tbuckley/cabot-search huggingface dataset:
Questionnaire survey onobstructive sleep apnea hypoventilation syndrome and related complications
Authors: Qian Cai, Hua Zou
Journal: BMJ (2011)

：Objective To investigaterelationship between obstructive sleep apnea hypoventilation syndrome(OSAHS) andhypertension.Methods Questionnaire survey was conducted among 1573 local permanentresidents in Guangzhou during March and June 2006 to understand prevalence of hypertensionand snoring,and polysomnography monitoring was performed for 347 of them with moderate andsevere snoring to estimate prevalence of OSAHS.Risk factors for hypertension was screenedwith multivariate logistic regression analysis.Results In total,1547 copies of validquestionnaires were collected,and 184 cases (11.9%) of hypertension were found with aprevalence of 10Department of Endocrinology,Shanxi Provincial People's Hospital,Taiyuan030012,China 0%,49 of diabetes with a prevalence of 2.7%,and 212 of dyslipidemia with aprevalence of 10.4%.Prevalence of OSAHS was found in 34 of them (2.2% ) with Epworthsleepiness scale (ESS) score equal to or greater than nine.Prevalence of hypertension inOSAHS group was 32.5%,much higher than that in non-snoring group (8.3% ) and snoring group( 17.1% ).Results of logistic regression analysis showed that age,gender,OSAHS,diabetesand dyslipidemia all were high-risk factors for hypertension,with OSAHS ranking thethird.Conclusion OSAHS is one of high-risk factors for hypertension.
继发于甲状腺功能减退症的睾丸鞘膜积液二例
Authors: 张玉泉, 郭志全, 李国丰
Journal: BMJ (2006)

睾丸鞘膜积液临床多见,但因甲状腺功能减退症引起者较少.我院近期收治2例,报告如下. 例1 49岁,发现右阴囊肿大且缓慢加重2个月.查体:右阴囊内约6 cm ×4cm×4 cm卵圆形包块,B超提示右侧睾丸鞘膜积液.入院后行睾丸鞘膜翻转术,术后第7天拆线,切口有渗出,迁延不愈.追问病史,有甲状腺功能低下症状,检测游离甲状腺素T3 2.5 pmol/L,游离甲状腺素T4 1.8pmol/L,诊断为甲状腺功能减退症,予甲状腺片口服,1个月后手术切口愈合,复查甲状腺功能正常.
Allogeneic stem cell transplantation in elderly lymphoma patients: Single-center experience.
Authors: Zafer Gulbas
Journal: Journal of Clinical Oncology (2020)

e19519 Background: Autologous stem cell transplantation is used as consolidation therapy in relapsed lymphoma patients. However, outcome of lymphoma patients relapsing after autologous stem cell transplantation is poor and allogeneic stem cell transplantation which can be curative is used in the transplant eligible patients in this setting. Besides, allogeneic stem cell transplantation can be an option before autologous stem cell transplantation in some high risk patients. In this study, we aimed to analyze the results of lymphoma patients older than 60 years of age who had undergone allogeneic transplantation in our center. Methods: We collected the data of lymphoma patients older than 60 years of age who had undergone allogeneic transplantation in our center and analyzed the results. Results: There were 20 patients over the age of 60 who had undergone allogeneic stem cell trasplantation with the diagnosis of lmphoma between 2011 and 2019. 18 patients had Non-Hodgkin lymphoma and 2 patients had Hodgkin lymphoma. 12 patients (60%) had been transplanted from HLA-matched sibling, while 6 patients (30%) had been transplanted from unrelted donors and 2 patients (10%) had been transplanted from haploidentical donors. The median age of the patients was 62 (61-66) and 30% of the patients were female. During the follow-up time only 1 patient had relapsed. The 2 year progression free survival (PFS) rate was 32% and the 2 year overall survival (OS) rate was 32%. The OS curve is shown in Figure 1. 100 day mortality was 30% and 1 year non-relapse mortalty (NRM) was 50%. The characteristics and results of the patients are summarized in Table 1. Conclusions: In the present study, although the number of patients is low, we showed that lymphoma patients over 60 years of age have a 2 year overall survival rate of 32% and a relapse rate of 5% suggesting that allogeneic stem cell transplantation which has a curative potential may be employed in transplant eligible elderly lymphoma patients.
Health-related quality-of-life assessment in accordance with reconstruction procedures for distal gastrectomy for stage I gastric cancer using data from JCOG0912.
Authors: Keiichi Fujiya, Masahiko Ando, Junki Mizusawa, Hitoshi Katai, Takanobu Yamada, Seiji Ito, Takeo Fukagawa, Etsuro Bando, Kazunari Misawa, Yutaka Tanizawa, Shinji Morita, Hiroshi Katayama, Takaki Yoshikawa, Masanori Terashima, Mitsuru Sasako
Journal: Journal of Clinical Oncology (2020)

