有机磷农药中毒引起“中间综合征”的研究现状

急性有机磷农药(OP)中毒可导致三种神经毒性表现。急性胆碱能危象(ACC)和迟发性周围神经病(OPIDN),是常见的两种。第三种称为中间综合征(IMS),由Senanayake等于1987年首次报道,因其发生于前两者之间而得名。IMS主要表现为在急     

急性有机磷农药中毒中间综合征48例诊治体会

急性有机磷农药中毒（AOPP）中间综合征（IMS）是AOPP经积极救治，在急性胆碱能危象消失后、迟发性周围神经病（OPIDP）出现之前发生的一组以肌无力为突出表现的临床综合征。无躯体感觉障碍，呼吸肌麻痹是其主要危险，此时有不同程度的呼吸困难，呼吸频率增加，进行性缺氧致意识障碍、昏迷甚至死亡，若对其认识不足，不能及时救治，病死率极高。我院2001-2006年间救治急性有机磷中毒170例，其中48例发生中间综合征，现将我们的诊治体会总结报道如下。     

小儿有机磷中毒后迟发性神经病变10例临床分析

有机磷中毒后迟发性神经病变是指有机磷中毒患者急性期后数天出现的一系列神经精神症状。我们收治有机磷中毒后迟发性神经病变患儿10例,现分析如下。临床资料:本组男7例、女3例;年龄4～11岁,平均6.5岁。毒物为敌敌畏(5例)、久效磷(2例)、1605(1例)、乐果(1例),不详(1例)。经消化道中毒6例,皮肤及呼吸道粘膜吸收中毒4例。中毒程度为轻度2例、中度6例、重度2例。中毒症状缓解距产生神经精神症状5～19(平均13.5)天。10例均有运动障碍,主要表现为四肢3例,双下肢7例。其特点为下肢重于上肢,远端重于近端,有明显对称性。本组伴周围神经感觉异常(四…     

中毒

993130有机磷中毒迟发性神经病75例临床分析/乔善亮…//陕西医学杂志一1999,28(3)一157一158 该组发生率为10.4写(75/721),以甲胺磷中毒是多(34例),其次为敌敌畏(26例)。主要表现为周围神经轴索变性、髓鞘脱失为病理特点,表现为四肢远端对称性运动、感觉及植物神经功能障碍。经综合治疗4个月中47例治愈.余28例再治疗9个月,25例治愈,仅3例仍轻度肢体运动障碍。参5(洪瑞香)993131急性有机磷中毒时复能剂用量与用法的临床观察/单沙林…刀中华内科杂志一1998,37(8)一548~549 治疗轻、中、重度中毒分别为6、10和31例。治疗方法为:阿托品首剂3型中…     

有机磷农药中毒致迟发性神经病的发病机制及治疗研究进展

有机磷农药中毒所致的迟发性神经病（OPIDN）是有机磷农药中毒后的严重并发症之一.我国报道的OPIDN多为口服重度有机磷农药中毒后获救者,半数由甲胺磷中毒所引起,其次为敌敌畏、美曲膦酯及乐果急性中毒者,少数由马拉硫磷、水胺硫磷、对硫磷、内吸磷所致.国内有报道甲胺磷中毒所致OPIDN的发生率为8%.     

急性有机磷中毒致中间综合征13例

急性有机磷中毒致中间综合征１３例虞炳庆，刘保群，黄明章近年来，关于有机磷中毒迟发神经肌病的研究报道较多，本文报告１３例急性有机磷中毒所致的另一种神经毒性反应─—中间综合征（ＩｎｔｅｒｍｅｄｉａｔｅｓｙｎｄｒｏｍｅＩＭＳ）。因其出现在急性中毒胆碱能危象...     

急性有机磷中毒后迟发性神经病86例的调查

急性有机磷中毒后迟发性神经病８６例的调查施宝兴，孙东红，周宏东我院位于苏州近郊的风景区，周围有７个乡镇，约３０万人口，是该片的医疗中心。凡有机磷农药中毒基本上转入本院救治，少数轻症病例由乡镇卫生院救治。病历完整的有机磷中毒８６例，其中男２５例，占２９...     

急性有机磷中毒致迟发性呼吸衰竭抢救体会

迟发性呼吸衰竭发生在急性有机磷中毒胆碱能危象之后,以呼吸肌麻痹为主要特征,为中间综合征的危重表现和急性有机磷中毒急性期后死亡的主要原因【门。我院１９９７年１月至１９９８年７月收治口服有机磷中毒１０９例,其中１３例发生迟发性呼吸衰竭,抢救成功１０例,报告如下。临床资料男３例,女１０例,年龄１９—３６岁。重度中毒１２例,轻度中毒１例。其中口服１６０５者８例,敌敌畏３例,氧化乐果２例。１２例服毒量大于５０Ｉｎｌ。所有患者均彻底洗胃、导泻,使用解毒剂治疗,１２例重度中毒患者均行血液灌流。经抢救后毒章碱样…     

急性有机磷农药中毒并发症的诊断和治疗

急性有机磷农药中毒并发症主要有急性肺水肿、脑水肿、呼吸衰竭和迟发性神经精神症等。一、急性肺水肿急性有机磷农药中毒并发肺水肿的临床特点是呼吸道分泌物增多,肺部有广泛性干湿性罗音,呼吸衰竭出现早;中枢性呼吸抑制和呼吸肌麻痹常是本病死亡的原因。诊断除中毒史及以上临床特点外,要特别抓住有机磷中毒的特殊表现,如瞳孔缩小、大汗、肌     

有机磷中毒与中间综合征

中间综合征是急性有机磷中毒后经积极抢救，急性胆碱能危象消失后、迟发性周围神经病变出现之前的一组以肌无力为突出表现的临床综合征。患者突出表现为呼吸困难、呼吸浅快无力，以呼吸肌麻痹为主的肌无力危象。本文探讨中间综合征的发病机制，以指导临床治疗，防止中间综合征的出现。     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.