Objective:To study the value of some biochemical indicators and Peradeniya Organophosphate Poisoning scale in prediction and prognosis of organophosphorus poisoning.Methods:This was a hospital-based prospective,observ...Objective:To study the value of some biochemical indicators and Peradeniya Organophosphate Poisoning scale in prediction and prognosis of organophosphorus poisoning.Methods:This was a hospital-based prospective,observational study.Various biochemical tests viz.complete blood count,random blood sugar,liver and renal function tests,creatine phosphokinase,and electrolytes were performed.Patients were assessed based on the Peradeniya Organophosphate Poisoning scale.All the patients were followed till the end point like recovery/death.Results:Out of the 100 patients,72%were males and 28%were females.The majority of the patients were farmers and 21 to 30 years of age.Suicidal was the most common manner(92,92%).Based on the Peradeniya Organophosphate Poisoning scale,47%were mild,34%moderate,and 19%severe.Serum creatinine,creatine phosphokinase,serum glutamic-oxaloacetic transaminase,serum glutamic pyruvic transaminase,and alkaline phosphatase levels showed a significant correlation with severity.Conclusions:Some biochemical indicators such as creatine phosphokinase,alkaline phosphatase can be used as prognostic markers of organophosphorus poisoning.The Peradeniya Organophosphate Poisoning scale can be used for assessing severity of the poisoning.展开更多
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 l...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.展开更多
In last few decades there is exponential increase in use of organophosphorus (OP) compounds as pesticides and insecticides leading to adverse effect on human population and live stock. There is a great need to develop...In last few decades there is exponential increase in use of organophosphorus (OP) compounds as pesticides and insecticides leading to adverse effect on human population and live stock. There is a great need to develop portable analytical tools that are amenable for remediation and bioremediation process monitoring, where rapid analysis of large number of samples is essential. Determination of various organophosphorus compounds has been achieved by integrating biocomponents with different transducers. The close integration of the biological events with the generation of a signal offers the potential for fabricating compact and easy-to-use analytical tools of high sensitivity and specificity. With the availability of new materials, associated with new sensing techniques has led to remarkable innovations in the design and construction of organophosphorus biosensors. The present review describes the specifications of most of the electrochemical Organophosphorus biosensors reported till date.展开更多
The substituent effects on ^(31)P-NMR chemical shifts, are determined by five empirical rules. The proposed rules are based on that the shielding (upfield shift) of resonance nucleus is governed by the spherical symme...The substituent effects on ^(31)P-NMR chemical shifts, are determined by five empirical rules. The proposed rules are based on that the shielding (upfield shift) of resonance nucleus is governed by the spherical symmetry of the electron cloud.展开更多
The built-up effect of inorganic compounds containing more active metal ions, such as Ca^2+ , Al^3+ , Cu^2+ , and Zn^2+ , as additives adding to phosphorus-containing flame retarding systems in suppression of smok...The built-up effect of inorganic compounds containing more active metal ions, such as Ca^2+ , Al^3+ , Cu^2+ , and Zn^2+ , as additives adding to phosphorus-containing flame retarding systems in suppression of smoke was studied. The data presented herein suggested that the amount of smoke in the burning process can be better suppressed after the cotton fabric finishing with built-up system was burnt. Some general principles were identified, and the likely causes of the observed effects were analyzed according to test data.展开更多
Additions of diethyl phosphite to α-nitroalkenes followed by the introduction of trimethylchlorosilane and an activated alkene, gave the corresponding title compounds via regioselective 1,3-dipolar cycloaddition in m...Additions of diethyl phosphite to α-nitroalkenes followed by the introduction of trimethylchlorosilane and an activated alkene, gave the corresponding title compounds via regioselective 1,3-dipolar cycloaddition in moderate yield.展开更多
1-Isocyano substituted benzylphosphonates were prepared by dehydration of 1-N-formylamino substituted benzylphosphonates,which were obtained by a tricomponental condensation described by us.Mean- while addition of die...1-Isocyano substituted benzylphosphonates were prepared by dehydration of 1-N-formylamino substituted benzylphosphonates,which were obtained by a tricomponental condensation described by us.Mean- while addition of diethyl phosphite to N-trityl aldimine followed by deprotection,formylation and dehydration gave corresponding 1-isocyano alkylphosphonates in one-pot procedure.展开更多
