[Analysis on early predictors of respiratory depression in patients with glufosinate poisoning].

Objective: To investigate the early predictors of respiratory depression in patients with glufosinate poisoning, and provide reference for clinicians to make decisions. Methods: In March 2022, the clinical data of patients with glufosinate poisoning admitted to the intensive care unit of the Affiliated Xiangshan Hospital of Wenzhou Medical University from March 2018 to January 2022 were retrospectively analyzed. The patients were divided into respiratory depression group and non-respiratory depression group according to the occurrence of respiratory depression during hospitalization. The clinical data such as age, gender, past history, intake, initial treatment and laboratory examination were compared between the two groups. Multivariate logistic regression was used to analyze the predictors of respiratory depression in patients with glufosinate poisoning, and its predictive value was analyzed by receiver operating characteristic (ROC) curve. Results: A total of 34 patients with glufosinate poisoning were enrolled, including 13 patients in non-respiratory depression group and 21 patients in respiratory depression group. There were significant differences in intake, blood amylase and bicarbonate radical in arterial blood gas between the two groups (P<0.05). Respiratory depression occurred at 6.5-48.0 h after ingestion, with a median of 15.0 (9.5, 24.0) h. Multivariate logistic regression analysis showed that the intake of glufosinate (OR=1.440, 95%CI: 1.033-2.009, P=0.032) and bicarbonate radical in arterial blood gas (OR=0.199, 95%CI: 0.040-0.994, P=0.049) were predictors of respiratory depression in patients with glufosinate poisoning, and the area under the curve (AUC) of ROC curves were 0.936 and 0.842. The optimal cut-off values were 15.0 g (sensitivity=95.2%, specificity=76.9%) and 17.6 mmol/L (sensitivity=71.4%, specificity=84.6%), respectively. Conclusion: The intake of glufosinate and bicarbonate radical in arterial blood gas have good prediction effects on the occurrence of respiratory depression in patients with glufosinate poisoning.

[Study on the relationship between job stress, job burnout and turnover intention of nurses in the operating room of a provincial top three hospital].

Objective: To explore the relationship between job stress, job burnout and turnover intention of operating room nurses in a tertiary hospital in Shandong Province. Methods: From January 2016 to January 2019, the operating room nurses with an average daily operation volume of more than 200 operating rooms in a tertiary hospital in Shandong Province were selected as the research objects. The work pressure, job burnout and turnover intention of nurses were investigated with the Chinese nurses' job stressor scale, job burnout table and turnover intention table. Pearson related factors were used to analyze job stress, job burnout and turnover intention Multivariate logistic regression was used to analyze the factors influencing turnover intention. A total of 98 questionnaires were distributed and 98 questionnaires were returned, with a recovery rate of 100%. Results: The average score of job stress, job burnout and turnover intention were 85.49±5.42, 36.17±3.52 and 14.99±3.32, respectively. There were differences in the scores of work stress among different age, working years, education background and establishment groups (P<0.05) . The scores of job burnout among nurses with different working years, education background, professional title, salary and establishment were different (P< 0.05) ; the scores of turnover intention of nurses in different age, working years, professional title, salary and establishment group were different (P<0.05) ; salary, job burnout and occupational pressure were the influencing factors of turnover intention (P<0.05) . Conclusion: The operating room nurses have high work pressure and job burnout is an important factor leading to high turnover intention.

A central role of TRAX in the ATM-mediated DNA repair.

DNA repair is critical for the maintenance of genome stability. Upon genotoxic stress, dysregulated DNA repair may induce apoptosis. Translin-associated factor X (TRAX), which was initially identified as a binding partner of Translin, has been implicated in genome stability. However, the exact role of TRAX in DNA repair remains largely unknown. Here, we showed that TRAX participates in the ATM/H2AX-mediated DNA repair machinery by interacting with ATM and stabilizing the MRN complex at double-strand breaks. The exogenous expression of wild-type (WT) TRAX, but not a TRAX variant lacking the nuclear localization signal (NLS), rescued the vulnerability of TRAX-null mouse embryo fibroblasts (MEFs). This finding confirms the importance of the nuclear localization of TRAX in the repair of DNA damage. Compared with WT MEFs, TRAX-null MEFs exhibited impaired DNA repair (for example, reduced phosphorylation of ATM and H2AX) after treatment with ultra violet-C or γ-ray irradiation and a higher incidence of p53-mediated apoptosis. Our findings demonstrate that TRAX is required for MRN complex-ATM-H2AX signaling, which optimizes DNA repair by interacting with the activated ATM and protects cells from genotoxic stress-induced apoptosis.

An ultrastructural demonstration of the agent of Legionnaires' disease in the human lung.

The authors have provided ultrastructural demonstration from human material of a small rod shaped organism that represents the causative agent of Legionnaires' disease. The organisms are found mainly in intracytoplasmic vacuoles of alveolar cells. They have a thin outer cell wall and a more delicate plasma membrane. On the basis of morphology, arguments are presented to classify these unusual organisms as rickettsia-like.

Molecular cloning and heterologous expression of a glutathione S-transferase involved in insecticide resistance from the diamondback moth, Plutella xylostella.

