芥子气中毒体内诊断生物标志物检测技术的研究进展

芥子气中毒体内诊断生物标志物检测技术的研究一直是人们关注的课题，目前芥子气中毒的生物诊断标志物主要有芥子气-DNA加合物、芥子气-蛋白质加合物及芥子气的尿中代谢物(包括水解产物及谷胱甘肽结合物)等。本文综述了上述3类生物诊断标志物的检测方法，包括液质联用(LC-MS)、气质联用(GC-MS)、免疫荧光等技术。     

芥子气所致氧化应激相关生物标志物研究进展

芥子气[bis（2-chloroethyl） sulfide, sulfur mustard, SM]是一种强效化学战剂,其作用机制复杂,尚无特效解毒剂。研究芥子气的中毒机制及病理生理学变化过程,是制定合理有效的治疗方案的关键。氧化应激作为芥子气中毒后的重要病理生理学改变,是芥子气产生毒性效应的重要原因之一,对其相应生物标志物的观察和研究能够更好地揭示氧化应激在芥子气中毒中的作用,从而对揭示芥子气中毒机制及制定具有针对性的防治措施产生重要意义。该文综述了芥子气氧化应激相关标志物的研究进展。     

加速器质谱技术在DNA加合物检测中的应用

大部分化学致癌物进入体内,或经代谢活化后,可与生物大分子——蛋白质或核酸形成共价相连的加合物,DNA加合物的形成是化学致癌过程中一个早期、可检测到的关键步骡。加速器质谱技术(accelemtor mass spectrometry,AMS)的DNA加合物检测,是目前最灵敏的检测方法,提供了人们研究低剂量效应的直接有力的手段。     

加器速质谱技术在DNA加合物检测中的应用

大部分化学致癌物进入体内，或经代谢活化后，可与生物大分子－蛋白质或核酸形成共价相连的加合物，DNA加合物的形成是致癌过程中一个早期、可检测到的关键步骤。加速器质谱技术（accelerator mass spectrometry,AMS)的DNA加合物检测，是目前最灵敏的检测方法，提供了人们研究低剂量效应的直接有力的手段。     

青蛙芥子气中毒温度效应的探讨

芥子气是一种似辐射剂,青蛙腹腔绝对致死量芥子气染毒后观察表明,中毒后环境温度降低,对中毒蛙平均存活时间所致差别无统计学意义,类似青蛙受辐射作用后表现的“温度效应”不明显;但染毒当时及染毒后较短时间内机体代谢状态与机体对芥子气的敏感性有非常密切的关系.     

芥子气中毒致外周血细胞和骨髓细胞形态学损伤的研究

目的 观察血细胞及骨髓细胞形态学指标在芥子气中毒人员的治疗过程中的变化与中毒严重程度的相关性。方法 对芥子气中毒人员进行外周血及骨髓细胞形态学分析。结果 44名芥子气中毒患者白细胞总数均进行性降低,有10名患者出现中性粒细胞减少症或中性粒细胞缺乏症,芥子气中毒早期嗜酸性粒细胞损伤较严重,淋巴细胞百分比及绝对值在早期显著降低,芥子气中毒对外周血的血小板总数影响不大,红细胞和血红蛋白在最初因血液浓缩而升高。血细胞及骨髓细胞形态改变明显,白细胞胞体肿大,胞质可见中毒颗粒、空泡等,所有中毒者均出现异型淋巴细胞,以幼稚型异型淋巴细胞为主,血小板形态改变不明显。芥子气中毒早期骨髓造血细胞损害严重。结论 检查血象和骨髓象是判断芥子气中毒患者中毒程度及预后的一项重要指标,淋巴细胞绝对值减少程度和恢复正常值的时间长短及骨髓细胞增生受抑制的程度与中毒严重程度有关。     

芥子气暴露的远后效应

芥子气是一种糜烂性化学毒剂,能作用于眼、呼吸系统、皮肤和骨髓等组织器官,导致急性损伤且遗留远后损伤效应.目前尚无针对芥子气中毒的特效解毒药,仅采取对症和支持疗法.     

