A 66-year-old female patient with multiple chronic diseases was on long-term treatment with digoxin, spironolactone, metoprolol, atorvastatin, dapagliflozin, and entecavir, with no abnormality platelet count (PLT). Due to hypertrophic obstructive cardiomyopathy and atrial fibrillation, digoxin was discontinued, and rivaroxaban 15 mg once daily orally was added to prevent thrombosis. Concurrently, furosemide, sacubitril valsartan, meglumine adenosine cyclophosphate, and silibinin was given for cardiac load reducement, blood pressure control and heart failure improvement, myocardial nutrition, and liver function improvement, respectively. After the initiation of this regimen, the patient′s PLT gradually decreased and was 51×10 9/L on day 13. Drug-induced thrombocytopenia was considered, with rivaroxaban being the likely causative agent. Rivaroxaban was then switched to warfarin, methylprednisolone 40 mg was administered intravenously once, and the remaining medications were continued. The patient′s PLT gradually increased. On day 11 after discontinuing rivaroxaban, the PLT was 155×10 9/L. At a 2-week follow-up, PLT of the patient was 169×10 9/L.

A 66-year-old female patient with multiple chronic diseases was on long-term treatment with digoxin, spironolactone, metoprolol, atorvastatin, dapagliflozin, and entecavir, with no abnormality platelet count (PLT). Due to hypertrophic obstructive cardiomyopathy and atrial fibrillation, digoxin was discontinued, and rivaroxaban 15 mg once daily orally was added to prevent thrombosis. Concurrently, furosemide, sacubitril valsartan, meglumine adenosine cyclophosphate, and silibinin was given for cardiac load reducement, blood pressure control and heart failure improvement, myocardial nutrition, and liver function improvement, respectively. After the initiation of this regimen, the patient′s PLT gradually decreased and was 51×10 9/L on day 13. Drug-induced thrombocytopenia was considered, with rivaroxaban being the likely causative agent. Rivaroxaban was then switched to warfarin, methylprednisolone 40 mg was administered intravenously once, and the remaining medications were continued. The patient′s PLT gradually increased. On day 11 after discontinuing rivaroxaban, the PLT was 155×10 9/L. At a 2-week follow-up, PLT of the patient was 169×10 9/L.

Objective:To investigate the effect of intravenous application of furosemide on occurrence of cardiac surgery-associated acute kidney injury (CSA-AKI) in patients after cardiac surgery.Methods:The electronic medical records of patients undergoing cardiac surgery in Linyi People′s Hospital from January 2014 to December 2022 were collected and retrospectively analyzed. According to whether CSA-AKI occurred after surgery, the patients were divided into AKI group and non-AKI group and the clinical characteristics between the 2 groups were compared. Multivariate logistic regression was used to analyze the influencing factors of CSA-AKI, and the odds ratio ( OR) and its 95% confidence interval ( CI) were calculated. Results:A total of 2 633 patients were enrolled in the analysis, including 1 601 males (60.8%) and 1 032 females (39.2%). The age was (62.8±8.9) years, ranging from 18 to 85 years. Among the 2 633 patients, 491 (18.6%) developed CSA-AKI. Multivariate logistic regression analysis showed that after adjusting for factors such as the type of operation, intraoperative cardiopulmonary bypass, hypertension, diabetes mellitus, hypoalbuminemia, NYHA cardiac function class Ⅲ/Ⅳ, intraoperative/postoperative aortic balloon counterpulsation, preoperative serum creatinine level, operation duration, and the number of vasoactive drugs used after the operation, postoperative intravenous application of furosemide was still independently associated with the occurrence of CSA-AKI ( OR=2.161, 95 %CI: 1.720-2.715, P<0.001). Conclusions:The incidence of CSA-AKI in patients enrolled in this study was 18.6%. Intravenous use of furosemide after cardiac surgery can increase the risk of CSA-AKI.

