[Risk factors of anxiety during anesthesia induction in children undergoing eye and ear-nose-throat surgery]

Objective: To explore the risk factors of anxiety during anesthesia induction in children undergoing eye and ear-nose-throat (ENT) surgeries. Methods: The clinical data of 930 children who underwent eye and ENT surgeries in the Eye & ENT Hospital of Fudan University from January to December 2019 were collected. The outcome variable was the degree of anxiety during anesthesia induction. Demographic information about the children and their family members, anxiety scores and the usage of preoperative sedative drugs were collected as the exposure factors. The risk factors of anxiety during anesthesia induction were determined by logistic regression analysis. Results: A total of 930 children were included in the study, of which 56(6.0%) cases developed anxiety during the induction period. Univariate logistic regression analysis showed that age (OR=0.72, 95%CI:0.61-0.86, P<0.001), anxiety grading of children by medical evaluation method (mild as the reference, moderate OR=5.42, 95%CI:2.92-10.07, P<0.001; severe OR=7.53, 95%CI: 2.54-22.29, P<0.001), Modified Yale Preoperative Anxiety Scale (mYPAS) score at arrival in the preoperative waiting room (OR=1.05, 95%CI:1.02-1.07, P<0.001) and sedation score (OR=0.48, 95%CI: 0.30-0.76, P<0.001) were risk factors for the development of anxiety during the induction period. Multivariate logistic regression analysis revealed that anxiety grading of children by medical evaluation method was a risk factor for affecting anxiety in the induction period (mild as the reference, moderate OR=4.08, 95%CI:1.81-9.18, P<0.01; severe OR=4.95, 95%CI:1.26-19.44, P=0.022). Conclusion: Anxiety grading of children by medical evaluation method is an essential risk factor for predicting anxiety during induction period.

[The experimental study of diquat on the half-Lethal dose and pothological injuny of related organs in wistor rats]

Objective: To explore the acute toxicity of Diquat in mice and to calculate the median lethal dose (LD(50)) of Diquat to rats and observe the pathological changes of tissues and organs in rats with different concentrations of Diquat. Methods: Diquat solution of 50 mg/kg was prepared freshly with 1 000 mg of Diquat and dilute the solution with water to a total of 20 ml. A total of 99 healthy adult male Wistar rats were randomly divided into part one, part two and control groups. In the first part, 36 rats were randomly divided into 4 groups: 100 mg/kg group, 200 mg/kg group, 300 mg/kg group and 400 mg/kg group, which were treated with 100 mg/kg, 200 mg/kg, 300 mg/kg and 400 mg/kg of Diquat solution by gavage, respectively. The death and symptoms of poisoning after intragastric administration were recorded, and the maximum tolerated dose and absolute lethal dose were measured. In the second part, 54 rats were randomly divided into 6 groups: 200 mg/kg group, 220 mg/kg group, 240 mg/kg group, 260 mg/kg、280 mg/kg group and 300 mg/kg group, whichwere treated with 200 mg/kg, 220 mg/kg, 240 mg/kg, 260 mg/kg, 280 mg/kg and 300 mg/kg of Diquat solution by gavage, respectively. The survival of rats in different concentration of Diquat was observed and the LD(50) was calculated by Excel processing the formula of Koch's method. The control group were given equal volume water under the same experimental conditions. And moreover, the lungs, kidneys, hearts, livers, and brain tissues were collected and fixed by formaldehyde, embedded by paraffin, and sectioned for histopathological light microscopy. Results: The maximum tolerated dose was 240 mg/kg and the absolute lethal dose was 300 mg/kg. The LD(50) of Diquat for Rats was 280.58 mg/kg. The high-dose group had significantly more organ damage than the low-dose group after diquat poisoning. Conclusion: The determination of the half-lethal dose of diquat, at the same time observed multiple organs damaged in rats after the diquat quickly poisoned. Kidneys, lungs and heart might be the main organ which was heavily damaged. With the extension of observation time, the organ damage of rats exposed to small doses gradually stabilized.

[Clinical analysis of lower limb thrombosis caused by paraquat poisoning]

Objective: To investigate the causes of peripheral vascular thrombosis in patients with paraquat poisoning. Methods: The patients with paraquat poisoning who were admitted to our department in recent two years were observed to screen out the patients with large vessel thrombosis. The data on toxic exposure history, clinical features, and treatment were collected to analyze the causes of thrombosis in the patients with paraquat poisoning. Results: Three patients had typical lower limb thrombosis. There was one case of right common femoral vein thrombosis, one case of bilateral calf muscle vein thrombosis, and one case of right calf superficial vein thrombosis and right calf muscle vein thrombosis. Conclusions: After paraquat poisoning, the blood is in a hypercoagulable state and prolonged bed rest may increase the risk of thrombosis.

[A group of occupational acute methyl bromide poisoning incident]

Objective: To investigate a mass of occupational acute methyl bromide poisoning incident and analyzed their clinical data. Methods: To investigate an incident a mass of occupational acute methyl bromide poisoning in occurred in Shandong province in November 2016, and the clinical datas of 3 cases of severe patients with methyl bromide poisoning were analysed. Results: This event was a sudden occupational poisoning incident. Lack of vocational training and irregularities is the main reason for the accident 3 patients with nervous system, respiratory system, circulatory system, urinary system damage is given priority to, after comprehensive rescue treatment, 2 cases died and 1 case survived. Conclusions: Methyl bromide can cause severe poisoning, has high mortality in patients with acute severe poisoning.