Role of penehyclidine in acute organophosphorus pesticide poisoning

BACKGROUND:Penehyclidine is a newly developed anticholinergic agent.We aimed to investigate the role of penehyclidine in acute organophosphorus pesticide poisoning(OP)patients.METHODS:We searched the Pubmed,Cochrane library,EMBASE,Chinese National Knowledge Infrastructure(CNKI),Chinese Biomedical literature(CBM)and Wanfang databases.Randomized controlled trials(RCTs)recruiting acute OP patients were identifi ed for meta-analysis.Main outcomes included cure rate,mortality rate,time to atropinization,time to 60%normal acetylcholinesterase(AchE)level,rate of intermediate syndrome(IMS)and rate of adverse drug reactions(ADR).RESULTS:Sixteen RCTs involving 1,334 patients were identifi ed.Compared with the atropineor penehyclidine-alone groups,atropine combined with penehyclidine significantly increased the cure rate(penehyclidine+atropine vs.atropine,0.97 vs.0.86,RR 1.13,95%CI[1.07–1.19];penehyclidine+atropine vs.penehyclidine,0.93 vs.0.80,RR 1.08,95%CI[1.01–1.15])and reduced the mortality rate(penehyclidine+atropine vs.atropine,0.015 vs.0.11,RR 0.17,95%CI[0.06–0.49];penehyclidine+atropine vs.penehyclidine,0.13 vs.0.08,RR 0.23,95%CI[0.04–1.28]).Atropine combined with penehyclidine in OP patients also helped reduce the time to atropinization and AchE recovery,the rate of IMS and the rate of ADR.Compared with a single dose of atropine,a single dose of penehyclidine also signifi cantly elevated the cure rate,reduced times to atropinization,AchE recovery,and rate of IMS.CONCLUSION:Atropine combined with penehyclidine benefi ts OP patients by enhancing the cure rate,mortality rate,time to atropinization,AchE recovery,IMS rate,total ADR and duration of hospitalization.Penehyclidine combined with atropine is likely a better initial therapy for OP patients than atropine alone.

IL-17和NF-κB信号通路在敌草快中毒后肾损伤中的作用及相互关系

敌草快是一种联吡啶类除草剂,近年来应用越来越广泛。敌草快对人体具有很强毒性,误服敌草快可导致全身多器官损伤。肾脏是敌草快中毒吸收后向体外排泄的主要器官,误服敌草快后引起的急性肾损伤逐渐引起人们的关注。敌草快中毒后能使体内细胞产生活性氧(ROS),导致氧化应激,从而提高白细胞介素17(IL-17)水平及激活核转录因子-κB(NF-κB)信号通路,IL-17与NF-κB信号通路相互作用,并作为损伤因子引起脏器结构和功能的损伤,其中包括肾脏的急性损伤。该文就敌草快中毒后肾损伤与IL-17及NF-κB信号通路之间可能的相互关系做一综述。

Duodenal perforation after organophosphorus poisoning: A case report

BACKGROUND Organophosphorus poisoning(OP)is one of the common critical conditions in emergency departments in China,which is usually caused by suicide by taking oral drugs.Patients with severe OP have disturbance of consciousness,respiratory failure,toxic shock,gastrointestinal dysfunction,and so on.As far as we know,the perforation of the duodenum caused by OP has not been reported yet.CASE SUMMARY A 33-year-old male patient suffered from acute severe OP,associated with abdominal pain.Multiple computed tomography scans of the upper abdomen showed no evidence of intestinal perforation.However,retrograde digital subtraction angiography,performed via an abdominal drainage tube,revealed duodenal perforation.After conservative treatment,the symptoms eased and the patient was discharged from hospital.CONCLUSION Clinicians should pay close attention to gastrointestinal dysfunction and abdominal signs in patients with severe OP.If clinical manifestation and vital signs cannot be explained by common complications,stress duodenal ulcer or perforation should be highly suspected.

Multiple miscarriages in a female patient with two-chambered heart and situs inversus totalis:A case report

BACKGROUND Single atrium with single ventricle,or a two-chambered heart,is an extremely rare congenital malformation.Few cases with two-chambered heart surviving to adulthood have been reported.CASE SUMMARY We reported an adult female patient with a two-chambered heart and situs inversus totalis accompanied by multiple pregnancies and abortions.Magnetic resonance imaging detected a two-chambered heart.B-ultrasound-guided uterine aspiration was performed to absorb 8 g and 10 g of organized villus and decidual tissues,respectively,with a small amount of bleeding.Postoperatively,cyanosis and fatigue-induced shortness of breath were gradually relieved.The patient has currently outlived all similar cases reported so far.CONCLUSION Hemodynamic changes in pregnant women with two-chambered heart impaired cardiac function,responsible for hypoperfusion and miscarriage.

