血气分析对肉毒中毒时吸呼肌麻痹监测作用的实验研究

呼吸肌麻痹是引起肉毒中毒病人死亡的重要原因。呼吸肌麻痹时可引起血气改变。为此,我们观察了肉毒中毒时血气值的改变,并探讨血气测定能否用于肉毒中毒时对呼吸肌麻痹的监护.材料和方法取健康家兔20只,随机分为两组.A 组每公斤体重耳静脉注射 A 型肉毒毒素0.5ml.B 组每公斤体重耳静脉注射 B 型肉毒毒素0.5ml.注射毒素前及后用含肝素的玻璃毛细管取充分动脉化的兔耳静脉血,立即用     

酶联免疫吸附试验检测肉毒中毒实验动物及患者肌红蛋白的研究

酶联免疫吸附试验(ELISA),具有特异,敏感快速、简便和經济等特点,因而在医学领域内得到了广泛的应用。肉毒毒素对肌肉的作用机理尚未完全明瞭,为此,我们应用酶联免疫吸附试验对肉毒中毒家兔实验動物模型及中毒患者血清中肌红蛋白(Mb)进行了检测。材料和方法一、動物实验模型: 选用健康家兔20只,先取血作Mb测定作为对照,后随机分为两组,A组每公斤体重由耳静脉注射A型肉毒毒素0.5ml,B组每     

A型肉毒毒素在神经科的应用

肉毒毒素是由厌氧的肉毒梭菌产生的一种细菌外毒素,是已知的毒性最强的微生物毒素之一,它能引起死亡率极高的肉毒中毒。肉毒梭菌共有A—G七型,分别产生相应的毒素,其中A、B、E、F型可使人类中毒。     

A型肉毒毒素联合减张压迫法在面部整形美容切口中的应用

目的:观察A型肉毒毒素联合减张压迫法在面部整形美容切口中的应用效果。方法:选取面部整形美容手术者78例,按照切口处理方法不同分为A组和B组,每组各39例。A组美容手术者在术后A型肉毒毒素注射联合拆线后,用3M免缝胶布减张压迫;B组美容手术者在单纯术后,注射A型肉毒毒素。比较两组美容手术者的切口愈合情况。结果:A组美容手术者切口愈合优良率为94.87%,显著高于B组的76.92%(P<0.05);两组美容手术者的表情均完全恢复,未发生明显并发症。结论:A型肉毒毒素注射联合减张压迫法用于面部整形美容切口的效果优于单纯术后A型肉毒毒素注射效果。     

微切口皮下搔刮术配合A型肉毒毒素注射治疗腋臭

目的：观察微切口皮下搔刮术配合A型肉毒毒素注射治疗腋臭的临床效果。方法82例腋臭患者随机分为A、B2组,A组52例采用微切口皮下搔刮术治疗,观察5个月后,针对未治愈者行A型肉毒毒素注射追加治疗,随访6个月,观察疗效;B组30例单纯行A型肉毒毒素注射治疗,观察6个月。结果A组患者微切口皮下搔刮术后5个月,治愈者4例,好转35例,缓解13例,无效0例,A型肉毒毒素注射追加治疗后,随访6个月,治愈36例,好转15例,缓解1例,无效0例;B组患者治愈5例,好转16例,缓解9例,无效0例。结论微切口皮下搔刮术配合A型肉毒毒素注射治疗是一种创伤小且效果更好的腋臭治疗方法。     

