OBJECTIVETo explore the possible mechanism and protective effect of BMSCs (bone mesenchymal stem cells) carrying superoxide dismutase (SOD) gene on mice with paraquat-induced acute lung injury.

METHODSTo establish the cell line of BMSCs bringing SOD gene, lentiviral vector bringing SOD gene was built and co-cultured with BMSCs. A total of 100 BALB/c mice were randomly divided into five groups, namely Control group, poisoning group (PQ group) , BMSCs therapy group (BMSC group) , BMSCs-Cherry therapy group (BMSC-Cherry group) , BMSCs-SOD therapy group (BMSC-SOD group) . PQ poisoning model was produced by stomach lavaged once with 1 ml of 25 mg/kg PQ solution, and the equal volume of normal saline (NS) was given to Control group mice instead of PQ. The corresponding BMSCs therapy cell lines were delivered to mice through the tail vein of mice 4h after PQ treatment.Five mice of each group were sacrificed 3 d, 7 d, 14 d and 21 days after corresponding BMSCs therapy cell lines administration, and lung tissues of mice were taken to make sections for histological analysis. The serum levels of glutathione (GSH) , malondialdehyde (MDA) , SOD, and the levels of transforming growth factor-β (TGF-β) and tumor necrosis factor-α (TNF-α) in lung tissue were determined. The level of SOD was assayed by Westen-blot.

RESULTSCompared with Control group, the early (3 days) levels of SOD protein in lung tissue of PQ group obviously decreased, and the late (21 days) levels of SOD obviously increased, while in therapy groups, that was higher than that in PQ group, and the BMSCs-SOD group showed most obvious (all P<0.05) . Compared with Control group, the levels of plasma GSH and SOD of PQ group and each therapy group wae significantly lower than those in Control group, while in therapy groups, those were higher than those of PQ group, and the BMSCs-SOD group showed most obvious (all P<0.05) .Compared with Control group, the level of plasma MDA, TNF-α and TGF-β in PQ group and therapy groups were significantly higher, while in therapy groups, that was lower than that in PQ group, and the BMSCs-SOD group showed most obvious (all P<0.05) . Lung biopsy showed that, the degree of lung tissue damage in each therapy group obviously reduced.

CONCLUSIONSOD is the key factor of the removal of reactive oxygen species (ROS) in cells, that can obviously inhibit the oxidative stress damage and the apoptosis induced by PQ, thus significantly increasing alveolar epithelial cell ability to fight outside harmful environment.

Acute Lung Injury ; chemically induced ; therapy ; Animals ; Antioxidants ; metabolism ; Cell Line ; Glutathione ; blood ; Lung ; pathology ; Malondialdehyde ; blood ; Mesenchymal Stem Cell Transplantation ; Mice ; Mice, Inbred BALB C ; Oxidative Stress ; Paraquat ; poisoning ; Superoxide Dismutase ; blood ; genetics ; Transforming Growth Factor beta ; metabolism ; Tumor Necrosis Factor-alpha ; metabolism

A 20-year-old male patient was admitted in our department 14 h after paraquat poisoning at the dose of about 50 mL. The patient underwent intensive hemoperfusion for 2 h (3 times a day) for 9 consecutive days and received continuous renal replacement therapy (CRRT) in the mode of continuous veno-venous hemofiltration (CVVH) for 10 consecutive days in addition to routine medications. The biochemical indexes were monitored during the therapy. After the treatment, paraquat concentrations in the blood and urine were decreased, and the patient's urine volume (UV) increased, serum creatinine (Cr) level decreased, and the oxygenation index became normal. Dynamic CT scan showed no obvious pulmonary fibrosis. The patient was followed up for 6 months after discharge and no complaint of discomforts was reported. This case suggests that early intensive hemoperfusion and long-term CVVH may help improve the prognosis after paraquat poisoning.
Blood Gas Analysis ; Blood Pressure ; Body Fluids ; Hemofiltration ; Hemoperfusion ; Humans ; Male ; Paraquat ; poisoning ; Poisoning ; therapy ; Prognosis ; Renal Dialysis ; Young Adult

Amylases ; blood ; Herbicides ; poisoning ; Humans ; Lipase ; blood ; Paraquat ; poisoning ; Poisoning ; blood

OBJECTIVETo investigate the changes in serum amylase (AMY) and lipase (LPS) and their clinical significance in patients with acute paraquat poisoning (APP).

METHODSThe clinical data of 62 APP. patients who were admitted to Guangzhou 12th People's Hospital in 2014 were retrospectively analyzed. With clinical death being regarded as the end point of observation, the 62 patients were divided into survival group (n=32) and death group (n=30). The fasting venous blood of the patients on the 1st, 3rd, and 7th day after admission were collected, and the AMY and LPS levels were determined; the obtained data were compared between the two groups and analyzed statistically.

