Objective:This study aims to systematically compare the differences in severity, clinical manifestations, and treatment processes between patients with foodborne and iatrogenic botulism, thereby providing evidence-based support for clinical diagnosis and management.Methods:A retrospective analysis was conducted on botulism patients admitted to the Second Hospital of Hebei Medical University between January 2010 and July 2024. The foodborne group was diagnosed according to the WS/T 83-1996 standard. The iatrogenic group required a documented history of type A botulinum toxin injection and typical clinical manifestations. Individuals with comorbid neurological disorders or incomplete clinical data were excluded. The severity of poisoning was classified into three groups: mild, moderate, and severe, according to the "Diagnosis and Treatment Protocol for Botulism". SPSS 26.0 software was used to statistically analyze the distribution of poisoning severity between groups and to compare clinical symptoms and course indicators across severity grades.Results:A total of 220 botulism patients were included in this study, comprising 86 cases of foodborne poisoning (39.1%) and 134 cases of iatrogenic poisoning (60.9%). There was a significant difference in the distribution of poisoning severity between the two groups ( P=0.001), the proportion of severe poisoning was significantly higher in the foodborne group. Analysis of clinical symptoms indicated that, among patients with mild poisoning, the incidence of nausea and vomiting was significantly higher in the foodborne group, compared to that in the iatrogenic group (44.0% vs. 16.4%, P=0.006). In patients with moderate poisoning, the iatrogenic group exhibited a significantly higher prevalence of hoarseness (60.5% vs. 35.7%, P=0.041) and neck weakness (53.5% vs. 17.9%, P=0.003) compared to the foodborne group. Conversely, the foodborne cohort experienced a notably longer interval before seeking medical attention when compared to their iatrogenic counterparts (2.25 d vs. 1.50 d, P=0.003). Among severe poisoning patients, the foodborne group exhibited a higher likelihood of experiencing fever (51.5% vs. 25.0%, P=0.044) and abdominal distension accompanied by constipation (69.7% vs. 41.7%, P=0.034) when compared to the iatrogenic group. Furthermore, the foodborne cohort demonstrated a significantly shorter incubation period (1.00 d vs. 2.45 d, P<0.001), an extended length of hospitalization (22.0 d vs. 16.00 d, P=0.001), and a prolonged duration of antitoxin therapy (14.00 d vs. 9.50 d, P<0.001), alongside a markedly higher total dosage administered (315 900 U vs. 163 300 U, P<0.001) compared to their iatrogenic counterparts. Conclusions:Statistically significant differences exist between food-borne and iatrogenic botulism. Food-borne botulism is characterized by acute onset, greater severity, and a prolonged course, predominantly featuring systemic symptoms and gastrointestinal dysfunction. In contrast, iatrogenic botulism primarily manifests with ocular and oropharyngeal muscle symptoms and is generally less severe.

