Yishen Yanggan Mingmu formula combined with anti-vascular endothelial growth factor drugs for the treatment of wet age-related macular degeneration / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To observe the clinical efficacy of Yishen Yanggan Mingmu formula combined with anti-vascular endothelial growth factor(VEGF)in the treatment of wet age-related macular degeneration(wARMD).METHODS: A total of 58 patients(58 eyes)with wARMD who were treated in Ningbo Eye Hospital from September 2020 to November 2022 were collected. They were divided into two groups according to randomized digital table: 29 patients(29 eyes)for the combination group and the other 29 patients(29 eyes)for the injection group. The injection group was only given intravitreal injection of conbercept; the combination group was orally administrated with Yishen Yanggan Mingmu formula combined with intravitreal injection of conbercept. The best corrected visual acuity(BCVA), central macular thickness(CMT)and the improvement of traditional Chinese medicine(TCM)syndromes after 3mo of treatment were observed and the clinical efficacy was evaluated.RESULTS: After 3mo of treatment, the total improved effective rate of the combination group(76%)was higher than the rate of the injection group(66%). After the treatment, the BCVA of the two groups was both higher than that before treatment(P<0.05), the CMT in both groups was lower than that before the treatment(P<0.05), and the improvement of CMT of the combination group was better than the injection group(-155.93±143.79μm vs. -95.36±56.81μm, P<0.05). After 3mo of treatment, each kinds of TCM syndrome in the combination group were significantly improved compared with those syndromes before the treatment(P<0.001). In the injection group, only blurred vision was improved(P<0.05). After the treatment, the scores of dizziness and insomnia, soreness and weakness of waist and knees, paleness and cold limbs, dry eyes and fatigue in the combination group were significantly lower than the injection group(P<0.001).CONCLUSIONS: The Yishen Yanggan Mingmu formula combined with intravitreal anti-VEGF drug injection is effective in the treatment of wARMD.

Effect of nasolacrimal duct packing combined with sodium hyaluronate gel injection in locating the nasal broken end in lacrimal canaliculus anastomosis which is difficult to find the broken end / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the effect of nasolacrimal duct packing combined with sodium hyaluronate gel injection in locating the nasal broken end in lacrimal canaliculus anastomosis which is difficult to find the broken end.METHODS:A total of 13 patients(13 eyes)with traumatic single lacrimal canaliculus rupture were treated in our hospital. RS lacrimal duct drainage tube was inserted into the lacrimal duct from intact lacrimal canaliculus to fill the nasolacrimal duct, then sodium hyaluronate gel was injected to make sodium hyaluronate gel overflow from the nasal broken end of fractured lacrimal canaliculus, which was used to locate the nasal broken end which was difficult to find and completed the lacrimal anastomosis operation.RESULTS: Among the patients with 13 eyes who were difficult to find the broken end, the nasolacrimal duct was filled with RS lacrimal duct drainage tube. After injection of sodium hyaluronate gel, the gel overflowed from the nasal broken end under direct vision of the microscope, and the lacrimal duct drainage tube was successfully inserted, and the success rate of finding the broken end was 100%. Thirteen eyes were extubated after being placed for 3mo, and then were followed up for 6mo. Among them, 9 eyes were cured, 3 eyes were markedly effective and 1 eye was ineffective. The cure rate was 69%, and the total effective rate was 92%.CONCLUSION: A new technique for rapid location of nasal broken end is proposed for patients in which are difficult to find the broken end. This method is simple to operate and requires a relatively low clinical experience. It is suitable for patients with different degrees of single lacrimal canaliculus rupture and can complete complex lacrimal canaliculus rupture anastomosis in a short time.

