Animals ; Bridged-Ring Compounds ; poisoning ; Disease Models, Animal ; Female ; Male ; Mice ; Sodium Oxybate ; therapeutic use ; Unithiol ; therapeutic use

To investigate the therapeutic effect of high-dosage gamma-aminobutyric acid (GABA) on acute tetramine (TET) poisoning, 50 Kunming mice were divided into 5 groups at random and the antidotal effects of GABA or sodium dimercaptopropane sulfonate (Na-DMPS) on poisoned mice in different groups were observed in order to compare the therapeutic effects of high-dosage GABA with those of Na-DMPS. Slices of brain tissue of the poisoned mice were made to examine pathological changes of cells. The survival analysis was employed. Our results showed that both high-dosage GABA and Na-DMPS could obviously prolong the survival time, delay onset of convulsion and muscular twitch, and ameliorate the symptoms after acute tetramine poisoning in the mice. Better effects could be achieved with earlier use of high dosage GABA or Na-DMPS. There was no significant difference in prolonging the survival time between high-dose GABA and Na-DMPS used immediately after poisioning. It is concluded that high-dosage GABA can effectively antagonize acute toxicity of teramine in mice. And it is suggested that high-dosage GABA may be used as an excellent antidote for acute TET poisoning in clinical practice. The indications and correct dosage for clinical use awaits to be further studied.
Acute Disease ; Antidotes/*administration & dosage ; Antidotes/therapeutic use ; Bridged Compounds/*poisoning ; Random Allocation ; Rodenticides/*poisoning ; Unithiol/therapeutic use ; gamma-Aminobutyric Acid/*administration & dosage ; gamma-Aminobutyric Acid/therapeutic use

OBJECTIVE: To explore the effective treatment and prognostic factors for fulminant Wilson's disease (FWD). METHODS: We retrospectively analyzed the clinical characteristics, therapeutic Methods and outcomes of 13 FWD patients. We investigated the treatment effect of the joint use of hormones, decoppering, and plasma exchange therapy in patients with FWD, compared the difference in the clinical features, biochemical data and treatment between the survival group and the death group. RESULTS: Thirteen patients with FWD presented with acute hepatic failure and severe jaundice: 7 accompanied with severe hemolytic anemia, 5 with primary peritonitis, 8 with hepatic encephalopathy. Prothrombin activity (PTA) of 5 was below 30% in the 13 patients. Plasma exchange (PE), dimercaptopropansulfonate sodium (DMPS) and short-term methylprednisolone /dexamethasone administration were performed in 7 patients, in which 6 survived and the other 1 who had primary peritonitis with PTA below 30% died. The other 6 patients without above-mentioned treatments all died, in which 4 accompanied with primary peritonitis with PTA all below 30%. CONCLUSION The level of hepatic failure and the occurrence of infection are the decisive factors for prognosis of patients with FWD. PE with decoppering treatment and corticosteroid administration are effective.
Chelating Agents ; therapeutic use ; Combined Modality Therapy ; Copper ; blood ; Female ; Hepatolenticular Degeneration ; therapy ; Humans ; Male ; Methylprednisolone ; therapeutic use ; Plasma Exchange ; methods ; Prognosis ; Retrospective Studies ; Unithiol ; therapeutic use

Adolescent ; Antidotes ; therapeutic use ; Bridged-Ring Compounds ; poisoning ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Infant ; Male ; Poisoning ; mortality ; therapy ; Survival Rate ; Treatment Outcome ; Unithiol ; therapeutic use

OBJECTIVETo investigate the changes of mercury (Hg) levels in cerebrospinal fluid (CSF) in patients with chronic mercury poisoning and elucidate the neurotoxic mechanism of mercury.

METHODSNine patients with chronic mercury poisoning (poisoning group) as well as eight patients without exposure to mercury were included in this study. Mercury concentrations of 24 hour urine (U-Hg) and CSF (CSF-Hg) were measured with cold-vapor atomic absorption spectrometry-alkali stannous chloride method. The concentration of blood (B-Hg) at the same day was measured with cold-vapor atomic absorption spectrometry-acidic stannous chloride method. In five patients of poisoning group, these concentrations before chelation therapy were compared with those after chelation therapy.

RESULTSThe levels of B-Hg, U-Hg, and CSF-Hg in poisoning group (250.00 +/- 48.54, 160.07 +/- 91.15, 20.22 +/- 10.21 nmol/L, respectively) were significantly higher than those in control group (81.04 +/- 63.01, 24.73 +/- 9.96 nmol/L, undetectable, respectively; P < 0.01). In nine patients of poisoning group, CSF-Hg concentrations were correlated with B-Hg (r = 0.675, P < 0.05), but not U-Hg. After chelation therapy with dimercaptopropane sulfonate in five patients of poisoning group, the levels of B-Hg, U-Hg, and CSF-Hg were decreased significantly (P < 0.05). The reduction of CSF-Hg was not related with B-Hg and U-Hg.

