1979年 · 第92卷第01期

In this article the author, after making a preliminary comment on traditional Chinese medicine, tries to present the modern concept of acupuncture. The nature of the so-called needling sensation, the efficacy of acupuncture according to stimulus strength and the relative specificity of acupuncture points are all reassessed from the neurophysiologic point of view. On the basis of experimental and clinical evidence the analgesic effect of acupuncture is considered as essentially the result or sensory interaction in the central nervous system. The path ways for mediation of the pain-inhibiting impulses arising from the point of acupuncture are believed to be in the extralemniscal system and the centromedian nucleus of the thalamus. The mode of the inhibitory action of the afferent impulses on the discharges of pain sensitive neurons in the thalamus and the neuronal circuit involved in this action are suggested. Endogenous morphine like peptides in the brain are envisaged as a possible synaptic transmitter involved in the process of acupuncture analgesia, acting in coordination with other endogenous substances for inhibition of pain.

21 cases of pathologically proved hepatic cavernous hemangioma were reported. The great majority of patients were between 40 and 50 years of age. The male to female ratio was 1:1.1. The incidence of single tumors in the left and right half of the liver was about the same. The biggest tumor resected measured 63×48.5×40 cm. The diagnosis of the disease is described in some detail. The most ideal method of treatment is thought to be surgical excision. Of 20 patients treated by this method, only 1 died. The others are living and well.

52 cases of bladder tumors, chiefly papilloma and papillary carcinoma and 1 case of carcinoma in situ, are treated with camptothecin, a comparatively new anti-neoplastic chemical compound, by instillation or local injection. The number of instillation varies from less than 10 times to over 200 times. 9 cases with 12 tumors, all non-infiltrative, received 1-6 local injections each. Few side effects and no serious complications have been observed. The clinical effects of 33 cases in the therapeutic group are: a. instillation group: complete disappearance of tumors 17 cases; unaffected 12 cases; not followed-up 4 cases. b. local injection group: 9 tumors sloughed off after 1-6 injections. Intra-bladder instillation of camptothecin after disappearance of tumors is proved to help prevent tumor recurrence. As to the 19 cases in the preventing group, no recurrence was noticed.

The influenza virus being characterized by antigenic mutation which exerts a decisive effect upon the scope of the epidemic which ranges from a few sporadic cases to pandemic magnitude, studying the local history of the disease, gaining an insight into its epidemiologic features and making strenuous efforts to hunt down cases are some of the prerequisites for the effective prevention of an epidemic. The emergency room of a Shanghai district-level hospital has been used as an observation post since 1973. It is shown that the data collected from this post on hyperpyrexic cases suffering from acute upper respiratory tract infections not only throws light on an influenza outbreak, but also on the probable epidemicity for the coming year. Hence the establishment of an observation post using the 95th or 99th percentiles as an indicator for prediction has become routine in district anti-epidemic stations here.

A brief account is given of some problems concerning organic psychosis. Its pathogenesis, onset and progress, severity and extent, site of brain damage, as well as individual predisposition and age are discussed in differential diagnosis, focal cerebral lesions presenting mimic psychiatric symptoms, functional psychiatric syndromes in brain damage and severe depression are emphasized. General principles of treatment are outlined.

Cholinesterase activity in more than 2,000 Ancylostoma duodenale and more than 1,000 Necator americanus collected from 205 cases was determined by estimating the pH change after the administration of various anthelmintics. The results demonstrated that with all anithelmintics, except dipterex, N. americanus showed a much higher activity of cholinesterase than A. duodenale. It is suggested that this marked difference in response of the worms to the same drug could reflect the difference in the metabolic processes of different species of hook-worms and account for the difference in the effectiveness of drugs used. Careful classification of the species for effective treatment is emphasized.

A simple method for detecting antigenic variation of influenza virus is described. Convalescent sera of infant patients of 6 months to 1½ years of age were used to perform hemagglutination inhibition test (HI) against newly isolates and typical strains of influenza A virus isolated during the past few years. The existence of any new influenza variants could be readily shown with a rise of HI titers. The method is simple, rapid, highly specific and easy. Apparatus required are available in most of the regional anti-epidemic stations of this country. The stepladder curve produced by the results of this method graphicaXy illustrates the main course of antigenic variation of influenza A virus from 1968-1975.

Cefathiamidine was first discovered and employed in this country in 1974. It possesses the merits of broad antibacterial spectrum, strong antibacterial activity, good tissue distribution and few side reactions. It was tried simultaneously with good results (87.44%) in 16 clinical institutions on 191 cases, including severe infections such as septicemia, bacterial endocarditis, pulmonary infections, purulent meningitis, hepatic abscesses, acute peritonitis, etc. The essentials concerning its antibacterial activity, pharmacologic properties and clinical applications are discussed in this paper.

A sensitive and stable RREA technique utilizing specific incorporation of radio-labelled antigen into the immune-precipitate has been developed for measuring serum alpha-fetoprotein (AFP) concentrations. AFP positivity rates of 83% and 85% were found among PHC patients in Peking and in a high incidence area, In a field survey over 10,000 people, 2 characteristic patterns of AFP elevation had been studied. Among 6 patients detected and operated on before AFP level exceeded l,000 ng/ml, 3 have done well and survived over 4 years. AFP doubling times before operation varied from 25 to 60 days. Cancer cell density was estimated to be in the range of 1.3-2.9×108 cells/cm3. All 3 asymptomatic patients with early PHC showed liver hyperplasia and positive serum HBsAg, 2 had episodes of low level AFP elevation during the years of follow-up.