Extracts of Poria cocos polysaccharides improves alcoholic liver disease in mice via CYP2E1 and NF-κB inflammatory pathways / 中国中药杂志

The present study investigated the effect of extract of Poria cocos polysaccharides(PCP) on cytochrome P450 2 E1(CYP2 E1) and nuclear factor κB(NF-κB) inflammatory signaling pathways in alcoholic liver disease(ALD) mice and explored its protective effect and mechanism. Sixty male C57 BL/6 N mice of SPF grade were randomly divided into a control group, a model group, a positive drug group(bifendate, 200 mg·kg~(-1)), and high-(200 mg·kg~(-1)) and low-dose(50 mg·kg~(-1)) PCP groups. Gao-binge mo-del was induced and the mice in each group were treated correspondingly. Liver morphological and pathological changes were observed and organ index was calculated. Serum levels of alanine aminotransferase(ALT) and aspartate aminotransferase(AST) were detected. Malondialdehyde(MDA) and superoxide dismutase(SOD) in liver tissues were detected by assay kits. The levels of interleukin-6(IL-6) and tumor necrosis factor-α(TNF-α) were detected by ELISA. The activation of macrophages was observed by immunofluorescence staining and protein expression of CYP2 E1, Toll-like receptor 4(TLR4), NF-κB p65, and phosphorylated NF-κB p65(p-NF-κB p65) were analyzed by Western blot. The ALD model was properly induced. Compared with the model group, the PCP groups significantly improved the pathological injury of liver tissues. Immunofluorescence staining revealed that compared with the model group, the groups with drug intervention showed decreased macrophages in liver tissues. Additionally, the PCP groups showed reduced ALT, AST, MDA, IL-6, and TNF-α(P<0.05), and potentiated activity of SOD(P<0.01). PCP extract has the protective effect against alcoholic liver injury in mice, and the underlying mechanism may be related to the regulation of the expression of CYP2 E1 and inhibition of TLR4/NF-κB inflammatory signaling pathway to reduce oxidative stress and inflammatory injury, thereby inhibiting the development of ALD.

Determination of Three Types of New Psychoactive Tryptamines in Blood by QuEChERS Combined with UPLC-MS/MS / 法医学杂志

Objective To establish a method combining QuEChERS and ultra-high liquid chromatography-tandem mass spectrometry （UPLC-MS/MS） for rapid screening and testing of three types of new psychoactive tryptamines in human blood： 5-MeO-DALT, 5-MeO-MiPT and 5-MeO-DiPT. Methods The effects of the type of extractant, the type and dosage of salting-out agent, and the dosage of adsorbent on the test results of the three tryptamines were investigated. Blood samples were processed by QuEChERS method and then determined by UPLC-MS/MS. Results The linear relationships of 5-MeO-DALT, 5-MeO-MiPT and 5-MeO-DiPT in human blood were good in the range of 0.5-100, 0.5-100 and 0.2-100 ng/mL, respectively, with their coefficients higher than 0.99. The limits of detection （LODs） were 0.1-0.2 ng/mg. The recoveries ranged from 84.86% to 94.57%. Intra-day and inter-day precisions were good. Conclusion The method is simple, rapid, easy to operate and has a high recovery. It is suitable for the qualitative and quantitative study of tryptamines in blood and can provide the reference for public security organs to deal with related cases.

Research progress of polycyclic polyprenylated acylphloroglucinols natural products / 中国中药杂志

Due to their fascinating chemical structures and extensive pharmacological activities, polycyclic polyprenylated acylphloroglucinols(PPAPs) have become one of the current research hotspots of natural products. In particular, some of the PPAPs not only have novel non-traditional skeleton types, but also contain more unknown possible activities, which are of great significance for the development of lead compounds. The structure, source, biosynthetic pathway and pharmacological activities of PPAPs with non-traditio-nal skeleton types isolated and identified in recent years are reviewed, in order to provide references for further research on such compounds.

