由致病性大肠埃希氏菌引起人猫食物中毒的报告

20 0 2年 12月 10日海安县农民吴某为女儿举行婚宴 ,将餐后的剩余饭菜投喂 2只家猫 ,约 4小时后 ,2只猫突然死亡 ;5小时后 ,就餐的 41人中 2 6人相继发病。经流行病学调查、临床特点的分析和病原体的分离鉴定 ,确定是由致病性大肠埃希氏菌引起人猫食物中毒 ,在海安地区是首次报道     

急性有机磷中毒患者外周血四项变化及临床意义

目的 :探索急性有机磷农药中毒患者红细胞 (RBC)、血红蛋白 (HB)、白细胞 (WBC)、血小板 (PL T)等指标的变化及临床意义。方法 :根据患者入院时中毒程度轻、中、重度中毒 3组及健康对照 1组。对各中毒组第 1、3、5、7日及重度中毒组第 14日分别采取静脉血作上述指标的动态观察。健康对照组门诊检测 1次。结果 :轻、中、重度中毒 3组各项指标随中毒的严重程度而变化显著。中毒第 3日 ,轻度中毒组各项指标恢复正常 ;中毒第 7日 ,中度中毒组RBC、HB、WBC基本恢复正常 ,PL T仍有增高 ;而重度中毒组第 14日部分患者四项指标仍异常 ,与病情预后相符。各项指标与健康对照组相比如 P<0 .0 5 ,差异有显著性。结论 :上述指标能较客观地反映各中毒组的病理变化过程。动态观察对病情判断、指导治疗有一定临床意义。     

32例急性CO中毒患者P300的研究

事件相关电位（Ｐ３００）是反映人类认知功能障碍的一项神经电生理指标。本文对３２例急性ＣＯ中毒患者进行了Ｐ３００及神经行为核心测验组合（ＮＣＴＢ）检查，结果发现中毒组Ｐ３００潜伏期延长、波幅降。１７例昏迷１２小时以上的中毒患者中，Ｐ３００潜伏期明显延长的９例，占５２．９％，提示Ｐ３００成份可用来预测ＣＯ中毒迟发脑病的发生。Ｐ３００与ＮＣＴＢ之间有很好的一致性。     

土默特左旗地方性砷中毒病区水、粮食、土壤中微量元素的特征

目的 探讨土默特左旗地方性砷中毒病区井水、粮食和土壤中As及其他微量元素浓度的分布情况，为地方性砷中毒的防治和改水提供理论依据。方法 用中子活化分析法测定了土默特左旗地区井水、粮食、土壤中As、Fe、Se、Cr、Zn、Ba、Co、Sr、Mo、Th、U、Rb、Au、Rb、稀士元素(REE)等25种元素的含量。结果 井水中砷含量(494μg／L)严重超过国家饮用水水质标准，Fe(2690μg／L)和Ba(1689μg／L)的含量明显高于水质标准，REE的含量远高于世界淡水元素背景值。粮食中的As和REE含量也明显高于对照区的含量。土壤中微量元素的含量与世界土壤背景值相似。结论 饮水中砷高是引起地方性砷病的主要原因，而Fe、Ba等微量元素可能会加重砷的中毒。     

慢性镉中毒肾功能损伤的研究

本实验用0.8％CdCl_2生理盐水按1 mgCd/kg体重,隔日1次皮下注射3个月,建立兔中毒模型。测定了血尿素氮、肌酐含量及肾皮质的Na~+/K~+-ATPase,Ca~(2+)-ATPase,γ-GT的活性。结果表明,在肾中毒早期,尿素氮、肌酐无明显变化,几种酶活性明显下降,P值分别<0.05及<0.001。提示,这些酶活性下降,可能是镉中毒所致肾功能紊乱和病理改变的启动环节之一和进一步导致肾衰的机理之一。     

包钢地区1010例儿童血铅水平及其对身高、体重的影响

目的　了解包钢地区儿童铅中毒的流行情况及其对儿童身高、体重的影响。方法　取末梢血 (指端 )15 μl,应用全血锌原卟啉 (ZnPP)测定仪测定 10 10例 0～ 12岁儿童血铅含量。 结果　铅中毒率为 70 79% ,不同年龄组儿童男女铅中毒率间差别无显著性意义 (P >0 0 5 )。 0～ 2岁与 7～ 12岁的儿童铅中毒组的身高、体重与非中毒组间差别均有非常显著性意义 (P <0 0 1) ,而 2～ 6岁的儿童铅中毒组的身高、体重与非中毒组间差别均无显著性意义(P >0 0 5 )。结论　包钢地区血铅中毒发生率高 ,影响儿童体格生长、发育 ,需加强健康教育。     

Benzodiazepine poisoning: experience of 702 admissions to an intensive care unit during a 14-year period

