百草枯中毒致肺损伤的CT表现

目的探讨百草枯中毒致肺损伤中的CT检查影像学特征和诊断价值。方法回顾性分析15例口服百草枯中毒致肺损伤病例的CT影像学资料。结果15例患者中毒早期（1～7d）主要CT表现包括支气管血管柬增粗伴支气管扩张显示轨道征（15／15）、磨玻璃密度影（14／15）、马赛克征（12／15）、树芽征（8／15）、肺实变（6／15）及胸膜下线（6／15）等；中毒中期（8～14d）主要表现支气管血管束增粗伴支气管扩张显示轨道征（11，11）、肺实变（7／11）及磨玻璃密度影（6／11）；中毒后期（〉14d）CT表现以肺实变（1／1）和纤维化（1／1）为主。结论百草枯中毒的肺部CT表现具有一定的特征性，其影像学变化对病情发展及指导临床治疗具有重要意义。     

Recurrent Poisoning in Children: A Review

The literature on poisoning accidents or ingestion of toxicsubstances in children is reviewed. Special emphasis is givento the phenomenon of recurrent or repeat episodes. Recommendationsare made concerning means for identifying children who are atrisk for repeat poison episodes, as well as for developing methodsof intervention to prevent such occurrences.     

急性有机磷中毒患者晚期氧化蛋白产物动态变化的临床研究

目的探讨晚期氧化蛋白（AOPP）在急性有机磷农药中毒（AOPP）患者中的临床意义。方法采用酶联免疫分析法（ELISA）动态检测90例有机磷农药中毒患者和30例健康对照者血清晚期氧化蛋白的含量，并探讨其与病情的相关性。结果AOPP患者血浆中晚期氧化蛋白含量发病后的第1天〉第3天〉第7天与健康对照组比较，P均〈0．01。血清CRP的含量在患者中毒后的第1天〉第3天〉第7天与健康对照组比较，P均〈0．01。在发病的第1天，AOPP患者血清晚期氧化蛋白和CRP的含量重度中毒组〉中度中毒组〉轻度中毒组与健康对照组比较，P均〈0．01。在第1天，AOPP患者的病情程度即MODS的评分值与血清晚期氧化蛋白和CRP的含量均呈明显的正相关性（r1=0．590和r2=0．627，P均〈O．01），而血清晚期氧化蛋白和CRP的含量之间也呈明显的正相关性（r3=0．792，P〈0．01）。结论晚期氧化蛋白的含量随急性有机磷农药中毒患者的病情和炎症反应加重而升高。晚期氧化蛋白可能参与了有机磷农药中毒患者发生多脏器功能障碍的病理生理过程。     

HLA class II DPB1, DQA1, DQB1, and DRB1 genotypic associations with occupational allergic cough to Bunashimeji mushroom

We previously reported that two-third of workers in a Bunashimeji mushroom (Hypsizigus marmoreus) farm complained of respiratory allergic symptoms, but one-third workers did not suffer from such symptoms even when working for a long period. CD4+ T-helper (Th) cells increased, and Th2/Th1 ratio increased in the allergic workers. To address these immunological backgrounds, we have investigated whether there is any relationship between mushroom allergy and human leukocyte antigen (HLA) class II alleles of DPB1, DQA1, DQB1, and DRB1 by using the polymerase chain reaction-restriction fragment length polymorphism (RFLP) and sequencing-based typing methods. We observed that the allele frequencies of DQA1*0103, DQB1*0601, and DRB1*0803 were significantly higher in the workers having no allergic symptoms than allergic workers (DQA1*0103: 57 vs 25%, DQB1*0601: 49 vs 14%, and DRB1*0803: 29 vs 0%). However, this phenomenon was not seen in workers producing another kind of mushroom, Honshimeji (Lyophyllum aggregatum). The HLA-DRB1*0803 allele alone, the DRB1*0803, DQA1*0103, DQB1*0601 haplotype, or both were negatively associated with allergy to Bunashimeji, and these alleles might be involved in the prevention of Bunashimeji mushroom-specific respiratory allergy.     

The relationship between exposure duration,carboxyhemoglobin, blood glucose,pyruvate and lactate and the severity of intoxication in 39 cases of acute carbon monoxide poisoning in man

The relationship between exposure duration, COHb, blood glucose, pyruvate and lactate and the severity of intoxication was investigated in a group of 39 cases of acute CO poisoning treated in the Clinical Toxicology Center in ód, Poland.On the basis of clinical criteria the patients were classified into cases of mild, moderate, severe and very severe CO poisoning. COHb and carbohydrate metabolites were estimated in venous blood taken immediately after admission of the patient to hospital prior to treatment.The severity of intoxication did not correlate with blood COHb; variation in exposure duration seems to be responsible for this phenomenon. Severe and very severe poisonings were associated with longer exposures and were accompanied by a markedly higher blood lactate level, compared to mild and moderate cases. Blood pyruvate depended less than lactate on the severity of intoxication. Blood glucose depended neither on exposure duration nor on the severity of intoxication.Among the carbohydrate metabolic parameters studied, blood lactate determination can be helpful in the evaluation of the severity of CO poisoning in man.     