4562 Background: There are three major reconstruction methods after gastrectomy for distal gastric cancer; Billroth-I (B-I), Roux-en-Y (RY) and pylorus-preserving gastrectomy (PPG). These procedures can affect postoperative health-related quality-of-life (HRQoL), but the method is often selected due to physician’s preference or each institutional policy without solid evidence. We aimed to explore differences in HRQoL after each reconstruction procedure selected in JCOG0912, a phase III noninferiority trial comparing open and laparoscopic distal gastrectomies for stage I gastric cancer. Methods: Among 33 institutions participated in JCOG0912, 4 major cancer centers were selected for HRQoL assessment. HRQoL was assessed using the EORTC QLQ-C30 and STO22 before (baseline) and at 1, 3, 12, and 36 months after surgery as preplanned exploratory analysis. Results: Excluding 2 patients who didn’t answer the questionnaire, 590 patients were analyzed in this study. For reconstruction, B-I was performed for 222 patients (37.7%), RY for 178 (30.2%) and PPG for 189 (32.1%). Proportion of the opted reconstruction procedures was not different in open and laparoscopic gastrectomies. Global health status (GHS) scores of QLQ-C30 were not different among 3 groups at any time point. In comparison of B-I and RY, B-I was better than RY in constipation, while RY was better than B-I in diarrhea and reflux symptoms. In comparison of B-I and PPG, B-I was better than PPG in constipation and reflux symptoms, while PPG was better than B-I in diarrhea. When comparing RY and PPG, RY was better than PPG in constipation and reflux symptoms, while PPG was better than RY in taste (table). Conclusions: GHS scores were similar regardless of the reconstruction procedure, however postoperative symptoms including reflux, constipation, and diarrhea were various according to reconstruction methods. [Table: see text]
The prevalence current condition and prospect of cervical cancer
Authors: 章文华
Journal: BMJ (2009)

涉及妇女健康的三大疾病是乳腺癌、宫颈癌和生殖道感染,其中威胁妇女生命的头号杀手依然是宫颈癌,它已成为全球性的公共卫生问题,其原因是:①人乳头状瘤病毒(HPV)感染急骤上升,全球每年有50万女性被HPV感染,每年有10%～15%新发病例;
Harnessing Natural Killer Immunity in Metastatic SCLC
Authors: Sarah A. Best, Jonas B. Hess, Fernando Souza-Fonseca-Guimaraes, Joseph Cursons, Ariena Kersbergen, Xueyi Dong, Jai Rautela, Stephanie R. Hyslop, Matthew E. Ritchie, Melissa J. Davis, Tracy L. Leong, Louis Irving, Daniel Steinfort, Nicholas D. Huntington, Kate D. Sutherland
Journal: Journal of Thoracic Oncology (2020)

SCLC is the most aggressive subtype of lung cancer, and though most patients initially respond to platinum-based chemotherapy, resistance develops rapidly. Immunotherapy holds promise in the treatment of lung cancer; however, patients with SCLC exhibit poor overall responses highlighting the necessity for alternative approaches. Natural killer (NK) cells are an alternative to T cell-based immunotherapies that do not require sensitization to antigens presented on the surface of tumor cells.We investigated the immunophenotype of human SCLC tumors by both flow cytometry on fresh samples and bioinformatic analysis. Cell lines generated from murine SCLC were transplanted into mice lacking key cytotoxic immune cells. Subcutaneous tumor growth, metastatic dissemination, and activation of CD8+ T and NK cells were evaluated by histology and flow cytometry.Transcriptomic analysis of human SCLC tumors revealed heterogeneous immune checkpoint and cytotoxic signature profiles. Using sophisticated, genetically engineered mouse models, we reported that the absence of NK cells, but not CD8+ T cells, substantially enhanced metastatic dissemination of SCLC tumor cells in vivo. Moreover, hyperactivation of NK cell activity through augmentation of interleukin-15 or transforming growth factor-β signaling pathways ameliorated SCLC metastases, an effect that was enhanced when combined with antiprogrammed cell death-1 therapy.These proof-of-principle findings provide a rationale for exploiting the antitumor functions of NK cells in the treatment of patients with SCLC. Moreover, the distinct immune profiles of SCLC subtypes reveal an unappreciated level of heterogeneity that warrants further investigation in the stratification of patients for immunotherapy.
Trend analysis of serum uric acid levels in health check-up subjects of Tianjin municipality 2007-2015
Authors: Li Liu, Qing Zhang, Xiaoyan Gong, Jing Cui, Xin Luo
Journal: BMJ (2017)

