Epidemiological characteristics of pesticide poisoning in Chengdu City from 2012 to 2021 / 中华劳动卫生职业病杂志

Objective: To explore the present situation and epidemiological characteristics of pesticide poisoning in Chengdu City from 2012 to 2021, and to provide scientific evidence for further prevention and control. Methods: In January 2022, the pesticide poisoning report cards of Chengdu City from 2012 to 2021 were collected from the China Disease Control and Prevention Information System. The data of the report card was reorganized and the distribution characteristics of pesticide poisoning such as time, region, gender, age and pesticide types were analyzed. Results: 14326 cases of pesticide poisoning were reported in Chengdu City from 2012 to 2021, 651 deaths, and the fatality rate was 4.54%. The cases of productive pesticide poisoning and unproductive pesticide poisoning were 504 and 13822, respectively. The fatality rates of productive and unproductive pesticide poisoning were 1.39% and 4.66%, which were significant different (χ(2)=11.99, P=0.001). The highest reported cases of pesticide poisoning was in 2013 (1779) and the lowest in 2021 (1047). The number of reported cases showed a downward trend year by year (t=-12.30, P<0.001), and the fatality rates also showed a downward trend year by year (χ(2)(trend)=25.48, P<0.001). The fluctuation range of unproductive pesticide poisoning cases in each month of the year was small, and the productive pesticide poisoning mainly occurred from May to August. The regions with the largest number of reported poisoning cases were Pengzhou (1620), Jianyang (1393), Jintang (1266) and Qionglai (1158). The high incidence of poisoning was among 25-54 years old (50.21%, 7193/14326). The fatality rate in the age group 75-96 years old was the highest (8.98%, 95/1058), and the fatality rates increased gradually with age (χ(2)(trend)=186.03, P<0.001). The pesticides causing poisoning were mainly insecticide (43.86%, 6284/14326) and herbicides (35.75%, 5121/14326). Herbicides paraquat had the highest fatality rate (9.54%, 286/2998) . Conclusion: Pesticide poisoning in Chengdu City is mainly unproductive poisoning. Health education should be carried out for key areas and people, and the control of highly toxic pesticides such as insecticide and herbicides should be strengthened.

Effects of specimen preservation and transportation on blood paraquat concentration in rats / 中华劳动卫生职业病杂志

Objective: To investigate the effects of duration, temperature and shake on paraquat (PQ) concentration in the blood of PQ-exposed rats during the specinen preservation and transportation. Methods: In March 2021, 60 SD male rats of Specific Pathogen Free class were randomly divided into low-dose group (10 mg/kg PQ) and high-dose group (80 mg/kg PQ). Each group was divided into 5 subgroups (normal temperature group, cold storage group, 37 ℃ storage group, shaking on normal temperature group and shaking on 37 ℃ group), six rats in each subgroup. The rats were given intraperitoneal injection of PQ, 1 h after exposure, the blood samples were obtained by cardiac extraction. After different interventions, the concentrations of PQ were detected and compared before and after the intervention in each subgroup. Results: In the shaking on 37 ℃ group, the results of PQ concentrations in PQ-exposed rats were significantly lower than those before the intervention (P<0.05). In the other subgroups, the results were not significantly different compared with before intervention (P>0.05) . Conclusion: The concentration of PQ in the blood of rats exposed to PQ was decreased by shaking for 4 hours at 37 ℃.

Effect of pirfenidone on paraquat-induced pulmonary fibrosis in rats / 中华劳动卫生职业病杂志

