Chlorfenapyr is a novel pyrrole insecticide widely used in agricultural production. Due to its broad insecticidal activity, low resistance, rapid action, and long-lasting effects, its use has been increasing. In the past three years, there have been incidents of imidacloprid poisoning in China. We reviewed and analyzed the clinical characteristics of patients treated for chlorfenapyr poisoning at the People's Hospital of Chuxiong Yi Autonomous Prefecture from November 2019 to November 2023. The 23 patients included 15 males and 8 females, with ages ranging from 11 to 71 years. Twenty-two cases were due to gastrointestinal exposure, and one case was due to skin or respiratory tract exposure. Clinical symptoms included nausea, vomiting, fever, profuse sweating, and altered consciousness. Laboratory tests showed elevated levels of aspartate aminotransferase and creatine kinase. There was no specific antidote available, and 10 patients died after treatment, resulting in a mortality rate of 43.5%. Among the deceased, a higher proportion experienced fever, profuse sweating, altered consciousness, and generalized muscle stiffness.

Radiotherapy is an important part of the standard treatment regimen for rectal cancer, bringing survival benefits and improved quality of life to patients with rectal cancer. However, the radiotherapy resistance of rectal cancer patients greatly limits the effectiveness of treatment and affects the prognosis of patients. The emergence of nanoparticles provides a new way to improve radiotherapy resistance of rectal cancer, which can overcome radiotherapy resistance by inhibiting DNA damage repair, affecting cell cycle, targeting delivery, enhancing DNA damage, and regulating tumor microenvironment, etc. In this article, complex coordination mechanism leading to radiotherapy resistance in rectal cancer was reviewed, current relevant studies on nanoparticles in improving radiotherapy response in rectal cancer were summarized, and the feasibility and future research direction of the combination of nanoparticles and radiotherapy in clinical treatment of rectal cancer were discussed.

Radiotherapy is an important part of the standard treatment regimen for rectal cancer, bringing survival benefits and improved quality of life to patients with rectal cancer. However, the radiotherapy resistance of rectal cancer patients greatly limits the effectiveness of treatment and affects the prognosis of patients. The emergence of nanoparticles provides a new way to improve radiotherapy resistance of rectal cancer, which can overcome radiotherapy resistance by inhibiting DNA damage repair, affecting cell cycle, targeting delivery, enhancing DNA damage, and regulating tumor microenvironment, etc. In this article, complex coordination mechanism leading to radiotherapy resistance in rectal cancer was reviewed, current relevant studies on nanoparticles in improving radiotherapy response in rectal cancer were summarized, and the feasibility and future research direction of the combination of nanoparticles and radiotherapy in clinical treatment of rectal cancer were discussed.

Chlorfenapyr is a novel pyrrole insecticide widely used in agricultural production. Due to its broad insecticidal activity, low resistance, rapid action, and long-lasting effects, its use has been increasing. In the past three years, there have been incidents of imidacloprid poisoning in China. We reviewed and analyzed the clinical characteristics of patients treated for chlorfenapyr poisoning at the People's Hospital of Chuxiong Yi Autonomous Prefecture from November 2019 to November 2023. The 23 patients included 15 males and 8 females, with ages ranging from 11 to 71 years. Twenty-two cases were due to gastrointestinal exposure, and one case was due to skin or respiratory tract exposure. Clinical symptoms included nausea, vomiting, fever, profuse sweating, and altered consciousness. Laboratory tests showed elevated levels of aspartate aminotransferase and creatine kinase. There was no specific antidote available, and 10 patients died after treatment, resulting in a mortality rate of 43.5%. Among the deceased, a higher proportion experienced fever, profuse sweating, altered consciousness, and generalized muscle stiffness.

Surgical position is very important in upper urinary calculi surgery.The correct surgical position can provide a good surgical field of view,shorten the operation time,reduce the incidence of complications,and ensure the safety of patients'airway and comfort.Endoscopic surgery is the preferred treatment for kidney and ureteral stones.As the traditional position causes higher recurrence rate and more complications,more positions have been experimented.This article reviews the application and therapeutic effects of different surgical positions in percutaneous nephrolithotomy(PCNL),retrograde intrarenal flexible ureteroscopic lithotripsy(RIRS)as well as their combined use,and summarizes the advantages and disadvantages for clinical reference.