Objective
To assess the changing trend of serum uric acid (SUA) levles in health check-up subjects of Tianjin municipality 2007-2015.


Method
Data were collected from 266 043 subjects receiving annual health check-up from 2007 to 2015 in Tianjin municipality. Changing trends of SUA levels and incidence of hyperuricemia were analyzed during the 9 year period.


Results
From 2007 to 2015 SUA levels in males were increased from (347±73) μmol/L to (373±78) μmol/L, while in females were increased from(253±59) μmol/L to (267±61) μmol/L. The trend test showed that both for men and women the incidence of hyperuricemia was increased in each year (men: χ2=270.30, women : χ2=15.10, both P=0.00). The incidence of hyperuricemia by each year was increased more markedly in men than that in women (χ2 level: 194.80-1 877.00, all P=0.00). The incidence of hyperuricemia in young adults (20-39) was higher than that in middle-ages (40-59), and the latter was higher than that in elderly (>60). For the 7-year (2009-2015)incidence of hyperuricemia in young and middle-aged men, the trend test showed statistical siganificance (χ2 level: 14.11-233.90, all P=0.00). By contrast, the incidence hyperuricemia in women was increased with aging, and for the 9-year incidence of hyperuricemia in young women, the trend test showed statistical siganificance (χ2 level: 115.30-480.20, all P=0.00).


Conclusion
The incidence rates of hyperuricemia are high in Tianjin health check-up subjects, especiallly in young males and old females. There is a time trend of increasing incidence of hyperuricemia in the young and middle-aged subjects. The results indicate that the prevention and control of hyperuricemia in Tianjin are of clinical and social significance.


Key words: 
Hyperuricemia; Health examination; Trend test; Factor analysis, statistical
Phase I trial of personalized mRNA vaccine encoding neoantigen in patients with advanced digestive system neoplasms.
Authors: Xianbao Zhan, Bin Wang, Yiran Wang, Longpei Chen, Xiaobo Peng, Jie Li, Meihong Wu, Linli Zhang, Shuhui Tang
Journal: Journal of Clinical Oncology (2020)

e15269 Background: Cancer cells have characteristics of genetic instabilities and accumulate somatic mutations rapidly which could produce tumor specific antigens (TSAs) called as neoantigens. As the cancer vaccine based on TSAs has potential to treat the disease, personalized neoantigen-based immunotherapies are emerging. We report for the first time that vaccines are used to treat advanced digestive system neoplasms. Methods: In this single-arm, open-label, first-in-human phase I pilot study (NCT03468244) to investigate the feasibility, safety, immunogenicity and clinical activity of personalized mRNA vaccine. Patients with advanced digestive system neoplasms received up to 20 stimulatory synthetic long peptides vaccine at a dose of 0.2 mg on days 1 and 0.8mg on days 2, administered subcutaneously of every 3 weeks(Q3W) for 12 weeks. Patients was treated with standard treatments according to NCCN guideline simultaneously. Adverse Event (AE) grade categorization is according to CTCAE 4.0, and tumor response was assessed per RECIST 1.1. Immune factors and ELISPOT assay were examined every 3 weeks after vaccination. Results: As of February 1st, 2020, three patients (52yrs, 47yrs and 52yrs; ECOG PS: 0) with advanced rectal, colon and gastric cancer completed the vaccine therapy for 3-4 cycles. There were no serious adverse events, treatment-related death or severe neurotoxicity occurred in the study. The most common treatment-emergent adverse event (TEAE) was erythema at injection sites in three patients. Vaccine combined standard treatments treatment was associated with G3/4 hematological side effects: leucopenia (18%); neutropenia (9%); anemia (0); thrombocytopenia (18%). Blood samples for immune monitoring (ELISPOT and intracellular cytokine staining [ICS]) were collected pre-dose and at weeks 3 and 12. The level of IL-1β, IL-2 receptor, IL-6, IL-8, IL-10, and TNF-α increased for all patients. Especially, IL-8 and IL-2R increased significantly for more than 800 times in the patient with rectal cancer and more than 4 times in the patient with gastric cancer after injection, respectively. The PFS were 3.2, 3.0 and 3.0 months and the OS were 9.1, 6.0 and 7.8 months, respectively. Best response was 2 SD and 1 PD. Conclusions: This clinical study indicated that personalized mRNA vaccine may be safe and could activate immune response in vivo which is convinced by ELISPOT assay in vitro. Further studies are indicated to explore the personalized mRNA vaccine in gastrointestinal cancer. Clinical trial information: NCT03468244 .
Quality of life (QOL), financial burden, and perception of care in patients enrolled on clinical trials (CTs).
Authors: Surbhi Sidana, Cristine Allmer, Melissa C. Larson, Amylou C. Dueck, Kathleen J. Yost, Rahma M. Warsame, Gita Thanarajasingam, James Robert Cerhan, Jonas Paludo, S. Vincent Rajkumar, Thomas Matthew Habermann, Grzegorz S. Nowakowski, Yi Lin, Morie A. Gertz, Thomas E. Witzig, Angela Dispenzieri, Wilson I. Gonsalves, Stephen M. Ansell, Carrie A. Thompson, Shaji Kumar
Journal: Journal of Clinical Oncology (2020)