Objective: To construct paraquat (PQ) poisoning rat model and to explore the effect of pirfenidone (PFD) on PQ-induced pulmonary fibrosis. Methods: In April 2017, male 6-8 week-old Wistar rats were selected, and PQ was administered intraperitoneally at one time. PFD was administered by gavage 2 hours after poisoning. The daily gavage doses were 100, 200 and 300 mg/kg, and the rats were divided into physiological saline group, PQ group, PQ+PFD 100 group, PQ+PFD 200 group, PQ+PFD 300 group, with 10 rats in each group at each observation time point. The pathological changes of lung tissue at different time points (the 1st, 3rd, 7th, 14th, 28th, 42nd and 56th days) after poisoning and the effect of PFD intervention with different dose on PQ-induced pulmonary fibrosis were observed. Pathological evaluation of lung tissue was performed by Ashcroft scale method. The PQ+PFD 200 group was selected to further explore the pathological changes of lung tissue, the contents of hydroxyproline and malondialdehyde in lung tissue were determined.And the tumor necrosis factor (TNF) -α, interleukin (IL) -6, transforming growth factor (TGF) -β1, fibroblast growth factor (FGF) -B, platelet-derived growth factor (PDGF) -AB, insulin-like growth factor (IGF) -1 and PQ concentrations in serum and lung tissue were determined. Results: On the 1st to 7th day after PQ exposure, rats developed lung inflammation, which was aggravated on the 7th to 14th day, and pulmonary fibrosis appeared on the 14th to 56th day. Compared with PQ group, the Ashcroft scores of lung fibrosis in PQ+PFD 200 group and PQ+PDF 300 group decreased significantly in 7th and 28th day (P<0.05), while the Ashcroft score of lung fibrosis in PQ+PFD 100 group had no significant difference (P>0.05). After PQ exposure, the content of hydroxyproline in lung tissue increased gradually and reached the peak value on the 28th day. Compared with the PQ group, the contents of hydroxyproline in the PQ+PFD 200 group decreased at the 7th, 14th and 28th day, and the contents of malondialdehyde decreased at the 3rd and 7th day, the differences were statistically significant (P<0.05). The levels of TNF-α, IL-6 in rat serum and lung tissue reached the peak value on the 7th day after PQ exposure, and the levels of TGF-β1, FGF-B and IGF-1 in rat serum and lung tissue reached the peak value on the 14th day after PQ exposure, and the level of PDGF-AB in rat serum and lung tissue reached the peak value on the 28th day after PQ exposure. Compared with PQ group, the level of serum IL-6 in PQ+PFD 200 group decreased significantly on the 7th day, and serum TGF-β1, FGF-B, PDGF-AB and IGF-1 on the 14th and 28th day were decreased significantly (P<0.05). The levels of TNF-α, IL-6 in lung tissue of rats in PQ+PFD 200 group on the 7th day decreased significantly, and the levels of TGF-β1, FGF-B and IGF-1 in lung tissue of rats on the 14th day were significantly decreased, and the level of PDGF-AB in lung tissue of rats on the 28th day were significantly decreased (P<0.05) . Conclusion: PFD partially alleviates the PQ-induced lung inflammation and fibrosis by inhibiting oxidative stress, reducing the levels of pro-inflammatory and pro-fibrotic cytokines in serum and lung tissue, but does not affect the concentrations of PQ in serum and lung tissue.

Effects of Nintedanib associated with Shenfu Injection on paraquat-induced lung injury in rats / 中华劳动卫生职业病杂志

Objective: To study the effects of Nintedanib associated with Shenfu Injection on lung injury induced by paraquat (PQ) intoxication. Methods: In September 2021, a total of 90 SD rats were divided into 5 groups in random, namely control group, PQ poisoning group, Shenfu Injection group, Nintedanib group and associated group, 18 rats in each group. Normal saline was given by gavage route to rats of control group, 20% PQ (80 mg/kg) was administered by gavage route to rats of other four groups. 6 hours after PQ gavage, Shenfu Injection group (12 ml/kg Shenfu Injection), Nintedanib group (60 mg/kg Nintedanib) and associated group (12 ml/kg Shenfu Injection and 60 mg/kg Nintedanib) were administered with medicine once a day. The levels of serum transforming growth factor beta1 (TGF-β1), interleukin-1 beta (IL-1β) were determined at 1, 3 and 7 d, respectively. The pathological changes of lung tissue, the ratio of wet weight and dry weight (W/D) of lung tissue, the levels of superoxide dismutase (SOD) and malondialdehyde (MDA) in lung tissue were observed and determined after 7 d. Western blot was used to analyse the expression levels of fibroblast growth factor receptor 1 (FGFR1), platelet derivation growth factor receptor alpha (PDGFRα), vascular endothelial growth factor receptor 2 (VEGFR2) in lung tissue after 7 d. Results: The levels of TGF-β1, IL-1β in all poisoning groups went up first and then went down. The levels of TGF-β1, IL-1β in associated group at 1, 3, 7 d were lower than that of PQ poisoning group, Shenfu Injection group and Nintedanib group at the same point (P<0.05). Pathological changes of lung tissue under the light microscopes showed that the degrees of hemorrhage, effusion and infiltration of inflammatory cells inside the alveolar space of Shenfu Injection group, Nintedanib group and associated group were milder than that of PQ poisoning group, and the midest in associated group. Compared with control group, the W/D of lung tissue was higher, the level of MDA in lung tissue was higher, while the level of SOD was lower, the expressions of FGFR1, PDGFRα and VEGFR2 in lung tissue were higher in PQ poisoning group (P<0.05). Compared with PQ poisoning group, Shenfu Injection group and Nintedanib group, the W/D of lung tissue was lower, the level of MDA in lung tissue was lower, while the level of SOD was higher, the expressions of FGFR1, PDGFRα and VEGFR2 in lung tissue were lower in associated group (P<0.05) . Conclusion: Nintedanib associated with Shenfu Injection can relieve lung injury of rats induced by PQ, which may be related to Nintedanib associated with Shenfu Injection can inhibit the activation of TGF-β1 and the expressions of FGFR1, PDGFRα, VEGFR2 in lung tissue of rats.

