Patients with organophosphate poisoning usually die from respiratory depression and respiratory failure. The incidence of rhabdomyolysis is relatively low, but the mortality rate is extremely high once it occurs. In this paper, the treatment of a patient with acute phoxim poisoning was analyzed. The patient developed severe rhabdomyolysis syndrome on the 3rd day of treatment, the creatine kinase exceeded the normal value by more than 300 times (up to 103510.65 U/L) , and renal failure occurred. Clinical treatment included active detoxification, blood purification, organ support, and internal environment maintenance. The patient's rhabdomyolysis continued, and the condition worsened. Finally, the family gave up the treatment and the patient died. It is suggested that attention should be paid to the occurrence of rhabdomyolysis syndrome during the treatment of organophosphorus poisoning, and timely blood purification technology may be the key to treatment.
Humans ; Rhabdomyolysis/chemically induced* ; Organothiophosphorus Compounds ; Creatine Kinase ; Incidence ; Acute Kidney Injury

OBJECTIVETo observe the effect of sodium bicarbonate combined with ulinastatin on cholinesterase activity for patients with acute phoxim pesticide poisoning.

METHODSA total of 67 eligible patients with acute phoxim pesticide poisoning, Who were admitted to the emeryency department of hospital from March 2011 to February 2014, Acording to different treatments au patients were randomly divided into the conventional treatment group (n=34) and the sodium bicarbonate+ulinastatin group (n=35) . The conventional treatment group were given thorough gastric lavage with water, the sodium bicarbonate + ulinastatin group were given gastric lavage with 2% sodium bicarbonate solution. Both groups were given such treatments as catharsis, administration of oxygen, fluid infusion, diuresis, and antidotes such as atropine and pralidoxime methylchloride. On the basis of comprehensive treatment, people in the sodium bicarbonate+ulinastatin group were given 5% sodium bicarbonate injection and ulinastatin. The clinical effect of the two groups were compared.

RESULTSThe serum cholinesterase activity of the sodium bicarbonate+ulinastatin group was significantly higher than the conventional treatment group from the 5th day, and the difference was statistically significant (P<0.05) . The total atropine dosage, total pralidoxime methylchloride dosage and hospitalization days were better than the conventional treatment group, and the differences were statistically significant (P<0.05) . The difference in the time of atropinization between the two groups was not statistically significant (P>0.05) . The results of arterial blood pH, HCO3- of the sodium bicarbonate + ulinastatin group were higher than the conventional treatment group, and the difference of HCO3- at the 10th day was statistically significant (P<0.05) .

CONCLUSIONSSodium bicarbonate combined with ulinastatin can improve the therapeutic effect and reduce complications in the treatment of acute phoxim pesticide poisoning, and have beneficial effects on the recovery of cholinesterase activity.

Atropine ; therapeutic use ; Cholinesterases ; metabolism ; Glycoproteins ; therapeutic use ; Humans ; Organophosphate Poisoning ; drug therapy ; Organothiophosphorus Compounds ; poisoning ; Pesticides ; poisoning ; Pralidoxime Compounds ; therapeutic use ; Sodium Bicarbonate ; therapeutic use

OBJECTIVETo explore the effects of aspirin and inflammation on the maturation and function of dendritic cells (DC) on the supernatant of VX-2 squamous cell carcinoma.

METHODSThe rabbit buccal VX-2 squamous cell carcinoma models with inflammation were established by tumor particle implantation, mechanical trauma, and high sugar diet. The rabbits were divided into three groups. For the experimental group (rabbit buccal VX-2 squamous cell carcinoma with local inflammation), aspirin were given by gavage for three consecutive days. For the control group (rabbit buccal VX-2 squamous cell carcinoma with local inflammation), normal saline was given by gavage for three consecutive days. For the blank group (tumor without inflammation), normal saline was given by gavage for three consecutive days. Each tumor specimens were collected in three days and made into tissue homogenate. The supernatant was collected after centrifugation. Normal rabbit peripheral blood mononuclear cells were separated and co-cultured with different states of supernatant. The expression of DC surface markers CD83, CD86, and human leukocyte antigen-DR (HLA-DR) were detected by flow cytometry. The state of function of DC was tested by mixed lymphocyte reaction.

RESULTSThe positive rate of CD83, CD86, and HLA-DR of the experimental and control groups were both lower than that of the blank group (P<0.05). In addition, the ability to stimulate T cell proliferation of the experimental and control groups were weaker than that of the blank group (P<0.05). No significant difference was observed between the experi- and HLADR of DC. The short-term administration of aspirin is not conducive to the phenoty and function of DC in a rabbit mental and control groups (P>0.05).

