肺移植术治疗终末期肺淋巴管平滑肌瘤病临床探讨

探讨肺移植治疗终末期肺淋巴管平滑肌瘤的手术适应证、手术方式和术后并发症。回顾性分析l例肺淋巴管平滑肌瘤终末期患者行右侧单肺移植术的临床资料。术后患者恢复良好,未出现支气管、肺动静脉吻合口并发症,肺功能明显改善,顺利出院。术后生存3年,死于对侧肺过度膨胀,移植肺感染。肺淋巴管平滑肌瘤终末期行肺移植术能明显改善肺功能,但单...     

肺移植术治疗终末期肺淋巴管平滑肌瘤病临床探讨

探讨肺移植治疗终末期肺淋巴管平滑肌瘤的手术适应证、手术方式和术后并发症.回顾性分析1例肺淋巴管平滑肌瘤终末期患者行右侧单肺移植术的临床资料.术后患者恢复良好,未出现支气管、肺动静脉吻合口并发症,肺功能明显改善,顺利出院.术后生存3年,死于对侧肺过度膨胀,移植肺感染.肺淋巴管平滑肌瘤终末期行肺移植术能明显改善肺功能,但单肺移植术后易出现对侧自体肺过度膨胀,尽可能选择双肺移植.     

超声引导下微创治疗子宫肌瘤

目前正式报道的超声引导下微创治疗子宫肌瘤的方法有两大类：（1）局部热消融治疗：在超声准确定位监视下或超声引导下将物理高温导入子宫肌瘤结节内,将肌瘤组织热凝固灭活,包括高强度聚焦超声、微波消融及射频消融。（2）在超声引导下向肌瘤内注入凝固剂或化疗药物灭活肌瘤组织。各种局部热消融治疗方法在消融范围内均可将肌瘤细胞有效灭活,疗效可靠,治疗后肌瘤可有效缩小、临床症状明显改善或消失,对正常生理功能影响很小或无明显影响。各种方法中,高强度聚焦超声无创伤,但治疗所需时间较长;微波或射频热效率高,治疗耗时短,但需肌瘤穿刺。肌瘤内注入凝固剂或药物操作方便,但由于药物弥散的因素适合3cm以下肌瘤的治疗。超声引导微创治疗子宫肌瘤创伤小、保留子宫,在有效使肌瘤缩小并控制临床症状的同时对患者的生理功能无影响或影响很小,并发症少,术后恢复快,有望成为治疗子宫肌瘤的主要方法之一。但治疗前应排除子宫恶性病变,并严格掌握适应证。     

子宫腺肌瘤术后序贯应用GnRH-a和优思明疗效观察

序贯应用促性腺激素释放激素激动剂(GnRH-a),屈螺酮炔雌醇(优思明)做为子宫腺肌瘤挖除术后后续治疗方案的治疗效果。选取2010年1月到2013年12月之间在柳州市工人医院妇产科行腹腔镜或开腹子宫腺肌瘤挖除术患者,按术后治疗方案分为A组(GnRH-a)、B组(GnRH-a+优思明)和C组(观察),随访2年对比各组疗效。结果 A组、B组、C组症状复发率分别为12%、4%、27%。术后各组子宫体积明显缩小,月经量评分(PBAC评分)明显下降(P0.05),随访第1年及第2年A、B组PBAC评分及VAS疼痛评分明显低于C组。B组子宫缩小比例明显大于C组。子宫腺肌瘤病灶切除术后应用GnRH-a能缓解痛经,减少月经量,使子宫体积缩小,序贯联合应用优思明可减轻GnRH-a副作用,为子宫腺肌瘤患者带来更好的临床治疗策略,降低远期复发率。     

浅谈超声消融治疗对子宫肌瘤临床决策的影响

晚近聚焦超声消融治疗技术的发展,使其在非侵入性消融治疗症状性子宫肌瘤的临床应用中显示出安全、高效、适应范围广等特点,可能成为一种较理想的保留子宫治疗肌瘤的技术,从而改变子宫肌瘤治疗的临床决策,值得进一步研究和关注。     