The risk prediction value of paraquat poisoning dose, urine protein and myocardial enzymes / 中华劳动卫生职业病杂志

Objective: To explore the value of paraquat (PQ) intake, urine protein and myocardial enzyme indexes in judging the prognosis of patients with acute PQ poisoning. Methods: From September to December 2021, all 201 patients with acute PQ poisoning admitted to Guangzhou Twelfth People's Hospital from January 2010 to December 2019 were selected as the research objects. Based on follow-up results 60 days after poisoning, the research objects were divided into survival group (n=78) and death group (n=123) . The differences in information about poisoning, treatment plan, PQ intake, urine protein, creatine kinase, creatine kinase isoenzyme, lactate dehydrogenase, and α-hydroxybutyrate dehydrogenase between the two groups of patients were compared and analyzed. Logistic regression and Cox regression were used to analyze the correlation between poisoning outcome and PQ intake, urine protein and myocardial enzymes. ROC curve and principal component analysis were used to explore high-efficiency indicators for predicting the outcome of acute PQ poisoning. Results: The PQ intake[50 (20, 100) ml], urine protein (total rank 15570.50) , creatine kinase[ (336.36±261.96) U/L], creatine kinase isoenzyme[ (43.91±43.74) U/L], lactate dehydrogenase [ (346.01±196.50) U/L], α-hydroxybutyrate dehydrogenase content[ (271.23±11.92) U/L] of patients in the death group were all higher than the survival group[15 (10, 20) ml, 4730.50, (187.78±178.06) U/L, (18.88±15.50) U/L, (190.92±60.50) U/L, (152.60±48.34) U/L, respectively] (P<0.05) . The outcome of acute PQ poisoning was positively correlated with PQ intake, urine protein, creatine kinase, creatine kinase isoenzyme, lactate dehydrogenase, and α-hydroxybutyrate dehydrogenase (P<0.05) . Multivariate logistic regression and multivariate Cox regression analysis showed that creatine kinase, creatine kinase isoenzyme, lactate dehydrogenase and α-hydroxybutyrate dehydrogenase was positively correlated with the prognosis of patients with acute PQ poisoning (P<0.05) . ROC curve analysis and principal component analysis showed that the combined indexes of PQ intake, urine protein and myocardial enzymes had the highest efficacy and weight in judging the prognosis of patients (AUC=0.91, weight coefficient=0.19, sensitivity=0.76, specificity=0.89) . When the combined score was ≥4, the probability of accurately predicting the death of patients was as high as 91% (positive predictive value=0.91) . Conclusion: PQ intake, urine protein combined with creatine kinase, creatine kinase isoenzyme, lactate dehydrogenase, and α-hydroxybutyrate dehydrogenase has high value in predicting the prognosis of patients with acute PQ poisoning.

Intoxicación fatal con paraquat por vía dérmica. Reporte de caso / Fatal paraquat poisoning by dermal exposure. Case report

Introducción: Por su alta letalidad el paraquat® es utilizado con fines suicidas, siendo la principal vía de uso, la oral; los casos por vía cutánea son escasos y raras veces son fatales. Este reporte presenta un caso de compromiso sistémico severo y muerte después de exposición dérmica a paraquat® . Resumen del caso: Paciente femenina de 47 años, soltera, ama de casa, de procedencia rural, con secundaria incompleta; e historia de aplicación de paraquat® en ulcera. A las 24h de aplicación presento fiebre, vómito y malestar general; al ingreso hospitalario presento además ictericia generalizada, insuficiencia renal aguda, insuficiencia respiratoria, deterioro progresivo de su estado de salud y muerte, por lo que fue remitida a autopsia médico legal. Los hallazgos de autopsia descartaron la ingesta oral y mostraron páncreas hemorrágico, riñones congestivos, hígado de tamaño aumentado (2550g) y hemorrágico, corazón aumentado de tamaño. Los estudios histopatológicos mostraron daño alveolar difuso, (membranas hialinas, edema y hemorragia); neumonía en pulmón y congestión visceral generalizada...(AU)

Intoxicação cutânea grave por Paraquat / Serious skin poisoning by Paraquat

O Paraquat é um herbicida não seletivo altamente tóxico, sendo responsável por altas taxas de letalidade acidentais ou provocadas, devido, principalmente, à insuficiência respiratória. Apesar de a intoxicação por via oral ser a principal e mais grave, o contato prolongado com a substância em uma grande área corporal pode gerar uma toxicidade similar e levar ao óbito ­ fato pouco elucidado na literatura. Este é o relato de caso de um homem de 22 anos, que foi admitido em um hospital devido a queixas de mal-estar, náuseas, febre, cefaleia, dor abdominal, diarreia, queimaduras e dispneia. A suspeita diagnóstica inicial foi de hantavirose, leptospirose, dengue e tromboembolismo pulmonar e, posteriormente, foi comprovado intoxicação exógena com agrotóxico por via inalatória e cutânea. Exames de imagem revelaram fibrose pulmonar difusa e ele também apresentou alterações renais, hepáticas e coagulatórias. Como não há antídoto específico, foi empregado tratamento sintomático e suportivo, com uso de carvão ativado, antibióticos, corticoides, antioxidantes e hemodiálise. No entanto, o paciente teve uma piora progressiva do quadro, vindo a óbito devido à síndrome da angústia respiratória aguda e fibrose pulmonar. O Paraquat, embora proibido no Brasil em 2020, continua sendo utilizado de forma ilegal. Além disso, seu substituto, o Diquat, possui toxicidade semelhante. Assim, é fundamental que os profissionais da saúde reconheçam o diagnóstico da intoxicação por tais substâncias e suas diferentes vias de exposição. Também são necessárias novas medidas de fiscalização das substâncias e maior investimento em educação em saúde para evitar exposições acidentais, assim como relatado (AU).

