Macroscopic hematuria in wasp sting patients: a retrospective study

BackgroundMacroscopic hematuria after wasp sting has been reported in Asia to occur before acute kidney injury (AKI), and is often used by clinicians as a sign indicating the need for intensive care and blood purification therapy. However, there is no study on the clinical characteristics and prognosis of this symptom.MethodsThe clinical data of 363 patients with wasp sting admitted to Suining Central Hospital from January 2016 to December 2018 were retrospectively analyzed. At admission, the poisoning severity score (PSS) was used as the criterion for severity classification. According to the presence of macroscopic hematuria, the patients were divided into macroscopic hematuria and non-macroscopic hematuria group.ResultsOf the 363 wasp sting patients, 219 were male and 144 were female, with a mean age of 55.9 ± 16.3 years. Fifty-one (14%) had macroscopic hematuria, 39 (10.7%) had AKI, 105 (28.9%) had rhabdomyolysis, 61 (16.8%) had hemolysis, 45 (12.4%) went on to received hemodialysis, and 14 (3.9%) died. The incidence of AKI in macroscopic hematuria group was 70.6%, and oliguric renal failure accounted for 72.2%. Patients with macroscopic hematuria had significantly higher PSS (2.2 ± 0.5 vs. 1.1 ± 0.3, p < .001).ConclusionMacroscopic hematuria can be regarded as a surrogate marker of deteriorating clinical outcome following wasp stings. In wasp sting patients with symptoms of macroscopic hematuria or serum LDH higher than 463.5 u/L upon admission, the risk of AKI increases significantly, therefore hemodialysis should be considered. The PSS is helpful in early assessment of the severity of wasp sting patients.     

国产氟马西尼的临床应用

探讨苯二氮 艹卓 受体拮抗剂 氟马西尼治疗昏迷的临床价值。结果表明 :氟马西尼治疗后 15 ,30 ,6 0和 180minMGCS得分较治疗前依次增加 5 3,8 0 ,9 4和 7 3分 ,较常规药物组分别增加 5 2 ,7 7,8 7和 6 9分 (P <0 .0 1)。治疗后OAA/S得分也较治疗前增加 1 9分 (P <0 .0 1)。治疗过程中除少数患者出现轻度激越现象和窦性心动过速外 ,未发现其它副作用。提示氟马西尼能有效地拮抗因急性苯二氮 艹卓 类药物中毒而引起的意识障碍 ,具有较好的抗昏迷作用     

大鼠急性氧中毒后全脑细胞能量代谢的活体^31P磁共振谱 …

目的：探讨大鼠急性氧中毒后脑的能量代谢产物与脑细胞内ＰＨ变化的规律。方法：采用磁共振方法,用４．７Ｔ动物磁共振谱仪,检测氧中毒后不同时程各种磷酸化合物与无机磷酸根（Ｐｉ）、磷酸肌酸（ＰＣｒ）与γ－ＡＴＰ以及β－ＡＴＰ与Ｐｉ之间的比值,并根据Ｐｉ的化学位移推算脑细胞内ＰＨ值。结果：氧中毒组物舱１和３小时后ＰＣｒ／Ｐｉ,ＰＣｒ／γ－ＡＴＰ以及β－ＡＴＰ／Ｐｉ值均显著降低;５ｈ后恢复正常;２４和４８小时     

慢性砷中毒自觉症状和皮肤改变影响因素的Logistic分析

目的探讨慢性砷中毒患者自觉症状、皮肤色素异常丑过度角化的影响因素。方法选择山西大同地区山阴县黑疙瘩乡大营村进行调查问卷及体检,结果进行单因素及多因素Logistic逐步回归分析。结果单因素分析提示,年龄、迁入时间、饮含砷井水时间、吸烟、饮茶等与自觉症状、色素异常及皮肤角化显著相关,水果是保护因素。多因素Logistic逐步回归分析结果表明,年龄、迁入时间是自觉症状的主要危险因素;年龄是色素异常的主要危险因素,水果摄入是保护因素;年龄、迁入时间、饮含砷井水时间是皮肤过度角化的主要危险因素,水果摄入是保护因素。结论自觉症状及皮肤改变主要与砷的撮入及蓄积量有关。砷中毒病区地理环境背景也是影响皮肤改变的因素之一。水果等抗氧化物质的摄入可能起保护作用。     

Children's Health and the Environment—The First Herbert L. Needleman Award Lecture

Children today are exposed extensively to toxins in the environment. Prominent among these are exposures to over 70,000 synthetic chemicals, all newly developed in the past 50 years and largely untested for their hazards to children's health. Children are uniquely vulnerable to toxins, and with increasing incidence they are developing chronic, disabling, life-threatening diseases known or suspected to be of environmental origin–asthma, endocrine disruption, cancer, and the diseases caused by tobacco. Pediatricians need to consider toxic etiologies in the differential diagnosis of childhood illness.     

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.