Details of a thallium poisoning case revealed by single hair analysis using laser ablation inductively coupled plasma mass spectrometry

ChatGPT 3.5

please translate the following:" 4.6 Alignment of thallium and lead distribution profiles with the victim’s symptoms The victim had experienced alopecia twice: loss of her long hair at the end of 1994, and then loss of all newly grown short hair in March 1995. Based on the hair length, ZL1995H9 likely fell from the victim during the first occurrence of alopecia, and ZL1995H5 likely fell during the second occurrence. Fig. 5 showed the alignment of the thallium and lead distribution profiles in these two hairs with the victim’s symptoms and life track from late 1994 to early 1995. Fig. 5 Alignment of the Tl and Pb distribution profiles in ZL1995H9 and ZL1995H5 with the victim’s symptoms and life track during 1994–1995. The toxicity of thallium stems from its ability to replace potassium and interfere with various potassium-dependent physiological processes due to similar charge and ionic radius. Thallium ions can be absorbed by human body rapidly and almost completely via virtually any route (ingestion, inhalation, skin contact), causing a wide spectrum of symptoms including gastroenteritis, multi-organ failure and neurologic injuries. The onset of poisoning signs and symptoms varies depending on both dose and exposure route . Alignment of ZL1995H9 with the first episode indicated that the victim had already been exposed to thallium for ∼3 months before the abrupt start of the striking poisoning symptoms. The sporadic intakes of relatively small doses during this prolonged period did not cause any apparent health problems, except a sudden and temporary vision loss occurring sometime in the fall of 1994. This may be attributed to the single high dose of thallium detected in the middle of ZL1995H9. The lack of any gastrointestinal or neurological response upon such a large exposure may suggest that thallium was possibly absorbed through eye contact, which usually only resulted in local irritation instead of systematic effects . It is also noteworthy that the victim used to wear contact lens but had to switch to glasses after this incident. The more frequent and larger thallium peaks near the root of ZL1995H9 correlate with the appearance of the hallmark signs of systematic thallium intoxication starting from early December 1994, including gastrointestinal manifestations (stomach pain, nausea and vomiting) that are characteristics of oral ingestion of thallium, ascending peripheral neuropathy (pins and needles sensation in the hands and feet), and gradual hair loss. Such correlation may indicate a change in exposure route to oral ingestion along with the transition from the chronic to acute poisoning. The victim went home in mid-December and became completely bald in late December 1994, a period of ∼2 weeks during which hair ZL1995H9 likely fell off. After a short remission with hair re-growing, the victim returned to school in late February 1995, only soon suffered another round of acute symptoms that ultimately forced her to go back to home again in early March. She then lost all the newly grown short hair. ZL1995H5 likely fell off during this period, and the short, yet consistent, exposure to the large amount of thallium reflected by this hair shaft would account for these acute intoxication manifestations as well as the clinical signs documented after she was sent to the hospital, including delirium, seizure, convulsion and eventually slipping into a coma for several months. More than a month later, quantitative GF-AAS analysis (measuring only thallium) was conducted and revealed significant amounts of thallium in her urine, blood, cerebrospinal fluid, hair and nails . Continuing monitor of the thallium levels in the victim’s blood and urine during the following medical treatment with thallium-specific antidotes demonstrated the gradual elimination of thallium from her body. The victim was eventually brought back to consciousness ∼4 months later, but suffered permanent memory impairment, another neuropsychological effect which can be caused by thallium intoxication . Computed tomography (CT) scan of her brain revealed both cerebral and cerebellar atrophy . Interestingly, lead could also attack both central and peripheral nervous system and, in the situation of acute exposure of large doses, trigger a set of polyneuropathy clinical signs that are very similar to those resulting from thallium poisoning, including severe pain, muscle weakness, delirium, convulsion and coma. An important mechanism of lead toxicity arises from its ability to replace divalent cations that are necessary for some critical cellular activities. For example, lead can replace calcium ions and pass through the blood-brain barrier, causing neurological abnormalities including memory-related neurotransmitter activities that may lead to memory loss . Therefore, the possible co-ingestion of lead with thallium in the second poisoning episode, as indicated by the co-presence of large amount of thallium and lead in ZL1995H5, would also synchronize with the victim’s symptoms during that period. However, alopecia was a distinct symptom only associated with thallium poisoning , thus the original diagnosis, medical treatment and forensic investigation have only focused on thallium. Thallium is also more acutely toxic than lead , which explains why the victim responded appreciably well to the thallium-specific antidotes, even though more lead than thallium was detected in ZL1995H5. Prior to this work, there had been no suspicion that the victim might have been co-poisoned by another heavy metal, since the amount of thallium detected in her body could adequately explain all the observed symptoms and responses following the medical treatment. This case thus highlighted the importance of assessing multiple elements in different biological specimens to aid in the medico-legal investigation of suspicious heavy metal poisoning upon clinical observations." into Chinese