Paraquat is a highly toxic non-selective herbicide and is responsible for high accidental or provoked lethality rates, mainly due to respiratory failure. Although oral poisoning is the primary and most severe, prolonged contact with the substance in a large body area can lead to similar toxicity and death ­ a fact that is little elucidated in the literature. This is the case report of a 22-year-old man admitted to a hospital due to complaints of malaise, nausea, fever, headache, abdominal pain, diarrhea, burns and dyspnea. The initial diagnostic suspicion was hantaviruses, leptospirosis, dengue and pulmonary thromboembolism, and there was subsequently proven exogenous intoxication with pesticides by inhalation and cutaneous route. Imaging tests revealed diffuse pulmonary fibrosis and he also had renal, hepatic and coagulation alterations. As there is no specific antidote, symptomatic and supportive treatment was performed using activated charcoal, antibiotics, corticosteroids, antioxidants and hemodialysis. However, the patient had a progressive worsening of the condition and died due to acute respiratory distress syndrome and pulmonary fibrosis. Paraquat, although banned in Brazil in 2020, continues to be used illegally. In addition, its substitute, the Diquat, has similar toxicity. Thus, it is essential that health professionals recognize the diagnosis of intoxication by such substances and their different exposure routes. New control measures for these substances and greater investment in health education are also needed to prevent accidental exposure, as reported (AU).

Swertiamarin attenuates paraquat-induced pulmonary epithelial-like cell apoptosis via NOX4-mediated regulation of redox and mitochondrial function

Abstract The aim of the present study was to investigate the effect of swertiamarin (STM) in attenuating paraquat (PQ)-induced human lung alveolar epithelial-like cell (A549) apoptosis and the underlying mechanisms. A549 cells were pretreated with different concentrations of STM for 2 hr and then cultured with or without PQ (700 µM) for 24 hr. Cell survival was determined using the CCK8 assay. Morphological changes, MDA content, inflammatory factors, fibrogenesis parameters, apoptosis rates, redox status and mitochondrial membrane potential (MMP) were evaluated. The expression of several genes involved in the modulation of redox status was measured by Western blotting. Cell viability and MMP were decreased, but the apoptosis rate and DCFH oxidation were elevated by PQ exposure. STM pretreatment notably increased cell viability and MMP and reduced the apoptosis rate and DCFH oxidation. Furthermore, TLR4- NOX4 signaling was significantly inhibited by STM. The downregulation of NOX4 by siRNA exerted the same protective effects as STM. This study provides the first evidence that STM attenuates PQ-induced pulmonary epithelial-like cell apoptosis via NOX4-mediated regulation of redox and mitochondrial function

Características sociodemográficas y clínicas relacionadas con la condición final de pacientes intoxicados por paraquat en un hospital del suroccidente de Colombia / Sociodemographic and clinical characteristics related to the final condition of patients intoxicated by paraquat in a hospital in southwestern Colombia

Introducción. El herbicida paraquat constituye la primera causa de decesos por intoxicaciones en distintos países. Objetivo. Relacionar las características sociodemográficas y clínicas con la condición final de pacientes intoxicados por paraquat atendidos en un hospital del suroccidente de Colombia. Materiales y métodos. En este estudio observacional, descriptivo, analítico, transversal y retrospectivo, se revisaron las historias clínicas de pacientes atendidos por intoxicación con paraquat en una institución de tercer nivel de complejidad en Pasto (Colombia) entre el 2013 y el 2018. Se recolectó la información sobre la condición final (vivo o fallecido) de cada paciente, así como los datos sociodemográficos, clínicos y de los exámenes paraclínicos. Se establecieron comparaciones por grupos y se diseñó un modelo de regresión logística binaria. Resultados. Se filtró la información de 299 registros y se analizaron finalmente 160 casos. Las características relacionadas con la condición final de los pacientes fueron el tiempo de estancia (OR=0,124; IC95% 0,03-0,6; p=0,009), la frecuencia cardiaca (OR=35,65; IC95% 1,44-884,78; p=0,029) y la creatinina inicial (OR=1,73; IC95% 1,23-2,44; p=0,002). Conclusiones. La proporción de la letalidad fue mayor entre los pacientes con estancia hospitalaria corta, taquicardia y elevación de la concentración sérica de creatinina al ingreso. Este reporte puede ser útil como fundamento de una escala de gravedad para detectar a los pacientes con resultados adversos en la fase temprana para que puedan recibir una intervención oportuna.

Introduction: Paraquat is an agrochemical that constitutes the first cause of death by poisoning in different countries. Objective: To relate sociodemographic and clinical characteristics with the final condition of patients intoxicated by paraquat in a hospital in southwestern Colombia. Materials and methods: This was an observational, descriptive, analytical, crosssectional, and retrospective study. We reviewed the medical records of patients diagnosed with paraquat poisoning at a level III hospital in Pasto, Colombia, from 2013 to 2018. We collected the data regarding their final condition (alive or deceased) and their sociodemographic, clinical, and paraclinical information. We established group comparisons and designed a binary logistic regression model. Results: We reviewed 299 records and, after the exclusion, we analyzed 160 cases. The characteristics related to the final condition of the patients were length of stay (OR = 0.124; 95% CI: 0.03-0.6; p = 0.009), heart rate (OR = 35.65; 95% CI: 1.44-884.78; p = 0.029), and initial creatinine (OR = 1.73; 95% CI: 1.23-2.44; p = 0.002). Conclusion: The proportion of case fatality was higher in patients with short hospital stay times and elevated heart rates and admission creatinine levels. This report may be useful as a rationale for the creation of a severity scale for the early detection of patients with adverse outcomes and their timely treatment.

