目的通过观察不同价态无机砷染毒大鼠肝脏砷形态代谢产物分布,初步探讨不同价态无机砷体内代谢和毒性机制。方法 W istar大鼠42只,随机分成7组,于染砷3个月后,处死动物,迅速摘取肝脏,于-80℃冷藏;采用高效液相色谱-氢化物发生原子荧光...目的通过观察不同价态无机砷染毒大鼠肝脏砷形态代谢产物分布,初步探讨不同价态无机砷体内代谢和毒性机制。方法 W istar大鼠42只,随机分成7组,于染砷3个月后,处死动物,迅速摘取肝脏,于-80℃冷藏;采用高效液相色谱-氢化物发生原子荧光光谱法(HPLC-HGAFS)测定并比较各组染砷大鼠肝脏中砷形态代谢产物的水平和分布,计算一甲砷酸(MMA)加标回收率评价结果准确度;通过肝脏中总砷含量评价砷蓄积能力;分析肝脏中甲基化代谢指标一甲基化率(PM I)和二甲基化率(SM I)水平,评价各组间甲基化代谢能力或途径差异。结果亚砷酸钠与砷酸钠高、中、低剂量组总砷水平分别为(1 142.9±50.4)、(484.6±37.4)、(323.3±20.2)和(3 695.2±345.9)、(1833.8±229.6)、(1 170.5±77.4)ng/g,砷酸钠各剂量组总砷水平明显高于亚砷酸钠组(P<0.05);亚砷酸钠中、低剂量组iAs3+[(118.4±23.9)、(252.3±14.3)]ng/g和二甲砷酸(DMA)[(353.2±45.6)、(55.2±10.6)]ng/g含量均低于砷酸钠组(P<0.05);亚砷酸钠中、低剂量组MMA含量高于砷酸钠组(P<0.05),同时,亚砷酸钠各剂量组PMI和SMI均低于砷酸钠各剂量组(P<0.05)。结论五价砷代谢产物在肝脏蓄积能力强于三价砷,五价砷在肝脏一甲基化及二甲基化代谢能力强于三价砷,具有较大肝脏毒性。展开更多
Background： The reported mortality rate of mushroom-induced acute liver failure with conventionaltreatment is 1.4%–16.9%. Emergency liver transplantation may be indicated and can be the only curativetreatment option...Background： The reported mortality rate of mushroom-induced acute liver failure with conventionaltreatment is 1.4%–16.9%. Emergency liver transplantation may be indicated and can be the only curativetreatment option. This study aimed to assess the prognostic value of criteria for emergency livertransplantation in predicting 28-day mortality in patients with mushroom-induced acute liver injury.Methods： A retrospective cohort study was performed between January 2005 and December 2015. Alladult patients aged≥18 years admitted with mushroom intoxication at our emergency department wereevaluated. All patients with acute liver injury, defined as elevation of serum liver enzymes （〉5 timesthe upper limit of normal, ULN） or moderate coagulopathy （INR 〉 2.0） were included. The ability of the King’s College, Ganzert’s, and Escudié’s criteria to predict 28-day mortality was evaluated.展开更多
Background There was a hospital outbreak of venous diethylene glycol poisoning in Guangzhou, China. It is the only massive episode of venous diethylene glycol poisoning in history. Here we report its clinical features...Background There was a hospital outbreak of venous diethylene glycol poisoning in Guangzhou, China. It is the only massive episode of venous diethylene glycol poisoning in history. Here we report its clinical features, laboratory findings, and imaging appearances. Methods The clinical features of 15 venous diethylene glycol poisoning patients with liver disease were analyzed and summarized. Their laboratory findings and imaging appearances were comparatively analyzed before and after poisoning. Results All poisoned patients presented with oliguric acute renal failure with anuria after a mean of 6 days. Carbon dioxide combination power of 13 patients dropped after a mean of 9 days with valley value on the 10th day, when metabolic acidosis developed. Gastroenteric symptoms or aggravation of gastroenteric symptoms were displayed in 11 patients after a mean of 9 days. Neurological system impairment was observed in 10 patients after a mean of 14 days. Seven patients had low fever after a mean of 6 days. Causes of death of 14 patients included multiple organ dysfunction syndrome, severe lung infection and massive haemorrhage of digestive tract. Blood creatinine and urea nitrogen were abnormal after a mean of 5 days with peak value on the 11th and 14th days, respectively. Serum calcium had no obvious change, and phosphorus was distinctively increased. Liver functions did not change significantly. Poisoned patients had higher white blood cell counts, but lower red blood cell counts and hemoglobin value. Of the 7 patients who exhibited mild moderate or severe patchy consolidation shadowing in the lung, 2 manifested mild or severe gaseous distention and dilation of gastroentedc tract. Conclusions Main features of venous diethylene glycol poisoning in patients with liver disease include oliguric acute renal failure, metabolic acidosis, gastroenteric symptoms or aggravation of gastroenteric symptoms, neurological system impairment and low fever, with a mortality rate of 93.33% in poisoned patients. There is also higher white展开更多