CONCLUSIONInflammation may inhibit the function and expression of CD83, CD86, buccal VX-2 squamous cell carcinoma inflammatory environment

Animals ; Aspirin ; pharmacology ; Carcinoma, Squamous Cell ; Coculture Techniques ; Dendritic Cells ; drug effects ; Flow Cytometry ; Humans ; Inflammation ; Leukocytes, Mononuclear ; Organothiophosphorus Compounds ; Rabbits

OBJECTIVETo investigate the characteristics of pesticide poisoning in Jiangsu Province, China, and to provide a scientific basis for developing effective intervention measures and prevention strategies.

METHODSThe data from report cards of pesticide poisoning in Jiangsu Province from 2006 to 2013 were arranged using EXCEL tables, and assessed. Statistical analysis was applied to the epidemiological data using SPSS.

RESULTSFrom 2006 to 2013, a total of 32672 cases of pesticide poisoning were reported in Jiangsu Province. Most of the cases were caused by non-occupational poisoning (life poisoning) (72.78%). A majority of patients with pesticide poisoning were 35-54 years old (40.85%) or older than 65 years (15.69%). There were more female patients (58.22%) than male patients (41.78%). Among patients with occupational poisoning, male patients (50.90%) were more than female patients. Among patients with non-occupational poisoning, female patients were more than male patients (38.37%). Pesticide poisoning mainly occurred from July to September. The case-fatality rate of occupational poisoning (0.47%) was lower than that of non-occupational poisoning (7.10%). All 13 cities in Jiangsu Province reported cases of pesticide poisoning. There were more cases in the northern regions than in the southern regions. Pesticide poisoning was mainly caused by organophosphorus insecticides including methamidophos, dichlorvos, dimethoate, omethoate, and parathion, which accounted for 65.58%of all cases. Paraquat had the highest case-fatality rate (10.06%) among all pesticides, followed by tetramine (10.00%), dimethoate or omethoate (7.85%), methamidophos (7.79%), and dimehypo (7.68%).

CONCLUSIONPesticide poisoning cannot be ignored. The management and control should be improved in production and usage of highly toxic pesticides including organophosphorus insecticides, rodenticides, and herbicides. More attention should be paid to the protection of vulnerable groups including women, children, and the elderly.

Adult ; Age Distribution ; Aged ; China ; epidemiology ; Cities ; Dichlorvos ; Dimethoate ; analogs & derivatives ; Environmental Exposure ; prevention & control ; statistics & numerical data ; Female ; Herbicides ; poisoning ; Humans ; Insecticides ; poisoning ; Male ; Middle Aged ; Organothiophosphorus Compounds ; Paraquat ; Pesticides ; poisoning ; Poisoning ; epidemiology ; prevention & control ; Rodenticides

OBJECTIVETo investigate the levels of organophosphorus pesticides (OPPs) in animal foods and to assess the diet exposure risk of OPPs to Chinese population.

METHODS115 samples, including pork, beef, mutton, chicken, fish, eggs, and milk were collected from 13 provinces in China, were analyzed by dual gas chromatography-dual pulsed flame photometry (GC-PFPD) for the contamination of 58 organophosphorus pesticide residues including their metabolites. The cumulative exposure assessment and high-end exposure assessment were used to assess the diet exposure risk of OPPs to Chineses population.

RESULTSThe contamination levels of OPPs in animal foods were in the range of not detected (ND)-0.343 mg/kg, and the total detection rate was 37.4% (43/115). OPPs were frequently detected in samples of milk, fish and pork compared with other animal foods with the detection rate of 12/19, 9/16 and 7/16, respectively. The cumulative exposure amount of 10 OPPs to Chinese population was 0.12 µg×kg(-1)·d(-1), which accounted for 7.29% of the ADI.

CONCLUSIONThe residue levels of OPPs were low in animal food in the surveyed areas in China with some banned individual OPPs, such as methamidophos and monocrotophos, were detected. The dietary exposure risk of OPPs raised by the intake of animal foods in surveyed areas of China was low.

