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Objective:To analyze the clinical characteristics of patients with acute glyphosate herbicide poisoning and the differences in the severity of poisoning.Methods:A retrospective analysis was performed on patients with acute glyphosate herbicide poisoning admitted to the First Affiliated Hospital of Zhengzhou University from January 2014 to December 2020. The general information, exposure time, poisoning dose, poisoning cause, poisoning route, clinical manifestations, laboratory examination results during hospitalization, treatment measures, hospital stays and prognosis of the patients were collected. The patients were graded according to the poisoning severity scoring standard of Chinese Expert Consensus on Diagnosis and Treatment of Acute Poisoning in 2016. The highest severity score during hospitalization was used as the final grade. According to the final grade, asymptomatic and mild patients were included in the mild group, and moderate, severe and death patients were included in the severe group. The independent sample T test or Mann-Whitney U test was used for measurement data, and χ2 test or Fisher's exact test was used for counting data. The differences of general data and clinical data between the two groups were compared. Results:According to the inclusion and exclusion criteria, 83 patients with acute glyphosate herbicide poisoning were selected as the study subjects. All patients survived, mainly mild poisoning (56.6%), with a male to female ratio of 33∶50, and an average age of 39 years. The number of poisoning cases increased yearly (the highest in 2019), and most cases occurred in spring and summer. The main cause of poisoning was suicide (71.1%), direct oral administration (83.1%) was the primary route of poisoning, and the dominating clinical manifestations were digestive symptoms (71.1%). Laboratory tests showed increased white blood cell count (WBC), neutrophil percentage (NEUT %) and D-dimer, and decreased hemoglobin and potassium. Compared with the mild group, patients in the severe group were older [(51±17) years vs. (35±19) years], had a higher proportion of suicide and direct oral administration, a longer hospital stay [8.0 (4.8, 12.0) d vs. 3.0 (2.0, 5.5) d], a higher dose of poisoning [200.0 (50.0, 200.0) mL vs. 30.0 (11.3, 57.5) mL], and higher NEUT % within 24 h of admission [(83.4±10.4) vs. (73.2±12.8)]. The increase of WBC, NEUT %, aspartate aminotransferase, prothrombin time, D-dimer and the decrease of serum potassium were more common in the severe group than the mild group, with statistical significance (all P<0.05). Conclusions:The number of patients with acute glyphosate herbicide poisoning is increasing yearly. Generally, the condition is mild and the prognosis is satisfying. The severity is more serious in the middle-aged and elderly patients andthose with direct oral administration, high toxic dose, and high NEUT % within 24 h of admission. Severe poisoning is more likely to cause changes in laboratory indicators.
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Sepsis is a life￣threatening organ dysfunction caused by deleterious host response due to infection. Septic shock is a type of sepsis that has a high mortality rate worldwide each year. At present, 0. 9% saline is still the first choice for resuscitation fluid in septic shock in the world,but hyperchloremia and acute kidney injury caused by 0. 9% saline resuscitation are receiving more and more attention. This review elaborates on the mechanism of hyperchloremia and acute kidney injury caused by saline,and explores a new type of liquid (balanced crystalloids) instead of 0. 9% saline for fluid resuscitation,thereby reducing compli￣cations caused by fluid resuscitation.
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In order to understand the existing problems in the management of medical ethical review,this paper summed up related domestic literature published in 2001 to 2015 with the method of literature analysis.There existed several problems in the construction and management,the ability of ethical review,external supervision,and other aspects of the current medical ethics committee.It suggests that strengthening external continuous supervision,strengthening the ethics committee itself construction and management and participating in standardized certification can help medical ethics committee to solve the above problems and have important significance for the standardized development.
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Taking CRA as the research object,and using the method of questionnaire investigation to collect the evaluation results of CRA to the operation status of the hospital ethics committee,this paper found that the review efficiency of ethics committee and the professional level of ethics staffs existed insufficiency.Aiming at this,this paper put forward to strengthen the connotation construction from the perspectives of information disclosure,system construction,committee training,improvement of staff internal quality and professional level and so on,in order to improve the efficiency and quality of ethical review.
