磷化铝灭鼠安全应用的研究

目的探讨磷化铝作为一种灭鼠剂进行鼠洞灭鼠的安全性。方法在社区采用磷化铝堵洞灭鼠,收集近几年磷化铝的使用量和驻市医院化学性食物中毒的病例报告,比较、分析南宁市磷化铝的使用量和化学性食物中毒的发生情况。结果 2003-2007年间发生的39起化学性食物中毒,无一例与磷化铝有关。结论社区使用磷化铝灭鼠是安全的。     

Mortality in acute aluminium phosphide poisoning having hypomagnesaemia with and without ECG changes

Acute aluminium phosphide poisoning produces hypomagnesaemia with or without ECG changes. The mortality rate is significantly higher in those patients with hypomagnesaemia who have ECG changes.     

PROGNOSTIC FACTORS IN ALUMINIUM PHOSPHIDE POISONING

A prospective study was done on 12 consecutive cases of aluminium phosphide poisoning admitted to a zonal hospital in Punjab. Patients were in 18-36 years age group and mortality was more in females. The dose of aluminium phosphide was more in non-survivors and fresh tablets were more likely to cause fatality. Early vomitting and prompt initiation of treatment resulted in better outcome. Survivors responded to treatment early, but duration of shock had no predictive value. Shock and cardiac arrhythmias were present in all cases and extracardiac complications occurred more commonly in fatal group. With vigorous treatment of shock and other complications 33 per cent of the cases could be saved.KEYWORDS: Aluminium phosphide poisoning, Complications, Mortality, Prognostic factors     

Current trend of poisoning--a hospital profile

A one-year study was carried out among the poisoning cases admitted in the emergency wing of Guru Nanak Dev Hospital attached to Government Medical College, Amritsar during the period from 10-5-1997 to 9-5-1998. Out of 10,664 admitt emergencies, 3.19% were poisoning cases. Male to female ratio was nearly 3:1. Majority (45.59%) of the victims were in the age group of 21-30 years, 69.12% were married and 51.47% belonged to urban area. At the time of admission 61.47% cases were conscious, 26.17% were partially conscious and 12.36% were unconscious. Majority (76.47%) of the victims committed suicide, in 20.88% cases manner of death was accident and homicide was reported in 1.76% cases. Commones poison was aluminium phosphide (38.23%) followed by organophosphorus compounds (17.64%). The study observed increasing trend of suicide by aluminium phosphide and organophosphorus compounds, whereas other poisons for committing suicide were less commonly used.     

Dangerous bodies: a case of fatal aluminium phosphide poisoning

A case of fatal aluminium phosphide poisoning that forced the evacuation of the emergency department of a Sydney teaching hospital highlights the importance of hospitals being able to safely manage hazardous materials incidents.     

Successful management of hypokalaemia related conduction disturbances in acute aluminium phosphide poisoning

A case of acute aluminium phosphide poisoning is described, who presented in shock secondary to electrolyte related cardiac rhythm disturbance and the judicious correction of the same could save his life without any consequence.     

Corrosive-like strictures caused by ingestion of aluminium phosphide

Aluminium phosphide ingestion is a major cause of poisoning-related mortality in tropical countries. Local oesophageal complications due to aluminium phosphide have been reported to occur rarely. We describe 3 patients who survived the intake of aluminium phosphide tablets and developed oesophageal strictures.     

