Pesticide poisoning remains a critical public health challenge worldwide.At present,chlorfenapyr,classifi ed by the World Health Organization(WHO)as a moderately toxic insecticide,is increasingly used in agriculture,l...Pesticide poisoning remains a critical public health challenge worldwide.At present,chlorfenapyr,classifi ed by the World Health Organization(WHO)as a moderately toxic insecticide,is increasingly used in agriculture,leading to more poisoning incidents.It has a fatality rate as high as 76%after poisoning.[1]Here,we report a successful treatment of a patient with mixed pesticide poisoning caused by lethaldose emamectin benzoate(EB)and chlorfenapyr in the Department of Critical Care Medicine,Yangzhou Hongquan Hospital.展开更多
Organophosphate pesticide poisoning is an acute form of poisoning primarily found in underdeveloped regions.Its main clinical manifestations include muscarinic symptoms,nicotinic symptoms,and central nervous system di...Organophosphate pesticide poisoning is an acute form of poisoning primarily found in underdeveloped regions.Its main clinical manifestations include muscarinic symptoms,nicotinic symptoms,and central nervous system disturbances.This report presents a case of a middleaged female who developed extremely rare symptoms of optic nerve damage after ingesting a large amount of an organophosphate pesticide.展开更多
BACKGROUND:This study is to evaluate clearance eff ects of hemoperfusion(HP),continuous renal replacement therapy(CRRT),and plasma exchange(PE)for chlorfenapyr and its metabolite tralopyril in patients with acute pois...BACKGROUND:This study is to evaluate clearance eff ects of hemoperfusion(HP),continuous renal replacement therapy(CRRT),and plasma exchange(PE)for chlorfenapyr and its metabolite tralopyril in patients with acute poisoning.METHODS:This retrospective study included 18 patients with acute oral chlorfenapyr poisoning treated at our department between January 2022 and January 2024.All patients received conventional therapies combined with blood purification,including HP,CRRT,and PE.HP was performed three sessions within the fi rst 24 h,followed by CRRT and PE.Serial blood samples were collected to measure plasma concentrations of chlorfenapyr and tralopyril using gas chromatography/liquid chromatography-mass spectrometry(GC/LC-MS).The toxin-clearance eff ects were assessed using a linear mixed-eff ects(LME)model.RESULTS:The hourly decline rate of the plasma chlorfenapyr concentration(median[IQR])was 8.83%(1.79%)for HP,4.12%(1.26%)for CRRT,and 6.85%(1.44%)for PE.LME analysis showed higher decline rate in the plasma concentration with HP(β=5.00;P<0.001)and PE(β=2.15;P=0.003)compared to CRRT.For tralopyril,the hourly decline rates were 3.04%(0.62%)for HP,1.82%(0.48%)for CRRT,and 