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BACKGROUND:Brahma-related gene 1 (Brg1), a catalytic subunit of an important chromatin remodeling complex, has been considered as a key nuclear transcriptional factor, and tends to be decreased in diabetic cardiomyopathy. OBJECTIVE:To construct an adenovirus vector carrying Brg1, and observe its protective role in oxidative stress induced-cardiomyocyte apoptosis. METHODS:The recombinant adenovirus plasmid was linearized and transfected into HEK293 cel s using Fugene HD for packaging and amplification. The adenovirus particles were further purified, quantified, and sequential y transfected to cardiomyocytes of neonatal Sprague-Dawley rats. The Adeno-EGFP transfected and non-transfected cardiomyocytes were used as control group. 24 hours later, the transfection efficiency was observed by fluorescent microscope, and expressions of Brg1 mRNA and protein were detected by quantified PCR and western blotting. After treatment with 100 μmol/L H2O2 for 12 hours, the expressions of Brg1 protein and cleaved-Caspase 3 were measured by western blotting, and cel apoptosis was analyzed by flow cytometry. RESULTS AND CONCLUSION:(1) The recombinant adenovirus vector of Brg1 had been successful y transfected into cardiomyocytes with higher expressions of Brg1 mRNA and protein, and the transfection efficiency reached more than 90%. (2) After H2O2 treatment, the Brg1 was significantly down-regulated in contrast to the up-regulation of cleaved-Caspase 3;the flow cytometry data showed that the apoptotic cel s were increased. But in Adeno-Brg1 transfected cardiomyocytes, the H2O2 induced cel apoptosis was significantly decreased compared with non-transfected cel s and empty vector transfected cel s. (3) These results suggest that oxidative stress can directly inhibit the Brg1 expression, and overexpression of Brg1 can protect the cardiomyocytes from cel apoptosis induced by oxidative stress.
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[ ABSTRACT] AIM:To explore the mechanisms of fluctuant high blood glucose-induced apoptosis of hepatocytes. METHODS:SD rats were randomly divided into normal control group ( N) , stable high blood glucose group ( S) , fluctu-ant high blood glucose group ( F) and insulin group ( I) .Diabetic rats were induced by intraperitoneal injection of strepto-zotocin (65 mg/kg) , and the fluctuant high blood glucose animal model was induced by intraperitoneal injection of ordinary insulin and glucose at different time points every day.The blood glucose fluctuation patterns of the animals in F group with-in 12 weeks were similar every day and no significant difference of the HbA1c concentration was observed compared with S group, indicating that the fluctuant hyperglycemia was successfully established in F group.The activity of superoxide dis-mutase ( SOD) and glutathione peroxidase ( GSH-Px) , and the content of malondialdehyde ( MDA) and nitric oxide ( NO) in the homogenate of the liver tissues were detected by colorimetry.The mRNA and protein levels of JNK, p-JNK, Bax and Bcl-2 were examined by RT-PCR and Western blot.RESULTS:After 12 weeks, the increases in the intakes of food and water, the urine output, and the abnormal liver function were observed in S group, I group and F group.Compared with N group, the MDA level was increased, the content of NO and the activity of SOD and GSH-Px were decreased, and up-regu-lation of JNK mRNA and p-JNK and Bax proteins, and down-regulation of Bcl-2 were also found in S group, I group and F group.The above effects were more obviously showed in F group.CONCLUSION:Oxidative stress activates JNK-MAPK signaling pathway, which is involved in fluctuant high glucose-induced apoptosis of hepatocytes.
