职业性慢性重度二甲基甲酰胺中毒性肝病一例

职业性急性二甲基甲酰胺(DMF)中毒，近年时有报道，然而，职业性慢性DMF中毒却未见报道。最近，我们根据患者长期、反复、高浓度DMF职业接触史，在临床检查排除其他肝病的基础上，诊断了1例职业性慢性重度DMF中毒性肝病，现报道如下。     

一起职业性中毒性肝病鉴定案例分析

职业性中毒性肝病是在职业性接触中吸收化学毒物所引起的中毒性肝脏疾病。常见的肝脏毒物有金属及非金属无机化合物类、卤代烃类、芳香族氨基及硝基化合物类,二甲基甲酰胺、有机磷农药等化学物,近年来时有职业性中毒性肝病报道。剖析本起职业性中毒性肝病鉴定案例,从慢性中度中毒性肝病的诊断、首次鉴定排除慢性中度中毒性肝病到再鉴定为无职业病的过程中,有些经验教训值得反思,现报告如下。     

二甲基甲酰胺致职业性慢性中毒性肝病1例分析

目的 分析1例二甲基甲酰胺致职业性慢性中毒性肝病病例的诊疗经过及现场调查结果,为制定监管对策提供参考.方法 收集、分析病例资料并开展现场卫生学调查.结果 根据职业接触史、发病诊疗经过和病程,结合现场卫生学调查结果综合分析,患者诊断为职业性慢性中度中毒性肝病.结论 长期接触二甲基甲酰胺可引起慢性中毒性肝病.用人单位应提高...     

急性二甲基甲酰胺中毒合并肝脓肿一例

患者因接触二甲基甲酰胺后出现中毒症状去医院就诊,入院时诊断为"二甲基甲酰胺中毒,中毒性肝病",住院后一个月,出现发热、血白细胞增多,胸部CT检查检查提示多发肝脓肿。因病情复杂、难以控制,故多次转院治疗。出现病重、病危情况,最后肝部分切除。从疾病的程度和常人的理解能力来看似乎诊断重度中毒比较合理,且不容易与病人及家属发生矛盾。然而通过反复研究和对照GBZ59-2010,GBZ85-2002诊断标准结合现场流行病学调查,职业性中毒性肝病不包含有肝脓肿,而肝脏切除主要由于肝脓肿引起。故不符合职业性中度或重度肝中毒。但肝脓肿确实是在因为是在患者住院期间发生的,为了更好的做好职业病诊断工作,保护好患者的健康权益,我们在职业病诊断后加上合并症的诊断,最终诊断结果为职业性急性轻度二甲基甲酰胺中毒,职业性急性轻度中毒性肝病合并肝脓肿、末梢胆管扩张、继发感染。并告知患者做劳动能力鉴定,病情程度可以通过劳动能力鉴定得到反应,最后得到病人的认同和理解。从这里我们体会到职业病诊断的过程中,认真研究、反复对照并严格执行职业病诊断标准的意义。     

职业性慢性重度二甲基甲酰胺中毒性肝病一例的教训

二甲基甲酰胺(dimethylformamide,DMF)是工业上常用的有机溶剂,职业性急性DMF中毒,近年报道较多.由于DMF属于低毒有机溶剂,体内排泄快,长期接触致工人慢性中毒较少见[1-2].最近,我们根据1例患者长期、反复、高浓度DMF职业接触史,在临床检查排除其他肝病的基础上,诊断为职业性慢性重度DMF中毒性肝病,报道如下.一、发病及诊治经过患者女、42岁,2004年12月进入某合成革公司干法车间涂台岗位工作,上岗前未进行职业健康检查,存在的主要职业病危害因素为DMF,但未告知.2007年5月,企业委托有职业健康体检资质的单位进行职业健康体检,发现该患者丙氨酸转氨酶(ALT)102 U/L、天冬氨酸转氨酶(AST)99 U/L,病毒性肝炎(甲肝、乙肝、丙肝、戊肝)抗体检查均为阴性,血小板减少(78×109/L),自觉腹痛、食欲缺乏.经休息与治疗后,因无明显自觉症状,患者仍继续在原岗位工作.     

