Objective To describe the diagnosis,treatment,and clinical course of a patient with severe acute organophosphorus pesticide poisoning(AOPP)complicated by recurrent respiratory failure,intermediate syndrome(IMS),multiple organ dysfunction syndrome(MODS)and sepsis.Methods On May 8,2021,a patient who self-administered the pesticide Dimethoate AOPP was admitted to the department of internal medicine intensive care unit(MICU)of the First People's Hospital of Yunnan Province.After 29 days of treatment,the patient was successfully cured and discharged.The clinical diagnosis and treatment process was introduced.Results The 78-year-old male patient suffered from severe AOPP due to self-ingestion of the pesticide leptophos.Upon admission,he rapidly developed respiratory failure requiring urgent endotracheal intubation and mechanical ventilation support.A series of targeted treatments were administered,including the use of reactivators such as pralidoxime iodide,anticholinergic agents like atropine and scopolamine,as well as antibiotic therapy and management of water-electrolyte balance and acid-base equilibrium.Throughout his treatment,the patient experienced multiple complications,including episodes of sepsis,fluctuating cholinesterase levels,infections from multidrug-resistant bacteria,and recurrent respiratory failures.After 29 days of meticulous care,the patient was successfully weaned off the ventilator,regained normal organ function,and was discharged.Conclusion The analysis of this case highlights the importance of closely monitoring and managing drug dosage adjustments,preventing and treating infections,addressing septic shock,paying attention to the prevention and control of ventilator-associated pneumonia(VAP),conducting timely psychological evaluations,and providing interventions during the treatment process for AOPP.

Objective: To explore the practice and effect of transparent supervision in the prevention and control of multidrug-resistant organism (MDRO). Methods: Transparent supervision was introduced to intervene into the MDRO management of monitored departments. Such transparent supervision was aided by IT means, and transparent MDRO control indexes. These indexes included hand hygiene compliance rate, qualification rate of ATP detection of environmental object surface, implementation rate of main MDRO prevention and control measures, MDRO resistance rate, and nosocomial infection incidence. The data before and after the intervention were compared by Chi square test to evaluation the effect. Results: After intervention, the hand hygiene compliance rate increased from 49.83% to 65.61% (χ²=47.389, P<0.001), and the qualification rate of ATP detection of environmental object surface increased from 48.50% to 83.33% (χ²=96.115, P<0.001). Meanwhile, such indexes as prescription of patient isolation, placement of isolation identifiers and that of specialized bedside equipments increased significantly(P<0.001). The MDRO detection rate decreased from 75.08% to 63.31% (χ²=28.123, P<0.001), and the incidence of nosocomial infection decreased from 4.77% to 3.47%(χ²=20.303, P<0.001). Conclusions The practice of transparent supervision could reduce the risk of MDRO transmission at hospitals effectively, proving its importance in ensuring medical quality and patient safety.

Toxoplasma gondii causes serious infection worldwide in humans and animals. In this study, the seroepidemiology of toxoplasmosis was investigated in wild boars (Sus scrofa) (n=377), wild rabbits (cape hare, Lapus capensis) (n=331), and wild chickens (red junglefwol, Gallus gallus) (n=571) in 4 forested and country sided area of Hubei province of China. For this, blood samples were collected and tested by indirect hemagglutination test (IHA). The seroprevalence was found to be 7.2%, 5.1%, and 12.6% in wild boars, rabbits, and chickens, respectively, with significant differences among these species. The prevalence of T. gondii infection in male and female wild boars was found to be 7.9% and 6.5% (P<0.01), in male and female rabbits was 5.6% and 4.9% (P<0.01), and in male and female chickens was 17.1% and 7.7% (P<0.01), respectively, with significant differences between 2 genders of chickens (P<0.01). The findings of this study may help in planning of the prevention measures against T. gondii infection in wild animals in this area.
Animals ; Animals, Wild ; Chickens* ; China* ; Female ; Forests ; Hares ; Hemagglutination Tests ; Humans ; Male ; Prevalence ; Rabbits* ; Seroepidemiologic Studies* ; Sus scrofa* ; Toxoplasma* ; Toxoplasmosis*

OBJECTIVE:To evaluate the rationality of cefoxitin use in our hospital. METHODS:Evaluation index and evalua-tion criteria were established on the basis of DUE. The relative weight of evaluation index were calculated by using attribute-based AHM weight method,and the gas between medical orders and complete rational ones were evaluated by using TOPSIS processing method. The proportion of rational medical orders were calculated to evaluate the rationality of drug use. RESULTS:Among 116 medical records,there were 19%reasonable medical orders(including 4.3%complete reasonable medical orders,5 cases),50%ba-sically reasonable medical orders(58 cases)and 31% unreasonable medical orders(36 cases). CONCLUSIONS:It is reasonable and feasible to use AHM weighted TOPSIS method to evaluate the rationality of cefoxitin. The utilization of cefoxitin in our hospital is basically reasonable,but there are still many problems.

