Acute liver injury,acute liver failure and acute on chronic liver failure: A clinical spectrum of poisoning due to Gyromitra esculenta

Gyromitra esculenta, also known as “false morel” is one of the most poisonous mushrooms. This species is found all over the world, growing in coniferous forest in early spring time. Common manifestation of poisoning includes gastrointestinal symptoms which include varied degrees of liver impairment.We describe three cases: acute liver injury, acute liver failure and acute-on-chronic liver failure due to G. esculenta poisoning. At admission patients presented with encephalopathy and features of liver failure. Two of them recovered completely following supportive management while the remaining patient who also had preexisting liver disease developed multiorgan failure and subsequently died.Although a rare occurrence, G. esculenta poisoning should be considered in the differential diagnosis of acute liver failure.     

Successful avoidance of superior vena cava injury during transvenous lead extraction using a tandem femoral-superior approach

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急性一氧化碳中毒后迟发性脑病的临床表现和影像学特点

目的探讨急性一氧化碳中毒后迟发性脑病的临床表现和影像学特点及其诊断价值。方法回顾性对23例急性一氧化碳中毒后迟发性脑病的临床表现和影像学特点进行归纳和分析。结果23例患者中智能障碍23例（100％），言语功能障碍17例（73.9％），另有共济失调精神障碍帕金森综合症及尿失禁等。头部CT和MRI主要表现为皮层下脑白质异常信号及基底节区或苍白球区异常信号，极少累及大脑皮质脑干和小脑。结论急性一氧化碳中毒后迟发性脑病的诊断主要依靠病史和临床症状，MRI比CT更有诊断价值。     

存样食物在追查食物中毒源头中的作用

[目的]针对食物中毒事件追查源头的困难局面,探索1种新的食物中毒追查方法。[方法]通过分析各种常见类型食物中毒的潜伏期,结合各种实际情况,探讨存样食物保存的时间和方法。[结果]存样食物至少要保存24h。[结论]这种存样待检方法有其先进性,但仍存在不少问题,需进一步改进。     

CS_2作业工人血清脂质过氧化水平与LDH同功酶谱研究

ＣＳ_２作业工人血清脂质过氧化水平与ＬＤＨ同功酶谱研究张文昌，连祥霖，张连娜，杨乃富（福建医学院劳动卫生学教研室，福州３５０００４）结果表明，高接触水平组（浓度为１０．４２～４６．５４ｍｇ／ｍ３或Σｍｇ·年≥５０）血清ＬＰＯ含量与对照比较，显著性增高?..     

aVR sign as a risk factor for life-threatening arrhythmic events in patients with Brugada syndrome

BACKGROUND: Risk stratification in Brugada syndrome (BS) is controversial, especially in asymptomatic individuals. OBJECTIVE: The aim of this study was to evaluate the significance of lead aVR in patients with BS. METHODS: Twenty-four patients with the electrocardiogram pattern of BS (24 male, mean age 32.1 +/- 13.6 years) and 24 healthy age- and gender-matched controls were studied. RESULTS: Thirteen patients were symptomatic. The R-wave amplitude or R/q ratio in lead aVR was significantly greater in patients experiencing a recurrence compared with those who did not. The aVR sign was defined as R wave >/= 0.3 mV or R/q >/= 0.75 in lead aVR. Most of the recurrences (78%) were in patients with present aVR sign; 84% of BS patients with present aVR sign had events during follow-up. In contrast, only 27% of BS patients with absent aVR sign had events during follow-up. CONCLUSION: Our study shows significant correlation between a prominent R wave in lead aVR (aVR sign) and risk for development of arrhythmic events in BS. In the presence of BS, prominent R wave in lead aVR may reflect more right ventricular conduction delay and subsequently more electrical heterogeneity, which in turn is responsible for a higher risk of arrhythmia.     

脐血铅水平与妊娠结局及影响因素的关系

目的 :了解本地区脐血铅水平现状及其妊娠结局与妊娠并发症 ,新生儿体格发育及神经行为发育的关系 ,并探讨脐血铅与环境因素的关系。方法 :采用 HB2 10 0原子吸收光谱仪用原子吸收法测定 178例经剖宫分娩的新生儿脐带血水平 ,同时观察孕妇妊娠与分娩期有无合并症与并发症 ,并于新生儿出生后即刻测量体重、身长 ,2 4 h内测量头围、胸围和腹围 ,采用神经行为发育量表 ,对出生后 4 2 d的 5 0例婴儿进行神经行为发育评分。同时对产妇家庭环境等相关因素进行问卷调查。结果 :178例脐血铅最高值 12 2 μg/ L,最低值 1μg/ L,中位数 36 μg/ L,脐血铅≥ 10 0 μg/ L 者 6例 ,占3.33%。脐血铅水平与妊娠并发症无明显相关性 ,与新生儿体格发育及神经行为发育评分无明显相关性。新生儿血铅水平与环境因素 (家庭住址、居室新旧、家庭经济情况、职业等 )差异有显著性 ,P<0 .0 5。结论 :本组脐血铅水平与孕期并发症及新生儿体格发育及神经行为发育评分无明显关系。脐血铅水平与环境因素有关。     

气管切开与呼吸机机械通气抢救有机磷农药中毒致呼吸肌麻痹6例

目的：探讨气管切开与呼吸机机械通气抢救重度有机磷农药中毒（ＡＯＰＰ）致呼吸肌麻痹的疗效。方法：对６例重度ＡＯＰＰ致呼吸肌麻痹患者在综合治疗基础上，及时予气管切开，并使用全能呼吸机机械通气。结果：治愈５例，死亡１例。抢救成功率达８３．３％。结论：对重度ＡＯＰＰ患者及时行气管切开，并使用全能呼吸机机械通气，抢救效果良好。     

A study of the relationship between ambient lead and blood lead among lead battery workers

 Objective: To examine the relationship between ambient lead levels and blood lead levels and to explore the modifiers of the relationship between ambient lead and blood lead. Method: A cross-sectional study was conducted in two lead battery factories. Blood lead level and ambient lead concentration were measured for each participant concurrently. A structured questionnaire was administered to collect sociodemographic characteristics and occupational history. Design: Biological and personal environmental measurements of 219 lead-exposed workers were analyzed by both simple and multiple linear regression. A regression model was selected for interpretation. Results: A high correlation (r=0.62) between ambient lead (PbA) and blood lead (PbB) was observed. In addition, numerous factors, including age, sex, alcohol consumption, personal hygiene practice and type of lead exposure, were also found to influence blood lead levels. Although PbB was highly correlated with PbA, blood lead level may not be effectively lowered by reducing ambient lead level. Based on the regression coefficients, improvement of hygienic practice was more effective at lowering PbB than reducing ambient lead level. Good hygienic practice may be the preferential way to reduce lead exposure in current conditions. Conclusion: Education of correct work practice may be more important than engineering control in the developing countries to lower blood lead levels in lead battery factories. Received: 28 May 1996/Accepted: 30 August 1996