Hallazgos en imágenes de tórax en una intoxicación aguda con paraquat: reporte de un caso / Findings on thorax images in acute paraquat poisoning: case report

Resumen El Paraquat es un herbicida ampliamente utilizado para el control de las malezas en Chile. Su ingesta determina una alta probabilidad de mortalidad dado su inherente toxicidad mediante la producción de radicales libres, que afectan a múltiples órganos, principalmente los pulmones; a esto se suma la falta de un tratamiento efectivo. Se presenta el caso clínico de un hombre de 18 años que en un intento suicida consume 50 mL de paraquat (200 g/L), con desenlace fatal. La presentación clínica depende la cantidad de Paraquat ingerida y los hallazgos radiológicos descritos varían según la temporalidad del cuadro e, inclusive, podrían determinar el pronóstico.

Paraquat is an herbicide widely used for weed control in Chile. Its intake determines a high probability of mortality because of its inherent toxicity through the production of free radicals. Multiple organs are affected, mainly the lungs; to this is added the lack of effective treatment. We present the clinical case of an 18-year-old man who in a suicidal attempt swallows 50 mL of paraquat (200 g/L), with a fatal outcome. The clinical presentation depends on the amount of Paraquat ingested. Radiological findings described vary according to the temporality of the condition and could even determine the prognosis

In Vitro and In Vivo evaluation of montmorillonite for paraquat poisoning

Abstract Evaluation of montmorillonite for paraquat by in vitro and in vivo test. In vitro test were evaluated by a batch test, taking the paraquat concentration, adsorbents, reaction environment and time as indices, the absorption rate was screened by orthogonal design. In vivo test was executed with rabbits. Group 1: 4 rabbits dosed with montmorillonite. Group 2: 8 rabbits dosed with 200 mg/kg paraquat. Group 3: 6 rabbits dosed with 200 mg/kg paraquat then gavage with montmorillonite 5 min later. Group 4: 6 rabbits dosed with 200 mg/kg paraquat then gavage with montmorillonite 30 min later. Blood paraquat concentration, serum cytokines, blood gas analysis and histopathology of lung were implemented. In vitro test found that all the four factors influence the absorption rate of paraquat (P < 0.05). In vitro test found that oral montmorillonite could change toxicokinetics parameters of paraquat (P < 0.05); decrease raised serum TGF-ß1 and HMGB1 (P < 0.05) and alleviate the histopathology damage of lung. Montmorillonite might exert its protective effects on paraquat induced damage

Dynamic changes of locus coeruleus damage in Parkinson's disease-like mice induced by paraquat / 中华劳动卫生职业病杂志

Objective: To observe the dynamic changes of brainstem locus coeruleus (LC) damage in Parkinson' s disease (PD) -like mice by paraquat (PQ) . Methods: In October 2019, 36 male C57BL/6 mice were randomly divided into the exposure group and the control group, with 18 mice in each group. The mice in the exposure group were given intraperitoneal injection of 15 mg/kg PQ, and the mice in the control group were given intraperitoneal injection of 0.9% saline, twice a week for 8 weeks. Neurobehavioral changes (pole climbing test, swimming test, open field test, tail hanging test, high plus maze test and water maze test) were observed at 4 weeks, 6 weeks and 8 weeks, respectively, and the changes of motor ability, emotion and cognitive function were evaluated. The brain tissue of mice were taken and stained with Hematoxylin-Eosin (HE) to observe the pathological changes of LC. Nissl staining was used to detect the changes of neuronal Nissl bodies in LC. Immunohistochemistry (IHC) staining was used to detect the expression of neuron nuclear antigen (NeuN) , dopamine (DA) neurons and norepinephrine (NE) neuron markers tyrosine hydroxylase (TH) , α-synuclein (α-syn) in substantia nigra (SN) and LC. The expression levels of NeuN, TH and α-syn in the midbrain and brainstem were detected by Western blotting. TUNEL staining was used to detect neuronal apoptosis in LC. Results: Compared with the 4th week of PQ exposure group, the time of pole climbing and swimming immobility were gradually increased, the ratio of open arm residence time of high plus maze test and the number of times of the platform and the residence time of platform quadrant in water maze test were gradually decreased (P<0.05) in the exposure group with the progress of exposure time. The results of HE and Nissl staining showed that the neurons in LC gradually arranged loosely, the nucleus were deeply stained, the cytoplasm was pyknosis, and the number of Nissl bodies gradually decreased (P<0.05) in the exposure group with the progress of exposure time. IHC results showed that the number of NeuN and TH positive cells in SN and LC of mice were gradually decreased, and the positive expression of α-syn was gradually increased (P<0.05) in the exposure group with the progress of exposure time. Western blotting results showed that the expression levels of NeuN and TH in the midbrain and brainstem were gradually decreased, and the expression level of α-syn was gradually increased (P<0.05) in the exposure group with the progress of exposure time. TUNEL staining showed that the apoptosis rates of neurons in LC were gradually increased (P<0.05) in the exposure group with the progress of exposure time. Conclusion: PQ induces progressive damage in the LC area of PD-like mice, which may be caused by the abnormal accumulation of pathological α-syn in the LC area.

