BACKGROUND Severe bleeding as a result of a major vascular injury is a potentially fatal event commonly observed in the emergency department.Bowel necrosis and gastric ulcers secondary to ischemia are rare due to thei...BACKGROUND Severe bleeding as a result of a major vascular injury is a potentially fatal event commonly observed in the emergency department.Bowel necrosis and gastric ulcers secondary to ischemia are rare due to their rich blood supply.In this case,we present the case of a patient who was treated successfully following rupture of his femoral artery resulting in bowel necrosis and an unusually large gastric ulcer.CASE SUMMARY A 28-year-old male patient sustained a knife stab wound to the right thigh,causing rupture of his femoral artery and leading to massive bleeding.He underwent cardiopulmonary resuscitation and received a large blood transfusion.Abdominal surgeries confirmed bowel necrosis,and jejunostomy was performed.The necrotic intestine was removed,the remaining intestine was anastomosed,and the right thigh was amputated.After three surgeries,the patient's overall condition gradually improved,and the patient was discharged from the hospital.However,one day after discharge,the patient was admitted again due to dizziness and melena,and a gastroduodenoscopy revealed a giant banded ulcer.After 2 weeks of treatment,the ulcer had decreased in size without bleeding.Six months after the last surgery,enterostomy and reintroduction surgery were completed.The patient was fitted with a right lower limb prosthesis one year after surgery.After 3 years of follow-up,the patient did not complain of discomfort.CONCLUSION Trauma department physicians need to be aware of the possible serious complications involving the abdomen of trauma patients with massive bleeding.展开更多
BACKGROUND:Penehyclidine is a newly developed anticholinergic agent.We aimed to investigate the role of penehyclidine in acute organophosphorus pesticide poisoning(OP)patients.METHODS:We searched the Pubmed,Cochrane l...BACKGROUND:Penehyclidine is a newly developed anticholinergic agent.We aimed to investigate the role of penehyclidine in acute organophosphorus pesticide poisoning(OP)patients.METHODS:We searched the Pubmed,Cochrane library,EMBASE,Chinese National Knowledge Infrastructure(CNKI),Chinese Biomedical literature(CBM)and Wanfang databases.Randomized controlled trials(RCTs)recruiting acute OP patients were identifi ed for meta-analysis.Main outcomes included cure rate,mortality rate,time to atropinization,time to 60%normal acetylcholinesterase(AchE)level,rate of intermediate syndrome(IMS)and rate of adverse drug reactions(ADR).RESULTS:Sixteen RCTs involving 1,334 patients were identifi ed.Compared with the atropineor penehyclidine-alone groups,atropine combined with penehyclidine significantly increased the cure rate(penehyclidine+atropine vs.atropine,0.97 vs.0.86,RR 1.13,95%CI[1.07–1.19];penehyclidine+atropine vs.penehyclidine,0.93 vs.0.80,RR 1.08,95%CI[1.01–1.15])and reduced the mortality rate(penehyclidine+atropine vs.atropine,0.015 vs.0.11,RR 0.17,95%CI[0.06–0.49];penehyclidine+atropine vs.penehyclidine,0.13 vs.0.08,RR 0.23,95%CI[0.04–1.28]).Atropine combined with penehyclidine in OP patients also helped reduce the time to atropinization and AchE recovery,the rate of IMS and the rate of ADR.Compared with a single dose of atropine,a single dose of penehyclidine also signifi cantly elevated the cure rate,reduced times to atropinization,AchE recovery,and rate of IMS.CONCLUSION:Atropine combined with penehyclidine benefi ts OP patients by enhancing the cure rate,mortality rate,time to atropinization,AchE recovery,IMS rate,total ADR and duration of hospitalization.Penehyclidine combined with atropine is likely a better initial therapy for OP patients than atropine alone.展开更多