Mannitol inhibits the proliferation of neural stem cell by a p38 mitogen-activated protein kinase-dependent signaling pathway

Purpose:Mannitol is one of the first-line drugs for reducing cerebral edema through increasing the extracellular osmotic pressure.However,long-term administration of mannitol in the treatment of cerebral edema triggers damage to neurons and astrocytes.Given that neural stem cell(NSC)is a subpopulation of main regenerative cells in the central nervous system after injury,the effect of mannitol on NSC is still elusive.The present study aims to elucidate the role of mannitol in NSC proliferation.Methods:C57 mice were derived from the animal house of Zunyi Medical University.A total of 15 pregnant mice were employed for the purpose of isolating NSCs in this investigation.Initially,mouse primary NSCs were isolated from the embryonic cortex of mice and subsequently identified through immunofluorescence staining.In order to investigate the impact of mannitol on NSC proliferation,both cell counting kit-8 assays and neurospheres formation assays were conducted.Thein vitro effects of mannitol were examined at various doses and time points.In order to elucidate the role of Aquaporin 4(AQP4)in the suppressive effect of mannitol on NSC proliferation,various assays including reverse transcription polymerase chain reaction,western blotting,and immunocytochemistry were conducted on control and mannitol-treated groups.Additionally,the phosphorylated p38(p-p38)was examined to explore the potential mechanism underlying the inhibitory effect of mannitol on NSC proliferation.Finally,to further confirm the involvement of the p38 mitogen-activated protein kinase-dependent(MAPK)signaling pathway in the observed inhibition of NSC proliferation by mannitol,SB203580 was employed.All data were analyzed using SPSS 20.0 software(SPSS,Inc.,Chicago,IL).The statistical analysis among multiple comparisons was performed using one-way analysis of variance(ANOVA),followed by Turkey’’s post hoc test in case of the data following a normal distribution using a Shapiro-Wilk normality test.Comparisons between 2 groups were determined using Student’s t-test,if the data exhibited a normal distribution using a Shapiro-Wilk normality test.Meanwhile,data were shown as median and interquartile range and analyzed using the Mann-WhitneyU test,if the data failed the normality test.A p<0.05 was considered as significant difference.Results:Primary NSC were isolated from the mice,and the characteristics were identified using immunostaining analysis.Thereafter,the results indicated that mannitol held the capability of inhibiting NSC proliferation in a dose-dependent and time-dependent manner using cell counting kit-8,neurospheres formation,and immunostaining of Nestin and Ki67 assays.During the process of mannitol suppressing NSC proliferation,the expression of AQP4 mRNA and protein was downregulated,while the gene expression of p-p38 was elevated by reverse transcription polymerase chain reaction,immunostaining,and western blotting assays.Subsequently,the administration of SB203580,one of the p38 MAPK signaling pathway inhibitors,partially abrogated this inhibitory effect resulting from mannitol,supporting the fact that the p38 MAPK signaling pathway participated in curbing NSC proliferation induced by mannitol.Conclusions:Mannitol inhibits NSC proliferation through downregulating AQP4,while upregulating the expression of p-p38 MAPK.

Increased Efficacy of Antivenom Combined with Hyperbaric Oxygen on Deinagkistrodon acutus Envenomation in Adult Rats