A retrospective study covering a 14-year period was carried out to estimate the incidence and assess the clinical features of benzodiazepine (BZD) poisoning. The annual contribution of BZDs to the total number of drug overdose cases admitted to an intensive care unit displayed an increasing trend over the period, and during the last years BZDs were involved in nearly one-third of all cases. Among the 702 cases of BZD overdosage, 144 had ingested BZD alone, 200 had poisoned themselves with BZD combined with alcohol and 358 had taken BZD with other miscellaneous drugs. In 56% of all the cases the patients had severe central nervous system depression on admission. In 47% orotracheal intubation was performed and in 18% artificial ventilation was administered. Complications were recorded in 69 of the 702 cases (9.8%) and five cases were fatal. These clinical features were essentially the same in the group that had overdosed with just BZD. In conclusion, patients with drug overdosage involving BZD have a low hospital mortality, but the acute somatic risk is not negligible. Moreover, they consume a substantial proportion of the resources in the emergency room and the intensive care unit.     

Asymptomatic sequelae to acute sarin poisoning in the central and autonomic nervous system 6 months after the Tokyo subway attack

Six to eight months after the Tokyo subway attack in March 1995, the neurophysiological effects of acute sarin poisoning were investigated in 18 passengers exposed to sarin (sarin cases) in the subways to ascertain the focal or functional brain deficits induced by sarin. The event-related and visual evoked potentials (P300 and VEP), brainstem auditory evoked potential, and electrocardiographic R-R interval variability (CV_RR), together with the score on the posttraumatic stress disorder (PTSD) checklist, were measured in the sarin cases and the same number of control subjects matched for sex and age. None of the sarin cases had any obvious clinical abnormalities at the time of testing. The P300 and VEP (P100) latencies in the sarin cases were significantly prolonged compared with the matched controls. In the sarin cases, the CV_RR was significantly related to serum cholinesterase (ChE) levels determined immediately after exposure; the PTSD score was not significantly associated with any neurophysiological data despite the high PTSD score in the sarin cases. These findings suggest that asymptomatic sequelae to sarin exposure, rather than PTSD, persist in the higher and visual nervous systems beyond the turnover period of ChE; sarin may have neurotoxic actions in addition to the inhibitory action on brain ChE. Received: 2 April 1997 Received in revised from: 15 July 1997 Accepted: 1 August 1997     

血清胆汁酸谱在肝病鉴别诊断中的应用研究

为探索血清胆汁酸谱在各种肝病中的特异性，用气相色谱法观察了黑索金，氯乙烯职业接触者及急性黄疸型肝炎、慢性活动型肝炎、肝硬化、肝癌等患者血清胆汁酸的变化情况。结果发现２种亲肝性毒物致肝损害时胆汁酸变化不同，黑索金接触者血清鹅脱氧胆酸（ＣＤＣＡ）、脱氧胆酸（ＤＣＡ）、石胆酸（ＬＣＡ）水平均升高，与对照组比较有显著性差异（Ｐ＜０．０５、Ｐ＜０．０１、Ｐ＜０．０１）；氯乙烯接触者则只有ＤＣＡ、ＬＣＡ水平升高，（Ｐ＜０．００１、Ｐ＜０．０００５）。其变化主要集中在次级胆汁酸上。急性黄疸型肝炎、慢性活动型肝炎、肝硬化、肝癌４种普通肝病血清ＣＡ、ＣＤＣＡ、ＤＣＡ和ＬＣＡ均有不同程度升高，以ＣＡ、ＣＤＣＡ变化较明显，与对照组比较其差异显著（Ｐ＜０．００５），但彼此间４种胆汁酸水平的变化都无显著性差异（Ｐ＞０．０５），而ＣＡ与ＣＤＣＡ比值互有不同，其差异有统计学意义，提示血清胆汁酸可用于鉴别诊断各型肝病。     

Sodium Polystyrene Sulfonate Treatment for Lithium Toxicity: Effects on Serum Potassium Concentrations

Objective: To examine the effects of sodium polystyrene sulfonate (SPS) on serum potassium (K) concentrations in mice pretreated with parenteral lithium (Li).
Methods: A placebo–controlled murine model trial of SPS therapy following IV Li was performed. Sixty male CD–I mice weighing 18–22 g were administered either IV LiCl (125 mg/kg) or a control solution (normal saline). Half of the mice in each of these groups were then given orogastric water 20, 40, 90, 150, and 210 minutes after LiCl or normal saline; the other half received SPS (5 g/kg/dose) at equivalent times. Subgroups of each of these four groups were sacrificed at one, two, and six hours after pretreatment and the serum was analyzed for K concentration. Serum K concentrations for the various groups were compared with analysis of variance and Newman–Keuls tests for the comparison of multiple means.
Results: A statistically significant reduction of serum K concentrations occurred in the animals that received SPS treatment following either IV saline or LiCl solutions. The degree of K reduction that resulted from the combination of LiCl and SPS treatment (35% reduction at six hours, compared with the placebo–treated controls) was larger than that which resulted from eimer IV Li with oral water (15% reduction) or IV saline with oral SPS (20% reduction).
Conclusions: These findings suggest that development of hypokalemia may represent a potential limitation in the use of SPS in the treatment for Li toxicity.