中山市细菌性食物中毒流行特征分析及预防对策

目的分析中山市近年细菌性食物中毒流行特征，为预防和控制食物中毒的发生提供依据。方法用回顾性流行病学方法分析中山市1998～2004年细菌性食物中毒流行情况。结果中山市1998～2004年共发生细菌性食物中毒69起，中毒人数3172人，平均每起中毒人数46人。中毒发生有明显的季节性，以第3季度发生的起数最高，有41起，占中毒起数的59．4％；第2季度次之；中毒人数也以第3季度最多，中毒2037人，占中毒人数的64．2％，第2季度次之。中毒发生场所以集体食堂最多，共有56起，占中毒起数的81．2％；中毒人数2567人，占总中毒人数的80．9％。中毒的致病因素以变形杆菌和副溶血性弧菌引起为主，分别有28和25起，占中毒起数的40．6％和36．2％。中毒食物种类主要是肉及其制品，共有38起，占中毒起数的55．1％，其次是凉拌菜食品，共有13起，占中毒起数的18．8％。结论中山市近年来细菌性食物中毒主要发生在集体食堂，且致病因素发生变化，以变形杆菌和副溶血性弧菌引起的食物中毒为主。加强卫生监督监测力度，把好发证关，提高从业人员卫生安全意识和建立危害分析与临界控制点（HACCP）体系是预防和控制食物中毒发生的关键措施。     

纳洛酮治疗急性酒精中毒46例疗效观察

目的:总结纳洛酮(naloxone)治疗急性酒精中毒的疗效和经验。方法:对用纳洛酮治疗的46急性酒精中毒患者的临床资料进行分析。结果:纳洛酮治疗轻、中度患者症状消失时间为(0.6±0.1)小时,重度中毒患者神志清醒时间为(3.0±0.3)小时,与传统的治疗相比有明显的优势。结论:纳洛酮是治疗急性酒精中毒的有效药物,使用简单,疗效快速可靠。     

Study of an outbreak of ciguatera fish poisoning in Hong Kong.

Ciguatera fish poisoning (CFP) has been a significant and increasing public health problem in Hong Kong since 1980s. With growing demand for imported live coral fishes, the number of people who suffered from this disease has also been increasing. An outbreak of CFP in 2004 was the second most prominent in record as compared with the most significant one that occurred in 1998. In 2004, out of a total of 823 reported food poisoning outbreaks involving 3159 persons, 65 incidents (7.9%) affecting 247 people (7.8%) were attributed to CFP. Validated mouse bioassay analysis of surveillance samples revealed that seven samples (13%) were confirmed to be contaminated with ciguatoxins (CTXs). Typical symptoms of CTXs were found in mice injected with 20mg of fish extracts. The causative fishes included Cheilinus undulatus, Epinephelus coioides, Plectropomus areolatus, and Plectropomus leopardus. Most of these CTX-positive samples analyzed had only trace amounts of CTXs in their extract, except a C. undulatus sample which contained a mice lethal dose (2.5MU/20mg ether extract). This fish species was also the major origin of coral fish that caused clusters of CFP in the last quarter of 2004. Cigua-Check analysis of 20 flesh grains from seven CTX-positive fishes, previously confirmed as CTX-positive samples by mouse bioassay, showed that 50% of flesh grains were CTX contaminated.     

Is there a risk of human poisoning by azaspiracids from shellfish harvested at the Portuguese coast?

Azaspiracid poisoning (AZP), the most recently discovered human gastrointestinal illness resulting from consumption of contaminated shellfish, so far has been found in coastal areas of northern Europe. This is the first report of a survey carried out for contamination of shellfish harvested in costal areas of Portugal for the presence of azaspiracids. The study design covered the commercial species usually more contaminated by toxins from dinoflagellates (blue mussel, common cockle, donax clam) in coastal areas representative of the NW, SW and south coasts. A method based on liquid chromatography–mass spectrometry was setup for the first time for this purpose. No azaspiracids were found on 300 samples tested between 2002 and 2003. On at least three samples a peak with a retention time matching that of AZA2 was found, never surpassing one tenth of the current EU limit. Unambiguous identification of any known AZA did not occur yet. The risk for human outbreaks of AZP seems to be very low, comparatively with amnesic shellfish poisoning (ASP), where levels close to the allowance level are found sparsely, or to diarrhetic shellfish poisoning (DSP) and paralytic shellfish poisoning (PSP), where high levels and registered human outbreaks have been found in recent years.     

Confirmation of brevetoxin metabolism in cockle, Austrovenus stutchburyi, and greenshell mussel, Perna canaliculus, associated with New Zealand neurotoxic shellfish poisoning, by controlled exposure to Karenia brevis culture.

We examined metabolism of PbTxs in New Zealand cockle, Austrovenus (A.) stutchburyi, and greenshell mussel, Perna (P.) canaliculus, by means of liquid chromatography coupled with tandem mass spectrometry. PbTx-2, PbTx-3 and BTX-B5 were detected in Karenia (K.) brevis culture medium in the ratio of ca. 50:2:5. The amounts of PbTx-3 and BTX-B5 were greatly increased in both seawater and shellfish exposed to K. brevis cultures or supernatant prepared by disruption of K. brevis under appropriate condition, while those of PbTx-2 were decreased. Some PbTx-2 was present in P. canaliculus, but not in A. stutchburyi. Low levels of BTX-B1 were detected in A. stutchburyi, but not P. canaliculus. Levels of PbTx-3 and BTX-B5 were highest immediately after exposure and then declined rapidly in both shellfish. BTX-B1 increased in concentration after exposure, and was then gradually eliminated from A. stutchburyi. Three successive exposures of A. stutchburyi to K. brevis cultures resulted in similar initial levels of PbTx-3 and BTX-B5, while BTX-B1 accumulated after each dose. In P. canaliculus, initial levels of PbTx-3 were similar, while PbTx-2 and BTX-B5 accumulated after each dose. PbTx-3 and BTX-B5 are proposed to be suitable markers for monitoring shellfish toxicity after a red tide event.     

