岭南针灸发展史概述

砭石、药物、艾灸、毫针、导引等中医治病方法,岐伯在《黄帝内经素问·异法方宜论》中指出灸法起源北方,因"北方者,天地所闭藏之域也,其地高陵居,风寒冰冽,其民乐野处而乳食,脏寒生满病,其治宜灸焫。故灸焫者,亦从北方来。"岭南地理气候湿热,灸法按理不适广泛使用,但是从现存的古代岭南针灸文献中,大都与灸法相关。当今学者对岭南医学的研究,采取"博古约今"取材原则。"博古"即明清以前,五岭之南皆收而录之;"约今"即明清以后,核心部位在广东尤其珠江三角洲,广东称为"岭南"。古代岭南号称"瘴疠"之乡,在其医学漫长的发展过程中形成了独具特色的地域流派,岭南医学。在其针灸学发展过程中,出现过一些有影响的针灸医家,如著名女灸家鲍姑,有的还撰写了不少针灸著述,可惜很多已佚失,现存有关针灸的文献仅有《肘后备急方》《采艾编》《采艾编翼》《幼幼集成》等寥寥数部针灸学专著。本文针对现存的清及清以前岭南针灸医家及其学术成就进行简单梳理,希望为今后岭南针灸学的深入研究助以微薄之力。     

Bug off! Severe toxicity following inhalational exposure to N,N-diethyl-meta-toluamide (DEET)

N, N-diethyl-meta-toluamide (DEET) is an insect repellent currently used by millions of people since 1956. DEET has an excellent safety profile and has remarkable protection against mosquitoes, ticks and various other arthropods. Toxicity is unusual, and is generally associated with incorrect, or overuse of the product. We report a patient with severe toxicity following inhalational exposure to a “bug bomb”.containing 98% DEET.     

Upper limb ischemia resulting from arterial thromboembolism.

Acute ischemia of the upper limb is commonly caused by trauma and embolic arterial occlusion. However, primary atherosclerotic thrombosis is found infrequently and concern regarding its incidence, recognition, and treatment prompted a review of our clinical experience. Of 36 patients with acute ischemia of the upper limb, 17 (47.2 per cent) had embolic occlusion, 9 (25 per cent) iatrogenic thrombosis in the brachial artery, and 10 (27.8 per cent) primary arterial thrombosis. Of the total group, noncardiac arterial emboli (two patients) and primary atherosclerotic thrombosis (six patients) accounted for 8 of 36 (22.2 per cent) ischemic limbs. Including 2 additional patients who had atherosclerotic thrombosis associated with trauma, the total number represented 10 of 36 (27.8 per cent). An aggressive approach to the undiagnosed patient with acute ischemia of the upper limb is warranted, including the use of arteriography in most cases. In patients with iatrogenic thrombosis in the brachial artery, we believe that the routine use of intraoperative arteriograms may improve the operative results.     

无神经系统定位体征的癲癇大发作患者的EEG和CT分析

目的探讨无神经系统定位体征的癲癇大发作患者的脑电图(EEG)和脑CT变化.方法 68例无神经系统定位体征的癲癇大发作患者作EEG 及脑CT检查.结果 EEG异常率为82.35%,CT异常率为32.35%.CT正常组和异常组中,EEG异常率无明显差异.CT异常率与病程关系不大,但有发病诱因的继发性癲癇CT异常率较无明显原因者显著增高.结论 EEG为癲癇诊断的重要电生理检查方法,且有粗略定位意义,而CT能显示脑结构方面的病理改变,有利于查找病因及病变部位.