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.

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.

Objective:To explore the long-term therapeutic efficacy and outcomes of liver transplantation for patients with hepatic myelopathy (HM).Methods:Retrospective analysis of 24 adult liver transplantation recipients due to HM at First Central Municipal Hospital from January 2006 to October 2022. HM was extensively classified by the severity of lower extremity symptoms, degree of muscle stiffness, capability for independent ambulation and muscle strength. Furthermore, their long-term outcomes were examined. From January 2000 to October 2022, the databases of China National Knowledge Infrastructure (CNKI) , Google Scholar, PubMed and Web of Science were searched with such keywords as "肝性脊髓病and肝移植" "Hepatic Myelopathy and Liver Transplantation" .Results:After liver transplantation, liver functions and blood ammonia normalized and most clinical symptoms improved. During a follow-up period of (12-190) months, 19 patients showed a lowered grade of HC as compared to pre-transplantation. Four cases achieved a complete recovery of extremity function. No change occurred in severity grade for the remaining 5 patients. However, 4 of them experienced varying degrees of improvement in muscle strength and independent walking capability. This review summarized the clinical characteristics and clinical outcomes of 17 patients from both domestic and international sources. Most of them experiences varying degrees of symptomatic improvements after liver transplantation (16 cases).Conclusions:This study has confirmed the effectiveness of liver transplantation for HM and its contribution to the long-term patient recovery.

Objective To determine the effectiveness of quality control measures in the laboratory by participating in the national personal dose monitoring ability assessment, and to improve personal dose monitoring ability and quality. Methods According to the requirements of the National Personal Dose Monitoring Ability Assessment Program and standards, seven groups of personal dosimeter were prepared and irradiated by accurate radiation source as requested, and the dose was measured by the laboratory participating in the assessment. The data were processed, and the uncertainty of the measurement results was evaluated. Results In 2018, the assessment results H_p (10) dose range was 0.68-4.27 mSv, the single group performance deviation was −0.01 to −0.06, and the comprehensive performance deviation was 0.04, and the result was qualified. In 2019, the assessment results H_p (10) dose range was 0.74-8.06 mSv, the single group performance deviation was 0.00 to −0.08, and the comprehensive performance deviation was 0.04, and the result was qualified. In 2020, the assessment results H_p(10) dose range was 0.83-3.93 mSv, the single group performance deviation was −0.01 to −0.10, and the comprehensive performance deviation was 0.06, and the result was excellent. Conclusion The personal dose monitoring system in our laboratory runs smoothly, and the monitoring results are accurate and reliable. The laboratory can issue test reports that meet the requirements of national standards.

Objective To explore the effects of the new melatonin nonselective agonists Neu-P11 on intraocular pressure (IOP) and glial fibrillary acid protein (GFAP) expression in the retina of acute high IOP rat.Methods Twenty-four male Sprague-Dawley rats were randomly divided into 4 groups (6 cases in each group):Normal IOP with local treatment (NIL) group,high IOP with local treatment (HIL) group,HILwith melatonin treatment (HIL-M) group,HIL with Neu-P11 treatment (HIL-N) group.10 μL normal saline was instilled in NIL group and HIL group,while 10 μL 100 μmol · L-1 Mel/Neu-P11 treated in HIL-M group and HIL-N group.After 2 hours of rest,rats were placed in the Trendelenburg position duration 45 minutes.And then,IOP was measured every hour for 6 hours,and repeated it for a week.The excessive sodium pentobarbital was injected to SD rats at the end of the experiment.The rat eyeballs were took out to perform HE and immunohistochemical staining to detect retina GFAP protein expression.Results After a week,IOP in HIL group was (41.26 ± 1.73) mmHg (1 kPa =7.5 mmHg),NIL group was (13.61 ± 0.55) mmHg,which mean the Trendelenburg could induce high IOP in SD rats.Compared with the NIL group,the retinal becoming thick,the level of organization was not clear and the expression of GFAP protein was quite high in HIL group.At the same time,the GFAP protein expression and IOP were significantly weakened in HIL-M group and HIL-N group compared with HIL group.Conclusion Neu-P1 1 can reduce IOP,inhibit the activation of gliocyte,and decrease the expression of GFAP to protect the retina.

