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Objective To analyze the clinical features and risk factors of death in patients with acute mushroom poisonings. Methods The clinical data of 210 patients with acute mushroom poisoning admitted to the Affiliated Hospital of Southwest Medical University from July 2013 to December 2016 and received follow-up for at least 6 months were retrospectively analyzed. The data included gender, age, hospitalization time, toadstool features, incubation period, clinical performance, laboratory indicators, and prognosis. According to the prognosis, the patients were divided into survival group and non-survival group, the clinical characteristics and organ or system involvement of the two groups were analyzed, and the risk factors of death in patients with acute mushroom poisoning were explored by univariate and Logistic regression analysis. Results All 210 patients were enrolled in the final analysis, with 172 patients (81.9%) in survival group, and 38 (18.1%) in non-survival group. Patients with an incubation period of 6-24 hours had the highest mortality [15.2% (32/210)]. Most toadstools were in white, red or yellow, with an intake of 20-500 g. More than 85% of patients had gastrointestinal reactions, and liver damage was the most common [58.1% (122/210)] in all patients. The patients with heart and nervous system damage had higher mortality [61.4% (27/44) and 61.3% (19/31)], and the more organs or systems involved, the higher the mortality was. Univariate analysis showed that incubation period ≥ 6 hours, white blood cell (WBC) ≥12×109/L, alanine aminotransferase (ALT)≥200 U/L, aspartate aminotransferase (AST) ≥ 200 U/L, lactate dehydrogenase (LDH) ≥ 500 U/L, prothrombin time (PT) ≥ 20 s, activated partial thrombin time (APTT) ≥ 40 s, prothrombin activity (PTA) ≤ 60%, Na+≤ 135 mmol/L, MB isoenzyme of creatine kinase (CK-MB) ≥ 5 μg/L and myoglobin (Mb) ≥ 100 μg/L were the risk factors of death in patients with acute mushroom poisoning. Multiple factors Logistic regression analysis showed that APTT ≥ 40 s had the greatest lethal risk and could increase the risk of death by 5.35 times [odds ratio (OR) = 6.35, 95% confidence interval (95%CI) = 1.24-32.44], indicating that APTT was an independent risk factor of death in patients with acute mushroom poisoning. Conclusions The mortality of acute mushroom poisoning was high, and liver was the mainly involved organ. The incubation period, WBC, ALT, AST,LDH, PT, APTT, PTA, Na+, CK-MB and Mb could be early indicators to evaluate the prognosis in patients with acute mushroom poisoning, and patients with APTT ≥ 40 s had the greatest lethal risk.
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Objective To investigate the effects of minocycline on regional cerebral blood flow and the expression of endothe-lin-1(ET-1) in ischemic penumbra of rats after focal cerebral ischemia reperfusion injury .Methods Middle cerebral artery occlusion (MCAO) with nylon suture was used to be established as focal cerebral ischemia reperfusion mode (I/R) ,a total of 35 male Spra-geue-Dawley rats were randomly divided into 3 groups :sham-operated group(n= 10) ,model group(n= 15) and minocycline group (n= 15) .After 24 hours of I/R ,The neurobehavioral function of rats was evaluated by Longa′s test ,the regional cerebral blood flow in ischemic penumbra was assessed with laser-Doppler flowmetry .After 6 and 24 hours of I/R ,the expression of ET-1 in peri-in-farct region was measured by both immunohistochemistry and radioimmunoassay .Results Compared with sham-group ,the Longa′s test scales ,ET-1 protein expression increased and the rCBF decreased in ischemic penumbra in model group(P< 0 .05) .the Longa′s test scales ,ET-1 protein expression decreased and the rCBF decreased in ischemic penumbra in minocycline group when compared to the model group(P< 0 .05) .Conclusion Minocycline could promote neurological functional recovery of rats after MCAO ,which might be attributed to increase the cerebral blood flow and regulate the endothelin-1 expression in ischemic penumbra .