA-B~*5801 allele and allopurinol-induced severe cutaneous adverse reaction in Han ethnic group patients in Jiangsu province

江苏汉族患者HLA-B~*5801等位基因与别嘌呤醇诱导的重度皮肤不良反应的相关性

Objective To understand the current situation of poisoning caused by poisonous animals,poisonous plants,and poisonous mushrooms in our country in order to understand the direction of work for controlling poisoning caused by poisonous organisms and to provide scientific basis for the research on key technique for controlling poisoning.Methods China Hospital Knowledge Database and Wanfang Database were searched,and published literature regarding poisoning cases or events caused by poisonous animals,poisonous plants,and poisonous mushrooms in 1994-2011 was collected.The data was analyzed using retrospective descriptive epidemiological methods.Results Three thousand four hundred and sixtythree articles consistent with the criteria were collected and a total of 94 700 poisonous patients were reported,of which 46 110 were produced by poisonous animals,37 172 produced by poisonous plants,and 11 418 produced by poisonous mushrooms.Poisoning mainly occurred in the south area which was abundant in various species and the case distribution was nearly consistent with that of the species.The spectrum of poison were relatively concentrated in several families,and in the number of poisoning cases caused by the top 5 poison categories,poisonous animals and poisonous plants accounted for 78.77%(36 321/46 110) and 84.03%(31 234/37 172) of total number of poisoning cases caused by the 2 kinds of poisonous organisms,respectively.The main categories of poisonous animals causing poisoning were toxic snakes,fish gall bladder,and puffer fish and main plants;the main categories of poisonous plants causing poisoning were Leguminosae and Ranunculaceae.Most poisonous mushrooms poisoning was due to unknown species which accounted for 77.09%(8802/11 418),and Amanitaceae and Boletaceae were the most common mushrooms in known poisonous mushroom poisoning.The main causes of poisoning were accidents(50.24%,41 291/ 82 185) and mistaken ingestion(42.19%,34 670/82 185) and the main route of intoxication was oral ingestion(70.34%,66 438/94 458).The case fatality rates due to poisonous animals,poisonous plants,and poisonous mushrooms were 2.52%(1008/39 951),1.66%(547/33 001),and 12.39%(1248/10 076), respectively.Conclusions Poisoning of poisonous plants,poisonous animals,and poisonous mushrooms could cause serious damage and was characterized by higher fatality rate,significant regionalism,and relatively concentrated poisonous spectrum.Therefore,from now on,the work for controlling poisoning caused by poisonous plants,poisonous animals and poisonous mushrooms should be enhanced;surveillance system should be established;studies on the key technique for controlling poisoning should be conducted; propaganda and education on the identification,hazards,prevention of poisons should be strengthened in order to minimize the incidence of poisoning.

He Qian

Ma PeiBin

Sun ChengYe

Analysis of current situation of poisoning caused by poisonous animals, poisonous plants, and poisonous mushrooms in China.

中国有毒动物、有毒植物和有毒蘑菇中毒现状分析

The coronavirus disease 2019 (COVID-19) epidemic is facing the most critical situation As of January 11, 2021, there have been nearly 90 million confirmed cases worldwide and nearly 2 million deaths The local epidemic situation in China is sporadic and locally clustered, and the situation of epidemic prevention is difficult and complicated In this situation, there are many problems in medication safety of patients, such as safety issues in off-label medication and compassionate medication of COVID-19 treatment, safety problems in the combination use of drugs for COVID-19 and drugs for other diseases, monitoring of adverse drug reactions in COVID-19 treatment, the safety issues in self-purchased drugs for prevention and treatment of COVID-19, and the medication safety in patients with other diseases during the epidemic Therefore, it is necessary to pay more attention to the medication safety of patients to fight the epidemic scientifically and to win a greater victory in the fight against the COVID-19 epidemic at a smaller price © 2021 Chinese Medical Association

H. Cai

Pay attention to the medication safety of patients during the period of coronavirus disease 2019 epidemic prevention

关注新型冠状病毒肺炎疫情防控期间患者的用药安全

注意新型冠状病毒肺炎疫情防控期间患者的用药安全

关注新型冠状病毒肺炎疫情防控期间患者用药安全

涉及主题	医学生物内科学外科化学遗传学麻醉生物化学内分泌学心理学精神科病理药理学免疫学胃肠病学有机化学
出版信息	出版商: Chinese Medical Journals Publishing House Co.Ltd，出版周期: ，期刊类型: journal，开源期刊: 否
基本数据	创刊年份: 2020，原创研究文献占比: 0.00%，自引率:N.A.， Gold OA占比: 0.00%

Adverse Drug Reactions Journal

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Anaesthetic effect and safety of lumbar anesthesia combined with intravenous dexmedetomidine in elderly patients

Investigation and analysis of a poisoning event caused by Galerina sulciceps

Severe adverse reactions induced by cisplatin in cancer patients:analysis of 228 reports

Correlation between HLA-B~*5801 allele and allopurinol-induced severe cutaneous adverse reaction in Han ethnic group patients in Jiangsu province

Analysis of current situation of poisoning caused by poisonous animals, poisonous plants, and poisonous mushrooms in China.

Pay attention to the medication safety of patients during the period of coronavirus disease 2019 epidemic prevention

Pay attention to the medication safety of patients during the period of coronavirus disease 2019 epidemic prevention

Pay attention to the medication safety of patients during the period of coronavirus disease 2019 epidemic prevention

Pay attention to the medication safety of patients during the period of coronavirus disease 2019 epidemic prevention

Pay attention to the medication safety of patients during the period of coronavirus disease 2019 epidemic prevention

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期刊索引	中国科学引文数据库中国科技核心期刊目录

ISSN	1008-5734
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