急性泪囊炎不同排脓途径的疗效观察

由于急性泪囊炎的一期处理过程中经泪小管引流脓液与经皮肤切开排脓对治疗效果的影响不同,将我院2007年以来接诊的急性泪囊炎患者随机分为观察组与对照组:患者抗感染治疗后经泪小管引流脓液,成人行经鼻内镜泪囊开窗引流术,先天性泪囊炎患儿行泪道探通;对照组患者急性期经皮肤切开排脓、放置引流条和消炎处理后再行泪囊鼻腔吻合术.观察组患者治疗成功率98.46％,外观满意率98.25％;对照组患者治疗成功率89.11％,外观满意率54.35％.观察组患者较对照组患者疗程缩短约7天～10天.急性泪囊炎经全身抗感染治疗后行泪小管引流脓液能更有效地控制炎症,不给患者带来新的创伤,值得临床推广应用.     

三种疗法治疗瘢痕疙瘩的比较研究

探讨手术加醋酸曲安奈德注射加放射治疗瘢痕疙瘩的临床意义.根据不同治疗方案分组,291例瘢痕疙瘩患者分为3组,A组86例,手术切除瘢痕疙瘩后,术中注射醋酸曲安奈德,术后90Sr-90Y敷贴治疗；B组79例,采用手术切除联合术后90 Sr-90Y敷贴治疗；C组126例,采用单纯醋酸曲安奈德局部注射治疗.比较3组治愈率、有效率和并发症的差异.结果A组治愈率和有效率分别为82.56％、93.02％；B组治愈率和有效率分别为74.68％、89.87％;C组治愈率和有效率分别为30.95％、57.94％；A、B组治愈率、有效率明显优于C组,差别均有统计学意义(P＜0.05)；A组治愈率、有效率略优于B组,但无统计学上的差异(P＞0.05).综合疗法治疗瘢痕疙瘩是比较有效的方法,术中注射醋酸曲安奈德治愈率与有效率略高于手术切除联合术后90 Sr-90Y敷贴治疗,但无统计学差异,不影响切口愈合.     

三维适形放疗治疗晚期腹部恶性肿瘤的临床受益和毒副反应

为观察三维适形放疗治疗晚期腹部恶性肿瘤的临床受益情况和毒副反应。对38例晚期腹部恶性肿瘤患者进行三维适形放疗,疗中和疗后进行临床受益情况和毒副反应的观察和评价。结果临床受益情况：有效为28．9％,稳定为42．1％,疼痛缓解率为28．9％;毒副反应主要为骨髓抑制、胃肠道反应、生化指标改变,除少数病例出现Ⅳ度生化指标改变外,其余均在Ⅲ度以下。结论三维适形放疗可以提高晚期腹部恶性肿瘤患者的生存质量,毒副反应轻微,是一种有效的姑息治疗手段。     

强迫思维服刑人员的认识领悟疗法咨询个案报告

目的:初步探索认识领悟疗法在监内治疗强迫思维服刑人员的效果。方法:1例强迫思维服刑人员在监内接受连续5周,每周一次的认识领悟疗法治疗。采用SAS、SDS、耶鲁—布朗强迫症量表(Y-BOCS)对在干预前、干预后分别实施测评,并收集来访者、他人和治疗师的随访评价。结果:个案经认识领悟疗法治疗后三月随访,焦虑、抑郁水平下降,Y-BOCS减分率达58%,痊愈。结论:认识领悟疗法在监内治疗强迫思维服刑人员存在一定的效果,但未来仍需更多的实证研究来证实。     

动作疗法在灾后心理康复中的运用

在四川经历了汶川大地震后两年,青海又发生了玉树地震。地震灾害不仅对灾区幸存者造成了身体上的伤害,让人们失去家园和亲人,在心理上也给他们造成了严重的创伤。因此,对于这类人群的灾后心理康复治疗尤为重要。然而,幸存者心理的康复,单纯依靠心理辅导和治疗是不够的,而肢体上的运动能够起到缓解心理症状的良好效果。动作疗法就是一种行之有效的疗法。本文将介绍动作疗法在灾后心理康复的治疗中的运用,并提出具有针对性的动作疗法的措施。     

焦虑障碍的虚拟现实暴露疗法研究述评

虚拟现实暴露疗法(VRET)是传统的行为疗法的一种转换形式, 也是经典的现实情境暴露疗法的替代性治疗形式。虚拟现实整合了即时计算机图形学、身体感觉传感、视觉成像技术, 给来访者提供近似真实的、可以沉浸(immersion)和交互作用的虚拟环境。研究者采用虚拟现实暴露疗法治疗幽闭恐怖症、恐高症、飞行恐怖症、创伤后应激障碍、惊恐障碍等焦虑障碍, 并且关注虚拟现实暴露疗法的认知机制以及心理生理机制。实验研究表明, 虚拟现实暴露疗法在治疗焦虑障碍时是有效的。被试经过治疗之后, 对情境的控制感和自我效能感提升, 消极自我评价降低, 对创伤事件的容忍力提高, 重新获得对情境的控制感。与心率指标相比, 皮肤电是预测虚拟现实暴露疗法治疗效果更好的指标。虚拟现实暴露疗法还处于实验验证阶段, 并没有应用到实际临床中, 需要更加规范的实验设计验证该疗法的认知机制以及心理生理机制。虚拟现实暴露疗法结合功能磁共振成像(FMRI)用于心理治疗, 会是未来发展的新方向。     