Animal Feed ; Animals ; Cattle ; China ; Chromatography, Gas ; Diet ; Eggs ; Food ; Food Contamination ; Meat ; Milk ; Organophosphorus Compounds ; Organothiophosphorus Compounds ; Pesticide Residues ; Pesticides ; Sheep ; Swine

BACKGROUND: In general, measuring the level of consciousness in neurological patients is important. To assess the patient's mental status, the Glasgow Coma Scale (GCS) and the level of consciousness (drowsiness, stupor, and coma) have been used in clinical situations. The aim of the present study was to identify the correlation between bispectral index (BIS) and level of consciousness in brain injured patients. METHODS: Eighty-nine adult patients of both sexes were included in the study. A blinded observer evaluated the mental status (GCS and level of consciousness) of a patient who is admitted in intensive care unit with brain injury, while an investigator noted the patient's BIS. The BIS was measured using a BIS monitor, Model A-3000 vista(TM) with Sensor Bis quatro(TM) (Aspect Medical Systems, Norwood, USA). A Spearman's rank correlation coefficient was used to determine if the level of consciousness correlated with the BIS. RESULTS: In 89 patients, the BIS was found to be significantly correlated with the level of consciousness (r = 0.723, P < 0.01) and GCS (r = 0.646, P < 0.01). The BIS values increased with an increasing level of consciousness. Mean BIS values of coma, semicoma, stupor and drowsiness were 0.14 +/- 0.23, 38.9 +/- 18.0, 60.3 +/- 14.5, and 73.6 +/- 16.5, respectively. CONCLUSIONS: In the present study, a significant correlation existed between level of consciousness and BIS. These findings suggest that BIS may be used for assessing the level of consciousness in brain injured patients. However, the scatter of BIS values for any level of consciousness limited the worth of BIS in predicting mentality except in coma patients.
Adult ; Brain ; Brain Injuries ; Coma ; Consciousness ; Consciousness Monitors ; Glasgow Coma Scale ; Humans ; Intensive Care Units ; Organothiophosphorus Compounds ; Research Personnel ; Sleep Stages ; Stupor

PURPOSE: Ischemia and reperfusion (I/R) injury is a major cause of hepatic failure after liver surgery, but there is no direct method to monitor it in real-time (like an ECG in heart disease) during surgery. Recently we found the possible role of bioelectrical impedance (BEI) to monitor I/R injury in liver, but the mechanism responsible for ischemia-related BEI changes has not been clearly determined. METHODS: The authors used a LCR meter to quantify BEI changes at 0.12 KHz. Livers were subjected to 70% partial ischemia for 120 minutes, and ATP content, cation changes in extracellular fluid (ECF; determined using an in vivo intracellular microdialysis technique), hepatocyte sizes, and histological changes were then examined. RESULTS: Liver tissue BEI was found to increase gradually during the first 60 minutes of ischemia and then tended to plateau. During the same period, intracellular ATP content decreased to below 20% of the baseline level, [Na+] in ECF decreased from 150.4+/-3.8 to 97.8+/-10.6 mmol/L, and [K+] in ECF increased from 7.5+/-0.3 to 34.3+/-5.5 mmol/L during the first 60 minutes of ischemia. Hepatocyte diameter increased by approximately 20% during the first 60 minutes of ischemia. CONCLUSION: This study suggests that BEI changes during hepatic ischemia are probably caused by sodium and potassium concentration changes in the ECF due to reduced intracellular ATP content.
Adenosine Triphosphate ; Cations ; Electric Impedance ; Electrocardiography ; Extracellular Fluid ; Heart ; Hepatocytes ; Ischemia ; Liver ; Liver Failure ; Microdialysis ; Organothiophosphorus Compounds ; Potassium ; Reperfusion ; Reperfusion Injury ; Sodium

BACKGROUND: Hemodynamic optimization improves postoperative outcomes in high-risk surgery patients. The monitoring of cardiac output (CO) and dynamic parameters of fluid responsiveness can guide hemodynamic optimization. We conducted a survey to assess the current hemodynamic monitoring and management practices of Korean anesthesiologists during high-risk surgery. METHODS: E-mails containing a link to our survey, which consisted of 33 questions relating to hemodynamic monitoring during high-risk surgery, were sent to 3,943 members of the Korean Society of Anesthesiologists (KSA). The survey web page was open from December 30, 2011 to March 31, 2012. RESULTS: A total of 139 anesthesiologists responded during the survey period. Invasive arterial pressure (97.2%) and central venous pressure (93.4%) were routinely monitored. CO was monitored in 58.5% of patients; stroke volume variations were monitored in 50.9% of patients. However, CO was consistently optimized by < 20% of anesthesiologists. An arterial pressure waveform-derived CO monitor was the most frequently used device to monitor CO (79.0%). Blood pressure, urine output, central venous pressure, and clinical experience were considered to be the best indicators of volume expansion than CO or dynamic parameters of fluid responsiveness. CONCLUSIONS: The survey revealed that KSA members frequently monitor CO and dynamic parameters of fluid responsiveness during high-risk surgery. However, static indices were used more often to judge volume expansion. The current study reveals that CO is not frequently optimized despite the relatively high incidence of CO monitoring during high-risk surgery in Korea.
Aluminum Hydroxide ; Arterial Pressure ; Blood Pressure ; Carbonates ; Cardiac Output ; Central Venous Pressure ; Electronic Mail ; Hemodynamics ; Humans ; Incidence ; Korea ; Organothiophosphorus Compounds ; Stroke Volume ; Treatment Outcome