CONCLUSIONCSF-Hg concentration in chronic mercury poisoning patient is increased with the rise of B-Hg, but not U-Hg. When the levels of B-Hg and U-Hg drop to normal, the CSF-Hg level is still high enough to be detected. It indicates that mercury is combined with protein after entering brain and this complex is difficult to cross through blood-cerebral barrier. The complex may cause neuromuscular disorder and fremitus in chronic mercury poisoning.

Adult ; Antidotes ; therapeutic use ; Chronic Disease ; Female ; Humans ; Male ; Mercury ; cerebrospinal fluid ; Mercury Poisoning ; cerebrospinal fluid ; drug therapy ; Middle Aged ; Occupational Exposure ; Spectrophotometry, Atomic ; Unithiol ; therapeutic use

Acute Disease ; Adolescent ; Adult ; Anticonvulsants ; therapeutic use ; Antidotes ; therapeutic use ; Bridged-Ring Compounds ; poisoning ; Diazepam ; therapeutic use ; Drug Therapy, Combination ; Electroencephalography ; Female ; Humans ; Male ; Poisoning ; drug therapy ; Treatment Outcome ; Unithiol ; therapeutic use

OBJECTIVETo observe the clinical manifestation of 155 patients with hepatolenticular degeneration (HLD) complicated with epilepsy and the therapeutic effect of integrative Chinese and Western medicine treatment on them.

METHODSClinical manifestation of patients and its relationship with abnormalities in cranial CT and/or MRI were observed. Patients were treated by combined treatment of copper repellent with sodium dimercaptosulfonate 20 mg/kg per day by intravenous dripping, and modified Gandou Decoction (GDD) by oral intake and antiepileptics as well, after treatment for 8-10 courses, the clinical effect, copper levels in urine and serum were compared between groups.

RESULTSIn the 155 HLD patients, 96 were complicated with petit mal and 59 with grand mal. In the CT and/or MRI conducted in 72 patients, all showed abnormal images, besides such frequently met images as bilateral symmetrical basal ganglia focal lesion in 65 case-episode (90.3%) and brain atrophy of various degrees in 61 case-episode (84.7%), the massive lesions in cerebral white matter as principal, with the cortex involved, were also found in 54 patients (74%), which were mostly bilateral and symmetric or located in 2 adjecent lobes of brain, the sites of damage, in sequence of occurrence, were frontal lobe, parietal lobe, temporal lobe and callosal gyrus. Brain atrophy was found in all the remained patients without above-mentioned lesions. Abnormal EEG was shown in 29 patients (40.2%), which mainly manifested as theta wave of moderate to high potential and/or short paroxysmal spike-slow or sharp-slow complex wave evoked. The urinary copper level in patients after treatment was 34.5 +/- 21.6 micromol/24 hrs, significantly higher than that before treatment, 4.49 +/- 1.93 micromol/24 hrs (P < 0.01). And the serum copper level in patients also lowered significantly (P< 0.01). Epileptic seizure was controlled completely along with the gradually improving of extrapyramidal symptoms.

CONCLUSIONPartial seizure was the most common type of seizure of HLD patient complicated with epilepsy, the next is systemic seizure. Cerebral damage lesion and obvious brain atrophy could be the main etiological factors of HLD complicated with epilepsy, combined copper repellent therapy of integrative Chinese and Western medicine, and antiepileptics produced good clinical effect on the patients.

Adolescent ; Adult ; Anticonvulsants ; therapeutic use ; Chelating Agents ; therapeutic use ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Epilepsy ; complications ; drug therapy ; Female ; Hepatolenticular Degeneration ; complications ; drug therapy ; Humans ; Male ; Phytotherapy ; Unithiol ; therapeutic use

