Table of Content

20 June 2022, Volume 37 Issue 6

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Effects of moderate exercise on the prognosis of patients with atrial fibrillation:A systematic review and Meta-analysis

Zhang Haifu, Ye Xiangqing, Chen Zhexu, Chen Shijian, Yang Dong, Zhang Xingwei

2022, 37(6):  485-489.  doi:10.3969/j.issn.1004-583X.2022.06.001

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Objective To analyze the effects of moderate exercise on exercise capacity and long-term clinical prognosis of patients with atrial fibrillation. Methods The databases of CNKI, Wanfang, VIP, Pubmed, OVID, Cochrane Central Register of Controlled Trials (CENTRAL) and web of science were searched for clinical trials of moderate physical activity intervention on patients with atrial fibrillation. The main endpoints of this study involved the resting heart rate, maximum heart rate, 6-minute walk test, maximum exercise power, all-cause mortality and stroke incidence to evaluate the effects of moderate physical activity on activity tolerance and prognosis of patients with atrial fibrillation. Results A total of 7 trials including 2 452 patients were included. The experimental group was the moderate exercise group, and the control group was the inactive group. Moderate exercise did not significantly increase the resting heart rate (MD=-1.68, P=0.70) and maximum heart rate (RD=9.72, P=0.11). Exercise training could significantly improve the exercise capacity of patients with atrial fibrillation, increase the 6-minute walking distance (MD=59.07, 95%CI=11.70-106.44, P<0.05), and improve the exercise power to a certain extent (MD=17.96, 95%CI=-6.30-42.22, P=0.15). Moderate exercise had no adverse effects on the long-term prognosis of patients with atrial fibrillation. Compared with inactive group, moderate exercise group had 15.7% vs 14.2% (RD=0.03, 95%CI=-0.18-0.25, P=0.75) in all-cause mortality and 5.0% vs 2.9% (RD=0.02, 95%CI=-0.06-0.09, P=0.69) in stroke incidence, and the differences in two groups were not statistically significant. Conclusion Moderate exercise can improve the activity tolerance of patients with atrial fibrillation without increasing stroke and all-cause mortality.

Meta analysis on diagnostic value of external anal sphincter electromyography in multiple system atrophy and Parkinson's disease

Sun Yanan, Hao Yifeng, Li Xiaohong

2022, 37(6):  490-496.  doi:10.3969/j.issn.1004-583X.2022.06.002

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Objective To evaluate the diagnostic value of external anal sphincter electromyography (EAS-EMG) in multiple system atrophy (MSA) and Parkinson’s disease (PD). Methods Computer retrieval was applied for PubMed, Web of science, Cochrane library,Embase,CBM disc,CNKI,Wanfang Data, and relevant studies on EAS-EMG in MSA and PD with the retrieval duration extending from the library setup to January 1st,2021 were selected. The literature were screened out based on the inclusion and exclusion criteria by two independent researchers. Quality of studies was assessed according to the Newcastle-Ottawa Scale(NOS). The detection on the data merger and publication bias was performed with Software Revman5.3. Results A total of 14 studies were included, including 2 cohort studies and 12 case-control studies. The NOS scores of all studies were ≥6 points. Meta analysis results showed the duration of mean motor unit potential (MUP) in MSA group was significantly longer than that in PD group (MD=2.70, 95%CI=2.07-3.34); average MUP amplitude in the MSA group was higher than that in the PD group (MD=43.21, 95%CI=-7.36-93.78); the percentage of polyphase wave in the MSA group was significantly higher than that in the PD group (MD=13.34, 95%CI=6.22-20.46); the time limit of MUP >10 ms% in the MSA group was significantly higher than that in the PD group (MD=18.88, 95%CI=4.89-32.87); and the percentage of satellite potential in the MSA group was significantly higher than that in the PD group (MD=8.36, 95%CI=3.85-12.86). The Study was found to have a slight publication bias. Conclusion EAS-EMG delivers important reference value in the differential diagnosis of MSA and PD. The duration of mean MUP, percent of multiphase wavE, MUP duration >10 ms% and satellite potential % in EAS-EMG delivers high diagnostic value, while MUP amplitude exhibits less diagnostic value. EAS-EMG may be of greater value in the differential diagnosis on MSA and early PD, and further studies are required.