Objective To investigate the neuroprotective effect and its mechanism of p38 mitogenactivated protein kinase inhibitor after subarachnoid hemorrhage (SAH).Methods Twenty-seven SPF-grade adult male SD rats were selected to induce a SAH model using the prechiasmal pool blood injection.Three dead rats were excluded.Twenty-four rats were randomly divided into four groups:sham operation group,SAH group,dimethyl sulfoxide (DMSO) group,and DMSO +p38 inhibitor group (n =6 in each group).Western blot was used to detect the expression levels of p38,phosphorylation p38,Parkinson's disease protein 7 (DJ-1),autophagy associated gene 5 (Atg5),autophagy adaptor protein p62,microtubule-associated protein Ⅰ Light Chain 3 (LC3-Ⅰ),microtubule-associated protein Ⅱ light chain 3 Ⅱ (LC3-Ⅱ),and the Garcia neurological function score was used to judge the nerve injury.PC12 cell oxygenated hemoglobin was used to induce an in vitro SAH model.They were completely randomly divided into four groups:sham operative group,SAH group,DMSO group,and DMSO + p38 inhibitor group.Fluorescent probe JC-1 was used to observe the changes of mitochondrial membrane potential.Results (1) There were significant differences in the expression of p38,phosphorylation-p38 and DJ-1 in rat brain tissue among the 4 groups (F values were 94.959,150.293 and 698.476,respectively,all P ＜ 0.01).There were significant differences in mitochondrial membrane potential in PC12 cells among the 4 groups (F value was 24.989,P ＜ 0.01).There were significant differences in the expression levels of autophagy related protein LC3-Ⅱ/LC3-Ⅰ ratio,Atg5 and p62 in rat brain tissue among the 4 groups (F values were 235.319,110.490 and 36.311,respectively,all P ＜ 0.01).There was significant difference in nerve function score among the 4 groups (F value was 25.550,P ＜ 0.01).(2) Compared with the sham operative group,the expression levels of p38,phosphorylation-p38 and DJ-1 were upregulated significantly after SAH (from 0.43 ±0.06,0.41 ±0.02 and 0.07 ±0.01 to 0.61 ± 0.08,0.79 ± 0.07 and 0.17 ± 0.03,respectively,all P ＜ 0.01),mitochondria membrane potential depolarization (from 8.29 ±0.28 to 9.23 ±0.42,P ＜0.01);upregulation of Atg5 expression and increase of LC3-Ⅱ/LC3-Ⅰratio (from 0.23 ± 0.04 and 0.25 ± 0.04 to 0.47 ± 0.04 and 0.46 ± 0.04,respectively,all P ＜ 0.01),down regulation of p62 expression (from 1.09 ± 0.14 to 0.54 ± 0.10,P ＜ 0.01);neurological score was decreased (from 17.5 ± 0.6 to 11.3 ± 2.7,P ＜ 0.01);p38 inhibitor was significantly down regulated the expression of phosphorylation-p38 after SAH (from 0.79 ± 0.07 to 0.47 ± 0.04,P ＜ 0.01),the expression of DJ-1 was up-regulated (from 0.17 ± 0.03 to 1.02 ± 0.06,P ＜ 0.01),mitochondrial membrane potential recovery (from 9.23 ±0.42 to 8.47 ±0.36,P ＜0.01),cell autophagy related protein LC3-Ⅱ/LC3-Ⅰ ratio and Atg5 were upregulated(from 0.46 ±0.04 and 0.47 ±0.04 to 0.77 ± 0.06 and 0.95 ± 0.12,all P ＜ 0.01),p62 expression returned to the levels of SAH group (from 0.57 ± 0.09,to 0.54 ± 0.10,P =0.650),and the neurological score was significantly improved (from 11.3 ± 2.7 to 15.5 ± 1.0,P ＜0.01).Conclusions After SAH,the p38 inhibitor downregulates the activity of2 phosphorylation p38.It may inhibit abnormal autophagy and maintain mitochondrial function by up-regulating the expression of DJ-1 protein,and then play a neuroprotective function.

Objective To evaluate the correlation of MRI image with the detection rate of prostate cancer and cancer malignancy grade.Methods The prostate biopsy data of patients with prostate specific antigen (PSA) less than 20 μg/L were retrospectively analyzed.The correlations of MRI results with the cancer detection rate,Gleason score and tumor metastasis were analyzed and compared.Results Of 218 cases,88 prostate cancer patients (40.4％) were detected out by prostate puncture biopsy.In 126 MRI-positive prostate cancer patients,the detection rate of prostate cancer by prostate puncture biopsy was 57.9％ (73 cases).In 92 MRI-negative prostate cancer patients,the detection rate of prostate cancer by prostate puncture biopsy was 16.3％ (15 cases).The sensitivity,specificity,positive prognostic rate and negative prognostic rate by MRI were 82.95％,58.78％,57.94％ and 83.70％,respectively.The area under receiver operating characteristic (ROC) curve for MRI to predict prostate cancer was 0.709.MRI results had a correlation with Gleason score.Conclusions MRI image has significant correlation with prostate cancer detection rate and Gleason score in patients with PSA less than 20 μg/L.