Acute Gelsemium poisoning is a systemic disease primarily affecting the central nervous system and respiratory symptoms caused by the ingestion of a substantial amount of Gelsemium within a short period. It manifests as sudden onset and rapid progression, primarily caused by accidental ingestion due to misidentification, and posing significant health risks. The compilation of the Technical Plan for Emergency Health Response to Acute Gelsemium Poisoning describes in detail the specialized practice and technical requirements in the process of handling acute Gelsemium poisoning, including accident investigation and management, laboratory testing and identification, in-hospital treatment, and health monitoring. The guidelines clarify key procedures and requirements such as personal protection, investigation elements, etiology determination, medical rescue, and health education. The key to acute Gelsemium poisoning investigation lies in promptly identifying the toxin through exposure history, clinical manifestations, and sample testing. Because there is no specific antidote for Gelsemium poisoning, immediate removal from exposure, rapid elimination of the toxin, and respiratory monitoring are critical on-site rescue measures. Visual identification of food or herbal materials, followed by laboratory testing to determine Gelsemium alkaloids in samples is a rapid effective screening method. These guidelines offer a scientific, objective, and practical framework to support effective emergency responses to acute Gelsemium poisoning incidences.

Objective To analyze the epidemiological characteristics and related occupational diagnosis situations of occupational heat illness (OHI) diagnosed by Guangdong Province Hospital for Occupational Disease Prevention and Treatment (GDHOD) from 2011 to 2022. Methods A total of 203 patients who applied for OHI diagnosed in GDHOD from 2011 to 2022 were recruited as research subjects using the retrospective analysis method. Clinical data of OHI diagnosed cases was collected from "Occupational Diseases and Hazards Monitoring Information System" under "China Disease Prevention and Control Information System", and data of cases that diagnosed as non-OHI were collected from the occupational disease diagnosis file of GDHOD for retrospective analysis. Resultsi) The number of OHI diagnosed patients was 174 among 203 cases, with a rate of 85.7%. ii) The heat stroke accounted for 72.4% with a mortality rate of 7.5%, male patients accounted for 86.2% among the 174 OHI diagnosed cases. The median age of onset was 47 years, and patients aged 45-60 years accounting for 56.3%. The median working period of onset of illness was 80 days, with 20.1%, 40.8%, 53.4% and 70.1% of cases occurring within 1, 30, 90 and 365 days of working, respectively. The patients were concentrated in the Pearl River Delta region, accounting for 93.1%. The peak incidence of OHI occurred from May to September, accounted for 96.6%, with the highest incidence occurred in July. About 67.3% of cases occurred on days when the maximum temperature was ≥35.0 ℃. Cases occurred between 12:00 and 18:00 accounting for 74.1%, and cases occurred within 8 hours of work accounting for 75.2%. OHI of patients occurred during operations in non-heat-source workshops accounted for 43.7% of cases, while outdoor operations accounted for 39.7%. OHI patients in manufacturing and small private enterprises accounted for 55.2% and 62.6%, and the main occupations were workshop operators, loaders/unloaders, and sanitation workers, comprising 63.2% of cases. iii) Among the 29 cases diagnosed as non-OHI, accounting for 86.2% patients with high-temperature work history who did not meet clinical diagnostic criteria, most of them were diagnosed as OHI precursor. Conclusion OHI patients in Guangdong Province predominantly occur in summer and autumn, with heat stroke being the primary condition. Middle-aged males, workers in non-heat-source workshops and outdoor settings have higher risk of OHI. OHI cases are concentrated in specific region and enterprise. The OHI prevention should be enhanced on high-risk workers, who work in the Pearl River Delta region, manufacturing, and small private enterprises.