Four glutathione S-transferase (GST, EC 2.5.1.18) isozymes have been characterized in the larvae of the diamondback moth (DBM), Plutella xylostella L., a cosmopolitan insect pest of crucifiers. This work aimed at cloning and heterologously expressing the cDNA of DBM GST-3, an isozyme involved in this insect resistance to some organophosphorus insecticides, and studying the molecular basis for its increased expression in the resistant strains. Reverse-transcription polymerase chain reaction (RT-PCR) using midgut mRNA from a methyl parathion resistant MPA strain and degenerate primers complimentary to the N-terminal and internal amino acid sequences of GST-3 generated a 128 bp DNA product. A clone of 809 bp, obtained by screening a midgut cDNA library of MPA strain using this PCR product as probe, encoded a protein of 216 amino acids (calculated Mr 24,083 and pI 8.50). This GST of DBM, PxGST3, shared the highest (46.3%) amino acid sequence identity, among insects, to MsGST1 of Manduca sexta. PxGST3 mRNA level was considerably higher in MPA than in susceptible strains, and Southern blots suggested that gene amplification was probably not involved in the increased expression of this GST isozyme. Enzymatically active PxGST3 expressed heterologously in E. coli exhibited similar biochemical and toxicological properties as GST-3 purified from DBM larvae. It is the first cloned GST with a well-defined role in insecticide resistance.

Spectrum of ultrastructural patterns of renal cell adenocarcinoma.

The ultrastructure of renal cell carcinoma was studied in 6 patients. This study demonstrated a spectrum of ultrastructural patterns ranging from the classic electron microscopic features of granular cell carcinoma at one extreme, to those of clear cell carcinoma at the other extreme. Other tumors demonstrated intermediate features. There was reasonably good correlation between the light microscopy and electron microscopy. Unusual findings of connective tissue banded structures and basement membrane branching were demonstrated.

Tuberous sclerosis complex and renal angiomyolipoma. Collective review.

Numerous case reports of renal angiomyolipoma with or without tuberous sclerosis continue to be published with increasing frequency in the urologic literature. The need for a comprehensive and updated review of the subject is timely. A collective pathologic, clinical, and radiologic review of the subjects of tuberous sclerosis complex and renal angiomyolipoma is presented; and a plan for the urologic management is discussed.

Extrapulmonary histopathologic manifestations of Legionnaires' disease: evidence for myocarditis and bacteremia.

Legionnaires' disease, although primarily seen as a pulmonary affection, may also manifest systemic involvement. Evidence is given to demonstrate bacteremia and focal myocarditis in a patient with cirrhosis and pneumonia.

Dermatomyositis: ultrastructure of abnormal mitochondria in the skeletal muscle.

The mitochondrial anomalies observed in the skeletal muscle of a patient with dermatomyositis included paracrystalline inclusions, dense bodies and stacks of lamellae. Virions were not found. These anomalies are similar to those noted in other myopathies.

Amyotrophic lateral sclerosis. Inclusion bodies in a case of the classic sporadic form.

Postmortem light and electron microscopic studies of a 52 year old black male who died 17 months after the onset of upper and lower motor neuron signs showed: (1) degeneration of cortico-spinal tracts, (2) loss of spinal neurons and gliosis and (3) cellular inclusions with neurotubules, neurofilaments and granular material. Although these cellular inclusions resemble Lafora bodies, they differ in that, to the authors' knowledge, the latter were not reported to have microtubules. Review of the literature revealed no previous report of these inclusions in cases of amyotrophic lateral sclerosis. Tissue cultures of cord, hindbrain and cerebrum did not show cytopathic effect during a three-week observation period.

Annulate lamellae in human tumor cells.

Annulate lamellae have been found in a primitive neuroectodermal tumor, a metastatic cerebellar tumor, a testicular seminoma, a retinoblastoma and three melanomas. These annulate lamellae are arranged in stacked parallel arrays in the cytoplasm of tumor cells. The number of annulate lamellae observed to comprise a single stack varies from 2--4 in the seminoma tumor to 5--18 in the cerebellar tumor. Although the functional significance of annulate lamallae is still unknown, in many instances they have been found to be continuous with rough-surfaced cisternae of the endoplasmic reticulum and ribosomes have been demonstrated on the surface of annulate lamellae. This may suggest that annulate lamellae participate in protein synthesis.

Extracellular cross-striated banded structures in human connective tissue.

Extracellular cross-striated banded structures have been found in the connective tissues of a variety of organs. Rarely have they been found in conditions such as: hyperplastic parathyroid, follicular adenoma of the thyroid, metastatic hemangiopericytoma in the lung, sarcoidosis of lymph node, and two biopsies of nerve as reported here. The shape and size of the structure varies, as well as its periodicity, which is usually in the range of 1000 to 15000 A. An unusual exception to this general rule is the banded structure in the follicular adenoma of the thyroid where the periodicity is 270 A. These structures are quite different from native collagen or experimentally reconstituted long-space collagen, both by staining reaction with phosphotungstic acid or uranyl acetate and lead nitrate, and in their ultrastructural morphology.