急性一氧化碳中毒迟发性脑病的动物模型制备研究

目的建立急性一氧化碳(CO)中毒迟发性脑病的动物模型,为其机制研究提供基础.方法体重240～280 g雄性SD大鼠,分次腹腔注射CO染毒制备模型,动态监测尾血碳氧血红蛋白(HbCO)浓度,确定染毒剂量和间隔 .分别于染毒后1、3、7、14、21 d取脑组织,常规制备石蜡病理切片,行HE、Luxol氏坚牢蓝焦油紫及Tunnel原位末端凋亡染色.结果染毒后,大鼠体内血液HbCO迅速升高,使用分次腹腔注射法,大鼠可维持长时间(＞16 h)高HbCO状态(HbCO＞50%) ;病理学检查显示染毒大鼠除急性脑损伤外,还在染毒1～2周后出现脑细胞凋亡、大脑白质脱髓鞘、大脑基底结区变性坏死等二次损伤改变,与临床病理学特点十分吻合.结论本研究建立了一种较为符合迟发性脑病临床特征的动物模型,该模型的建立将可为深入研究急性CO中毒致迟发性脑损伤的机制提供可靠基础.     

急性一氧化碳中毒后迟发性脑病患者血清白介素水平的变化及其临床意义

目的 探讨急性一氧化碳（CO）中毒后迟发性脑病（DEACMP）患者血清白介素（IL）水平变化及其临床意义。方法 采用酶联免疫吸附法检测34例DEACMP患者治疗前、后血中IL-2、4、6的水平,并与30名健康人和30例急性CO中毒（ACMP）患者进行比较。结果 （1）DEACMP组治疗后血中IL-2、4、6的含量显著高于治疗前（均P〈0．01）,但仍显著低于ACMP组和健康对照组（均P〈0．01）;（2）ACMP组血IL-2、4、6的含量明显高于健康对照组（均P〈0．01）。结论 DEACMP的发生与神经免疫病理损伤有关,血中IL-2、4、6的水平可以反映DEACMP患者机体的免疫状态。     

核因子红细胞2相关因子2在毒死蜱毒性机制中的作用

毒死蜱(chlorpyrifos,CPF)是一种广泛使用的有机磷农药,其对人类健康和生态系统的潜在风险已引起广泛关注。CPF主要通过抑制乙酰胆碱酯酶(AChE)发挥杀虫作用,但越来越多的研究表明,CPF的毒性作用远不止于此,也与氧化应激、炎症反应、 细胞死亡等多种生物学过程密切相关,因而可能导致神经退行性疾病、生殖发育障碍以及其他慢性健康问题。核因子红细胞2相关因子2(Nrf2)作为一种关键的抗氧化应激调节因子,具有显著的保护作用。本文旨在综述Nrf2在调节CPF诱导的氧化应激、神经毒性、细胞死亡和炎症反应中的作用机制,探讨其作为潜在治疗靶点的前景,以为开发新的CPF中毒治疗策略提供理论基础。     

APACHEⅡ评分与重度有机磷中毒患者肠道屏障功能的相关性分析

目的 分析急性生理与慢性健康状况系统Ⅱ(APACHEⅡ)评分与重度有机磷中毒患者肠道屏障功能的相关性.方法 回顾性选取2017年1月至2019年12月安徽理工大学附属亳州市人民医院收治的119例重度有机磷中毒患者.按照患者预后情况,将患者分别纳入存活组80例、病死组39例.记录患者入院即刻及入院48、72、144 h ...     

Determination of paralytic shellfish poisoning toxins in Norwegian shellfish by liquid chromatography with fluorescence and tandem mass spectrometry detection.

A novel extraction and clean-up method has been developed for the determination of paralytic shellfish poisoning (PSP) toxins in shellfish samples. Raw shellfish material was extracted with an acidic acetonitrile/water (80:20, v/v) solution, whilst being homogenised. During the homogenisation the sample extraction solution was cooled with ice water. Subsequently, the extract was frozen at -20 degrees C for at least 4h. During freezing, two layers were formed, only the lower predominantly aqueous layer was used for the determination. The final extract solution was cleaned-up using a combination of Oasis HLB and Carbograph activated carbon SPE columns. The developed extraction and clean-up methods combined with gradient elution liquid chromatography (LC)-mass spectrometry/mass spectrometry (MS/MS) has resulted in a method which can determine the analogs GTX 1-5, C1-2, DcGTX 2-3, DcSTX, Neo, STX in a single analysis with an overall detection limit of 313mug STXdiHCL-eq./kg shellfish meat. The use of the developed extraction method with post-column high performance liquid chromatography (HPLC) with fluorescence detection (FLD) method provided an overall limit of detection of 89mug STXdiHCL-eq./kg shellfish meat for the same toxins. Both post-column HPLC-FLD and LC-MS/MS was used to investigate the Norwegian PSP toxin profile. It was found that the PSP toxins could be detected in shellfish samples from the Norwegian coastline for 10 months of the year, from March till December. The toxin profile consisted mainly of the carbamate toxins, GTX 1-4, Neo and STX, in terms of both concentrations and contribution to the overall toxicity. In addition, several of the n-sulfo-carbamoyl toxins were either detected in the samples at relatively low concentrations or their presence in the samples were indicated but could not be confirmed by the post-column HPLC-FLD and LC-MS/MS analyses.