BACKGROUND Organophosphorus poisoning(OP)is one of the common critical conditions in emergency departments in China,which is usually caused by suicide by taking oral drugs.Patients with severe OP have disturbance of c...BACKGROUND Organophosphorus poisoning(OP)is one of the common critical conditions in emergency departments in China,which is usually caused by suicide by taking oral drugs.Patients with severe OP have disturbance of consciousness,respiratory failure,toxic shock,gastrointestinal dysfunction,and so on.As far as we know,the perforation of the duodenum caused by OP has not been reported yet.CASE SUMMARY A 33-year-old male patient suffered from acute severe OP,associated with abdominal pain.Multiple computed tomography scans of the upper abdomen showed no evidence of intestinal perforation.However,retrograde digital subtraction angiography,performed via an abdominal drainage tube,revealed duodenal perforation.After conservative treatment,the symptoms eased and the patient was discharged from hospital.CONCLUSION Clinicians should pay close attention to gastrointestinal dysfunction and abdominal signs in patients with severe OP.If clinical manifestation and vital signs cannot be explained by common complications,stress duodenal ulcer or perforation should be highly suspected.展开更多
BACKGROUND Single atrium with single ventricle,or a two-chambered heart,is an extremely rare congenital malformation.Few cases with two-chambered heart surviving to adulthood have been reported.CASE SUMMARY We reporte...BACKGROUND Single atrium with single ventricle,or a two-chambered heart,is an extremely rare congenital malformation.Few cases with two-chambered heart surviving to adulthood have been reported.CASE SUMMARY We reported an adult female patient with a two-chambered heart and situs inversus totalis accompanied by multiple pregnancies and abortions.Magnetic resonance imaging detected a two-chambered heart.B-ultrasound-guided uterine aspiration was performed to absorb 8 g and 10 g of organized villus and decidual tissues,respectively,with a small amount of bleeding.Postoperatively,cyanosis and fatigue-induced shortness of breath were gradually relieved.The patient has currently outlived all similar cases reported so far.CONCLUSION Hemodynamic changes in pregnant women with two-chambered heart impaired cardiac function,responsible for hypoperfusion and miscarriage.展开更多
Purpose:Mannitol is one of the first-line drugs for reducing cerebral edema through increasing the extracellular osmotic pressure.However,long-term administration of mannitol in the treatment of cerebral edema trigger...Purpose:Mannitol is one of the first-line drugs for reducing cerebral edema through increasing the extracellular osmotic pressure.However,long-term administration of mannitol in the treatment of cerebral edema triggers damage to neurons and astrocytes.Given that neural stem cell(NSC)is a subpopulation of main regenerative cells in the central nervous system after injury,the effect of mannitol on NSC is still elusive.The present study aims to elucidate the role of mannitol in NSC proliferation.Methods:C57 mice were derived from the animal house of Zunyi Medical University.A total of 15 pregnant mice were employed for the purpose of isolating NSCs in this investigation.Initially,mouse primary NSCs were isolated from the embryonic cortex of mice and subsequently identified through immunofluorescence staining.In order to investigate the impact of mannitol on NSC proliferation,both cell counting kit-8 assays and neurospheres formation assays were conducted.Thein vitro effects of mannitol were examined at various doses and time points.In order to elucidate the role of Aquaporin 4(AQP4)in the suppressive effect of mannitol on NSC proliferation,various assays including reverse transcription polymerase chain reaction,western blotting,and immunocytochemistry were conducted on control and mannitol-treated groups.Additionally,the phosphorylated p38(p-p38)was examined to explore the potential mechanism underlying the inhibitory effect of mannitol on NSC proliferation.Finally,to further confirm the involvement of the p38 mitogen-activated protein kinase-dependent(MAPK)signaling pathway in the observed inhibition of NSC proliferation by mannitol,SB203580 was employed.All data were analyzed using SPSS 20.0 software(SPSS,Inc.,Chicago,IL).The statistical analysis among multiple comparisons was performed using one-way analysis of variance(ANOVA),followed by Turkey’’s post hoc test in case of the data following a normal distribution using a Shapiro-Wilk normality test.Comparisons between 2 groups were determined using Student’s