Background:This study aims to explore the significance of serum amylase levels in patients with organophosphorus pesticide(OP)poisoning and to provide a new perspective for evaluating the severity and prognosis of OP ...Background:This study aims to explore the significance of serum amylase levels in patients with organophosphorus pesticide(OP)poisoning and to provide a new perspective for evaluating the severity and prognosis of OP poisoning.Methods:The clinical data of 67 patients with acute OP poisoning,who had been treated in the emergency department of the General Hospital of Ningxia Medical University between September 2020 and August 2022,were retrospectively analyzed.Using Spearman rank correlation,serum amylase levels during admission and severity of poisoning correlated with discharge outcomes.Based on serum amylase levels,receiver operating characteristic curves were plotted to predict the severity and mortality of patients who experience organophosphate poisoning.The optimal threshold serum amylase level at admission was determined based on the maximum Youden index.Results:Using Spearman rank correlation analysis,serum amylase levels at admission positively correlated with the severity of poisoning and discharge outcomes,but the degree of correlation was weak(r_(s):0.344;0.264;P<0.05).The patients’serum amylase levels at admission had receiver operating characteristic area under the curve values of 0.726 and 0.735 to predict the degree of severe poisoning and death,respectively.Based on the maximum Youden index,the optimal threshold of serum amylase were 97.8 and 194.1 U/L when the degree of poisoning was severe and the discharge outcome of patients was died.In comparison to patients with serum amylase levels≤194.1 U/L at admission,the OR values of death in patients with serum amylase levels>194.1 U/L at admission was 15.944(95%CI:1.825-139.274).Conclusion:Serum amylase levels in patients with organophosphate poisoning correlate with the degree of poisoning and discharge outcomes.Higher serum amylase level was a risk factor for organophosphorus poisoning death.展开更多
BACKGROUND: Acute organophosphate poisoning can cause injuries of multiple visceras; especially,central nervous system injury can increase risk factors of patients with severe acute organophosphate poisoning. An appl...BACKGROUND: Acute organophosphate poisoning can cause injuries of multiple visceras; especially,central nervous system injury can increase risk factors of patients with severe acute organophosphate poisoning. An application of modem image may increase diagnostic rate of brain injury in an earlier period and provide evidences for clinical treatment.OBJECTIVE: To reveal imaging manifestations, pathological characteristics and multi-ways injured mechanism of brain injury due to acute organophosphate poisoning.DESIGN: Contrast observational study.SETTING: Department of Medical Image, the Second Hospital of Hebei Medical University.MATERIALS: The experiment was carried out in the Department of Nerve Molecule Imaging Medicine and Laboratory of Neurology, the Second Hospital of Hebei Medical University from August 2003 to February 2004. A total of 30 healthy cats weighing 2.8 - 3.5 g and of both genders were selected from Animal Experimental Center of Hebei Medical University.METHODS: Thirty healthy cats were randomly divided into control group (n =5) and intoxication group (n=25). Cats in the control group were subcutaneously injected with 0.3 mL/kg saline at four points; while, cats in the intoxication group were subcutaneously injected with 400 g/L 0.3 mL/kg O,O-dimethyl-S-(methoxycarbonylmethyl) thiophosphate at four points. Two minutes after intoxication, cats received muscular injection with 0.5 mg/kg atropine sulfate, and then, brain tissues were collected from parietal lobe, basal ganglia, hippocampus, cerebellum and brain stem were observed at 3, 6, 24 hours, 3 and 7 days after intoxication respectively under optic microscope and electron microscope and expressions of acetylcholinesterase (AChE), choline acetyltransferase (ChAT), glial fibrillary acidic protein (GFAP),glutamic acid (Glu) and γ-amino butyric acid after immunohistochemical staining.MAIN OUTCOME MEASURES: Results of MRI examinations; histological changes under optic microscope and electron microscope; expressions of AChE, ChAT, GFAP, Glu and γ -amino butyric acid after immunohistochemical staining.MAIN OUTCOME MEASURES: Results of MRI examinations; histological changes under optic microscope and electron microscope; expressions of AChE, ChAT, GFAP, Glu and γ -amino butyric acid after immunohistochemical staining.RESULTS: All 30 healthy cats