Effect of neuregulin-1 on cardiac glucose metabolism in rats with experimental myocardial infarction / 中华心血管病杂志

Objective: To investigate the effect of neuregulin-1(NRG-1) on cardiac glucose metabolism in Sprague Dawley (SD) rats with experimental myocardial infarction (MI). Methods: Adult male SD rats were randomly divided into three groups: the sham-operated group, MI group, and MI+NRG1 group. The rat MI model was established via ligation of the left anterior descending coronary artery. Two weeks after operation, echocardiography was performed, MI rats with left ventricular ejection fraction (LVEF) between 0.3-0.5 were selected and randomly assigned to MI group and MI+NRG-1 group. Rats in MI+NRG-1 group were treated with recombinant human NRG-1β (100 μg/kg) via tail vein at 2 weeks after operation (twice per week for 6 weeks); while rats in sham-operated group and MI group received equal volume of physiological saline. By the end of administration, echocardiography and small animal positron emission tomography (PET) were performed to detect cardiac function and myocardial glucose uptake. Myocardial morphology and collagen volume fraction, cardiomyocyte apoptosis and reactive oxygen species (ROS) production were evaluated by histopathologic analysis. Myocardial pyruvate dehydrogenase (PDH) and citrate synthase (CS) activity, as well as ATP production were detected by commercial kits. The mRNA and protein expression levels of NRG-1, p-ErbB4, and key factors involved in glucose metabolism (including Glut-4, HK2, PDK4, PDH, CS) were detected by quantitative real-time PCR (qRT-PCR) and Western blot assay, respectively. Results: With the MI model successfully established, the left ventricular ejection fraction(LVEF) and left ventricular shortening fraction(LVFS) were significantly lower in MI group and MI+NRG-1 group than that in sham group (both P<0.01), while there was no significant difference between MI group and MI+NRG-1 group(all P>0.05). After 6 weeks of NRG-1β intervention, the LVEF and LVFS were significantly higher in MI+NRG-1 group than in MI group (both P<0.01). By the end of experiment, PET imaging showed that the mean standardized uptake value (SUVmean) were lower in MI+NRG-1 group than in the sham group (4.06±0.28 vs. 5.18±0.37, P<0.01), while significantly higher than that in MI group (4.06±0.28 vs.2.86±0.49, P<0.01). Histopathological analysis showed that compared with MI group, rats in MI+NRG-1 group exhibited significantly decreased left ventricle collagen volume fraction ((7.83±1.24) % vs. (18.31±3.58) %, P<0.01), cardiomyocyte apoptosis((37.98±4.26)% vs. (67.04±5.38)%, P<0.01), and DHE fluorescence intensity(0.057 28±0.007 06 vs. 0.076 94±0.008 46, P<0.01), indicating that NRG-1β could reduce ROS production. PDH activity, CS activity, and ATP production were significantly higher in MI+NRG-1 group than in MI group (all P<0.05). qRT-PCR demonstrated an upregulated Glut-4, HK2 and CS, but downregulated PDK4 mRNA expression in MI+NRG-1 group compared with MI group (all P<0.01). Western blot assay showed significantly higher protein expression of NRG-1, p-ErbB4, Glut-4, HK2, PDH, CS in MI+NRG-1 group than in MI group (all P<0.01). Conclusion: NRG-1 could improve glucose uptake and utilization in myocardium by activating phosphorylation of myocardial ErbB4 receptor in MI rats, thus providing a therapeutic option for improving energy metabolism after MI.

The compilation and explanation of Technical Plan for Emergency Treatment of Acute 1,2-Dichloroethane Poisoning / 中国职业医学

Acute 1,2-dichloroethane poisoning causes serious illness, deaths and is a social event of great influence. The compilation of Technical Plan for Emergency Treatment of Acute 1,2-Dichloroethane Poisoning provides scientific guidance for effective treatment of 1,2-dichloroethane poisoning events. The plan describes in detail the specific practice and technical requirements of six links in the process of handling emergency of acute 1,2-dichloroethane poisoning, including accident investigation and treatment, risk assessment, collection and testing of samples, medical treatment, health monitoring and emergency response, et al. The key contents of individual protection requirements, investigation content, etiology determination, medical assistance and health education in the disposal of poisoning incidents were clarified, and the procedures and requirements of health education were added. The technical scheme is scientific, objective and operable, which can provide scientific guidance for the effective treatment of 1,2-dichloroethane poisoning accidents.

