ABSTRACT
Objective To investigate the effect and safety of transcutaneous electrical stimulation at Zusanli acupoint for elimination of gastrointestinal poison in patients with oral organophosphorus pesticide poisoning. Methods A prospective study was conducted, including 62 patients with oral organophosphorus pesticide poisoning from September 2013 to February 2015 in the Department of Emergency of Xingtai People's Hospital of Hebei Province. The patients were divided into a observation group and a control group (each, 31 cases) in accord with the principle of simple random sampling. All the patients in two groups were given comprehensive treatment according to the diagnosis and treatment of the guide for organic phosphorus pesticide poisoning. In addition, the transcutaneous electrical stimulation at bilateral Zusanli acupoints was carried out in the observation group, once therapeutic time 30 minutes and every 8 hours once, and stopped until the discharge of melena. The incidence of vomiting after application of cathartics, the first stool time, the time of melena discharge, daily defecation frequency, the time of reaching atropinization, the total amount of atropine used, the time of cholinesterase (ChE) activity returning to its 1/2 normal activity, the length of stay in hospital, cure rate and mortality were observed in both groups. The changes in hemodynamics and pulse blood oxygen saturation (SpO2) were observed before and after transcutaneous electrical acupoint stimulation, and the occurrence of adverse reactions in the therapeutic course were observed in the observation group.Results After application of cathartics, the incidence of vomiting in control group was significantly higher than that in the observation group [32.2% (10/31) vs. 9.7% (3/31),P < 0.05]. In the observation group, the first stool time (hours: 9.3±3.6 vs. 11.6±5.2) and the time of melena discharge (hours: 11.3±5.3 vs. 14.5±6.8) were significantly shorter than those in the control group (both P < 0.05); while the frequency of bowel movements during catharsis was higher than that of the control group (times/d: 4.3±0.5 vs. 3.1±0.4,P < 0.01). In the observation group, the time reaching atropinization (hours: 66.3±22.8 vs. 84.6±24.2), the total amount of atropine used (mg: 66.3±22.8 vs. 84.6±24.2), and the time of ChE activity returning to its 1/2 normal range (days: 6.1±2.4 vs. 8.3±3.9) were significantly shorter than those in the control group (allP < 0.01). At the end of treatment, the average length of stay in hospital was shorter (days: 11.3±2.8 vs. 13.4±4.2,P < 0.05) and the cure rate was higher [96.8% (30/31) vs. 83.9% (26/31),P < 0.05] in the observation group than those in the control group; in observation group, the hemodynamics and SpO2 before and after acupoint electrical stimulation did not change significantly; in the course of treatment, no adverse reactions occurred.Conclusion The addition of transcutaneous electric stimulation at bilateral Zusanli acupoints in patients with oral organophosphorus pesticide poisoning has following advantages: lowering the incidence of vomiting during catharsis, enhancing the cathartic effect, promoting gastrointestinal poisoning discharge as soon as possible, reducing total atropine used during hospitalization, shortening the time reaching atropinization, shortening the duration of hospitalization, promoting the recovery of cholinesterase activity and elevating clinical therapeutic effects.
ABSTRACT
BACKGROUND: Metabotropic glutamate receptor(mGluR) is G-protein coupled membrane receptors, which participate in various physiology or pathology process in brain, but how it induce brain ischemic tolerance(BIT)is unclear.OBJECTIVE: To study roles of mGluR2/3 and mGluR1/5 in the BIT induction.DESIGN: Randomized controlled study based on experimental animals.SETTING: Neurological department of provincial hospital and pathophysiological department of basic institute in a university.MATERIALS: The study was conducted at the Pathophysiological Department, Institute of Basic Medicine, Hebei Medical University from May 2002 to May 2003. Totally 64 healthy male SD rats were selected from the Experimental Animal Center of Hebei Medical University. Glial fibrillary acidic protein (GFAP) antibody, MTPG and(s)-4C3HPG were got from Sigma Company.INTERVENTIONS: 4 vessel occlusion(4VO) brain ischemic models in rats stained with thionine staining and GFAP immunohistochemistry staining. were used. Sixty-four rats, of which bilateral vertebral arteries were occluded permanently by electrocautery, were divided into the following 8groups: sham operation group, cerebral ischemic preconditioning(CIP)group, ischemic insult group; BIT group; MTPG + sham operation group;MTPG+BIT group; MTPG+ischemia group and(s) -4C3HPG+BIT coup. All the rats were killed 7 days after the operation or the final ischemic treatment. Cerebral sections were selected and stained with thionine staining and GFAP immunohistochemistry staining.MAIN OUTCOME MEASURE: The changes of the morphologic hippocampal pyramidal cell and GFAP expression of astrocyte.RESULTS: ① The 8 minutes ischemic insult increased the histological grade(HG) in CA1 area, decreased the pyramidal neuronal density(ND)and increased the expression of GFAP significantly( P ＜ 0.05) . ② The above changes were not observed in the BIT group, indicating that the CIP could protect pyramidal neurons against the 8-minute ischemic insult. ③The protective effects of the CIP were blocked by MTPG or(s)-4C3HPG, as manifested by significant increases in HG and decreases in ND in the groups of MTPG + BIT, MTPG + ischemia and(s)-4C3HPG + BIT( P ＜ 0.05).CONCLUSION: MTPG or (s) -4C3HPG could block the induction of BIT induced by CIP, but mGluR2/3 or mGluR1/5 could participate in the induction of BIT by which protect effect of mGluR is further induced.
ABSTRACT
AIM: To explore the role of NO in the induction of brain ischemic tolerance (BIT) by observing changes of NOS activity and NO_2-/NO_3- content following a transient cerebral ischemia. METHODS: The rat 4-vessel occluding brain ischemic model was used. 140 male Wistar rats were divided into sham, cerebral ischemic preconditioning (CIP), ischemic insult and CIP+ischemic insult groups. An occlusion of the 4 vessels for 3 min was normally used as CIP, and a relative long one for 10 min was used as ischemic insult. When CIP was followed by ischemic insult, the interval between them was 3 d. The CA1 region of the hippocampus of rats was dissected out at 0 h, 2 h, 16 h, 24 h, 36 h, 72 h and 7 d after the last time of ischemia to assay its NOS activity and NO_2-/NO_3- content. RESULTS: The NOS activity and NO_2-/NO_3- content began to increase at 16 h, peaked at 24 h and decreased to basal level at 36 h of reperfusion after CIP. The duration of the up-regulation of NOS activity and NO_2-/NO_3- content was much shorter than that of BIT, which usually takes place 1-7 d after CIP. The pattern of upregulation of the NOS activity and NO_2-/NO_3- content was similar to the CIP group, but the maximum (24 h) was much more than that in CIP group (P