论公费医疗大额死亡病例的资源消耗与医学目的

从北京市公费医疗大额消耗的９２例死亡病例的费用结构及住院城数的统计，提示由住院日地长，贵重卫生资源的盲目过量投入等而致。这与中国国情不符。因此，医学目的概念应更新，以及应如何正确对待死亡病例的医疗服务值得进行讨论。     

军团菌肺炎的临床特点探讨

作者对１０例军团菌肺炎和１０例非军团菌肺炎患者临床资料进行分析。本组军团菌肺炎特点为：病情重、进展快、消化道症状及肌肉关节痛、低钠血症、低氧血症、代酸或呼碱发生率较高，Ｘ线胸片多见双侧或多叶肺浸润伴胸膜反应，病死率高。     

枸杞多糖对高温损伤小鼠睾丸曲细精管影响的电镜观察

为研究枸杞多糖对小鼠睾丸生细红胞的作用，本次以热吹风器对小鼠双侧睾丸透热(B组)，另取正常不透热小鼠为空白对照（A组)，蒸馏水灌胃对照(C组)和透热后灌鼠枸杞多糖(D组)，进行实验观察，待B、C、D各组于透热结束后即刻、3天、1周、2周，5周处死动物，取双侧睾丸，常规作光镜和电镜观察。实验结果表明，B组各期生精细胞进行性受损，属肿胀溶解性细胞变性坏死过程，D组则在1周时受损部位和程度未见进行性加重，5周对基本恢复正常，提示枸杞多糖有明显的抗高温，保护生精细胞作用。     

The expression of nuclear estrogen receptor and its relation to cytoplasmic estrogen receptor in breast cancer]

Sixty specimens of breast cancer were assayed with ER-monoclonal antibody by immunocytochemical staining. Twenty-nine (48.33%) were nuclear estrogen receptor positive (ERn+). The number of ERn+ cancer cells decreased in the following sequence: mucinous carcinoma, invasive lobular carcinoma, invasive ductal carcinoma, and papillary adenocarcinoma. Two apocrine carcinomas were ERn-. ERn+ rate was higher in patients over 60 years of age (P less than 0.05). The amount of ERn+ cells was much greater in cancer cells than in the surrounding benign epithelial cells. This phenomenon may indicate that malignant cells are more hormone-dependent than benign cells. The results of immunocytochemical staining and steroid binding assay were compared. By immunocytochemical staining, twenty-four of fifty-seven cases (42.11%) were ERn+ and ERc+. Sixteen cases (28.07%) were ERn- and ERc-. This study showed that in a number of breast cancers ERs were positive in both cytoplasms and nuclei and the concordant rate was 70.18%. In the remaining cases 13 (22.81%), ERs were positive in the cytoplasm, and in 4 cases (7.02%) positive in nuclei only. Additionally, fifty-two out of 60 cases were assayed by 3H-estradiol and 3H-R5020 by means of steroid binding assay. Twenty-seven cases of them (51.92%) showed ERc+ and PRc+, and seventeen cases (32.69%) were ERc- and PRc-. Their correspondent rate was 84.61%.     

蝮蛇抗栓酶治疗缺血性脑血管病的甲襞微循环及血液流变性观察

对使用蝮蛇抗栓酶、维脑路通的缺血性脑血管病患者各５０例进行甲襞微循环和血液流变指标的检测。结果表明：蝮蛇抗栓酶组用药后，微循环和血液流变各项异常指标显著下降（Ｐ＜０．０１～０．０５）。而维脑路通对脑血栓的微循环障碍、血液粘度、β－脂蛋白、甘油三酯、血小板聚集等异常指标改善不大（Ｐ＞０．０５）。提示：蝮蛇抗栓酶是优于维脑路通的降粘药物。     

玻璃熔窑蜂窝状窑顶的节能机理及效果

根据窑顶辐射率，内表面积和角系数的变化，窑顶，胸墙和玻璃液面温度的改变，以及火焰－窑顶－胸墙－玻璃液面四者之间的辐射热交换，阐明了熔窑蜂状窑顶的节能机理。用计算机通过实例计算，定量表明了蜂窝状窑顶的节能效果。     

高血压患者左室构型和房性心律失常的关系

目的了解高血压患者左室构型和房性心律失常关系。方法应用超声心动图及动态心电图，测定左室结构及房性心律失常发生率。结果Ｋｌｅｉｇｅｒ３～６发生和构型有联系（Ｐ＜０．００１）。结论左室构型影响房性心律失常。     

五瓣法整复条蹼状瘢痕挛缩畸形

报告了一组应用五瓣法（５—Ｆｌａｐｔｅｃｈｎｉｑｕｅ）整复损伤和烧伤所致蹼状瘢痕挛缩畸形，获得良好治疗效果。并就手术设计、原理、操作方法及适应证进行了讨论。     

Greenfield filter prophylaxis of pulmonary embolism in patients undergoing surgery for acetabular fracture.

Pulmonary embolism is a potentially lethal complication among patients with acetabular fractures requiring surgery. The reliability, safety, and extent of efficacy of pharmacologic as well as existing nonpharmacologic anticoagulation prophylaxis in this patient group has not been determined. A careful analysis of the myriad factors acting on these patients who have had major trauma and have undergone a major surgical procedure about the hip prompted a change in our approach to prophylaxis in this patient group. In the period from March 1984 through October 1987, 51 patients having 52 acetabular fractures underwent osteosynthesis at the Wake Forest University Medical Center. Twenty-four patients had two or more identifiable risk factors and underwent insertion of a Greenfield filter for prevention of pulmonary emboli. Filters were inserted at the time of acetabular surgery with C-arm guidance via the internal jugular vein approach. The average time for insertion was 57 min. Placements were verified by plain roentgenograms. There were no complications during filter insertion. Four patients with filters (17%) developed leg edema; in three the edema was minor, and in one the filter trapped what could have been a fatal embolus but caused lower extremity venous stasis severe enough to result in peripheral lower extremity tissue loss. There were no pulmonary emboli (by clinical criteria). The remaining 27 patients had routine medical prophylaxis and no filters. In this group, two patients had a clinically evident pulmonary embolus (7%), and one of these patients died. Two other patients (7%) had minor chronic leg edema. In one of them, a proximal deep venous thrombosis in the lower extremity was documented with venography, requiring rehospitalization and anticoagulant therapy.(ABSTRACT TRUNCATED AT 250 WORDS)     

胆囊病与冠心病的关系

为探讨胆囊病与冠心病的关系。本文对217例胆囊病和306例冠心病易患因素及发病情况进行对照分析。结果发现胆囊病合并冠心病的发病率为11.28%;胆囊病合并冠心病多见于女性;胆囊病合并冠心病者血清胆固醇和β脂蛋白水平、脂肪肝的发生率明显高于单纯胆囊病和单纯冠心病者。表明胆囊病与冠心病关系密切。