t-test,if the data exhibited a normal distribution using a Shapiro-Wilk normality test.Meanwhile,data were shown as median and interquartile range and analyzed using the Mann-WhitneyU test,if the data failed the normality test.A p<0.05 was considered as significant difference.Results:Primary NSC were isolated from the mice,and the characteristics were identified using immunostaining analysis.Thereafter,the results indicated that mannitol held the capability of inhibiting NSC proliferation in a dose-dependent and time-dependent manner using cell counting kit-8,neurospheres formation,and immunostaining of Nestin and Ki67 assays.During the process of mannitol suppressing NSC proliferation,the expression of AQP4 mRNA and protein was downregulated,while the gene expression of p-p38 was elevated by reverse transcription polymerase chain reaction,immunostaining,and western blotting assays.Subsequently,the administration of SB203580,one of the p38 MAPK signaling pathway inhibitors,partially abrogated this inhibitory effect resulting from mannitol,supporting the fact that the p38 MAPK signaling pathway participated in curbing NSC proliferation induced by mannitol.Conclusions:Mannitol inhibits NSC proliferation through downregulating AQP4,while upregulating the expression of p-p38 MAPK.展开更多
Background：Snakebites are a neglected threat to global human health with a high morbidity rate.The present study explored the efficacy of antivenom with hyperbaric oxygen （HBO） intervention on snakebites,which coul...Background：Snakebites are a neglected threat to global human health with a high morbidity rate.The present study explored the efficacy of antivenom with hyperbaric oxygen （HBO） intervention on snakebites,which could provide the experimental basis for clinical adjuvant therapy.Methods：Male Sprague-Dawley rats （n =96） were randomized into four groups：the poison model was established by injecting Deinagkistrodon acutus （D.acutus） venom （0.8 LD50） via the caudal vein;the antivenom group was injected immediately with specific antivenom via the caudal vein after successful establishment of the envenomation model;and the antivenom ＋ HBO group was exposed to HBO environment for 1 h once at predetermined periods of 0 h,4 h,12 h,and 23 h after antivenin administration.Each HBO time point had six rats;the control group was left untreated.The rats in the experimental group were euthanized at the corresponding time points after HBO therapy,and brain tissue and blood were harvested immediately.Hematoxylin and eosin （H＆E） staining was used to investigate the pathological changes in the rat brain.Immunohistochemistry （IHC）,real-time polymerase chain reaction （PCR）,and Western blotting were used to detect the expression ofNestin mRNA and protein in the subventricular zone （SVZ） of the brain.The levels of coagulation function （prothrombin time,activated partial thromboplastin time [APTT],and fibrinogen） and oxidation/antioxidation index （malondialdehyde [MDA] and superoxide dismutase [SOD]） were analyzed.Data were analyzed using one-way analysis of variance.Results：The brain tissue from rats in the poison model was observed for pathological changes using H＆E staining.Tissues showed edema,decreased cell number,and disordered arrangement in the SVZ in the snake venom group.The antivenom-HBO intervention significantly alleviated these observations and was more prominent in the antivenom ＋ HBO group.The serum levels of SOD and MDA in the snake venom group were increased and the antivenom-HBO intervention further increased the SOD levels but significantly decreased the MDA levels;however,this was enhanced within 1 h after HBO administration （MDA：F=5.540,P=0.008,SOD：F=7.361,P =0.000）.Activated partial thromboplastin time （APTT） was significantly abnormal after venom administration but improved after antivenom and was even more significant in the antivenom ＋ HBO group 5 h after envenomation （F =25.430,P =0.000）.Only a few nestin-positive cells were observed in the envenomation model.The expression levels were significant in the antivenom and antivenom ＋ HBO groups within 1 and 5 h after envenomation and were more significant in the antivenom ＋ HBO group as determined by IHC,real-time PCR,and Western blotting （P 〈 0.05）.D.acutus envenomation has neurotoxic effects in the brain of rats.Conclusions：Antivenin and HBO,respectively,induced a neuroprotective effect after D.acutus envenomation by attenuating brain edema,upregulating nestin expression in SVZ,and improving coagulopathy and oxidative stress.The intervention efficacy of antivenom with HBO was maximum within 5 h after envenomation and was more efficacious than antivenom alone.展开更多
