健肝愈胃汤合西药治疗门脉高压性胃病临床观察

目的探讨中药健肝愈胃汤（自拟）、西药心得安、奥美拉唑、胶态果胶铋胶囊联合治疗门脉高性胃病（PHG）的疗法。方法将136例PHG患者随机分成两组,对照组52例常规口服心得安、奥美拉唑、果胶铋;治疗组84例在常规服用以上西药的同时服用中药健肝愈胃汤。两组疗程均为2个月。结果治疗组临床治疗总有效率89.3%。显效率46.4%;对照组临床治疗总有效率80.7%,显效率13.5%。两组比较有显著性差异（P〈0.05）。结论中药健肝愈胃汤、西药心得安、奥美拉唑、果胶铋联合治疗PHG疗效显著。     

自拟人参二苓解毒汤联合盐酸恩丹西酮注射液治疗顺铂引起恶心呕吐临床观察

[目的]探讨顺铂引起恶心呕吐的有效治疗途径。[方法]对肺癌患者64例,随机分2组。自拟人参二苓解毒汤联合盐酸恩丹西酮注射液(以下简称商品名欧贝)(B组)和单独使用欧贝(A组)对顺铂为主的静脉化疗后镇吐疗效。[结果]B组(78·13%,93·75%)较A组(59·38%,75·00%)在近期镇吐治疗(指化疗后24-48h出现恶心呕吐)有明显差异(P<0·05),并在副作用方面,如便秘,乏力症状和血三系下降有明显差异(P<0·05)。[结论]辅以自拟人参二苓解毒汤确有增效解毒功能。     

胃胆宁汤治疗胆汁反流性胃炎54例

目的:观察自拟胃胆宁汤治疗胆汁反流性胃炎的临床疗效。方法:选符合标准的该病患者82例,随机分为两组,治疗组54例予自拟胃胆宁汤,对照组28例用吗丁啉片及雷尼替丁,两组治疗4周为1疗程。结果:治疗组痊愈20例,显效13例,有效16例,无效5例,总有效率为90.74%(95%CI=83.01%～98.48%);对照组痊愈5例,显效6例,有效9例,无效8例,总有效率为71.43%(95%CI=54.70%～88.16%);两组综合疗效比较,有显著性差异(u=2.3027,P=0.0215)。结论:自拟胃胆宁汤治疗胆汁反流性胃炎疗效优于吗丁啉及雷尼替丁,其收益为OR=0.25(95%CI=0.07～0.87),NNT=5(95%CI=2.78～37.88)。     

根据桂枝汤的效应消除半衰期和表观消除半衰期制订给药方案的探讨

为探讨药效法估测的效应消除半衰期和效量法估测的表观半衰期对合理制订给药方案的意义和作用,以桂枝汤解热和抗炎的药物动力学实验中所得的相应参数值设计了给药方案,观察了它们在提高药效上的作用。结果表明在给药总剂量相等、首次给药同时开始的情况下,以半衰期设计的给药方案组的药效均明显高于习惯的一次给药组;而以效应消除半衰期设计给药方案组药效增强率又高于以表观半衰期设计的方案组。提示效应消除半衰期比表观半衰期似更有实践意义。     

中西医结合治疗胫腓骨开放性骨折82例

对８２例胫腓骨开放性骨折，采用中西医结合治疗收到良好效果，治疗中主张在彻底清创的基础上使开放性骨折变为闭合性骨折，外固定时要求患者呈坐位，让伤肢自然下垂悬空，利用肢体的垂直重力作用使骨折正确复位，再根据具体情况进行有效的外固定。少用内固定，在用药方面，根据骨折治疗的不同时期采用中西药结合的辨证论治，同时强调早期进行功能锻炼。     

Investigations on integration of mossy fiber inputs to Purkyně cells in the anterior lobe

