Objective:To evaluate the predictive value of 3 methods, namely plasma paraquat concentration, severity index of paraquat poisoning (SIPP), and acute physiology and chronic health evaluation (APACHE II) in severity evaluation and prognosis of acute paraquat poisoning. Methods:A total of 73 acute paraquat poisoning patients with oral administration were collected. Paraquat concentration in the plasma and other parameters on admission for SIPP and APACHE II were taken from medical records. According to the clinical outcome in the hospital or 7 days atfer the discharge, discrimination and calibration test were performed to evaluate the prognosis of the 3 methods. Results:Discrimination of the 3 methods was greater than 0.8, and the area under the receiver operator curve for SIPP (0.938) was greater than paraquat concentration in the plasma (0.857) and APACHE II (0.801) with statistical signiifcance (z=2.429, 2.021;P=0.015, 0.043). Difference in plasma paraquat concentration (0.857) and APACHE II (0.801) had no statistical signiifcance (z=0.755, P=0.450). Hosmer-Lemeshow good fit test suggested better calibration value with statistical signiifcance for the 3 methods (P>0.05). Conclusion:hTe 3 methods are valid in the severity evaluation and prognosis of acute paraquat poisoning. SIPP is the most preferred method, followed by paraquat concentration on admission. When there is no facility to measure paraqut concentration, APACHE II can be used as a reference for the death risk in acute paraquat poisoning.

Induced pluripotent stem cells(iPS)are derived from the differentiated somatic cells that regain the differentiation capabilities by the direct nuclear reprogramming with the exogenous factors.The methods for iPS induction evolved from transcription factors to RNA binding proteins,small molecules,and extracellular signals with the efforts in improving biosafty.The cellular and epigenetic characterization for iPS generation is a progressive and time-dependent process,which is tightly associated with the cellular differentiation status.However,epigenetics of iPS is not same as the embryonic stem cells.In combination with gene therapy and cellular transplantation therapy,the achievements of iPS had been applied in animal disease model treatment.

Objective To discuss the correlations between hemoperfusion(HP) times and therapeutic effects/prognosis in patients with severe acute organophosphorus poisoning(AOPP). Methods According to the frequency of HP,82 patients with severe AOPP were divided into three groups:non HP(25 cases),HP1(27 cases) and HP2(30 cases)groups. The non HP group received only routine treatment,on the basis of routine treatment,the HP1 group accepted once HP within 12 hours after poisoning and the HP2 group underwent twice or more times of HP,the interval between each time being 24 hours. The comparisions of clinical indexes,incidences of complications and rates of mortality among the three groups were performed. Results With the increase of HP times,the dosages of atropine and pralidoxime chloride were significantly reduced,the times of serum cholinesterase(ChE)activity recovery,consciousness recovery,hospitalization and mechanical ventilation were significantly shortened,the score of acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score in 48 hours after admission,incidence of complications and mortality were evidently decreased(all P<0.05). Compared with those in HP1 group,the dosages of atropine(mg:164.57±68.82 vs. 256.81±97.06)and pralidoxime chloride(mg:6.95±1.40 vs. 8.76±1.64) in HP2 group were significantly reduced,the times of ChE activity recovery(day:9.03±2.46 vs. 10.96±3.44), consciousness recovery(hour:23.83±6.29 vs. 39.93±8.24),hospitalization(hour:9.57±2.39 vs. 11.52±3.02) and mechanical ventilation(hour:40.50±16.55 vs. 65.74±18.88)in HP2 group were significantly shortened;APACHEⅡscore during 48 hours after admission(11.97±3.47 vs. 14.26±2.88)was obviously decreased,and the incidences of complications,such as intermediate syndrome(10.0% vs. 18.5%),rebound phenomenon(3.3% vs. 25.9%),arrhythmia(13.3%vs. 44.4%),multiple organ dysfunction syndrome(MODS,6.7%vs. 29.6%)and mortality rate(6.7% vs. 18.5%)in HP2 group were markedly decreased(all P<0.05). Conclusion It is recommendable that combined with routine treatment,early and multiple HP application would enhance the therapeutic effect and decrease the mortality in patients with severe AOPP.

