Anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) induced by anti-thyroid drugs has been reported occasionally, but methimazole-induced AAV is not as frequently reported. This case report described a 54-year-old male who developed AAV and multiple organ failure after more than 20 days of methimazole treatment. After timely discontinuation of the disease-causing drug methimazole, the patient received methylprednisolone shock, cyclophosphamide immunosuppression, renal replacement therapy, and other supportive treatments, and the disease was alleviated without recurrence.

Anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) induced by anti-thyroid drugs has been reported occasionally, but methimazole-induced AAV is not as frequently reported. This case report described a 54-year-old male who developed AAV and multiple organ failure after more than 20 days of methimazole treatment. After timely discontinuation of the disease-causing drug methimazole, the patient received methylprednisolone shock, cyclophosphamide immunosuppression, renal replacement therapy, and other supportive treatments, and the disease was alleviated without recurrence.

Objective In order to evaluate nursing students' clinical nursing knowledge and ability objectively, we tested a clinical nursing examination system which is based on the computer technology. Methods The proposed project used the whole group of sampling methods. Data were collected via class unit. All the 620 subjects recruited from seven classes of grade 2007 (280 students )and eight classes of grade 2008 (340 students). Results Students of grade two without clinical practice had lower scores when answering clinical nursing case problems compared with grade one students who went through clinical practice. Conclusions The computer simulated clinical nursing testing system has better validity and reliability in evaluating students' clinical nursing ability.

Objective To study the pharmacokinetics and metabolism of arsenic trioixide (As2O3) and its main side effects.Method As2O3 was administered intravenously at the dose of 10 mg per day for the treatment of 8 relapsed acute promyelocytic leukemia (APL) patients. The arsenic content was measured by Gas-phase chromotography. Results The plasma maximal concentration (Cpmax) was 0.94±0.37 mg/L (±s), time to peak concentration (Tp) was 4 hours, plasma distribution half-time (t1/2α) and elimination half-time (t1/2β) were 0.89±0.29 hours and 12.13±3.31 hours, respectively. Apparent distribution volume (Vc) was 3.83±0.45 L, system clearance (CLs) was 1.43±0.17 L/h, and area under curve (AUC) was 7.25±0.97 mg*h/L. The continuous administration of As2O3 did not alter its pharmacokinetic behaviors. During As2O3 treatment, 24-hour arsenic content in urine accounted for 1%-8% of the dialy dose (10 mg). When arsenic accumulation in hair and nail increased continuously, the peak concentration could be five to seven-fold higher than that of pre-treatment. Importantly, arsenic contents in both urine and hair or nail declined gradually after drug withdrawal. No bone marrow suppression or severe organ-impairment was found.Conclusion As2O3 is a relatively safe and effective remedy in the treatment of patients with relapsed APL, in spite of certain degree of arsenic accumulation in some tissues.