e19112 Background: We sought to study the longitudinal QOL, financial burden and perception of care (PoC) in patients with multiple myeloma (MM) or lymphoma (LYM) enrolled on CTs vs. those receiving standard care (Non-CT). Methods: QOL was evaluated using the FACT-G questionnaire (baseline, 1, 2, 3, 6 &amp; 12 months). Financial burden was evaluated using 10 questions adapted from the MEPS survey and PoC was evaluated using 6 questions adapted from the CAHPS survey (baseline, 3, 6 &amp; 12 months). Results: 35 (28%) of 123 enrolled patients were treated on CTs. Demographics, QOL and financial burden are shown in the Table. Baseline QOL scores were similar in CT vs non-CT groups. Age, gender and self-reported performance status were significantly associated with baseline QOL, while lines of therapy &amp; cancer type were not. There were no significant differences in change in QOL vs. baseline in patients treated on CTs vs. non-CTs at 1, 2, 3, 6 and 12 months from baseline, including the total FACT-G score and the subdomains of functional, physical, emotional and social well-being. Within each group, there was a decline in QOL over the first 3 months, specifically physical WB, which gradually returned to baseline. Baseline answers to financial burden questions were similar, except patients on CTs reported less need for taking extended time-off from work (22% vs. 46%, p = 0.02). The only statistically significant difference in individual Qs over 1 year was ‘worry about having to pay large medical bills’ at the 6-month timepoint (CT: 0%, non-CT: 52%, p = 0.01). Using a composite score from 4 MEPS questions, financial burden over time was lower in the CT group, though the differences were not statistically significant. There were no significant differences in PoC at baseline, 3, 6 and 12 months in the two groups based on answers to each of the six questions adapted from the CAHPS survey. Conclusions: Over 1 year, patients on CTs experienced a similar QOL and perceived their care to be similar as non-CT patients. Financial burden was lower in the CT group, though differences were not statistically significant. [Table: see text]
Non-pharmacological treatment of depression: a systematic review and evidence map
Authors: Farah Wigdan H, Alsawas Mouaz, Mainou Maria, Alahdab Fares, Farah Magdoleen H, Ahmed Ahmed T, Mohamed Essa A, Almasri Jehad, Gionfriddo Michael R, Castaneda-Guarderas Ana, Mohammed Khaled, Wang Zhen, Asi Noor, Sawchuk Craig N, Williams Mark D, Prokop Larry J, Murad M Hassan, LeBlanc Annie, 江敏俊, 何燕玲
Journal: BMJ (2017)

背景
抑郁症非药物治疗的疗效比较目前仍然不清楚。


方法
我们对一些系统性综述作了概述，回顾了随机对照试验（RCT），比较抑郁症非药物治疗的有效性和认知行为治疗（CBT）。对多个电子数据库在2016年2月之前发表的所有文献进行了检索，不限制语言。成对的评阅人进行资料纳入、数据提炼并评估偏倚的风险。在适用的时候进行了荟萃分析。


