A Statistical Analysis of Lung Cancer Registered in the Annual of Pathological Autopsy Cases in Japan between 1958 and 1987, with Special Reference to the Characteristics of Lung Cancer in Japan

Autopsy cases of lung cancer, 41,988 in males and 13,818 in females, consecutively registered between 1958 and 1987, were analysed statistically and compared with other case materials and mortality statistics. Cases of malignant tumor showed a gradual increase, and now comprise 60% of the total male and 55% of the total female autopsy cases. The percentage of lung cancer cases among the total autopsy cases was 9% for males and 5% for females. The percentage of lung cancer cases among total cases of malignant tumor was about 17% for males and 9% for females. Among fatal malignant tumors, gastric cancer and lung cancer showed the highest frequency. The relative incidence of gastric cancer was seen to decrease, whereas that of lung cancer increased. Of the histological types of lung cancer in both sexes, adenocarcinoma was the most frequent, followed by squamous cell carcinoma. During the period studied the peak age of patients with lung cancer shifted from the seventh to eighth decade, and a significant elevation of mean age was demonstrated for all of the major histological types in both sexes. The male: female ratio for all lung cancer cases was 3.0, which was much lower than those for the United States and Europe, but very similar to the ratios of mortality statistics in Japan and other Asian countries. As a result of a previous autopsy study at the University of Tokyo, it was also confirmed that the male: female ratio relative to age in each country reflects very well the histological distribution.     

《丹溪医案》成书与流传考略

《丹溪医案》是元代朱震亨的一部医案集,目前无刊本、抄本流传.明代贺岳所著《医经大旨》中征引了部分医案,笔者以此为线索,结合史志书目记载及医学著作中《丹溪医案》内容的征引情况,综合考查《丹溪医案》的成书与流传状况,并此推测《丹溪医案》确有刊本流传,但是流传不广.     

《千金》解肌汤方义及验案举隅

[目的]基于《里中医案》,探究明代医家李中梓遣方用药的特点。[方法]纳入李中梓《里中医案》中所载医案134例,整理其中所载方剂和药物,建立临床方药数据库,描述方药频数并进行分析。[结果]《里中医案》的134例医案,使用方剂共53种,中药共203味。方剂使用频数最高的前8位依次是补中益气汤、六君子汤、肾气丸、十全大补汤、理中汤、六味地黄丸、归脾汤、参附汤。两方合用共出现27次,其中两方均为补益剂17次,补益剂与泻实剂合用9次,两方均为泻实剂1次。用药频数最高者分别为人参、甘草、姜、白术、陈皮、茯苓、当归、黄芪、肉桂、熟地、附子、升麻、柴胡等。[结论]李中梓遣方用药具有脾肾双补、偏重补脾,两方合用、偏于补益,用药灵活、细致精准三个特点,其遣方用药特点值得深入研究和借鉴。     

新安医家程原仲辨治郁证经验探析

[目的]探析新安医家程原仲辨治郁证的经验。[方法]以《程原仲医案》为主要研究内容,结合《内经》、丹溪、河间等名家论著,整理、分析程原仲郁证验案,归纳、总结其辨治思路及特色。[结果]程氏认为,凡人身之滞而不通,皆为之郁。诊法上,程氏四诊合参,重视脉诊,擅于凭脉辨证。辨证论治方面,程氏认为,诸因皆可生郁,当各求其属,随证治之。虚可致郁,郁久易虚,解郁补虚须审察标本,谨守病机,同时重视脾胃中土的枢机作用。治疗时,若情志不舒、气机郁滞,治以开郁养心;若误用寒凉、血郁邪伏,治以开郁逐邪;若误用温补、气血郁滞,治以行气开郁。程氏临证善用古法而不泥古,常有独创之见,脾胃中土,畏其壅淤,郁则夺之,有硝黄下之,有桂附温之,亦有平胃散燥之,皆为“土郁夺之”之发挥。对于儿科患者的辨治,程氏重视气的生理作用,提出“幼无七情,惟气滞则诸病生焉”,治疗则重在调畅气机。[结论]程氏临床诊治郁证,善从脉证入手,治疗上注重调和脾胃中土和全身气机。整理分析程原仲郁证验案及其辨治特色,可为现代临床中此类疾病的治疗提供更广阔的思路。     

胆内瘘56例诊治分析

目的：探讨胆内瘘的诊断及治疗方法；方法：对1989年－2002年胆内瘘病人进行回顾性分析；结果：仅14.3%(8/56)的病人术前诊断胆内瘘，85.7%(48/56)的病人为术中发现;在胆内瘘类型中,76.8%(43/56)为胆囊十二指肠内瘘,14.3%(8/56)为胆囊胆总管内瘘,5.4%(3/56)为胆囊胃内瘘,3.6%(2/56)为胆囊横结肠瘘;结论:胆内瘘术前诊断困难,对长期胆囊结石病人,尤其是发现胆道积气征应高度怀疑,其治疗方法可采用胆总管瘘口、十二指肠瘘口、横结肠瘘口修补等方法，对胃瘘口可采用瘘口修补或胃部分切除处理。     

大骨节病体液生化类型与早期诊断方法研究

对大骨节病区7-13岁儿童1987人次的体液生化检查,发现大骨节病儿童具有特殊的生化类型。检查项目包括碱性磷酸酶(ALK)、谷草转氨酶(GOT)、谷丙转氨酶(GPT)、乳酸脱氢酶(LDH)、磷酸肌酸激酶(CPK)、γ-谷氨酰转肽酶(GGT)、α-羟基丁酸酶(α—HBDH)、血清磷、血清钙、尿肌酐、尿肌酸、尿粘多糖、尿羟脯氨酸、尿类卟啉、尿总硫等15项指标。经过用判别分析方法筛选,构造了血清酶谱与尿液生化两个判别方程组,可用于对个案做生化类型划分和诊断亚临床病例,亦可先于 X 线改变预测点区病情的动态。     

Acupuncture Treatment for 98 Cases of Ventricular Premature Beat

Ventricular premature beat is a commonly encountered arrhythmia,which can occur in patients with and without cardiac diseases.In TCM.ventricular premature beat fall into the category of palpitation and obstruction of qi in the chest.The authors treated it with acupuncture and obtained satisfactory thera-peutic effects.A summary follows.     

王颖治疗眼肌麻痹经验

王颖教授在针灸临床中本大医之精诚,精研针理穴法,提出"同一穴位,针刺方向、深度不同,作用不同"的理论。治疗眼肌麻痹以整体观念、经络理论、脏腑学说为基础,以"补气行血健脾,祛邪通络疏肝"为治疗原则,运用"眶内与眶外针刺相结合"的方法,屡见奇效。文章从中医基础理论入手,阐述针灸治疗眼肌麻痹的具体方法和注意事项,并通过选取的两则医案,介绍了王教授治疗眼肌麻痹的诊疗思路和临证经验,最后讨论了中医治疗眼肌麻痹的优势。     

骨髓结核病1例及文献复习

本文介绍一例骨髓结核患者的临床表现、实验室指标、治疗等,并进行相关文献复习。该患者临床表现为发热、呼吸困难,骨髓病理示造血细胞增生 活跃伴肉芽肿,并淋巴细胞浸润。痰找抗酸杆菌 2+。腰椎穿刺送检脑脊液示：脑脊液压力 260mmH 2 O,脑脊液糖/血糖 0.119,腺苷脱氨酶（ADA） 5.0U/L 经抗结核、抗感染及对症支持治疗等未能逆转疾病进展。