Objective To detect EPPB41L3 methylation frequency difference between esophageal squamous cell carcinoma (ESCC) tissues and the normal tissues and between ESCC patients′plasma and healthy volenteers′plasma, and to analyze the correlation with clinicopathological parameters. Methods We collected esophageal squamous cell carcinoma tissues (n = 42 patients) and adjacent surrounding normal tissues (n = 42 patients), and plasma from 42 patients with ESCC and from 50 healthy individuals. We used methylation specific PCR (MSP) combined with agarose gel electrophoresis to detect the methylation status of the EPB41L3. We used the SPSS 13.0 software for statistical analysis by χ2 test and Fisher′s exact test. Results EPB41L3 frequency of methylation was significantly higher in tumor tissues than in the adjacent tissues (59.5% vs. 4.8%), the difference was statistically significant (χ2 = 28.873, P < 0.001). For plasma, EPB41L3 methylation frequency was 31.0%in cancer patients, while was not detectable in the healthy volunteers. Methylation of EPB41L3 in tissues was more frequently found in patients with tumor size of ≥ 5 cm or T3 than in patients with tumor size of < 5 cm or T1-2. Conclusions The methylation frequency of EPB41L3 is higher in ESCC tissues than in control normal tissues, and higer in plasma from ESCC patients than that from the healthy volunteers. EPB41L3 methylation is more frequently found in patients with more advanced disease.

Objective To evaluate the clinicopathological features,treatments and prognostic factors of male breast cancer (MBC) patients.Methods Clinical data of 102 MBC patients with histopathology confirmation at Tianjin Medical University Cancer Hospital were retrospectively analyzed.Results All 102 cases got follow-up.The follow-up rate was 100％.The follow-up period was 3-279 months.The mean follow-up period was 65 months.During the follow-up period,recurrence was found in 21 cases,metastasis occurred in 28 cases (including pulmonary metastasis in 8,osseous metastasis in 7,hepatic metastasis in 9,brain metastasis in 3,and soft tissues and adrenal gland metastasis in 1).The 5-year disease free survival rate was 54.3％ and the 5-year overall survival rate was 72.8％.Univariate analysis showed that tumor size,axillary lymph node status,TNM stage,chemotherapy influenced the disease free and overall survival.Multivariate Cox regression shows that axillary lymph node status (P =0.085)was the independent prognostic factor of disease free survival for MBC.Tumor size(P =0.041)and axillary lymph node (P =0.024) status were independent prognostic factors of overall survival for MBC.Conclusions Early diagnosis and comprehensive treatment strategy consisting of radical mastectomy is essential to improve the survival of patients with MBC.

OBJECTIVETo investigate the effect of adjuvant chemotherapy on the prognosis of patients with low-risk cervical cancer (without pelvic lymph node metastasis, parametrial involvement, positive surgical margin, primary tumor size > 4 cm, deep cervical stromal invasion, or lymph-vascular space invasion).

METHODSThe clinical data of 208 patients with low-risk cervical cancer were studied retrospectively to analyze the indications of adjuvant chemotherapy and its relationship with tumor recurrence and the patients' survival.

RESULTSThe median follow-up time of the cohort was 73 months. The overall tumor recurrence rate was 4.8% and the total 5-year survival rate of the patients was 96.0%. Sixty-nine of the patients received adjuvant chemotherapy (Taxol+Cisplatin) after the operation with a median of 2.5 (2-4) courses. Univariate analysis showed that the histological tumor grade was significantly associated with adjuvant chemotherapy (P<0.001). In the 114 grade III patients, 50 received adjuvant chemotherapy as compared with 19 in the 94 grade I-II patients. Among the grade III patients, no significant differences was found in the overall survival rate (97.0% vs 95.0%) or tumor recurrence rate (4.0% vs 4.7%) rate between the patients with adjuvant chemotherapy and those without. The tumor size (2 cm or less vs >2 cm) was significantly associated with tumor recurrence rate (1.1% vs 7.5%, P=0.034) and the overall 5-year survival rate (100.0% vs 93.0%, P=0.034) in the 208 patients. In the 139 patients receiving only surgical treatment, the tumor recurrence and 5-year survival rates were not significantly correlated with the histologic grade, age, FIGO staging, gross type, tumor size or histologic type.

CONCLUSIONB There has been no sufficient evidence to support the prescription of postoperative adjuvant chemotherapy for low-risk cervical cancer based on histological grading of the tumor, which may not help in reducing tumor recurrence or improving the long-term survival of the postoperative patients.