Purpose： To observe the therapeutic effect of interventional embolization and haemorrhage control in multiple trauma patients with a major abdominal or pelvic injury. Methods： Data of 160 multiple trauma patients wi...Purpose： To observe the therapeutic effect of interventional embolization and haemorrhage control in multiple trauma patients with a major abdominal or pelvic injury. Methods： Data of 160 multiple trauma patients with a major abdominal or pelvic injury were retro- spectively analyzed. They were admitted into the Department of Emergency of the First Affiliated Hospital of Zunyi Medical College from October 2013 to April 2016. Eighty-seven patients who received emergent intervention for embolization and haemorrhage control were set as group A, including 72 males and 15 females, with an average age of （39.32 ±14.0） years. Patients underwent emergent intervention for embolization and hemostasis. The other 73 patients who received traditional surgeries were set as group B, including 62 males and 11 females, with an average age of （38.48 ± 13.12） years. The time from admission to emergency intervention, the time of interventional embolization, transfusion during hospitalization, length of stay and prognosis were observed. The whole treatment and prognosis were compared between group A and group B. Results： In group A, the average time from admission to intervention exploration was （132.05 ± 86.80） min, the average operation time was （149 ± 49.69） min, the average hospitalization time was （18.37±4.71 ） days, the average amount of RBC transfusion during hospitalization was （Z2 ± 4.33） units, and the mortality was 4.60% （4 patients died）. The corresponding data in group B were respectively （138.95± 82.49） min, （183 ± 52.39） min, （22.72 ± 6.63） days, （12.23 ± 5.43） units, and 9.59% （7 cases died）. There was no statistical difference in the time from admission to operation between the two groups （p 〉 0.05）, but there was statistical difference in operation time, RBC transfusion, hospitalization time, prognosis, and mortality between the two groups （all p 〈 0.05）. Conclusion： The emergent intervention for embolization and haemorrhage control of multiple trauma patients with a major abdominal or pelvic injury and visceral organ haemorrhage has the advantages of less trauma, shorter operation time, shorter hospital stay, less blood transfusion in comparison to the traditional emergency surgeries.展开更多
Purpose The increasing number of deaths due to road traffic accidents(RTAs)has attracted global attention.However,the influence of road types is rarely considered in the study of RTAs.This study evaluates the influenc...Purpose The increasing number of deaths due to road traffic accidents(RTAs)has attracted global attention.However,the influence of road types is rarely considered in the study of RTAs.This study evaluates the influence of different road types in RTAs in northern Guizhou to provide a basis for the formulation of evidence-based policies and measures.Methods We obtained the data from the Zunyi Traffic Management Data Platform for the years 2009–2018.The mortality rates of RTAs were calculated.Descriptive methods and Chi-square tests were used to analyze the characteristics of road traffic collisions on different road types.We also examined the associations between the mortality rate per 10,000 vehicles and the growth of per capital gross domestic product(GDP)with Spearman’s rank correlation analysis.According to the passing volume and the infrastructure,we defined different types of roads,like administrative road,functional road,general urban road and urban expressway.Results In 2012,the traffic mortality rate of administrative roads was 8.9 per 100,000 people,and the mortality rate of functional roads was 7.4 per 100,000 