Alveolar-arterial partial pressure difference as an early predictor for patients with acute paraquat poisoning.

OBJECTIVE: Paraquat (PQ) is associated with high mortality rates in acute poisoning. This study aimed to determine the importance of the alveolar-arterial partial pressure difference (A-aDo2) in the expected consequences of acute PQ poisoning. METHODS: Patients who were hospitalized for PQ poisoning in 2018 were enrolled in this retrospective study. A-aDo2 data were collected. Multivariate analysis was performed using binary logistic regression to determine whether A-aDo2 is an independent risk factor for mortality from PQ. RESULTS: A total of 352 cases were analyzed. The mean PQ dose was 36.84 ± 50.30 mL (0.3-500 mL). There were 185 survivors and 167 non-survivors. The mean A-aDo2 was not significantly correlated between survivors and non-survivors on day 1. However, there were significant differences in A-aDo2 between survivors and non-survivors on days 3, 7, 14, and 21. Increased A-aDo2 values were correlated with an increased mortality rate. The mean A-aDo2 on day 14 showed the most significant difference between survivors and non-survivors. CONCLUSION: Our study suggests that A-aDo2 plays an important role as a reference index, which could be a useful predictor in assessing acute PQ poisoning, especially on the 14th day after onset of poisoning.

[Clinical manifestation and influential factors in patients with acute arsenic poisoning].

OBJECTIVE: To investigate the clinical characteristics of acute arsenic poisoning and its influential factors. METHODS: Clinical data of 47 cases of arsenic poisoning were collected and analyzed. Two cases of observation, 40 cases of mild acute poisoning, and 5 severe acute poisoning were investigated in this group. RESULTS: Myocardial enzyme activity was correlated with age and urine arsenic concentrations. Myocardial enzyme, the liver ALT, total bilirubin (TBil) and indirect bilirubin (IBil) were negatively correlated with vomiting frequency, with statistical significance (P < 0.05). Urine arsenic concentration was correlated with vomiting frequency and amount of soup drunk, with statistically significant difference (P < 0.05). Despite no statistical significance in age and amount of soup drunk, the patients with more vomiting or diarrhea had less urine arsenic concentrations, cardiac enzymes and liver enzyme concentration. CONCLUSION: Acute arsenic poisoning can lead to multiple organ damage. The damage is relevant with amount of arsenic intake, vomiting, diarrhea and urinary frequency arsenic concentration. So early use of gastric lavage, vomiting, poison discharges, and adequate application of effective antidote (Na-DMPS) as soon as possible, symptomatic treatment and the reinforced monitoring, are the rescue key for patients with acute arsenic poisoning.

[Relationship of occupational injuries with social and economic factors].

OBJECTIVE: To explore the relationship of occupational injuries with social and economic factors in chemical industry during 2000.01 - 2001.12. METHOD: 1:2 paired case-control study, univariable logistic regression analysis, principal component analysis, and multiple logistic regression analysis were used in this study. RESULTS: Univariable analysis showed that occupational injuries had significant relationship with age, sex, education, employment pattern, technology, workplace, work changing, wage, family income, enterprise scale, enterprise proprietorship, projective device, operation rules, and training rules of work safety. The extracted four principal components (PC(1), PC(2), PC(3) and PC(4), ranked by contribution) gave good expressions to the initial 11 variables. The cumulative proportion of the four principal components reached 77.36%. PC(1) was the indicative factor of occupational injuries, which represented 46.69% information of initial variables. PC(2) was the kinetic factor of occupational injuries. PC(3) was the stable factor of occupational injuries. PC(4) was the sex factor of occupational injuries. The results of multiple conditional logistic regression analysis showed that occupational injuries had statistically significant relationship with PC(1) and PC(2). Among the initial variables, sex, employment pattern, income, scale of enterprise, and property of enterprise were more prominent. CONCLUSION: Occupational injuries are related with multiple social and economic factors, which often interact on each other. The prevention and control of occupational injuries should require a comprehensive approach, including training and education of work safety, improving workers' consciousness of self-protection, and enhancing proprietors' consciousness of work safety.