Teicoplanin-induced hepatocellular liver injury: a case report and literature review of 17 cases in mainland China.

We report a rare case of teicoplanin- induced hepatocellular liver injury in a 49-year-old male patient with pulmonary infection. Liver function returned to normal after drug withdrawal. We reviewed 17 case reports of adverse reactions associated with teicoplanin in mainland China and found that (1) among all patients 15 were male and 53% of patients were elderly, (2) red man syndrome, anaphylactic shock and symptom of hematological system were common, (3) red man syndrome, excitement and anaphylactic shock related to teicoplanin reported in mainland China were very rare abroad. The clinician should be vigilant about the adverse reaction of teicoplanin and further studies are needed to explore the pathogenesis.

Inhibition of xanthine oxidase activity by gnaphalium affine extract.

OBJECTIVE: To evaluate the inhibitory effect of Gnaphalium affine extracts on xanthine oxidase (XO) activity in vitro and to analyze the mechanism of this effect. METHODS: In this in vitro study, Kinetic measurements were performed in 4 different inhibitor concentrations and 5 different xanthine concentrations (60, 100, 200, 300, 400 Μmol/L). Dixon and Lineweaver-Burk plot analysis were used to determine Ki values and the inhibition mode for the compounds isolated from Gnaphalium affine extract. RESULTS: Four potent xanthine oxidase inhibitors were found in 95% ethanolic (v/v) Gnaphalium affine extract. Among them, the flavone Eupatilin exhibited the strongest inhibitory effect on XO with a inhibition constant (Ki) of 0.37 Μmol/L, lower than the Ki of allopurinol (4.56 mol/L), a known synthetic XO inhibitor. Apigenin (Ki of 0.56 Μmol/L, a proportion of 0.0053‰ in Gnaphalium affine), luteolin (Ki of 2.63 Μmol/L, 0.0032‰ in Gnaphalium affine) and 5-hydroxy-6,7,3',4'-tetramethoxyflavone (Ki of 3.15 Μmol/L, 0.0043‰ in Gnaphalium affine) also contributed to the inhibitory effect of Gnaphalium affine extract on XO activity. CONCLUSIONS: These results suggest that the use of Gnaphalium affine in the treatment of gout could be attributed to its inhibitory effect on XO. This study provides a rational basis for the traditional use of Gnaphalium affine against gout.

Montelukast sodium-induced hematuria: a case report and literature review of 19 cases in mainland China.

We report a rare case of montelukast sodium-induced hematuria in a 58-year-old female patient with allergic rhinitis. Renal function returned to normal after drug withdrawal. We reviewed 19 case reports of adverse reactions associated with montelukast sodium in mainland China and found that (1) 37% of patients were pediatric patients, (2) psychiatric disorders, rashes and uropoietic organs symptom were common, (3) uropoietic organ symptoms reported in mainland China were very rare abroad. The clinician in China should be vigilant about the adverse reaction of montelukast sodium and further studies are needed to explore the pathogenesis of montelukast-induced uropoietic organ symptoms.

[Modernized study on eye's signs of blood-stasis syndrome].

OBJECTIVE: To make out a computerized formula to diagnose eye's signs of blood-stasis syndrome (BSS), and to improve the previous diagnostic methods by naked eyes. METHODS: The formula was created by detecting and analyzing the changes of eye's signs in 544 patients (261 of non-BSS and 283 of BSS) quantitatively, adopting computer's color scale principle. And the sensitivity, specificity and accuracy of the formula were verified in 382 patients (97 non-BSS and 285 of BSS). The computerized integral was compared with the naked eye integral, and the normal reference value was calculated with percentile. RESULTS: Various observatory indices of eye's sign were positively correlated with BSS. The specificity of the computerized method was 83.5%, and the diagnostic sensitivity was 89.8%, the accuracy 88.2%, and the correct index 0.733. Comparisons between the computerized integral method and the naked eye integral method showed significant difference in patients of non-BSS or of BSS in various degrees (including mild, moderate and severe) (P < 0.01). The reference value of the naked eye method was below 15. CONCLUSION: The computerized formula of eye's signs has higher specificity and sensitivity in the diagnosis of BSS, while the naked eye integral method is proved to be useful.

[Screening indices for diagnosis of traditional blood stasis syndrome by Delphi method].

OBJECTIVE: To screening out the indices for diagnosis of traditional blood stasis syndrome (BSS) by investigating experts'experiences, evaluating their significance, for providing reference to the quantitative diagnosis of BSS. METHODS: Using Delphi method, some diagnostic indices that being considered as importance by experts was screened out, and applied in 108 patients to assess their specificity and sensitivity in double-blinded condition, taking the Chinese diagnostic standard as gold standard. RESULTS: Ten indices were screened out from 50 items for traditional observing on BSS, which are considered essential by experts uniform, and showed a coincidence rate of 91.4% when applied for comprehensive diagnosis of BSS. CONCLUSION: The indices for BSS diagnosis screened out by Delphi method can serve as a reference to the BSS quantitative diagnosis.