Preliminary study on time-dependent changes of intestinal tract and brain-gut axis in mice model of Parkinson's disease induced by paraquat / 中华劳动卫生职业病杂志

Objective: To observe the intestinal time-dependent changes in Parkinson's disease (PD) mouse model constructed by intraperitoneal injection of paraquat (PQ) and to establish the brain-gut axis connection initially. Methods: In October 2019, 48 mice were randomly divided into treated group and control groups: treated 4-week (P-4) group, treated 6-week (P-6) group, treated 8-week (P-8) group, control 4-week (C-4) group, control 6-week (C-6) group, and control 8-week (C-8) group. The treated group was injected with 15 mg/kg PQ solution and the control group was injected with 0.9% saline (0.2 ml/20 g) by intraperitoneal injection twice a week. After the initial state (0 weeks) and the treatment at the end of 4, 6 and 8 weeks, the mood changes and motor functions of mice were assessed by neurobehavioral tests (open field test, pole climbing test, tail suspension test and elevated plus maze test) . And the number of fecal pellets for 1 h and water content were calculated to assess the functional status of the gastrointestinal tract. Western blotting experiments were performed to detect the expression levels of α-synuclein (α-syn) and tyrosine hydroxylase (TH) in the nigrostriatal region of the mouse brain, the tight junction markers zonula occludens-1 (ZO-1) and Occludin, the inflammatory markers of integrin αM subunit (CD11b) , inducible nitric oxide synthase (iNOS) , high mobility group box 1 (HMGB1) , interleukin-1β (IL-1β) , and the neuronal markers βⅢ-tubulin and α-syn protein in the colon.Immunohistochemical staining was performed to detect the expression levels of colonic tight junction proteins ZO-1 and Occludin. Immunofluorescence staining was performed to detect the expression levels of TH in the substantia nigra region of the midbrain, and the co-localization of colonic intestine neuronal marker (βⅢ-tubulin) and Ser129 α-syn in the colonic. Results: Compared with the initial state (0 weeks) and C-8 group, mice in the P-8 group had significantly higher pole climbing test scores and resting time, and significantly lower total active distance, mean active speed, percentage of open arm entry and 1 h fecal instances (P<0.05) . After poisoning, the 1 h fecal water content of model mice first increased and then decreased, the P-4 and P-6 groups were significantly higher than the simultaneous point control group, and the P-8 groups were significantly lower than the initial state (P<0.05) . Compared with control, P-4 and P-6 groups, the expression levels of ZO-1 and Occludin in the P-8 group were significantly decreased (P<0.05) . Compared with control group, the expression levels of CD11b and IL-1β in the P-4 group were significantly increased (P<0.05) . Compared with control and P-4 group, the expression levels of CD11b, iNOS, HMGB1 and IL-1β in the P-6 and P-8 groups were significantly increased (P<0.05) . Compared with the control and P-4 groups, the expression levels of βⅢ-tubulin in the colon of mice in the P-8 group were significantly decreased, and the expression levels of α-syn and Ser129 α-syn were significantly increased (P<0.05) . The expression level of Ser129 α-syn in the colon of model mice was negatively correlated with the expression level of βⅢ-tubulin (r(s)=-0.9149, 95%CI: -0.9771--0.7085, P<0.001) . Ser129 α-syn and βⅢ-tubulin co-localization in the colonic intermuscular plexus region increased gradually with the time of exposure. Compared with the control, P-4 and P-6 groups, the expression level of TH in the nigrostriatal region of the brain was significantly decreased, and the expression levels of α-syn and Ser129 α-syn were significantly increased in the P-8 group (P<0.05) . Correlation analysis showed that the relative expression level of Ser129 α-syn in the nigrostriatal region of the brain was negatively correlated with the expression level of TH in the model mice (r(s)=-0.9716, 95% CI: -0.9925--0.8953, P<0.001) . Conclusion: The PD mouse model is successfully established by PQ, and the intestinal function of the model mice is reduced in a time-dependent manner. And on this basis, it is preliminary determined that the abnormal aggregation of α-syn may be an important substance connecting the brain-gut axis.

A five-year follow-up report on lung imaging and exercise endurance of a patient with paraquat poisoning / 中华劳动卫生职业病杂志

A patient with paraquat poisoning was followed up for five years, and it was showed that the interstitial lesion areas in chest CT of this patient gradually decreased after acute period of the poisoning and no significant changes were found six months later. After that the density of the lesions gradually reduced, while the cystic air cavities slowly increased. In addition, the patient's exercise endurance gradually improved over time, and the lung function was close to the normal level five years after poisoning. The follow-up report helps clinicians to have a deeper understanding of the long-term outcome of paraquat poisoning.