Recreational gasoline sniffing: acute gasoline intoxication and latent organolead poisoning. Case reports and literature review

Gasoline is a readily obtainable intoxicant that unfortunately lends itself to habitual abuse by sniffing, a practice found particularly among children and adolescents. The concerted effects of the multiple hydrocarbon and other constituents of gasoline result in a predictable acute toxic syndrome. Organoleads, primarily tetraethyl lead (TEL), cause a separate toxicologic symptom-sign complex that overlaps with the initial acute toxic syndrome. The different clinical symptomatology, effects on hemoglobin synthesis, and response to chelation therapy are all in keeping with the view that organolead poisoning is a separate and distinct toxicologic entity from that of classical elemental lead poisoning or "plumbism".     

2010—2020年云南省学校食源性疾病暴发事件流行病学分析

目的 了解云南省学校食源性疾病暴发事件流行病学特征和趋势。 方法 收集2010—2020年云南省各地报告的学校食源性疾病暴发资料,并进行描述性流行病学分析。 结果 2010—2020年共发生学校食源性疾病暴发260起,发病6 600人,死亡2人,总体呈下降趋势。学校食源性疾病暴发高峰期为第二、四季度,占总起数的66.54%(173/260);暴发场所多发生在小学,占总起数的58.08%(151/260)。报告明确或可疑致病因子的185起事件中由微生物或可疑微生物引起的占40.00%(74/185),毒素引起的占46.49%(86/185);明确致病因子的118起暴发事件中,60.17%(71/118)是由4种致病因子引起的,其中蓖麻毒素导致的最多,达22起(18.64%),发病人数428人,其次是蜡样芽孢杆菌20起(16.95%),原因食品被归因为一类食品植物类,主要是大米、三明治、面包。导致暴发污染环节最多的是生产加工环节(50.77%,132/260)。 结论 关注学校食源性疾病暴发事件流行特征,在学生开学季时,加强对小学食堂植物类食品的生产加工环节管理和监督。微生物、毒素感染是学校食源性疾病主要的致病因素,且原因查明率低,进一步强化医疗机构食源性疾病微生物、毒素检测能力,提高原因查明率,最大限度地降低学校食源性疾病的发病率。     

一起赤潮后海产品麻痹性贝类毒素衰减结果分析

目的 以2017年漳州沿海一起赤潮引起的麻痹性贝类毒素(paralytic shellfish poisoning,PSP)中毒事件为研究起点,研究贝类海产品中的PSP在自然条件下的衰减情况。方法 在漳浦佛昙和龙海港尾海域采集牡蛎和贻贝进行PSP检测。结果 2017年6月8日相关海域海产品最大毒素总毒力为21 056.7 μg/kg,2017年6月26日海产品PSP总毒力值衰减86%以上,2017年7月20日海产品PSP总毒力值衰减97%以上,2018年12月所有海产品中PSP均未检出。结论 本次赤潮发生后,漳浦佛昙和龙海港尾两个海域贝类海产品约需45天净化周期方可食用,相关海域约需18个月净化至贝类毒素完全消失。     

国家突发中毒事件卫生应急移动处置中心建设经验探讨

中华人民共和国国家卫生健康委员会自2016年在全国分区域布局建设4类11个国家卫生应急移动处置中心,其中仅有的2个国家突发中毒事件卫生应急移动处置中心设立于在山东和贵州。山东以山东第一医科大学附属省立医院为承建单位。项目于2020-11-04顺利通过国家卫健委专家验收,本文拟从能力建设、队员配置、装备配置、培训演练、队伍管理等方面进行分析总结建设过程,并结合美国和日本等发达国家经验,提出建设中遇到的问题和解决办法,为国家应急队伍以后的标准化建设和管理提供参考。     

Association of Opioid Use Disorder With 2016 Presidential Voting Patterns: Cross-sectional Study in New York State at Census Tract Level

BackgroundOpioid overdose-related deaths have increased dramatically in recent years. Combating the opioid epidemic requires better understanding of the epidemiology of opioid poisoning (OP) and opioid use disorder (OUD).ObjectiveWe aimed to discover geospatial patterns in nonmedical opioid use and its correlations with demographic features related to despair and economic hardship, most notably the US presidential voting patterns in 2016 at census tract level in New York State.MethodsThis cross-sectional analysis used data from New York Statewide Planning and Research Cooperative System claims data and the presidential voting results of 2016 in New York State from the Harvard Election Data Archive. We included 63,958 patients who had at least one OUD diagnosis between 2010 and 2016 and 36,004 patients with at least one OP diagnosis between 2012 and 2016. Geospatial mappings were created to compare areas of New York in OUD rates and presidential voting patterns. A multiple regression model examines the extent that certain factors explain OUD rate variation.ResultsSeveral areas shared similar patterns of OUD rates and Republican vote: census tracts in western New York, central New York, and Suffolk County. The correlation between OUD rates and the Republican vote was .38 (P<.001). The regression model with census tract level of demographic and socioeconomic factors explains 30% of the variance in OUD rates, with disability and Republican vote as the most significant predictors.ConclusionsAt the census tract level, OUD rates were positively correlated with Republican support in the 2016 presidential election, disability, unemployment, and unmarried status. Socioeconomic and demographic despair-related features explain a large portion of the association between the Republican vote and OUD. Together, these findings underscore the importance of socioeconomic interventions in combating the opioid epidemic.