Pesticide poisoning

Acute poisoning with pesticides is a global public health problem and accounts for as many as 300,000 deaths worldwide every year. The majority of deaths occur due to exposure to organophosphates, organochlorines and aluminium phosphide. Organophosphate compounds inhibit acetylcholinesterase resulting in acute toxicity. Intermediate syndrome can develop in a number of patients and may lead to respiratory paralysis and death. Management consists of proper oxygenation, atropine in escalating doses and pralidoxime in high doses. It is Important to decontaminate the skin while taking precautions to avoid secondary contamination of health personnel. Organochlorine pesticides are toxic to the central nervous system and sensitize the myocardium to catecholamines. Treatment involves supportive care and avoiding exogenous sympathomimetic agents. Ingestion of paraquat causes severe inflammation of the throat, corrosive injury to the gastrointestinal tract, renal tubular necrosis, hepatic necrosis and pulmonary fibrosis. Administration of oxygen should be avoided as it produces more fibrosis. Use of immunosuppressive agents have improved outcome in patients with paraquat poisoning. Rodenticides include thallium, superwarfarins, barium carbonate and phosphides (aluminium and zinc phosphide). Alopecia is an atypical feature of thallium toxicity. Most exposures to superwarfarins are harmless but prolonged bleeding may occur. Barium carbonate Ingestion can cause severe hypokalaemia and respiratory muscle paralysis. Aluminium phosphide is a highly toxic agent with mortality ranging from 37% to 100%. It inhibits mitochondrial cytochrome c oxidase and leads to pulmonary and cardiac toxicity. Treatment is supportive with some studies suggesting a beneficial effect of magnesium sulphate. Pyrethroids and insect repellants (e.g. diethyltoluamide) are relatively harmless but can cause toxic effects to pulmonary and central nervous systems. Ethylene dibromide-a highly toxic, fumigant pesticide-produces oral ulcerations, followed by liver and renal toxicity, and is almost uniformly fatal. Physicians working in remote and rural areas need to be educated about early diagnosis and proper management using supportive care and antidotes, wherever available.     

磷化铝对达乌尔黄鼠杀灭效果的试验观察

目的观察磷化铝对达乌尔黄鼠的杀灭效果,并对不同年代不同厂家生产的磷化铝灭鼠效果进行对比。方法查洞堵洞法。结果除1995年出厂的磷化铝灭效稍差外,其余年份磷化铝灭效均较好,无显著性差异(P>0.05)。结论不同年代的磷化铝用于杀灭达乌尔黄鼠均能起到很好的效果,选择适宜的使用方法和灭鼠时机效果更佳。     

Electrocardiographic abnormalities in aluminium phosphide poisoning with special reference to its incidence, pathogenesis, mortality and histopathology

Ninety-five patients out of total 190 cases of aluminium phosphide (ALP) poisoning, who exhibited ECG changes were studied for incidence, type and pattern of ECG abnormalities, their effect on mortality and their relationship with histopathology of heart. Its incidence in the present study was 50%. The arrhythmias, conduction disturbances and ischaemic pattern occurred more or less in equal frequency. Certain ECG abnormalities which had not been reported previously ie, early repolarisation syndrome, varied sino-atrial blocks, bradycardia-tachycardia syndrome and electrical alternans were observed in this study. The clinical profile of these cases was similar irrespective of whether patients had ECG abnormalities or not. Shock was the cardinal feature. There was no effect of ECG abnormalities on mortality. The mortality which was otherwise high, depended upon severity of poisoning, dose of poison consumed, duration of shock, failure of response of shock to resuscitative measures and severe hypomagnesaemia. The pathogenesis of ECG abnormalities is still obscure. Hypomagnesaemia was observed in all the 18 cases studied, irrespective of ECG abnormalities. However, these were common when hypomagnesaemia was severe. Hypoxaemia and shock were not the contributory factors for these abnormalities. Autopsy revealed stereotyped histopathological changes of toxic myocarditis independent of ECG findings.     

急性磷化铝中毒临床和胸部X线表现

对１０例经口服磷化铝急重重度中毒患者的临床和胸部Ｘ线表现进行了观察，发现临床和Ｘ线胸片均有肺水肿表现。肺水肿在Ｘ线胸片上分为间质性和肺泡性两类。讨论了Ｘ线表现与临床症状的关系；强调早期地重症磷化铝中毒患者进行Ｘ线胸片检查有助于生肺水肿的防治。     

