Objective:To explore the clinical features of metronidazole-related acute pancreatitis.Methods:Literature included in PubMed database up to September 2019 were searched and cases with a clear causal relationship between metronidazole and acute pancreatitis and relatively complete clinical data were collected. The following information of patients including nationality, gender, age, primary diseases, comorbidity, metronidazole medication, combined medication, occurrence of acute pancreatitis (time from medication to the onset of acute pancreatitis, symptoms, major laboratory tests results, pancreatic imaging findings, and etc.), and clinical treatments and outcomes was extracted. The collected data was analyzed by descriptive statistical method.Results:A total of 12 patients were entered, including 8 from the Unite States, 4 from Greece, France, Ireland, and Turkey, respectively; 3 were males and 9 were females, aged from 22 to 63 years. The primary diseases in 5 patients were vaginitis and in 7 patients were Crohn disease, aspiration pneumonia, ulcerative colitis, pseudomembranous colitis, periodontal abscess, and ulcerative colitis combined with Clostridium difficile colitis, and Clostridium difficile colitis, respectively; 1 of them were accompanied by history of peptic ulcer. A total of 24 times of metronidazole-related acute pancreatitis occurred in 12 patients (1, 2, 3, and 4 times occurred in 4, 5, 2, and 1 patients, respectively); 23 of them occurred in oral medication and 1 in intravenous medication; 16 cases occurred when metronidazole was used alone and 8 when metronidazole was in combination with other drugs. Time from the first application of metronidazole to the onset of acute pancreatitis was (3.9±2.8) days in 12 patients, time from reapplying metronidazole to recurrence of acute pancreatitis in 8 patients was (3.0±2.5) days, and the range of occurrence time both were 12 hours to 8 days after medication. The clinical symptoms, laboratory tests, and imaging findings of metronidazole-related acute pancreatitis were similar to those caused by other drugs. All the 24 times of acute pancreatitis had clinical symptoms, including 24 times of abdominal pain, 21 times of nausea, and 20 times of vomiting. Metronidazole was discontinued after the diagnosis of acute pancreatitis. Treatment measures were described in 17 times of acute pancreatitis, including symptomatic and supportive treatments such as fasting, analgesia, and antiemesis in 11 times. All patients recovered after 2-22 days of metronidazole withdrawal. Conclusions:Metronidazole-related acute pancreatitis usually occurred within 8 days of medication and it mainly manifested as abdominal pain. Prodromal symptoms such as nausea and vomiting might occur in some patients. Early diagnosis and timely discontinuation of the drug might be helpful to a better prognosis in general.

Objective:To explore the clinical features of metronidazole-related acute pancreatitis.Methods:Literature included in PubMed database up to September 2019 were searched and cases with a clear causal relationship between metronidazole and acute pancreatitis and relatively complete clinical data were collected. The following information of patients including nationality, gender, age, primary diseases, comorbidity, metronidazole medication, combined medication, occurrence of acute pancreatitis (time from medication to the onset of acute pancreatitis, symptoms, major laboratory tests results, pancreatic imaging findings, and etc.), and clinical treatments and outcomes was extracted. The collected data was analyzed by descriptive statistical method.Results:A total of 12 patients were entered, including 8 from the Unite States, 4 from Greece, France, Ireland, and Turkey, respectively; 3 were males and 9 were females, aged from 22 to 63 years. The primary diseases in 5 patients were vaginitis and in 7 patients were Crohn disease, aspiration pneumonia, ulcerative colitis, pseudomembranous colitis, periodontal abscess, and ulcerative colitis combined with Clostridium difficile colitis, and Clostridium difficile colitis, respectively; 1 of them were accompanied by history of peptic ulcer. A total of 24 times of metronidazole-related acute pancreatitis occurred in 12 patients (1, 2, 3, and 4 times occurred in 4, 5, 2, and 1 patients, respectively); 23 of them occurred in oral medication and 1 in intravenous medication; 16 cases occurred when metronidazole was used alone and 8 when metronidazole was in combination with other drugs. Time from the first application of metronidazole to the onset of acute pancreatitis was (3.9±2.8) days in 12 patients, time from reapplying metronidazole to recurrence of acute pancreatitis in 8 patients was (3.0±2.5) days, and the range of occurrence time both were 12 hours to 8 days after medication. The clinical symptoms, laboratory tests, and imaging findings of metronidazole-related acute pancreatitis were similar to those caused by other drugs. All the 24 times of acute pancreatitis had clinical symptoms, including 24 times of abdominal pain, 21 times of nausea, and 20 times of vomiting. Metronidazole was discontinued after the diagnosis of acute pancreatitis. Treatment measures were described in 17 times of acute pancreatitis, including symptomatic and supportive treatments such as fasting, analgesia, and antiemesis in 11 times. All patients recovered after 2-22 days of metronidazole withdrawal. Conclusions:Metronidazole-related acute pancreatitis usually occurred within 8 days of medication and it mainly manifested as abdominal pain. Prodromal symptoms such as nausea and vomiting might occur in some patients. Early diagnosis and timely discontinuation of the drug might be helpful to a better prognosis in general.