Effects on extravascular lung water of lung protective ventilation strategy applied on piglets with acute respiratory distress syndrome induced by paraquat / 中华劳动卫生职业病杂志

Objective: To study the effects on extravascular lung water of lung protective ventilation strategy applying on piglets with acute respiratory distress syndrome (ARDS) induced by paraquat (PQ) under pulse indicating continuous cardiac output (PiCCO) monitoring. Methods: The piglets models with ARDS induced by PQ were established in June 2020 and all of them were received mechanical ventilation and divided into three groups according to tidal volume (V(T)) : small V(T) group (6 ml/kg) , middle V(T) group (10 ml/kg) and large V(T) group (15 ml/kg) , there were 5 piglets in each group. The positive end expiratory pressure (PEEP) were all setup on 10 cmH(2)O. The indexes such as arterial blood gas analysis, oxygenation index (OI) , extravascular lung water index (ELWI) and pulmonary vascular permeability index (PVPI) were monitored at time of before the model was established (baseline) , time of the model was established (t(0)) and 2 h (t(2)) , 4 h (t(4)) , 6 h (t(6)) after mechanical ventilation. Lung tissue were punctured at time of baseline, t(0) and t(6) to be stained by Hematoxylin-eosin (HE) staining and pulmonary pathology were observed under light microscopy. Results: The heart rate (HR) , mean arterial pressure (MAP) and partial pressure of carbon dioxide (PaCO(2)) of all groups were higher than the base value while the pH values, partial pressure of oxygen (PaO(2)) and OI were lower than the base value when the models were established (P<0.05) . After mechanical ventilation, the HR and MAP values of all groups at t(2), t(4) and t(6) were lower than t(0) while the PaCO(2) of t(4) and t(6) were all higher than t(0), the differences were statistically significant (P<0.05) . The PaO(2) and OI of all groups showed a trend of rising at first and then decreasing after mechanical ventilation. The MAP, PaO(2), PaCO(2) and OI of the middle V(T) group and large V(T) group were apparently lower than that of the small V(T) group at t(2), t(4) and t(6) (P<0.05) . The ELWI and PVPI at t(0) of all groups were higher than that of baseline (P<0.05) . The ELWI of the small V(T) group at t(6) were lower than t(0) of the same group and t(6) of the middle V(T) group and large V(T) group (P<0.05) . HE staining showed congestion and edema of alveolar tissue, swelling of capillaries, exudation of red blood cells and widening of alveolar septum in piglets after successful modeling. And further widening of alveolar septum and rupture of alveolar septum could be seen in the lung tissues of each group at t(6), and the injury was the slightest in the small V(T) group. Conclusion: The lung protective ventilation strategy can alleviate the extravascular lung water and ARDS induced by PQ and improve oxygenation.

Effects of ultra high dilution of paraquat 30 ch on growth, chlorophyll content and yield of rice crop

The application of synthetic fertilizers reduces the natural fertility of the soil and contaminates groundwater. Some photosynthesis inhibitors at ultra-high dilution (UHD) increase photosynthesis, growth, and yield of crops. A weedicide Paraquat at UHD enhanced the growth and yield of potatoes in fields. The objective is to see whether the UHD of Paraquat is also effective on rice. This weedicide was serially diluted with distilled water and manually succussed in 30 steps following the preparation of homeopathic dilutions called potencies. In this way, the 30thpotency of Paraquat called Paraquat 30 cH was prepared and preserved in 90 % ethanol. Paraquat 30 cH was diluted with water 1:1000 (v/v) and sprayed on rice plants in a field measuring 0.3125 acres. The control plot of the same area was situated 300 meters away from the test plot. Three treatments were given at an interval of 7 days. The treated plot showed increased growth, chlorophyll content, and rice yield significantlycompared to control. The UHD of the weedicide produced precisely the opposite effect of the crude material on plants. The increased growth and yield of rice by Paraquat 30 cH may be due to the enhancement of photosynthesis of treated plants. The UHD of Paraquat increased the yield of rice by 19.35% over the control.

Analysis Methods of Common Herbicides in Biological Material and Research Progress / 法医学杂志

Herbicides are a kind of chemical or biological agents that can effectively destroy or inhibit weed growth. Because of the widespread and frequent use of herbicides, herbicide poisonings have often been reported. At present, the main species reported to have caused poisoning are paraquat, diquat, glyphosate, and glufosinate. The main instrumental analysis method is LC-MS. This paper reviews the research progress on analysis methods of common herbicides in biological material and their application, summarizes the sample pretreatment and instrumental analysis situation of qualitative and quantitative analysis of herbicides in biological material, and collects test data of actual poisoning cases, to provide reference for clinical diagnosis and treatment and forensic identification of herbicide poisoning.

Pulmonary histopathology in fatal paraquat poisoning

Paraquat is a potent herbicide widely used in the Indian agriculture industry. Human fatality due to paraquat poisoning is not uncommon in this country. The primary effect of paraquat is on the lungs, and the resultant pulmonary damage leads to the patient's demise. There is a high mortality rate in paraquat poisoning as the treatment is usually supportive with no known antidote. There are limited human studies that have observed the histopathological changes in lungs in paraquat poisoning. The authors have discussed the time-related histopathological changes in lungs in paraquat poisoning on autopsy subjects. The role of anticoagulants and fibrinolytic agents in the treatment of this poisoning has also been discussed.

