Sick individuals and sick populations: Yunnan unexplained sudden death from the perspective of population medicine / 中华地方病学杂志

Individuals and populations affected by Yunnan unexplained sudden death have different causes, so different research methods and control strategies should be adopted for these two different causes. By reviewing relevant research literature on Yunnan unexplained sudden death, we reinterpret some characteristics of the disease from the perspective of population medicine. At the same time, it is found that some studies have shown that residents in areas where sudden death occurs have a higher proportion of myocardial damage compared to control areas, making them a population with basic sickness. Population medicine methods can be used to conduct etiology research and disease prevention and control.

Analysis of acute occupational poisoning events in China during 2006-2016 / 中华劳动卫生职业病杂志

Objective@#To analyze the epidemic characteristics of acute occupational poisoning events in order to state the regularity of outbreak and provide scientific evidences of prevention and control measure in China.@*Methods@#According to the report information from the Management Information System of Public Health Emergency, we analyzed acute occupational poisoning events time distribution, regional distribution, toxicant variety, route of exposure and events detection from 2006 to 2016.@*Results@#The total number of acute occupational poisoning events reported in 26 provinces of China from 2006 to 2016 was 337, causing 2 399 people poisoned, and the fatality rate was 18.09%. Majority of them were higher grade events and the top three provinces of acute occupational poisoning events were Shanghai, Anhui, Shandong. Inhalation is the main cause of poisoning. The acute occupational poisoning events for carrying out poison dectection were accounted for 56.68%.@*Conclusion@#Acute occupational poisoning events in China is reducing year by year, But fatality rate is not decrease. So the country should increase the supervision and management of safety in production, strengthen the safety education of employees and coordination mechanism among different departments.

Analysis of hazard in mushroom poisoning incidents in China mainland / 中华急诊医学杂志

Objective To analyze the epidemic characteristics of mushroom poisoning incident in order to find the regularity of outbreak and provide the fundamental guidelines of prophylaxis,control,diagnosis and treatment.Methods According to the reported information from the Management Information System of Public Health Emergency in China mainland,the area-time distribution of mushroom poisoning incidents from 2004 to 2014 was analyzed,and the descriptive analysis of mushrooms poisoning incidents including causes,places,occupation of victims and incidents identification were made from 2010 to 2014.Results In China (excluding Hong Kong,Macao and Taiwan),the top five provinces of mushroom poisoning incidents were Yunnan,Guizhou,Sichuan,Guangxi and Hunan.The epidemic peak was reached in summer-autumn season.The major and significant incidents accounted for 76.56％ of overall mushroom poisoning incidents,and the fatality rate of 3 701 patients accounted for 21.24％ (786 deaths).The causes were mistaking poisonous mushrooms as edible mushrooms or purchasing poisonous mushrooms in the market by accident.About 87.50％ incidents happened at home.Farmers,workers,children and students were easily subjected to mushroom poisoning because of their large range of activities,strong curiosity and lacking related ability for distinguishing edible mushroom from poisonous mushrooms.No identification was done in 200 mushroom poisoning incidents from 2010 to 2014,which accounted for 92.59％ of mushroom poisoning incidents in the corresponding period.Standard species identification was carried out only in two poisonous mushroom incidents.Conclusions Mushroom poisoning incident was one of the most important causes of death in per-oral poisoning incidents.It should to cope with surveillance and meticulous management during high prevalence season and in high-risk provinces.At the same time,it should be strengthened to train doctors and health professionals with the knowledge of identification of mushroom poisoning in key areas as well as to develop the health promotion of mushrooms poisoning prevention.

Experimental study on acute hepatotoxicity in beagles induced by Amanita exitialis / 中华急诊医学杂志

Objective To establish acute hepatotoxic model induced by Amanita exitialis and to study the characteristics of acute toxic liver failure induced by mushrooms containing peptide toxins,in hope for providing some help to experimental research on poisoning induced by mushrooms containing peptide toxins.Methods UPLC-MS/MS (Ultra performance liquid chromatography-tandem mass spectrometry) method was used to detect peptide toxins in Amanita exitialis.To establish acute toxic liver hepatic failure model,the beagles were fed with 60 mg/kg of lyophilized powder of Amanita exitialis fungus which encapsulated in starch capsules.Toxic sighs were observed,coagulation function,hepatic and renal function,liver histopathological morphology,peptide toxin concentration in plasma and urine were detected during the experiment.Results Total peptide toxins in Amanita exitialis was (3 482.6 ± 124.94) mg/ kg.All the beagles had toxic signs including vomiting and diarrhea in 12-48 h after ingestion.On 24 h after ingestion,the beagles' ALT,AST,TBIL,ALP,PT and APTT levels increased obviously.On 36 h after ingestion,the beagles' ALT,AST,PT and APTT values reached their peaks (ALT:283.2 ± 112.9 Kallmann unit;AST:223.9 ±93.8 Kallmann units;PT:132.9 ± 152.6 s;APTT:131.4 ± 153.9 s).On 48 h after ingestion,the beagles' TBIL and ALP levels reached their peaks (TBIL:23.3 ± 14.6 mol/L;ALP:274.5 ± 115.5 U/L).The beagles' TBIL,TP and APTT returned to normal 1 week after ingestion,their ALT,AST and ALP levels returned to normal 3 weeks after ingestion.Three dogs died during 24-72 h after ingestion.Liver histopathological morphology study showed hemorrhagic necrosis of hepatocytes.Peptide toxins can be detected in plasma within 24 h after ingestion.Peptide toxins can be detected in urine within 96 h after ingestion.Conclusion Amanita peptide toxins can cause hemorrhagic necrosis of liver cells and lead to acute liver failure.This model is consistent with clinical pathophysiological process of acute toxic liver failure induced by mushrooms containing peptide toxins,and it can be applied to the study of diagnosis and treatment of poisoning induced by mushrooms containing peptide toxins.