A型肉毒毒素对脊髓α运动神经元活性的调节作用

目的探索大鼠背根神经节A型肉毒毒素注射对脊髓前角α运动神经元活性及相关肌肉运动功能的影响作用。方法40只雄性Wistar大鼠,采用数字表法随机分为4组(每组10只):A组、B组、C组、D组。于实验前1天对各组大鼠进行H反射检测及运动功能评价,后以10%水合氯醛0.3 mL/kg腹腔注射进行麻醉,无菌条件下行左侧L4、L5、L6限制性椎板部分切除后暴露背根神经节。A组、B组分别以A型肉毒毒素背根神经节注射,C组注射等容积(6μL)0.9%氯化钠注射液,D组不干预为正常对照组。各组分别于注射后1,3,7,14 d进行H反射及运动功能评定。结果 (1)H反射测定:A型肉毒毒素注射后各观察时间点,A组大鼠左后肢H反射潜伏期、波幅较注射前均明显延长、降低(P<0.05,P<0.01);B、C、D 3组大鼠注射后各观察时间点与注射前比较H反射潜伏期及波幅差异均无统计学意义。A组大鼠A型肉毒毒素注射后各观察时间点H反射潜伏期及波幅较B、C、D组的相应观察时间点明显延长(P<0.05)和降低(P<0.01);A型肉毒毒素注射后各观察时间点B组与C组,B组与D组,C组与D组组间两两比较,H反射潜伏期及波幅差异无统计学意义(P>0.05)。(2)改良Rivlin斜板实验:A组大鼠,A型肉毒毒素注射后各观察时间点,斜板度数均较注射前为低(P<0.05);A型肉毒毒素注射后第7天,第14天,A组斜板度数显著低于B、C、D组(P<0.05,P<0.01,P<0.01);注射后不同时间点B组与C组,B组与D组,C组与D组斜板度数组间两两比较差异无统计学意义(P>0.05)。结论背根神经节A型肉毒毒素注射具有抑制脊髓反射环路,降低脊髓前角α运动神经元兴奋性的作用。     

食用制作不当酱豆引起肉毒中毒的报告

<正> 肉毒中毒是由于食用被肉毒梭菌污染并产生肉毒毒素的食物而引起的、病死率极高的食物中毒。欧美国家多以动物性食物为原因食品,主要菌型为A型、其次为B型、E型肉毒梭菌。我国肉毒中毒主要分布在西部省区,原因食物主要是发酵豆制品及肉制品,常见菌型为B型,其次为AB型及A型。1988年5月,我区涡阳县发生1起因食用制作不当的自制酱豆引起     

两种稀释度A型肉毒毒素治疗腋臭的疗效比较研究

背景　肉毒毒素治疗腋臭,已有一定时日。临床证实,其疗效相对比较可靠,不良反应小。但是,肉毒毒素的配制方案,尚无统一标准,甚至肉毒毒素生产厂家也未能给出确切方案。目的　探讨两种不同稀释度A型肉毒毒素治疗腋臭疗效的差异。方法　选取2014年1月—2017年6月南方医科大学深圳医院门诊收治的腋臭患者120例为研究对象,每级患者采用随机数字法分为A组59例,B组61例。A组以0.9%氯化钠溶液稀释A型肉毒毒素为50 U/1 ml,B组以0.9%氯化钠溶液稀释A型肉毒毒素为50 U/2 ml,皮丘式注射。注射后随访14 d,记录患者起效时间及治疗效果。结果　随访显示,注射A型肉毒毒素后第3天开始有患者认为有效,到第14天,全部起效。A组平均起效时间为（7.3±2.0）d,B组平均起效时间为（6.5±2.0）d,差异有统计学意义（t=2.029,P=0.045）。A组患者无效8例,有效26例,显效25例;B组患者无效5例,有效29例,显效27例,两组患者治疗效果比较,差异无统计学意义（u=-0.492,P=0.622）。结论　两种不同稀释度A型肉毒毒素治疗腋臭疗效相近,但低浓度起效更快。     

A型肉毒毒素治疗面肌痉挛的临床疗效分析

目的探讨A型肉毒毒素治疗面肌痉挛的疗效。方法将52例面肌痉挛患者依据接受A型肉毒毒素治疗的次数分为两组:首次治疗组32例、长期重复治疗组(连续接受4次及4次以上A型肉毒毒素治疗)20例。本次注射A型肉毒毒素后随访6个月,比较两组在起效时间、达峰时间、疗效等级等方面的差别。结果两组患者注射A型肉毒毒素后在起效时间、达峰时间、疗效等级等方面比较均无明显差异。结论长期重复应用A型肉毒毒素治疗面肌痉挛疗效依然显著,在起效时间、疗效等级等方面保持不变。     

