重度失水所致应激性高血糖症

本文报道2例肠梗阻和1例有机磷农药中毒患者出现暂时性高血糖症。该3例患者均无糖尿病史,因有重度失水,经大量补液纠正失水后血糖迅速恢复正常。口服葡萄糖耐量试验正常。作者认为非糖尿病患者可因重度失水而致应激性高血糖症。     

Preventing percutaneous absorption of industrial chemicals: the "skin" denotation

Percutaneous absorption has received comparatively little attention in occupational health, although this route of entry has repeatedly caused occupation-related intoxications. In practice, the evaluation of skin penetration rates is far from simple. Much evidence has been obtained from studies of chemicals used for cosmetics and topical therapeutics, but the information available on compounds encountered in occupational health is limited. The data obtained from experimental studies have confirmed that the concentration, type of vehicle, skin area, skin condition, and extent of occlusion are important factors in determining the degree of percutaneous absorption, but no general model has been developed. Also, too little is known about the basic chemical properties governing the rate of penetration. Thus, prediction is difficult and bound to be rather inaccurate. Current preventive practice follows the procedure used by ACGIH and is mainly based on a "skin" denotation in official listings of chemicals to which exposure limits have been allocated. The number of substances and groups of chemicals which have received skin denotation in 17 selected countries varies between 24 and 179 and a total of 275 are listed as a skin hazard in one or more countries; ACGIH lists 143. Thus, the denotation practice varies. As an unfortunate result of these discrepancies and the dichotomy of skin denotation, the absence of skin denotation may erroneously indicate that efforts to protect the skin are unnecessary. Thus, an evaluation of skin penetration potentials should be incorporated in occupational health practice as a supplement to the official denotations.     

血液灌流治疗百草枯中毒临床观察

目的观察血液灌流治疗百草枯中毒的疗效。方法血液灌流治疗组（治疗组）22例在常规治疗的基础上，采用血液灌流治疗并观察疗效。非血液灌流治疗组（对照组）16例。结果治疗组22例中死亡14例，病死率为63．6％，对照组病死率87．5％，两组相比P〈0．05。结论血液灌流治疗百草枯中毒可提高治愈率，降低病死率，是临床上抢救百草枯中毒较有效的方法。     

百草枯中毒致肺损伤的CT表现

目的探讨百草枯中毒致肺损伤中的CT检查影像学特征和诊断价值。方法回顾性分析15例口服百草枯中毒致肺损伤病例的CT影像学资料。结果15例患者中毒早期（1～7d）主要CT表现包括支气管血管柬增粗伴支气管扩张显示轨道征（15／15）、磨玻璃密度影（14／15）、马赛克征（12／15）、树芽征（8／15）、肺实变（6／15）及胸膜下线（6／15）等；中毒中期（8～14d）主要表现支气管血管束增粗伴支气管扩张显示轨道征（11，11）、肺实变（7／11）及磨玻璃密度影（6／11）；中毒后期（〉14d）CT表现以肺实变（1／1）和纤维化（1／1）为主。结论百草枯中毒的肺部CT表现具有一定的特征性，其影像学变化对病情发展及指导临床治疗具有重要意义。     

Recurrent Poisoning in Children: A Review

The literature on poisoning accidents or ingestion of toxicsubstances in children is reviewed. Special emphasis is givento the phenomenon of recurrent or repeat episodes. Recommendationsare made concerning means for identifying children who are atrisk for repeat poison episodes, as well as for developing methodsof intervention to prevent such occurrences.