The rabbit experimental study for toxicokinetics of chlorpyrifos impacted by hemoperfusion / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigate toxicokinetic parameters impacted by hemoperfusion after oral chlorpyrifos exposure, to investigate the adsorption effect of hemoperhusion for chlorpyrifos poisoning.</p><p><b>METHODS</b>12 rabbits were divided into two groups after oral exposure with chlorpyrifos 300 mg/kg body weight. Control group: without hemoperfusion; hemoperfusion group: hemoperfusion starts 0.5 h after chlorpyrifos exposure and lasts for 2h. Blood samples were collected at different times, concentrations of chlorpyrifos were tested by GC, then, toxicokinetic parameterswere calculated and analysis by DAS3.0.</p><p><b>RESULTS</b>In hemoperfusion group, peak time was (7.19±3.74) h, peak concentrations was (1.37±0.56) mg/L, clearance rate was (13.93±10.27) L/h/kg, apparent volume of distribution was (418.18±147.15) L/kg The difference of these parameter were statistically significant compared with control group (P<0.05).</p><p><b>CONCLUSION</b>Hmoperfusion will decrease the inner exposure and load dose of rabbits with chlorpyrifos poisoning.</p>

Effect of acetamide on histopathology in cerebral cortex of rats with tetramine poisoning / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To observe the effect of different doses of acetamide on the histopathology in the cerebral cortex of rats with tetramine (TET) poisoning and to provide a basis for the treatment of fluoroacetamide poisoning with acetamide.</p><p><b>METHODS</b>Eighty clean Sprague-Dawley rats were randomly divided into five groups: saline control group,dimethylsulfoxide water solution control group,TET poisoning group, acetamide (2.88 g/kg/d) treatment group, and acetamide (5.68 g/kg/d) treatment group, with 16 rats in each group. Rats in the poisoning group and treatment groups were poisoned with TET by intragastric administration after fasting; then, saline was injected intramuscularly into rats of the poisoning group, and different doses of acetamide were injected intramuscularly into rats of treatment groups; the course of treatment was 5 d. At 3 h, 12 h, 48 h, and 7 d after treatment, the cerebral cortex was harvested from rats in each group, and the histopathological changes in the cerebral cortex were evaluated under light and electron microscopes.</p><p><b>RESULTS</b>The light microscopy showed that the TET poisoning group had hypoxia changes in the cerebral cortex, which worsened over time; the treatment groups had reduced hypoxia changes, and the acetamide (2.88 g/kg/d) treatment group had more reduction than the acetamide (5.68 g/kg/d) treatment group. The electron microscopy showed that the apoptosis of neuronal cells were the main pathological changes in the TET poisoning group; the treatment groups had reduced apoptotic changes, and the acetamide (2.88 g/kg/d) treatment group had more reduction than the acetamide (5.68 g/kg/d) treatment group.</p><p><b>CONCLUSION</b>No pathological changes associated with the synergistic toxic effect of acetamide and TET are found in the cerebral cortex. Acetamide (2.88 g/kg/d) could reduce central nervous lesions, but the efficacy is not improved after increasing the dose. For patients who cannot be identified with TET or fluoroacetamide poisoning, acetamide could be considered for treatment.</p>

Clinical study of four forms of activated charcoal in treatment of oral poisoning / 中国综合临床

Objective To evaluate the applicability of activated charcoal in treatment of oral poisoning. Methods The feasibility of clinical manipulation and tastiness of 4 forms of activated charcoal were investigated, with different dosage forms in 35 nurses and 50 volunteers, respectively. The feasibility of the clinical manipulation was assessed by gastrelavage time and block numbers of stomach duet,and the tastiness by volunteers' taking orally. Results The gastrolavage time (151.8±17.8) s for powder, (96.9±24.80) s for suspension, (319.0±82.4) s for tablet and (314.3±93.3) s for suspension(P <0.001). Conclusion There are significant differences in the applicability of activated charcoal in different dosage forms. The suspension is the best form in feasibility. Capsule and tablet are better than powder and suspension in tastiness. Suspension and powder are the worst to accept.