注射用A型肉毒毒素联合眼袋整形术治疗眼周皮肤松弛效果分析

目的:通过回顾分析手段对在眼袋整形术治疗眼周皮肤松弛中应用注射A型肉毒毒素的临床效果进行分析。方法:回顾分析86例在我院接受眼袋整形术治疗眼周皮肤松弛的患者,将其均分至采用单纯眼袋整形术治疗的A组与眼袋整形联合注射肉毒毒素治疗的B组。对比分析两组患者术后鱼尾纹减轻度、不良反应发生情况。结果:采用眼袋切除术联合注射用A型肉毒毒素的B组在静、动两种情况下,无论是眼袋减轻情况42例(97.7%)、鱼尾纹减轻情况43例(100%),还是治疗后皮肤光泽增强度40例(93.0%)均明显优于A组。两组不良反映情况无明显差异。结论:采用眼袋整形术联合注射A型肉毒毒素治疗眼周皮肤松弛不仅疗效显著,而且治愈率高,患者满意度高。     

An overview of type E botulism in China

The geographical distribution of C. botulinum type E and its associated disease, type E botulism in China, is different from that in other areas of the world. Cases of type E botulism generally arise in costal regions. In China, however, type E botuhsm is found primarily in the Qinghai-Tibet plateau of northwest China far from the ocean, at an altitude of approximately 4-5 kin. The foods most commonly associated with the disease are fermented grain and beans as well as raw meat A suspected outbreak of type E botulism poisoning in the central costal region of China in the 1990s prompted the collection and analysis of samples of mud, sand, and fish from the region. The toxin produced by type E botulinum was found in these samples. Surprisingly, though, upon further analysis, the strain isolated from the samples was identified not as type E C. botulinum, but as the neurotoxigenic bacterium Clostridiurn butyricurn.     

Molecular and Epidemiological Characterization of Infant Botulism in Beijing,China

Laboratory-based pathogen isolation, identification, and toxicity determination were performed on samples from a suspected case of infant botulism. Mice injected with cultures generated from the enema sample and ingested Powered infant formula (PIF) presented typical signs of botulism. Antitoxins to polyvalent botulinum neurotoxins (BoNTs) and monovalent BoNT type B antitoxin had protective effects. Clostridium botulinum isolated from the enema and residual PIF samples were positive for type B toxin. Pulsed-field gel electrophoresis (PFGE) revealed that the two strains of C. botulinum isolated from the two samples produced indistinguishable pulsotypes. These findings confirmed this case of type B infant botulism associated with the ingestion of PIF contaminated by type B C. botulinum spores.     

Botulism in New South Wales, 1980-1981

The isolation of Clostridium botulinum from the home environment of New South Wales patients with infant botulism is reported. Of the three cases of infant botulism type B, the bacteria were isolated from soil around the dwelling in one, and from tank rainwater in another. In one case with type A, the bacteria were present in the soil, vacuum-cleaner dust, and tank rainwater. The bacteria were not detected in the environment of two adult patients and a child with C. botulinum in their stools. The home location of the patients with infant botulism, and the frequency of isolation of the bacteria from rainwater, soil and vacuum-cleaner dust in Cobar, Nyngan, some Sydney suburbs, and at five pastoral homesteads suggest that infants in rural areas are more at risk than those in large metropolitan areas. The age of the infants with diagnosed botulism in New South Wales, compared with those reported in the United States data, strongly suggests that the disease is not being fully recognised in younger infants.     

Ocular findings in botulism type B.

In April 1977, fifty-nine persons became ill with type B botulism in a large, common-source outbreak. A combination of signs and symptoms that should make the clinician strongly suspect botulism was derived from the histories and ocular findings of these persons. Certain signs of third cranial nerve dysfunction reliably predicted in which patients ventilatory insufficiency would develop.     

Infant botulism. Epidemiological, clinical, and laboratory aspects.

Clostridium botulinum organisms and toxin were identified in the feces of six infants, aged 5 to 20 weeks, who had illnesses clinically consistent with botulism. Five of the infants lived in California and became ill within a six-month period in 1976; one infant became ill in New Jersey in 1975. Three cases were type A botulism, and three were type B. No source of ingested botulinal toxin could be found in any case. However, one infant with type B botulism had ingested a food containing C botulinum type B organisms, and no toxin was found in it. The clinical findings in these cases include constipation, weak sucking and crying ability, pooled oral secretions, cranial nerve deficits, generalized weakness, and, on occasion, sudden apnea. A characteristic electromyographic pattern termed "brief, small, abundant, motor-unit action potentials" (BSAP) was observed. The sources of C botulinum toxin for these six infants is thought to have been in vivo (gastrointestinal) production following ingestion of C botulinum organisms. Studies are underway to determine the full clinical spectrum, incidence, and potential public health importance of this infectious disease newly recognized in infants.     