Objective To study the protective effects of aldioxa tablets on aspirin-induced gastric mucosal lesions in rat model. Methods Sixty healthy male Wistar rats were randomly divided into five groups: Ⅰ (injury group), Ⅱ (control group), Ⅲ (sucralfate protective group), Ⅳ (aluminium hydroxide protective group), and Ⅴ (aldioxa protective group). The three protective groups were treated with sucralfate, aluminium hydroxide and aldioxa tablets respectively before gastric mucosal injury was induced. Then the ulcer index (UI), epithelial damage scoring (EDS) were measured, and the pathological changes on histological sections and ultrastructural sections of gastric mucosa were assessed under microscope or electron microscope. Results The data of group Ⅰ, Ⅱ, Ⅲ, Ⅳ, Ⅴ obtained were as follow: ulcer index: 42.13±6.22, 3.13±1.46, 8.63±3.48, 18.00±6.16, 8.00±3.17, respectively; epithelial damage scoring: 3.67±0.49, 1.25±0.45, 1.41±0.51, 2.42±0.79, 1.50±0.52, respectively. In comparison with injury group, the ulcer index and epithelial damage scoring of gastric mucosa in aldioxa protective group were significantly decreased. Conclusions The results revealed that aldioxa tablets had a significant protection effect on rats with acute gastric mucosal injury induced by aspirin.

Humans ; Laparoscopy ; methods ; trends ; Pancreaticoduodenectomy ; methods

Adolescent ; Alkanes ; poisoning ; Alkenes ; poisoning ; Daphne ; chemistry ; Humans ; Male

Administration, Oral ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Peracetic Acid ; administration & dosage ; poisoning ; Poisoning ; diagnosis ; therapy

Objective To explore curriculum and faculty qualification of Chongqing operating room (OR) specialty certified nurse theoretical tralning program by feedback of students, and to im-prove the quality of tralning. Method Relying on the national key project of the First Affiliated Hos-pital of Chongqing Medical University, Chongqing Health administration OR nurse specialist tralning program set additional courses related to research, teaching, patient safety and first ald tralning based on operation room specialist nurse tralning outline. 81 participants were given questionnalres issued by college of nursing after the 7th OR specialist nurse theoretical tralning, and statistics analysis was made of it. Result Effective questionnalres was100%. The overall judgment on theory tralning was high, with 92.60%of the students giving overall score above 150 points (out of 170);93.84%of students sat-isfied on teaching staff ratio while 95.06% students satisfied on course content. For the 17 items, the majority scores given by the students were ≥ 9 points (a 10-points scale), on the top of the list were item “Theoretical tralning helps to enhance professional theoretical level and guide clinical practice”“Teaching content meet needs of OR specialist nurses” “Teaching content is helpful to improve the core competence of specialist nurses” (all 96.30%, 78 out of 81), while the bottom was “Instructor create an environment which fosters student participation”(85.19%, 69 out of 81). Conclusion Chong-qing OR specialist theoretical tralning has good practical and guidance property, the content meet OR nurses needs, instructor ratio is reasonable, and students are highly satisfied with it. Instructors need to encourage students' participation in class interaction, and pay attention to improving their research capabilities.

Objective To investigate toe-brachial index ( TBI) in the diagnosis of peripheral artery disease ( PAD) and its risk factors in the patients with type 2 diabetes.Methods TBI was examined in the 238 patients with type 2 diabetes.The patients were divided into the group with low TBI ( TBI≤0.7 ) and the group with normal ABI ( TBI>0.7 ) .The two groups were compared for clinical parameters.Results Thirty two patients (13.4%)with abnormal ABI (TBI≤0.7) showed older age [(63.8 ±9.9) yrs vs (54.9 ±10.8) yrs, P =0.000] , lower diastolic blood pressure [(70.5 ±6.9) mmHg vs (74.9 ±9.1) mmHg, P =0.003], more frequency of hypertension (56.3%vs 38.3%, P =0.043), coronary artery heart disease (28.7%vs 10.7%, P =0.020) and cere-bral vascular disease (15.6%vs 4.4%, P =0.025).Step-wise analysis screened that age and diastolic blood pressure were the inde-pendent risk factors for TBI .Conclusions Aging and hypertension were the risk factors in the patients with abnormal TBI in type 2 di-abetes.TBI was an easy and economical method for diagnosing PAD in patients with type 2 diabetes.

ObjectiveTo study the effect of astragaloside Ⅳ(AS-Ⅳ) on glucose-induced podocyte adhesion and its possible mechanism. MethodsConditionally immortalized mouse podoeytes were treated with 10, 50, 100 mg/L AS-Ⅳ and with 100 mg/L AS-Ⅳ for 3, 6, 12, 24 h. Cell attachment was measured by fluorescence and centrifugation cell adhesion assays, respectively. Expression of α3β1 integrin mRNA and protein was examined by real-time PCR and Western blot. ResultsHigh glucose induced a significant reduction in adherent podocytes compared to normal glucose group (P<0.05). AS-Ⅳ improved high glucose-induced podocyte adhesion in a time- and dose-dependent manner. Real-time PCR and Western blot analysis revealed that high glucose-induced down-regulation of α3β1 integrin in podocytes were significantly meliorated by AS-Ⅳ (P<0.05). ConclusionAstragaloside Ⅳ improved high glucose-induced podocyte adhesion which may be mediated through α3β1 integrin up-regulation.