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.     

急性有机磷中毒患者晚期氧化蛋白产物动态变化的临床研究

目的探讨晚期氧化蛋白（AOPP）在急性有机磷农药中毒（AOPP）患者中的临床意义。方法采用酶联免疫分析法（ELISA）动态检测90例有机磷农药中毒患者和30例健康对照者血清晚期氧化蛋白的含量，并探讨其与病情的相关性。结果AOPP患者血浆中晚期氧化蛋白含量发病后的第1天〉第3天〉第7天与健康对照组比较，P均〈0．01。血清CRP的含量在患者中毒后的第1天〉第3天〉第7天与健康对照组比较，P均〈0．01。在发病的第1天，AOPP患者血清晚期氧化蛋白和CRP的含量重度中毒组〉中度中毒组〉轻度中毒组与健康对照组比较，P均〈0．01。在第1天，AOPP患者的病情程度即MODS的评分值与血清晚期氧化蛋白和CRP的含量均呈明显的正相关性（r1=0．590和r2=0．627，P均〈O．01），而血清晚期氧化蛋白和CRP的含量之间也呈明显的正相关性（r3=0．792，P〈0．01）。结论晚期氧化蛋白的含量随急性有机磷农药中毒患者的病情和炎症反应加重而升高。晚期氧化蛋白可能参与了有机磷农药中毒患者发生多脏器功能障碍的病理生理过程。     

The relationship between exposure duration,carboxyhemoglobin, blood glucose,pyruvate and lactate and the severity of intoxication in 39 cases of acute carbon monoxide poisoning in man

The relationship between exposure duration, COHb, blood glucose, pyruvate and lactate and the severity of intoxication was investigated in a group of 39 cases of acute CO poisoning treated in the Clinical Toxicology Center in ód, Poland.On the basis of clinical criteria the patients were classified into cases of mild, moderate, severe and very severe CO poisoning. COHb and carbohydrate metabolites were estimated in venous blood taken immediately after admission of the patient to hospital prior to treatment.The severity of intoxication did not correlate with blood COHb; variation in exposure duration seems to be responsible for this phenomenon. Severe and very severe poisonings were associated with longer exposures and were accompanied by a markedly higher blood lactate level, compared to mild and moderate cases. Blood pyruvate depended less than lactate on the severity of intoxication. Blood glucose depended neither on exposure duration nor on the severity of intoxication.Among the carbohydrate metabolic parameters studied, blood lactate determination can be helpful in the evaluation of the severity of CO poisoning in man.     

Recreational gasoline sniffing: acute gasoline intoxication and latent organolead poisoning. Case reports and literature review

Gasoline is a readily obtainable intoxicant that unfortunately lends itself to habitual abuse by sniffing, a practice found particularly among children and adolescents. The concerted effects of the multiple hydrocarbon and other constituents of gasoline result in a predictable acute toxic syndrome. Organoleads, primarily tetraethyl lead (TEL), cause a separate toxicologic symptom-sign complex that overlaps with the initial acute toxic syndrome. The different clinical symptomatology, effects on hemoglobin synthesis, and response to chelation therapy are all in keeping with the view that organolead poisoning is a separate and distinct toxicologic entity from that of classical elemental lead poisoning or "plumbism".     

Patterns of coverage of psychiatric emergencies

A massive change in the detection of psychiatric cases in the emergency room was recorded when pattern of coverage was changed from "on-call" basis to "continuous physical presence" of psychiatry residents in the emergency room.     

2010—2020年云南省学校食源性疾病暴发事件流行病学分析

目的 了解云南省学校食源性疾病暴发事件流行病学特征和趋势。 方法 收集2010—2020年云南省各地报告的学校食源性疾病暴发资料,并进行描述性流行病学分析。 结果 2010—2020年共发生学校食源性疾病暴发260起,发病6 600人,死亡2人,总体呈下降趋势。学校食源性疾病暴发高峰期为第二、四季度,占总起数的66.54%(173/260);暴发场所多发生在小学,占总起数的58.08%(151/260)。报告明确或可疑致病因子的185起事件中由微生物或可疑微生物引起的占40.00%(74/185),毒素引起的占46.49%(86/185);明确致病因子的118起暴发事件中,60.17%(71/118)是由4种致病因子引起的,其中蓖麻毒素导致的最多,达22起(18.64%),发病人数428人,其次是蜡样芽孢杆菌20起(16.95%),原因食品被归因为一类食品植物类,主要是大米、三明治、面包。导致暴发污染环节最多的是生产加工环节(50.77%,132/260)。 结论 关注学校食源性疾病暴发事件流行特征,在学生开学季时,加强对小学食堂植物类食品的生产加工环节管理和监督。微生物、毒素感染是学校食源性疾病主要的致病因素,且原因查明率低,进一步强化医疗机构食源性疾病微生物、毒素检测能力,提高原因查明率,最大限度地降低学校食源性疾病的发病率。     

放射卫生机构在核辐射卫生应急体系作用探讨

分析和探讨放射卫生机构在核辐射卫生应急体系中发挥的作用。通过对比发现,核辐射紧急医学救援基地多由取得放射卫生技术服务（甲级）资质或放射性疾病诊断机构资质的单位承担建设任务。放射卫生机构在平时工作中积累的辐射监测、污染检测、剂量估算、健康效应评价等技术能力可在核辐射卫生应急处置中发挥重要作用,实现能力建设的“平急结合”。建议各级放射卫生机构继续发挥自身所长,通过参加放射卫生监测项目的机会提高自身能力,并积极参与放射卫生技术机构检测能力考核,为核辐射卫生应急工作做好人才和技术储备。     

一起赤潮后海产品麻痹性贝类毒素衰减结果分析

目的 以2017年漳州沿海一起赤潮引起的麻痹性贝类毒素(paralytic shellfish poisoning,PSP)中毒事件为研究起点,研究贝类海产品中的PSP在自然条件下的衰减情况。方法 在漳浦佛昙和龙海港尾海域采集牡蛎和贻贝进行PSP检测。结果 2017年6月8日相关海域海产品最大毒素总毒力为21 056.7 μg/kg,2017年6月26日海产品PSP总毒力值衰减86%以上,2017年7月20日海产品PSP总毒力值衰减97%以上,2018年12月所有海产品中PSP均未检出。结论 本次赤潮发生后,漳浦佛昙和龙海港尾两个海域贝类海产品约需45天净化周期方可食用,相关海域约需18个月净化至贝类毒素完全消失。