ABSTRACT
Objective To observe the clinical effect of hemoperfusion in the treatment of patients with critical severe organophosphorus poisoning. Methods Sixty-two patients with critical severe organophosphorus poisoning admitted to the Department of Critical Care Medicine of Jincheng People's Hospital from August 2016 to August 2018 were enrolled, and they were divided into a routine treatment group and a hemoperfusion group according to whether hemoperfusion or not, 31 cases in each group. The routine treatment group was treated with western drugs combined with continuous gastric lavage, while the hemoperfusion group was additionally treated with hemoperfusion for consecutive 3 days on the basis of the routine emergency regimen. The changes of the dosage of penehyclidine hydrochloride used, recovery time of consciousness, recovery time of cholinesterase (ChE) activity, off-line time of mechanical ventilation, hospitalization time, poisoning rebound and mortality were observed in the two groups after treatment; Glasgow coma scale (GCS) was used to assess the prognosis of patients. Results The dosage of penehyclidine hydrochloride used in hemoperfusion group was less than that in the routine treatment group (mg: 3.1±1.2 vs. 5.8±1.3), and the time of consciousness recovery (hours: 3.3±1.7 vs. 13.4±2.4), recovery time of ChE activity (days: 7.7±1.5 vs. 17.9±3.3), off-line time (days: 2.1±0.9 vs. 7.5±2.6), hospitalization time (days: 12.3±1.5 vs. 19.8±3.6) in hemoperfusion group were shorter than those in the routine treatment group (all P < 0.05); poisoning rebound [3.23% (1/31) vs. 16.13% (5/31)] and mortality [9.68% (3/31) vs. 25.81% (8/31)] in hemoperfusion group were lower than those in the routine treatment group (both P < 0.05). The Glasgow coma score (GCS) of the hemoperfusion group on 3, 4 and 5 days after treatment were all higher than those of the routine treatment group (9.9±2.9 vs. 5.7±2.6, 13.3±2.7 vs.7.8±3.2, 13.3±1.5 vs.9.3±2.6, all P < 0.05). Conclusion The conventional treatment, western drug and gastric lavage, combined with hemoperfusion in patients with critical severe organophosphorus poisoning can further reduce the hospital stay, improve the quality of life and reduce the mortality of such patients, therefore.
ABSTRACT
Objective To investigate the prevalence of cervical human papillomavirus (HPV)infection in women with and without cervical lesions in Zhejiang province.Methods Cervical exfoliated cell samples were collected in 865 women with cervical lesions and 630 women with normal cytology from Zhejiang Provincial People's Hospital,Red Cross Hospital of Hangzhou,Maternal and Child Health Hospital of Fuyang City,and the Department of Basic Medical Sciences of Zhejiang Medical College of Zhejiang province.The flow-through hybridization technique (HybriMax) was used to detect 21 kinds of HPV genotypes.x2 and exact test were used for the comparison of HPV infection rates and genotype distributions between women with cervical lesions and those with normal cytology.Results The prevalenceof HPV infection in women with cervical lesions (27.28％,236/865) was significantly higher than that in women with normal cytology (10.32％,65/630) (x2 =65.2,P ＜0.01).In cervical lesion group,60 out of 236 HPV-positive patients (25.42％) were infected with multiple HPVs,including 42 patients infected with 2 genotypes of HPV,12 with 3 types of HPV,5 with 4 types of HPV and 1 with 5 types of HPV ; while in HPV-positive women with normal cytology,only 1 case was infected with multiple HPVs,with a rate of 1.54％ (1/65) (x2 =18.0,P ＜ 0.01).Totally 321 strains (covering 19 HPV genotypes) of HPV were obtained in cervical lesion group,including 188 (58.57％) strains of high-risk,114 (35.51％) strains of low-risk,and 19 (5.92％) strains of other types,and the most prevalent high-risk genotypes were HPV-16,HPV-58,HPV-33,HPV-52 and HPV-39.While in normal cytology group,66 strains (covering 16 HPV genotypes) of HPV were obtained,and the most prevalent genotypes were HPV-52,HPV-16,HPV-31,HPV-58 and HPV-ep8304.Conclusion The prevalence of HPV infection in women with cervical lesions is significantly higher than that in women with normal cytology,and the most prevalent genotypes of infection are HPV-16,HPV-58,HPV-33,HPV-52 and HPV-39.