结果
我们收录了367项RCT，纳入了约2 000名患者，进行了11种治疗，导出17项独立的头对头比较。通过标准化的量表评估，发现CBT、自然疗法、行为干预与躯体活动干预可以降低抑郁的严重程度。然而，这些非药物干预的相对疗效仍然缺乏。这些干预对临床缓解和复发的效果不清楚。CBT的发生率比抗抑郁药物更低。


局限性
由于证据缺乏一致性、证据不清或偏倚风险高，导致证据的质量只是低到中等，限制了我们研究结果的可信度。


结论
抑郁症的非药物治疗能减少抑郁症状，在轻度到重度抑郁症患者中，应当合并抗抑郁药物治疗，一同进行。对于非药物治疗的选择，应当根据患者的价值观、偏好、临床和社会因素来与患者共同作出决定。
POLARGO: Randomized Phase III study of polatuzumab vedotin plus rituximab, gemcitabine, and oxaliplatin (R-GemOx) in relapsed/refractory diffuse large B-cell lymphoma (R/R DLBCL).
Authors: Corinne Haioun, Matthew J. Matasar, Juan-Manuel Sancho, Andreas Viardot, Juana Hernandez, Thomas Perretti, Andrew McMillan
Journal: Journal of Clinical Oncology (2020)

TPS8070 Background: The antibody-drug conjugate polatuzumab vedotin (pola; POLIVY) targets CD79b on B-cell malignancies. Pola plus bendamustine and rituximab (BR) has significantly improved efficacy vs BR alone in patients (pts) with R/R DLBCL. As a result, pola-BR was approved by the FDA for pts with R/R DLBCL after ≥2 prior therapies. This year, the EU granted conditional marketing authorization for pola-BR in pts with stem cell transplant (SCT)-ineligible R/R DLBCL. A range of therapies are used for R/R DLBCL; one recommended option is R-GemOx. Platinum-based chemotherapies such as oxaliplatin are a preferred salvage therapy. In the POLARGO study, the safety and efficacy of pola-R-GemOx vs R-GemOx alone will be assessed in pts with R/R DLBCL. Methods: POLARGO (MO40598; NCT04182204) is a multicenter, open-label, Phase III study, comprising a safety run-in stage (pola-R-GemOx; n=10) and a randomized controlled trial (RCT) stage (pola-R-GemOx vs R-GemOx alone; expected n=206). Pts must have histologically confirmed R/R DLBCL and ECOG PS of 0–2. Exclusion criteria include prior allogeneic SCT and/or planned autologous/allogeneic SCT, and baseline grade &gt;1 peripheral neuropathy (PN). Pts in the RCT stage will be recruited from 80–90 sites globally. The primary endpoint of the safety run-in stage is the safety and tolerability of pola-R-GemOx (pola, 1.8mg/kg; R, 375mg/m 2 ; Gem, 1000mg/m 2 ; Ox, 100mg/m 2 ) administered in 21-day cycles, with a focus on PN. In the RCT stage, pts will be stratified by number of prior lines of therapy, outcome of last systemic therapy and age, and randomized (1:1) to receive up to eight 21-day cycles of pola-R-GemOx or R-GemOx. The RCT stage primary endpoint is overall survival. Key secondary endpoints are independent review committee-assessed complete response (CR) and objective response rate (ORR; Lugano 2014 criteria). Other secondary efficacy endpoints include investigator-assessed best overall response, CR rate and ORR. Safety and health-related quality of life during treatment will be assessed. PET-CT and CT scans will be obtained at screening, during, and after the treatment period; follow-up will continue for up to 2 years. POLARGO is currently open and recruiting. Acknowledgment: POLARGO is sponsored by F. Hoffmann-La Roche Ltd. Third-party medical writing assistance, under the direction of Prof. Haioun, Dr McMillan and Dr Hernandez, was provided by Lucinda Sinclair of Gardiner-Caldwell Communications and was funded by F. Hoffmann-La Roche Ltd. Clinical trial information: NCT04182204 .
Efficacy and safety of immunotherapy in non-small cell lung cancer patients with poor performance status.
Authors: Riccardo Lobefaro, Giuseppe Viscardi, Raimondo Di Liello, Giacomo Massa, Maria Lucia Iacovino, Francesca Sparano, Roberto Ferrara, Diego Signorelli, Claudia Proto, Arsela Prelaj, Giulia Galli, Alessandro De Toma, Marta Brambilla, Monica Ganzinelli, Benedetta Trevisan, Achille Bottiglieri, Filippo G. De Braud, Floriana Morgillo, Marina Chiara Garassino, Giuseppe Lo Russo
Journal: Journal of Clinical Oncology (2020)