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AIM:ToinvestigatetheprotectiveeffectofquercetinonangiotensinⅡ(AngⅡ)-inducedcardio-myocyte hypertrophy and its possible mechanism .METHODS: Cardiomyocyte hypertrophy was induced by AngⅡ ( 100 nmol/L) in primary neonatal cardiomyocytes and H 9c2 cells.The cells were treated with different concentration of querce-tin (10 μmol/L, 20 μmol/L and 40 μmol/L) for 48 h and then the cardiomyocyte surface areas were measured by immu-nofluorescence .Proteasome activity was detected by fluorescent peptide substrate .The phosphorylated levels of GSK-3α/βand Akt in H9c2 cells were determined by Western blot .RESULTS:Compared with control group , the cardiomyocyte sur-face areas were both increased in primary cultured neonatal cardiomyocytes and H 9c2 cells, while the surface areas were significantly decreased by quercetin , especially at concentration of 20 μmol/L compared with Ang Ⅱgroup (P<0.05). Compared with control group , the chymotrypsin-like, trypsin-like and caspase-like activities of proteasome were all in-creased in H9c2 cells (P<0.05).The trypsin-like and caspase-like activities of proteasome were inhibited by 20 μmol/L and 40 μmol/L quercetin , while chymotrypsin-like activity was inhibited only at 20 μmol/L of quercetin compared with AngⅡgroup (P<0.05).In addition, phosphorylated levels of GSK-3α-Ser21, GSK-3β-Ser9 and Akt-Ser473 in AngⅡgroup were all increased compared with control group , which were obviously inhibited by in 20 μmol/L and 40 μmol/L quercetin ( P<0.05 ) .CONCLUSION: Quercetin decreases cardiomyocyte hypertrophy through proteasome inhibition , which may be related to the inhibition of Akt and therefore increasing activation of GSK -3α/βin H9c2 cells.
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Objective To study the effects of the integrity of the tensor tympani muscle on the postoperative hearing recovery and the morphology of tympanic membrane,to provide the reference for the handling of the tensor tympani muscle during the operation.Methods A total of 145 cases of chronic tympanitis were grouped by the integ-rity of the tensor tympani muscle and the implanted types of biological auditory ossicles,the clinical data were ana-lyzed retrospectively.There were 80 cases in the tensor tympani muscle intact group,including 45 cases of PORP group and 35 TORP group.The tensor tympani muscle rupture group of 65 cases consisted of 34 cases of PORP group,and 31 cases of TORP group.The postoperative recovery conditions of tympanic membrane morphology, hearing threshold Ac and air-bone gap(ABG)between the tensor tympani muscle intact group and the tensor tym-pani muscle rupture group were compared 1 month or 3 months,and 6 months after the operation.ResuIts One month after the operation,there was no significant difference in tympanic membrane morphology between the two groups.Three months after the operation,the tensor tympani muscle intact group had a higher ratio about the loca-tion and shape of tympanic membrane ,closer to the normal than the tensor tympani muscle rupture group in which the ratio in the intact group was 81.25% (65/80),while in the rupture group it was 52.31% (34/65 ).After 6 months,with the operation of PORP,the tensor tympani muscle intact group of AC value was 27.48±10.02 dB HL, and ABG value was 13.57±6.36 dB,while the rupture group of AC value was 32.36±9.34 dB HL,and ABG value was 25.73±7.44 dB.With the operation of TORP,the tensor tympani muscle intact group of AC value was 28.76± 7.14 dB HL,and ABG value was 21.02±5.48 dB,while the rupture group of AC value was 39.93 ±5.12 dB HL, and ABG value was 31.41±6.25 dB.The postoperative recovery condition of the tensor tympani muscle intact group was better than those of in the rupture group.ConcIusion The tensor tympani muscle can maintain the morphology and location of the postoperative tympanic membrane.The integrity of the tensor tympani muscle may has a positive effect on the improvement of the postoperative hearing.
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Objective To explore the effects of oscillating blood glucose on apoptosis in renal tubular epithelial cells of diabetic rats and the role of oxidative stress.Methods Renal tubular epithelial cells (HK-2) were cultured in vitro with stable high glucose or oscillating high glucose,and MTF assay was applied to the neasurement of cell proliferation.Streptozotocin induced diabetic model was established with SD rats and the oscillating high blood glucose animal model was induced by intraperitoneal injection of insulin and glucose at different time points every.day.12 weeks later 24 h urine protein (24hUP),blood urea nitrogen (BUN),serum creatinine (Scr),superoxide dismutase (SOD), and malondialdehyde (MDA)were determined. Apoptosis was assessed by terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL),and immunohisto-chemistry was used to detect apoptosis associated gene Bax,Bcl-2,and NOX-4 expression in kidney.Changes in ultrastructure were observed.Results Oscillating high glucose may inhibit renal cells proliferation obviously when comparing with stable high glucose.In the rats with oscillating blood glucose rather than those with stable high blood glucose,there was a significant increase of BUN,Scr,24hUP,and MDA and a decrease of SOD[ (21.50 ± 1.72 vs 12.50 ± 1.85 )mmol/L,(97.51 ± 7.84 vs 82.12 ± 11.48 ) μmol/L,( 1.57 ± 0.09 vs 1.04 ± 0.12 ) mg/24 h,( 23.50 ± 1.87 vs 14.82 ± 2.96) nmol/ml,( 17.22 ± 1.12 vs 21.11 ± 1.80) U/ml,all P＜0.05 ] ; cell apoptosis was intensified with the up-regulation of Bax and NOX-4 protein expression and down-regulation of Bcl-2 in glomerular endothelial cells; and more severe pathological damages were observed.ConclusionComparing with stable high blood glucose,oscillating high blood glucose induces more apoptosis and less proliferation of renal tubular epithelial cells and the mechanism may be related to the increased oxidative stress.