people,which decreased in 2018 to 6.1 deaths per 100,000 people and 5.2 deaths per 100,000 people,respectively.The mortality rate per 10,000 vehicles reached the highest level in 2011(28.8 per 10,000 vehicles and 22.5 per 10,000 vehicles on administrative and functional roads,respectively).The death rate of county roads was the highest among administrative roads(χ^(2)=17.389,p<0.05)and that of fourth-class roads was the highest among functional roads(χ^(2)=21.785,p<0.05).The mortality rate per 10,000 vehicles was negatively correlated with per capital GDP.Conclusion Although our research shows that RTAs in northern Guizhou have steadily declined in recent years,the range of decline is relatively small.Many measures and sustainable efforts are needed to control road traffic death and accelerate the progress in road traffic safety in northern Guizhou.展开更多
文摘BACKGROUND Severe bleeding as a result of a major vascular injury is a potentially fatal event commonly observed in the emergency department.Bowel necrosis and gastric ulcers secondary to ischemia are rare due to their rich blood supply.In this case,we present the case of a patient who was treated successfully following rupture of his femoral artery resulting in bowel necrosis and an unusually large gastric ulcer.CASE SUMMARY A 28-year-old male patient sustained a knife stab wound to the right thigh,causing rupture of his femoral artery and leading to massive bleeding.He underwent cardiopulmonary resuscitation and received a large blood transfusion.Abdominal surgeries confirmed bowel necrosis,and jejunostomy was performed.The necrotic intestine was removed,the remaining intestine was anastomosed,and the right thigh was amputated.After three surgeries,the patient's overall condition gradually improved,and the patient was discharged from the hospital.However,one day after discharge,the patient was admitted again due to dizziness and melena,and a gastroduodenoscopy revealed a giant banded ulcer.After 2 weeks of treatment,the ulcer had decreased in size without bleeding.Six months after the last surgery,enterostomy and reintroduction surgery were completed.The patient was fitted with a right lower limb prosthesis one year after surgery.After 3 years of follow-up,the patient did not complain of discomfort.CONCLUSION Trauma department physicians need to be aware of the possible serious complications involving the abdomen of trauma patients with massive bleeding.
文摘BACKGROUND:Penehyclidine is a newly developed anticholinergic agent.We aimed to investigate the role of penehyclidine in acute organophosphorus pesticide poisoning(OP)patients.METHODS:We searched the Pubmed,Cochrane library,EMBASE,Chinese National Knowledge Infrastructure(CNKI),Chinese Biomedical literature(CBM)and Wanfang databases.Randomized controlled trials(RCTs)recruiting acute OP patients were identifi ed for meta-analysis.Main outcomes included cure rate,mortality rate,time to atropinization,time to 60%normal acetylcholinesterase(AchE)level,rate of intermediate syndrome(IMS)and rate of adverse drug reactions(ADR).RESULTS:Sixteen RCTs involving 1,334 patients were identifi ed.Compared with the atropineor penehyclidine-alone groups,atropine combined with penehyclidine significantly increased the cure rate(penehyclidine+atropine vs.atropine,0.97 vs.0.86,RR 1.13,95%CI[1.07–1.19];penehyclidine+atropine vs.penehyclidine,0.93 vs.0.80,RR 1.08,95%CI[1.01–1.15])and reduced the mortality rate(penehyclidine+atropine vs.atropine,0.015 vs.0.11,RR 0.17,95%CI[0.06–0.49];penehyclidine+atropine vs.penehyclidine,0.13 vs.0.08,RR 0.23,95%CI[0.04–1.28]).Atropine combined with penehyclidine in OP patients also helped reduce the time to atropinization and AchE recovery,the rate of IMS and the rate of ADR.Compared with a single dose of atropine,a single dose of penehyclidine also signifi cantly elevated the cure rate,reduced times to atropinization,AchE recovery,and rate of IMS.CONCLUSION:Atropine combined with penehyclidine benefi ts OP patients by enhancing the cure rate,mortality rate,time to atropinization,AchE recovery,IMS rate,total ADR and duration of hospitalization.Penehyclidine combined with atropine is likely a better initial therapy for OP patients than atropine alone.