Objective:To evaluate the effect of artesunate on intestinal ischemia/reperfusion (I/R)-induced lung injury in mice and relationship with heme oxygenase-1 (HO-1).Methods:Twenty-four healthy SPF male C57BL/6 mice, aged 8-9 weeks, weighing 18-22 g, were divided into 4 groups ( n=6 each) using a random number table method: sham operation group (group Sham), intestinal I/R group (group I/R), artesunate group (group A), and artesunate plus HO-1 inhibitor Zinc protoporphyrin Ⅸ(ZnPP) group (group AS). The model of intestinal I/R injury was established by occluding the superior mesenteric artery for 45 min followed by 2 h reperfusion in anesthetized animals.Artesunate 40 mg/kg was injected via the tail vein at 1 h before ischemia in group A. ZnPP 7.5 mg/kg was injected via the tail vein at 12 h before ischemia, and artesunate 40 mg/kg was injected via the tail vein at 1 h before ischemia in group AS.The animals were sacrificed at the end of reperfusion, and the lung tissues were obtained for microscopic examination of the pathologic changes and for determination of the wet/dry lung weight (W/D) ratio, myeloperoxidase (MPO) activity, malondialdehyde (MDA) content, expression of interleukin-6 (IL-6) mRNA (by fluorescence quantitative polymerase chain reaction) and apoptotic index (AI) (by TUNEL). The lung injury score was assessed. Results:Compared with group Sham, the lung injury score, W/D ratio, MPO activity, MDA content and AI were significantly increased, and the expression of IL-6 mRNA was up-regulated in group I/R ( P<0.05). Compared with group I/R, the lung injury score, W/D ratio, MPO activity, MDA content and AI were significantly decreased, and the expression of IL-6 mRNA was down-regulated in group A ( P<0.05). Compared with group A, the lung injury score, W/D ratio, MPO activity, MDA content and AI were significantly increased, and the expression of IL-6 mRNA was up-regulated in group AS ( P<0.05). Conclusions:Artesunate can alleviate intestinal I/R-induced lung injury, and the mechanism may be related to activation of HO-1 in mice.

Objective:To evaluate the role of cannabinoid type 2 receptor (CB2R) in sevoflurane postconditioning-induced reduction of intestinal ischemia-reperfusion (I/R) injury in rats.Methods:Twenty-four clean-grade healthy male Sprague-Dawley rats, aged 8-10 weeks, weighing 220-270 g, were divided into 4 groups ( n=6 each) using a random number table method: sham operation group (group Sham), intestinal I/R group (group I/R), intestinal I/R+ sevoflurane postconditioning group (group Sevo) and intestinal I/R+ sevoflurane postconditioning+ CB2R antagonist AM630 group (group AM). The model of intestinal I/R injury was established by occluding the superior mesenteric artery for 45 min followed by 2 h reperfusion.In the group Sevo, 2% sevoflurane was inhaled immediately at the beginning of reperfusion for 30 min.In the group AM, CB2R antagonist AM630 3 mg/kg was intraperitoneally injected at 1 h before ischemia, and the other treatments were similar to those previously described in group Sevo.At 2 h of reperfusion, the animals were sacrificed after anesthesia, and small intestinal tissues were obtained for microscopic examination of the pathologic changes which was scored according to Chiu and for determination of wet/dry weight ratio (W/D ratio), for detection of malondialdehyde (MDA) content (by thiobarbituric acid colorimetry), for determination of myeloperoxidase (MPO) activity (by MPO assay) and cleaved caspase-3 protein expression (by Western blot). Results:Compared with group Sham, the Chui score, W/D ratio, MDA content and MPO activity in the intestinal tissues were significantly increased, cleaved caspase-3 expression was up-regulated in group I/R ( P<0.05). Compared with group I/R, the Chui score, W/D ratio, MDA content and MPO activity in the intestinal tissues were significantly decreased, cleaved caspase-3 expression was down-regulated in group Sevo ( P<0.05). Compared with group Sevo, the Chui score, W/D ratio, MDA content and MPO activity were significantly increased, cleaved caspase-3 expression was up-regulated in group AM ( P<0.05). Conclusion:CB2R is involved in the process of sevoflurane postconditioning-induced reduction of intestinal I/R injury in rats.