Treatment experience of a case of brodifacoum poisoning / 中国职业医学

OBJECTIVE: To analyze the experience of diagnosis and treatment of a case of brodifacoum poisoning. METHODS: The clinical data of a case of unexplained brodifacoum poisoning was retrospectively analyzed. RESULTS: The patient went to the doctor for unexplained bleeding. The bleeding symptoms included nasal o blood ozing, blood in saliva and skin ecchymosis. Blood anticoagulative rodenticide test showed positive with brodifacoum. The results of coagulative function tests showed that the indexes of partial prothrombin time, prothrombin time and fibrinogen were increased. The patient was diagnosed as brodifacoum poisoning based on the clinical symptoms and laboratory test results. The combined use of 40 mg/d of vitamin K_1 and frozen plasma improved the clotting time and quickly alleviated the bleeding symptoms of the patient. However, the patient′s bleeding symptoms recurred when vitamin K_1 was discontinued. The patient was hospitalized for 62 days and then discharged. With follow-up one month after discharge, the patient showed no bleeding symptoms, but brodifacoum could still be detected in the blood. CONCLUSION: The symptoms of brodifacoum poisoning may relapse and the treatment course is long. Vitamin K_1 could be used as the first-choice medicine for the treatment of brodifacoum poisoning, but its usage needs to be optimized.

Exploring pharmacological mechanism of Magnoliae Officinalis Cortex based on systems pharmacology / 中草药

Objective: To explore the pharmacological mechanism of traditional Chinese medicine (TCM) Magnoliae Officinalis Cortex by systems pharmacology (SP). Methods: A database of magnolia components was established by using the database of TCM ingredients and a large number of literature search. After that, ADME was used to screen the active compounds of magnolia, and these ingredients and an in silico software were used to identify targets. Finally, the pharmacological mechanism of magnolia was analyzed by SP methods network analysis and pathway analysis. Results: The most comprehensive database of magnolia ingredients to date have been established, containing a total of 144 magnolia compounds. After screening, we obtained seven magnolia active compounds which meet the conditions and identified 54 interacting targets. The network analysis showed that these targets were mainly related to intestinal motility, inflammation, diabetes and thrombus. Through pathway analysis, we found that a total of 152 biological pathways were involved in the targets of magnolia, and these pathways were involved in cancer-related mechanisms in addition to the above diseases. Conclusion: This study not only uses SP to reveal the pharmacological mechanisms of magnolia on intestinal motility, inflammation, diabetes, thrombus and cancer, but also reflects the typical “multi-component, multi-target, multi-channel” TCM characteristics of magnolia and provides a new SP technology to explore the pharmacological mechanism of TCM.

Clinical and pathological features of idiopathic membranous nephropathy with phospholipase A2 receptor negative and serum anti PLA2R antibody negative: 40 cases analysis / 中国实用内科杂志

OBJECTIVE: To investigate the clinicopathological features of phospholipase A2 receptor(PLA2R) negative patents with idiopathic membranous nephropathy(IMN). METHODS: IMN patients diagnosed by renal biopsy were enrolled in this study. Glomerular PLA2 R deposition(GAg) and serum anti-PLA2 R antibodies(SAbs) were detected by immunohistochemical staining and enzyme linked immunosorbent assay, respectively. Patients were divided into two groups. Both GAg and SAbs were negative in patients of Group A. Patients of group B were selected from patients who were positive for GAg and SAbs and were matched with group A in gender and age. The clinical and laboratory data of the two groups were collected. Glomerular thrombospondin type-1 domaincontaining 7A(THSD7A) deposition and serum anti-THSD7 A antibody were also measured by immunohistochemical staining and indirect immunofluorescence in the two groups, respectively. RESULTS:(1) Compared with group B, patients in group A had lower levels of proteinuria, lower proportion of microscopic hematuria, higher remission rate(P<0.05). The positive rate of IgG4 in group A(45.0%) was significantly lower than that in group B(85.0%)(P<0.01).(2) The positive rate of glomerular THSD7 A deposition and serum anti-THSD7 A antibody of group A were 17.5% and 7.5%. Patients in group B showed negative THSD7 A tissue staining and antiTHSD7 A antibodies. CONCLUSION: Compared with patients who were positive for GAg and SAbs, patients who were negative for GAg and SAbs exhibited lower levels of proteinuria and higher remission rate. The positive rate of glomerular THSD7 A deposition and serum anti-THSD7 A antibody was low in patients with IMN.