PURPOSE: To identify the frequency of bacterial isolates in early-onset neonatal sepsis (EONS) and their antimicrobial resistance pattern. METHODS: A retrospective study of EONS was conducted at the Beni Suef University Hospital from September 2008 to September 2012. A case of EONS was defined as an infant who had clinical signs of infection or who was born to a mother with risk factors for infection, and in whom blood culture obtained within 72 hours of life grew a bacterial pathogen. RESULTS: Of 673 neonates screened, there were 138 positive blood cultures (20.5%) (confirmed EONS). Of the recovered isolates, 86.2% were gram-negative pathogens. Klebsiella pneumoniae (42.8%), Enterobacter cloacae (22.5%), and Escherichia coli (13.8%) were the commonest isolated organisms. The most common gram-positive microorganism was Staphylococcus aureus accounting for only 12 isolates (8.7%). All Klebsiella isolates and 93% of Enterobacter isolates were resistant to ampicillin. Gram-negative pathogens had the maximum overall sensitivity to imipenem, cefepime, and ciprofloxacin; whereas, gram-positive isolates were most susceptible to vancomycin, imipenem, and piperacillin. CONCLUSION: K. pneumoniae was the predominant causative bacteria of EONS followed by E. cloacae and E. coli. There was a high resistance to ampicillin. Imipenem had the maximum overall activity against the causative bacteria. Continuous surveillance is needed to monitor the changing epidemiology of pathogens and antibiotic sensitivity.
Accounting ; Ampicillin ; Bacteria ; Cephalosporins ; Cloaca ; Drug Resistance ; Drug Resistance, Microbial ; Enterobacter ; Enterobacter cloacae ; Escherichia coli ; Humans ; Imipenem ; Infant ; Infant, Newborn ; Intensive Care, Neonatal ; Klebsiella ; Klebsiella pneumoniae ; Mothers ; Organothiophosphorus Compounds ; Pneumonia ; Retrospective Studies ; Risk Factors ; Sepsis ; Staphylococcus aureus ; Vancomycin

BACKGROUND: The hemoglobin A1c (HbA1c) level is widely used to monitor glycemic control in diabetes mellitus patients, and various methods are used for its determination. The CAPILLARYS 2 FLEX Piercing (Sebia) is a fully automated, high-throughput glycohemoglobin (HbA1c) analyzer based on capillary electrophoresis. METHODS: The analytical performance of the CAPILLARYS 2 FLEX Piercing analyzer was evaluated for its precision, linearity, correlation with the Variant II Turbo (Bio-Rad Laboratories, Inc.) analyzer, and its vulnerability to interference by carbamylated hemoglobin. We also investigated its agreement with National Glycohemoglobin Standardization Program (NGSP) targets. All evaluations were performed according to CLSI guidelines EP05, EP06, and EP09. RESULTS: The coefficients of variation (CVs) for within-run and total imprecision were 1.7% and 1.8% at low concentrations and 1.2% and 1.3% at high concentrations, respectively. Linearity was excellent, with R2=0.9882 in the range of 5.13-13.83%; these results highly correlated with those produced by Variant II Turbo (R2=0.9978). The 95% confidence interval (for differences from the NGSP target) was -0.3618-0.3343%. No significant interference of carbamylated hemoglobin was noted. CONCLUSIONS: The CAPILLARYS 2 FLEX Piercing analyzer showed excellent precision and linearity. Its results correlated with those obtained by the Variant II Turbo analyzer, and were agreement with the NGSP target. Therefore, its analytical performance is satisfactory for diabetes diagnosis and treatment monitoring.
Capillaries ; Diabetes Mellitus ; Electrophoresis, Capillary ; Hemoglobins ; Humans ; Organothiophosphorus Compounds