A 45-year-old male patient was treated with canagliflozin 100 mg once daily orally for type 2 diabetes mellitus due to poor blood sugar control. On the 4th day of medication, the patient developed slight abdominal distension and fatigue; on the 5th day, the patient felt nausea and general fatigue, and the color of urine became dark brown. The laboratory tests showed serum creatinine (Scr) 136 μmol/L, blood urea nitrogen (BUN) 9.7 mmol/L, urine protein (+), and urinary occult blood (++). Acute kidney injury induced by canagliflozin was considered. Canagliflozin was stopped, and acarbose 50 mg (before meal), 2 Haikun Shenxi capsules (海昆肾喜胶囊), and 3 Jinshuibao capsules (金水宝胶囊) orally thrice daily were given. After 2 days of drug withdrawal, the symptoms of nausea and fatigue disappeared, and the color of urine was normal. After 5 days of drug withdrawal, laboratory tests showed fasting blood glucose 5.6 mmol/L, Scr 112 μmol/L, BUN 8.5 mmol/L, urine protein (-), and urine occult blood (-). After 19 days of drug withdrawal, the patient′s renal function indexes were all within the normal range, and no discomfort symptoms recurred.

A 45-year-old male patient was treated with canagliflozin 100 mg once daily orally for type 2 diabetes mellitus due to poor blood sugar control. On the 4th day of medication, the patient developed slight abdominal distension and fatigue; on the 5th day, the patient felt nausea and general fatigue, and the color of urine became dark brown. The laboratory tests showed serum creatinine (Scr) 136 μmol/L, blood urea nitrogen (BUN) 9.7 mmol/L, urine protein (+), and urinary occult blood (++). Acute kidney injury induced by canagliflozin was considered. Canagliflozin was stopped, and acarbose 50 mg (before meal), 2 Haikun Shenxi capsules (海昆肾喜胶囊), and 3 Jinshuibao capsules (金水宝胶囊) orally thrice daily were given. After 2 days of drug withdrawal, the symptoms of nausea and fatigue disappeared, and the color of urine was normal. After 5 days of drug withdrawal, laboratory tests showed fasting blood glucose 5.6 mmol/L, Scr 112 μmol/L, BUN 8.5 mmol/L, urine protein (-), and urine occult blood (-). After 19 days of drug withdrawal, the patient′s renal function indexes were all within the normal range, and no discomfort symptoms recurred.

Objective:To investigate the effect of miR-425-5p on glucagon-like peptide-1(GLP-1) secretion in intestinal L cells induced by lipopolysaccharide(LPS), and to explore its mechanism.Methods:GLUTag cells of intestinal L cell line were incubated with LPS to determine the levels of miR-425-5p and GLP-1. Cell viability was determined by MTT assay, and cell apoptosis was detected by flow cytometry. Quantitative real time-PCR and western blot were performed to determine the expressions of miR-425-5p, phosphatase and tensin homology(PTEN), proglucagon, and GLP-1. Activity of Wnt/β-catenin signaling pathway was determined by detecting TOP/FOP ratio. Interaction among miR-425-5p, PTEN, and β-catenin was analyzed using luciferase activity assay and chromatin immunoprecipitation(ChIP)assay.Results:In GLUTag cells, with the elevation of LPS concentration, the expression of miR-425-5p and the apoptosis rate were increased, while the level of active GLP-1 and the cell viability were decreased. MiR-425-5p was involved in the regulation of LPS on GLP-1 secretion and intestinal L cell viability. Inhibition of miR-425-5p reduced the mRNA expression of proglucagon and the TOP/FOP ratio, increased PTEN protein level, and inhibited cell viability. In LPS-treated GLUTag cells, miR-425-5p increased the level of β-catenin by targeting PTEN, and β-catenin acted as a cis-acting element to induce the transcription of proglucagon and promote the secretion of GLP-1.Conclusion:In LPS-induced intestinal L cells, miR-425-5p promotes the expression of GLP-1 by targeting PTEN to modulate β-catenin.

