Severe acute dichlorvos poisoning is characterized by rapid onset, swift disease progression and serious complications. It frequently involves multiple organ failure (central, respiratory and circulatory systems), severe acidosis, and rare occurrences of gastric perforation. When secondary gastric perforation occurs, treatment becomes difficult and the prognosis of patients is poor. Thus, early and sufficient gastrointestinal decontamination is crucial. This article presented two cases of gastric perforation secondary to dichlorvos poisoning and discussed the causes of gastric perforation, as well is clinical diagnostic and treatment methods.

Severe acute dichlorvos poisoning is characterized by rapid onset, swift disease progression and serious complications. It frequently involves multiple organ failure (central, respiratory and circulatory systems), severe acidosis, and rare occurrences of gastric perforation. When secondary gastric perforation occurs, treatment becomes difficult and the prognosis of patients is poor. Thus, early and sufficient gastrointestinal decontamination is crucial. This article presented two cases of gastric perforation secondary to dichlorvos poisoning and discussed the causes of gastric perforation, as well is clinical diagnostic and treatment methods.

Chlorfenapyr is a moderately dangerous insecticide widely used in agriculture. The mortality of acute poisoning patients is high, and there is no effective treatment. This paper retrospectively analyzes the clinical data of two cases of compound chlorfenapyr poisoning. The main symptoms of the patients were high fever, sweating, gradual coma, increased creatine kinase and myoglobin, with delayed poisoning symptoms. Despite comprehensive treatment, both patients died eventually. It indicated that chlorfenapyr was highly toxic and had a high mortality. In addition to routine symptomatic treatment for patients with acute poisoning, blood purification treatment should be actively carried out in the early stage.

Chlorfenapyr is a moderately dangerous insecticide widely used in agriculture. The mortality of acute poisoning patients is high, and there is no effective treatment. This paper retrospectively analyzes the clinical data of two cases of compound chlorfenapyr poisoning. The main symptoms of the patients were high fever, sweating, gradual coma, increased creatine kinase and myoglobin, with delayed poisoning symptoms. Despite comprehensive treatment, both patients died eventually. It indicated that chlorfenapyr was highly toxic and had a high mortality. In addition to routine symptomatic treatment for patients with acute poisoning, blood purification treatment should be actively carried out in the early stage.

Objective:To understand the needs of end-stage cancer patients for hospice care, so as to provide a basis for the development of human-centered quality nursing services in hospice care.Methods:13 patients with end-stage cancer in tumor ward were interviewed by personal in-depth interview, and the data were sorted and analyzed by Colaizzi's seven-step analysis method.Results:A total of four themes of hospice care needs of patients with end-stage cancer were extracted. The need to maintain self-subject: the desire to maintain self-efficacy and self-image of dignity in life; the need to relieve the symptoms of self-discomfort. The need to relieve the physical symptoms and psychological discomfort. Meet the needs of self-determination: participate in medical care decisions and choose comfortable social relationships. Express their own emotional needs: the past farewell and remembrance and future wish to achieve the expectationsConclusions:Patients with end-stage cancer have diverse needs for hospice care. In clinical work, medical staff should adhere to the people-oriented concept, explore patients' needs and preferences, and implement individualized quality nursing measures to meet patients' needs for hospice care.

Objective To explore the differences in autophagic expression levels between hypertrophic scar (HS) tissue and normal skin tissue,and further investigate the relationship between hypertrophic scar formation and autophagy protein expression through the rabbit ear hypertrophic scar model.Methods 30 patients with hypertrophic scar were collected.One hypertrophic scar tissue and one normal skin tissue were harvested.The relative expressions of LC3,P62 and Beclin-1 in each tissue specimen were detected by immunohistochemistry and Western blot.Western blot was used to detect the autophagic-associated protein LC3 (MAPLC3),P62 and Beclin-1 in the hypertrophic scar tissue of rabbit ear and the corresponding normal tissue of rabbit ears at 4 weeks,8 weeks,12 weeks,and 24 weeks,and further explore their clinical significance.Results In vivo,the expression of hypertrophic scar tissue protein LC3 and Beclin-1 was significantly stronger than that in normal skin tissue (P ＜ 0.05).The expression of P62 was significantly weaker than that in normal skin tissue (P ＜ 0.05).In animal experiments,during the process of HS formation,the protein expression of LC3 gradually increased,while the protein expression of P62 gradually decreased;the protein expression of Beclin-1 was higher than that of normal rabbit ears tissue,with statistically significant differences (P ＜ 0.05).Conclusions The expression of LC3 and Beclin-1 in human hypertrophic scar tissues is higher than that in normal tissues.While the expression of P62 is lower than that in normal tissues.That is,the expression of autophagy in human hypertrophic scar tissue showed an upward trend in a certain period of time,and was significantly higher than that in normal tissue.