RESULTSThe AMY and LPS levels of the survival group on the 1st, 3rd, and 7th day after admission were significantly lower than those of the death group (P<0.05); the AMY and LPS levels of the death group on the 3rd day were significantly higher than those on the 1st day after admission (P<0.05); the survival group demonstrated no significant changes in AMY and LPS levels (P>0.05).

CONCLUSIONChanges in AMY and LPS levels in APP patients are reliable indicators for the determination of poisoning severity and prognosis.

Amylases ; blood ; Humans ; Lipase ; blood ; Paraquat ; poisoning ; Poisoning ; blood ; mortality ; Prognosis ; Retrospective Studies

OBJECTIVETo explore the dynamic variation rule of kidney injury makers of molecule 1 (KIM-1), Cystatinc (Cys-C), Blood urea nitrogen (BUN) and Creatinine (Cr) in kidney injury in rats with acute paraquat poisoning.

METHODSHealthy adult rats were randomly divided into control group (normal saline solution) and exposure group (2% paraquat solution 40 mg/kg), and 90 in each group. Six rats in each group were randomly sacrificed at one, one point five, two, three, six, twelve, twenty four, seventy two or one hundred and sixty eight hours after different administration, abdominal aortic blood and the kidney tissue were collected. The concenstrations of kidney injury makers of molecule 1 (KIM-1), cystatinc (Cys-C), blood urea nitrogen (BUN) and creatinine (Cr) were determined by ELASA. The concenstrations of paraquat were determined by HPLC. Pathological changes of kidney tissue that stained by HE were axamined by optical microscopy. The cell apoptosis in kidney tissue were analyzed by TUNEL assay. The ptotein expression of KIM-1 was determined by immunohistochemistry.

RESULTSSerum levels of KIM-1 were significantly increased in exposure group as compared with control group at two, three, six, twelve, twenty four, seventy two or one hundred and sixty eight hours, and the peak level was at twenty four hours, and there was a statistical significance between control group and exposure group (P < 0.01). Serum levels of Cys-C were significantly increased in exposure group as compared with control group at six, twelve, twenty four, seventy two or one hundred and sixty eight hours, the peak level was at twenty four hours, and there was a statistical significance between control group and exposure group (P < 0.01). Serum levels of BUN were significantly increased in exposure group as compared with control group at twelve, twenty four, seventy two or one hundred and sixty eight hours, and the peak level was at seventy two hours, and there was a statistical significance between control group and exposure group (P < 0.01). Compared with control group, there was mild tubular epithelial cells edema in exposure group of three hours, serious epithelial cells edema and few slightly increased glomeruli in exposure group of six hours, severe epithelial cells swelling, tube formation, and interstitial lesions including edema, congestionin and increased inflammatory cell infiltration in exposure group of twelve hours, these pathologic changes gradually reached the peak at twenty four hours, the pathologic injury score was 5.56 ± 0.0349 (P < 0.01), and then the pathological lesion was more palliative. Apoptosis rate of kidney tissue were significantly increased in exposure group as compared with control group at three, six, twelve, twenty four, seventy two or one hundred and sixty eight hours, and the peak level was at twenty four hours, and there was a statistical significance between control group and exposure group (P < 0.01). The immunohistochemical assay indicated that KIM-1 of control group were weakly positive expressed in tubular epithelial cell membrane, but the positive expression of KIM-1 were slightly increased in exposure group of two hours, the.immunohistochemistry score was 5.47 ± 0.1033 (P < 0.05), the positive expression of KIM-1 were gradually increased in exposure group of three, six and twelve hours, it reached peak at twenty four hours, the.immunohistochemistry score was 11.73 ± 0.4676 (P < 0.01), then the positive expression of KIM-1 decreased, but there was still positive expression at one hundred and sixty eight hours.

CONCLUSIONSerum levels of KIM-1 and Cys-C were significantly increased in the kidney injury in rats with acute paraquat poisoning in early stage, earlier than the changes of BUN and Cr. KIM-1 had relation with apoptosis rate. Cys-C had relation with pathological lesion changes.

Animals ; Blood Urea Nitrogen ; Creatinine ; blood ; Cystatin C ; blood ; Immunohistochemistry ; Kidney ; drug effects ; pathology ; Membrane Glycoproteins ; blood ; Paraquat ; poisoning ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo investigate the prognostic values of initial serum paraquat (PQ) concentration and time lag after PQ ingestion in patients with PQ poisoning.

METHODSA retrospective analysis was performed on 189 patients who ingested PQ between 2.5 and 48 h before admission. The values of initial serum PQ concentration and time lag after PQ ingestion for the prognosis after poisoning were analyzed by the receiver operating characteristic (ROC) curve and multiple logistic regression analysis.

