A 68-year-old female patient with invasive urothelial carcinoma received immune treatments with disitamab vedotin 120 mg and toripalimab 240 mg intravenously on the first day, and 14 days was a cycle. Nineteen days after the first medication, the patient complained of lower back muscle soreness. Laboratory tests showed creatine kinase (CK) 1 079 U/L and CK-MB 33 U/L. The 2nd cycle of immunotherapy was suspended and prednisone 20 mg orally once daily was given. Five days later, the patient felt chest tightness, and laboratory tests showed CK 3 366 U/L, CK-MB 91 U/L, lactic dehydrogenase 518 U/L, myoglobin 1 282 μg/L, high-sensitivity troponin T 0.068 μg/L, and N-terminal pro-brain natriuretic peptide 148 ng/L. Myocarditis caused by the combination of disitamab vedotin and toripalimab was considered, referring to the cardiac color Doppler ultrasound examination. Prednisone was switched to IV infusion of methylprednisolone 160 mg once daily. The above laboratory test indicators gradually decreased, but the electrocardiogram showed ectopic heart rhythm. Amiodarone was added. After 11 days of methylprednisolone treatment by IV infusion, methylprednisolone 20 mg orally once daily was given, which was gradually reduced and discontinued finally. Four days later, the patient′s laboratory indicators and electrocardiogram showed no abnormalities in the re-examination.

A 68-year-old female patient with invasive urothelial carcinoma received immune treatments with disitamab vedotin 120 mg and toripalimab 240 mg intravenously on the first day, and 14 days was a cycle. Nineteen days after the first medication, the patient complained of lower back muscle soreness. Laboratory tests showed creatine kinase (CK) 1 079 U/L and CK-MB 33 U/L. The 2nd cycle of immunotherapy was suspended and prednisone 20 mg orally once daily was given. Five days later, the patient felt chest tightness, and laboratory tests showed CK 3 366 U/L, CK-MB 91 U/L, lactic dehydrogenase 518 U/L, myoglobin 1 282 μg/L, high-sensitivity troponin T 0.068 μg/L, and N-terminal pro-brain natriuretic peptide 148 ng/L. Myocarditis caused by the combination of disitamab vedotin and toripalimab was considered, referring to the cardiac color Doppler ultrasound examination. Prednisone was switched to IV infusion of methylprednisolone 160 mg once daily. The above laboratory test indicators gradually decreased, but the electrocardiogram showed ectopic heart rhythm. Amiodarone was added. After 11 days of methylprednisolone treatment by IV infusion, methylprednisolone 20 mg orally once daily was given, which was gradually reduced and discontinued finally. Four days later, the patient′s laboratory indicators and electrocardiogram showed no abnormalities in the re-examination.

Objective To discuss the clinical curative effect and pharmacoeconomics of inhaled glucocortico-steroids(ICS)in the treatment of children with cough variant asthma(CVA),in order to provide the reference for reasonable and economic drug -use of clinic treating children with CVA.Methods 128 children with CVA were divided into A,B,C three groups according to random number table method in our hospital from March 2013 to May 2014.The children with CVA of A,B,C groups were respectively given budesonide aerosol(200 -800μg/day,twice per day),fluticasone propionate aerosol(50 -100μg/time,twice per day),beclometasone dipropionate aerosol(50 -100μg/time,three times per day)on the basis of bronchodilator,smooth wheezing and expectorant.The clinical effica-cy and cost -effectiveness was evaluated after 12 weeks of treatment.Results The clinical total effective rates of A, B,C group were 90.0%,93.4%,90.7% respectively,and there were no statistically significant difference(χ2 =25.215,22.878,21.336,all P >0.05 ).The per capita cost of A,B,C group were 498.68yuan,671.20yuan, 541.14yuan respectively,and A group had the lowest cost -effectiveness ratio(C /E =5.54).Conclusion Budes-onide aerosol has better economy in treating of children with CVA.