Objective: To explore the expulsion effect of sodium dimercaptopropanesulfonate (DMPS) on mercury in different organs of mercury poisoning and the therapeutic effect of glutathione (GSH) combined with antioxidant therapy on mercury poisoning. Methods: In February 2019, 50 SPF male SD rats were randomly divided into 5 groups, 10 rats in each group: A (saline negative control group) , B (HgCL2 positive control group) , treatment group (C: intramuscular injection of DMPS 15 mg/kg treatment, D: intramuscular injection of DMPS30 mg/kg treatment, E: intramuscular injection of DMPS 15 mg/kg and intraperitoneal injection of GSH200 mg/kg treatment) . Rats in group B, C, D and E were subcutaneously injected with mercury chloride solution (1 mg/kg) to establish a rat model of subacute mercury poisoning kidney injury. Rats in group A were subcutaneously injected with normal saline. After the establishment of the model, rats in the treatment group were injected with DMPS and GSH. Rats in group A and group B were injected with normal saline. At 21 d (treatment 7 d) and 28 d (treatment 14 d) after exposure, urine and blood samples of 5 rats in each group were collected. Blood biochemistry, urine mercury, urine microalbumin and mercury content in renal cortex, cerebral cortex and cerebellum were detected. Results: After exposure to mercury, the contents of mercury in renal cortex, cerebrum and cerebellum of rats in group B, C, D and E increased, and urine microalbumin increased. Pathology showed renal tubular injury and renal interstitial inflammation. Compared with group B, urinary mercury and renal cortex mercury in group C, D and E decreased rapidly after DMPS treatment, and there was no significant decrease in mercury levels in cerebellum and cerebral cortex of rats, accompanied by transient increase in urinary albumin after DMPS treatment (P<0.05) ; the renal interstitial inflammation in group E was improved after GSH treatment. There was a positive correlation between urinary mercury and the contents of mercury in renal cortex, cerebral cortex and cerebellum (r=0.61, 0.47, 0.48, P<0.05) . Conclusion: DMPS mercury expulsion treatment can significantly reduce the level of metal mercury in the kidney, and there is no significant change in the level of metal mercury in the cortex and cerebellum.
Animals ; Brain/drug effects* ; Glutathione ; Inflammation ; Kidney/drug effects* ; Kidney Diseases/chemically induced* ; Male ; Mercuric Chloride/therapeutic use* ; Mercury/urine* ; Mercury Poisoning/drug therapy* ; Rats ; Rats, Sprague-Dawley ; Saline Solution/therapeutic use* ; Unithiol/therapeutic use*

OBJECTIVETo investigate the factors affecting clinical therapeutic effect on acute tetramine poisoning.

METHODSUsing Logistic regression to analyze the relationships among the degree of tetramine poisoning, time of onset, time of admission, exposure history, sex, age, unithol, gastric lavage, etc with the death of poisonded patients.

RESULTSThe fatality rate of patient with tetramine poisoning who got gastric lavage was less than that who did not (5.85% vs 38.00%, P < 0.01). In patients who got gastric lavage, the fatality rates were increased with the degree of tetramine poisoning (control: 0%, mild poisoning: 3.07%, severe poisoning: 9.14%, P < 0.05). There was no significant difference in fatality between using unithol and not using patients (7.22% vs 8.25%, P > 0.05).

CONCLUSIONUnithol has no significant influence of clinical therapeutic effect on tetramine poisoning patients and dose not reduce the fatality rate of patient with tetramine poisoning, but gastric lavage and the degree of tetramine poisoning do. Logistic regression analysis showed that gastric lavage is the main factor affecting the therapeutic effect on tetramine poisoning.

Acute Disease ; Adolescent ; Adult ; Antidotes ; therapeutic use ; Bridged-Ring Compounds ; poisoning ; Child ; Female ; Gastric Lavage ; methods ; Humans ; Insecticides ; poisoning ; Logistic Models ; Male ; Poisoning ; mortality ; therapy ; Retrospective Studies ; Survival Rate ; Time Factors ; Treatment Outcome ; Unithiol ; therapeutic use

OBJECTIVETo evaluate four therapeutic measures on acute tetramethylene disulphotetramine (TETS) poisoning and the effects of it on intelligence of children.

METHODSAll 86 patients of acute TETS poisoning were randomly divided into 4 groups (the control group, sodium valproate group, sodium dimercaptopropane sulfonate group and the hemoperfusion group). The therapeutic effects were observed after the arranged treatment was administrated. According to age, residence, sex, education and domestic economy, 30 children were matched by 1:1 with children of TETS poisoning.

RESULTSThe termination time of seizure, doses of diazepam, mental symptoms and the continual time of mental symptoms were not significantly different among these three groups. After hemoperfusion, the seizure of patients was terminated or the frequency was obviously decreased, but the level of TETS in blood was not reduced. The average scores of full intelligence quotient (FIQ), the verbal intelligence quotient (VIQ) and the performance intelligence quotient (PIQ) of children in poisoning group were 9.1, 8.8 and 7.7 less than the controls. The average scores of FIQ of children with bad state were 15 less than the controls.

CONCLUSIONTherapeutic effects of sodium valproate and sodium dimercaptopropane sulfonate on acute TETS poisoning should be not better than using diazepam and sodium phenobarbital. Therapeutic effects of hemoperfusion on TETS poisoning is good. TETS poisoning should have a great influence on intelligence of children.

Acute Disease ; Adolescent ; Adult ; Anticonvulsants ; therapeutic use ; Antidotes ; therapeutic use ; Bridged-Ring Compounds ; poisoning ; Child ; Female ; Hemoperfusion ; methods ; Humans ; Intelligence ; drug effects ; Intelligence Tests ; Male ; Poisoning ; complications ; physiopathology ; therapy ; Seizures ; etiology ; prevention & control ; Treatment Outcome ; Unithiol ; therapeutic use ; Valproic Acid ; therapeutic use ; Young Adult