were involved in the final analysis. ① Imaging and pathological observation: Image manifestations of brain injury induced by acute organophosphate poisoning showed as cerebral edema and symmetry signal abnormality of bilateral basal ganglia; while, pathological manifestations also showed as cerebral edema. ② Observation of immunohistochemical staining: As compared with the control group, after organophosphate poisoning, area of AChE immune-positive cells was decreased obviously (P〈0.01), but area of ChAT immune-positive cells was not changed (P〉0.05); in addition, positive cells of GFAP were increased remarkably (P〈0.01), positive cells of γ -amino butyric acid in cerebral cortex were increased obviously (P〈0.05), but numbers of positive cells of Glu were not changed (P〈0.05).CONCLUSION: Multi-ways injured mechanism invovled in acute organophosphate poisoning. An application of modern image can increase diagnostic rate of brain injury in an earlier period and provide evidences for clinical treatment.展开更多
Spraying of organophosphorus insecticides (OPI) using high volume technique may result in poisoning cases among farmers or inhabitants in the spraying zone. This study reported a case among farmers in Gaza Strip, Pale...Spraying of organophosphorus insecticides (OPI) using high volume technique may result in poisoning cases among farmers or inhabitants in the spraying zone. This study reported a case among farmers in Gaza Strip, Palestine and discussed the follow up treatments. Results showed sever fasciculation of tongue and all muscle, pinpoint pupils not reacting to light, losing consciousness and disoriented, irritability, followed by diarrhea, vomiting, and severe inhibition of acetyl choline esterase (ACHE). Irritability and low level of ACHE activity were the unique syndromes of this case. Management of the poisoning with Atropine injection was not successful treatment to cure the case. Treatment with Toxogonin as intravenous injection resulted in relieved the irritability of the poisoned case and cure the patient at the end point. During the six weeks of follow up period, the case was severely poisoned in the 1st week, moderate poisoned in the 2nd week and slightly poisoned at the 3rd week. A medical decision to release the patient was made after ACHE activity level reached 4750 U/L, which very close to the normal range. The farmers left the hospital after three weeks of medical treatments and follow up. It is recommended to use Toxogonin in the management of poisoned cases with OPI immediately on arrival of cases with losing consciousness.展开更多
Background:Penehyclidine hydrochloride(PHC)has been used for many years as an anticholinergic drug for the treatment of acute organophosphorus pesticide poisoning(AOPP).The purpose of this meta-analysis was to explore...Background:Penehyclidine hydrochloride(PHC)has been used for many years as an anticholinergic drug for the treatment of acute organophosphorus pesticide poisoning(AOPP).The purpose of this meta-analysis was to explore whether PHC has advantages over atropine in the use of anticholinergic drugs in AOPP.Methods:We searched Scopus,Embase,Cochrane,PubMed,ProQuest,Ovid,Web of Science,China Science and Technology Journal Database(VIP),Duxiu,Chinese Biomedical literature(CBM),WanFang,and Chinese National Knowledge Infrastructure(CNKI),from inception to March 2022.After all qualified randomized controlled trials(RCTs)were included,we conducted quality evaluation,data extraction,and statistical analysis.Statistics using risk ratios(RR),weighted mean difference(WMD),and standard mean difference(SMD).Results:Our meta-analysis included 20,797 subjects from 240 studies across 242 different hospitals in China.Compared with the atropine group,the PHC group showed decreased mortality rate(RR=0.20,95%confidence intervals[CI]:0.16–0.25,P<0.001),hospitalization time(WMD=-3.89,95%CI:-4.37 to-3.41,P<0.001),overall incidence rate of complications(RR=0.35,95%CI:0.28–0.43,P<0.001),overall incidence of adverse reactions(RR=0.19,95%CI:0.17–0.22,P<0.001),total symptom disappearance time(SMD=-2.13,95%CI:-2.35 to-1.90,P<0.001),time for cholinesterase activity to return to normal value 50–60%(SMD=-1.87,95%CI:-2.03 to-1.70,P<0.001),coma time(WMD=-5.57,95%CI:-7.20 to-3.95,P<0.001),and mechanical ventilation time(WMD=-2.16,95%CI:-2.79 to-1.53,P<0.001).Conclusion:PHC has several advantages over atropine as an anticholinergic drug in AOPP.展开更多
