Objective:To analyze the clinical characteristics of patients with acute glyphosate herbicide poisoning and the differences in the severity of poisoning.Methods:A retrospective analysis was performed on patients with acute glyphosate herbicide poisoning admitted to the First Affiliated Hospital of Zhengzhou University from January 2014 to December 2020. The general information, exposure time, poisoning dose, poisoning cause, poisoning route, clinical manifestations, laboratory examination results during hospitalization, treatment measures, hospital stays and prognosis of the patients were collected. The patients were graded according to the poisoning severity scoring standard of Chinese Expert Consensus on Diagnosis and Treatment of Acute Poisoning in 2016. The highest severity score during hospitalization was used as the final grade. According to the final grade, asymptomatic and mild patients were included in the mild group, and moderate, severe and death patients were included in the severe group. The independent sample T test or Mann-Whitney U test was used for measurement data, and χ2 test or Fisher's exact test was used for counting data. The differences of general data and clinical data between the two groups were compared. Results:According to the inclusion and exclusion criteria, 83 patients with acute glyphosate herbicide poisoning were selected as the study subjects. All patients survived, mainly mild poisoning (56.6%), with a male to female ratio of 33∶50, and an average age of 39 years. The number of poisoning cases increased yearly (the highest in 2019), and most cases occurred in spring and summer. The main cause of poisoning was suicide (71.1%), direct oral administration (83.1%) was the primary route of poisoning, and the dominating clinical manifestations were digestive symptoms (71.1%). Laboratory tests showed increased white blood cell count (WBC), neutrophil percentage (NEUT %) and D-dimer, and decreased hemoglobin and potassium. Compared with the mild group, patients in the severe group were older [(51±17) years vs. (35±19) years], had a higher proportion of suicide and direct oral administration, a longer hospital stay [8.0 (4.8, 12.0) d vs. 3.0 (2.0, 5.5) d], a higher dose of poisoning [200.0 (50.0, 200.0) mL vs. 30.0 (11.3, 57.5) mL], and higher NEUT % within 24 h of admission [(83.4±10.4) vs. (73.2±12.8)]. The increase of WBC, NEUT %, aspartate aminotransferase, prothrombin time, D-dimer and the decrease of serum potassium were more common in the severe group than the mild group, with statistical significance (all P<0.05). Conclusions:The number of patients with acute glyphosate herbicide poisoning is increasing yearly. Generally, the condition is mild and the prognosis is satisfying. The severity is more serious in the middle-aged and elderly patients andthose with direct oral administration, high toxic dose, and high NEUT % within 24 h of admission. Severe poisoning is more likely to cause changes in laboratory indicators.
目的 分析总结非重症与重危症新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)患者早期临床特征和实验室检查等特点,以便临床及时评估与识别危重信号.方法 回顾性收集2020年1月16日至2020年3月1日郑州大学第一附属医院收治的COVID-19病例的临床特征、实验室检查等资料,分析非重症型与重危症型之间的差异.结果 共纳入67例确诊患者,其中非重症组22例,重危症组45例.重危症组患者年龄及基础病比例均高于非重症组(P<0.05).初发症状按发生率前五位依次为发热、咳嗽、胸闷、乏力、咳痰,重危症组胸闷症状及肺部啰音比例均高于非重症组,但差异无统计学意义(P>0.05),余症状体征均无统计学意义.入院时重危症组白细胞总数、中性粒细胞比例、D-二聚体及乳酸脱氢酶均高于非重症组,淋巴细胞计数低于非重症组,差异具有统计学意义(P<0.05);首诊于郑州大学第一附属医院的重危症组患者自发病至转为重危症的中位时间为10天,病情加重时较入院时白细胞总数、D-二聚体升高,淋巴细胞计数降低(P<0.05).结论 高龄、有无基础病、初始白细胞总数、中性粒细胞比例、D-二聚体、乳酸脱氢酶及淋巴细胞计数均与COVID-19病情程度有关.白细胞总数和D-二聚体逐渐升高、淋巴细胞绝对值逐渐降低等动态变化提示病情有转为重危症的风险;发病后第10天可能是病情转为重危症的重要时间点,建议及时复查.
> 近年来,对小儿先天性心脏病(先心病)的神经系统影响,国外有较多研究,发现约有25%先心病患儿有神经系统的症状和体征。我们对50例先心病患儿的脑电图(EEG)进行了研究,并对异常EEG发生率与动脉血氧饱和度(SaO 2 )、分流量大小及与年龄的关系进行了探讨。一、对象和方法收集1987年10月~1988年9月我院儿科住院进行心导管检查的先心病患儿50例,男26例,女24例,年龄3~12岁。其中青紫型19例,非青紫型31例。全部病例均经心导管和/或手术诊断。