Low Calf Circumference Predicts Nutritional Risks in Hospitalized Patients Aged More Than 80 Years / 生物医学与环境科学（英文）

OBJECTIVE@#The aim of this study was to determine whether low calf circumference (CC) could predict nutritional risk and the cutoff values of CC for predicting nutritional risk in hospitalized patients aged ⪖ 80 years.@*METHODS@#A total of 1,234 consecutive patients aged ⪖ 80 years were enrolled in this study. On admission, demographic data, CC, and laboratory parameters were obtained. Patients with Nutritional Risk Screening 2002 (NRS-2002) total score ⪖ 3 were considered as having nutritional risk.@*RESULTS@#CC values were significantly lower in patients with nutritional risk compared to those in patients without nutritional risk [27.00 (24.50-31.00) vs. 31.00 (29.00-33.50], P < 0.001]. CC was negatively correlated with age and nutritional risk scores. Logistic regression analysis of nutritional risk revealed that body mass index, albumin level, hemoglobin level, cerebral infarction, neoplasms, and CC (OR, 0.897; 95% confidence interval, 0.856-0.941; P < 0.001) were independent impact factors of nutritional risk. Nutritional risk scores increased with a decrease in CC. In men, the best CC cutoff value for predicting nutritional risk according to the NRS-2002 was 29.75 cm. In women, the cutoff value was 28.25 cm.@*CONCLUSION@#CC is a simple, noninvasive, and valid anthropometric measure to predict nutritional risk for hospitalized patients aged ⪖ 80 years.

Effects of sevoflurane postconditioning on oxidative stress and expression of SIRTl/PGC-1α of hippocampus in a rat model of hemorrhagic shock and resuscitation / 中国药理学通报

Aim To investigate the effects of sevoflurane postconditioning on oxidative stress and the expression of silent information regulation (SIRT1) and peroxisome proliferator-activated receptor γ coactivator la (PGC-1α) in hippocampus of rats subjected to hemorrhagic shock and resuscitation. Methods Male SD rats were randomly divided into sham surgery group (Sham group), shock and resuscitation group (Shock group) and 2.4% sevoflurane postconditioning group (Sevo group). The rats in Sevo group were inhaled 2.4% sevoflurane when received resuscitation after hemorrhagic shock, while rats in Sham and Shock group were treated with 95% O2 and 5% CO2 in the corresponding period. MAP and arterial blood gases were measured at TO (start bleeding), Tl (30 min after bleeding),T2 (start resuscitation), and T3 (30 min after resuscitation). After 24h of surgery,rats with successful model were chosen for the detection of various indexes. The content of malonaldehyde (MDA) in hippocampus and the activity of superoxide dismutase (SOD) in mitochondria isolated from hippocampal tissue were detected. Western blot was used to analyze the protein relative expression levels of SIRT1 and PGC-la in hippocampus. Results Compared with Sham group, the content of MDA increased, the activity of SOD decreased, and the expression of SIRT1 and PGC-1α a increased in Shock group (P < 0. 05). Compared with Shock group, the content of MDA decreased, the activity of SOD increased, and the expression of SIRT1 and PGC-1α increased in Sevo group (P < 0. 05). Conclusions Sevoflurane postconditioning can alleviate oxidative stress in hippocampus of a model rat of hemorrhagic shock and resuscitation, which may be correlated with the up-regulation of the protein relative expression levels of SIRT1 and PGC-1α.