芥子气皮肤损伤43例报告分析

芥子气是一种糜烂性化学毒剂。2003年8月4日,在黑龙江省齐齐哈尔市发生集体芥子气中毒事件。我院共收治44例中毒患者,其中43例伴有皮肤损伤,现将其救治体会总结如下。     

人类芥子气中毒的长期效应

芥子气是双功能烃化剂,中毒后可遗留长期效应。两伊战争中伊朗芥子气中毒人群成为芥子气长期效应研究的热点。对这些伊朗患者芥子气中毒后数年的研究表明,他们都有不同程度迟发性并发症产生,以眼、皮肤和呼吸系统为主,表现为皮肤的干燥、瘙痒和色素过度沉着,眼睛的结膜炎、角膜溃疡和视力障碍,呼吸系统的慢性支气管炎、支气管扩张和肺纤维化。此外,芥子气中毒的长期效应还与肿瘤的发生、生殖毒性、血液系统、免疫系统的影响和神经精神方面症状有关。     

青蛙芥子气中毒温度效应的探讨

芥子气是一种拟辐射剂,为进一步了解辐射和芥子气之间的关系,用致死量芥子气腹腔染毒青蛙,观察染毒前后不同温度条件下的3组染毒青蛙,其平均活存时间分别为3.14,3.38, 3.60h,结果表明染毒环境温度的改变,对中毒青蛙平均活存时间所致差别无统计学意义(P>0.05)。类似青蛙受辐照后表现的“温度效应”不明显。染毒前后均处于较低温度环境下的青蛙,平均活存时间为6.34h,与其它3组比较差别显著(P<0.05),表明染毒当时及染毒后较短时间内机体代谢状态及机体对芥子气的敏感性有非常密切的关系。     

Liquid sulfur mustard exposure

A 35-year-old active duty service member sustained a 6.5% body surface area burn as a result of exposure to the chemical warfare agent sulfur mustard, which is the most severe mustard exposure of a U.S. military member since World War II that is known to us. New techniques were used to demonstrate the detectable persistence of mustard metabolites in the patient's blood for at least 41 days after exposure, validating these techniques for the first time for a human mustard patient; they were also used for the first time with human mustard blister fluid. The techniques extend eightfold the period of time that mustard exposure can be definitively diagnosed, compared with previous techniques. Although this patient's lesions were never life-threatening, he required 2 weeks of intensive burn care. He has been left with ongoing posttraumatic stress disorder and has had an incomplete dermatological recovery. In a major terrorist attack involving many patients exposed to sulfur mustard, care resources would be depleted quickly.     

Ocular injuries caused by mustard gas: diagnosis, treatment, and medical defense

Sulfur mustard has been used as a vesicant chemical warfare agent. To investigate the ocular damage it causes, we studied the effects on chemical casualties in the Iran-Iraq War. The patient population consisted of more than 5,000 chemical casualties, both military and civilian. The range of ocular damage was wide. The most common ocular effects were conjunctivitis and photophobia. Patients with significant corneal involvement are at risk for corneal ulceration and rarely for anterior chamber scarring and neovascularization, any of which would result in prolonged disability. In conclusion, the eye is the organ most sensitive to sulfur mustard vapor. Ocular injuries generally heal completely. In severe cases, blindness may occur. The need for corneal transplantation is rare.     