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ObjectiveTo investigate the role of Notch1 gene in xenografted human cutaneous squamous cell (SCL-1) carcinoma. MethodsFifteen nude mice were divided into three groups, including untreated group(inoculated with SCL-1 cells treated with phosphate buffered saline), empty vector group (inoculated with SCL-1 cells transfected with empty vector) and Notch1 group(inoculated with SCL-1 cells transfected with Notch1 expression vector). All the mice were inoculated with SCL-1 cells(1 x 108/ml) of0.2 ml. Then, the growth of xenografted tumor was observed every other day. Fifteen days later, the mice were sacrificed, tumor tissue was dissected and subjected to terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay for the detection of cell apoptosis, reverse-transcription(RT)-PCR and Western blot for the examination of mRNA and protein expressions of Notch1, bcl-2 and bax, respectively. ResultsThe proliferation of xenografted tumor in Notch1 group was obviously inhibited compared with the untreated group. The weight of xenografted tumor in Notch1 group was significantly lower than that in the untreated group and empty vector group (0.574 ± 0.219 g vs. 2.642 ± 0.404 g and 2.606 ± 0.512 g, F= 26.642, P＜ 0.01). TUNEL assay demonstrated that the number of apoptotic cells per 500 cells in tumor tissue specimens was(87 ± 9) in Notch1 group, evidently higher than that in the untreated group(8 ± 2) and empty vector group(10 ± 3) (F = 194.266, P ＜ 0.05 ). Further, RT-PCR and Western blot revealed that the mRNA and protein expressions of Notch1 and bax were significantly upregulated, but those of bcl-2 were markedly downregulated in the Notch 1 group, with significant difference among the three groups(all P ＜ 0.05). ConclusionsNotch 1 gene can inhibit the growth of xenogra ffted human cutaneous squamous cell(SCL-1) carcinoma and induce SCL-1 cell apoptosis likely by upregulating bax expression and downregulating bcl-2 expression.
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ObjectiveTo investigate the role and clinical pathological significance of PTTG and bFGF in cutaneous squamous cell carcinoma(CSCC).MethodsTissue specimens were collected from the lesions of 42 patients with CSCC and normal skin of 42 normal human controls.The protein and mRNA expressions of PTTG and bFGF were detected by immunohistochemistry and in situ hybridization in these specimens respectively.ResultsA significant increase was observed in the positive expression rates of PTTG and bFGF proteins[64.3％(27/42) vs.11.9％(5/42),73.8％(31/42) vs.21.4％(9/42),both P＜ 0.05] and mRNA [59.5％(25/42) vs.7.1％(3/42),75.0％(29/42) vs.16.7％(7/42),both P＜ 0.05] in the CSCC tissue specimens than in the control specimens.The protein and mRNA expressions of PTTG were positively correlated with those of bFGF(both P ＜ 0.05),and closely correlated with histological grade of CSCC (both P ＜0.05).ConclusionThe high expression of PTTG and bFGF may be associated with the initiation of CSCC.