A review of botulism in China

The epidemiological characteristics and etiology of botulism in China, as well as the distribution of different types of Clostridium botulinum in China, are described. Through 1989, 15 provinces and autonomous regions reported the occurrence of botulism. There were 2861 cases involved in 745 outbreaks. Among the cases 421 died, with a case fatality of 14.7%. The main epidemiological characteristics of botulism in China are: (i) the major foods causing botulism are homemade fermented bean products which accounted for 62.6% of the cases; (ii) the incubation period is longer (3 h-54 days) than that described in the western literature (mostly 2-7 days); (iii) the peak occurrence is from February to May; (iv) the progression of symptoms and signs is slower than that of western cases. All types of C. botulinum, with the exception of type G, have been found in China. The distribution of various types of C. botulinum is significantly different between southern and northern China; this is related to the latitude and is correlated with the prevalence of this disease. Most of the botulism outbreaks occurred above 30 degrees north latitude in northern China and outbreaks rarely occurred below 30 degrees north latitude. Nationwide surveys showed that the average detection rate of C. botulinum spores in soil and foods in the northern parts of China was 14.8%, while it was only 2.5% in the south. C. botulinum types A, B, E, and F, which are involved in human botulism, were frequently found in the North, while types C and D, which are involved only in animal intoxication, were found more frequently in the south.     

Type B botulism outbreak caused by a commercial food product. West Virginia and Pennsylvania, 1973

In the week of May 7, 1973, seven persons contracted botulism after eating together. The most common symptoms were vomiting, constipation, dry mouth, dysphagia, and dysphonia. All were treated with trivalent botulinal antitoxin, and none died. Serum specimens obtained from all seven patients were negative for botulinal toxin, but stool specimens from three patients were positive for type B toxin. Electromyographic studies performed on five patients documented the neurophysiologic abnormalities of botulism. Commercially canned peppers in oil were implicated epidemiologically, and type B toxin was identified in leftover peppers. The processor voluntarily recalled the pepper product, and no further cases were reported.     

Coproexamination for botulinal toxin and clostridium botulinum. A new procedure for laboratory diagnosis of botulism.

Stool or serum specimens or both from 318 persons pertaining to 165 botulism investigations over a three-year period were examined. Botulinal toxin was detected in stools of 19 of 56 patients and in sera of 20 of 60 patients with clinical botulism; it was not detected in specimens from 246 persons with an illness other than botulism or well contacts of patients. Clostridium botulinum was identified in stools of 36 of 60 clinical botulism patients and in four of 27 asymptomatic contacts of patients with botulism victims, but not in stools of 65 persons not associated with confirmed botulism. When stool and serum samples were examined, confirmatory evidence was obtained for 72.9% of the botulism cases. Detection of botulinal toxin or C botulinum in the stool of a persons should be considered evidence supporting the clinical diagnosis of botulism.     

Type A and type B botulism in the North: first reported cases due to toxin other than type E in Alaskan Inuit.

Botulism outbreaks shown to be due to type A and type B toxin occurred in Alaska, a region previously known for only type E botulism. The outbreak due to type A toxin involved three people, two of whom died. The outbreak due to type B toxin involved nine people, none of whom died. Both outbreaks were in Inuit villages, and native foods were incriminated. The occurrence of these outbreaks strongly suggests that Clostridium botulinum, types A and B are indigenous to Alaska. The outbreaks underscore the need for initial treatment of patients with antitoxin that is trivalent (ABE), even in Arctic regions.     

Food-borne botulism in Canada, 1971-84

Sixty-one outbreaks of food-borne botulism involving a total of 122 cases, of which 21 were fatal, were recorded from 1971 to 1984 in Canada. Most occurred in northern Quebec, the Northwest Territories or British Columbia. Of the 122 victims 113 were native people, mostly Inuit. Most of the outbreaks (59%) were caused by raw, parboiled or “fermented” meats from marine mammals; fermented salmon eggs or fish accounted for 23% of the outbreaks. Three outbreaks were attributed to home-preserved foods, and one outbreak was attributed to a commercial product. The causative Clostridium botulinum type was determined in 58 of the outbreaks: the predominant type was E (in 52 outbreaks), followed by B (in 4) and A (in 2). Renewed educational efforts combined with a comprehensive immunization program would significantly improve the control of botulism in high-risk populations.