职业性急性重度二甲基甲酰胺中毒合并甲胎蛋白增高1例

目的积累职业性急性重度二甲基甲酰胺(DMF)中毒合并甲胎蛋白(AFP)显著增高患者经验。方法对某鞋材厂1例DMF中毒的患者进行诊断治疗。结果患者的临床表现和实验室检查均符合急性重度中毒性肝病的诊断标准。在脱离原工作环境、经积极治疗、肝损害得到控制后,AFP恢复正常。结论本例患者的AFP暂时性明显升高为预后良好的征象。     

多种毒物致职业性中毒性肝病报道

在职业环境中引起中毒性肝病的毒物种类很多，有金属及非金属无机化合物类、卤代烃类、芳香族氨基及硝基化合物类和其他类（二甲基甲酰胺、有机磷农药等）。南通市疾病预防控制中心职业病诊断小组2007年确诊1例多种毒物所致职业性慢性中毒性肝病，现报道如下。     

二甲基甲酰胺致慢性中毒性肝病1 例报告

正N,N-二甲基甲酰胺(N,N-dimethylformamide,DMF)是一种无色带有鱼腥味的液体,具有很强的溶解能力,被誉为"万能溶剂",广泛应用于仿皮制造、有机合成、染料、制药、石油提炼等行业。由于DMF毒性低,体内排泄快,长期接触致慢性中毒较少见[1]。2015年4月本中心诊断小组确诊1例职业性慢性轻度DMF中毒性肝病,该例肝脏受损致纤维化的同时,肾脏、心脏功能均受损伤,现报告如下。     

二甲基甲酰胺联合丙烯腈致急性重度中毒性肝病1例报告

<正>N,N-二甲基甲酰胺(N,N-dimethylformamide,DMF)是一种无色带有鱼腥味的液体,具有很强的溶解能力,被誉为"万能溶剂",广泛应用于仿皮制造、有机合成、染料、制药、石油提炼等行业。丙烯腈(acrylonitrile,C3H3N)是三大合成材料(合成纤维、合成橡胶、合成树脂)基本且重要的原料,广泛应用于聚丙烯腈、丁腈胶乳和其他树脂材料的合成。由DMF引起的急性中毒性肝病近年来时有报道,但二甲基甲酰胺联合丙烯腈致急性中毒性肝病较为罕见。2016年1月本中心诊断小组依据《职业性急性二甲基甲酰胺中毒的诊断》(GBZ85—2014)确诊了1例二甲基甲酰胺联合丙烯腈致急性重度中毒性肝病病例,现报道如下。     

1例二甲基乙酰胺致急性重度中毒性肝病调查

目的调查分析1例二甲基乙酰胺(DMAC)职业中毒所致的急性重度中毒肝病。方法通过作业场所职业卫生学调查、患者职业接触史询问和实验室检查等方法,对某厂1例因二甲基乙酰胺暴露引起的急性肝病合并复发病例进行调查。结果该病例为中年男性,曾因短期接触二甲基乙酰胺后出现重度中毒性肝病症状,谷丙转氨酶高达474IU/L,且甲胎蛋白高达711.4ng/mL。经治疗后好转,回岗作业数天内肝功能再次受损,谷丙转氨酶升高至166.5IU/L。结论本病例依照标准诊断为职业性中毒性急性肝病。DMAC具有首次暴露出现肝损,再次暴露短期内即可出现肝损的特性,需引起重视。     

N-substituted amino acid derivatives with hyperalphalipoproteinaemic activity

A series of N-substituted amino acid derivatives was synthesized and the compounds were evaluated for their effects on serum total cholesterol, HDL cholesterol and triglycerides in experimental animals. Hyperalphalipoproteinacmic activity was found for some of the compounds tested, especially BRL 26314 (2) and related 3-aryl-2-[(arylmethyl)]-aminopropionic acids. Structure-activity relationships are discussed.     

Synthesis and pharmacological properties of N-thienyl alkylenediamines

A series of N-thienylalkylenediamines was synthesized and tested for their analgesic, anti-inflammatory and anti-pyretic activities, as well as for their acute toxicity and central effects. Acetylsalicylic acid, phenylbutazone and indomethacin were used as reference drugs. Several compounds showed interesting aspirin-like properties associated with good systemic and gastric tolerance.     

Antitumor and antimycobacterial activities of cyclopalladated complexes: X-ray structure of [Pd(C,N-dmba)(Br)(tu)] (dmba = N,N-dimethylbenzylamine, tu = thiourea)

The reactions between [Pd(C²,N-dmba)(μ-X)]₂ (dmba = N,N-dimethylbenzylamine; X = Cl, Br) and thiourea (tu) in the 1:2 molar ratio at room temperature resulted in the mononuclear compounds [Pd(C²,N-dmba)(Cl)(tu)] (1) and [Pd(C²,N-dmba)(Br)(tu)] (2), which were characterized by elemental analyses and infrared (IR), ¹H- and ¹³C{¹H} NMR spectroscopies. The crystal and molecular structures of 2 were determined by single-crystal X-ray diffraction. In vitro cytotoxicity assays of the compounds 1, 2, tu, dmba and cisplatin were carried out using two murine tumor cell lines, namely mammary adenocarcinoma (LM3) and lung adenocarcinoma (LP07). The compounds 1, 2, tu and dmba were also tested against Mycobacterium tuberculosis and their MIC values were determined.     

