Clinical experiences with fetal heart rate monitoring of one thousand patients in labor

A series of 1,000 labor patients has been monitored electronically, and their records reviewed. Monitoring provides accurate objective evidence that fetal condition is good and that tolerance for labor is normal. With a normal record, the likelihood is strong that a normal baby will be delivered. Electronic fetal heart rate monitoring is unreliable in the prediction of babies born in poor condition. It does, however, provide an excellent screening test for selection of patients for scalp pH determinations. Electronic monitoring of fetal heart rate provides early evidence of fetal anoxia. It should be carried out in all patients receiving oxytocin during labor to avoid episodes of fetal anoxia. External monitoring methods currently available permit routine monitoring of all patients in labor. Whether monitoring all normal patients will improve fetal health and survival is still an unanswered question.     

Sacrifice of the unsatisfactory hand.

A hand which compares unfavorably with a prosthesis in function, comfort, and appearance may be better amputated. This decision must be made conjointly by the surgeon and the patient. Contributory factors are severe tissue loss, pain, appearance, infection, functional requirements, sexual reasons, psychological makeup of the patient, economics, safety, the time elapsed since injury, the patient's body image and his desires, and the surgeon's opinion. Fifteen patients elected hand amputation for various combinations of these factors. Eleven were fitted with a prosthesis at the time of operation and three within 3 weeks. All patients expressed satisfaction with their decision and 12 were successful users of the prosthesis.     

Ultrasonic identification and examination of fetal heart structures

Ultrasonic studies were performed on normal fetuses ranging from 36 to 40 weeks gestational age in an attempt to visualize anatomical details of the fetal heart. We were able to visualize cardiac structures hitherto thought to be unidentifiable. Two-dimensional B-scan exposures of sections showed transverse and longitudinal sections of the fetal heart, including the cardiac septa and inlet and outlet sites of the large vessels. To attempt to elucidate the dynamics of the fetal heart, the motility patterns of the cardiac structures were examined by time-motion mode scanning and the patterns obtained were compared to those observed in the postnatal heart. The reliability of the theories advanced and the further prospects are discussed.     

对《诸病源候论》毒邪症状界定的分析

《诸病源侯论》论毒邪篇幅之多,明目之清,发前人所未发,打破传统束缚,注重临床实际。如其提出毒邪判断要以阴阳为纲;毒邪向内为病重,向外为病轻;赤白为轻,青紫黑为重;过肘膝为重,以及伤肠胃心肝脾肾均有不同的症状特征,提示了六淫从化于毒,毒邪与六淫有不同表现等问题,值得一读。     

防范医疗纠纷 提高病案基础质量

防范医疗纠纷 ,必须提高病案基础质量和医疗工作者意识 ,认清病案基础质量存在的主要问题 ;对存在问题进行改进 ;保证病案基础质量 ,维护自己和医院合法权益。