薤白的本草考证

通过本草考证与实地考察,认为古代所用的薤白是百合科植物薤Allium chinense,而不是小根蒜A.macrostemon,把小根蒜作薤白使用发生在清代以后,建议把薤与小根蒜并作中药薤白的植物来源。     

应用苯妥英钠后急性低压缺氧条件下大鼠脑单胺递质的变化

目的探讨苯妥英钠（Ｄｉｐｈｅｎｙｌｈｙｄａｎｔｏｉｎ，ＤＰＨ）在急性缺氧条件下的脑保护作用。方法给大鼠应用ＤＰＨ，用荧光分光法检测其在低压舱模拟升空７．５ｋｍ后１ｈ、２ｈ的脑匀浆单胺递质含量，同时观察脑细胞形态学改变。结果ＤＰＨ实验组在缺氧１ｈ及２ｈ时脑多巴胺和５－羟色胺含量升高（Ｐ＜０．０５），而脑去甲肾上腺素在缺氧１ｈ时降低（Ｐ＜０．０５），缺氧２ｈ恢复正常。电镜形态学观察，低压缺氧条件下对照组大鼠脑细胞水肿，线粒体嵴严重缺失，细胞核明显变形；应用ＤＰＨ的实验组细胞形态基本正常。结论给大鼠应用苯妥英钠后，在急性缺氧条件下，动物脑单胺递质含量的变化可能与缺氧适应或耐受的形成有关。     

王正公老师治学之道

王正公,四世业医,行医六十余年,家学渊源,擅治外感热病,主张“伤寒温病一炉共冶,新感伏邪在于辨证”,尤推崇张子和六门三法,主张“攻病宜早,达邪务尽”。先生重视临床实践,有遍尝百草、以身试药之习惯,且善于向病家学习,不断总结临床经验,他谦虚好学,广交师友,能博采众长,好读书,常以“养心莫善寡欲,至乐无如读书”作为座右铭。他做为全国名老中医专家学术思想研究班指导老师,对学生循循善诱,谆谆教导,真可谓呕心沥血。他勤于笔耕,发表论文七十余篇,出版书籍《哮喘与慢支的防治和康复》及将出版《正斋医稿》二书。     

Microvascular free tissue transfer in head and neck and esophageal surgery

Successful reconstruction for excisional defects of the head and neck and esophagus was accomplished in 93 percent of our patients using microvascular free tissue transfer. Complete failure occurred in 7 percent of the patients. Major defects after head and neck cancer surgery constituted the main indication for use of microvascular free tissue transfer for reconstruction. Ninety-four percent of the patients had undergone an extensive excisional procedure. A wide range of cutaneous, myocutaneous, and osteocutaneous free flaps, as well as free bowel autotransfers were used. Complete failure was three times higher in the previously irradiated patients (4 of 41 patients) compared with nonirradiated patients (1 of 34 patients). Morbidity and mortality rates were consistent with expected ranges in patients who were undergoing major head and neck resection. Donor site complications occurred in 23 percent. Thin flaps are favored for reconstruction of anterior defects in the oral cavity, whereas bulkier flaps are more suitable for deeper defects in the oropharynx and hypopharynx. The advantages are both aesthetic and functional. The free jejunal autograft is considered the reconstructive method of choice for defects produced by laryngopharyngoesophagectomy. Highly developed and sophisticated microsurgical skills continue to be the mainstay of success. The implication of free tissue transfer failure, especially for defects of the upper aerodigestive tract, are impressive in terms of morbidity, mortality, and cost. These considerations limit the application of this method of reconstruction to centers that have sophisticated and productive reconstructive surgeons with microsurgical skills.     

Successful treatment of a case of electrical burn of the abdomen complicated with intestinal perforation

This article reports the experience of treating a case of high voltage electrical burn of the abdomen complicated by intestinal perforation. The diagnosis and treatment are discussed and a review of the foreign and Chinese literature given.     

王船山历史哲学的大视域

由历史之势与历史之理结合而形成的历史过程在王船山那里被表述为“天” ,它既是一种秩序 ,也是一种视域。“天”与“人”相对 ,它意味着非人为性 ,也就是说 ,历史秩序具有非人为设计、非计划的特征 ,它是一个自生自发性的、自然而然的过程 ,因此 ,它也不是某种先验的“应当”的实施或具体化 ,也不是超验的绝对本源的展开过程 ,道德化与形而上学化的历史书写应该被拒绝。另一方面 ,天又超出了人的预知能力 ,因而 ,历史秩序是未决定性的 ,不可测度的 ,它显示的是历史理性本身的“机巧”。王船山的历史哲学 ,向我们展现了一个以流动性、未决性、自生自发性、非人为计划性为特征的秩序观。自发性的历史秩序同时也意味着一种历史的大视域 ,它超越了以个人或现在为中心的“小视域” ,换言之 ,历史过程一方面把主体与他人关联起来 ,另一方面 ,又在过去、未来与现在之间建立联系。个人的活动只有与这种大视域结合起来 ,才真正具有历史的意义 ,主体也只有与它联系起来 ,才能获得存在的历史深度。因此 ,参与历史、走向历史性的生存 ,关键是把主体与历史大视域的“天”融合起来。     

Tangential excision of eschar for deep burns of the hand: analysis of 156 patients collected over 10 years

Deep burns affecting the dorsum of the hand have been treated by tangential excision of the eschar in 156 patients involving 208 hands. From our 10-year experience we have concluded that: If the patient's general condition permits it all hands with deep partial and full thickness skin loss burns are suitable for early tangential excision of the eschar. The best time for the operation is within the first week after injury. If the burn is of limited extent and the requirement for autograft skin is small the operation may be carried out under nerve block anaesthesia. When the burn is more extensive (i.e. involving both hands) intravenous ketamine anaesthesia is recommended. During tangential excision sequential layers of tissue must be removed until the base of the burn appears porcelain white in colour, has a lustrous appearance with many small bleeding points and is firm in consistency. If there are deep burns of the finger webs they are incised or excised and then grafted. Postoperatively an absence of fever, pain or exudation from the wound indicates that inspection of the wound can be delayed for about 2 weeks. By this time the wound is usually healed and functional rehabilitation and physiotherapy can commence.     

辽吉冰凉花总甙对心功能影响的实验研究

辽吉冰凉花总甙(APAW)1.0mg/kg iv,能使麻醉家兔正常心脏的P-dP/dt环体面积(LO),LV-dP/dt_max,Vpm及LVSP比药前增大,HR减慢。APAW和冰凉花(AAR)及毒毛旋花子甙K(SK)一样,能明显改善衰竭兔心的心功能。静脉恒速输入0.5 mg/ml APAW,25min后,心衰家兔的LVSP,LV—dP/dt max,LO均明显回升,LVEDP降低,t-dP/dt max缩短。三种强心甙的最大强心效力无显著性差异。但APAW的治疗宽度和治疗指数均较AAR和SK为大,而AAR和SK间则无显著性差异。