OBJECTIVES: Major depressive disorder (MDD) patients with anhedonia tend to have a poor prognosis. The underlying imaging basis for anhedonia in MDD remains largely unknown. The relationship between nodal properties and anhedonia in MDD patients need to be further investigated. Herein, this study aims to explore differences of cerebral functional node characteristics in MDD patients with severe anhedonia (MDD-SA) and MDD patients with mild anhedonia (MDD-MA) before and after the antidepressant treatment. METHODS: Ninety participants with current MDD were recruited in this study. 24-Item Hamilton Depression Scale (HAMD-24) and Snaith-Hamilton Pleasure Scale (SHAPS) were used to assess the severity of depression and anhedonia at baseline and the end of 6-months treatment. The MDD patients who scored above the 25th percentile on the SHAPS were assigned to an MDD-SA group (n=19), while those who scored below the 25th percentile were assigned to an MDD-MA group (n=18). All patients in the 2 groups received antidepressant treatment. Functional magnetic resonance imaging (fMRI) images of all the patients were collected at baseline and the end of 6-months treatment. Graph theory was applied to analyze the patients' cerebral functional nodal characteristics, which were measured by efficiency (e_i) and degree (k_i). RESULTS: Repeated measures 2-factor ANCOVA showed significant main effects on group on the e_i and k_i values of left superior frontal gyrus (LSFG) (P=0.003 and P=0.008, respectively), and on the e_i and k_i values of left medial orbital-frontal gyrus (LMOFG) (P=0.004 and P=0.008, respectively). Compared with the MDD-MA group, the significantly higher e_i and k_i values of the LSFG (P=0.015 and P=0.021, respectively), and the significantly higher e_i and k_i values of the LMOFG (P=0.015 and P=0.037, respectively) were observed in the MDD-SA group at baseline. Meanwhile, higher SHAPS scores could result in higher e_i and k_i values of LSFG (P=0.019 and P=0.026, respectively), and higher e_i value of LMOFG (P=0.040) at baseline; higher SHAPS scores could result in higher e_i values of LSFG (P=0.049) at the end of 6-months treatment. The multiple linear regression analysis revealed that sex were negatively correlated with the e_i and k_i values of LSFG (r= -0.014, P=0.004; r=-1.153, P=0.001, respectively). The onset age of MDD was negatively correlated with the k_i value of LSFG (r=-0.420, P=0.034) at the end of 6-months treatment. We also found that SHAPS scores at baseline were positively correlated with the HAMD-24 scores (r=0.387, P=0.022) at the end of 6-months treatment. CONCLUSIONS There are obvious differences in nodal properties between the MDD-SA and the MDD-MA patients, such as the high e_i of LSFG in the MDD-SA patients, which may be associated with the severity of anhedonia. These nodal properties could be potential biomarkers for the prognosis of MDD. The increased e_i and k_i values in the LSFG of MDD-SA patients may underlie a compensatory mechanism or protective mechanism. The mechanism may be an important component of the pathological mechanism of MDD-SA. The poor prognosis in the MDD-SA patients suggests that anhedonia may predict a worse prognosis in MDD patients. Sex and onset age of MDD may affect the nodal properties of LSFG at baseline and the end of 6-months treatment.
Anhedonia ; Antidepressive Agents/therapeutic use* ; Depressive Disorder, Major/drug therapy* ; Humans ; Infant ; Infant, Newborn ; Magnetic Resonance Imaging ; Prefrontal Cortex

OBJECTIVE: To investigate the changes of hemorheology and blood lipid index in patients with occupational hand-arm vibration disease(OHAVD). METHODS: A total of 78 patients with OHAVD were selected as the OHAVD group, and 78 workers without hand transmitted vibration exposure were selected as control group by judgment sampling method. The hemorrheology and blood lipid indexes of the two groups were detected. RESULTS: The whole blood viscosities(low-, medium-and high-shear), hematocrit, erythrocyte aggregation index, and abnormal rate of whole blood viscosities(mid-and high-shear) in the OHAVD group were higher in the OHAVD group than that in the control group(P<0.05). The erythrocyte deformability index and erythrocyte electrophoresis index were lower in the OHAVD group than that of the control group(P<0.05). In the vibration-induced white finger(VWF) subgroup of the OHAVD group, the whole blood viscosity(low-, medium-and high-shear), hematocrit were increased(P<0.05), and the abnormal rate of whole blood viscosity(high-shear) was higher(P<0.017) than that of the control group.The whole blood viscosity(medium shear), hematocrit and erythrocyte aggregation index were increased in the non-VWF subgroup than that of the control group(P<0.017). The concentration of low density lipoprotein cholesterol in the OHAVD group and non-VWF subgroup was higher than that in the control group(P<0.05). The whole blood viscosity(low-, medium-and high-shear), hematocrit, erythrocyte deformability index, erythrocyte aggregation index and erythrocyte electrophoresis index were not correlated with the length of service and age in the OHAVD group(P>0.05). CONCLUSION: The changes of hemorheological properties and blood lipids in OHAVD patients may be associated with vibration vascular injury.