慢性乙型肝炎抗病毒治疗

目前对于慢性乙型肝炎所采用的治疗方法主要有抗病毒、免疫调节、保肝降酶等,其中抗病毒治疗是关键。可以使用单药、联合或序贯疗法,应答率约30%~40%,由于其难治性,出现了一些误区,如盲目用药等,需要科学引导。     

藕汤里的母爱

正我一直都很喜欢喝母亲用蜂窝煤炉煨的藕汤,那浓稠的汤汁、烂熟的藕,还有杂骨的清香,都时时诱惑着我的味蕾。只要一想母亲的藕汤,我就忍不住舌上生津,回味无穷。小时候,不管家里多穷,母亲每个月都要煨一大锅藕汤。藕是父亲下湖采的野生藕,有一丝清甜的味道。没钱买排骨,母亲总是买没肉的杂骨,因为杂骨的价钱要便宜一些。煨过汤后,母亲将里面的骨头捞出来放好,留着下一次煨汤时再用,这样一来,     

煨冬

正冬日凛冽的风,把夏秋草木的葳蕤和假象扫荡,留下大把的光阴和广袤的空间。冬日闲,回到"一切都慢"的从前,煨,就是最动人的字眼。煨是什么?是盆中的火。地冻天寒,人们想亲近的,自然是火。火红,四散的是温暖。耶律楚材在送行友人时说:"幸有和林酒一樽,地炉煨火为君温。"这样的情景,令人艳羡。通常,不但没有美酒,连围炉而坐也是奢望。那火,是临时寻到的柴草     

片段弓矫治技术在前牙外伤中的应用

本文探讨片段弓矫治技术在前牙外伤中的应用效果。利用方丝弓矫治器对上前牙外伤68例患者（共89颗外伤牙,其中29颗松动Ⅱ度,51颗松动Ⅲ度,9颗完全脱位）进行复位、固定,并在治疗结束后半年、一年进行随诊观察。一年后固定成功率达到90％以上,患牙及颌骨复位精确,咬合关系恢复良好,并发症少。应用片段弓矫治技术治疗前牙外伤可获得良好的疗效,该技术安全可靠。     

Bilingualism and brain functional asymmetry

The task of the neural organization of the native language, acquired by a direct method and of another language, studied at school, performed correspondingly by the left and the right hemispheres, was studied in the bilingual patient after unilateral electroconvulsive therapy used in psychiatry. It was established that in such a bilingual type the right hemisphere is concerned with the formation of deep semantic structures of the native language while the left hemisphere is responsible for the formation of second language deep structures and of surface structures of both languages. The effect of language learning method on cerebral organization of bilingualism is postulated.     

Effect of personal involvement in traumatic events on memory: The case of the Dolphinarium explosion

The association between memories of the terrorist explosion at the Dolphinarium discotheque in Tel Aviv and the level of personal involvement in the explosion was investigated. Memories of injured victims, uninjured eyewitnesses, and uninvolved controls who learned about the explosion from the mass media were compared. It was expected that memory of the explosion would be most and least detailed and accurate among the victims and the controls, respectively. The participants responded to an open-ended question about the explosion, as well as to specific and multiple-choice questions. Data analyses showed that the victims and the eyewitnesses remembered more details than the controls, and that the victims remembered both central and peripheral details more accurately than the other participants. Degree of involvement in the same traumatic experience was thus shown to be differentially associated with memory accuracy.     

Psychological implications of a vision disorder

The paper discusses how the condition of crossed‐eyes affects a baby's eye contact with mother and potentially results in the loss of a vital emotional connection with her during the earliest days of life. This loss may contribute to a rupture that arrests emotional development at a deep psychic level. It is suggested that, in the same way as premature separation, the rupture can precipitate a ‘fusional complex’, a defence that develops to protect the infant against psychotic anxieties. The paper proposes that psychological development atrophies in this place and creates a blind spot. These ideas are explored through analytic theory and developmental literature. The dreams of a patient and his art are used to illustrate a 10‐year ‘alchemical’ process of bringing repressed material into consciousness and transformation. Healing the psychological wounds of deficits in early eye contact may be found to bring sight to a blind spot that was created by the nature of the condition itself.     