Simultaneous quantitative analysis of four triterpenes in Poria Cocos from different habitats by QAMS / 中草药

Objective To establish a new method and validate its feasibilities by the simultaneous quantitative assay of four triterpenes in Poria cocos. Methods A new quality evaluation method of multi-components by single marker (QAMS) was established and validated for P. cocos. Pachymic acid (PA), dehydropachymic acid (DPA), dehydrotumulosic acid (DTA), and dehydrotrametenolic acid (DMA) were selected as analytes while pachymic acid was chosen as internal reference substance to evaluate the quality. The relative correction factor (RCF) of pachymic acid to the other three triterpenes were calculated. The method was evaluated by the comparison of quantity between external standard method and QAMS method. Results The contents of four triterpenes in 17 batches of P. cocos from QAMS method were not significantly different from those from external standard method. Conclusion The method with a single marker is accurate and feasible to determine PA, DPA, DTA, and DMA when some authentic standard substance are unavailable.

Quantitative analysis of 16 components in Cyclocarya paliurus leaf by UPLC-QE-Orbitrap-MS / 中国中药杂志

Modern research showed that components in the dried leaf of Cyclocarya paliurus. had various biological activities. The current quality control research was focused on content determination of polysaccharides and flavonoids, while there were less research on quantitative analysis of terpenes and phenolic acids. In this paper, the contents of 16 components of 3 kinds in C. paliurus leaf were determined by UPLC-QE-Orbitrap-MS. The results were as following: good linear relationship of 16 analytes existed within the studied concentration rages (²>0.996), and RSDs were of <3.0% in the precision test and replicate test, with the average recovery rates 95.20%-104.4%, respectively. The results indicatod that the method is simple and accurate, which can be used for the comprehensive quality evaluation of C. paliurus leaf. The established method was applied to determine the contents of 12 batches of C. paliurus leaf from different areas, and the 16 analvtes contents in the samples could be different from several times to dozens times, which indicated that there might be significant quality difference in C. paliurus leaf from different areas.

Anti-inflammatory effects of compound Cervi Cornu Degelatinatum extract on adjuvant arthritic rats / 中成药

AIM To study the anti-inflammatory effects of compound Cervi Cornu Degelatinatum extract on adjuvant arthritic rats.METHODS The rats,except for those assigned into a blank group,were induced to be the adjuvant arthritis models by Freund's complete adjuvant and randomly divided into model group,Prednisone Acetate Tablets group,Tripterygium wilfordii polyglycoside tablets group,and compound Cervi Cornu Degelatinatum extract groups (1 000 mg/kg high-dose group,500 mg/kg medium-dose group,and 250 mg/kg low-dose group) to observe changes in body weight,mental state,and extent of joints injury.Post-treatment levels of TNF-α,IL-6,IL-10 and PGE-2 were determined by ELISA,and the pathological changes of ankle joints were assessed by HE staining.RESULTS Significantly lower body weight and IL-10 level,markedly higher levels of TNF-α,IL-6,PGE-2,and joints injury in the model group than those in the blank group were observed (P ＜0.01).Such indices also revealed the significant superiority in the high-dose,medium-dose groups of compound Cervi Cornu Degelatinatum extract and the positive control group as compared with the model group.CONCLUSION Compound Cervi Cornu Degelatinatum extract highlights the rheumatoid arthritis management through proinflammatory cytokines secretion reduction,the antiinflammatory factors improvement,and the inflammatory reaction and tissue damage alleviation.

Precision nursing:trend and implication / 中华护理杂志

The purpose of this article is to provide an overview of precision nursing and its implications for education,practice and research.The emphases are on the contributions of nursing practice and research to genomics as well as precision health and precision medicine.Recommendations are elucidated on how to build knowledge and competence of precision nursing within the broad arena of precision health and precision medicine to promote the development of precision nursing.