Adult ; Aged ; Chemotherapy, Adjuvant ; Female ; Humans ; Middle Aged ; Prognosis ; Retrospective Studies ; Survival Rate ; Treatment Outcome ; Uterine Cervical Neoplasms ; drug therapy ; mortality ; pathology ; Young Adult

Objective To investigate the effect of adjuvant chemotherapy on the prognosis of patients with low-risk cervical cancer (without pelvic lymph node metastasis, parametrial involvement, positive surgical margin, primary tumor size>4 cm, deep cervical stromal invasion, or lymph-vascular space invasion). Methods The clinical data of 208 patients with low-risk cervical cancer were studied retrospectively to analyze the indications of adjuvant chemotherapy and its relationship with tumor recurrence and the patients' survival. Results The median follow-up time of the cohort was 73 months. The overall tumor recurrence rate was 4.8%and the total 5-year survival rate of the patients was 96.0%. Sixty-nine of the patients received adjuvant chemotherapy (Taxol+Cisplatin) after the operation with a median of 2.5 (2-4) courses. Univariate analysis showed that the histological tumor grade was significantly associated with adjuvant chemotherapy (P<0.001). In the 114 grade III patients, 50 received adjuvant chemotherapy as compared with 19 in the 94 grade I-II patients. Among the grade III patients, no significant differences was found in the overall survival rate (97.0%vs 95.0%) or tumor recurrence rate (4.0%vs 4.7%) rate between the patients with adjuvant chemotherapy and those without. The tumor size (2 cm or less vs>2 cm) was significantly associated with tumor recurrence rate (1.1%vs 7.5%, P=0.034) and the overall 5-year survival rate (100.0%vs 93.0%, P=0.034) in the 208 patients. In the 139 patients receiving only surgical treatment, the tumor recurrence and 5-year survival rates were not significantly correlated with the histologic grade, age, FIGO staging, gross type, tumor size or histologic type. Conclusion There has been no sufficient evidence to support the prescription of postoperative adjuvant chemotherapy for low-risk cervical cancer based on histological grading of the tumor, which may not help in reducing tumor recurrence or improving the long-term survival of the postoperative patients.

Objective To investigate the effect of adjuvant chemotherapy on the prognosis of patients with low-risk cervical cancer (without pelvic lymph node metastasis, parametrial involvement, positive surgical margin, primary tumor size>4 cm, deep cervical stromal invasion, or lymph-vascular space invasion). Methods The clinical data of 208 patients with low-risk cervical cancer were studied retrospectively to analyze the indications of adjuvant chemotherapy and its relationship with tumor recurrence and the patients' survival. Results The median follow-up time of the cohort was 73 months. The overall tumor recurrence rate was 4.8%and the total 5-year survival rate of the patients was 96.0%. Sixty-nine of the patients received adjuvant chemotherapy (Taxol+Cisplatin) after the operation with a median of 2.5 (2-4) courses. Univariate analysis showed that the histological tumor grade was significantly associated with adjuvant chemotherapy (P<0.001). In the 114 grade III patients, 50 received adjuvant chemotherapy as compared with 19 in the 94 grade I-II patients. Among the grade III patients, no significant differences was found in the overall survival rate (97.0%vs 95.0%) or tumor recurrence rate (4.0%vs 4.7%) rate between the patients with adjuvant chemotherapy and those without. The tumor size (2 cm or less vs>2 cm) was significantly associated with tumor recurrence rate (1.1%vs 7.5%, P=0.034) and the overall 5-year survival rate (100.0%vs 93.0%, P=0.034) in the 208 patients. In the 139 patients receiving only surgical treatment, the tumor recurrence and 5-year survival rates were not significantly correlated with the histologic grade, age, FIGO staging, gross type, tumor size or histologic type. Conclusion There has been no sufficient evidence to support the prescription of postoperative adjuvant chemotherapy for low-risk cervical cancer based on histological grading of the tumor, which may not help in reducing tumor recurrence or improving the long-term survival of the postoperative patients.

Objective To evaluate the influence of Helicobacter pylori (Hp) eradication on clinical manifestations, endoscopic features and pathological findings of chronic gastritis. Methods This was a multiple-center, prospective and randomized cohort study. Patients with non-atrophy chronic gastritis from January 2009 to December 2010 were randomized into 3 groups as Hp positive group with eradication, Hp positive group without eradication and Hp negative group. Clinical manifestations, endoscopic findings and pathologic changes of inflammation were compared before and after administration of gastric mucosal protective agent for 8 weeks. Results A total of 211 patients were recruited. Changes of symptom score, endoscopic erosion and mucosal inflammation were significantly different before and after treatment in 3 groups. The decrease in symptom scores of eradication group was ( 3.56 ± 1.37 ), which was significantly higher than that of non-eradication group (2. 80 ± 1.30, P ＜0. 01 ). The decrease of mucosal inflammation and inflammatory activity scores in eradicate group was 1.08 ± 1.34 and 1.42 ± 1.09, respectively, which were also significantly higher than those of the eradication group (0. 49 ± 1.47 and 0. 61 ± 1.34, P ＜0. 01 ). But the improvement of endoscopic erosion in 2 groups showed no significant difference. There were no significant differences in these variables between non-eradication group and Hp-negative group ( P ＞ 0. 05 ). Conclusion For chronic non-atrophic gastritis patients with positive Hp infection, combination of mucosal protective agents and Hp eradication can achieve better improvement in symptoms and gastric inflammation repair.