OBJECTIVE: To summarize and analyze the diagnostic ideas of new occupational lung tumors in Guangdong Province.METHODS: According to the Law of the People′s Republic of China on the Prevention and Control of Occupational Disease and the GBZ 94-2002 Diagnostic Criteria of Occupational Cancer, the key diagnostic points of 6 new occupational lung tumors diagnosed in Guangdong Province from 2010 to 2011 were analyzed. RESULTS: There were 9 cases of 6 new kinds of new occupational tumors were diagnosed in Guangdong Province in 2010-2011. The cases included 3 occupational lung cancer of coke oven workers, 2 occupational lung cancer caused by asbestos, 1 occupational mesothelioma caused by asbestos, 1 occupational lung cancer caused by arsenate, 1 occupational lung cancer caused by chromate salt, and 1 occupational lung cancer caused by asphalt. During the process, the diagnosis was based on the principles of the comprehensive analysis and the attribution diagnosis, combined with occupational history, occupational disease hazard exposure history, clinical data and auxiliary examination results. If the patients were diagnosed with a primary tumor, the patients′ exposure history to occupational carcinogens should be tracked, traced and confirmed, and the diagnosis should be confirmed by referring to the list of occupational carcinogens and literature reports of the International Labor Organization, and not limited to only the personnel in a particular industry. CONCLUSION: During the diagnostic process of occupational tumors, attention should be paid to confirm the exposure history of occupational carcinogen. The key is to determine the exposure of corresponding occupational carcinogen, the route and the time of exposure and the incubation period.

Objective: To investigate the effect of Ethephon on the testis pathological structure and apoptosis of spermatogenic cell in offspring male rats. Methods: Twenty-four healthy female SD rats of 45 days old were randomly divided into control group, low-dose Ethephon group, medium-dose Ethephon group and high-dose Ethephon group according to body weight.The male rats of the same age were selected to mate with female rats.The rats were fed with Ethephon solution of different concentrations or 9 g/L saline every day, and they were continued to be fed with Ethephon during pregnancy and lactation.At the age of 7 days and 14 days, 10 offspring male rats were randomly selec-ted from each group and were put to death.The testicular tissue was stained with HE, and the morphological changes in the testis were observed with light microscope; the apoptotic cells were labeled with terminal deoxynucleotidyl transfe-rase dUTP nick-end labeling (TUNEL method) and the apoptosis index(AI) of testis spermatogenic cells was detected with fluorescence microscope. Results: At the age of 7 days, the testis internal structure of the control group developed well, and the spermatic tubules were neatly and compactly arranged.In the low-dose Ethephon group, the seminiferous tubules of the testis were slightly smaller and the spermatogenic cells were loosely arranged compared with the control group.In the medium-dose Ethephon group, the testis seminiferous tubules were slightly disordered and the cell gap increased.In the high-dose Ethephon group, the testis development was poor, the diameter of seminiferous tubules decreased significantly, and the spermatogenic cells arrangement was in disorder.There was no statistically significant difference in spermatogenic cell AI between the low-dose group [(0.54±0.10)%] and the control group[(0.53±0.09)%] (P>0.05), while the spermatogenic cell AI in the medium-dose Ethephon group [(0.63±0.11)%] and the high-dose Ethephon group [(0.81±0.06)%] were higher than that in the control group, thus there exists a statistically significant difference (all P<0.01). The spermatogenic cell AI in the low-dose Ethephon group [(0.54±0.10)%] was lower than that in the medium-dose Ethephon group [(0.63±0.11)%], and the difference was statistically significant (P<0.05). The spermatogenic cell AI in the medium-dose Ethephon group was higher than that in the high-dose Ethephon group, and the difference was statistically significant (P<0.01). At the age of 14 days, the spermatogenic cells AI in control group, low-dose Ethephon group, medium-dose Ethephon group and high-dose Ethephon group were (0.54±0.08)%, (0.65±0.11)%, (0.77±0.11)%, and (0.88±0.10)% respectively, and the spermatogenic cells AI in all groups increased gradually, in which the differences were statistically significant (all P<0.01). Conclusions Excessive dose of Ethephon can induce pathological changes in testicular tissue and increase the apoptosis of spermatogenic cells, resulting in low fertility of offspring rats.

