A 53-year-old male patient who had a history of pulmonary tuberculosis with fever, hyperhidrosis with slight cough,in other hospital diagnosed as pulmonary tuberculosis,received quadruple anti tuberculosis therapy(isoniazid,rifampicin,pyrazinamide and ethambutol). On the 11th day of therapy,patients developed nasal bleeding and lower extremity ecchymosis petechiae,rapidly expanding to the whole body. On the 13th day,the patient was sent to our hospital,the blood routine examination showed his blood platelet count(PLT)was 1×109/L,the antituberculous drugs were discontinued,and the treatment of raising platelets,anti allergy,hemostasis and anti infection was given. On the 4th day of treatment,the patient's temperature returned to normal,the nasal bleeding stopped,and PLT was 18×109/L. On the 7th day,his body ecchymosis subside,and PLT was 92×109/L. On the 16th day,his PLT was 151×109/L, and multi-slice spiral CT examination showed right lower lung lesion was absorbed.

A 53-year-old male patient who had a history of pulmonary tuberculosis with fever, hyperhidrosis with slight cough,in other hospital diagnosed as pulmonary tuberculosis,received quadruple anti tuberculosis therapy(isoniazid,rifampicin,pyrazinamide and ethambutol). On the 11th day of therapy,patients developed nasal bleeding and lower extremity ecchymosis petechiae,rapidly expanding to the whole body. On the 13th day,the patient was sent to our hospital,the blood routine examination showed his blood platelet count(PLT)was 1×109/L,the antituberculous drugs were discontinued,and the treatment of raising platelets,anti allergy,hemostasis and anti infection was given. On the 4th day of treatment,the patient's temperature returned to normal,the nasal bleeding stopped,and PLT was 18×109/L. On the 7th day,his body ecchymosis subside,and PLT was 92×109/L. On the 16th day,his PLT was 151×109/L, and multi-slice spiral CT examination showed right lower lung lesion was absorbed.

ObjectiveTo explore the efficacy of terlipressin therapy for refractory ascites in cirrhosis and type-2 hepatorenal syndrome (HRS-2). MethodsForty patients with refractory ascites in cirrhosis and HRS-2 who were admitted to our hospital from June 2009 to June 2014 were randomly divided into treatment group (n=23) and control group (n=17). The control group was given comprehensive medical treatment including liver protection therapy, anti-infection therapy, and nutritional support, and the treatment group was treated with terlipressin in addition to the treatment for the control group. The body weight, abdomen circumference, urine volume and urinary sodium output within 24 hours, liver and kidney function, and adverse reactions in both groups were evaluated before and after treatment. Between-group comparison of continuous data was performed by t test, and between-group comparison of categorical data was performed by χ2 test. ResultsIn the treatment group, the urine volume and urinary sodium output within 24 hours were significantly increased after treatment (270.0±120.0 vs 1200.0±490.0 ml, P＜0.05; 20.6±10.5 vs 62.5±16.5 mmol, P＜0.05), while the body weight and abdomen circumference were significantly reduced after treatment (58.5±5.3 vs 53.6±4.8 kg, P＜0.05; 97.6±7.5 vs 90.5±6.8 cm, P＜0.05). The serum levels of alanine aminotransferase, total bilirubin, blood urea nitrogen, and creatinine in the treatment group were significantly lower after treatment (P＜0.05), while the serum level of Alb in the treatment group was significantly higher after treatment (P＜005). All the above indices were significantly superior in the treatment group than in the control group (P＜0.05). The overall response rate in the treatment group was significantly higher than that in the control group (82.6% vs 52.9%, P＜0.05). There were no severe adverse reactions in both groups. ConclusionOn the basis of comprehensive medical treatment, terlipressin achieves good efficacy in the treatment of refractory ascites in cirrhosis and HRS-2 with few adverse reactions.

Objective In order to reduce the toxicity and still maintain the bioactivity of the medicinal plant Tripterygium wilfordii(TW),the whole plant biotransfomed method was employed.By observing the pharmacological activities and the toxicity of MeOH extracts from the root of T.wilfordii that were biotransformed by the fungi Aspergillums spp.and Rhizopus spp.,the best biotransformed fungi strain has been selected based on the experimental data.Methods Applying the models of acute and chronic inflammation, the weight of immune organ and cell immunity were used to study the pharmacological activities,and ip injection to observe the acute toxicity.Results The anti-inflammation and immunosuppression have been increased slightly and the toxicity decreased significantly after being biotransformed by Aspergillus spp.(TW1),while the anti-inflammation,immunosuppression,and the toxicity have been declined after being biotransformed by Rhizopus spp.(TW2).Conclusion Although both selected fungi could change the pharmacological activities and toxicity of the T.wilfordii,Aspergillus spp.is better than Rhizopus spp.