In this paper,we compared the sensitivities of AFEST(a thermophilic esterase from the archaea Archaeoglobus fulgidus) and acetylcholinesterase(AChE) towards five organophosphorus compounds(OPs) by means of molec...In this paper,we compared the sensitivities of AFEST(a thermophilic esterase from the archaea Archaeoglobus fulgidus) and acetylcholinesterase(AChE) towards five organophosphorus compounds(OPs) by means of molecular docking,and found that only the docking energy between AFEST and dichlorvos is lower than that between AChE and dichlorvos.Via the docking model of AFEST and dichlorvos,Arg43 was found to play an important role in the interaction between AFEST and dichlorvos by means of stabilizing the complex.Then mutant R43S was constructed,the IC 50(the concentration required to reduce virus-induced cytopathicity by 50% is estimated as 50% inhibitory concentration) of which to dichlorvos was lower than that of the wild type AFEST by a factor of 1.56,indicating the enhanced sensitivity of mutant R43S to dichlorvos.Combining of theory with experiment,we have obtained important structure-function information of AFEST,which will be helpful to the further studies of esterase.展开更多
Background:Acute severe organophosphorus pesticide poisoning is a common severe emergency in developing countries.Our meta-analysis aimed to clarify the efficacy of hemoperfusion combined with hemodialysis on acute se...Background:Acute severe organophosphorus pesticide poisoning is a common severe emergency in developing countries.Our meta-analysis aimed to clarify the efficacy of hemoperfusion combined with hemodialysis on acute severe organophosphorus pesticide poisoning.Methods:Several databases were searched.After formulating relevant inclusion and exclusion criteria,qualified studies were included,and the data were extracted.The outcome indicators were the success rate of rescue,the time of hospitalization,the incidence of com-plications,the time for the cholinesterase level to return to normal,the coma time,and the atropine dosage.The results were analyzed using risk ratios,weighted mean difference,standard mean difference,and 95%confidence interval.The Cochrane Collaboration tool was used to assess the risk of bias in all the included studies.In terms of statistical methods,we used RevMan software(version 5.3;The Nordic Cochrane Centre,The Cochrane Collaboration,Copenhagen,Denmark)and Stata(versions 14 and 16;StataCorp,College Station,TX,USA)for the data analysis.Results:We included 92 randomized controlled trials with 6899 participants.Compared with the conventional emergency treatment group(CET group),the hemoperfusion group(HP+CET group),and the hemodialysis group(HD+CET group),the use of hemoperfusion combined with hemodialysis based on CET(HP+HD+CET group)significantly increased the success rate of rescue and reduced hos-pitalization time,the incidence of complications,time for cholinesterase level to return to normal,coma time,and atropine dosage.Conclusion:Hemoperfusion combined with hemodialysis is effective in the treatment of acute severe organophosphorus pesticide poi-soning.In the future,more scientifically designed,large-scale,high-quality,multicenter randomized controlled trials are needed to validate this study further.展开更多
Objective To investigate the effect of hyperbarci oxygen(HBO) on recovery of nerves injury in rats suffered from acute organophosphorus poisoning. Method We established organophosphorus poisoning models and observed e...Objective To investigate the effect of hyperbarci oxygen(HBO) on recovery of nerves injury in rats suffered from acute organophosphorus poisoning. Method We established organophosphorus poisoning models and observed effect of HBO on recovery of injure nerves. Results Compared with control group, cerebrospinal fluid induced peak potential and incubation period in HBO group were significantly recovered(P<0.05).HBO could accelerated repair of injured nerves. Conclusion HBO could relieve injury of nerves during treatment of organophosphorus poisoning.展开更多
文摘Objective:To study the value of some biochemical indicators and Peradeniya Organophosphate Poisoning scale in prediction and prognosis of organophosphorus poisoning.Methods:This was a hospital-based prospective,observational study.Various biochemical tests viz.complete blood count,random blood sugar,liver and renal function tests,creatine phosphokinase,and electrolytes were performed.Patients were assessed based on the Peradeniya Organophosphate Poisoning scale.All the patients were followed till the end point like recovery/death.Results:Out of the 100 patients,72%were males and 28%were females.The majority of the patients were farmers and 21 to 30 years of age.Suicidal was the most common manner(92,92%).Based on the Peradeniya Organophosphate Poisoning scale,47%were mild,34%moderate,and 19%severe.Serum creatinine,creatine phosphokinase,serum glutamic-oxaloacetic transaminase,serum glutamic pyruvic transaminase,and alkaline phosphatase levels showed a significant correlation with severity.Conclusions:Some biochemical indicators such as creatine phosphokinase,alkaline phosphatase can be used as prognostic markers of organophosphorus poisoning.The Peradeniya Organophosphate Poisoning scale can be used for assessing severity of the poisoning.
