How to rescue high-dose methotrexate induced nephrotoxicity and literature review about hemodiafiltration?

Methotrexate (MTX) is a highly renal and liver toxicity drug used in hematological malignancy treatment in children and adults. High-dose methotrexate (HD-MTX) therapy may cause impairment of kidney and decrease the elimination of MTX, at the same time, the serum concentration of MTX increased. Today the treatment for preventing MTX toxicity after renal shutdown is Carboxypeptidase. We report a patient who experienced nephrotoxicity after the HD-MTX infusions during the treatment for non-Hodgkin lymphoma (NHL) and received hemodiafiltration (HDF) with large dose of leucovorin (LV) to treat MTX intoxication. LV is very potent in the prevention of neurotoxicity and administration of LV could protect the normal cells, but the dosage and duration of LV should be according to the MTX concentration. Although a large dose of LV was applied, the patient's condition did not improve. It was found that the HDF with large dose of LV to save the patient and steadily improved the patient's clinical condition.

Physical performance and life quality in postmenopausal women supplemented with vitamin D: a two-year prospective study.

AIM: To investigate the effects of calcium and vitamin D supplementation on bone turnover marker levels, muscle strength and quality of life in postmenopausal Chinese women. METHODS: A total of 485 healthy postmenopausal Chinese women (63.44±5.04 years) were enrolled in this open-label, 2-year, prospective, community-based trial. The participants were divided into group A, B, C, which were treated with calcium (600 mg/d) alone, calcium (600 mg/d) and cholecalciferol (800 IU/d) or calcium (600 mg/d) and calcitriol (0.25 µg/d), respectively, for 2 years. Serum levels of 25-hydroxyvitamin D, parathyroid hormone, ß-CTX and P1NP were measured, and the muscle strength and quality of life were assessed at baseline and at 12- and 24-month follow-ups. RESULTS: Four hundred and sixty one participants completed this study. Serum levels of 25-hydroxyvitamin D were significantly increased in group C, but not changed in groups A and B at 24-month follow-up. Serum levels of parathyroid hormone, bone turnover marker ß-CTX and bone formation marker P1NP were significantly decreased in group C, while serum levels of ß-CTX were increased in group A at 24-month follow-up. The participants in group C maintained the grip strength, while those in groups A and B exhibited decreased grip strength at 24-month follow-up. The quality of life for the participants in groups B and C remained consistent, but that in group A was deteriorated at 24-month follow-up. CONCLUSION: Supplementation with calcitriol and calcium modifies the bone turnover marker levels, and maintains muscle strength and quality of life in postmenopausal Chinese women, whereas supplementation with cholecalciferol and calcium prevents aging-mediated deterioration in quality of life.

[Changes of soil biological characters beneath greenhouse cucumber under different cultivation systems].

A 3-year pot experiment with 8-year continuously cropped greenhouse cucumber soil was conducted to study the effects of different cultivation systems on the soil quality, soil nematode quantity, and crop yields. The third year' s data were taken into analysis. Comparing with traditional cultivation system (two seasons planting cucumber with fallowing in summer) , planting leafy vegetable and garlic in summer increased the yields of the two crops and the soil microbial biomass carbon content, total microbial population, and sucrase activity, decreased the amounts of soil nematode and root-knot nematode, and maintained a relative high Shannon-Weaver index. Planting crown daisy, garlic, and spinach in summer increased soil sucrase activity by 8.9%, 89.5%, and 36.9%, and the planting of crown daisy and garlic also increased the Shannon-Weaver index by 7.7% and 9.4%, respectively. All the results suggested that catching crop and rotation had definite restoration effects on the soil quality under continuously cropping of cucumber, and the effects of planting crown daisy and garlic were more significant.

In vivo and in vitro evaluation of essential oils from Ligusticum chuanxiong Hort on the transdermal delivery of flurbiprofen in rabbits.

The present study was designed to evaluate skin permeation enhancement effect of essential oils from Ligusticum chuanxiong Hort (chuanxiong oil) in rabbits and to compare the in vivo absorption and in vitro permeation using flurbiprofen as a model drug. In vivo results demonstrated that chuanxiong oil showed a rapid and marked permeation enhancement effect. The group with 10% oil exhibited the highest value of area under the curve (AUC) of 418+/-124 microg/ml x h, which was 2.43 times the high of control. The AUC value of 3% oil group (245+/-81.6 microg/ml x h) was similar to that of 5% oleic acid group (235+/-74.5 microg/ml x h). Whereas in vitro results indicated the enhancement of chuanxiong oil was relatively weak. The group with 3% oil appeared to the highest flurbiprofen flux (84.9+/-19.3 microg/cm2/h), to some extent lower than 5% oleic acid group (107+/-5.85 microg/cm2/h). At 10% and 15% concentrations, chuanxiong oil even decreased the flux of flurbiprofen compared with the control. Both in vitro results with pretreated skin and flurbiprofen content accumulated in skin indicated the potential mechanism for the in vitro enhancement of chuanxiong oil was the weakened barrier function by improving in the partitioning of flurbiprofen to the stratum corneum. The discrepancy was noted between the in vivo and in vitro results, indicating only about the weakened barrier function was not enough to explain the sharply increment of in vivo absorption of flurbiprofen by chuanxiong oil. The GS-MS results indicated phthalides identified from chuanxiong oil might mainly contribute to enhance in vivo absorption of flurbiprofen because of its large quantities (91.15%).