The correlation between neonatal brain damage and perinatal infection: A Meta-analysis

Wang Jie, Chen Baochang, Huang Jiayu, Meng Jinfeng, Li Shangbin, Yan Weichen, Zhao Qian, Li Jiao, Ren Changjun

2022, 37(6):  497-503.  doi:10.3969/j.issn.1004-583X.2022.06.003

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Objective To evaluate the correlation between neonatal brain damage and perinatal infection with Meta-analysis system, identify the cause of brain damage, intervene and treat newborns with brain damage to earliest convenience, and improve the prognosis of newborns. Methods The searched databases involving China Biology Medicine disc(CBM disc), CNKI, VIP, Wanfang, PubMed, Web of Science, Cochrane Library and Embase were included,and the studies on effects of Perinatal infection on neonatal brain damage were included. The literature search was up to October 9, 2020. A fixed(random) effect model was utilized to combine findings of literatures, and then the odds ratio (OR value) and corresponding 95% confidence interval (CI) were calculated. The reasons for heterogeneity was sought, and potential publication bias was analyzed. Results A total of 14 articles are included, and all the articles are case-control studies. The results concluded from Meta-analysis show that the OR value of the gestational infectious group was 4.13[95%CI:3.18-5.37], OR value of maternal gestational infectious disease group was 9.15[95%CI:5.42-15.45], and OR value of the neonatal infection group is 3.04[95%CI:2.24-4.11]. Conclusion The risk of co-infection is significant when neonatal brain damage occurs, or the neonatal brain damage is related to perinatal infection.

Clinical characteristics and long-term prognosis of initial patients with new onset different type of heart failure combined atrial fibrillation

Zhang Jingshui, Xu Yanan, Wang Jun, Yang Yi, Jiang Haibing, Tang Long, Wang Xianping, Shao Mingliang

2022, 37(6):  504-509.  doi:10.3969/j.issn.1004-583X.2022.06.004

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Objective This study investigated outcomes related to new onset different type of heart failure in patients with atrial fibrillation (AF). Methods This study was a retrospective observational study. The subjects were recruited from the People's Hospital of Xuancheng City from July 2017 to July 2020. All Patients with heart failure with reduced ejection fraction (HFrEF) or heart failure with mid-range ejection fraction (HFmrEF) were initially diagnosed. According to the result of AF, the patients were divided into four groups, HFrEF with AF (n=41),HFrEF with non- AF (n=59), HFmrEF with AF (n=58), HFmrEF with non- AF (n=35). The clinical characteristics and clinical adverse events of the 4 groups were compared.Multivariate Cox regression was used to analyze the effect of HFmrEF and HFrEF patients with AF on clinical adverse events. Results A total of 193 patients were selected. The mean follow-up time was (28.87±11.13) months. Among the four groups, the difference was statistically significant in the gender, age, uric acid, N-terminal pro-B-type natriuretic peptide (NT-proBNP), Left ventricular end diastolic diameter (LVEDD), left atrial diameter (LAD), left ventricular shortening score, CHA₂DS₂ - VASc score, New York heart association (NYHA), the utilization rate of β-blockers and diuretics, and the incidence of major adverse cardiovascular and cerebrovascular events (All P<0.05). Multiple Cox regression analysis shows that NYHA(HR=1.814,95%CI=1.051-3.131),NT-proBNP(HR=1.076,95%CI=1.033-1.120),CHA₂DS₂-VASc score(HR=1.375,95%CI=1.022-1.851),HFrEF with AF(HR=5.822,95%CI=1.699-19.955),HFmrEF with AF(HR=5.023,95%CI=1.565-16.118) were the influencing factors of main adverse cardiovascular and cerebrovascular events(All P<0.05). Kaplan-Meier analysis showed that the difference was a statistically significant in the incidence of long-term major adverse cardiovascular and cerebrovascular events among the four groups (χ²=12.432, P=0.006). Conclusion The initial patients with (HFrEF) or heart failure with mid-range ejection fraction (HFmrEF) combined AF were associated with increased risk of main adverse cardiovascular and cerebrovascular events.

