大鼠吸入性乙酸酐中毒的病理观察

为了观察吸入乙酸酐后机体的病理变化，在染毒柜中让大鼠吸入乙酸酐，然后在光镜下观察其吸入性损伤。结果显示：（1）急性肺水肿；（2）小支气管、细支气管粘膜凝固性坏死，炎症细胞浸润；（3）小支气管早期痉挛，后期扩张。表明引起这些损伤是由于乙酸酐对粘膜的刺激和腐蚀作用。     

鱼胆中毒的实验病理研究

40只Wistar 大鼠随机分为3个实验组和1个对照组。实验组分别以6. 9ml/kg、4. 6ml/kg 和2. 3ml/kg 剂量灌服草鱼胆汁。每3天一次,共5次。结果表明:实验大鼠肾近曲小管上皮细胞广泛变性坏死,其AKP 酶活性明显下降;血清BUN 显著增高。提示急性鱼胆申毒在病程迁延时主要损害肾脏,其死因为急性肾功能衰竭。本实验较成功地复制出鱼胆中毒的动物模型。     

急性及己中毒的实验病理学研究

目的探讨及己对小鼠毒性作用的病理变化及其毒作用机制。方法应用及己水煎液对小鼠经口急性染毒,进行组织病理学观察血清生化、凝血机能检测。结果及己对小鼠的半数致死量(LD50)为41.12g/kg;染毒小鼠血清ALT和BUN升高;血液血小板计数减少、凝血时间延长;肝、脾、肾器官系数增大;肝、肾、心肌细胞变性、坏死明显,全身诸多器官淤血、出血性改变。结论及己毒作用的主要靶器官或靶组织是肝脏、肾脏、心脏和全身血管。毒作用机制是对线粒体、内质网等膜性结构及体内凝血机制的破坏。     

毒鼠强中毒尸检5例病理分析

毒鼠强（Tedlenwhsuhaetrannne或TetranUne简写为TIC：IS），化学名为四次甲基二现四胺，由西德拜尔公司于1949年首先合成，在国外Tit：：IS曾被用于杀鼠剂，因对哺乳类动物有极强的毒性，能引起二次中毒及污染环境，所以一直未大规模用于灭鼠并被禁用。1991年，我国国家化工部、农业部农药检定所分别发文指出：“是剧毒急性杀鼠剂，有严重的二次中毒作用。这种杀鼠剂与氟乙酸胺类似，且毒性更高，属禁用品种”。但我国仍有少数地下工厂非法生产，因而TIt：］：S所致的中毒时有发生，但其毒理作用、临床表现等尚未被广大的临床及法医…     

1例乐果中毒恢复期猝死的尸检病理分析

１例乐果中毒恢复期猝死的尸检病理分析陈龙，黄光照，刘良（同济医科大学法医学系，湖北４３００３０）有机磷农药乐果属于中毒类，ＬＤ５０为１００～１０００ｍｇ／ｋｇ，经口吸收的毒性较大。生产使用上的相对毒性低和进入体内的绝对毒性高，使乐果具有毒性的两重性。...     

鲤醇硫酸酯钠急性中毒的实验病理研究

鲤醇硫酸酯钠（纯度99．2％），给小鼠腹腔注射，测得LD50为115．15mg／kg。40只小鼠随机分为4组，三个实验组分别以1．5LD50、1．0LD50和0．5LD50剂量腹腔注射染毒。结果表明，实验鼠肾小管上皮变性坏死；心肌细胞水变性，可见多发性肌溶灶；肝有单细胞性坏死。与草鱼胆汁中毒的病变基本相似。提示鲤醇硫酸酯钠是草鱼胆汁的主要毒性成分，主要损害肾，心肌，肝等脏器。     

急性斑蝥中毒的实验病理学研究

本文报告斑蝥急性中毒的实验病理学研究,结果显示,实验组大鼠血白细胞增高,淋巴细胞比值下降;血清GPT、GOT及BUN增高;肾G6P酶和ATP酶活性下降;脾、肾脏器系数增大;肾、肝细胞变性、坏死明显,淋巴器官的淋巴细胞变性坏死显著,胃、肠、膀胱等粘膜有出血、坏死。提示急性斑蝥中毒对淋巴组织具有免疫抑制作用,其中毒靶器官为淋巴器官、肾和肝。     