A 42-year-old male patient, who suffered serious wound pollution due to falling after drinking, received an intravenous infusion of levofloxacin hydrochloride injection 0.2 g dissolved in 0.9% sodium chloride injection 250 ml to prevent infection. When the first dose of levofloxacin was infused intravenously for about 2 minutes (about 4 ml), the patient suddenly developed dyspnea, restlessness, and agitation. His heart rate was 120 beats per minute, breath rate was 26 times per minute, blood pressure was undetectable, and blood oxygen saturation was 0.80. Levofloxacin was immediately discontinued and antiallergic therapy such as epinephrine and dexamethasone was given. Two minutes later, the patient′s heart rate dropped to 50 beats per minute, breathing decreased to 8 times per minute, and cyanotic appeared on the skin. Anaphylactic shock and type 2 respiratory failure were diagnosed and cardiopulmonary resuscitation, tracheal intubation, balloon assisted ventilation, and norepinephrine etc. were given immediately. Three hours later, the patient developed dark urine and elevated creatine kinase (CK), myoglobin, alanine aminotransferase, aspartate aminotransferase, and serum creatinine (Scr). His peak value of CK was 17 160 U/L, myoglobin was >3 000 μg/L, and peak value of Scr was 492 μmol/L. Rhabdomyolysis with acute kidney injury was considered. The symptomatic and supportive treatments such as hemofiltration, plasma infusion, correction of acidosis, and fluid replacement were given. Ten hours later, the patient′s blood pressure returned to normal, ventilator assisted breathing was continued, and the patient′s condition was gradually improved. Thirty-four days later, the levels of myoglobin, CK and Scr returned to within the normal range. Thirty-eight days later, the patient returned to spontaneous breathing and the ventilator was withdrawn.

A 42-year-old male patient, who suffered serious wound pollution due to falling after drinking, received an intravenous infusion of levofloxacin hydrochloride injection 0.2 g dissolved in 0.9% sodium chloride injection 250 ml to prevent infection. When the first dose of levofloxacin was infused intravenously for about 2 minutes (about 4 ml), the patient suddenly developed dyspnea, restlessness, and agitation. His heart rate was 120 beats per minute, breath rate was 26 times per minute, blood pressure was undetectable, and blood oxygen saturation was 0.80. Levofloxacin was immediately discontinued and antiallergic therapy such as epinephrine and dexamethasone was given. Two minutes later, the patient′s heart rate dropped to 50 beats per minute, breathing decreased to 8 times per minute, and cyanotic appeared on the skin. Anaphylactic shock and type 2 respiratory failure were diagnosed and cardiopulmonary resuscitation, tracheal intubation, balloon assisted ventilation, and norepinephrine etc. were given immediately. Three hours later, the patient developed dark urine and elevated creatine kinase (CK), myoglobin, alanine aminotransferase, aspartate aminotransferase, and serum creatinine (Scr). His peak value of CK was 17 160 U/L, myoglobin was >3 000 μg/L, and peak value of Scr was 492 μmol/L. Rhabdomyolysis with acute kidney injury was considered. The symptomatic and supportive treatments such as hemofiltration, plasma infusion, correction of acidosis, and fluid replacement were given. Ten hours later, the patient′s blood pressure returned to normal, ventilator assisted breathing was continued, and the patient′s condition was gradually improved. Thirty-four days later, the levels of myoglobin, CK and Scr returned to within the normal range. Thirty-eight days later, the patient returned to spontaneous breathing and the ventilator was withdrawn.

A 56-year-old female patient received epalrestat 50 mg thrice daily orally because of the diagnosis of diabetic peripheral neuropathy. After 3 times of epalrestat treatment that day (about 10 hours after the first medication), the patient developed red papules on the face and patch-like erythema on the head and neck. On day 2 of epalrestat treatment, the rashes were progressively aggravated and the patient was diagnosed with erythema multiforme-type drug eruption. Considering that it might be caused by epalrestat, the drug was replaced by lipoic acid injection and symptomatic treatments with dexamethasone, vitamin C injection, and calcium gluconate injection were given. Three days later, the patient′s allergic symptoms were alleviated. Anti-allergic drugs were phased out gradually while the other drugs were continued. Six days later, the patient had no discomfort and was discharged from the hospital. At 20 days of follow-up, the rashes did not recur.