Clinical application of nutritional support on mechanical ventilation in acute exacerbation of chronic obstructive pulmonary disease

Zhang Zhiping, Zhang Baomin, Qin Wei, Gao Lingjie, Chen Dong

2022, 37(6):  510-514.  doi:10.3969/j.issn.1004-583X.2022.06.005

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Objective To investigate the effect of nutritional support on nutritional status and prognosis of patients with mechanical ventilation(MV) in acute exacerbation of chronic obstructive pulmonary disease(AECOPD). Methods Using randomized method,100 MV patients in AECOPD were divided into treatment group and control group. In 48 hours after MV, the treatment group(n=50) was given enteral nutrition (EN) ; the control group(n=50) were given self-made liquid food. The nutritional indicators were monitored before treatment and days 7 and 14 days of treatment, including arm muscle circumference (AMC), serum albumin (ALB), prealbumin (PA), hemoglobin (Hb), nitrogen balance (NB).The nutritional status was assesses including body mass index (BMI), triceps fold thickness (TSF), arm muscle circumference (AMC); The immunological parameters were observed including immunoglobulin A (IgA). The clinical indicators were evaluated including weaning success rate, MV time, ICU time, the incidence of ventilator-associated pneumonia (VAP). The APACHE Ⅱ score and intolerance to EN were recorded, including the incidence of gastric retention, regurgitation, and aspiration, catheter-related infection, and the incidence of other related adverse events. At the same time, patients who did not reach the endpoint (death occurred or abandoned treatment) were withdrawn from treatment. Results Compared with before treatment, the serum ALB, PA, Nb and IgA of the patients in the treatment group were significantly higher than those in control group on day 14 of treatment (all P<0.05); BMI, TSF and AMC in the treatment group were significantly improved (all P<0.05); APACHE Ⅱ score in the treatment group was significantly improved (all P<0.05). Compared with the control group, the MV time, ICU time and the incidence of VAP in the treatment group were significantly lower (P<0.05); and the weaning success rate within 2 weeks in the treatment group was significantly higher (P<0.05). Adverse events occurred in both groups, but there was no statistical significance. There were patients with withdrawal from both group, four in the treatment group and 10 in the control group. No comparison of relevant indicators was conducted among all patients with withdrawal. Conclusion For MV patients in AECOPD, EN is an important measure. It can improve the nutritional status, better promote protein synthesis, improve the body immunity, comprehensively improve the therapeutic effect and improve the prognosis of patients.

Change of miR-223-3p level in peripheral blood of β-thalassemia treated with thalidomide and corresponding clinical value

Zhu Weijian, He Ying, Huang Mufang, Fu Shezhu, Wang Xiaoqi, Li Zhixin, Chen Lijun, Li Xiaoliang

2022, 37(6):  515-518.  doi:10.3969/j.issn.1004-583X.2022.06.006

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Objective To explore the change level of miR-223-3p in peripheral blood mononuclearcell (PBMC) of patients with transfusion-dependent β thalassemia under thalidomide treatment, and to analyze its correlation with hemoglobin concentration and fetal hemoglobin (HbF). Methods The 5ml peripheral venous blood was collected from 8 patients with transfusion-dependent β thalassemia and 8 healthy subjects, PBMCs were isolated, then total RNA was extracted from the PBMCs. The effective expression level of miR-223-3p in PBMCs of patients with transfusion-dependent β thalassaemia with oral thalidomide were detected by real-time PCR, and the correlations between miR-223-3p and hemoglobin concentration, HbF, red blood cells (RBC), hematocrit (HCT) value, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH) and platelets (PLT) were analyzed. Results The relative expression level of miR-223-3p in PBMC of β-thalassemia patients was 0.191±0.089, being significantly higher that of the control group at 0.053±0.039(P=0.003), and the relative expression level of miR-223-3p upon oral administration of thalidomide was 0.106±0.047(P=0.047), and the expression quantity decreased. The expression level of miR-223-3p was found inversely correlated with the level of Hb(r=-0.488,P=0.015) and HCT (r=-0.420,P=0.004). Conclusion The miR-223-3p is highly expressed in patients with transfusions dependent β thalassemia, and the expression level of miR-223-3p decreases upon oral administration of thalidomide. Thalidomide may alleviates anemia by targeting the regulation of miR-223-3p, thereby improving the anemia.

