The patient,male,42 years old,was given 1.5 mg·kg-1·h-1 sodium valproate via intravenous infusion due to epilepsy,resulting in multiple organ failure.The diagnosis and treatment process of the patient was retrospectively analyzed.The relevance evaluation was carried out using Naranjo's ADR evaluation probability scale,and the relevant literatures were reviewed to provide a reference for the clinical safety of sodium valproate.

The patient,male,42 years old,was given 1.5 mg·kg-1·h-1 sodium valproate via intravenous infusion due to epilepsy,resulting in multiple organ failure.The diagnosis and treatment process of the patient was retrospectively analyzed.The relevance evaluation was carried out using Naranjo's ADR evaluation probability scale,and the relevant literatures were reviewed to provide a reference for the clinical safety of sodium valproate.

OBJECTIVE To provide reference for the safe use of bevacizumab in cancer patients. METHODS The diagnosis and treatment of a 65-year-old female lung adenocarcinoma patient with diabetic ketoacidosis （DKA） induced by bevacizumab was retrospectively analyzed， and the possible mechanisms and causes were analyzed based on literature review. RESULTS & CONCLUSIONS The diagnosis and treatment process of patients were analyzed， and DKA caused by other drugs and disease factors were excluded. DKA was considered to be caused by the use of bevacizumab according to Naranjo’s ADR evaluation scale； the acidosis of the patient improved rapidly after one hemodialysis treatment. DKA caused by bevacizumab is rare in clinic， clinicians should be aware that bevacizumab may affect pancreatic function and induce DKA， and early detection and treatment should be achieved to improve the prognosis.

Objective:To evaluate the clinical efficacy of Bazheng Powder combined with Traditional Chinese Medicine (TCM) fumigation in the treatment of refractory urinary tract infection patients with Yin deficiency damp-heat syndrome.Methods:Randomized controlled trial design. Ninety-seven patients with Yin deficiency and damp-heat syndrome of refractory urinary tract infection in our hospital from April 2021 to May 2022 were selected as observation objects, and were divided into observation group (49 cases) and control group (48 cases) by random number table method. The control group was treated with antibiotics, and the observation group was treated with Bazheng powder plus or minus plus TCM fumigation on the basis of control group. Both groups were treated for 14 days. TCM syndrome score was performed before and after treatment. Test tube method was used to measure WBC, urine routine nitrite was used to measure urinary bacteria count, and the time to return to normal urine routine, symptom remission time and symptom disappearance time were recorded. Adverse reactions were recorded and clinical efficacy was evaluated.Results:The total effective rate was 95.92% (47/49) in the observation group and 81.25% (39/48) in the control group, and the difference between the two groups was statistically significant ( χ2=5.19, P=0.022). After treatment, TCM syndrome score of observation group was significantly lower than that of the control group ( t=13.18, P<0.01), WBC and urinary bacteria count were significantly lower than those in the control group ( t values were 19.77 and 22.99, P<0.01). The time of urine routine recovery, symptom remission and symptom disappearance in the observation group were significantly faster than those in the control group ( t values were 23.61, 9.80, 7.34, P<0.01). During the treatment period, the incidence of adverse reactions was 8.33% (4/48) in the control group, and no adverse reactions occurred in the observation group, the difference between the two groups was statistically significant ( χ2=4.26, P=0.039). Conclusion:The addition and reduction of Bazheng Powder combined with TCM fumigation can improve the clinical symptoms and clinical efficacy of patients with Yin deficiency damp-heat syndrome of refractory urinary tract infection, and no adverse reactions occurred.

A 35-year-old female patient with diabetes ketoacidosis received insulin, meropenem, ganciclovir, correction of acidosis, and fluid infusion due to pulmonary infection. Because sputum culture results suggested aspergillus infection, ganciclovir was stopped and replaced by caspofungin; because the patient′s peak temperature dropped, meropenem was stopped and replaced by piperacillin sodium and tazobactam sodium. Before antibacterial treatments, the blood potassium and calcium were 3.7 mmol/L and 2.07 mmol/L, respectively, and the blood potassium and calcium were 3.5 and 2.18 mmol/L, 3.0 and 1.89 mmol/L, 2.6 and 1.96 mmol/L, and 3.0 and 1.97 mmol/L, respectively on the 3rd, 6th, 8th, and 10th days after using caspofungin and on the 2nd, 3rd, 7th, and 9th days of treatment with piperacillin sodium tazobactam sodium. Piperacillin sodium tazobactam sodium was stopped, caspofungin, potassium and calcium supplements, and other symptomatic treatments were continued. Two days later, blood potassium was 3.0 mmol/L and blood calcium was 1.96 mmol/L. Then caspofungin was stopped and replaced by voriconazole. Three days later, the blood potassium was 3.8 mmol/L and the blood calcium was 2.12 mmol/L. It was considered that the hypokalemia and hypocalcemia were possibly induced by caspofungin.

A 35-year-old female patient with diabetes ketoacidosis received insulin, meropenem, ganciclovir, correction of acidosis, and fluid infusion due to pulmonary infection. Because sputum culture results suggested aspergillus infection, ganciclovir was stopped and replaced by caspofungin; because the patient′s peak temperature dropped, meropenem was stopped and replaced by piperacillin sodium and tazobactam sodium. Before antibacterial treatments, the blood potassium and calcium were 3.7 mmol/L and 2.07 mmol/L, respectively, and the blood potassium and calcium were 3.5 and 2.18 mmol/L, 3.0 and 1.89 mmol/L, 2.6 and 1.96 mmol/L, and 3.0 and 1.97 mmol/L, respectively on the 3rd, 6th, 8th, and 10th days after using caspofungin and on the 2nd, 3rd, 7th, and 9th days of treatment with piperacillin sodium tazobactam sodium. Piperacillin sodium tazobactam sodium was stopped, caspofungin, potassium and calcium supplements, and other symptomatic treatments were continued. Two days later, blood potassium was 3.0 mmol/L and blood calcium was 1.96 mmol/L. Then caspofungin was stopped and replaced by voriconazole. Three days later, the blood potassium was 3.8 mmol/L and the blood calcium was 2.12 mmol/L. It was considered that the hypokalemia and hypocalcemia were possibly induced by caspofungin.

The transportation of electron is inseparable from vacuum environment. The maintenance of the vacuum system of Elekta linear accelerator depends on two sputtering ionic pumps at the gun end and the target end. The traveling wave acceleration were used in Elekta linear accelerators. And the design of the electron gun filament is detachable. Because of these two reasons, the vacuum stability is relatively weak. Only two vacuum values are used to reflect the operation state of the whole vacuum system, which causes a few failures but will not trigger a the machine interlock. Considering the complexity of whole vacuum system, the problem of vacuum caused by the failure of various components in vacuum system is analyzed in this paper. It is hoped that some useful repairing experience and suggestions for the maintenance engineers of linear accelerator to solve the vacuum fault and rebuild the vacuum can be provided quickly.
Electrons ; Particle Accelerators ; Radiotherapy Dosage ; Vacuum