Aspects of poisoning with traditional medicines in southern Africa

During 1981-1985, 1306 patients were admitted to Ga-Rankuwa Hospital due to acute poisoning. The major causes were paraffin (59.0%) and traditional medicines (15.8%). The mortality from paraffin was low (2.1%), but poisoning from traditional medicine resulted in a high mortality (15.2%) and accounted for 51.7% of all deaths. The traditional healer was the main source (83.4%), of traditional medicines, while 11.6% was bought from African medicine shops. The rest was acquired from other sources. In 82.5% of cases traditional medicines were taken orally, and in 10.5% of cases they were administered as an enema. Poisoning by traditional medicines was always accidental and probably due to overdosage. Vomiting, diarrhea, and abdominal pain were the most frequently encountered symptoms while the lungs, liver, and central nervous system were commonly affected. Treatment consisted of ventilation, intravenous fluids, and other palliative measures. A great deal of secrecy still surrounds traditional medicine, hampering rational therapy. Questioning of patients and interviews with traditional healers facilitated the identification of a number of major etiological agents. This elucidated the problem and should promote effective treatment.     

类白血病反应的病因及其鉴别诊断

本文就类白血病反应(简称类白)30例进行了分析。重点阐述及讨论了引起类白的病因及有关鉴别诊断问题。引起类白的主要病因有感染、肿瘤、中毒、大量出血等。但以感染多见,本组达53.3％。类白临床上并不罕见,有时易与白血病混淆,本文就类白血病的鉴别要点进行了讨论。     

新疆某三甲医院329例急性中毒患者流行病学调查

目的：分析某三甲医院院内急性中毒的流行病学特点。方法收集2009-2014年新疆医科大学第一附属医院急救中心收治的329例急性中毒住院患者的临床资料，采用回顾性研究方法，对年龄、性别、民族、中毒谱、中毒季节、发病时间和预后进行分析。结果329例急性中毒住院患者中，男女比例为1.08：1，主要分布于20~50岁这个年龄段，男性与女性急性中毒类型构成比差异有统计学意义(χ2=17.00，P<0.01)。急性中毒以汉族居多，其次为维吾尔族与回族，其他民族所占比例较少。中毒谱构成比差异有统计学意义(χ2=506.35，P<0.01)，其中农药中毒最多，其次为食物中毒，第三位的为气体中毒。季节构成比差异有统计学意义(χ2=330.78，P<0.01)，其中以夏季最多。死亡6例，其中农药中毒5例，药物中毒1例。结论急性中毒为急诊科常见疾病，在发病早期得不到准确的诊断及有效的治疗，常可危及患者生命。本文反映了我院急诊科收治的急性中毒谱，在一定程度上反映了地域性中毒特点，具有一定的临床意义。     

Aluminium bone disease in patients receiving plasma exchange with contaminated albumin

Aluminium balance studies were carried out on eight patients with various immunological disorders who were receiving plasma exchange with albumin solutions known to be contaminated with aluminium. Four patients with impaired renal function (creatinine clearance less than 50 ml/min) retained between 60% and 74% of the aluminium infused during a single plasma exchange. Transiliac bone biopsy specimens from three patients in this group had a high content of aluminium and showed histological evidence of current or previous bone disease related to aluminium. Two of these patients suffered intermittent bone pain. The main route of excretion of injected aluminium was in urine, only a small proportion of the total input being removed in the "plasma bag" during plasma exchange. The extent of aluminium retention and bone deposition was not reflected by the plasma aluminium concentration before or after plasma exchange. Treatment of five patients with intravenous desferrioxamine increased the plasma aluminium concentration and urinary output of aluminium in those with evidence of aluminium retention. These studies show that patients with poor renal function receiving treatment with albumin contaminated with aluminium retain the metal and deposit it in bone, where it may eventually cause aluminium bone disease. Plasma exchange should be used with caution in patients with renal impairment.     