Background：Snakebites are a neglected threat to global human health with a high morbidity rate.The present study explored the efficacy of antivenom with hyperbaric oxygen （HBO） intervention on snakebites,which could provide the experimental basis for clinical adjuvant therapy.Methods：Male Sprague-Dawley rats （n =96） were randomized into four groups：the poison model was established by injecting Deinagkistrodon acutus （D.acutus） venom （0.8 LD50） via the caudal vein;the antivenom group was injected immediately with specific antivenom via the caudal vein after successful establishment of the envenomation model;and the antivenom ＋ HBO group was exposed to HBO environment for 1 h once at predetermined periods of 0 h,4 h,12 h,and 23 h after antivenin administration.Each HBO time point had six rats;the control group was left untreated.The rats in the experimental group were euthanized at the corresponding time points after HBO therapy,and brain tissue and blood were harvested immediately.Hematoxylin and eosin （H＆E） staining was used to investigate the pathological changes in the rat brain.Immunohistochemistry （IHC）,real-time polymerase chain reaction （PCR）,and Western blotting were used to detect the expression ofNestin mRNA and protein in the subventricular zone （SVZ） of the brain.The levels of coagulation function （prothrombin time,activated partial thromboplastin time [APTT],and fibrinogen） and oxidation/antioxidation index （malondialdehyde [MDA] and superoxide dismutase [SOD]） were analyzed.Data were analyzed using one-way analysis of variance.Results：The brain tissue from rats in the poison model was observed for pathological changes using H＆E staining.Tissues showed edema,decreased cell number,and disordered arrangement in the SVZ in the snake venom group.The antivenom-HBO intervention significantly alleviated these observations and was more prominent in the antivenom ＋ HBO group.The serum levels of SOD and MDA in the snake venom group were increased and the antivenom-HBO intervention further increased the SOD levels but significantly decreased the MDA levels;however,this was enhanced within 1 h after HBO administration （MDA：F=5.540,P=0.008,SOD：F=7.361,P =0.000）.Activated partial thromboplastin time （APTT） was significantly abnormal after venom administration but improved after antivenom and was even more significant in the antivenom ＋ HBO group 5 h after envenomation （F =25.430,P =0.000）.Only a few nestin-positive cells were observed in the envenomation model.The expression levels were significant in the antivenom and antivenom ＋ HBO groups within 1 and 5 h after envenomation and were more significant in the antivenom ＋ HBO group as determined by IHC,real-time PCR,and Western blotting （P 〈 0.05）.D.acutus envenomation has neurotoxic effects in the brain of rats.Conclusions：Antivenin and HBO,respectively,induced a neuroprotective effect after D.acutus envenomation by attenuating brain edema,upregulating nestin expression in SVZ,and improving coagulopathy and oxidative stress.The intervention efficacy of antivenom with HBO was maximum within 5 h after envenomation and was more efficacious than antivenom alone.

Interventional treatment experience in multiple injury with major abdominal or pelvic injuries： 160 cases analysis

PurposeTo 与一个学生一起与 160 个多重损伤病人的主要腹或骨盆的 injury.MethodsData 在多重损伤病人观察 interventional embolization 和出血控制的治疗学的效果腹或骨盆的损害回顾地被分析。他们从 2013 年 10 月被同意进入 Zunyi 医学院的首先隶属于的医院的紧急情况的部门到 2016 年 4 月。为 embolization 和出血控制收到了突现的干预的 87 个病人被放作为组 A，包括 72 男性和 15 女性，与平均年龄(39.32 ? 瑩 ?睳慥 吗？

Influence of road types on road traffic accidents in northern Guizhou Province,China

Purpose The increasing number of deaths due to road traffic accidents(RTAs)has attracted global attention.However,the influence of road types is rarely considered in the study of RTAs.This study evaluates the influence of different road types in RTAs in northern Guizhou to provide a basis for the formulation of evidence-based policies and measures.Methods We obtained the data from the Zunyi Traffic Management Data Platform for the years 2009–2018.The mortality rates of RTAs were calculated.Descriptive methods and Chi-square tests were used to analyze the characteristics of road traffic collisions on different road types.We also examined the associations between the mortality rate per 10,000 vehicles and the growth of per capital gross domestic product(GDP)with Spearman’s rank correlation analysis.According to the passing volume and the infrastructure,we defined different types of roads,like administrative road,functional road,general urban road and urban expressway.Results In 2012,the traffic mortality rate of administrative roads was 8.9 per 100,000 people,and the mortality rate of functional roads was 7.4 per 100,000 people,which decreased in 2018 to 6.1 deaths per 100,000 people and 5.2 deaths per 100,000 people,respectively.The mortality rate per 10,000 vehicles reached the highest level in 2011(28.8 per 10,000 vehicles and 22.5 per 10,000 vehicles on administrative and functional roads,respectively).The death rate of county roads was the highest among administrative roads(χ^(2)=17.389,p<0.05)and that of fourth-class roads was the highest among functional roads(χ^(2)=21.785,p<0.05).The mortality rate per 10,000 vehicles was negatively correlated with per capital GDP.Conclusion Although our research shows that RTAs in northern Guizhou have steadily declined in recent years,the range of decline is relatively small.Many measures and sustainable efforts are needed to control road traffic death and accelerate the progress in road traffic safety in northern Guizhou.