Objective To evaluate the relationship between 25-(OH) vitamin D [25-(OH) D] level and peripheral neuropathy in patients with type 2 diabetes mellitus.Methods Eighty patients with type 2 diabetes mellitus were enrolled in this cross-sectional study,including 37 subjects with and 43 without diabetic neuropathy.Anthropometric data was collected and serum levels of 25-(OH) D,HbA1c,blood lipid,and hepatic and renal functions were determined in all patients.Results Serum 25-(OH) D level was significantly lower in patients with diabetic neuropathy compared to those without neuropathy [(12.73 ± 4.68 vs 17.56 ± 5.28) ng/ml,P＜0.01].Logistic regressions demonstrated that vitamin D level was associated with diabetic neuropathy (OR=1.222,95％ CI 1.095-1.364).Conclusions Vitamin D insufficiency is associated with diabetic peripheral neuropathy.25-(OH) D level seems to be an independent risk factor of diabetic neuropathy in patients with type 2 diabetes mellitus.

Objective To study the cytogenetic features of acute myeloid leukemia (AML) and analyze the association with cytogenetic features and early responses after induction therapy.Methods The karyotypes of 395 patients who had been newly diagnosed with AML were analyzed.These patients were divided into three groups (low-risk,intermediate-risk and high-risk),according to the AML NCCN guidelines.The incidence of different karyotypes in these three groups and the complete remission (CR) rate after the first cycle of induction therapy were analyzed.Results The incidence rates of karyotypes in high-risk,intermediate-risk and low-risk groups were 50.56 ％ (180/356),39.89 ％ (142/356),9.55 ％ (34/356),respectively.All patients with t(15;17) who completed induction therapy reached CR.There was significant difference in the CR rates of t(8;21) groups with or without additional karyotypes [92.00 ％(23/25) vs 50.00 ％(11/22)] (x2 =10.317,P =0.001).There was no significant difference in the CR rates between normal and-Y karyotype group [61.90 ％ (39/63) vs 58.82 ％ (10/17)] (x2 =0.054,P =0.817).Complex cytogenetics ascribed to the low-risk group,of which monosomal karyotype was common,nine of ten patients with monosomal karyotype were associated with an inferior CR rate.Conclusion The cytogenetic features of AML are different from previous reports by other centers.The cytogenetic features of AML patients not only influence the long-term survival,but also the CR rates of induction therapy.

Objective: To observe the effect oftuina plus music therapy on range of motion of ankle joints and muscle spasm of lower limbs in children with spastic cerebral palsy. Method:All of 286 cases that conformed to the diagnostic criteria of infantile cerebral palsy were treated with 7 types of tuina manipulations respectively to unblock the Governor Vessel, reinforce the kidney and strengthen the spleen, pinch along the spine, stimulate specific foot-reflex area and different spinal segments, accelerate recovery of muscle strength and increase joint range of motion, 25-30 rain each treatment, once or twice a day, 30 d constitute a course of treatment.After this, the efficacy on femoral medial adduction and dorsiflexion angle and composite spasticity score (CSS) was evaluated. Result: The statistical analysis showed significant differences in dorsiflexion and femoral medial adduction angle and CCS scores (P<0.01) after the treatments. Conclusion: Tuina plus music therapy can lubricate the joints, relax contraction of tendons, alleviate muscle spasm and improve scissors and toe-walking gaits, thereby benefiting the gross motor function of infants in sitting, kneeling, standing and walking.

[Objective]To discuss the clinical effect of the anterior approach for the treatment of thoracolumbar burst fractures by decompression and bone graft.[Method]A total of 34 patients underwent anterior approach for the treatment of thoracolumbar burst fractures were retrospectively analyzed from September 2003 to September 2005.According to the Denis classification system,there were 6 type A,16 type B,6 type C,4 type D,and 2 type E.Preoperative and postoperative neurologic changes,spinal canal decompression,segmental angulation,and arthrodesis rate were evaluated.[Result]The average preoperative canal compressopm decreased from 66.5% to 2.0%.Mean preoperative segmental kyphosis improved from 22.10? to 2.30?.There was neurologic deterioration.Twenty-six(86.7%) of 30 patients with neurologic deficits had an improvement by at least one modified Frankel grade.All patients went on to apparently stable arthrodesis.[Conclusion]Types of anterior spinal instrumentation and reconstruction techniques allow direct anterior decompression of neural elements,improvement in segmental angulation,and acceptable rates of arthrodesis without the need for supplemental posterior instrumentation.

Objective:To investigate if CD4~+CD25~+ regrating T cells can suppress GVHD mediated by CD4~+ T cells in murine semi-allogeneic bone marrow transplantation model and try to figure out the mechanisms evolved.Methods:C3H(H-2~k) as donors, C3H?B6(H-2~ k/b) F1(recipients) were lethally irradiated and reconstituted with antibody T cell depleted bone marrow(ATBM), and divided into 4 groups: (A)No further treatment(n=10);(B)Infused 5?10~5 C3H CD4~+T cells(CD4,n=10);(C)Infused 5?10~5 CD4~+CD25~+Treg(CD25,n=5);(D)Infused 5?10~5 CD4~+T cells plus 5?10~5 CD4~+CD25~+Treg(CD4/CD25,n=6).Results:All mice in ATBM group, CD25 group and CD4/CD25 groups survived until 60 days without any GVHD symptoms, while all mice in CD4 group died in 10 days from GVHD.Conclusion:CD4~+CD25~+Treg cells did not cause GVHD and can prevent GVHD mediated by CD4~+ T cells while co-injected with CD4~+ T cells.