文摘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.
文摘In last few decades there is exponential increase in use of organophosphorus (OP) compounds as pesticides and insecticides leading to adverse effect on human population and live stock. There is a great need to develop portable analytical tools that are amenable for remediation and bioremediation process monitoring, where rapid analysis of large number of samples is essential. Determination of various organophosphorus compounds has been achieved by integrating biocomponents with different transducers. The close integration of the biological events with the generation of a signal offers the potential for fabricating compact and easy-to-use analytical tools of high sensitivity and specificity. With the availability of new materials, associated with new sensing techniques has led to remarkable innovations in the design and construction of organophosphorus biosensors. The present review describes the specifications of most of the electrochemical Organophosphorus biosensors reported till date.
文摘The substituent effects on ^(31)P-NMR chemical shifts, are determined by five empirical rules. The proposed rules are based on that the shielding (upfield shift) of resonance nucleus is governed by the spherical symmetry of the electron cloud.
文摘The built-up effect of inorganic compounds containing more active metal ions, such as Ca^2+ , Al^3+ , Cu^2+ , and Zn^2+ , as additives adding to phosphorus-containing flame retarding systems in suppression of smoke was studied. The data presented herein suggested that the amount of smoke in the burning process can be better suppressed after the cotton fabric finishing with built-up system was burnt. Some general principles were identified, and the likely causes of the observed effects were analyzed according to test data.
文摘Additions of diethyl phosphite to α-nitroalkenes followed by the introduction of trimethylchlorosilane and an activated alkene, gave the corresponding title compounds via regioselective 1,3-dipolar cycloaddition in moderate yield.
文摘1-Isocyano substituted benzylphosphonates were prepared by dehydration of 1-N-formylamino substituted benzylphosphonates,which were obtained by a tricomponental condensation described by us.Mean- while addition of diethyl phosphite to N-trityl aldimine followed by deprotection,formylation and dehydration gave corresponding 1-isocyano alkylphosphonates in one-pot procedure.
基金Ningxia Medical University General Hospital’s Ethics Committee(Ethics Number:KYLL-2022-1243).
文摘Background:This study aims to explore the significance of serum amylase levels in patients with organophosphorus pesticide(OP)poisoning and to provide a new perspective for evaluating the severity and prognosis of OP poisoning.Methods:The clinical data of 67 patients with acute OP poisoning,who had been treated in the emergency department of the General Hospital of Ningxia Medical University between September 2020 and August 2022,were retrospectively analyzed.Using Spearman rank correlation,serum amylase levels during admission and severity of poisoning correlated with discharge outcomes.Based on serum amylase levels,receiver operating characteristic curves were plotted to predict the severity and mortality of patients who experience organophosphate poisoning.The optimal threshold serum amylase level at admission was determined based on the maximum Youden index.Results:Using Spearman rank correlation analysis,serum amylase levels at admission positively correlated with the severity of poisoning and discharge outcomes,but the degree of correlation was weak(r_(s):0.344;0.264;P<0.05).The patients’serum amylase levels at admission had receiver operating characteristic area under the curve values of 0.726 and 0.735 to predict the degree of severe poisoning and death,respectively.Based on the maximum Youden index,the optimal threshold of serum amylase were 97.8 and 194.1 U/L when the degree of poisoning was severe and the discharge outcome of patients was died.In comparison to patients with serum amylase levels≤194.1 U/L at admission,the OR values of death in patients with serum amylase levels>194.1 U/L at admission was 15.944(95%CI:1.825-139.274).Conclusion:Serum amylase levels in patients with organophosphate poisoning correlate with the degree of poisoning and discharge outcomes.Higher serum amylase level was a risk factor for organophosphorus poisoning death.