急性博落回中毒的实验病理学研究

目的 探讨博落回中毒作用的靶器官、靶组织和病变特点,以及博落回中毒机理。方法 应用博落回水煎液对大鼠经口急性染毒,行组织病理学和重要脏器电镜检查及血清生化检测。结果 博落回对大鼠的半数致死量(LD50)为19.5g/kg,染毒大鼠血清谷丙转氨酶(GPT)、肌酐(Cr)、尿素氮(BUN)、肌酸激酶(CK)及其同功酶(CK-MB)增高;心电图(EKG)表现异常;肝、脾、肾脏器系数减小。光镜下中毒大鼠心、脑、肝、肾等器官呈淤血、出血性改变;电镜下中毒大鼠心、脑、肝、肾细胞内线粒体、内质网、核膜等膜性结构破坏。结论 博落回毒作用的主要靶器官或靶组织是心、脑、肝、肾,病变特点为受累脏器淤血、出血性变;毒作用的主要机理是对线粒体、内质网和核膜等膜性结构的破坏。     

亚急性黄药子中毒的实验病理学研究

目的 研究黄药子对小鼠毒性作用的病理变化及其毒作用机制。方法 按1/4LD_(50),1/10LD_(50),1/30LD_(50)剂量给ICR小鼠连续灌服200％的黄药子水煎剂,观察中毒小鼠各主要器官的组织学与超微结构变化,酶组织化学检查及血清生化检测。结果 中毒小鼠肝细胞脂肪变性,糖原增多,严重者可见灶性坏死;肾小管上皮细胞变性、坏死。通过酶组织化学方法发现肝脏SDH酶和G-6-P酶活性下降,血清ALT和BUN升高。结论 黄药子毒作用的主要靶器官或靶组织为肝和肾。毒作用机理是对线粒体、内质网等膜性结构的破坏导致酶活性的降低,影响代谢。     

溴甲烷中毒致死1例

1案例2001年9月中旬某夫妻俩相继出现身体不适,头晕、精神萎靡不振、走路不稳,醉酒步态等症状。10月开始出现神志恍惚、行走不稳、言语不清等于20日被邻居送往医院住院治疗。丈夫入院检查:BP100/70mmHg(13.3/9.33kPa)心律齐,双肺呼吸音粗,神志模糊,躁动,不对答,针刺痛觉不配合,     

Ethylene glycol poisoning

A 40-year-old man was admitted to the emergency department after a suicide attempt. The patient was found at home unconscious, with an open bottle of antifreeze near him. The patient was in a coma on admission, but neurological examination excluded intracranial changes. Results of initial urine and serum toxicological screening tests were negative. Laboratory values indicated metabolic acidosis, leukocytosis, urinalysis revealed hematuria and unrecognized crystals. Osmolality and osmol gap were not determined on patient admission. Treatment with ethanol as an antidote and hemodialysis were started because of metabolic acidosis, anamnestic data and clinical status of the patient, and subsequently led to improvement of his condition. Further toxicological analyses of glycolic and oxalic acids in serum and urine samples were performed by ion-chromatography (IC) method and showed high values in spot urine and serum ultrafiltrate at admission, but during therapy the values progressively decreased. Treatment of poisoned patient for 3 weeks resulted in complete recovery.     

中毒死亡案件的法医学分析

目的分析中毒性死亡案件和与中毒死亡有关的医疗纠纷案件的法医学特点,探讨此类案件的防护重点和鉴定要点。方法对四川大学法医学院1985～2004年106例中毒死亡尸体剖验病理材料进行回顾性统计分析。结果性别:男性61例,女性45例,男女比例1.36:1;年龄:以21～40岁年龄组(60.38%)为主;死亡方式:意外死亡最多见(52.83%),其次为自杀(33.02%)和他杀(14.15%);死亡原因:CO中毒、有机磷类中毒、毒鼠强及药物中毒多见(72.64%);医疗纠纷:发生医疗不当12例(11.32%),7例为医源性中毒性医疗纠纷,5例为中毒后在医院抢救中发生的医疗纠纷,主要发生于乡镇医院和县级医院(83.33%)。结论加强毒物的管理、提高安全意识、加强法制教育、增加生产安全等是减少中毒性死亡的重要手段。提高城乡医疗水平,加强中毒急诊抢救临床技能是防止中毒性医疗纠纷的关键。     

东莨菪碱的GC／MS检验

目的用气质联用方法分离定性案件检材中微量的东莨菪碱成分。方法以液-液萃取法提取分离,用CP5860(CP-sil8CB)毛细管拄(30m×0.25mm×0.33!m),并采用气质联用仪(GC/MS)测定东莨菪碱。结果可检出检材中微量东莨菪碱,色谱分离良好。结论以气质联用仪(GC/MS)测定东莨菪碱方法灵敏度高,测定结果准确可靠。     

Criminal poisoning of commuters in Bangladesh: prospective and retrospective study

