负荷量苯巴比妥联合持续静脉滴注地西泮治疗新生儿破伤风的临床研究

目的观察负荷量苯巴比妥及持续静脉滴注地西泮治疗新生儿破伤风（NT）的临床疗效。方法将2006—2010年在中山大学附属汕头医院治疗的63例破伤风新生儿按不同抗惊厥治疗方案进行分组,“圊顾性分析负荷量苯巴比妥20mg／kg肌注联合地西泮10mg／（kg·d）维持5灿g／（kg·min）静脉泵注治疗NT的临床疗效,并与传统抗惊厥治疗方法进行比较,对疗效结果进行统计学分析。结果负荷量苯巴比妥及持续静脉滴注地西泮治疗NT与传统方式比较,其痉挛控制时间快,住院时间短,肺炎、痉挛窒息、呼吸衰竭等并发症发生率及死亡率低,治愈率高,差异均有统计学意义（P〈0．05）。结论负荷量苯巴比妥及持续静脉滴注地西泮治疗NT效果好,优于传统方式,值得临床推广。     

Heliotrine poisoning of broiler chickens: an experimental clinicopathologic study of low dose intoxication

Poisoning of 7-day-old broiler chickens with a low dose of heliotrine (10 mg/kg/day for 3 days) produced retarded rate of growth in male and female birds for a period of 14 to 21 days. Liver lesions in the majority of birds were not apparent grossly and were minimal microscopically. There was no biochemical evidence of hepatic dysfunction. Microscopic lesions consisted of slight swelling of hepatocytes and enlargement of hepatocyte nuclei and occasional haemorrhage. Ultrastructural examination revealed hepatic perisinusoidal fibrosis for a period of 4 to 21 days in association with minimal morphological hepatocyte change. Some birds developed ascites and more obvious liver lesions but degeneration, necrosis or megalocytosis of hepatocytes was not a feature. It was concluded that retardation of growth rate was not due to hepatic dysfunction.     

Massive intracerebral aspergillosis responding to combination high dose liposomal amphotericin B and cytokine therapy without surgery.

This report describes a patient with intracranial Aspergillus flavus infection in whom it was impossible to remove the fungal mass surgically. Progressive fungal infiltration of the optic nerves was reversed and the extensive intracranial fungal burden was managed successfully with combination antifungal-immunomodulatory therapy alone.     

A clinical appraisal of diazepam

The author reviews the pharmacology of diazepam and gives guidelines for its use for anxiety and other medical and psychiatric indications. The drug's potential for abuse and its record of relative safety are discussed. Emphasis is placed on proper use of diazepam, careful monitoring of patients on long-term therapy, and gradual tapering off as steps in avoiding abuse and withdrawal symptoms. Nonpharmacologic management, such as psychotherapy and relaxation exercises, also may relieve anxiety, particularly lesser states.     

Massive Fibroid

This ten-year study of the massive fibroid at the Queen of Angels Hospital will reveal an average of 66 cases per year which could be classified as large and massive. Only about ten cases per year qualify as massive (four gestational months or larger). There were none considered giant size (25 lbs or more).     

Massive ovarian oedema

Eighteen cases of massive ovarian oedema are presented. The age of patients averaged 26 years and 16 presented with an acute abdomen. Hormonal symptoms included virilism in three cases and one with precocious pseudopuberty. Ultrasonographic findings were variable and not diagnostically accurate. When performed, CA 125 levels were not raised. Seventy-two percent of cases occurred in the right ovary and none were bilateral. Torsion occurred in 14 cases. Salpingo-oophorectomy was performed in all cases.
To elucidate its pathogenesis, be this either due to intermittent chronic torsion or to a proliferative phenomenon, immunohistochemistry for Ki-67 and PCNA proliferation antigens, alpha-actin and oestrogen and progesterone receptors was performed. The Ki-67 proliferation index ranged between 0% and 3%, demonstrating the low proliferative status of stromal cells. The PCNA indices, however, were unusually high (60% and above). The divergence between these findings is explained by the fact that PCNA positivity may be related to nuclear reparation subsequent to ischaemia. Alpha-actin was consistently positive in stromal cells, reflecting a myofibroblastic transformation of these cells. These findings together with the clinical evidence of torsion in the majority of cases, lead us to consider that ovarian oedema is a reactive, non-proliferative state of specific stromal cells, occurring as a response to torsion and subsequent ischaemia. The stromal cells have positive oestrogen and progesterone receptors and may undergo stimulatory changes responsible for the hormonally related symptoms often found associated with massive ovarian oedema.     

Massive prepatellar bursa

An adult male with cerebral palsy was admitted to our institution with a massive prepatellar bursa. The condition resulted from the patient's use of crawling as a means of household ambulation. The bursa had become infected secondarily, prompting him to seek medical attention. The bursa was excised in its entirety, allowing for relief of his symptoms. The patient expired three years later from unrelated causes.     

Fatal aluminium phosphide poisoning due to myocardial depression refractory to high dose inotropic support and intra-aortic balloon counterpulsation

We report a case of aluminium phosphide poisioning that presented to us with refractory myocardial depression. This patient developed worsening circulatory failure that did not respond to inotropic or vasopressor support and intra-aortic balloon counterpulsation. She went on to develop progressive metabolic acidosis, renal failure and died within 48 hours of admission to the intensive care unit.     

Mechanism of the anticonvulsant action of diazepam

Diazepam is highly effective in the prevention of convulsions induced by thiosemicarbazide (TSC), i.e., due to γ-aminobutyric acid (GABA) deficiency. Electrophysiological experiments to record the recovery cycle of the interzonal response of the cat motor cortex showed that diazepam reduces the amplitude of the test response, indicating the strengthening of inhibition. This test revealed antagonism of diazepam to bicuculline, specifically blocking GABA-ergic receptors, and to TSC. Diazepam was shown to be capable of increasing the GABA concentration in the brain by inhibiting the activity of GABA transaminase in the mitochondrial fraction of brain tissue.     

A double-blind randomized control trial of diazepam

A double-blind randomized controlled trial of diazepam against placebo in the management of minor conditions seen in general practice demonstrated that administration of either diazepam or placebo was associated with a substantial reduction in symptomatology three weeks later. There was no demonstrable difference between diazepam and placebo.     

Massive edema of the ovary

A case of unilateral massive ovarian edema is presented which clinically had been mistaken for an ovarian tumor. Correct diagnosis was only possible on gross and histologic pathological examination. This is a rare entity which should not be confused with neoplastic lesions by both clinicians and pathologists.