不同性别人群免疫球蛋白G N-糖基化结构谱型比较

目的 对不同性别人群的免疫球蛋白G（IgG） N-糖基结构谱型进行分析比较。方法 采用整群抽样,以2012年1-6月在北京市宣武医院体检的669名居民为研究对象,留取空腹静脉血5 ml,对IgG N-糖基进行分离、纯化、标记后,采用超高压液相色谱串联质谱法对IgG N-糖基进行检测,最终得到24个色谱峰,每个峰代表不同的糖基结构。不同性别人群的糖基结构比较采用两独立样本t检验或非参数检验,P<0.05为差异有统计学意义。结果 669名参与者中男性235人（35.13%）,女性434人（64.87%）,平均年龄为（44.23±9.82）岁。女性核心岩藻糖基化水平Fⁿ（Z=-2.192,P=0.028）高于男性;女性半乳糖基化水平G0ⁿ（Z=-7.898,P<0.001）、G1ⁿ（Z=-2.343,P=0.019）低于男性,而G2ⁿ（Z=-8.414,P<0.001）水平高于男性;女性唾液酸化水平F^totalS1/F^totalS2（Z=-5.049,P<0.001）、FS1/FS2（Z=-3.336,P=0.001）高于男性。结论 IgG N-糖基结构水平可能与性别有关。     

N-Haloacetyl-amino-acid amides as active-site-directed inhibitors of papain and cathepsin B

A series of N-haloacetyl-amino-acid amides were synthesized and tested as models of cysteine-protease inhibitors. They irreversibly inactivated papain and cathepsin B via a reversible enzyme-inhibitor intermediate. Apparent second-order rate constants of inactivation ranging from 65 to 16 700 M⁻¹ s⁻¹ were observed. Reactivity against papain, as compared to glutathione, was increased 16 400-fold for N-bromoacetyl-leucine isopentylamide and 25 700-fold for the corresponding iodoacetyl derivative; these increases are probably due to proximity effects. No inhibition of trypsin, chymotrypsin and porcine pancreatic elastase was observed. Haloacetamides represent an interesting class of easily synthesized, efficient, irreversible inhibitors of cysteine proteases, which have low non-specific alkylating properties.     

Synthesis and aldose reductase inhibitory activity of N-(quinolinyl thiocarbonyl) glycine derivatives

The onset of diabetic complications may be prevented by the inhibition of aldose reductase. Derivatives of N-(quinolinyl thiocarbonyl) glycine were prepared and their in vitro and ex vivo aldose reductase inhibitory activities were tested on rat lens. The cincophen derivatives were the most potent in vitro with an enzyme inhibition value of 29% at 10⁻⁸ M and 91% at 10⁻⁷ M for the N-[(2-phenylquinolin-4-yl)thiocarbonyl]-N-methylglycine compound 10a. This activity was shown to be dependent on the nature of the substituents and seems to be optimal for the acids; esters were found to be inactive. No compound have shown ex vivo inhibitory activity. It is concluded that the lack of ex vivo activity is likely due to a poor bioavailability or a bad penetration of the compounds in target tissue (lens).     

Studies towards the identification of putative bioactive conformation of potent vasodilator arylidene N-acylhydrazone derivatives

In this report we disclose the synthesis, vasodilatory activity, and identification of bioactive conformation of new N-acylhydrazone and N-methyl-N-acylhydrazone derivatives, structurally designed by bioisosteric replacements of previously described cardioactive compounds LASSBio-294 and its N-methyl derivative LASSBio-785. Some of these novel derivatives presented improved vasorelaxant properties, being new cardiovascular drug candidates.     

Angular overlap model applied to transition metal complexes and d N -ions in oxide host lattices

The ability of the angular overlap model (AOM) to rationalize the d^N energy level scheme of an arbitrarily coordinated transition metal complex is shown. The underlying theory is summarized, including recent extensions such ass-d mixing, misdirected valency, and non-additive π-contributions (Orgel effect), which may be important when chelate ligands with conjugated π-electrons are present. Experimental data obtained from optical spectra in absorption and emission are used to derive AOM parameter values, which are still scarce for third-row transition metal ions. Special attention is paid to spectrum-structure correlations, in particular to the interrelation ofd- level splittings with the angular geometry of the chromophore. Various examples are presented, in which angular distortions of the coordination sphere can be evaluated with high accuracy by means of the AOM. Further applications are given for some chromium-doped oxides for which particular metal-oxygen binding properties have to be considered.