Objective To determine the clinical indicators of early death (within 72 hours) in patients with acute paraquat poisoning.Methods The data of 93 acute paraquat poisoning patients admitted to emergency intensive care unit (EICU) of the First Hospital of China Medical University were retrospectively analyzed.The patients were divided into two groups according to whether they died within 72 hours or not.The gender,age,poison dose,paraquat concentration in urine,reduction of paraquat amount in urine after each hemoperfusion,and the worst value of white blood cell (WBC) count,lymphocytes count,arterial blood gas analysis,blood K +,Na+,Cl-,and serum amylase,serum lipase,serum total bilirubin,troponin Ⅰ,creatine kinase (CK),blood urea nitrogen,serum creatinine within 24 hours after poisoning were compared.Spearman correlation analysis was used to analyze the correlation between paraquat concentration in urine and the dose of paraquat.The predictive value of each indicator at death in early stage of poisoning was analyzed with receiver operating characteristic curve (ROC curve).Results Nineteen patients in the group of those died in early stage of poisoning (within 72 hours) resulted in a mortality rate of 20.4％.Compared with non-early death group,in early death group,the value of poison dose (mL:133.4 ± 108.8 vs.58.6 ± 40.0,t=3.145,P=0.002),paraquat concentration in urine [mg/L:16.34 (11.87,96.76) vs.4.46 (1.21,12.78),Z=-3.422,P=0.001],WBC (× 109/L:22.63 ±9.72 vs.14.95 ±8.39,t=3.446,P=0.001),blood lactate [Lac (mmol/L):6.7 (2.2,12.1) vs.1.9 (1.1,3.4),Z=-3.294,P=0.001] were significantly higher,and the reduction rate of paraquat concentration in urine after first perfusion [(38.4 ± 15.63)％ vs.(67.59 ± 27.87)％,t=2.945,P=0.004] and arterial partial pressure of carbon dioxide [PaCO2 (mmHg,1 mmHg=0.133 kPa):28.7 ± 9.3 vs.34.8 ± 6.7,t=-3.245,P=0.002] were significantly lowered.There was no significant difference between two groups in other indexes.Poison dose and paraquat concentration in urine showed significantly positive correlation (r=0.450,P＜0.001).ROC curve showed that the predictive value of paraquat concentration in urine,WBC,and Lac in early death were significant [area under the ROC curve (AUC) of paraquat concentrations in urine was 0.806,95％ confidence interval (95％CI) 0.699-0.913,the cut-off value was 11.64 mg/L,with sensitivity 84.6％,specificity 71.4％; AUC of WBC was 0.734,95％CI 0.569-0.899,the cut-off value was 15.94 × 109/L with sensitivity 69.2％,specificity 76.8％ ; AUC of Lac was 0.729,95％CI 0.568-0.891,the cut-off value was 1.95 mmol/L with sensitivity 84.6％,specificity 42.9％].Conclusions Paraquat concentrations in urine,WBC,Lac,poison dose and PaCO2 were the risk factors of the early death of the acute paraquat poisoning.The research suggests that paraquat concentration in urine,WBC and Lac are valuable in predicting early death of the patients.

Animals ; Annexin A2 ; chemistry ; genetics ; metabolism ; physiology ; DNA Replication ; Endocytosis ; Exocytosis ; Humans ; Neoplasm Invasiveness ; Neoplasm Metastasis ; Neoplasms ; metabolism ; pathology ; Prognosis ; Tissue Plasminogen Activator ; metabolism ; physiology

0.05).Conclusion DTI can noninvasive detect the potential disorder of corpus eallosum in vivo,thus providing useful information to differentiate the cerebral ischemia disease from multiple sclerosis.