2019-2021 pathogen infection characteristics and drug resistance analysis on patients from Intensive Care Unit of the Hospital

Guo Hao, Zhuang Huicui, Yang Limei, Ren Jing, Cui Dongsheng, Zhang Liran

2022, 37(6):  519-524.  doi:10.3969/j.issn.1004-583X.2022.06.007

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Objective To investigate and analyze the distribution of pathogenic bacteria, drug resistance and change trend of patients infected in the Intensive Care Unit (ICU) of our Hospital, to compare to the China Antimicrobial Surveillance Network for a clinical guidance of the rational use of antibiotics. Methods A retrospective study was performed to statistically analyze on the drug susceptibility results of pathogenic bacteria isolated from specimens of ICU patients from 2019 to 2021. Results A total of 2 088 strains of bacteria including 1 463 strains of bacteria for lower respiratory tract (70.1%), 211 strains of bacteria for blood (10.1%) and 115 strains of bacteria for midstream urine (5.5%) were collected and isolated. In the 2 088 strains of bacteria, there were 1 483 gram-negative bacilli (accounting for 70.1%), 527 gram-positive bacilli (accounting for 25.2%) and 78 fungi (accounting for 3.7%). The top four gram-negative bacilli were Klebsiella pneumoniae, Acinetobacter baumannii, Escherichia coli and Pseudomonas aeruginosa. The top three gram-positive bacteria were Staphylococcus aureus, Enterococcus faecium and faecal enterospherus. The fungi were mainly Candida albicans. The maximum drug resistance to carbapenems were Acinetobacter baumannii, followed by Pseudomonas aeruginosa, Klebsiella pneumoniae and Escherichia coli. The resistance rate of Acinetobacter baumannii to carbapenem increased significantly, exceeding 80%. The resistance rate of pseudomonas aeruginosa to carbapenem was close to or more than 20%.The isolation rate of Klebsiella pneumoniae had been on the rise since 2020, accounting for the first place, its drug resistance rate against carbapenem was less than 20%, and Escherichia coli was sensitive to carbapenem. Staphylococcus aureus resistant to oxacillin was 27.3%-34.5%, and no linezolid, vancomycin or tigecycline resistance was found to be drug resistant. Conclusion The main pathogenic bacteria sources of patients from ICU of the Hospital are the bacteria for lower respiratory tract infection, followed by the bacteria for bloodstream infection and urinary tract infection. Pathogenic bacteria are mainly composed of Gram-negative bacilli, followed by Gram-positive bacteria and fungi. The growth trend of drug resistance shows increment growth, and the separation rate and drug resistance rate of extended-spectrum β-lactamase and carbapenem-resistant Klebsiella pneumonia are lower than the data of China Antimicrobial Surveillance Network, the drug resistance rate of Acinetobacter baumannii to carbapenem is higher than the data of China Antimicrobial Surveillance Network, and the drug resistance of other bacteria is basically equivalent to national level. The drugs selected for clinical practices shall follow nosocomial drug sensitivity results.

Analysis and treatment of primary spinal infection

Luo Weigang, Yin Yuanyuan, Ren Huiling

2022, 37(6):  525-529.  doi:10.3969/j.issn.1004-583X.2022.06.008

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Objective To explore clinical characteristics of patients with primary pyogenic spinal infection (PSI), tuberculous spinal infection (TSI) and Brucella spinal infection (BSI). Methods The Clinical data of 79 patients with primary spinal infection (PSI) admitted to the Third Hospital of Hebei Medical University from January 2016 to December 2020 were retrospectively analyzed and statistically analyzed. Results The percentage of neutrophils, C-reactive protein (CRP), and procalcitonin (PCT) on admission in the PSI group were higher than those in the TSI group and BSI group, and the white blood cell count(WBC) in the PSI group was higher than that of the BSI group; the TSI group had a longer onset time and lower erythrocyte sedimentation rate(ESR) compared with those of the PSI group, and the differences were statistically significant(P<0.05). The most common clinical symptom of spinal infection was neck or back pain [69 cases (87.3%)], followed by the fever or chills [39 cases (49.4%)]. The proportion of patients with symptoms involving the fever or chill in the PSI group was higher than those of the TSI group, and the difference was statistically significant (P<0.017). Lumbosacral site was the most frequently involved site in the three groups, being 28 (87.5%), 16 (57.1%), and 16 (84.2%) cases, respectively. However, cervical or thoracic involvement was more common in the TSI group than in the PSI group, and the difference was statistically significant (P<0.017). The proportion of paravertebral abscess and psoas abscess in the TSI group was higher than that of the PSI group and the BSI group, and the difference was statistically significant (P<0.017). Conclusion The patient has the fever or chills, significantly increasing non-specific inflammatory indicators, and acute onset shows PSI. The involved site is the cervicothoracic spine, multiple segments are involved, paravertebral abscess and psoas abscess are companied, and a longer course of disease shows TSI. History of close contact with livestock or animal products, slight increase in non-specific indicator, mild vertebral body damage and anterior osteophyte formation, and slight paravertebral abscess suggests BSI.