文摘BACKGROUND Organophosphorus poisoning(OP)is one of the common critical conditions in emergency departments in China,which is usually caused by suicide by taking oral drugs.Patients with severe OP have disturbance of consciousness,respiratory failure,toxic shock,gastrointestinal dysfunction,and so on.As far as we know,the perforation of the duodenum caused by OP has not been reported yet.CASE SUMMARY A 33-year-old male patient suffered from acute severe OP,associated with abdominal pain.Multiple computed tomography scans of the upper abdomen showed no evidence of intestinal perforation.However,retrograde digital subtraction angiography,performed via an abdominal drainage tube,revealed duodenal perforation.After conservative treatment,the symptoms eased and the patient was discharged from hospital.CONCLUSION Clinicians should pay close attention to gastrointestinal dysfunction and abdominal signs in patients with severe OP.If clinical manifestation and vital signs cannot be explained by common complications,stress duodenal ulcer or perforation should be highly suspected.
基金Supported by Chinese Ministry of Education(No.2020-39)Zunyi Science and Technology Project,No.Zunshi Kehe HZ(2020)246.
文摘BACKGROUND Single atrium with single ventricle,or a two-chambered heart,is an extremely rare congenital malformation.Few cases with two-chambered heart surviving to adulthood have been reported.CASE SUMMARY We reported an adult female patient with a two-chambered heart and situs inversus totalis accompanied by multiple pregnancies and abortions.Magnetic resonance imaging detected a two-chambered heart.B-ultrasound-guided uterine aspiration was performed to absorb 8 g and 10 g of organized villus and decidual tissues,respectively,with a small amount of bleeding.Postoperatively,cyanosis and fatigue-induced shortness of breath were gradually relieved.The patient has currently outlived all similar cases reported so far.CONCLUSION Hemodynamic changes in pregnant women with two-chambered heart impaired cardiac function,responsible for hypoperfusion and miscarriage.
基金National Natural Science Foundation of China(no.82260385 and 82260254)Health commission of Guizhou Province(gzwkj2022-103)+1 种基金Chinese Ministry of Education(no.2020-39)Science and Technology Project of Guizhou province(no.20204Y149 and 2023580).
文摘Purpose:Mannitol is one of the first-line drugs for reducing cerebral edema through increasing the extracellular osmotic pressure.However,long-term administration of mannitol in the treatment of cerebral edema triggers damage to neurons and astrocytes.Given that neural stem cell(NSC)is a subpopulation of main regenerative cells in the central nervous system after injury,the effect of mannitol on NSC is still elusive.The present study aims to elucidate the role of mannitol in NSC proliferation.Methods:C57 mice were derived from the animal house of Zunyi Medical University.A total of 15 pregnant mice were employed for the purpose of isolating NSCs in this investigation.Initially,mouse primary NSCs were isolated from the embryonic cortex of mice and subsequently identified through immunofluorescence staining.In order to investigate the impact of mannitol on NSC proliferation,both cell counting kit-8 assays and neurospheres formation assays were conducted.Thein vitro effects of mannitol were examined at various doses and time points.In order to elucidate the role of Aquaporin 4(AQP4)in the suppressive effect of mannitol on NSC proliferation,various assays including reverse transcription polymerase chain reaction,western blotting,and immunocytochemistry were conducted on control and mannitol-treated groups.Additionally,the phosphorylated p38(p-p38)was examined to explore the potential mechanism underlying the inhibitory effect of mannitol on NSC proliferation.Finally,to further confirm the involvement of the p38 mitogen-activated protein kinase-dependent(MAPK)signaling pathway in the observed inhibition of NSC proliferation by mannitol,SB203580 was employed.All data were analyzed using SPSS 20.0 software(SPSS,Inc.,Chicago,IL).The statistical analysis among multiple comparisons was performed using one-way analysis of variance(ANOVA),followed by Turkey’’s post hoc test in case of the data following a normal distribution using a Shapiro-Wilk normality test.Comparisons between 2 groups were determined using Student’s t-test,if the data exhibited a normal distribution using a Shapiro-Wilk normality test.Meanwhile,data were shown as median and interquartile range and analyzed using the Mann-WhitneyU test,if the data failed the normality test.A p<0.05 was considered as significant difference.Results:Primary NSC were isolated from the mice,and the characteristics were identified using immunostaining analysis.Thereafter,the results indicated that mannitol held the capability of inhibiting NSC proliferation in a dose-dependent and time-dependent manner using cell counting kit-8,neurospheres formation,and immunostaining of Nestin and Ki67 assays.During the process of mannitol suppressing NSC proliferation,the expression of AQP4 mRNA and protein was downregulated,while the gene expression of p-p38 was elevated by reverse transcription polymerase chain reaction,immunostaining,and western blotting assays.Subsequently,the administration of SB203580,one of the p38 MAPK signaling pathway inhibitors,partially abrogated this inhibitory effect resulting from mannitol,supporting the fact that the p38 MAPK signaling pathway participated in curbing NSC proliferation induced by mannitol.Conclusions:Mannitol inhibits NSC proliferation through downregulating AQP4,while upregulating the expression of p-p38 MAPK.