Taxa de sobrevivência após intoxicação por paraquat: impacto das variáveis clínicas emergenciais e laboratoriais / Survival rate after paraquat poisoning: impact of emergency clinical and laboratory variables

RESUMO Objetivo analisar a associação da sobrevida às medidas de atendimento de emergência, sintomas clínicos e marcadores bioquímicos usados para pacientes intoxicados por paraquat. Métodos coorte retrospectiva, norteada pela ferramenta Strengthening the Reporting of Observational Studies in Epidemiology . O protocolo de coleta e análise de dados foi baseado em duas fases: primeira, com o levantamento das fichas de investigação de intoxicações exógenas da Secretaria de Vigilância Epidemiológica; segunda, com a análise das informações nos prontuários médicos impressos. Resultados dos 36(100%) pacientes investigados, 19(53,0%) sobreviveram; no tocante às manifestações clínicas, houve significância estatística para o sistema respiratório (p=0,003); no que tange às variáveis bioquímicas, houve significância estatística para as enzimas hepáticas. As medidas de emergências inicias 13(56,5%) dos sobreviventes receberam lavagem gástrica com carvão ativado. Conclusão observou-se falta de eficácia dos impactos das medidas de atendimento de emergência e dos medicamentos em aumentar a sobrevida dos pacientes.

ABSTRACT Objective to analyze the association of survival to emergency care measures, clinical symptoms and biochemical markers used for paraquat intoxicated patients. Methods retrospective cohort, guided by the Strengthening the Reporting of Observational Studies in Epidemiology tool. The data collection and analysis protocol were based on two phases: first, with the survey of the investigation forms of exogenous poisoning from the Secretariat of Epidemiological Surveillance; second, with the analysis of information in printed medical records. Results of the 36 (100%) patients investigated, 19 (53.0%) survived; regarding the clinical manifestations, there was statistical significance for the respiratory system (p=0.003); regarding the biochemical variables, there was statistical significance for liver enzymes. The initial emergency measures 13(56.5%) of survivors received gastric lavage with activated charcoal. Conclusion we observed a lack of efficacy of the impacts of emergency care measures and medications in increasing patient survival.

Miocarditis aguda por Paraquat. Presentación de un caso y revisión de la literatura / Acute paraquat myocarditis. Case report and literature review

Resumen Paciente masculino de 41 años vecino de Jicaral de Puntarenas. Sin antecedentes personales patológicos de importancia quien es referido al Servicio de Emergencias del Hospital Víctor Manuel Sanabria Martínez por consumo de aproximadamente 20 mililitros de Paraquat el día anterior con propósitos autolíticos. El paciente es ingresado en el Servicio de Medicina Interna y al momento de la valoración presenta únicamente lesiones ulceradas a nivel de la lengua. Durante su internamiento presenta deterioro en la función renal y alteraciones electrolíticas y al décimo día presenta cuadro de dolor torácico tipo opresivo acompañado de datos de insuficiencia cardiaca aguda. Los biomarcadores de laboratorio presentan incremento de la Troponina I y del Péptico Natriurético Cerebral. La radiografía de tórax mostró una cardiomegalia grado II con signos de falla cardiaca. Se le realiza un ecocardiograma que documentó trastornos en la contractilidad de manera difusa con deterioro en la función ventricular y dilatación de las cámaras cardiacas. Se le realiza una arteriografía coronaria que documenta arterias coronarias epicárdicas sin lesiones significativas. Se confirma el diagnóstico de miocarditis aguda por Paraquat y se da tratamiento para la insuficiencia cardiaca presentando una evolución satisfactoria y recuperación de la función cardiaca evidenciada por ecocardiograma control a los 9 meses posterior a el episodio inicial.

Summary Acute paraquat myocarditis. Case report and literature review A 41-year-old male patient from Jicaral of Puntarenas. Without significant pathological personals backgroun of importance who is referred to the Emergency Service of the Victor Manuel Sanabria Martínez Hospital for consumption of approximately 20 milliliters of Paraquat the previous day for autolytic purposes. The patient is admitted to the Internal Medicine Service and at the time of the evaluation presents only ulcerated lesions at the level of the tongue. During hospitalization, there is deterioration in renal function and electrolyte disturbances and on the tenth day, he presents a episode of oppressive chest pain accompanied by data on acute heart failure. Laboratory biomarkers show an increase in Troponin I and Brain Natriuretic Peptic. Chest radiography showed grade II cardiomegaly with signs of heart failure. An echocardiogram was performed which documented diffuse contractility disorders with deterioration in ventricular function and dilation of the cardiac chambers. A coronary arteriography is performed that documents epicardial coronary arteries without significant injuries. The diagnosis of acute Paraquat myocarditis is confirmed and treatment for heart failure is presented, the patient presenting a satisfactory evolution and recovery of heart function evidenced by a control echocardiogram at 9 months after the initial episode.