Objective: To study the the application characteristics of paediatric CT examination by investigating four main children′s hospital of Shanghai. Methods: All the CT scan cases of paediatric patients in this work were obtained from the radiology information system (RIS) database in four hospitals between 2011 and 2014. The distribution of using CT scans was analysed according to the age, gender, anatomical regions and the duplicated cases of the patient, then estimated the paediatric CT scan rates of four hospitals in Shanghai. Results: Retrospective review of RIS showed 249 350 CT examinations from 175 672 young patients were performed between 2011 and 2014 in the surveyed hospitals. More males (62%) were scanned than females (38%). The majority of children receiving the examinations were 1 to 5 years old, which amounted to 40.3% in all. Cardiac CT accounted for 14.5% among all children of ≤1 year old CTs and accounted for 63.0% among all cardiac CT scans. There were 33 634 (19.1%) individuals who had received 2 or more CT scans during the four years. The estimated paediatric CT scan frequencies of four hospitals in Shanghai from 2011 to 2014 were 37.9 examinations per 1 000 population in 2011, 43.3 examinations per 1 000 population in 2012, 43.3 examinations per 1 000 population in 2013 and 39.0 examinations per 1 000 population in 2014. Conclusions The CT scan frequencies of four hospitals in children and young adults was almost keeping stable in Shanghai.

With the development of modern medical technology,accurate resection of tumor and timely repair and repair of defective tissues and organs are important concerns in the field of tumor research.The precise excision of tumor,refers to the preoperative assessment of systemic and local detection based on detailed to personalized surgical planning,the use of precise operation in operation,ensure as much as possible while minimizing surgical trauma to patients after removal of the lesions,creating the optimal conditions of recovery for trauma patients.Repair and regeneration of defective tissues and organs refers to the deletion or damage of tissues and organs,and gradually resume its anatomical structure and function process under the action of a variety of cells,extracellular mechanisms and related regulatory factors.Then from the tumor resection,tumor resection and accurate regeneration after three point repair technology to change rapidly in the tissue of tumor plastic organ regeneration in tissue of origin.

Objective: To observe the therapeutic efficacy of alanyl glutamine injection on patients with gastrointestinal function obstacle caused by severe phorate poisoning. Methods: A total of 80 eligible patients with gastrointestinal function obstacle caused by severe phorate poisoning were randomly divided into the control group (n=40) and treatment group (n=40) . The control group was treated with the conventional therapy, which included forbidden diet, atropine, pralidoxime iodide, anti-inflammatory, albumin infusion, ω-3 fish oil fat emulsion, protection of organs function, blood perfusion, and Fat Emulsion, Amino Acids (17) and Glucose Injection. The treatment group was treated with alanyl glutamine injection plus the conventional therapy. To observe the time of recovering to normal of gastrointestinal function between the two groups, compared the AChE activity and changes of prealbumin, albumin and total protein of the two groups respectively. Furthermore, the total atropine dosage, the total pralidoxime iodide dosage and ICU stay time between the two groups were also compared. Results: The gastrointestinal function recovery time of patients in the treatment group was less than the control group, the difference was statistically significant (P<0.05) . From the third day of treatment, the serum cholinesterase activity of the treatment group was higher than the control group, the difference was statistically significant (P<0.05) . On the 5th day and 10th day of the treatment, the prealbumin, albumin and total protein of the treatment group were significantly higher than these indexes of the control group in the same period, the difference were statistically significant (P<0.05) . The total atropine dosage, the total pralidoxime iodide dosage and ICU stay time in the treatment group were lower than the control group, the difference were statistically significant (P<0.05) . Conclusion Alanyl glutamine injection has a great therapeutic effect for gastrointestinal function obstacle patients caused by severe phorate poisoning.

Objective To explore the effects of fat emulsion made of fish oil for total parenteml nutrition on patients with systemic inflammatory response syndrome(SIRS).Methos Forty patients with SIRS in the intensive care unit(ICU),Liaocheng People's Hospital,from January to June 2007 were randomly divided into conventional total parenteral nutrition(TPN)group(group A,n=20)and fish oil emulsion+TIN group(group B,n=20).Patients of both groups received equal amount of nitrogen and calories.The energy give.Was 20 kcal/(kg·d),and nitrogen 0.2 g/(kg·d)for 7 days and the fish oil emulsion given was 1-2 ml/(kg·d)(Commoditieds:Omegaven,No.UK 1580,Wuxi,China SINO-SWEO Pharmaceutical CORP.Ltd.).The levels of serurn TNF-α,IL-1 and IL-6 were checked before TPN and 1 d,3 d and 7 d after TPN.The davs of ICU stay,the incidence of MODS and the mortality within 28 aays of two groups were also recorded.Data were analyzed wotj inde pent-saraples t test and paired-sarnples t test using the SPSS 10.34 software.Results There wsa no significant difference in APACHF-Ⅱ score between two groups of patients.Compared with group A,the levels of serum TNF-α,IL-1 and IL-6 in group B decreased markedly at different intervals(P<0.05,P<0.01).The duration of ICU slay shortened obviously in group B than that in group A[(11.5±2.4)days vs.(15.8±2.3)days,P<0.05].Conclusions The fat emulsion made of fish oil has protective effects on patients with SIRS by the mechanism of decrease in the levek of Serum TNF-α,IL-1 and IL-6,and thereby reduees the incidence of MODS,shortens the duration of ICU stay,increasing the survival rote of seriously ill patients.