Hyperemesis gravidarum(HG)refers to persistent and severe nausea and vomiting during early pregnancy.Severe HG may lead to maternal dehydration,electrolyte imbalances,malnutrition,and even hypotension and arrhythmias,potentially affecting fetal growth and development.Due to the unique physiological state of pregnancy,treatment options for HG are limited.Metoclopramide,has become a commonly used drug in treating HG due to its prove efficacy and safety.Previous studies have primarily focused on the extrapyramidal side effects of metoclopramide,but research on its psychiatric adverse effects,such as mania and somnolence,remains limited,particularly in pregnant patients.This paper reports a case of psychiatric abnormalities in an HG patient following metoclopramide administration.By analyzing the patient's condition,medication use,and adverse reactions,this study explores the potential mechanisms underlying metoclopramide-induced psychiatric abnormalities and provides clinical recommendations for preventing and managing such psychiatric adverse effects during pregnancy.These findings offer valuable guidance for healthcare professionals regarding the appropriate use of this medication.

Hyperemesis gravidarum(HG)refers to persistent and severe nausea and vomiting during early pregnancy.Severe HG may lead to maternal dehydration,electrolyte imbalances,malnutrition,and even hypotension and arrhythmias,potentially affecting fetal growth and development.Due to the unique physiological state of pregnancy,treatment options for HG are limited.Metoclopramide,has become a commonly used drug in treating HG due to its prove efficacy and safety.Previous studies have primarily focused on the extrapyramidal side effects of metoclopramide,but research on its psychiatric adverse effects,such as mania and somnolence,remains limited,particularly in pregnant patients.This paper reports a case of psychiatric abnormalities in an HG patient following metoclopramide administration.By analyzing the patient's condition,medication use,and adverse reactions,this study explores the potential mechanisms underlying metoclopramide-induced psychiatric abnormalities and provides clinical recommendations for preventing and managing such psychiatric adverse effects during pregnancy.These findings offer valuable guidance for healthcare professionals regarding the appropriate use of this medication.

Objective To compare the efficacy and safety of levofloxacin 750 mg for 5 days versus 500 mg for 7‐14 days intravenous (IV ) infusion in the treatment of community‐acquired pneumonia (CAP ) . Methods This study was a multi‐center , randomized , open‐label , non‐inferiority , controlled clinical trial .The CAP patients were randomized to receive levofloxacin 750 mg IV daily for 5 days or levofloxacin 500 mg IV daily for 7‐14 days .The clinical symptoms , laboratory tests , imaging results and microbiology data were collected and compared between the two treatment groups in terms of efficacy and safety .Results A total of 241 patients were enrolled in this clinical trial from 10 study centers .Among these patients ,223 were eligible for full analysis set (FAS) analysis ,including 111 in 750 mg group and 112 in 500 mg group .Of the 223 patients in FAS ,211 were eligible for per‐protocol set (PPS) analysis ,including 107 in 750 mg group and 104 in 500 mg group .Two hundred and forty‐one patients were included in safety set (SS) ,including 121 patients in 750 mg group and 120 in 500 mg group .The median treatment duration was 5 .0 days in 750 mg and 9 .0 days in 500 mg group .The median total dose was 3 750 mg in 750 mg group and 4 500 mg in 500 mg group .The overall efficacy rate was 86 .2% in 750 mg group and 84 .7% in 500 mg group in terms of FAS at visit 4 ,which suggested that the efficacy of 750 mg group was non‐inferior to 500 mg group .Of the 111 FAS patients in 750 mg group ,40 were bacteriological evaluable ,and 41 strains of pathogens were isolated .Forty‐nine of the 112 FAS patients in 500 mg group were bacteriological evaluable ,and 51 bacterial strains were obtained .The bacterial eradication rate was 100% in both groups .The clinical treatment efficacy rate for atypical pathogens was 100% in both groups .In 750 mg group ,the most common clinical adverse drug reactions (ADRs) were injection site adverse reactions including injection site pruritus ,pain and hyperemia .The other common ADRs were insomnia ,nausea ,skin rash .The most common drug‐related laboratory abnormalities were neutrophil percentage decreased , decreased white blood cell (WBC ) count , alanine aminotransferase (ALT) and aspartate aminotransferase (AST) elevation .Most of the ADRs were mild in severity and well‐tolerated .The safety profile of the two treatments was comparable in terms of the drug‐related treatment discontinuation and the incidence of ADRs .Conclusions The short‐course regimen of levofloxacin 750 mg IV for 5 days is at least as effective and well tolerated as the long‐course regimen of 500 mg IV for 7‐14 days in treatment of CAP .

With the advantages of displaying visceral organs intuitively,showing the operative procedure vividly,making and spreading videos conveniently in clinical teaching,electrobronchoscopy image system was adopted in clinical teaching of respiratory medicine to assist the traditional teaching method,to make up for the deficiencies of tradition method and to improve the learning effectiveness of respiratory medicine for medical students at internship.

AIM:To observe the expression of chemokine fractalkine,and its receptor,CX3CR1,in kidneys of lupus-prone BXSB mice,and their changes after treatment with prednisone. The role of fractalkine and CX3CR1 in the pathogenesis of lupus nephritis was also discussed. METHODS:Twelve 12-week-old male BXSB mice were randomly divided into two groups,the prednisone treatment group (BXSB-prednisone group,n=6) and the experimental control group (BXSB group,n=6). Six male C57BL/6J mice at the same weeks of age served as a normal control group (C57BL/6J group). Both the C57BL/6J and the BXSB group of mice received a daily intragastric administration of 0.5 mL normal saline. The BXSB-prednisone group of mice was given a daily intragastric administration of prednisone (0.18 mg/20 g BW) dissolved in 0.5 mL normal saline. All treatments lasted for 10 weeks. The mRNA and protein expressions of fractalkine and CX3CR1 in kidneys of mice were detected by reverse transcription-polymerase chain reaction (RT-PCR) and Western blotting analysis respectively. The changes of laboratory index and the kidney histopathology of mice were also investigated. RESULTS:The mRNA and protein expressions of fractalkine and CX3CR1 in kidneys of BXSB mice were significantly higher than those in C57BL/6J mice. The expressions of fractalkine and CX3CR1 in BXSB-prednisone group of mice were much lower than those in BXSB group of mice,accompanied by the lower serum IgG,IgM and anti-dsDNA antibody levels as well as blood urea nitrogen,serum creatinine and urine protein. The glomerular immune complex deposition and the kidney histopathology were also significantly improved in BXSB-prednisone group of mice. CONCLUSION:These results indicate that fractalkine and CX3CR1 participate in the pathogenesis of lupus nephritis in BXSB mice,and the effect of glucocorticoids treatment may be attributed,in part,to its ability to inhibit the expression of fractalkine in kidney.