文摘BACKGROUND: Acute organophosphate poisoning can cause injuries of multiple visceras; especially,central nervous system injury can increase risk factors of patients with severe acute organophosphate poisoning. An application of modem image may increase diagnostic rate of brain injury in an earlier period and provide evidences for clinical treatment.OBJECTIVE: To reveal imaging manifestations, pathological characteristics and multi-ways injured mechanism of brain injury due to acute organophosphate poisoning.DESIGN: Contrast observational study.SETTING: Department of Medical Image, the Second Hospital of Hebei Medical University.MATERIALS: The experiment was carried out in the Department of Nerve Molecule Imaging Medicine and Laboratory of Neurology, the Second Hospital of Hebei Medical University from August 2003 to February 2004. A total of 30 healthy cats weighing 2.8 - 3.5 g and of both genders were selected from Animal Experimental Center of Hebei Medical University.METHODS: Thirty healthy cats were randomly divided into control group (n =5) and intoxication group (n=25). Cats in the control group were subcutaneously injected with 0.3 mL/kg saline at four points; while, cats in the intoxication group were subcutaneously injected with 400 g/L 0.3 mL/kg O,O-dimethyl-S-(methoxycarbonylmethyl) thiophosphate at four points. Two minutes after intoxication, cats received muscular injection with 0.5 mg/kg atropine sulfate, and then, brain tissues were collected from parietal lobe, basal ganglia, hippocampus, cerebellum and brain stem were observed at 3, 6, 24 hours, 3 and 7 days after intoxication respectively under optic microscope and electron microscope and expressions of acetylcholinesterase (AChE), choline acetyltransferase (ChAT), glial fibrillary acidic protein (GFAP),glutamic acid (Glu) and γ-amino butyric acid after immunohistochemical staining.MAIN OUTCOME MEASURES: Results of MRI examinations; histological changes under optic microscope and electron microscope; expressions of AChE, ChAT, GFAP, Glu and γ -amino butyric acid after immunohistochemical staining.MAIN OUTCOME MEASURES: Results of MRI examinations; histological changes under optic microscope and electron microscope; expressions of AChE, ChAT, GFAP, Glu and γ -amino butyric acid after immunohistochemical staining.RESULTS: All 30 healthy cats were involved in the final analysis. ① Imaging and pathological observation: Image manifestations of brain injury induced by acute organophosphate poisoning showed as cerebral edema and symmetry signal abnormality of bilateral basal ganglia; while, pathological manifestations also showed as cerebral edema. ② Observation of immunohistochemical staining: As compared with the control group, after organophosphate poisoning, area of AChE immune-positive cells was decreased obviously (P〈0.01), but area of ChAT immune-positive cells was not changed (P〉0.05); in addition, positive cells of GFAP were increased remarkably (P〈0.01), positive cells of γ -amino butyric acid in cerebral cortex were increased obviously (P〈0.05), but numbers of positive cells of Glu were not changed (P〈0.05).CONCLUSION: Multi-ways injured mechanism invovled in acute organophosphate poisoning. An application of modern image can increase diagnostic rate of brain injury in an earlier period and provide evidences for clinical treatment.
文摘Spraying of organophosphorus insecticides (OPI) using high volume technique may result in poisoning cases among farmers or inhabitants in the spraying zone. This study reported a case among farmers in Gaza Strip, Palestine and discussed the follow up treatments. Results showed sever fasciculation of tongue and all muscle, pinpoint pupils not reacting to light, losing consciousness and disoriented, irritability, followed by diarrhea, vomiting, and severe inhibition of acetyl choline esterase (ACHE). Irritability and low level of ACHE activity were the unique syndromes of this case. Management of the poisoning with Atropine injection was not successful treatment to cure the case. Treatment with Toxogonin as intravenous injection resulted in relieved the irritability of the poisoned case and cure the patient at the end point. During the six weeks of follow up period, the case was severely poisoned in the 1st week, moderate poisoned in the 2nd week and slightly poisoned at the 3rd week. A medical decision to release the patient was made after ACHE activity level reached 4750 U/L, which very close to the normal range. The farmers left the hospital after three weeks of medical treatments and follow up. It is recommended to use Toxogonin in the management of poisoned cases with OPI immediately on arrival of cases with losing consciousness.