3.01%(0.37%)for PE.LME analysis showed that the clearance effects of HP(β=0.027;P<0.001)and PE(β=0.022;P=0.001)were superior to CRRT.Pre-treatment toxin levels and the interval from hospital admission to blood purifi cation showed no signifi cant interaction with clearance outcomes.CONCLUSION:In our study,HP was associated with a higher decline rate in plasma chlorfenapyr concentration compared to CRRT and PE,supporting HP as a preferred early intervention.However,all three methods showed limited effi cacy in reducing tralopyril levels.Further research into the toxicokinetics and mechanisms of chlorfenapyr is warranted to optimize purifi cation strategies.展开更多
目的探讨短链脂肪酸(SCFA)对急性有机磷中毒(AOPP)小鼠脑组织损伤的保护作用及其可能机制。方法采用随机数字表法将18只小鼠分为对照组(control)组、敌敌畏(DDVP)组和DDVP+SCFA组,每组6只。control组小鼠口服0.5 mL 0.9%氯化钠溶液。DDV...目的探讨短链脂肪酸(SCFA)对急性有机磷中毒(AOPP)小鼠脑组织损伤的保护作用及其可能机制。方法采用随机数字表法将18只小鼠分为对照组(control)组、敌敌畏(DDVP)组和DDVP+SCFA组,每组6只。control组小鼠口服0.5 mL 0.9%氯化钠溶液。DDVP组小鼠口服溶解于0.5 mL 0.9%氯化钠溶液的DDVP(10 mg/kg),以此产生神经毒性。DDVP+SCFA组小鼠同时口服溶解于0.5 mL 0.9%氯化钠溶液的DDVP(10 mg/kg)和SCFA(500 mg/kg)。建模23 h后,采用SHIRPA方案评估小鼠神经行为学改变。收集小鼠大脑海马体组织,标准干湿法测量脑组织含水量;酶联免疫吸附试验检测海马体组织中炎症因子白细胞介素(IL)-1β、IL-6和肿瘤坏死因子-α(TNF-α)水平;蛋白质印迹法检测海马体组织中炎症相关蛋白[核因子-κB(NF-κB)p65、磷酸化NF-κB(p-NF-κB)p65]和线粒体自噬相关蛋白[磷酸酶及张力蛋白同源基因诱导的激酶1(PINK1)、E3泛素连接酶(Parkin)、微管相关蛋白1轻链3Ⅱ/Ⅰ(LC3Ⅱ/Ⅰ)、选择性自噬接头蛋白p62(p62)]表达水平。另取45只小鼠采用随机数字表法分为control组、DDVP组和DDVP+SCFA组,每组15只,记录小鼠7 d存活率。结果与control组比较,DDVP组小鼠7 d存活率、SHIRPA总分均降低,脑组织含水量增加,海马体组织中IL-1β、IL-6、TNF-α水平均升高,p-NF-κB p65蛋白表达水平升高,PINK1、Parkin和LC3Ⅱ/Ⅰ蛋白表达水平均升高,p62蛋白表达水平降低,差异均有统计学意义(均P<0.05)。与DDVP组比较,DDVP+SCFA组小鼠SHIRPA总分升高,脑组织含水量减少,海马体组织中IL-1β、IL-6和TNF-α水平均降低,p-NF-κB p65蛋白表达水平降低,PINK1、Parkin和LC3Ⅱ/Ⅰ蛋白表达水平均升高,p62蛋白表达水平降低,差异均有统计学意义(均P<0.05)。结论SCFA可通过调控线粒体自噬改善AOPP小鼠脑组织损伤。展开更多
文摘Pesticide poisoning remains a critical public health challenge worldwide.At present,chlorfenapyr,classifi ed by the World Health Organization(WHO)as a moderately toxic insecticide,is increasingly used in agriculture,leading to more poisoning incidents.It has a fatality rate as high as 76%after poisoning.[1]Here,we report a successful treatment of a patient with mixed pesticide poisoning caused by lethaldose emamectin benzoate(EB)and chlorfenapyr in the Department of Critical Care Medicine,Yangzhou Hongquan Hospital.
文摘Organophosphate pesticide poisoning is an acute form of poisoning primarily found in underdeveloped regions.Its main clinical manifestations include muscarinic symptoms,nicotinic symptoms,and central nervous system disturbances.This report presents a case of a middleaged female who developed extremely rare symptoms of optic nerve damage after ingesting a large amount of an organophosphate pesticide.
基金funded by the Medical Science Research Project of the Hebei Provincial Health and Health Commission(20230550).