Objective:To establish a preoperative forecasting model for the nature of duodenal papillary tumors and to discuss its main predictors.Methods:A case-control study was conducted;the case group included patients with malignant duodenal papillary tumors and the control group included patients with benign duodenal papillary tumors.All the patients were from Changhai Hospital. Data of patients,including the demographic characteristics,clinical symptoms during onset,laboratory findings,and radiological data, were collected by face-to-face interviews or by reviewing the medical history.Chi-square,t-test or ANOVA were employed to performed univariate analysis.All factors with P values less than or equal to 0.25 in the univariate analysis were used as independent variables for multivariate analysis,and a Logistic regression forecasting model for the nature of duodenal papillary tumors was established.Results: Totally 199 patients with pathologically-confirmed duodenal papillary tumors were included in the present study,with 166 in the case group and 33 in the control group.Multivariate analysis showed that hemoglobin(Hb),total bilirubin(Tbil),direct bilirubin(Dbil), aspartate transferase(AST),alkaline phosphatase(AKP),gamma glutamyl transpeptidase(GGT),and carcinoembryonic antigen(CEA) were independent predictors for nature of duodenal papillary tumors,with their odds ratios(95% confidence interval)being 0.981 (0.959,1.003),0.867(0.794,0.948),1.207(1.075,1.355),1.028(1.008,1.048),0.996(0.992,1.000),1.002(1.000,1.004),and 0.974(0.953,0.994),respectively.Conclusion:The Logistic regression model,which takes into consideration of Hb,Tbil,Dbil,AST, AKP,GGT,and CEA,can be used to predict the nature of duodenal papillary tumors,and its clinical value need to be further studied.

Abstract?AlM: To observe the anterior chamber angle shape of patients with diabetic retinopathy ( DR) at different stages using OCT, and to explore a more sensitive and accurate glaucoma preventing measure.?METHODS: A total of 613 cases of DR patients were divided into proliferation phase group ( 353 cases ) and background phase group ( 260 cases ) , another 100 cases of patients with only diabetes were selected as control group. OCT was used to detect the anterior chamber angle related parameters, including angle opening distance ( AOD) , trabecular-iris space area ( TlSA) , angle recess area ( ARA ) , anterior chamber depth ( ACD ) and anterior chamber angle ( ACA) .?RESULTS: There were significant difference among AOD500, AOD750, TlSA500, TlSA750, ARA500 and ARA750 of control group, proliferation phase group and background phase group ( P< 0. 01 ). The proliferation phase group was the lowest, AOD500, AOD750, TlSA500, TlSA750, ARA500 and ARA750 were 0. 60 ± 0. 22mm, 0. 78 ± 0. 39mm, 0. 22 ± 0. 12mm2 , 0. 45 ± 0. 19mm2 , 0. 29 ± 0. 18mm and 0. 46 ± 0. 15mm, respectively. There were significant difference among ACA500, ACA750, ACD500 and ACD750 of control group, proliferation phase group and background phase group ( P< 0. 01 ). The proliferation phase group was the lowest, ACA500, ACA750, ACD500 and ACD750 were 30. 29o ± 8. 19o, 21. 20o ± 7. 40o, 2. 32 ± 0. 23μm and 2. 52±0. 16μm, respectively. ln addition, ROC results indicated that all these indices exert significant difference on evaluating the stage of DR. ?CONCLUSlON: Anterior chamber angle shape detected using OCT can reflect the change of retinopathy. OCT is an accurate and simple technique for detecting DR staging.

Adult ; Diagnosis, Differential ; Histiocytoma, Malignant Fibrous ; pathology ; Humans ; Laryngeal Neoplasms ; diagnostic imaging ; metabolism ; pathology ; surgery ; Laryngectomy ; Leiomyosarcoma ; pathology ; Male ; Rhabdomyosarcoma ; diagnostic imaging ; metabolism ; pathology ; surgery ; Tomography, X-Ray Computed ; Vimentin ; metabolism

Adenocarcinoma, Follicular ; epidemiology ; genetics ; metabolism ; pathology ; Carcinoma, Papillary ; pathology ; DNA-Binding Proteins ; metabolism ; Diagnosis, Differential ; Genes, ras ; genetics ; Humans ; Point Mutation ; Prognosis ; Thyroglobulin ; metabolism ; Thyroid Neoplasms ; epidemiology ; genetics ; metabolism ; pathology ; Transcription Factors

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By analysis on mechanism of dampness and hotness obstruction of RA in active stage,explore the relationship between RA and dampness and hotness obstruction, and the clinical status of Qingre Lishi Huoxue Tongluo method in treating RA in active stage, for more effectively guiding clinic administration.