免疫缺陷病毒(human immunodeficiency virus,HIV)合并丙型肝炎病毒(hepatitis C virus,HCV)肝损伤主要由病毒、药物、毒物、酒精、免疫及环境等因素导致。外感疫疠毒邪是发病的始动因素,药物致毒时有发生,情志郁毒是重要的致病因素。...免疫缺陷病毒(human immunodeficiency virus,HIV)合并丙型肝炎病毒(hepatitis C virus,HCV)肝损伤主要由病毒、药物、毒物、酒精、免疫及环境等因素导致。外感疫疠毒邪是发病的始动因素,药物致毒时有发生,情志郁毒是重要的致病因素。外感疫毒、药物毒、情志郁毒长期作用于机体,致湿热郁毒横生,毒邪侵袭致机体气血阴阳失调,毒虚交结,既可由虚致实,也可由实致虚。故HIV合并HCV肝损伤为本虚标实之证,正虚为本,湿热郁毒为标。治疗时应以解毒补虚为基本治则。肝损伤急性发病期,应急则治其标,以抗炎护肝为主,重用清热利湿解毒退黄药,应用龙胆泻肝汤、茵陈蒿汤等加减;情志郁毒所致者应用柴胡疏肝散、逍遥散等以疏肝解郁、行气导滞;风阳上扰者应用镇肝熄风汤加减以清肝泻火、镇肝潜阳;应用重剂解毒药物同时需佐少量健脾益气药物以顾护正气,使邪祛而不伤正。肝损伤的慢性发展期或恢复期,应缓则治其本,以扶正固本,调畅气血为治则,应用四君子汤或黄芪汤加减以健脾益气,同时加用疏肝理气药物,使土得木而达。展开更多
Young male rats were orally intubated with podophyllotoxin: Group I, control animals, orally fed with vehicle only; Group Ⅱ, fed with an initial dose of 5 mg.kg-1 b.w., followed by a daily dose of 1.67 mg-kg-1 b.w. f...Young male rats were orally intubated with podophyllotoxin: Group I, control animals, orally fed with vehicle only; Group Ⅱ, fed with an initial dose of 5 mg.kg-1 b.w., followed by a daily dose of 1.67 mg-kg-1 b.w. for 7d. Group III, fed with an initial dose of 15 mg.kg-1 b.w., followed by a daily dose of 5 mg.kg-1 b.w. for 7d. All animals were sacrificed 72 h after the last dosing.Histopathological examination revealed dose-related fatty change of the liver, atrophy andi degenerative changes of the intestinal epithelial linings and testicular seminiferous tubules. Depletion of the pancreatic acinar cell granules was also apparent in the Group III animals. No pathology, however, was observed in the kidneys. The present study demonstrated for the first time degenerative changes in the liver, intestine, testis, and pancreas of animals ingested podophyllotoxin. These pathological changes correlate well with the clinical signs/symptoms of abnormal liver function, abdominal pain and diarrhea, and reduced serum amylase in humans poisonded by podophyllum. Inhibition of protein synthesis and mitosis (disruption of microtubules) are believed to be the underlying mechanisms of these changes observed in the animals intoxicated by. podophyllotoxin.展开更多
Background:There are few data Oll hepatotoxicity induced by acute or chronic paracetamol poisoning in the pediatric population.Paracetamol poisoning data can reveal the weakn嗍ofparacetamol poisoning management guidel...Background:There are few data Oll hepatotoxicity induced by acute or chronic paracetamol poisoning in the pediatric population.Paracetamol poisoning data can reveal the weakn嗍ofparacetamol poisoning management guidelines.Methods:We retrospectively studied the patients of less than 18 years old with measurable paracetamol levels,who were brought to the emergency department(ED)of La Paz University Hospital,Madrid,Spain,for suspected paracetamol overdoses between 2005 and 2010.展开更多
文摘Background： The reported mortality rate of mushroom-induced acute liver failure with conventionaltreatment is 1.4%–16.9%. Emergency liver transplantation may be indicated and can be the only curativetreatment option. This study aimed to assess the prognostic value of criteria for emergency livertransplantation in predicting 28-day mortality in patients with mushroom-induced acute liver injury.Methods： A retrospective cohort study was performed between January 2005 and December 2015. Alladult patients aged≥18 years admitted with mushroom intoxication at our emergency department wereevaluated. All patients with acute liver injury, defined as elevation of serum liver enzymes （〉5 timesthe upper limit of normal, ULN） or moderate coagulopathy （INR 〉 2.0） were included. The ability of the King’s College, Ganzert’s, and Escudié’s criteria to predict 28-day mortality was evaluated.
