Survival after rupture of the oesophagus and subsequent candidal endocarditis: use of new serological methods in management

The prognosis following both spontaneous rupture of the oesophagus(Boerhaave's syndrome) and candidal endocarditis is poor. Antifungaltreatment for the latter has, in the past, been empirical. Apatient who survived both these conditions is described, hiscase demonstrating some of the major risk factors for candidalendocarditis. Management of his antifungal treatment was guidedby newly developed serological methods. Close liaison betweenmicrobiologist and clinician is essential for the managementof this serious condition.     

Enteral feed obstructing its own way

Esophageal obstruction due to solidified enteral feeds is a rare but distressful complication in intensive care unit (ICU) patients. It has been suggested that gastroesophageal reflux, very low gastric pH, decreased pepsin and pancreatic enzyme secretions may be responsible for the solidification of casein containing enteral formulas. Recognition and avoidance of these factors will prevent such complication.     

The Reaction of three Purified Lectins with Guinea Pig Lymphocytes

Three purified phytohemagglutinins, LcH-A, LcH-B, and AbH bind to guinea pig lymphocytes, the first two stimulating lymphocytes in culture and the last causing no stimulaton. By fluorescence microscopy essentially every examined lymphocyte isolated from various lymphoid organs bound both LcH-A and AbH. From the fact that both the stimulant (LcH-A) and the nonstimulant (AbH) showed similar microscopic staining patterns, it is suggested that the type of staining pattern seen is not directly related to the stimulation process. Although LcH-A and LcH-B have very similar specificities, they have subtly different lymphocyte stimulating properties, the former being a better stimulant for blood and lymph node cells and the latter a better stimulant of thymus cells. Despite the fact that AbH is not a stimulator of guinea pig lymphocytes, it could, under certain conditions, significantly affect the stimulation of guinea pig lymphocytes by LcH-A.     

比色法测定小儿化毒散中胆红素的含量

目的 :建立小儿化毒散中胆红素的含量测定方法。方法 :本实验采用比色法测定胆红素的含量,用重氮化试剂为显色剂,检测波长为533 nm。结果 :胆红素浓度在0.010 3~0.050 0 mg/ml范围内与吸收度呈良好的线性关系(r=0.999 8,n=5),平均回收率为99.36%(RSD=0.45,n=6)。结论 :该法简便、快速、稳定、可靠,可用于测定小儿化毒散中胆红素的含量。     

丹芪偏瘫胶囊中羚羊角用人工牛黄替代的初步研究

为研究丹芪偏瘫胶囊(DPC)及其羚羊角替代方(DPCAS)对脑缺血的保护作用,初步探讨人工牛黄替代羚羊角的可能性,该文采用左侧大脑中动脉栓塞(MCAO)模型,将150只SD大鼠随机分为假手术组,模型组,DPC(0.246 g·kg^-1·d^-1)组,丹芪偏瘫胶囊去羚羊角(DPCRA,0.246 g·kg^-1·d^-1)组,丹芪偏瘫胶囊去羚羊角人工牛黄翻倍(DPCBD,0.246 g·kg^-1·d^-1)组。于第5天给药后1 h 制备MCAO模型。术后24 h,眼内眦取血,测定血清超氧化物歧化酶(SOD)活性、内皮素(ET)含量。术后72 h取脑组织,氯化三苯基四氮唑(TTC)染色法测定大脑梗死面积、测定脑指数。荧光定量PCR方法检测脑组织bcl-2,caspase-3,IL-1β,P-选择素,E-选择素,ICAM-1 mRNA的表达,免疫组化方法检测缺血半暗区ICAM-1,IL-1β,TNF-α,IL-6的表达。结果,与模型组比较,DPCBD和DPC组实验结果基本一致,均能明显改善脑梗死指数和脑指数(P<0.05),均可明显增强大鼠血清 SOD活性(P<0.05);均可在一定程度上降低大鼠血清 ET 水平;均可降低脑组织caspase-3的表达(P<0.05),升高bcl-2的表达(P<0.05);均可降低脑组织IL-1β,P-选择素,E-选择素,ICAM-1 mRNA的表达(P<0.05),均能减少缺血半暗区ICAM-1,IL-1β,TNF-α,IL-6阳性细胞的表达(P<0.05)。DPCRA组对各指标的影响明显不如DPCBD和DPC组。表明DPCBD与DPC疗效相当,提示丹芪偏瘫胶囊中羚羊角可用人工牛黄进行替代。     

小儿抗感冒类药品中人工牛黄的质量考察

目的对市售小儿抗感冒类药品中人工牛黄质量进行考察,提高药厂及监管部门对产品质量的重视。方法通过改进方法对不合格样品中人工牛黄的成分进行分析。结果与结论小儿抗感冒类药品中人工牛黄质量存在问题,应完善质量标准、加强管理,保证质量。     

紫外分光光度法测定牛黄上清胶囊中胆酸的含量

目的建立牛黄上清胶囊中胆酸的含量测定方法。方法本实验采用紫外分光光度法,以硫酸溶液显色,对样品的提取检测波长为385nm。结果牛黄上清片中胆酸的含量限度为不低于0.34mg/粒,胆酸浓度在0.0386～0.1980mg/mL范围内与吸收度呈良好的线性关系(r=0.9996,n=5),平均回收率为100.2%(RSD=0.56%,n=9)。结论该法简便、快速、稳定、可靠,可用于测定牛黄上清胶囊中胆酸的含量。     

RAPUNZEL SYNDROME WITH GASTRIC PERFORATION IN AN ADULT

Rapunzel syndrome is a rare condition of gastric trichobezoar with contiguous extension in the intestines found commonly in pediatric and teenage patients, mostly females, with underlying psychological disorders. We report the case of a 37‐year‐old widow who presented with epigastric pain, fullness and early satiety of 6 months duration. Investigations revealed a trichobezoar extending from the stomach through the duodenum into the jejunum. Psychiatric analysis revealed depressive symptoms. She was posted for elective surgery; however, 2 days prior to the surgery she presented with acute abdomen with plain X‐ray of the chest and abdomen showing free gas under the diaphragm. Urgent laparotomy was carried out which confirmed the diagnosis of gastric perforation due to Rapunzel syndrome. The perforation was closed primarily along with removal of the trichobezoar en masse by anterior gastrotomy. This is the first case of Rapunzel syndrome with gastric perforation that has presented in the fourth decade of life. Here we discuss the etiology, pathogenesis, diagnosis and treatment of this unusual syndrome.     

Four cases of lactobezoar in neonates

Four cases of lactobezoar, an unusual cause of vomiting in the neonatal period, are described and illustrated. From our experience with the first case we were able to diagnose the next three cases from the plain radiographs. The condition is likely to resolve spontaneously on intravenous feeding.