Objective To investigate the clinical features and prognostic characteristics of head and neck cancer in patients with esophagus cancer and triple primary carcinoma(TPC).Methods A total of 30 patients with head and neck cancer with esophagus cancer TPC were collected in Zhejiang Cancer Hospital from January 2007 to December 2016.The distribution of cancer kinds and the incidence of synchronous and metachronous cancer were described.The clinical characteristics and prognosis were also compared in synchronous and metachronous cancer.The influence of number of hospitalization and different treatments on the survival time were analyzed.Results The TPC of "laryngeal pharynx + esophagus + lung" and "laryngeal pharynx + esophagus + oropharynx" had the highest incidence,that was 20.0％ in 30 patients (6/30).The second type was "laryngeal pharynx + esophagus + larynx".Fifteen cases were synchronous cancer and other 15 cases were metachronous cancer.The rate of surgery was 73.3％ (11/15),and the number of hospitalization who more or equal than 5 was 73.3％ (11/15) in the synchronous cancer.While the rate of surgery was 33.3％ (5/15),and the number of hospitalization who more or equal than 5 was 33.3％ (5/15) in the metachronous cancer.There were significant differences between synchronous and metachronous cancer (x2 =4.661,4.661,all P ＜ 0.05).The 1-year,3-year and 5-year survival rates were 39.9％,19.9％ and 0.0％ in patients with synchronous cancer.The mean survival time was (18.4 ± 6.2)months.In contrast,the survival rates were 78.7％,77.8％ and 59.1％ in metachronous cancer.The mean survival time was (122.2 ± 17.2) months.There were significant differences between the two groups (survival rate:x2 =10.934,P =0.001;mean survival time:t =3.201,P =0.003).The survival rate of the number of hospitalization more than or equal to 5 times had significant difference compared with those less than 5 times (x2 =10.574,P =0.001).There was no statistically significant difference in the improvement of OS between single operation,chemotherapy and target treatment (P ＞ 0.05).Conclusion Head and neck cancer in patients with esophagus cancer TPC can still has a high survival rate through active combined modality therapies,especially in metachronous carcinoma.