A 56-year-old female patient received epalrestat 50 mg thrice daily orally because of the diagnosis of diabetic peripheral neuropathy. After 3 times of epalrestat treatment that day (about 10 hours after the first medication), the patient developed red papules on the face and patch-like erythema on the head and neck. On day 2 of epalrestat treatment, the rashes were progressively aggravated and the patient was diagnosed with erythema multiforme-type drug eruption. Considering that it might be caused by epalrestat, the drug was replaced by lipoic acid injection and symptomatic treatments with dexamethasone, vitamin C injection, and calcium gluconate injection were given. Three days later, the patient′s allergic symptoms were alleviated. Anti-allergic drugs were phased out gradually while the other drugs were continued. Six days later, the patient had no discomfort and was discharged from the hospital. At 20 days of follow-up, the rashes did not recur.

Objective To observe the effect of new vomit-receiving device in department of neurosurgery. Methods A total of 44 patients with vomiting symptoms in our department in May 2015 were randomly divided into the observation group (n=23) and the control group (n=21). The observation group used a new type of vomit-receiving device to carry out vomiting nursing, while the control group was treated with conventional vomiting nursing. The number of cases of vomiting and the number of occurrence times were observed. Results Observation group of 23 cases with no vomit leaks occur, and the control group 21 patients vomit leaked out in 16 cases, the incidence of vomit were leaked by 72.73% (χ2=27.53, P < 0.01), vomiting leaked rate was 40.74% (22/54) (χ2 = 32.49, P < 0.01), including who prepared to receive tools but not timely for 16 times, receive tools leakage for 5 times, no enough capacity of receive tool for 1 times. The total score of patients′ satisfaction in the observation group was 78, while the total score of patients in the control group was 57. The difference was statistically significant (t=2.80, P＜0.01). The total nursing time of the observation group was 68 min, and that of the control group was 347 min,the difference was statistically significant (t=-5.73, P＜0.01). Conclusions The new vomit-receiving device can effectively reduce the incidence of vomit substance leakage, and the installation is easy to install, easy to operate and conducive to the management of vomit. It greatly improves the efficiency of nursing, and effectively improves the satisfaction of patients and their families to nursing.

A 35﹣year﹣old male patient received an IV infusion of flurbiprofen axetil 100 mg,which was diluted in 100 ml of 0. 9% sodium chloride injection,once daily for waist and abdomen persistent colic because of right ureteral calculi. The patient developed dyspnea,facial swelling,nasal obstruction,runny nose,and laryngeal edema after the first dose of flurbiprofen axetil infusion for about 20 minutes( infusion volume was about 50 ml). Flurbiprofen axetil allergy was considered. Flurbiprofen axetil was stopped immediately and anti﹣allergy treatments with adrenaline,dexamethasone,budesonide,and promethazine were given,accompanied with symptomatic supportive treatment with oxygen. About 30 minutes later,the patient′s dyspnea relieved and 3 hours later,the facial swelling,nasal obstruction,runny nose,and laryngeal edema disappeared. Then IV infusions of cefuroxime sodium and phloroglucinol were given and the patient′s waist and abdomen pain obviously improved 3 days later.

A 35﹣year﹣old male patient received an IV infusion of flurbiprofen axetil 100 mg,which was diluted in 100 ml of 0. 9% sodium chloride injection,once daily for waist and abdomen persistent colic because of right ureteral calculi. The patient developed dyspnea,facial swelling,nasal obstruction,runny nose,and laryngeal edema after the first dose of flurbiprofen axetil infusion for about 20 minutes( infusion volume was about 50 ml). Flurbiprofen axetil allergy was considered. Flurbiprofen axetil was stopped immediately and anti﹣allergy treatments with adrenaline,dexamethasone,budesonide,and promethazine were given,accompanied with symptomatic supportive treatment with oxygen. About 30 minutes later,the patient′s dyspnea relieved and 3 hours later,the facial swelling,nasal obstruction,runny nose,and laryngeal edema disappeared. Then IV infusions of cefuroxime sodium and phloroglucinol were given and the patient′s waist and abdomen pain obviously improved 3 days later.