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Meng Z, Dong Y, Gao H, Yao D, Gong Y, Meng Q, Zheng T, Cui X, Su X, Tian Y. The effects of ω-3 fish oil emulsion-based parenteral nutrition plus combination treatment for acute paraquat poisoning. J Int Med Res 2018; 47:600-614. [PMID: 30392424 PMCID: PMC6381463 DOI: 10.1177/0300060518806110] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Objective To investigate the effects of parenteral nutrition (PN) including ω-3 fish-oil emulsion on nutritional state, inflammatory response, and prognosis in patients with acute paraquat poisoning. Methods Patients randomized to receive medium chain triglycerides (MCT)/long chain triglycerides (LCT)-based PN (control group) or MCT/LCT-based PN containing ω-3 fish-oil emulsion (intervention group) were compared for 90-day survival and short-term treatment efficacy. Results Tumour necrosis factor-α levels were significantly lower in the intervention group (n = 101) versus controls (n = 73) on treatment days 4 and 7. Intervention group C-reactive protein (CRP) levels were significantly increased on day 4, decreased to baseline (day 1) levels on day 7, and were significantly lower than baseline on day 10. Control group CRP levels were significantly increased on days 4 and 7 versus baseline, and returned to baseline levels on day 10. On day 7, retinol binding protein had recovered to baseline levels in the intervention group only. Intervention group mortality rate (36.6%) was significantly lower than controls (57.5%). ω-3 fish-oil PN was associated with reduced risk of death (hazard ratio 0.52; 95% confidence interval 0.33, 0.82). Conclusion In patients with acute paraquat poisoning, MCT/LCT with ω-3 fish-oil emulsion PN plus combination treatment advantageously attenuated the inflammatory response, modified the nutritional state, and was associated with significantly improved 90-day survival versus treatment without ω-3 fish oil.
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Affiliation(s)
- Zhaohua Meng
- 1 Emergency Department, Second Hospital of Hebei Medical University, Xinhua District, Shijiazhuang, Hebei, China
| | - Yanling Dong
- 1 Emergency Department, Second Hospital of Hebei Medical University, Xinhua District, Shijiazhuang, Hebei, China
| | - Hengbo Gao
- 1 Emergency Department, Second Hospital of Hebei Medical University, Xinhua District, Shijiazhuang, Hebei, China
| | - Dongqi Yao
- 1 Emergency Department, Second Hospital of Hebei Medical University, Xinhua District, Shijiazhuang, Hebei, China
| | - Yu Gong
- 1 Emergency Department, Second Hospital of Hebei Medical University, Xinhua District, Shijiazhuang, Hebei, China
| | - Qingbing Meng
- 1 Emergency Department, Second Hospital of Hebei Medical University, Xinhua District, Shijiazhuang, Hebei, China
| | - Tuokang Zheng
- 1 Emergency Department, Second Hospital of Hebei Medical University, Xinhua District, Shijiazhuang, Hebei, China
| | - Xiaolei Cui
- 1 Emergency Department, Second Hospital of Hebei Medical University, Xinhua District, Shijiazhuang, Hebei, China
| | - Xiaoyun Su
- 2 Division of Health Care, Second Hospital of Hebei Medical University, Xinhua District, Shijiazhuang, Hebei, China
| | - Yingping Tian
- 1 Emergency Department, Second Hospital of Hebei Medical University, Xinhua District, Shijiazhuang, Hebei, China
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Liu XW, Ma T, Li LL, Qu B, Liu Z. Predictive values of urine paraquat concentration, dose of poison, arterial blood lactate and APACHE II score in the prognosis of patients with acute paraquat poisoning. Exp Ther Med 2017; 14:79-86. [PMID: 28672896 PMCID: PMC5488431 DOI: 10.3892/etm.2017.4463] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 02/14/2017] [Indexed: 12/12/2022] Open
Abstract
The present study investigated the predictive values of urine paraquat (PQ) concentration, dose of poison, arterial blood lactate and Acute Physiology and Chronic Health Evaluation (APACHE) II score in the prognosis of patients with acute PQ poisoning. A total of 194 patients with acute PQ poisoning, hospitalized between April 2012 and January 2014 at the First Affiliated Hospital of P.R. China Medical University (Shenyang, China), were selected and divided into survival and mortality groups. Logistic regression analysis, receiver operator characteristic (ROC) curve analysis and Kaplan-Meier curve were applied to evaluate the values of urine paraquat (PQ) concentration, dose of poison, arterial blood lactate and (APACHE) II score for predicting the prognosis of patients with acute PQ poisoning. Initial urine PQ concentration (C0), dose of poison, arterial blood lactate and APACHE II score of patients in the mortality group were significantly higher compared with the survival group (all P<0.05). Logistic regression analysis revealed that C0, dose of poison and arterial blood lactate correlated with mortality risk of acute PQ poisoning (all P<0.05). ROC curve analysis suggested that the areas under the curve (AUC) values of C0, dose of poison, arterial blood lactate and APACHE II score in predicting the mortality of patients within 28 days were 0.921, 0.887, 0.808 and 0.648, respectively. The AUC of C0 for predicting early and delayed mortality were 0.890 and 0.764, respectively. The AUC values of urine paraquat concentration the day after poisoning (Csec) and the rebound rate of urine paraquat concentration in predicting the mortality of patients within 28 days were 0.919 and 0.805, respectively. The 28-day survival rate of patients with C0 ≤32.2 µg/ml (42/71; 59.2%) was significantly higher when compared with patients with C0 >32.2 µg/ml (38/123; 30.9%). These results suggest that the initial urine PQ concentration may be the optimal index for predicting the prognosis of patients with acute PQ poisoning. Additionally, dose of poison, arterial blood lactate, Csec and rebound rate also have referential significance.