Clinical Characteristics and Outcome of 66 Cases of Mantle Cell Lymphomas / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To analyze the clinical features and prognostic factors of patients with mantle cell lymphoma(MCL).</p><p><b>METHODS</b>The clinical data of 66 MCL patients were collected from the Department of Hematology of Shanghai Ruijin Hospital, Shanghai Jiaotong University Medical School from January 2000 to December 2014. The clinical characteristics, treatment efficiency and survival rate were analyzed retrospectively.</p><p><b>RESULTS</b>The sex ratio of male to female in these 66 MCL patients was 3.71:1, the nosopoietic median age was 59 years old, and most cases were diagnosed as MCL in Ann Arbor stage III-IV(90.9%). "R-HperCVAD" regimen had the highest CR-rate reached to 55.6%, and CR rate of "R-CHOP" reached to 44.4%. The total prospective 5-year overall survival and progress-free survival rates were 35.5%±11.5% and 8.8%±5.6%, respectively. Leukocyte count abnormality(>10×10/L or <4×10/L), B symptom, LDH level, bone marrow involvement, Ki-67 and high risk group of MIPI scores, and therapy combined with or without rituximab were the independent prognostic factors.</p><p><b>CONCLUSION</b>The prognosis of MCL patients is poor, and the incidence is higher in men. The extranodal sites of bone marrow and gastrointestinal tract are involved more easily. The treatment combined with rituximab can increase survival rate for these patients.</p>

Analysis on the characteristics of DMPS in the treatment of patients with increased urinary mercury / 中国职业医学

OBJECTIVE: To evaluate the efficacy and safety of sodium dimercaptopropane sulfonate( DMPS) in the treatment of patients with increased urinary mercury. METHODS: By random sampling method,68 patients with elevated urinary mercury were chosen as study subjects. Among them,61 cases were observation subjects working with mercury and 7 cases were chronic occupational mild mercury poisoning. DMPS was used to eliminate mercury by intramuscular injection. The changes of urinary mercury level were observed before and after treatment,and the curative effect was analyzed. RESULTS: The median( the 25 th and 75 th percentiles) of natural voiding urinary mercury was 36. 6( 28. 4,55. 6) μmol / mol creatinine and 24 hours total urine mercury amount was 1 074. 7( 608. 0,1 646. 3) μg / d in the first course of treatment.After 1 to 8 courses of mercury expulsion,the 24 hours total urine mercury amount in 68 patients were lower than the normal reference level( 45. 0 μg / d). The median( the 25 th and 75 th percentiles) of one-time morning urinary mercury level before hospital discharge was 2. 7( 1. 8,4. 0) μmol / mol creatinin,which was lower than the level of natural voiding urinary mercury( P < 0. 05). The first and second course of treatment resulted in the highest decline in urinary mercury,followed by a gradually decreased in urinary mercury in later courses. The number of treatment courses in observation subjects working with mercury was less than that in patients with chronic mild mercury poisoning [( 4. 0 ± 1. 3) vs( 5. 6 ±1. 1) times,P < 0. 05]. There was a positive correlation between the number of treatment courses and the level of natural voiding urinary mercury or 24 hours total urine mercury amount in the first course of treatment( P < 0. 01). The number of courses of mercury expulsion was not related to gender,length of service and age( P > 0. 05). One patient had dizziness and pale after intramuscular injection of DMPS,the symptom was disappeared with symptomatic treatment; 68 patients after treatment have no other adverse reactions. CONCLUSION: Using DMPS as mercury displacement treatment was effective and relatively safe. The change of urinary mercury after DMPS treatment can be used as a basis for establishing clinical standard for patients with increased urinary mercury.