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Objective To investigate the effect of pituitary tumor-transforming gene (PTTG)siRNA on the growth,invasion of,and expression of metastasis-related cytokines including matrix metalloproteinase-2 (MMP-2)and MMP-9 in xenografted human cutaneous squamous cell carcinoma in nude mice.Methods SCL-1 cells were subcutaneouslv inoculated into Balb/c nude mice to establish a xenograft model of human cutaneous squamous cell carcinoma.Then,15 mice bearing xenografted carcinoma were equally divided into 3 groups to be inoculated with phosphate buffer saline (PBS),control siRNA,and PTTG siRNA of 50 nmoI/L,respectively,ever),other day for 2 weeks.The size of xenograted carcinoma in these mice was measured every other day.At the end of 2-week treatment.the mice were killed followed by the evaluation of tumor weight,as well as the quantification of mRNA and protein expression of PTTG,MMP-2 and MMP-9 by reverse transcription (RT)-PCR and Western-blot,respectively.Results The xenograft model of human cutaneous squamous cell carcinoma was successfully established.The treatment with PTTG siRNA obviously inhibited the growth of the xenografted tumom and the expression of PTTG mRNA and protein compared with PBS and control siRNA (all P<0.05).In addition,the expression of MMP-2 and MMP-9 in xenografted tumors in PTTG siRNAtreated mice were significantly lower than those in PBS and control siRNA-treated mice.suggesting that PTTG siRNA evoked the decrease in invasive and metastatic ability of xenografted tumors.Conclusions PTTG siRNA can inhibit the growth of human cutaneous squamous cell carcinoma xenografts in nude mice,and downregulate the expression of invasion-and metastasis-related cytokines,including MMP-2 and MMP-9.
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OBJECTIVE@#To investigate the diagnostic value of high resolution CT for temporal bone traumatic facial nerve paralysis and the guidance significance for surgery.@*METHOD@#Twenty-nine patients of traumatic facial nerve paralysis were investigated. The predictive diagnosis was made according to the clinical data and the image features of HRCT, then a comparative analysis of the preoperative image features and the surgical findings were carried out.@*RESULT@#The trend of temporal bone fracture displayed on the CT scan was basically consisted with the surgical findings. The direct CT signs of facial nerve injury include the bone fracture line went through the tube, bone tube rupture or continuity interruption, while the indirect CT signs include local incrassation of the facial nerve, lower bone density of the tube, geniculate fossa expansion, oppressed facial nerve, et al. The predictive diagnostic accordance rates of all the image features were above 90% as to the surgical findings.@*CONCLUSION@#High resolution CT could localize the trend of temporal bone fracture,and is helpful to estimate the extent of facial nerve injury and other complications. High resolution CT could provide reliable basis for clinical diagnosis and treatment.
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Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Facial Nerve , Diagnostic Imaging , Facial Nerve Injuries , Diagnostic Imaging , Facial Paralysis , Diagnostic Imaging , Fractures, Bone , Diagnostic Imaging , Temporal Bone , Diagnostic Imaging , Wounds and Injuries , Tomography, X-Ray Computed , MethodsABSTRACT
Objective:To investigate the diagnostic value of high resolution CT for temporal bone traumatic facial nerve paralysis and the guidance significance for surgery.Method:Twenty-nine patients of traumatic facial nerve paralysis were investigated.The predictive diagnosis was made according to the clinical data and the image features of HRCT,then a comparative analysis of the preoperative image features and the surgical findings were carried out.Result:The trend of temporal bone fracture displayed on the CT scan was basically consisted with the surgical findings.The direct CT signs of facial nerve injury include the bone fracture line went through the tube,bone tube rupture or continuity interruption,while the indirect CT signs include local incrassation of the facial nerve,lower bone density of the tube,geniculate fossa expansion,oppressed facial nerve,et al.The predictive diagnostic accordance rates of all the image features were above 90%as to the surgical findings.Conclusion:High resolution CT could localize the trend of temporal bone fracture,and is helpful to estimate the extent of facial nerve injury and other complications.High resolution CT could provide reliable basis for clinical diagnosis and trotment.
