上海市婴幼儿血铅水平与体格发育的关系

目的探讨低水平铅暴露对儿童体格发育的影响。方法在上海市5个区县30所托幼机构,对1969名儿童进行了血铅水平的流行病学调查和体格发育等指标测量,并根据儿童身高、体重、头围和胸围计算其Z标准分,然后与血铅水平进行相关分析和逐步回归分析。结果上海市儿童血铅水平几何均数为0．400μmol／L,≥0．483μmol／L的比例为37．8％,血铅水平的几何均数与儿童身高、体重及头围的Z标准分呈显著的负相关。结论低水平铅暴露对上海市婴幼儿的体格发育可能具有不利影响。     

中毒剂量锌对大鼠小肠粘膜超微结构的影响

目的：阐明中毒剂量锌对肠粘膜免疫屏障结构的影响及其机理。方法：通过建立常锌（ＺＮ）、中毒剂量锌（ＺＰ）大鼠模型,应用病理形态学手段（电镜）对大鼠肠道粘膜的超微结构进行研究。结果：第４周末和第７周末血浆、红细胞膜和肠组织的锌含量ＺＰ组明显高于ＺＮ组（Ｐ＜０．０５）。第四周末和第七周末ＺＰ组光镜下肠粘膜未见异常改变;但是电镜下见肠道粘膜超微结构的严重损害。结论：中毒剂量锌可以引起肠道粘膜超微结构的严重损害;屏障功能削弱,大鼠小肠粘膜的免疫防御能力降低。     

刺梨利康饮对慢性汞中毒脂质过氧化损害的拮抗作用

用８３７－４９μｍｏｌ／Ｌ 含汞水饲养大鼠８ 周,复制出慢性汞中毒模型,然后分别自由饮用含维生素Ｃ６８１２－７６μｍｏｌ／Ｌ 的利康饮和ｉｐ １２５ｍｇ／ｋｇ 二巯基丙磺酸钠（ＤＭＰＳ）３ 周,探讨利康饮和ＤＭＰＳ 对慢性汞中毒大鼠尿汞排泄和脂质过氧化损害的影响。结果发现,慢性汞中毒引起血清、肝、脑和肾还原型谷胱甘肽（ＧＳＨ） 含量显著降低,血清、肝、脑和肾丙二醛（ ＭＤＡ） 含量、尿蛋白含量及尿碱性磷酸酶（ＡＫＰ） 活性显著升高;利康饮可显著增加尿汞排泄和血清维生素Ｃ 含量,并使慢性汞中毒引起的血清、肝、脑和肾ＧＳＨ 含量显著回升,血清、脑和肾ＭＤＡ 含量、尿蛋白含量及尿ＡＫＰ 活性显著回降;ＤＭＰＳ 虽有明显促进尿汞排泄效果和使血清ＭＤＡ 含量显著回降的作用,但对慢性汞中毒引起的其它脂质过氧化损害指标影响不明显。结果表明,刺梨利康饮具有一定排汞效果,并对慢性汞中毒引起的机体抗氧化功能降低和脂质过氧化损害具有明显拮抗作用。     

一起布伦登卢普沙门氏菌食物中毒调查

报道了对一起食物中毒的调查.参加婚宴者131人,其中117人先后在餐后5～56h发生中毒.分析参加婚宴者进食不同食物后的发病情况,认为中毒与进食几种被污染的菜肴有关.现场调查,对可疑食物、中毒者与婚宴食物加工与服务人员粪便标本的检验结果,证实这起食物中毒是因为从业人员中的布伦登卢普沙门氏菌(S.Braenderup)带菌者污染食物所致.提示应加强食品从业人员的健康检查和职业道德教育.以避免类似事件的发生.     

Haemodynamic study as guideline for the use of beta blockers in acute theophylline poisoning

It has been proposed that -blocker therapy reverses metabolic and cardiovascular disorders in acute theophylline poisoning. We present a case of acute theophylline overdose treated with esmolol under haemodynamic control. Haemodynamic monitoring was useful in determining the appropriate duration of administration of esmolol and in deciding on treatment with fluids.     

Effect of delayed administration of activated charcoal on nortriptyline absorption

Summary Activated charcoal is known to reduce the absorption of therapeutic doses of nortriptyline in vivo when administered 30 min after drug ingestion. In a group of volunteers, one sachet (10 g) of a new activated charcoal preparation, Medicoal was found to produce a highly significant reduction in nortriptyline absorption when given as long as four hours after nortriptyline dosing. Activated charchoal may therefore be useful in the treatment of tricyclic antide-pressant poisoning even if a delay of several hours ensues before medical help is sought.     

An acute fatal occupational cadmium poisoning by inhalation

Summary A 43-year-old male smelter was admitted to a hospital on account of severe dyspnea about 2 days after exposure to brownish-yellow smoke produced by melting of copper scrap. On admission pronounced hypoxemia was revealed, and an oxygen-enriched gas was administered after intubation. Although inspired oxygen concentration was gradually increased, hypoxemia progressed and he died on day 11 in hospital.The principal autopsy finding was chiefly confined to the lungs. Both lungs were heavy (the left weighing 1,470 g; the right 1,710 g) and firm to the touch. Histologically, no normal alveoli were found throughout the entire lung. Some alveolar spaces were occupied by pneumocytes, others by organized exudate with fibrosis. Interstitial fibrosis was present. Patchy areas of inflammatory cell infiltrations as well as intra-alveolar hemorrhages were observed. On the basis of the above findings a diagnosis of diffuse alveolar damage was made.Based on the available evidence (presence of cadmium in the copper scrap, feature of the smoke, clinical signs with latent time, and high cadmium concentration of the lung), the diffuse alveolar damage was considered to have been caused by inhaled cadmium. The pulmonary change of the present case was more advanced in pathologic stage in comparison with those reported in the literature.     

纳洛酮加清开灵治疗野生蕈中毒30例疗效观察

目的：观察纳洛酮与清开灵合用治疗急性野生蕈中毒的临床疗效。方法：采用随机数字表法将86例患者随机分为3组。治疗组30例以纳络酮加清开灵治疗，纳洛酮组26例单用纳洛酮治疗，清开灵组30例单用清开灵治疗。观察3组患者症状好转时间、症状消失时间、重症清醒时间。治疗5天为1疗程，共治2－8疗程。结果：治疗组在症状好转时间、症状消失时间、清醒时间均明显短于纳洛酮组和清开灵组（P＜0．05，P＜0．01）。结论：纳洛酮与清开灵合用，可以从不同途径作用于脑组织，尽快改善中毒症状，减少脑损伤，二者合用尚可减少纳洛酮的用量，从而减少纳洛酮的心血管效应。     

急性中毒并多器官功能失常综合征61例临床分析

目的调查急性中毒并多器官功能失常综合征(MODS)的发病情况和转归。方法回顾性分析300例急性中毒患者,其中61例并发MODS。结果61例并发MODS中,死亡14例,病死率22.9％。发生2、3、4、5或5个以上器官功能失常病死率分别为4.7％、15.7％、37.5％、80％。受累器官个数在死亡组和存活组的比较差异显著。结论 不同中毒致MODS的病死率不同,随器官功能失常数目的增加而升高。