Objective To investigate the relationship between serum phosphorus variability and mortality in maintenance hemodialysis (MHD) patients. Methods A total of 502 MHD cases from Renji hospital hemodialysis center were registered in Shanghai Registry Network from January 2007 to April 2015. They were recruited with general information, laboratory results and outcomes. According to their median of coefficient of variation (CV) of blood phosphorus, the patients were divided into high variation group (CV≥0.226 mmol/L) and low variation group (CV<0.226 mmol/L). The relationship of serum phosphorus CV with all?cause mortality and cardiovascular disease mortality was assessed respectively. Results The average age was (63.9±14.6) years, the median dialysis age was 82.0 (43.0, 139.0) months, 118 patients (23.5%) died for all cause and 64 patients (12.7%) died for cardiovascular disease. Compared with patients in low phosphorus variation group, patients had a higher all?cause mortality in high phosphorus variation group (27.7% vs 19.3%, P=0.028). Higher cardiovascular disease mortality was observed in high variation group as well, but this difference was no statistical significant (15.4% vs 10.0%, P=0.082). COX regression analysis showed that >60 years of age (HR=2.762, 95%CI 1.707?4.468, P<0.001), low hemoglobin (HR=0.466, 95%CI 0.317?0.686, P<0.001), low albumin (HR=0.555, 95%CI 0.366?0.840, P=0.005), high CV of phosphorus (HR=1.479, 95%CI 1.023 ? 2.139, P=0.037) were independent risk factors for all ? cause mortality. Moreover, >60 years of age (HR=2.666, 95%CI 1.469?4.837, P=0.001), low hemoglobin (HR=0.480, 95%CI 0.238?0.801, P=0.005), and high CV of phosphorus (HR=1.655, 95%CI 1.003?2.729, P=0.049) were independent risk factors for cardiovascular disease mortality. There was no significant statistical difference between patients phosphorus on target and patients phosphorus below target in all?cause disease mortality (P=0.065) and cardiovascular disease mortality (P=0.425). High variation group whose phosphorus on target had higher all?cause mortality and cardiovascular disease mortality than those in low variation group (29.2% vs 16.9%, P=0.047; 15.0% vs 6.0%, P=0.033). Kaplan?Meier method showed that patients with high phosphorus variation had higher all?cause (P=0.023) and cardiovascular disease mortality (P=0.047) than patients with low phosphorus variation. Conclusions The high CV of phosphorus is independently correlated with all?cause and cardiovascular disease mortality. Patients with standard ? reaching phosphorus in the low variation group have a lower mortality. A serum phosphorus level sustainably reaching the standard may improve the survival in MHD patients.

Objective To analyze the clinical manifestations and electroencephalogram (EEG)characteristics of agyria-pachygyria for its early diagnosis,treatment and prognosis judgment in clinical practice.Methods The clinical manifestations and EEG features of twenty-four patients with agyria-pachygyria who were diagnosed by CT or magnetic resonance imaging(MRI) at Pediatric Neurology of Children's Hospital of Chongqing Medical University from July 2004 to July 2013 were retrospectively analyzed.Results Of twenty-four patients,eighteen cases were diagnosed as diffuse agyria-pachygyria and six cases were diagnosed as partial agyria-pachygyria.The clinical features were mainly manifested as mental retardation (twenty-four patients),and motor retardation (twenty-four patients),and epilepsy (eighteen patients).All of the twenty-four patients had abnormal EEG pattern which were mainly three tapes.Type Ⅰ had diffused high amplitude alpha and beta activity in all cortical regions,frontal-central,or parietal-occipital region (fourteen patients).Type Ⅱ showed alternating high amplitude bursts with sharp and slow waves (seven patients).Type Ⅲ was characterized by high amplitude spike or sharp wave activity generalized or multifocal distribution and δ,θ wave mixing graphics (twelve patients).Nine of twenty-four patients showed two or three EEG characteristic patterns in an awake-asleep EEG recording.During the follow-up of 1-8 years old,twelve of the thirteen patients who were diagnosed as epilepsy in diffuse agyria-pachygyria had refractory epilepsy,mainly with infantile spasms or Lennox-Gastaut syndrome.One of the five patients who was diagnosed as epilepsy in focal agyria-pachygyria had refractory epilepsy,mainly for partial epilepsy secondary generalized seizures.There was a significant difference between them (P =0.008).Eighteen of twenty patients who had moderate-severe mental retardation or dyskinesia were diagnosed as diffuse a gyria-pachygyria,while two were focal agyria-pachygyria.Both of them had a significant difference (P =0.005).Conclusions Agyria-pachygyria is a brain malformation caused by neuronal migration abnormality.Diffuse agyria-pachygyria is presented with serious clinical manifestations and poor outcome while the clinical manifestation of focal agyria-pachygyria is relatively mild and epilepsy could be controlled by antiepileptic drugs or epilepsy surgery.These characteristics of EEG patterns along with clinical findings could provide important evidence for early diagnosis,timely treatment and prognosis judgment of agyria-pachygyria.

Objective This paper is to validate a speech intelligibility test in Chinese mandarin for the evaluation of speakers with cleft palate, and to determine the intelligibility deficit patterns based on minimal pairs. Methods Thirty cleft palate patients with dysarthria were included as speakers for the test. Then the speech intelligibility of each speaker was rated and the error proportions of each minimal pair were analyzed by SPSS 16.0. The stepwise multiple regression analysis was employed to determine which minimal pairs were the best predictors of reduced speech intelligibility. Results The intelligibility scores were obtained form the thirty speakers ranged from 37% to 92.4%. The error proportion of the minimal pairs was ranged from 0. 13 to 0. 80. The three most problematic pairs, from the most to least severe were dental versus retroflex pair (0.80), retroflex versus palatal pair(0.68), and aspirated versus un-aspirated affricative pair(0.66). The speech intelligibility from cleft palate patients could be predicted at 71.5% accuracy using two pairs, aspirated versus un-aspirated affricative pair, dentals versus palatal pair. Conclusion The speech intelligibility test for Chinese Mandarin speakers with cleft palate can be used as an effective evaluation method, both qualitatively and quantificationally.