Analysis on congenital cytomegalovirus infection rate and risk factors of high viral load of high-risk newborns in Xiaogan City Single Center

Yao Huajun, Zhou Jun, Yin Xue, Zhang Haie, Zhang Haiyan

2022, 37(6):  530-533.  doi:10.3969/j.issn.1004-583X.2022.06.009

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Objective To investigate the infections of congenital cytomegalovirus (CMV) of high-risk newborns in Xiaogan City, and to analyze the risk factors of such high viral load. Methods High-risk newborns admitted to the Department of Neonatology, Xiaogan Hospital Affiliated to Wuhan University of Science and Technology from January 2018 to December 2020 were selected as the research subjects, urine samples were collected for CMV-DNA quantitative polymerase chain reaction (PCR) detection, and the infection rate was calculated. The newborns were divided into high-load group and low-load group based on quantitative PCR detection of viral DNA load. The clinical data of the two groups were compared, and multivariate Logistic regression analysis was applied to analyze and screen out the independent risk factors of congenital CMV infection and high viral DNA load in high-risk newborns. Results The infection rate of congenital CMV in high-risk newborns admitted to Xiaogan Hospital Affiliated to Wuhan University of Science and Technology was approximately 7.0% (172/2 448). The differences between two groups in terms of the residence place of pregnant women and presence or absence of abnormal amniotic fluid were statistically significant (all P<0.05). Multivariate Logistic regression analysis showed that the risk of congenital CMV infection and high viral DNA load in high-risk newborns was elevated among pregnant women living in rural areas and abnormal increase in amniotic fluid (all P<0.05). Conclusion The infection rate of congenital CMV of high-risk newborns is relatively high in high-risk newborns treated in Xiaogan. Regional health care management during pregnancy and CMV screening after delivery, especially rural pregnant women and those with abnormal amniotic fluid should be strengthened.

Clinical and genetic analysis on 5 cases with neonatal 22q11.2 deletion syndrome

Cui Qingyang, Yang Yonghui, Hu Jintao, Sang Guimei, Sun Yazhou, Li Wen, He Xiaori

2022, 37(6):  534-538.  doi:10.3969/j.issn.1004-583X.2022.06.010

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Objective To analyze the clinical and genetic characteristics of 22q11.2 deletion syndrome (22q11.2DS). Methods The 22q11.2DS children admitted by the Department of Neonatology of the First Affiliated Hospital of Xinxiang Medical University and Division of Neonatology of the Second Xiangya Hospital of Central South University from February 2018 to October 2021 were selected, and their clinical manifestations, diagnosis and genetic testing results were retrospectively analyzed. Results There were 5 cases of 22q11.2DS neonates, 3 male cases and 2 female cases, 2 cases of premature babies and 4 cases of cesarean sections. Undersized or absent thymus was found in 4 cases by bedside chest radiography or ultrasonic examination, and one absent thymus was found during operation. Four cases were found to have congenital heart disease (2 cases with fallot's tetralogy, 2 cases with ventricular septal defect combined with atrial septal defect). There were 2 cases with intractable infection and 2 cases with recurrent hypocalcemia. The genetic testing results showed that there were 4 cases with novel variation, 1 case with maternal inheritance, 3 cases with absent fragment greater than 2.45 Mb and 2 cases with absent fragment in about 3.0 Mb. Conclusion The 22q11.2DS in the neonatal period are mainly manifested as congenital heart disease and undersized or absent thymus. The newborn suspected of 22q11.2DS should be diagnosed by genetic testing to the earliest convenience to guide further therapy.

