Objective To investigate the clinical features,treatment response and prognosis of patients with severe hemorrhagic fever with renal syndrome and complicated with acute anhemopoisis.Methods The clinical features of 18 patients with hemorrhagic fever with renal syndrome complicated with acute anhemopoisis were retrospectively analyzed.Resalts The clinical manifestations of the 18 adult patients(10 males and 8 females,age ranged from 14 to 55 years)with hemorrhagic fever with renal syndrome showed irregular fever,abrupt anemia and multiple sites hemorrhage at the severe stage(9-25 days after the onset).Peripheral leucocytes counts reduced to(2.3-3.2)×109/L,platelet to(23-31)×109/L,erythrocytes to(2.23-2.79)×1012/L,hemoglobulin to 52-67 g/L and reticulocyte to 0-0.002.Bone marrow test results showed that the hyperplasia of erythrocytes series decreased.The ratio of granulocyte to erythroeyte was significantly elevated,while granuloeyte and megalocaryocyte series decreased.The specific manifestations of acute anhemopoiesis were abrupt anemia,irregular fever and multiple sites hemorrhage.The major combined treatments were cortecosteroids and blood transfusion.These patients recovered at 26-60 days after the onset of the disease.Conclusions Hantaan virus could attack human bone marrow cells and induce cytopathogenic effect.In the course of hemorrhagic fever with renal syndrome,acute anhemopoisis could occur.The prognosis of these complicated cases is usually favorable.

Objective: To evaluate the efficacy and safety of low dose sublingual nifedipine dripping pills (5 mg) in treating moderate and severe hypertension in comparison with normal dose (10 mg) of sublingual nifedipine dripping pills. Methods: This study was designed as a randomized, double-blind, positive drug parallel controlled, multi-center, non-inferiority clinical trial. Patients with moderate and severe hypertension were enrolled by 14 clinical trial centers, randomly divided into the trial group (sublingual 5 mg nifedipine dripping pills) and the control group (sublingual 10 mg nifedipine dripping pills). The changes in blood pressure were monitored continuously within 2 hours after the initial administration, repeated the dose in 20 minutes interval after the initial administration for up to additional 3 doses (maximum 4 doses) if the antihypertensive efficacy was not satisfactory. The efficacy of antihypertensive therapy between the two groups was evaluated by repeated administration rates and blood pressure changes at 60 minutes post the initial administration, and the safety of treatment was evaluated by recording adverse event rate of the two groups. Results: The anti-hypertensive effective rates at 60 minutes after sublingual administration were 83.5% (202/242) and 86.7% (208/240) respectively between the trial group and control group (χ²=1.307, P=0.253) . On the aspect of antihypertensive effectiveness at 60 minutes after single dose of sublingual administration, the anti-hypertension effective rates of the trial group and the control group were 85.6% (154/180) and 87.2% (164/188) respectively (χ²=0.221, P=0.639). Prevalence of the repeated administration was also similar between the two groups (25.6%(62/242) in the trial group and 21.7% (52/240) in the control group, χ²=1.043, P=0.307). On the safety aspect, there was no adverse events/reactions in the trial group, but there were 15 cases of adverse events/reactions occurred in control group (6.25%, χ²=15.611, P<0.001). Conclusions In the treatment of moderate to severe hypertension, the antihypertensive efficacy of low dose nifedipine dripping pills is similar to that of conventional dosage, and the safety profile of low dose nifedipine dripping pills is better than that of the conventional dose.