刘公望教授针药结合治疗粉刺经验

粉刺临床证型多为瘀热结聚,病位在肺和脾胃,刘公望教授治疗粉刺方法独到,方用麻黄连翘赤小豆汤合黄连解毒汤化裁,针刺取风池、曲池、尺泽,并大椎、膈俞或至阳刺络拔罐。     

Pacemaker management for acute onset of heart block in childhood

Four children aged 2 to 15 years are described who had Stokes-Adams syndrome as the primary cardiac manifestation of complete heart block. All had mild, nonspecific antecedent symptoms without signs of congestive heart failure. Viral neutralizing antibody titers (coxsackievirus B1 and B2) rose significantly in two patients. Electrocardiography demonstrated complete heart block associated with one or more of the following: right bundle branch block, left anterior hemiblock, left bundle branch block, intraventricular conduction delay, and ventricular standstill. In addition, second-degree heart block was seen during the initial or resolving phases of illness. To prevent further life-threatening episodes of Stokes-Adams syndrome, temporary transvenous pacemakers were placed. Two patients with persisting complete heart block required permanent pacemakers. At last examination, the remaining two patients had sinus rhythm and normal conduction. Nonsurgical acquired complete heart block is unusual in childhood, and may be the only manifestation of myocarditis. Extreme bradycardia, which causes syncope, requires immediate temporary cardiac pacing; if the bradycardia persists, a permanent pacemaker should be implanted.     

Changes in the management of severely Rh-immunized patients

Since July 1, 1978, we have instituted the following changes in the management of severely Rh-immunized patients: (1) serial amniotic fluid optical density (delta OD450 ) values and real-time ultrasound scanning beginning at 21 weeks' gestation, (2) fetal transfusions as early as the twenty-third week, (3) ultrasound surveillance during and after intrauterine transfusions, and (4) planned premature delivery with neonatal exchange transfusions for selected cases between 29 to 32 weeks and for all patients after 32 weeks' gestation. The perinatal survival rate (83.8%) in 37 isoimmunized pregnancies managed with this regimen was significantly higher (p less than 0.05) than in 34 such pregnancies (55.9%) managed according to the protocol utilized during the previous four years.     

Placental protein 12 (PP12): factors affecting levels in late pregnancy

The circulating concentration of placental protein 12 was measured by radioimmunoassay in 109 pregnant women. The effect on the serum PP12 level of temperature, repeat freezing and thawing, and day-to-day and diurnal variation were assessed and the post partum changes of levels were studied. On average, PP12 levels in plasma are about one-half of those in serum in the same individual. PP12 immunoreactivity is destroyed by heating but not by repeated freezing and thawing. Changes in serum PP12 levels at various times of day showed a significant and consistent diurnal variation (F = 7.21; d.f.24; 96; P less than 0.001). The peak mean (+/- s.e.m.) value at 0800 h (80.8 +/- 8.7 ng/ml) was 41 per cent higher than the 24-h mean (P less than 0.05), and the nadir concentration at 1400 h (40.4 +/- 5.4 ng/ml) was 29 per cent lower than the 24-h mean (P less than 0.025). There is also considerable day-to-day variation (up to 72 per cent) in serum PP12 levels. If serum samples are taken at 0700 h, there is a slight negative correlation between PP12 concentration and placental weight (P less than 0.05), but not between PP12 level and birthweight of the child. In term pregnancy, the levels taken at 0700 h are higher (163.7 +/- 12.4 ng/ml) than at 0900 to 1300 h (115.7 +/- 11.4 ng/ml, P less than 0.001). The PP12 level is not affected by labour.(ABSTRACT TRUNCATED AT 250 WORDS)     

Residual carcinoma in the surgical specimen of patients with endometrial adenocarcinoma undergoing preoperative radiation therapy. A study of 80 patients and a literature review

Controversy continues to surround the significance of residual endometrial adenocarcinoma in the uterus following radiation therapy. Eighty patients with FIGO stage IA, IB, and II endometrial adenocarcinoma treated by preoperative radiotherapy were studied. No correlation was noted between the histologic grade of the lesion and the stage of disease. The frequency and the site of residual carcinoma were not related to the stage of disease but less-differentiated tumors persisted more frequently than grade I lesions. The modality of preoperative radiotherapy did not affect the frequency of residual tumor. Residual carcinoma within the uterus had no effect on the site or frequency of recurrence nor on patient survival.     

Decreased response of plasma immunoreactive erythropoietin to "available oxygen" in anemia of prematurity

Erythropoietin, hemoglobin, hematocrit, oxygen affinity (P50), and reticulocyte counts were measured weekly starting at 1 week of age in 10 very-low-birth-weight infants and on a single occasion in 15 healthy men. In the adults, "available oxygen" (derived from oxygen carrying capacity and P50) averaged 13.1 ml/dl blood and the mean erythropoietin level was 15.2 mU/ml. Erythropoietin levels in the infants were inversely related to concentration of hemoglobin, P50, and available oxygen. However, despite the much lower mean "available oxygen" of 9.3 ml/dl in the infants compared with that in adults (P less than 0.001), the mean erythropoietin value of 8.2 mU/ml in the infants was less than in adults (P less than 0.001). Furthermore, the erythropoietin response to decreased "available oxygen" was lowest in the least mature infants. VLBW infants often develop clinical evidence of hypoxia during the anemia of prematurity. The relatively low erythropoietin levels in relation to "available oxygen" are compatible with a decreased erythropoietin response to hypoxia compared with that in adults. Such a difference in response could be a contributing factor to the anemia of prematurity.     

路志正调理脾胃学术思想探讨

饮食失调、脾胃损伤,是现代常见的冠心病、糖尿病、高血脂、高血压、痛风等疾病发病的关键因素。脾胃损伤常见气虚血少、蕴湿、痰阻、血瘀、气机紊乱等病证,辨证要着眼于发病的根源,调理脾胃是其治本之道。     

The tangential excision of extensive or deep burns

This report contains our experience gained over 13 years of the tangential excision of burned tissue in 627 patients. We have discussed the indications for and timing of tangential excision, methods of determining the margin between viable and non-viable tissue using histological studies in some patients and the problem of wound coverage after tangential excision.     

Pelvic infections following gynecologic procedures in Bangladesh

Data were collected to establish the rate of pelvic infection following various gynecologic procedures, including postpartum intrauterine device (IUD) insertions, IUD insertion following menstrual regulation procecures, IUD insertion in women who were not recently pregnant, and induced and spontaneous abortions. The pelvic infection rate was only 1% in 97 women who underwent postpartum IUD insertions. The infection rate was related to the timing of IUD insertion and the type of IUD used. Finally, the pelvic infection rate was unacceptably high (10.3%) in women undergoing induced abortions vs. women having spontaneous abortions (1.1%).