Comparison of therapeutic effects between comprehensive therapy and routine therapy in treatment of occupational chronic n-hexane poisoning / 中国职业医学

OBJECTIVE: To evaluate the therapeutic effects between comprehensive therapy and routine therapy in treatment of occupational chronic n-hexane poisoning. METHODS: By randomized controlled trial,116 cases with occupational chronic n-hexane poisoning were divided into two groups: the control group( n = 58) and the treatment group( n = 58). Subjects in the control group were given vitamin B_(12) and vitamin B_1 for neural nutrition; and Danshen and deproteinized calf blood extractive injection for activating blood circulation to dissipate blood stasis. Subjects in the treatment group were treated with comprehensive treatment including traditional Chinese and Western medicine,which including mouse nerve growth factor,acupuncture,physical therapy( infraredtherapy,microwave irradiation therapy),Chinese medicine steamingwashing and comprehensive rehabilitation therapy for a period of 12 weeks in addition to the conventional treatment. The curative effect and adverse reactions of both groups were observed after 12 weeks,and the treatment results and hospital stay were followed up. RESULTS: Before treatment,no significant differences( P > 0. 05) were noted in both groups in scores of neurological symptoms,signs,activities of daily living and neurogenic damage indexes of electroneuromyography[including motor digital latency( MDL),motor nerve conduction velocity( MCV),sense nerve conduction velocity( SCV) of median nerve,ulnar nerve,sural nerve or common peroneal nerve; and the detection of lengthen MDL,shorten MCV and SCV]. After treatment,patients in both groups got better in terms of the above indicators( P < 0. 05),with larger extend of improvement noted in the treatment group than in the control group( P < 0. 05). No obvious adverse reactions were noted in the 2 groups. Hospital stay of patients in the treatment group was about 2 months shorter than that in the control group( P < 0. 05). CONCLUSION: The therapeutic effects of comprehensive therapy on occupational chronic n-hexane poisoning are obviously better than routine therapy,which is an effective and safe therapeutic method.

Clinical analysis on occupational chronic n-hexane poisoning cases / 中国职业医学

OBJECTIVE: To collect,analyze and summarize the clinical characteristics of occupational chronic n-hexane poisoning cases reported in the literatures published in domestic open public periodicals in order to provide evidence for the revision of GBZ 84 Diagnostic Criteria of Occupational Chronic n-Hexane Poisoning. METHODS: By the bibliometrics method,the databases of CNKI,VIP and WANFANG were used to retrieve literatures on the occupational chronic n-hexane poisoning published from 1990 to 2014. The literatures with detailed clinical data were screened and selected for summary and analysis. RESULTS: A total of 68 reference literatures meeting the inclusion criteria were chosen in 25 years of domestic publication. These literatures reported 1 027 cases of occupational n-hexane poisoning,including 165 males and 862 females. The median of age was 28. 3( 13. 0-59. 0) years. Most of the cases had a disease incubation period of 2. 0-10. 0months. The diagnostic classification was made in 817 cases( 79. 6%),with mild,moderate and severe chronic n-hexane poisoning in 418,241 and 158 cases,respectively. The n-hexane levels in workplace air were reported in 736 cases( 71. 7%),91. 8%( 676 /736) of which had exceeded the national occupational exposure limit. Chronic n-hexane poisoning was mainly characterized by peripheral nerve damage,626 cases( 61. 0%) had feeling and movement disorders,256 cases( 24. 9%) had movement disorder and 145 cases( 14. 1%) had feeling disorders. The clinical characteristics of these disorders were bilaterally symmetric feeling or movement disorders in distal limbs. The nerve-electromyography examination showed the neurogenic damage,which was parallel with the severity of patients' condition and could be detected at early stage of illness. The gas chromatography was used to detect the 2,5-hexanedione level of 156 cases( 15. 2%) of patients and the positive detection rate was 50. 6%( 70 /156). Currently,there was no specific medication or other therapy for treatment of chronic n-hexane poisoning. The comprehensive therapy which mainly include nerve restoration was the general therapy method. Addition of mouse nerve growth factor to the conventional therapy had significant treatment effects. The therapeutic effect was reported in 954 cases with the recovery rate of 83. 6%( 798 /954),and the complication in nervous system was observed in 156 cases who were not cured. CONCLUSION: The main clinical manifestation of chronic n-hexane poisoning is peripheral neuropathy. The nerve-electromyography is the most important diagnostic method. Currently,comprehensive therapy is used with good prognosis in the patients.