RESULTSThe serum PQ concentration of non-survivors was significantly higher than that of survivors (P<0.01) , and the time lag after PQ ingestion of non-survivors was significantly longer than that of survivors (P<0.01). The ROC curve analysis showed that the area under the ROC curve (AUC) showed no significant difference between initial serum PQ concentration and serum PQ concentration-time data when the time lag after PQ ingestion was between 2.5 and 48 h (z=0.563, P=0.574) ; the AUC showed a significant difference between initial serum PQ concentration and serum PQ concentration-time data when the time lag after PQ ingestion was between 2.5 and 6 h (z=2.199, P=0.034) and between 6 and 48 h (z=2.525, P=0.012).

CONCLUSIONInitial serum PQ concentration has a better predictive power than serum PQ concentration-time data in evaluating the prognosis of patients when the time lag after PQ ingestion is within 6 h. However, serum PQ concentration-time data has a better predictive power than PQ concentration alone in evaluating the prognosis of patients when the time lag after PQ ingestion is between 6 and 48 h.

Area Under Curve ; Humans ; Paraquat ; blood ; Poisoning ; blood ; diagnosis ; Prognosis ; ROC Curve ; Retrospective Studies ; Survivors ; Time Factors

OBJECTIVETo investigate the clinical significance of dynamic changes in the serum inflammatory cell factors consisting of β-endorphin (β-EP) , endothelins (ET) , tumor necrosis factor (TNF) , and nitric oxide (NO) after acute paraquat poisoning (APP).

METHODSThe 26 patients with APP (as observation group) were treated and the serum levels of plasma β-EP, ET, TNF, and NO were measured simultaneously. The 20 healthy volunteers from relatives of the patients (as control group) were also included in the study and their serum levels of β-EP, ET, TNF, and NO were measured.

RESULTSIn the 26 patients with APP, 10 were cured and 16 died. The serum levels of β-EP, ET, NO, and TNF in the 10 cured patients increased significantly immediately after admission, reached the peak values on day 2, and then decreased gradually and returned to the normal ranges after day 9. The serum levels of β-EP, ET, NO, and TNF in the 16 dead patients increased significantly on admission and kept rising in the course of treatment. The dead patients had significantly increased serum levels of β-EP, ET, NO, and TNF compared with the cured patients (all P<0.01).

CONCLUSIONCompared with those in cured patients with APP, the serum levels of β-EP, ET, NO, and TNF in dead patients with APP are significantly higher, keep rising, and maintain at high levels, indicating a severe condition.

Case-Control Studies ; Endothelins ; blood ; Humans ; Nitric Oxide ; blood ; Paraquat ; poisoning ; Tumor Necrosis Factor-alpha ; blood ; beta-Endorphin ; blood

OBJECTIVETo observe the prevention effects of patients with lung exudation and pulmonary fibrosis induced by paraquat poisoning in sodium bicarbonate (SB) with gastric lavage, atomization inhalation and intravenous injection.

METHODSTo collect 38 patients with paraquat poisoning in hospital, after poison immediately with gastric lavage of 1.5% SB, and atomization inhalation of 5% SB 10~15 ml twice daily and intravenous injection of 5% SB twice a day, continuous application of 5~7 days. and the HRCT score and liver and kidney function was performed on patients with lung after treatment. And the extraction of 38 SB patients with previously untreated with SB for comparison.

RESULTSLung HRCT average score in 72 h, 7 d, 30 d on patients with paraquat poisoning untreated with SB reached 2.87, 3.12, 2.13, HRCT display shows that the appearance of the wear glass shadow, grid shadow, honeycomb shadow, and other signs of fibrosis. Average HRCT reached 1.95, 2.20, 1.67 on patients treated with SB,signs of lung exudation and fibrosis was significantly reduced,compare two groups,there was statistically significance (P<0.01). And compared to the control group, activity of serum alanine aminotransferase (ALT) and aspartic acid transaminase (AST) decreased significantly in group of paraquat poisoning with triple application of SB, the level of serum urea nitrogen (BUN) and creatinine (Cr) significantly decreased, the difference is statistically significant (P<0.01).

CONCLUSIONThe triple application of SB can reduced the pulmonary fibrosis and effusion induced by paraquat poisoning,and protective effect on the function of liver and kidney is obvious, suggesting that the method for treatment of paraquat poisoning, prevention of paraquat lung and improve survival rate has the exact effect.

Blood Urea Nitrogen ; Creatinine ; blood ; Gastric Lavage ; Humans ; Injections, Intravenous ; Lung ; pathology ; Paraquat ; poisoning ; Pulmonary Fibrosis ; chemically induced ; therapy ; Sodium Bicarbonate ; therapeutic use ; Survival Rate

OBJECTIVETo explore the mechanism of paraquat (PQ) poisoning and to observe the changes in inflammatory cytokines in PQ-exposed rats treated in different ways.