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Affiliation(s)
- Xiao-Wei Liu
- Department of Emergency, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China
| | - Tao Ma
- Department of Emergency, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China
| | - Lu-Lu Li
- Department of Emergency, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China
| | - Bo Qu
- Department of Biostatistics, School of Public Health, China Medical University, Shenyang, Liaoning 110001, P.R. China
| | - Zhi Liu
- Department of Emergency, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China
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Huang M, Yang H, Zhu L, Li H, Zhou J, Zhou Z. Inhibition of connective tissue growth factor attenuates paraquat-induced lung fibrosis in a human MRC-5 cell line. ENVIRONMENTAL TOXICOLOGY 2016; 31:1620-1626. [PMID: 26129822 DOI: 10.1002/tox.22166] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 03/30/2015] [Accepted: 06/14/2015] [Indexed: 06/04/2023]
Abstract
Chronic exposure to Paraquat (PQ) may result in progressive pulmonary fibrosis and subsequent chronic obstructive pulmonary malfunction. Connective tissue growth factor (CTGF) has been proposed as a key determinant in the development of lung fibrosis. We investigated thus whether knock down of CTGF can prevent human lung fibroblasts (MRC-5) activation and proliferation with the subsequent inhibition of PQ-induced fibrosis. MRC-5 was transfected with CTGF-siRNAs and exposed to different concentrations of PQ. The siRNA-silencing efficacy was evaluated using western blotting analyses, qRT-PCR and flow cytometry. Next, the viability and migration of MRC-5 was determined. MMP-2, MMP-9, and TIMP-1 accumulation were quantified to evaluate the lung fibrosis exposure to PQ. Over expression of CTGF mRNA was observed in human MRC-5 cell as early as 6 h following PQ stimulation. CTGF gene expression in MRC-5 cells was substantially reduced by RNAi, which significantly suppressed the expression of the lung fibrosis markers such as tissue inhibitor of metalloproteinase-2 (TIMP-2), Matrix metalloproteinase-2 (MMP-2) and Matrix metalloproteinase-9 (MMP-9) that were stimulated by PQ. Inhibition of CTGF expression suppressed impeded the proliferation and migration ability of MRC-5 cells and resulted in cell-extracellular matrix (ECM) protein accumulation in cells. Our results suggest that CTGF promoted the development of PQ-induced lung fibrosis in collaboration with transforming growth factor β1 (TGFβ1). Furthermore, the observed arresting effects of CTGF knock down during this process suggested that CTGF is the potential target site for preventing PQ-induced pulmonary fibrosis. © 2015 Wiley Periodicals, Inc. Environ Toxicol 31: 1620-1626, 2016.
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Affiliation(s)
- Min Huang
- The Department of Occupational and Environmental Health, School of Public Health, Ningxia Medical University, 750004, 1160 Shengli Street, Xingqing District, Yinchuan, 750004, People's Republic of China
| | - Huifang Yang
- The Department of Occupational and Environmental Health, School of Public Health, Ningxia Medical University, 750004, 1160 Shengli Street, Xingqing District, Yinchuan, 750004, People's Republic of China
| | - Lingqin Zhu
- The Department of Occupational and Environmental Health, School of Public Health, Ningxia Medical University, 750004, 1160 Shengli Street, Xingqing District, Yinchuan, 750004, People's Republic of China
| | - Honghui Li
- The Department of Occupational and Environmental Health, School of Public Health, Ningxia Medical University, 750004, 1160 Shengli Street, Xingqing District, Yinchuan, 750004, People's Republic of China
| | - Jian Zhou
- The Department of Occupational and Environmental Health, School of Public Health, Ningxia Medical University, 750004, 1160 Shengli Street, Xingqing District, Yinchuan, 750004, People's Republic of China
| | - Zhijun Zhou
- School of Public Health, Key Lab of Public Health Safety, Ministry of Education, WHO Collaborating Center for Occupational Health, Fudan University, Shanghai, 200032, China.
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