Summary The 275 Purkyn cells identified by the criteria of the previous paper have been investigated with respect to their role as units integrating the input to the anterior lobe from various limb nerves. The discharges from single Purkyn cells have been studied in lightly anesthetized (pentothal) or in decerebrate unanesthetized cats, there being averaging usually of 128 responses in the form of post-stimulus time histograms and cumulative frequency distributions.Single Purkyn cells exhibited a wide variation in their responses to the diverse inputs from the various afferent nerves. Attention was focussed on excitatory and inhibitory responses evoked by mossy fibers with a short latency, usually 10–15 msec for hindlimb afferents. With most Purkyn cells these responses were predominantly evoked from cutaneous nerves, low threshold fibers being particularly effective. A few Purkyn cells were preponderantly excited by afferent volleys from muscle nerves, but there was a large group with a mixed input from cutaneous and muscle nerves. Graded strengths of stimulation of muscle nerves showed that sometimes group I volleys were prepotent, but other Purkyn cells were selectively excited by group II volleys. Though sometimes the afferent volleys from antagonistic muscles had a reciprocal action on a Purkyn cell, as on a motoneurone, it was more common to find similar actions. Also convergence of inputs from forelimb and hindlirnb nerves, both cutaneous and muscular, was not uncommon, particularly in marginal areas between hindlimb and forelimb zones. A special design feature is the convergence onto a Purkyn cell of mossy fiber and climbing fiber inputs evoked by the same afferent volley. This convergence was of particular interest along the parasagittal strip of hindlimb climbing fiber distribution in lobule V.It was not possible to translate the observations into some map of the cerebellar cortex on which are marked the territorial distributions from the various limb afferent nerves. Rather, there was an ill-defined patchy character, closely adjacent Purkyn cells often receiving very different subsets of the total input from the various limb nerves. The unitary integrations accomplished by the individual Purkyn cells are further integrated when their axons converge onto and inhibit the neurones of the cerebellar nuclei, and this integration by convergence would occur in each successive relay on the output pathways from the cerebellum.It is pointed out that the experimental findings on the integrative action of the individual Purkyn cells provide basic information for attempts to construct models simulating cerebellar performance and control.Post-Doctoral Fellow NINDS (1F2NB40, 545101 NSRB).Post-Doctoral Fellow UHF Grant No. FTF-3-UB-70.     

《伤寒论》水气证治论析

就《伤寒论》水气的涵义、致病特点、形成与发病、证治等方面进行了分析和探讨。认为：水气是一个病理概念,具有病理产物和致病因素的双重性,其本质是体内停蓄之水,其致病过程具有动而不居的特点;痰饮、水肿、湿痹皆是水气为患。水气的形成机制是阳虚,阳不制阴。治疗以“温药和之”为常法,振奋阳气以祛除水气;非尽以温药和之为变法,攻逐、清热、滋阴皆在其中。     

6. Die Chirurgie in der Entscheidung — 20 Jahre Berufsverband der Deutschen Chirurgen

Zusammenfasung 1. Chirurgische Arbeit erfordert Wissen und Können, aber auch Reife und Verantwortungs-Fähigkeit. Gewährleisten die derzeitigen Aus- und Weiterbildungsgänge und unsere Haltung dem Nachwuchs gegenüber dieses Erziehungs-Ziel? 2. Die Bewältigung zentrifugaler Kräfte und die Integration autonomer Teile in der Chirurgie gelingt nur mit Hilfe der Teilgebiets-Idee, die Abwehr von Tendenzen, die Chirurgie wieder zum operierenden Werkzeugo zu degradieren, nur durch verstärkte Interaktion mit den Nachbardisziplinen. 3. Die Überwindung der vielfältigen auf die Arbeit des Chirurgen ausgeübten Pressionen ist nur durch Bewahrung einer sich selbst verptlichteten Freiheit als Grundlage aller chirurgischen Berufstätigkeit erreichbar.     

半夏厚朴汤醇提物对大鼠慢性抑郁模型的影响

目的 :研究半夏厚朴汤醇提物对大鼠慢性抑郁模型 (CMS)的影响 ,探索其抗抑郁机制。方法 :以 1%蔗糖水摄入量作为指标 ,慢性给予各种低强度复合刺激 ,造成大鼠慢性抑郁模型。按试剂盒酶法测定血脂 ;采用乳酸脱氢酶 (LDH)释放法测定脾细胞内自然杀伤细胞活性 ;采用邻苯三酚自氧化法测定红细胞内超氧化物岐化酶活性 ;按试剂盒显色法测定血清和组织中一氧化氮合酶活性 ;采用硫代巴比妥酸法测定心脏中丙二醛含量。结果 :在大鼠CMS模型中半夏厚朴汤醇提物可增加动物蔗糖摄入量 ;增加其脾脏自然杀伤细胞活性 ;升高血清中高密度脂蛋白 (HDL C)水平 (P<0 .0 5 ) ,降低甘油三酯水平 (P<0 .0 0 1) ;降低血红细胞内超氧化物岐化酶活性及血清和肝组织中一氧化氮合酶活性 ;同时抑制组织中脂质过氧化程度 ,降低心肌组织中丙二醛含量。结论 :半夏厚朴汤醇提物通过多途径而达到抗抑郁作用。