文摘Background There was a hospital outbreak of venous diethylene glycol poisoning in Guangzhou, China. It is the only massive episode of venous diethylene glycol poisoning in history. Here we report its clinical features, laboratory findings, and imaging appearances. Methods The clinical features of 15 venous diethylene glycol poisoning patients with liver disease were analyzed and summarized. Their laboratory findings and imaging appearances were comparatively analyzed before and after poisoning. Results All poisoned patients presented with oliguric acute renal failure with anuria after a mean of 6 days. Carbon dioxide combination power of 13 patients dropped after a mean of 9 days with valley value on the 10th day, when metabolic acidosis developed. Gastroenteric symptoms or aggravation of gastroenteric symptoms were displayed in 11 patients after a mean of 9 days. Neurological system impairment was observed in 10 patients after a mean of 14 days. Seven patients had low fever after a mean of 6 days. Causes of death of 14 patients included multiple organ dysfunction syndrome, severe lung infection and massive haemorrhage of digestive tract. Blood creatinine and urea nitrogen were abnormal after a mean of 5 days with peak value on the 11th and 14th days, respectively. Serum calcium had no obvious change, and phosphorus was distinctively increased. Liver functions did not change significantly. Poisoned patients had higher white blood cell counts, but lower red blood cell counts and hemoglobin value. Of the 7 patients who exhibited mild moderate or severe patchy consolidation shadowing in the lung, 2 manifested mild or severe gaseous distention and dilation of gastroentedc tract. Conclusions Main features of venous diethylene glycol poisoning in patients with liver disease include oliguric acute renal failure, metabolic acidosis, gastroenteric symptoms or aggravation of gastroenteric symptoms, neurological system impairment and low fever, with a mortality rate of 93.33% in poisoned patients. There is also higher white
文摘免疫缺陷病毒(human immunodeficiency virus,HIV)合并丙型肝炎病毒(hepatitis C virus,HCV)肝损伤主要由病毒、药物、毒物、酒精、免疫及环境等因素导致。外感疫疠毒邪是发病的始动因素,药物致毒时有发生,情志郁毒是重要的致病因素。外感疫毒、药物毒、情志郁毒长期作用于机体,致湿热郁毒横生,毒邪侵袭致机体气血阴阳失调,毒虚交结,既可由虚致实,也可由实致虚。故HIV合并HCV肝损伤为本虚标实之证,正虚为本,湿热郁毒为标。治疗时应以解毒补虚为基本治则。肝损伤急性发病期,应急则治其标,以抗炎护肝为主,重用清热利湿解毒退黄药,应用龙胆泻肝汤、茵陈蒿汤等加减;情志郁毒所致者应用柴胡疏肝散、逍遥散等以疏肝解郁、行气导滞;风阳上扰者应用镇肝熄风汤加减以清肝泻火、镇肝潜阳;应用重剂解毒药物同时需佐少量健脾益气药物以顾护正气,使邪祛而不伤正。肝损伤的慢性发展期或恢复期,应缓则治其本,以扶正固本,调畅气血为治则,应用四君子汤或黄芪汤加减以健脾益气,同时加用疏肝理气药物,使土得木而达。
文摘Young male rats were orally intubated with podophyllotoxin: Group I, control animals, orally fed with vehicle only; Group Ⅱ, fed with an initial dose of 5 mg.kg-1 b.w., followed by a daily dose of 1.67 mg-kg-1 b.w. for 7d. Group III, fed with an initial dose of 15 mg.kg-1 b.w., followed by a daily dose of 5 mg.kg-1 b.w. for 7d. All animals were sacrificed 72 h after the last dosing.Histopathological examination revealed dose-related fatty change of the liver, atrophy andi degenerative changes of the intestinal epithelial linings and testicular seminiferous tubules. Depletion of the pancreatic acinar cell granules was also apparent in the Group III animals. No pathology, however, was observed in the kidneys. The present study demonstrated for the first time degenerative changes in the liver, intestine, testis, and pancreas of animals ingested podophyllotoxin. These pathological changes correlate well with the clinical signs/symptoms of abnormal liver function, abdominal pain and diarrhea, and reduced serum amylase in humans poisonded by podophyllum. Inhibition of protein synthesis and mitosis (disruption of microtubules) are believed to be the underlying mechanisms of these changes observed in the animals intoxicated by. podophyllotoxin.
文摘Background:There are few data Oll hepatotoxicity induced by acute or chronic paracetamol poisoning in the pediatric population.Paracetamol poisoning data can reveal the weakn嗍ofparacetamol poisoning management guidelines.Methods:We retrospectively studied the patients of less than 18 years old with measurable paracetamol levels,who were brought to the emergency department(ED)of La Paz University Hospital,Madrid,Spain,for suspected paracetamol overdoses between 2005 and 2010.