Planning units and syntax in sentence production

The study was conducted to determine, first, whether it is the deep or the surface clause that is more important as a speech planning unit, and second, whether syntactic decisions are made during sentence production. Subjects, while talking, heard tones to which they had to respond by pressing a button; reaction times to these tones were taken as an index of processing load during production. It was found that there were increased RTs at the ends compared with the beginnings of deep structure clauses. No difference was found between RTs at the beginnings and ends of surface clauses not corresponding to a deep clause. The results were interpreted as showing that deep clauses are major planning units and that some planning for clauses occurs at the end of the preceding clause. Differences were found between RTs during clauses of different syntactic structure. These results were interpreted as indicating that syntax influences production and were discussed in relation to previous studies of pausing and speech disruption.     

Disintegration of the self and the regeneration of ‘psychic skin’ in the treatment of traumatized refugees

This paper presents a tentative understanding of the characteristics of the extreme traumas, elsewhere called ‘complex PTSD’, that some refugees and asylum‐seekers bring into therapy. It suggests that these kinds of traumas suffered during adulthood may involve a disintegration of the self and a loss of ‘psychic skin’. This conceptualization is derived from the treatment of a refugee who survived multiple extreme traumas and with whom efforts were made in therapy to identify a complex methodology making use of supplementary therapeutic tools in addition to individual psychotherapy. The case demonstrates how the disintegration of self implies not only a deep somato‐psychic dissociation, but also a loss of intrapsychic and interpersonal space. In the treatment this was worked through via repetition of the victim‐aggressor dynamics at multiple levels. In the end, the therapeutic context was structured like a set of concentric layers, creating a ‘bandage’ over the patient's wounds whilst his ‘psychic skin’ was able to regenerate. The conditions triggered by extreme traumas in refugees challenge some of the cornerstones of individual psychoanalytic technique, as well as the idea that individual therapy may be thought of as existing in an environmental vacuum.     

Mainstreaming Gender in Theological Education

This article identifies themes and strategies for mainstreaming gender in theological education, based on the author's experience with theological education in Jamaica, the US, and Canada. It begins with the need to “visit the wounds” in such a way that realism about suffering can be accompanied by strategies for healing, transformation, and celebration of the reign of God already with us and in celebration of our agency to work toward it on earth as it is in heaven.     

On knowing the meaning of words we are unable to report confirmation of a guessing explanation

This experiment investigated Allport's (1977) claim that normal subjects can be induced to make semantic errors of the type characterised by “deep dyslexia”. The procedure followed that used by Allport except that a subject based control for the chance level of semantic errors was included. The results replicated the original finding by producing a semantic error rate of 12·7%. It was shown, however, that this rate was not significantly higher than the calculated chance rate of 11·5%. It was concluded, therefore, that the semantic error rates reported by Allport can be accounted for in terms of a guessing artefact and thus they bear no relevance to the problem of deep dyslexia.     

烧伤治疗--仍需走出困境

以促进创面干燥,再行切痂植皮为局部治疗特点的外科技术,仍是烧伤治疗的主流,促使创面干燥是渗出的对症处理,切痂植皮的实质是将烧伤创面变为刀伤创面,然后再修补刀伤创面。显然,烧伤外科的治疗观已撤开了烧伤的病理变化和机体的免疫力,再生力,孤立地看待烧伤创面,认识上形而上学,治疗上一刀切,没有从根本上解决创面的疼痛,进行性坏死、感染和瘢痕愈合四大难题,相反,干燥切痂植皮技术的实施又是建立在病人痛苦之上的,     

The resurrection as near-death experience

I suggest in this paper that Jesus Christ was not clinically dead but in a deep coma when he was taken down from the cross. He was revided by Joseph of Arimathea, who was permitted to take Jesus's body into his care. By Pentecost, seven weeks later, Jesus had finally recovered from his wounds, and his reappearance convinced his followers that he was the Son of God. I suggest that the Resurrection was not a physical happening, but a near-death experience. As such, it was totally real to Christ himself, and it also confirmed his belief that he could, by proxy, discharge humanity's sins.Roger B. Cook, M.A., was until 1991 a lecturer at the Open University, Milton Keynes, England.     

Integrating Divine Attachment Theory and the Enneagram to Help Clients of Abuse Heal in Their Images of Self,Others, and God

For victims of childhood abuse, healing their unconscious images of themselves, others, and God is of utmost importance in therapeutic work. Addressing the healing from both a scientific and a spiritual-contemplative approach is ideal in the context of spiritually integrated psychotherapy. Combining the frameworks of divine attachment theory and the Enneagram can help abused clients on their journey towards holistic healing in a way that addresses both the scientific and soulful dimensions of their deep unconscious wounds. This integration has the potential to heal multiple aspects of wounding, including unconscious images of clients, their offenders, and God. It also has the potential to dignify clients by showing how their unique God-given personality has a finite correspondence to God’s very own infinite personality and by outlining potential points of existential connection between aspects of their personality traits and the personality traits of the eternal God. Finally, clients can also grow in empathy and compassion for their abusers, which will help in the process of forgiveness.