基金This study was supported by grants from the Science and Technology Foundation of Guizhou Province （No. SY [2013]3067） and National Natural Science Foundation of China （No. 81560217）.
文摘Background：Snakebites are a neglected threat to global human health with a high morbidity rate.The present study explored the efficacy of antivenom with hyperbaric oxygen （HBO） intervention on snakebites,which could provide the experimental basis for clinical adjuvant therapy.Methods：Male Sprague-Dawley rats （n =96） were randomized into four groups：the poison model was established by injecting Deinagkistrodon acutus （D.acutus） venom （0.8 LD50） via the caudal vein;the antivenom group was injected immediately with specific antivenom via the caudal vein after successful establishment of the envenomation model;and the antivenom ＋ HBO group was exposed to HBO environment for 1 h once at predetermined periods of 0 h,4 h,12 h,and 23 h after antivenin administration.Each HBO time point had six rats;the control group was left untreated.The rats in the experimental group were euthanized at the corresponding time points after HBO therapy,and brain tissue and blood were harvested immediately.Hematoxylin and eosin （H＆E） staining was used to investigate the pathological changes in the rat brain.Immunohistochemistry （IHC）,real-time polymerase chain reaction （PCR）,and Western blotting were used to detect the expression ofNestin mRNA and protein in the subventricular zone （SVZ） of the brain.The levels of coagulation function （prothrombin time,activated partial thromboplastin time [APTT],and fibrinogen） and oxidation/antioxidation index （malondialdehyde [MDA] and superoxide dismutase [SOD]） were analyzed.Data were analyzed using one-way analysis of variance.Results：The brain tissue from rats in the poison model was observed for pathological changes using H＆E staining.Tissues showed edema,decreased cell number,and disordered arrangement in the SVZ in the snake venom group.The antivenom-HBO intervention significantly alleviated these observations and was more prominent in the antivenom ＋ HBO group.The serum levels of SOD and MDA in the snake venom group were increased and the antivenom-HBO intervention further increased the SOD levels but significantly decreased the MDA levels;however,this was enhanced within 1 h after HBO administration （MDA：F=5.540,P=0.008,SOD：F=7.361,P =0.000）.Activated partial thromboplastin time （APTT） was significantly abnormal after venom administration but improved after antivenom and was even more significant in the antivenom ＋ HBO group 5 h after envenomation （F =25.430,P =0.000）.Only a few nestin-positive cells were observed in the envenomation model.The expression levels were significant in the antivenom and antivenom ＋ HBO groups within 1 and 5 h after envenomation and were more significant in the antivenom ＋ HBO group as determined by IHC,real-time PCR,and Western blotting （P 〈 0.05）.D.acutus envenomation has neurotoxic effects in the brain of rats.Conclusions：Antivenin and HBO,respectively,induced a neuroprotective effect after D.acutus envenomation by attenuating brain edema,upregulating nestin expression in SVZ,and improving coagulopathy and oxidative stress.The intervention efficacy of antivenom with HBO was maximum within 5 h after envenomation and was more efficacious than antivenom alone.