Objective:To investigate the effect of intravenous application of furosemide on occurrence of cardiac surgery-associated acute kidney injury (CSA-AKI) in patients after cardiac surgery.Methods:The electronic medical records of patients undergoing cardiac surgery in Linyi People′s Hospital from January 2014 to December 2022 were collected and retrospectively analyzed. According to whether CSA-AKI occurred after surgery, the patients were divided into AKI group and non-AKI group and the clinical characteristics between the 2 groups were compared. Multivariate logistic regression was used to analyze the influencing factors of CSA-AKI, and the odds ratio ( OR) and its 95% confidence interval ( CI) were calculated. Results:A total of 2 633 patients were enrolled in the analysis, including 1 601 males (60.8%) and 1 032 females (39.2%). The age was (62.8±8.9) years, ranging from 18 to 85 years. Among the 2 633 patients, 491 (18.6%) developed CSA-AKI. Multivariate logistic regression analysis showed that after adjusting for factors such as the type of operation, intraoperative cardiopulmonary bypass, hypertension, diabetes mellitus, hypoalbuminemia, NYHA cardiac function class Ⅲ/Ⅳ, intraoperative/postoperative aortic balloon counterpulsation, preoperative serum creatinine level, operation duration, and the number of vasoactive drugs used after the operation, postoperative intravenous application of furosemide was still independently associated with the occurrence of CSA-AKI ( OR=2.161, 95 %CI: 1.720-2.715, P<0.001). Conclusions:The incidence of CSA-AKI in patients enrolled in this study was 18.6%. Intravenous use of furosemide after cardiac surgery can increase the risk of CSA-AKI.

Objective To investigate whether systemic lupus erythematosus (SLE) T cell function disorder is related to abnormal biochemical pathways.Methods After cross linking of anti CD3 mAbs to sheep anti mouse IgG and stimulating T cells,the changes of free calcium ion within T cells and these changes under interference of Thapsigargin and EGTA were observed respectively for 10 minutes with an adhesion cytometry.The relation between [Ca 2+ ]i response in SLE T cells and expression of CD3 molecules,or InsP 3 levels was evaluated.Results The base [Ca 2+ ]i response in T cells of SLE patients was similar to that of normal control ( P =0 105).Peak and plateau [Ca 2+ ]i responses were significantly higher in the group of SLE patients ( P

Objective To determine the degree of C 4 changes at precede or coincide with changes in systemic lupus erythematosus (SLE) activity by 5 global activity indices(PGA, M-SLEDAI, M-LAI, SLAM, and M-BILAG), and to evaluate the correlation between changes in C 4 levels and SLE activity in individual organ systems.Methods 53 lupus patients were observed monthly for 1 year in a longitudinal study. Lupus disease activity rate and complement levels were measured at each visit. Disease activity rates were calculated for subgroups defined by previous or concurrent changes in C 4 levels. Logistic regression models were used to determine the significance of the correlation between recent changes in complement levels and disease activity, and between changes in C 4 levels and SLE activity increased in specific organ systems.Results Lupus disease activity occurred at 12%,25%,13% and 12% respectively on PGA,M-SLEDAI,M-LAI,SLAM and M-BILAG. Disease activity by the M-LAI were more frequent when there was a concurrent decrease in C 4. Higher disease activity rates by the SLAM were correlated with previous increases in C 4. Decreases in C 4 were correlated with a concurrent increase in renal disease activity,or related to a concurrent decrease in the hematocrit levels and platelet count.Conclusions Reducing serum in C 4 levels were not consistently correlated with SLE disease activity, decrease in C 4 was correlated with a concurrent increases in renal and hematologic SLE activity.

Objective To demonstrate that SLE T cells primary function disordor was related to abnormal [Ca 2+ ]i responses,and to investigate the reason of abnormal [Ca 2+ ]i responses.Methods After cross-linking of anti-CD 3 mAb to sheep anti-mouse IgG and stimulating T cells,the changes of free calciumion [Ca 2+ ]i within T cells under interference of Thapsigarain and EGTA was observed respectively successively for 10 minutes by an adhesion cytometry.The relation between [Ca 2+ ]i responses in SLE T cells and InsP 3 levels was evaluated .Results The basic [Ca 2+ ]i response in T cells from SLE patients was similar to that from normal control(P=0 105),peak and plateau [Ca 2+ ]i responses were significantly higher in the group of SLE patients(P