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OBJECTIVE@#To observe the clinical efficacy of intratympanic dexamethasone (IT-DEX) for sudden deafness (SD) which were inefficient and contraindicant for systemic steroid.@*METHOD@#Thirty-four patients who were inefficient and contraindicant for systemic steroid were treated by IT-DEX (5 g/L) for 4 times within 12 days. The improvement of audits, tinnitus and stuffy were observed. And the results between the different influencing factor such as age, sex and course of disease were compared by statistical analysis.@*RESULT@#1) For total patients, the effective power of audits, tinnitus and stuffy were 52.9%, 58.8% and 82.4% respectively. And the patients who treated within 2 weeks result in higher effective power of audits and tinnitus than those having been treated for more than 2 weeks, but there was no significant difference between these two groups (P >0.05). 2) For the patients who were inefficient and contraindicant for systemic steroid, the audible effective power of them were 44.4% and 62.5% respectively.@*CONCLUSION@#IT-DEX can treat refractory SD effectively and safely. It is an effective treatment for the patients who were contraindicant for systemic steroid, and it could be used for salvage for the patients who were inefficient for systemic steroid.
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Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Dexamethasone , Therapeutic Uses , Drug Administration Routes , Hearing Loss, Sudden , Drug Therapy , Tympanic MembraneABSTRACT
OBJECTIVE@#To define the clinical and imaging features of external auditory canal cholesteatoma (EACC) and determine the characteristics most important to its clinical management.@*METHOD@#Seventeen cases (21 ears) of EACC were retrospectively reviewed. Clinical data were collected for the history, presentation, physical examination findings and CT scans. The surgical management approaches were reviewed.@*RESULT@#Patients presented with otalgia (n = 21), otorrhea (n = 16), ear-canal stenosis (n = 11), facial nerve dysfunction (n = 4). CT scans showed a soft tissue mass with adjacent bone erosion (n =21). Middle ear and mastoid involvement (n = 9), facial canal erosion (n = 4), sigmoid sinus erosion (n = 1) and jugular bulb dehiscence (n = 1) were observed. EACC excision and canaloplasty through transcanal approaches were performed in 12 ears, while postauricular incision and canal wall down mastoidectomy were used in 9 ears.@*CONCLUSION@#The possible causes of EACC and its possible extension may influence clinical management. Preoperative high-resolution temporal bone CT scans can be helpful in the diagnosis and management of EACC.
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Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Young Adult , Cholesteatoma , Diagnosis , Diagnostic Imaging , General Surgery , Ear Canal , Diagnostic Imaging , Pathology , Retrospective Studies , Tomography, X-Ray ComputedABSTRACT
OBJECTIVE To study the clinical features and therapeutic efficacy of middle ear adhesion.METHODS The clinical data of 40 cases of middle ear adhesion collected during 5 years from 2002 to 2007 were studied retrospectively. RESULTS Part or all of the tympanic membrane of the patients did not move under Siegle otoscopy. The lesions of middle ear adhesion were extensive and invaded all middle ear structures including round and oval windows.The lesions were severe, especially in narrow anatomical spaces such as mesotympanum,hypotympanum and interossicular spaces.Pure tone audiometry showed that average air-bone gap (A-B gap) were (35.34?6.99) dB preoperatively.The average A-B gap were (18.47?5.76) dB 6 months after operation.Follow-up observations and postoperative CT scan showed that tympanic membranes and middle ear cavity recovered well.CONCLUSION There are various degrees of tympanic fibrous adhesion and atelectatic tympanum in middle ear adhesion,especially in mesotympanum, hypotympanum and interossicular spaces.The middle ear adhesion can be treated with operation.The key points for a successful operation include preserving normal tympanum mucosa,opening eustachian tubes, making a bigger middle ear cavity,and performing tympanoplasty with perichondrium-cartilage plates.
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Objective To explore the new methods to fill local temporal depression or augment superciliary with autotissue graft.Methods Applying upper eyebrow perdicled dermis -fat petal to fill the local temporal depression or augment superciliary, accompanied with eyebrow lifting.Results Augmentation superciliary arch plasty with upper eyebrow perdicled dermis-fat petal was performed in 5 patients. All 5 patients' superciliary arch showed good shape and accompanied with no complications. Filling of local depression of temporal with derma-fat flap was performed in 6 patients, with dermis-fat flap and prosthesis was performed in 8 patients. 2 cases had hematoma. Conclusion Upper eyebrow perdicled dermis-fat petal as a material being ultilized to augment superciliary or to fill local temporal depression has advantages of better localization and more natural shape.[