Squamous cell carcinoma (SCC) of the renal pelvis is extremely rare and hardly to be diagnosed due to its lack of specificity in clinical manifestations and traditional imaging features. We reported a case with history of multiple operations for double kidney stones, who was admitted to our hospital twice due to "right kidney ureteral stones, left kidney complex stones, chronic renal insufficiency and urinary tract infection" . During this period, a total of 6 surgeries were performed. In the first 19-day hospitalization, right transurethral ureteroscopic lithotripsy and right percutaneous nephroscope lithotripsy(PCNL)were performed respectively. And 20 days later, the patient was admitted to hospital again for management of left complex kidney stones, and the left side PCNL was performed for 4 times within 27 days. During the two hospitalizations, no tumor was reported during the three times of contrast-enhanced CT examination of the urinary system. The patient continued to have fever after the 4th time of left PCNL, with failure of anti-infection treatment. Then, the of the left renal pelvis was considered clinically, and left nephrectomy was suggested after communication with the patient and his family members. Postoperative pathology confirmed renal pelvis SCC. After surgery, the patient’s temperature was back to normal and then discharged. The patient died 3 months after discharging due to the systemic metastasis.

Objective: To observe the clinical efficacy of the Mulligan technique in treating cervical vertigo (CV) in a hyperbaric oxygen (HPO) environment. Methods: Sixty-eight CV patients were randomly divided into a control group and an observation group, each of 34. Both groups were given routine treatment with ultrashortwave irradiation, but the observation group was additionally provided with 15 minutes of treatment based on the Mulligan technique in an environment with oxygen at 0.2 MPa, five days a week for two weeks. Both groups were assessed using the cervical vertigo symptoms and functional assessment scale (ESCV) and the daily frequency of vertigo was recorded before the treatment and 2, 4, 7, 14 and 60 days after treatment began. Moreover, the mean blood flow velocity in the patients′ vertebral (VA) and basilar arteries (BA) was detected using transcranial Doppler sonography before the treatment and after two weeks and two months. Results: There were no significant differences between the two groups in any of the measurements before the intervention. Afterward, however, significant improvement in all of the measurements was observed compared with before the treatment. After two weeks and two months the average ESCV score, daily occurrence of CV and mean VA and BA blood flows in the observation group were all significantly superior to those of the control group at the same time points. Conclusion Treatment based on the Mulligan technique in an environment with 0.2 MPa partial pressure of oxygen is a more effective way to relieve the symptoms of cervical vertigo and reduce the frequency of its occurrence. Such treatment is worthy of application in the clinic.

Objective To evaluate the role of phosphatidylinositol 3-kinase ( PI3K)∕protein kinase B ( Akt) signaling pathway in propofol-induced reduction of intestinal ischemia-reperfusion ( I∕R) injury in rats. Methods Thirty-two healthy male Sprague-Dawley rats, aged 2-3 months, weighing 225-275 g, were divided into 4 groups ( n=8 each) using a random number table method: sham operation group ( Sham group), intestinal I∕R group ( I∕R group), propofol group ( P group), and PI3K inhibitor wortmannin plus propofol group ( W+P group) . Intestinal ischemia was induced by occluding the superior mesenteric ar-tery for 45 min followed by 2 h of reperfusion to establish the model of intestinal I∕R injury. Propofol was in-travenously infused at a rate of 20 mg·kg-1 ·h-1 starting from the onset of reperfusion until the end of reper-fusion in group P. Wortmannin 15 μg∕kg was intravenously injected at 25 min before reperfusion, and propofol was intravenously infused at a rate of 20 mg·kg-1 ·h-1 starting from the onset of reperfusion until the end of reperfusion in group W+P. Rats were sacrificed at 2 h of reperfusion, and small intestinal tissues were obtained for microscopic examination of pathologic changes of intestinal mucosa and for determination of wet∕dry weight ratio (W∕D ratio), malondialdehyde (MDA) content (by thiobarbituric acid colorimetric method) , superoxide dismutase ( SOD ) activity ( using xanthine oxidase method ) , myeloperoxidase ( MPO) activity ( by MPO assay) , and phosphorylated Akt ( p-Akt) expression ( by Western blot) . Intes-tinal damage was assessed and scored according to Chiu. Results Compared with group Sham, Chiu' s score, W∕D ratio, MDA content and MPO activity were significantly increased, the SOD activity was de-creased, and p-Akt expression was down-regulated in group I∕R (P<0. 05). Compared with group I∕R, Chiu's score, W∕D ratio, MDA content and MPO activity were significantly decreased, the SOD activity was increased, and p-Akt expression was up-regulated in group P (P<0. 05). Compared with group P, Chiu's score, W∕D ratio, MDA content and MPO activity were significantly increased, the SOD activity was decreased, and p-Akt expression was down-regulated in group W+P (P<0. 05). Conclusion The mechanism by which propofol reduces intestrnal I∕R injury is related to activating PI3K∕Akt signaling path-way and inhibiting inflammatory and oxidative stress responses in rats.