e21601 Background: The introduction of Immunotherapy (IO) has dramatically improved the prognosis of patients (pts) with advanced Non-Small Cell Lung Cancer (NSCLC). However, data regarding the role of IO in ECOG Performance Status (PS) 2 pts are generally limited in randomized trials, and real-world evidences could support clinical decision-making. Methods: We retrospectively analyzed data about pts with stage IV NSCLC treated with IO between April 2013 and December 2019 in two Italian Centers. The aim of our study was to assess the impact of PS status (0-1 vs 2) on disease control rate (DCR), progression-free survival (PFS) and overall survival (OS). Response was classified according to RECIST v1.1 criteria. PFS and OS were estimated by the Kaplan-Meier method. Chi-square test was used to compare clinical-pathological variables: gender, age ( &lt; 70, 70-79, ≥80 years-old), smoking status, histology (squamous, non-squamous), PDL1 expression ( &lt; 1%, ≥1%), IO line (1°, ≥2°), number (N) of metastatic sites (1, ≥2), presence of liver and/or brain metastasis. Their impact on survival was evaluated through Cox proportional hazard models. Results: Four-hundred-one pts (35.7% female) with median age of 65.4 years (range 27-88) were studied. Baseline PS was 0 in 134 pts (33.4%), 1 in 209 pts (52.1%) and 2 in 58 pts (14.5%). 312 pts had non-squamous NSCLC, 89 squamous NSCLC. Clinical-pathological variables were uniformly distributed across PS groups except for a higher rate of liver metastasis in PS2 pts ( p= 0.046). Response evaluation was available for 386 pts. DCR was 49.7% in PS0-1 pts and 25.9% in PS2 pts ( p= 0.006). At a median follow-up of 29 months (mos), median PFS was 3.0 mos (95% CI 2.63-4.00) and 2.04 mos (95% CI 1.84-3.00) in pts with PS0-1 and 2 ( p&lt; 0.0001). Median OS was 13.2 mos (95% CI 11.18-15.78) and 4.0 mos (95% CI 2.66-5.62) in pts with PS 0-1 and 2 respectively ( p&lt; 0.0001). Univariate analysis showed significant correlation of PS2 status, negative PDL1, IO line ≥2, N of metastatic sites ≥2 and liver metastasis, for both PFS and OS. Multivariate analysis confirmed an independent association of PS ( p= 0.0013 for PFS, p&lt; 0.0001 for OS), PDL1 ( p= 0.0002 for PFS, p= 0.02 for OS) and liver metastasis ( p= 0.017 for PFS, p= 0.02 for OS). The incidence of Grade 3/4 adverse events was 10.5% in PS 0-1 pts and 13.7% in PS 2 pts ( p= 0.41). Conclusions: Our data confirm reduced efficacy of IO in pts with poor PS, regardless of the N of prior therapy lines or PDL1 expression. Despite IO appears to be safe and tolerable its role remains uncertain in PS2 pts based on worse survival outcomes.
急性川乌草乌中毒三例
Authors: 刘庆辉, 刘光辉, 臧建辉
Journal: BMJ (2004)

例1 男,28岁,入院前1 h前饮含生川乌、草乌的药酒约150 ml ,感口舌喉头麻木50 min,全身麻木无力、恶心、胸闷、心慌、抽搐30 min.查体:血压130/80 mm Hg(1 mm Hg=0.133 kPa),神志尚清,面色蜡黄,针样瞳,心率45～65次/min,律不齐,心电图示频发室性早搏,Ⅱ度1型房室传导阻滞.诊断川乌、草乌中毒,予吸氧、输液,静脉注射阿托品1 mg,洗胃后收重症监护室,监护发现室性心动过速,此时患者烦躁,血压60/30 mm Hg,静脉注射利多卡因50 mg,快速输液,多巴胺维持血压无效.监护示室扑、室颤,患者意识丧失,呼吸微弱,立即电击除颤,经口气管插管辅助通气,心律暂时恢复窦性,仍频发室早,并见R-on-T现象,10 min后再次反复室扑室颤,考虑乌头碱对心肌作用强.即连续作心肺复苏术 140 min,其间电击除颤6次,心律转为窦性,频发室早,患者神志转清,躁动,自主呼吸恢复,血压正常,继续予利多卡因1 mg/min及小剂量脱水剂,24 h后拔气管插管,7 d后痊愈出院。