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Background: Anatomical imaging methods and histological examinations have limited clinical value for early monitoring of brain function damage after cardiac arrest (CA) in vivo. Objective: We aimed to assess the cerebral protective effects of hydrogen in rabbits with CA by using fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT). Methods: Male rabbits were divided into the hydrogen-treated (n=6), control (n=6), and sham (n=3) groups. Maximum standardized uptake values (SUVmax) were measured by FDG-PET/CT at baseline and post-resuscitation. Blood Ubiquitin C-terminal hydrolase-L1 (UCH-L1) and neuron-specific enolase (NSE) were measured before and after the operation. After surgical euthanasia, brain tissues were extracted for Nissl staining. Results: SUVmax values first decreased at 2 and 24 h after resuscitation before rising in the hydrogentreated and control groups. SUVmax values in the frontal, occipital, and left temporal lobes and in the whole brain were significantly different between the hydrogen and control groups at 2 and 24 h postresuscitation (P Conclusion: FDG-PET/CT could be used to monitor early cerebral damage, indicating a novel method for evaluating the protective effects of hydrogen on the brain after CA.

The incidence of telbivudine-related adverse reactions has been gradually increased. The increased levels of muscle enzymes and blood lactate are common. In this case, a 23-year-old male patient with long-term oral telbivudine had a rare serious adverse reaction. The main clinical manifestations were progressive myalgia, gradually progressed to mental disorder, and together with multiple organ dysfunction, in which the level of blood lactate was increased significantly and metabolic acidosis was extremely severe. Blood purification and sodium bicarbonate were given to correct acidosis, while ceftazidime was used to prevent infection. Telbivudine was discontinued, and tenofovir disoproxil fumarate and liver protective drug were used. The patient was discharged with a better health condition. Such patients are easily misdiagnosed as neuromuscular diseases in the early stage, which might delay the treatment and worsen medical conditions. Clinicians need to be cautious and obtain an early identification to avoid misdiagnosis.替比夫定相关不良反应报道逐渐增多，较常见的有肌酶及乳酸水平升高。中南大学湘雅医院收治1例长期口服替比夫定的23岁男性患者，临床主要表现为进行性肌痛，逐渐进展至神志障碍，同时合并多器官功能障碍，其中乳酸水平明显升高，代谢性酸中毒极为严重，病情凶险，诊断为替比夫定所致罕见严重不良反应。给予血液净化、碳酸氢钠纠正酸中毒，头孢他啶抗感染，停用替比夫定，改用替诺福韦二吡呋酯并护肝等治疗，患者病情好转出院。此类患者早期极易误诊为神经肌肉系统疾病，延误治疗，导致病情恶化，临床医生需提高警惕，早期识别，避免误诊。.