文摘Background:Penehyclidine hydrochloride(PHC)has been used for many years as an anticholinergic drug for the treatment of acute organophosphorus pesticide poisoning(AOPP).The purpose of this meta-analysis was to explore whether PHC has advantages over atropine in the use of anticholinergic drugs in AOPP.Methods:We searched Scopus,Embase,Cochrane,PubMed,ProQuest,Ovid,Web of Science,China Science and Technology Journal Database(VIP),Duxiu,Chinese Biomedical literature(CBM),WanFang,and Chinese National Knowledge Infrastructure(CNKI),from inception to March 2022.After all qualified randomized controlled trials(RCTs)were included,we conducted quality evaluation,data extraction,and statistical analysis.Statistics using risk ratios(RR),weighted mean difference(WMD),and standard mean difference(SMD).Results:Our meta-analysis included 20,797 subjects from 240 studies across 242 different hospitals in China.Compared with the atropine group,the PHC group showed decreased mortality rate(RR=0.20,95%confidence intervals[CI]:0.16–0.25,P<0.001),hospitalization time(WMD=-3.89,95%CI:-4.37 to-3.41,P<0.001),overall incidence rate of complications(RR=0.35,95%CI:0.28–0.43,P<0.001),overall incidence of adverse reactions(RR=0.19,95%CI:0.17–0.22,P<0.001),total symptom disappearance time(SMD=-2.13,95%CI:-2.35 to-1.90,P<0.001),time for cholinesterase activity to return to normal value 50–60%(SMD=-1.87,95%CI:-2.03 to-1.70,P<0.001),coma time(WMD=-5.57,95%CI:-7.20 to-3.95,P<0.001),and mechanical ventilation time(WMD=-2.16,95%CI:-2.79 to-1.53,P<0.001).Conclusion:PHC has several advantages over atropine as an anticholinergic drug in AOPP.
基金Supported by the National Program on Key Basic Research Project of China(No.2012CB721003)the National Natural Science Foundation of China(No.31070638)the Natural Science Foundation of Jilin Province,China(No.201015109)
文摘In this paper,we compared the sensitivities of AFEST(a thermophilic esterase from the archaea Archaeoglobus fulgidus) and acetylcholinesterase(AChE) towards five organophosphorus compounds(OPs) by means of molecular docking,and found that only the docking energy between AFEST and dichlorvos is lower than that between AChE and dichlorvos.Via the docking model of AFEST and dichlorvos,Arg43 was found to play an important role in the interaction between AFEST and dichlorvos by means of stabilizing the complex.Then mutant R43S was constructed,the IC 50(the concentration required to reduce virus-induced cytopathicity by 50% is estimated as 50% inhibitory concentration) of which to dichlorvos was lower than that of the wild type AFEST by a factor of 1.56,indicating the enhanced sensitivity of mutant R43S to dichlorvos.Combining of theory with experiment,we have obtained important structure-function information of AFEST,which will be helpful to the further studies of esterase.
文摘Background:Acute severe organophosphorus pesticide poisoning is a common severe emergency in developing countries.Our meta-analysis aimed to clarify the efficacy of hemoperfusion combined with hemodialysis on acute severe organophosphorus pesticide poisoning.Methods:Several databases were searched.After formulating relevant inclusion and exclusion criteria,qualified studies were included,and the data were extracted.The outcome indicators were the success rate of rescue,the time of hospitalization,the incidence of com-plications,the time for the cholinesterase level to return to normal,the coma time,and the atropine dosage.The results were analyzed using risk ratios,weighted mean difference,standard mean difference,and 95%confidence interval.The Cochrane Collaboration tool was used to assess the risk of bias in all the included studies.In terms of statistical methods,we used RevMan software(version 5.3;The Nordic Cochrane Centre,The Cochrane Collaboration,Copenhagen,Denmark)and Stata(versions 14 and 16;StataCorp,College Station,TX,USA)for the data analysis.Results:We included 92 randomized controlled trials with 6899 participants.Compared with the conventional emergency treatment group(CET group),the hemoperfusion group(HP+CET group),and the hemodialysis group(HD+CET group),the use of hemoperfusion combined with hemodialysis based on CET(HP+HD+CET group)significantly increased the success rate of rescue and reduced hos-pitalization time,the incidence of complications,time for cholinesterase level to return to normal,coma time,and atropine dosage.Conclusion:Hemoperfusion combined with hemodialysis is effective in the treatment of acute severe organophosphorus pesticide poi-soning.In the future,more scientifically designed,large-scale,high-quality,multicenter randomized controlled trials are needed to validate this study further.
文摘Objective To investigate the effect of hyperbarci oxygen(HBO) on recovery of nerves injury in rats suffered from acute organophosphorus poisoning. Method We established organophosphorus poisoning models and observed effect of HBO on recovery of injure nerves. Results Compared with control group, cerebrospinal fluid induced peak potential and incubation period in HBO group were significantly recovered(P<0.05).HBO could accelerated repair of injured nerves. Conclusion HBO could relieve injury of nerves during treatment of organophosphorus poisoning.