文摘BACKGROUND:This study is to evaluate clearance eff ects of hemoperfusion(HP),continuous renal replacement therapy(CRRT),and plasma exchange(PE)for chlorfenapyr and its metabolite tralopyril in patients with acute poisoning.METHODS:This retrospective study included 18 patients with acute oral chlorfenapyr poisoning treated at our department between January 2022 and January 2024.All patients received conventional therapies combined with blood purification,including HP,CRRT,and PE.HP was performed three sessions within the fi rst 24 h,followed by CRRT and PE.Serial blood samples were collected to measure plasma concentrations of chlorfenapyr and tralopyril using gas chromatography/liquid chromatography-mass spectrometry(GC/LC-MS).The toxin-clearance eff ects were assessed using a linear mixed-eff ects(LME)model.RESULTS:The hourly decline rate of the plasma chlorfenapyr concentration(median[IQR])was 8.83%(1.79%)for HP,4.12%(1.26%)for CRRT,and 6.85%(1.44%)for PE.LME analysis showed higher decline rate in the plasma concentration with HP(β=5.00;P<0.001)and PE(β=2.15;P=0.003)compared to CRRT.For tralopyril,the hourly decline rates were 3.04%(0.62%)for HP,1.82%(0.48%)for CRRT,and 3.01%(0.37%)for PE.LME analysis showed that the clearance effects of HP(β=0.027;P<0.001)and PE(β=0.022;P=0.001)were superior to CRRT.Pre-treatment toxin levels and the interval from hospital admission to blood purifi cation showed no signifi cant interaction with clearance outcomes.CONCLUSION:In our study,HP was associated with a higher decline rate in plasma chlorfenapyr concentration compared to CRRT and PE,supporting HP as a preferred early intervention.However,all three methods showed limited effi cacy in reducing tralopyril levels.Further research into the toxicokinetics and mechanisms of chlorfenapyr is warranted to optimize purifi cation strategies.
文摘目的探讨短链脂肪酸(SCFA)对急性有机磷中毒(AOPP)小鼠脑组织损伤的保护作用及其可能机制。方法采用随机数字表法将18只小鼠分为对照组(control)组、敌敌畏(DDVP)组和DDVP+SCFA组,每组6只。control组小鼠口服0.5 mL 0.9%氯化钠溶液。DDVP组小鼠口服溶解于0.5 mL 0.9%氯化钠溶液的DDVP(10 mg/kg),以此产生神经毒性。DDVP+SCFA组小鼠同时口服溶解于0.5 mL 0.9%氯化钠溶液的DDVP(10 mg/kg)和SCFA(500 mg/kg)。建模23 h后,采用SHIRPA方案评估小鼠神经行为学改变。收集小鼠大脑海马体组织,标准干湿法测量脑组织含水量;酶联免疫吸附试验检测海马体组织中炎症因子白细胞介素(IL)-1β、IL-6和肿瘤坏死因子-α(TNF-α)水平;蛋白质印迹法检测海马体组织中炎症相关蛋白[核因子-κB(NF-κB)p65、磷酸化NF-κB(p-NF-κB)p65]和线粒体自噬相关蛋白[磷酸酶及张力蛋白同源基因诱导的激酶1(PINK1)、E3泛素连接酶(Parkin)、微管相关蛋白1轻链3Ⅱ/Ⅰ(LC3Ⅱ/Ⅰ)、选择性自噬接头蛋白p62(p62)]表达水平。另取45只小鼠采用随机数字表法分为control组、DDVP组和DDVP+SCFA组,每组15只,记录小鼠7 d存活率。结果与control组比较,DDVP组小鼠7 d存活率、SHIRPA总分均降低,脑组织含水量增加,海马体组织中IL-1β、IL-6、TNF-α水平均升高,p-NF-κB p65蛋白表达水平升高,PINK1、Parkin和LC3Ⅱ/Ⅰ蛋白表达水平均升高,p62蛋白表达水平降低,差异均有统计学意义(均P<0.05)。与DDVP组比较,DDVP+SCFA组小鼠SHIRPA总分升高,脑组织含水量减少,海马体组织中IL-1β、IL-6和TNF-α水平均降低,p-NF-κB p65蛋白表达水平降低,PINK1、Parkin和LC3Ⅱ/Ⅰ蛋白表达水平均升高,p62蛋白表达水平降低,差异均有统计学意义(均P<0.05)。结论SCFA可通过调控线粒体自噬改善AOPP小鼠脑组织损伤。
