一氧化碳中毒迟发性脑病的临床预防

目的　探讨临床治疗措施对一氧化碳中毒迟发性脑病的预防。方法　将 130例一氧化碳中毒患者随机分为A、B、C 3组 ,A组采用纳络酮、低分子肝素、高压氧治疗 ;B组采用胞二磷胆碱、醒脑注射液、高压氧治疗 ;C组采用胞二磷胆碱、醒脑注射液治疗。结果　A组昏迷时间与B、C组对比 ,B组与C组对比 ,明显缩短 ,有显著性差异 (P <0 .0 5或P <0 .0 1) ;本组 130例患者中 ,共发生迟发性脑病15例 ,发生率为 11.5 % ,迟发性脑病发生率A组与B、C组对比 ,B组与C组对比 ,明显降低 ,有显著性差异 (P <0 .0 5或P <0 .0 1)。结论　选择有效的药物 ,及早应用高压氧和充足的疗程是迟发性脑病临床预防的关键。     

职业性慢性轻度苯中毒诊治分析

目的 对长期慢性接触苯及同系物患者进行职业病诊断.方法 依据卫生部《职业健康监护管理办法》中的《职业健康检查项目及周期》中的要求,对患者进行职业健康检查,依据GBZ68-2002《职业性苯中毒诊断标准》的有关规定对患者进行复查.结果 该患者在3个月内每1～2周复查1次全血,白细胞计数持续低于4×109/L并常有头晕、头痛、乏力、失眠、记忆力减退等症状,依据GBZ68-2002《职业性苯中毒诊断标准》诊断为职业性慢性轻度苯中毒.结论 长期慢性接触苯可引起造血系统损害.     

营养性驱铅饮料的研究

本文研究营养性驱铅饮料的动物和人群试验。饮料与铅料动物组间比较,饮料组动物的尿、粪排铅量高,分别是对照组的1.5倍和1.1倍;血、肝、肾中含量低;体内 Zn、Cu、Fe 等微量元素基本稳定。其体重增长与对照组相一致。人群试验:试验组尿铅排出明显,试验末(2月后)仅为试验初的21.7%;血铅平均减少0.39μmol/l;血中 Hb、δ-ALAD 和尿中δ-ALA 等均恢复良好;不影响体内Zn、Cu 等微量元素,无不良反应。     

汞对人体必需元素干扰的研究

对42例汞吸收、2例汞中毒者(尿汞>99.7nmol/L),采用原子吸收光谱法,检测了汞对人体必需五种金属元素代谢的干扰。研究发现,汞时人体必需元素镁、铜具有拮抗作用。汞吸收者血清镁极显著低于对照组(P>0.01)。经驱汞治疗后,血清镁、铜自然上升与对照组无统计学差异(P>0.05),镁离子低下,可出现神经肌纤维兴奋性增高。由此推测,汞引起肌肉震颤的毒理,可能由汞拮抗镁离子低下引起。设想,对汞中毒者采用补镁制剂治疗,是否具有驱汞作用值得探讨。     

Fatal poisonings in Jutland (Denmark) during the 1980s

Summary During the period 1980 through 1989 a total of 1029 cases of fatal poisoning (638 men and 391 women) were examined at the Department of Forensic Medicine, Aarhus University, Denmark. In 68% of the cases death had been caused by drugs, whereas acute alcohol poisoning and carbon monoxide accounted for 15% and 14% of the cases, respectively. Alcohol was detected in more than half of the 1029 fatal poisoning cases, and in 42% of all cases the blood alcohol concentration was above 0.8 g/kg. In 57% of the cases death was categorized as accidental, only in 31% of the cases as suicide. Accidental deaths were especially predominant amongst drug and/or alcohol abusers. Propoxyphene was the drug found to have caused most fatal poisonings during the decade (30% of the drug-related deaths). Most of the propoxyphene-related deaths occurred during the early and mid-eighties. Barbiturate poisonings were quite frequent during the first half of the eighties. However, the number of deaths caused by barbiturates decreased significantly after 1986, when most barbiturates were withdrawn from the market. The number of deaths caused by narcotics and analgesics increased during the survey period, while no specific tendency was observed concerning antidepressants.     

NaFeEDTA预防大鼠铅中毒的研究及其对锌、铜的影响

为探讨乙二胺四乙酸铁钠 (NaFeEDTA)在预防大鼠铅中毒及减低铅毒性中的作用 ,同时研究其对锌、铜二元素的影响 ,采用随机分组的动物实验设计方法 ,将 60只Wistar大鼠随机分为空白对照组、模型对照组、阳性药物组和高、中、低NaFeEDTA组 ,共 6组 ,除空白对照组外 ,对其余各组大鼠进行持续性染铅 ,而且除模型对照组外的 4个染铅组分别同时给予二巯基丁二酸 (DMSA)、高、中、低浓度的NaFeEDTA溶液。 5周后实验结束 ,对相关指标进行测定。结果显示 ,三个NaFeEDTA组的血红蛋白含量均显著高于其它各组 ,同时其血铅、脑铅、肝脏铅、肾脏铅及胫骨铅含量显著低于模型对照组 ,而且它们的肝脏铅、肾脏铅和胫骨铅含量与每日每只大鼠铁补充量之间存在显著负相关 ,相关系数分别为 - 0 4432、- 0 61 34和 - 0 3878;除中、高浓度NaFeEDTA组的脑锌水平低于模型对照组以及低浓度NaFeEDTA组的肾脏铜含量高于模型对照组外 ,其余各NaFeEDTA组的脏器锌、铜含量与模型对照组相比均无显著性差异。提示NaFeEDTA可有效提高大鼠的血红蛋白含量 ,能够预防大鼠铅中毒 ,减低铅对大鼠的毒性作用 ;同时对体内锌、铜含量无太大影响     

MRI of the brain in chronic carbon monoxide poisoning

We examined 13 patients with chronic carbon monoxide (CO) poisoning by magnetic resonance imaging (MRI); all of them had been in an explosion in a coal mine 25 years previously. Symmetrical globus pallidus lesions were observed in 12, as was degeneration of the white matter, with focal cortical atrophy. The temporal parietal and occipital lobes were usually affected, the parietooccipital region being the most frequently and extensively damaged. Of the 12 patients with white matter degeneration 7 had definitely asymmetrical cortical and subcortical lesions. There were 6 patients with dilated temporal horns, probably due to atrophy of the hippocampal gyri. A history of CO inhalation and an awareness of the typical distributions of lesions are important for recognition of the effects of CO poisoning, especially when patients are in the chronic stage.     

Plant cardiac glycosides and digoxin Fab antibody

The potential application of the Digoxin Fab antibody (Wellcome Digibind) in the clinical management of plant poisoning was investigated. The cardiac glycoside contents of various Australian plants were studied using immunoassay techniques. The cross-reactions of the Fab antibody and two digoxin assay antibodies against extracts of these plants were also studied. Results obtained indicated that the Digibind antibody cross-reacted with a wide range of glycosides contained in Australian plants and therefore could be of use in the treatment of life-threatening plant poisoning.