芥子气中毒治疗药物的研究进展

本文介绍了近年来芥子气(sulfur mustard，HD)中毒抗毒药物的研究进展，阐述了HD清除剂、聚二磷酸腺苷聚合酶抑制剂、钙调节剂、抗炎药物、精氨酸类似物及其他相关药物的作用机制和应用概况。这些研究进展对芥子气抗毒药物研究有着积极的意义。     

Correlation of sulfur mustard exposure and tobacco use with expression (immunoreactivity) of p53 protein in bronchial epithelium of Iranian "mustard lung" patients

A unique chronic obstructive pulmonary disease (COPD), provisionally called "mustard lung", which occurs as a late complication of sulfur mustard (SM) exposure among SM-exposed Iranians, is presently poorly characterized. This investigation evaluates p53 immunoreactivity in bronchial epithelium of individuals with histories of tobacco use and/or SM exposure, as a tool to help define mustard lung. In this study, 68 COPD patients were segregated into two groups, 35 mustard-exposed patients (including 8 smokers) and 33 unexposed patients (including 16 smokers). Disease severity was assessed with pulmonary function tests. p53 protein in bronchial tissue obtained as biopsies was quantitated by immunostaining. Among nonsmokers, 41.2% of unexposed subjects and 14.8% of exposed subjects expressed p53. Among smokers, 25% of the unexposed group and 50% of the exposed group expressed the protein. Initial data trends suggest an additive contribution of SM exposure and smoking to p53 immunoreactivity. These results illustrate the use of p53 immunoreactivity in the characterization of COPD, including mustard lung.     

军事行动所致多器官衰竭生物样本库的构建及意义

随着科学研究的深入,在科学研究中需要越来越多的样本,生物样本库的建设显得特别重要。通过文献综述调研及国内生物样本库的建立和管理方法学习,探讨军事行动所致多器官衰竭生物样本库的创建意义和管理。规范、科学地管理多器官衰竭生物样本,有利于合理有效地利用样本,防止样本浪费。军事行动所致的器官衰竭样本非常珍贵,建立起专门的生物样本库对这些珍贵的样本进行科学、合理、规范的管理尤为必要。     

Options for future military health surveillance systems.

This paper examines the requirement for health surveillance systems for military forces. Military health surveillance is the routine systematic collection, analysis, interpretation, and reporting of standardised, population based data for the purpose of characterising and countering threats to the military population's health, well-being and performance. The components of a health surveillance system should enable concurrent or retrospective analysis of health effects in military personnel using a cohort study design. Military hazards include trauma, infection, toxic effects, radiation, psychological stress and ergonomic stress. Variations in distribution of the hazard, distribution of the population, fragility of the cohort, and the variation in the duration and magnitude of exposure complicate definition of the exposed cohort. The measurement of biological effect is complicated by limits in knowledge about the relationship between exposure to the hazard and effect. A biological model that explains detection, causality, pathological process and health effect should support this knowledge. Lastly the definition of health effect needs to consider the difference between clinical activity rates and true measures of health outcome. The UK has a number of health surveillance systems including sentinel reporting, a population-based primary care reporting system and measures of medical discharge and death. The US Army is developing IT-based surveillance systems to link hazard, personnel and medical databases. The paper suggests a conceptual model for such a system in the UK military.     

清除剂及抗氧化应激药物做为芥子气损伤防治药物的研究进展

氧化应激是芥子气毒性损伤作用重要的起始环节之一。该文综述了近年来芥子气清除剂及抗氧化应激药物研究进展,对现存药物和潜在候选化合物进行了分类评述。研究表明,硫醇类化合物、小分子金属卟啉类化合物、含氮类化合物以及多酚类化合物是受关注的4种主要药物类别。开展这些药物的抗毒作用研究,对推进芥子气抗毒药物开发有着积极的意义。     

Early resorptive effects of highly toxic alkylating substances

In the next few hours after exposure of mustards in harmful doses the injured suffer a complex of neurological deficits-headache, asthenia and emetic syndrome, and in case of lethal dosage-adynamia, tremor and convulsions. In case of percutaneous exposure of sulfur mustard, these disorders limit the terms of the conservation capacity of injured and determine the nature of the medical care they need at the pre-hospital stage. Perspective areas of drug prevention and treatment of early manifestations of acute resorptive action of mustards are the use of antiemetics, analgesics, and the removal of endogenous toxemia caused by inflammatory mediators, and biologically active substances in the gastro-intestinal origin.