Travel-related poisoning is an emerging social and public health emergency in Bangladesh but its cause and significance have not been determined. To investigate this syndrome we performed a prospective clinical study and retrospective analysis of hospital records in a general medicine unit of a public tertiary care teaching hospital in Dhaka, Bangladesh, using toxicological analysis by fluorescence polarization immunoassay (FPIA) and liquid chromatography coupled to time-of-flight mass spectrometry (LC-TOF MS). The participants of the prospective study were 130 consecutive patients aged 16-80 years who were admitted with central nervous system depression (Glasgow Coma Score 3-14) after using public transportation, in the absence of other abnormalities, from January through June 2004, and a convenience sample of 15 such patients admitted during 3 days in May 2006. In 2004-2006, travel-related poisoning increased from 6.1 to 9.5% of all admissions (210-309 of 3266-3843 per year), representing 46.6-55.7% of all admitted poisoning cases. Incidents were associated with bus (76%), taxi, train, and air travel, or local markets; 98% of patients remembered buying or accepting food or drinks before losing consciousness. Direct financial damage (missing property) was diverse and frequently existential. Among 94 urine samples analyzed by FPIA, 74% tested positive for benzodiazepines. Among 15 urine samples analyzed by LC-TOF MS, lorazepam was detected in all; five also contained diazepam or metabolites; nitrazepam was present in three. FPIA results obtained for these 15 samples were below the recommended cut-off in eight (53%; lorazepam only). Our findings show that the massive medicosocial emergency of travel-related poisoning in Bangladesh is the result of drug-facilitated organized crime and that benzodiazepine drugs are used to commit these crimes, suggesting modifications to the local emergency management of the victims of this type of poisoning. They also highlight the need for more research in the neglected field of acute poisoning in Bangladesh, and for criminal investigations of the use of benzodiazepine drugs in this country.     

毒鼠强中毒大鼠脑神经元GABA_A α1受体的检测

目的探讨GABAAα1受体在毒鼠强中毒大鼠脑组织中的变化及其机制。方法选择健康Sprague-Daw-ley大白鼠30只,分成5组,每组6只;分别以2.0 LD50、1.0 LD50、1/2 LD50、1/10 LD50毒鼠强量,采用灌胃染毒方法制作毒鼠强中毒模型,并以健康大鼠灌服生理盐水为对照;断颈处死大鼠,提取脑皮质、海马及脑干脑桥等脑组织进行免疫组织化学染色,观察GABAAα1受体阳性染色神经元的变化。结果不同LD50量染毒大鼠的皮层、海马及脑干,其GABAAα1受体免疫组化阳性染色神经元较对照组组减少,其中以1.0 LD50、1/2LD50组减少最为显著;相同染毒剂量,以脑干组织减少最多。结论GABAAα1受体表达下降与毒鼠强中毒机制相关。     

CI-mass fragmentographic analysis of methamphetamine and amphetamine in human autopsy tissues after acute methamphetamine poisoning

A 22-year-old male methamphetamine abuser was put under police protection owing to his abnormal state of excitation, but died 1 h later. Distribution of methamphetamine and amphetamine in the body was analyzed by the chemical ionization mass fragmentographic method. Amphetamine/methamphetamine concentrations (μmol/100 g) were $\text{0.24}\text{5.59}$ in blood, $\text{0.41}\text{9.43}$ in liver, $\text{0.41}\text{10.02}$ in brain, $\text{0.37}\text{9.80}$ in kidney, $\text{0.18}\text{4.57}$ in muscle, $\text{0.02}\text{0.63}$ in subcutaneous fat and $\text{1.87}\text{1464}$ in gastric contents. Total amount of methamphetamine hydrochloride in stomach contents was about 54 mg. Amphetamine concentrations in tissues ranged from 3.2% to 4.3% of methamphetamine, and was 0.1% in stomach contents. Amphetamine in tissues seems to be a metabolite of methamphetamine, and amphetamine in gastric contents is presumed to result from gastric mucous excretion. The blood concentration of methamphetamine was at a fatal level, and the total amount of the drug in gastric contents indicates that fatal poisoning occurred by ingestion.     

三甲基硫赶磷酸酯在甲胺磷农药中毒检验中的作用

目的探讨三甲基硫赶磷酸酯在甲胺磷农药中毒检验中的作用。方法利用气-质联用仪器(GC-MS)分析了甲胺磷中毒者的检材(血,胃内容物)。结果检出了O,O,S三甲基硫赶磷酸酯,却未检出甲胺磷。结论研究了这一现象的原因和确定了O,O,S三甲基硫赶磷酸酯(O,O,S-TMTP)可作为甲胺磷中毒的佐证物。     

氯氮平在家兔体内的分布研究

本文用薄层色谱扫描法研究了氯氮平在染毒家兔体内的分布情况，以639mg／kg剂量给家兔灌胃使其染毒致死．检验结果表明，其体内血、尿、胆汁、肝、脾、肾、心、肺和脑内氯氮平的浓度分别为19．1±6．9、50．2±12．6、75．9±12．5、25．9±4．0、34．0±47、13．3±2．2、5．0±2．3、20．0±4．3和43．6±43．4μg／g或μg／ml．