METHODSFifty 8-week-old clean male Wistar rats were randomly divided into high-dose curcumin plus conventional treatment group, low-dose curcumin plus conventional treatment group, high-dose curcumin group, PQ poisoning group, and blank control group. On days 1, 3, 5, 7, 14, and 21 after PQ exposure, serum levels of transforming growth factor-β₁(TGF-β₁) , tumor necrosis factor-α (TNF-α) , and interleukin-6 (IL-6) were measured. The pathological changes in lung tissue were evaluated by HE staining.

RESULTSCompared with the blank control group, the high-dose curcumin plus conventional treatment group, low-dose curcumin plus conventional treatment group, high-dose curcumin group, and PQ poisoning group had significantly increased serum levels of TGF-β₁, TNF-α, and IL-6 (P<0.05) , and the three cytokines in each group reached peak levels on day 14 after exposure. Compared with the PQ poisoning group, the high-dose curcumin group had significantly reduced serum levels of TGF-β₁, TNF-α, and IL-6 (P<0.05). On day 21 after exposure, there were no significant differences in serum levels of TGF-β₁, TNF-α, and IL-6 between the high-dose curcumin plus conventional treatment group and the low-dose curcumin plus conventional treatment group (P>0.05). The HE staining revealed alveolar inflammatory changes on days 1~7 and massive pulmonary fibrosis on days 14~21 in the high-dose curcumin plus conventional treatment group, low-dose curcumin plus conventional treatment group, high-dose curcumin group, and PQ poisoning group, but the above changes were milder in the high-dose curcumin group than in the PQ poisoning group.

CONCLUSIONFor rats with PQ poisoning, curcumin can significantly reduce inflammatory response and pathological changes in lung tissue and inhibit and delay the development and progression of body injury.

Animals ; Curcumin ; pharmacology ; Cytokines ; blood ; Interleukin-6 ; blood ; Lung ; pathology ; Male ; Paraquat ; poisoning ; Pulmonary Fibrosis ; pathology ; Rats ; Rats, Sprague-Dawley ; Rats, Wistar ; Transforming Growth Factor beta1 ; blood ; Tumor Necrosis Factor-alpha ; blood

OBJECTIVETo explore the clinical efficacy of early application of sequential gastrointestinal lavage in patients with acute paraquat poisoning by analyzing the clinical data of 97 patients.

METHODSA total of 97 eligible patients with acute paraquat poisoning were divided into conventional treatment group (n = 48) and sequential treatment group (n = 49). The conventional treatment group received routine gastric lavage with water. Then 30 g of montmorillonite powder, 30 g of activated charcoal, and mannitol were given to remove intestinal toxins once a day for five days. The sequential treatment group received 60 g of montmorillonite powder for oral administration, followed by small-volume low-pressure manual gastric lavage with 2.5%bicarbonate liquid. Then 30 g of activated charcoal, 30 g of montmorillonite powder, and polyethylene glycol electrolyte lavage solution were given one after another for gastrointestinal lavage once a day for five days. Both groups received large doses of corticosteroids, blood perfusion, and anti-oxidation treatment. The levels of serum potassium, serum amylase (AMY) alanine aminotransferase (ALT), total bilirubin (TBIL), blood urea nitrogen (BUN), creatinine (Cr), lactate (Lac), and PaO₂of patients were determined at 1, 3, 5, 7, and 10 days. Laxative time, mortality, and survival time of dead cases were evaluated in the two groups.

RESULTSThe incidence rates of hypokalemia (<3.5 mmol/L) and AMY (>110 U/L) were significantly lower in the sequential treatment group than in the conventional treatment group (P < 0.05). There were no significant differences in the incidence of ALT (>80 U/L), TBIL (>34.2 µmol/L), BUN (>7.2 mmol/L), and Cr (>177 µmol/L) between the two groups (P>0.05). However, the highest levels of ALT, TBIL, BUN, Cr, and Lac were significantly lower in the sequential treatment group than in the conventional treatment group (P < 0.05). Moreover, the sequential treatment group had significantly lower incidence of PaO₂(<60 mmHg), shorter average laxative time, lower mortality, and longer survival time of dead cases than the conventional treatment group (P < 0.05).

CONCLUSIONThe early application of sequential gastrointestinal lavage can shorten laxative time, alleviate organ damage in the liver, kidney, lung, and pancreas, reduce mortality, and prolong the survival time of dead cases in patients with acute paraquat poisoning.

Acute Disease ; Bentonite ; administration & dosage ; Bilirubin ; Blood Urea Nitrogen ; Charcoal ; Combined Modality Therapy ; Creatinine ; Gastric Lavage ; methods ; Humans ; Liver ; Paraquat ; poisoning ; Poisoning ; therapy ; Treatment Outcome