ChatGPT

Certainly! Here's the Chinese translation:

"4.6 铊和铅分布曲线与受害者症状的对齐

受害者曾经两次患有脱发：在1994年底失去长发，然后在1995年3月失去所有新长出的短发。根据头发长度，ZL1995H9可能是在第一次脱发期间从受害者身上掉下的，而ZL1995H5可能是在第二次脱发期间掉下的。图5显示了这两根头发中铊和铅分布曲线与受害者1994年底至1995年初的症状和生活轨迹的对齐。图5 ZL1995H9和ZL1995H5中Tl和Pb分布曲线与受害者1994年至1995年的症状和生活轨迹的对齐。

铊的毒性源于其取代钾并干扰各种依赖于钾的生理过程的能力，这是由于其相似的电荷和离子半径。铊离子可以通过几乎任何途径（摄入、吸入、皮肤接触）迅速而几乎完全地被人体吸收，引起一系列症状，包括胃肠炎、多器官衰竭和神经损伤。中毒的迹象和症状的发生取决于剂量和暴露途径。与第一次发作的ZL1995H9的对齐表明，在引起引人注目的中毒症状突然发作之前，受害者已经接触了铊约3个月。在这个延长期间的零星小剂量摄入并没有引起任何明显的健康问题，除了在1994年秋天发生的突然而暂时的视力丧失。这可能归因于ZL1995H9中间检测到的铊的单一高剂量。在这样大的暴露下没有发生任何胃肠或神经反应可能表明铊可能是通过眼睛接触而被吸收的，通常只引起局部刺激而不是系统效应。值得注意的是，受害者过去常戴隐形眼镜，但在这次事件后不得不换成眼镜。ZL1995H9根部附近较频繁和较大的铊峰与1994年12月初开始的系统性铊中毒的标志性症状的出现相一致，包括胃肠表现（胃痛、恶心和呕吐），上升性周围神经病变（手脚刺痛感）和逐渐脱发。这种关联可能表明，随着从慢性中毒到急性中毒的过渡，接触途径发生了改变，转为口服。受害者于12月中旬回家，并在1994年12月底完全秃头，这是ZL1995H9可能掉落的约2周的时间。在经历了短暂的缓解，头发重新长出后，受害者于1995年2月底回到学校，但很快又经历了另一轮急性症状，最终迫使她于3月初再次回家。然后，她失去了所有新长出的短发。ZL1995H5可能是在这个时期掉下的，而这根头发轴中短暂而一致的暴露于大量铊可能解释了这些急性中毒表现，以及她被送到医院后记录的临床症状，包括谵妄、抽搐、惊厥，最终陷入数月的昏迷。一个多月后，通过量化的GF-AAS分析（仅测量铊），在她的尿液、血液、脑脊液、头发和指甲中检测到了大量的铊。在接下来的铊特异性解毒治疗期间，对受害者的血液和尿液中的铊水平进行持续监测显示，铊逐渐从她的体内排出。大约4个月后，受害者最终恢复了意识，但遭受了永久性的记忆受损，这是铊中毒引起的另一种神经心理效应。她的脑部计算机断层扫描显示既有大脑萎缩又有小脑萎缩。

有趣的是，铅也可以攻击中枢和外周神经系统，在大剂量急性暴露的情况下，可能触发一组与铊中毒导致的非常相似的多神经病症状，包括剧烈的疼痛、肌肉无力、谵妄、抽搐和昏迷。铅毒性的一个重要机制是其取代对一些关键细胞活动至关重要的二价阳离子的能力。例如，铅可以取代钙离子穿过血脑屏障，导致神经异常，包括可能导致记忆丧失的与记忆有关的神经递质活动。因此，在ZL1995H5中检测到的铊和铅的大量共存可能与受害者在那个时期的症状同步。然而，脱发只是与铊中毒有关的一个明显症状，因此原始的诊断、医疗治疗和法医调查只集中在铊上。铊也比铅更急性毒性，这解释了为什么尽管在ZL1995H5中检测到的铅比铊多，受害者对铊特异性解毒药物的反应相当良好。在这项工作之前，没有人怀疑受害者可能被另一种重金属共同中毒，因为她体内检测到的铊量足以解释所有观察到的症状和在医疗治疗后的反应。这个案例突显了在临床观察的基础上，评估不同生物标本中的多个元素对于揭示可疑的重金属中毒在法医调查中的重要性。"

-----------------------------

这样的投毒pattern 只能是有条件反复能接触朱令私人物品的人