Depression-related factors and corresponding correlations with quality of life in patients with hepatocellular carcinoma

Li Ya, Qiu Shixiang, Chen Chao, Zhong Liming

2022, 37(6):  539-543.  doi:10.3969/j.issn.1004-583X.2022.06.011

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Objective To explore the related factors of depression and corresponding correlations with quality of life in patients with hepatocellular carcinoma (HCC). Methods Sixty seven patients with HCC diagnosed by Nanchong Central Hospital by means of pathology from 2019 to 2021 were divided into the depression group and non-depression group according to scores of Hamilton Depression Scale (HAMD). The differences in clinical data of patients in two groups were compared. Results Twenty three (34.3%) out of 67 patients suffered from depression, the differences in the gender, age, marriage, education level, alcohol consumption, smoking, affordability, knowledge of disease, therapeutic method, number of interventional treatment between groups weren’t statistically significant (P>0.05), and the differences in digital pain scale score, Pittsburgh sleep quality index(PSQI) scores, HAMA scores and clinical staging of HCC were statistically significant (P<0.05). The differences in the quality of life assessment, physical function, social function, nausea & vomiting, shortness of breath, diarrhea, constipation, scores of patients in groups weren’t statistically significant (P>0.05). The scores of role function, emotional function, cognitive function, general health in the non-depression group were higher than those in the depression group (P<0.05), and the scores of fatigue, insomnia pain, and economic status and loss of appetite in the non-depression group were lower than those in the depression group (P<0.05). The plotted forest plot showed that high PSQI score and HAMA score were risk factors for depression in patients with HCC. The multivariate linear regression analysis showed that the availability of depression had statistical significance on the quality of life of patients with HCC (P<0.05), and the quality of life of non-depression patients was 64.164 times higher than that of depression patients. Conclusion High PSQI and HAMA score are considered to be risk factors for depression in patients with HCC. The patients with HCC complicated with depression have poor quality of life. It is necessary to prevent the occurrence of depression symptoms in patients with HCC in clinical practices to improve the recovery and quality of life of patients.

Literature review on treatment of immune thrombocytopenia secondary to refractory systemic lupus erythematosus with belimumab combined with cyclosporine: A case report and literature review

Qin Meijie, Tian Maolu, Yang Yuqi, Zha Yan, Yuan Jing

2022, 37(6):  544-547.  doi:10.3969/j.issn.1004-583X.2022.06.012

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Objective To explore the effects of belimumab on systemic lupus erythematosus (SLE) complicated with refractory hematological damage. Methods A SLE patient mainly featured with refractory hematological damage admitted to Guizhou Provincial People's Hospital was retrospectively analyzed. Results The female patient with more than 1 year history of SLE was admitted to hospital for sub dermal ecchymosis complicated with abdominal pain lasting 10 days, was clearly diagnosed as SLE with refractory blood system damage after hospitalization. The patient's condition was significantly improved without adverse reactions after maintenance therapy with belimumab in addition to basic treatment including cyclosporine. The patient was followed up for more than 1 year, the glucocorticoid dosage was minimized, and no recurrence of disease was found. Conclusion Combination of belimumab with cyclosporine in the treatment of refractory SLE secondary immune thrombocytopenia provides a new treatment option, and more clinical efficacy remains to be observed and evaluated in the long term.

Furazolidone-containing quadruple therapy for Helicobacter pylori:A case report of severe adverse reactions

Feng Xiongcai, Huo Lijuan

2022, 37(6):  548-550.  doi:10.3969/j.issn.1004-583X.2022.06.013

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Objective To investigate the occurrence and possible influencing factors of furazolidone-containing quadruple therapy for Helicobacter pylori (Hp). Methods A retrospective analysis was performed on the data of a case of severe adverse reactions during the eradication of H. pylori who visited the First Affiliated Hospital of Shanxi Medical University from January 2020 to December 2020. CNKI, Wanfang Data knowledge service platform and PubMed database were searched by using “H.pylori”, “adverse reactions”, “furazolidone”, “Helicobacter pylori” as keywords, the possible adverse reactions and countermeasures of furazolidone during the eradication of Hp were assessed. Results The results showed that furazolidone-containing quadruple therapy for Helicobacter pylori could induced to hepatic dysfunction and anaphylactic shock, and Intestinal bacterial infection might be a factor of this adverse reaction. Conclusion During the eradication of Hp, furazolidone can cause serious adverse reactions including disulfiram-like reactions, toxic neuropsychiatric symptoms, hypertensive crisis, hepatic dysfunction, and toxic epidermal necrolysis. Over-dosage of drugs, combined underlying diseases, intestinal microflora is all potential factors in inducing adverse reactions. The clinicians should standardize clinical clinical drug use as the latest instructions of furazolidone.