化学性药物中毒1244例临床分析

【目的】探讨各类化学性药物中毒的特点、规律及危害，切实做好预防药物中毒工作。【方法】收集统计在我院毒检实验室做毒物分析的患者记录，按中毒患者的性别、年龄；中毒药物的类别、成分、季节和原因分别进行统计。【结果】化验确诊1244例化学性药物中毒患者（食物中毒或二次复查患者不在统计范围），艾司唑仑、安定中毒最多，分别占31．43％和8．76％，其次是有机磷农药敌敌畏中毒占7．63％。1244例化学性药物中毒（不含CO中毒）中，男性410例，女性834例，男女性别之比为1：2．03。患者年龄从6个月-82岁，其中20岁年龄组患者最多，占41．23％，其次是40岁年龄组，占31．59％，1年中就诊的化学性药物中毒患者5月份开始增加，7—8月份达到高峰，然后逐渐回落，12月份为低谷，化学性药物中毒显示出明显的季节性。【结论】普及宣传科学知识，创建和谐社会，建设文明家庭，是控制和减少中毒事件的关键。     

Alzheimer 病发病机理及中药防治研究的探讨与述评

从基因表达异常、胆碱能功能障碍、铝中毒、神经递质和钙离子民等方面对Ａｌｚｈｅｉｍｅｒ病（ＡＤ）的发病机理进行阐述。笔者认为其机理是综合因素所致中药对ＡＤ的防治方面应加强中药复方的研究，从方的研究，从多层次、全方位来阐明其作用机理。     

966例急诊中毒伤害病例分析

目的研究中毒伤害发生的特点和规律,为制定中毒伤害干预策略提供依据。方法收集2001年7月1日-2002年6月30日我院急诊科就诊的所有中毒病例及每季度前15d就诊的外科伤害病例,由接诊医生填写统一调查表后进行统计分析。结果本次调查共收到中毒伤害病例966份,其中中毒388例,伤害578例。15-55岁年龄组占总数的82．30％。中毒伤害发生的地点以公共场所最多,占67．08％。职业分布前三位为学生、专业技术人员和办公管理人员。伤害原因以机械性损伤和交通运输事故居前,伤害情况以浅表性损伤最多。中毒者以酒精中毒、一氧化碳中毒、食物中毒占前三位。经急诊处理后需留观或住院的占26．71％。结论急诊中毒伤害病例有其特点和规律,对制定中毒伤害干预政策有一定借鉴作用。     

C反应蛋白在两种中毒患者血清中的变化及意义

目的研究急性有机磷农药中毒(AOPP)、急性一氧化碳中毒(ACOP)患者血清C反应蛋白(CRP)水平的变化及其临床意义。方法根据50例AOPP、45例ACOP患者入院时中毒的程度分别各设轻度中毒组、中度中毒组和重度中毒组,并各另设健康对照组(各45例)。中毒患者在入院的第1天治疗前、第3天、第7天或第5天抽静脉血进行血清CRP检测。结果AOPP、ACOP患者入院第1、3天,中度中毒组和重度中毒组血清CRP水平明显高于健康对照组(P<0.01);轻度中毒组与健康对照组比较差异无显著性(P>0.05);AOPP第7天和ACOP第5天,其中度中毒组CRP水平与健康对照组比较差异无显著性(P>0.05);而第7天AOPP重度中毒组和第5天ACOP重度中毒组CRP水平明显高于健康对照组(P<0.01);AOPP重度中毒组第1、3、7天与ACOP重度中毒组第1、3、5天CRP水平与各自中度中毒组相对应入院天数比较,差异有高度显著性(P<0.01)。结论AOPP、ACOP患者血清中CRP水平与中毒的程度有关,可作为AOPP、ACOP患者诊疗的重要参考指标之一。     

1079例急性中毒患者流行病学调查

目的分析急性中毒患者的流行病学特点,为今后急性中毒防治提供依据。方法对2005年1月-2007年12月收治的1079例急性中毒病例进行回顾性流行病学分析。结果所调查患者当中男618例（57．2％）,女461例（42．8％）;中毒高发年龄段为21—30岁（26．21％）,男女比值为：1．34：1（P〈0．05）;职业因素分布中工人比例最高（31．0％）;最常见的中毒类型是酒精中毒（48．9％）,再次是治疗药物中毒（17．2％）,第三是有毒气体中毒（9．5％）,最后是农药中毒（6．6％）;一年中发病高峰月份是三月,六月,十二月。结论工人、农民、无业人员和学生是主要的中毒职业分布,社会各部门应加强对公众中毒防范的宣传教育,最大限度减少中毒的发生。