OBJECTIVE: To investigate the therapeutic effect of electroacupuncture on peripheral nerve damage induced by 1-bromopropane( 1-BP) exposure.METHODS: A total of 25 specific pathogen free healthy adult male Wistar rats were randomly divided into blank control group( n = 5),model control group( n = 10),and electroacupuncture treatment( EA) group( n = 10).Rats in the blank control group were not exposed to 1-BP and treated with electroacupuncture.The rats in model control group and EA group were placed in a dynamic inhalation exposure cabinet with 1-BP at concentration of 5 000 mg/m~3.The rats were continuously exposed to 1-BP 8 hours per day,5 days a week,for 4 weeks.At the 3 rd day after the end of the exposure,the EA group was treated with electroacupuncture on“Zu sanli”and“Huantiao”points for 4 courses.Each course included 20 minutes each time,once per day for 7 consecutive days.The body weight,the motor nerve conduction velocity( MCV) and sense nerve conduction velocity( SCV) of sciatic nerves on both posterior limbs of the rats were measured.RESULTS: During the course of 1-BP exposure,the rats in the EA and model control group showed reduction of eating,drinking and activities,limited autonomic activities and their hind limbs dragged.The MCV and SCV of posterior limb sciatic nerve of rats in the model control group were slower than that of the control group at the 4 th,6th and 8th week and the 0 week of the same group( P < 0.05).The MCV and SCV of posterior limb sciatic nerve of rats in the EA group improved with the increase of treatment time( P < 0.05),and those at the 6th and 8th weeks of the experiment( corresponding to the 2nd and 4th week after treatment) were faster than that of the model control group at the same time( P < 0.05).The SCV of the posterior limb sciatic nerve in the EA group recovered to normal level 4 weeks after treatment compared with the blank control group( P < 0.05).CONCLUSION: Electroacupuncture treatment can promote the recovery of peripheral nerve damage in rats with 1-BP poisoning.

OBJECTIVE To investigate the clinical significance of preoperative recurrent laryngeal nerve palsy (RLNP) for thyroid nodules with regard to the incidence of malignancy,recurrent laryngeal nerve involvement and histopathological character.METHODS Eighty patients with preoperative RLNP treated in Zhejiang Cancer Hospital between Jan 2007 to Dec 2014 were enrolled,their clinicopathological data were recorded and retrospectively analyzed.RESULTS Of 80 patients,16 patients had benign thyroid disease,while the other 64 had malignancies (80.0％).The preoperative RLNP incidence of benign and malignant lesions was 0.3％ and 0.9％ respectively.Poorly differentiated and anaplastic thyroid cancer had the higher incidence of preoperative RLNP comparing with other pathology types (25.93％,P＜0.05).The RLN did not preserved intraoperatively in 2 patients with benign lesions (2/16,12.5％) and in 42 patients with malignancy lesions (42/48,87.50％).All nerves were sacrificed in poorly differentiated and anaplastic thyroid cancer patients.The RLN could be isolated from 14 benign lesions and 6 malignancies,with or without adhesion,and the nerve function was recovered postoperatively.CONCLUSION The probability of preoperative RLNP is significantly higher in malignant lesions than benign lesions.Thyroid tumors with RLNP are strongly suggested of malignancy,with higher rate of intraoperative nerve sacrifice.The RLN should be preserved if it has not been invaded by the tumor,which offers a chance of functional recovery postoperatively.

Objective To study the protective effects of human umbilical cord-derived mesenchymal stem cells (ucMSCs)against severe acute pancreatitis (SAP) in rats.Methods A total of 135 Sprague-Dawley male rats were randomly divided into Sham group,SAP group and SAP+ucMSCs group (45 each).SAP+ucMSCs group:Severe acute pancreatitis was induced by injecting 5％ sodium taurocholate (0.1ml/100g) into the common bilio-pancreatic duct and then CM-DiI-labeled ucMSCs at 1 × 107cells/kg were injected via the tail vein.All the rats were sacrificed 12,24 and 72 hours after SAP.The 72h death rate was counted.Pathological changes in the pancrease were detected by HE staining and pathological score was graded,ucMSCs colonization was observed by fluorescence microscopy.The serum levels of amylase,lipase,TNF-α,IL-1β,IL-4 and IL-10 were determined by ELISA.Results ucMSCs colonize the injured area of pancreatic tissue,the 72h death rate was reduced,and the serum amylase and lipase were also reduced significantly.Moreover,ucMSCs significantly reduced the pathological score of the pancrea and the level of proinflammatory cytokines (TNF-α and IL-1β),but the levels of anti-inflammatory cytokines were increased (IL-4 and IL-10).Conclusion Transplantation of ucMSCs can reduce the severity of pancreatic injury and inflammation in SAP rats.