文摘Purpose： To observe the therapeutic effect of interventional embolization and haemorrhage control in multiple trauma patients with a major abdominal or pelvic injury. Methods： Data of 160 multiple trauma patients with a major abdominal or pelvic injury were retro- spectively analyzed. They were admitted into the Department of Emergency of the First Affiliated Hospital of Zunyi Medical College from October 2013 to April 2016. Eighty-seven patients who received emergent intervention for embolization and haemorrhage control were set as group A, including 72 males and 15 females, with an average age of （39.32 ±14.0） years. Patients underwent emergent intervention for embolization and hemostasis. The other 73 patients who received traditional surgeries were set as group B, including 62 males and 11 females, with an average age of （38.48 ± 13.12） years. The time from admission to emergency intervention, the time of interventional embolization, transfusion during hospitalization, length of stay and prognosis were observed. The whole treatment and prognosis were compared between group A and group B. Results： In group A, the average time from admission to intervention exploration was （132.05 ± 86.80） min, the average operation time was （149 ± 49.69） min, the average hospitalization time was （18.37±4.71 ） days, the average amount of RBC transfusion during hospitalization was （Z2 ± 4.33） units, and the mortality was 4.60% （4 patients died）. The corresponding data in group B were respectively （138.95± 82.49） min, （183 ± 52.39） min, （22.72 ± 6.63） days, （12.23 ± 5.43） units, and 9.59% （7 cases died）. There was no statistical difference in the time from admission to operation between the two groups （p 〉 0.05）, but there was statistical difference in operation time, RBC transfusion, hospitalization time, prognosis, and mortality between the two groups （all p 〈 0.05）. Conclusion： The emergent intervention for embolization and haemorrhage control of multiple trauma patients with a major abdominal or pelvic injury and visceral organ haemorrhage has the advantages of less trauma, shorter operation time, shorter hospital stay, less blood transfusion in comparison to the traditional emergency surgeries.
基金The study was supported by the National Natural Science Foundation of China(NSFC No.81760233)Science and Technology Project of Guizhou Province(No.[2020]4Y149 and[2019]5661).
文摘Purpose The increasing number of deaths due to road traffic accidents(RTAs)has attracted global attention.However,the influence of road types is rarely considered in the study of RTAs.This study evaluates the influence of different road types in RTAs in northern Guizhou to provide a basis for the formulation of evidence-based policies and measures.Methods We obtained the data from the Zunyi Traffic Management Data Platform for the years 2009–2018.The mortality rates of RTAs were calculated.Descriptive methods and Chi-square tests were used to analyze the characteristics of road traffic collisions on different road types.We also examined the associations between the mortality rate per 10,000 vehicles and the growth of per capital gross domestic product(GDP)with Spearman’s rank correlation analysis.According to the passing volume and the infrastructure,we defined different types of roads,like administrative road,functional road,general urban road and urban expressway.Results In 2012,the traffic mortality rate of administrative roads was 8.9 per 100,000 people,and the mortality rate of functional roads was 7.4 per 100,000 people,which decreased in 2018 to 6.1 deaths per 100,000 people and 5.2 deaths per 100,000 people,respectively.The mortality rate per 10,000 vehicles reached the highest level in 2011(28.8 per 10,000 vehicles and 22.5 per 10,000 vehicles on administrative and functional roads,respectively).The death rate of county roads was the highest among administrative roads(χ^(2)=17.389,p<0.05)and that of fourth-class roads was the highest among functional roads(χ^(2)=21.785,p<0.05).The mortality rate per 10,000 vehicles was negatively correlated with per capital GDP.Conclusion Although our research shows that RTAs in northern Guizhou have steadily declined in recent years,the range of decline is relatively small.Many measures and sustainable efforts are needed to control road traffic death and accelerate the progress in road traffic safety in northern Guizhou.