目标刺激运动特征对自闭症谱系障碍儿童平滑追踪眼动的影响

选取3~5岁自闭症谱系障碍儿童(Autism Spectrum Disorder,ASD)与正常儿童各18名,采集其观看目标刺激沿不同垂直幅度、水平速度正弦曲线运动视频的眼动数据,考察振幅、速度等目标运动特征对被试平滑追踪眼动的影响。结果发现:(1)ASD儿童平滑追踪目标刺激的视觉位置误差显著大于正常儿童,其追踪目标的眼动轨迹不如正常组儿童平滑均匀,平滑追踪眼动存在明显不足。(2)正常儿童追踪目标刺激大振幅运行的位置误差显著大于小振幅运行条件,但ASD儿童却与之相反。(3)与正常儿童一样,目标刺激运行速度越快,ASD儿童平滑追踪的位置误差越大。总之,ASD儿童存在平滑追踪能力的不足;相比追踪大振幅运动的目标,ASD儿童追踪小振幅运动目标的能力更差。     

子宫切除对患者身心健康的影响

子宫不但是重要的生殖器官，同时也被认为是一个内分泌器官。切除子宫虽是治疗子宫肌瘤的有效手段，但对患者的精神心理、性生活质量有无影响也是一个非常敏感的问题。本文将重点探讨子宫切除术对患者精神心理、性生活及内分泌的影响。     

对子宫肌瘤患者从医心理及治疗决策的思考

子宫肌瘤是妇科最常见的良性肿瘤,发病率高、恶变率低,目前治疗方法较多,但各有利弊;众多子宫肌瘤患者从医心理复杂,甚至难以配合治疗,医生应针对不同部位、大小、症状的肌瘤及患者的不同年龄、生育需求和心理状态,制定出个体化、人性化治疗方案,以期取得患者机体和心理均满意的和谐疗效。     

女性盆腔脏器脱垂的传统手术治疗

对于女性盆腔脏器脱垂的手术治疗,传统的手术方式包括阴道封闭术、曼氏手术和阴式全子宫切除术.阴道封闭术操作相对简单,适用于无性生活要求的、合并症较多的年老体弱者,但术后可能存在新发压力性尿失禁,并且导致性功能障碍,术中是否切除子宫尚有争议.曼氏手术保留子宫、操作简单,但术后脱垂复发及妊娠后宫颈机能不全问题仍有待研究.阴式全子宫切除术对于POP-Q评分II期及以内的脱垂患者,治疗效果最佳,期别高的患者术后复发仍可使用保守或再次手术治疗补救,本手术方式术后较少出现性交痛.总而言之,选择适当的适应证并积极与患者沟通后,女性盆腔脏器脱垂的传统手术治疗仍为不错的治疗方式.     

宫腔镜检查在诊断子宫内膜息肉中的价值分析

通过比较超声、宫腔镜检查与病理诊断子宫内膜息肉的结果,以及超声诊断结果阴性的病例中,宫腔镜与病理诊断的差异检出率,探讨宫腔镜检查对正确诊断子宫内膜息肉的重要性.回顾性收集连续在我院妇科行宫腔镜检查且证实子宫内膜息肉诊断的住院患者共730例.总结各病例超声诊断、宫腔镜检查及病理诊断的结果.统计分析显示,三者诊断子宫内膜息肉的检出率分别为82.7％、93.4％、90.8％.其中,由超声检查漏诊的子宫内膜息肉患者共126例,宫腔镜及病理检出率分别为96.8％、88.1％,且两者的阴性结果互不重叠,这种诊断差异在超声诊断结果示内膜增厚/内膜厚薄不均病例中尤为显著.因此,子宫内膜息肉的诊断方式中,宫腔镜诊断检出率最高,但仍有漏诊的病例由病理确诊,研究认为宫腔镜检查是确诊子宫内膜息肉的重要诊断方法.     

子宫肌瘤治疗策略

目前在有些医院对子宫肌瘤的治疗有过治、滥治的趋势,亟待统一认识、规范管理、明确治疗原则。本文将围绕子宫肌瘤该不该治疗,该不该手术,该不该切除子宫进行探讨,重点介绍手术、药物、介入及物理消融术等各种方法治疗子宫肌瘤的最新进展。     

The Challenges of COVID-19 for Divorcing and Post-divorce Families

COVID-19 and the accompanying procedures of shelter-in-place have had a powerful effect on all families but have additional special meanings in the context of families contemplating divorce, divorcing, or carrying out postdivorce arrangements. This paper explores those special meanings for these families. It also offers suggestions for couple and family therapists involved in helping these families during the time of COVID-19.     

Uterine Transplant: A Risk to Life or a Chance for Life?

Science and Engineering Ethics - Being inherently different from any other lifesaving organ transplant, uterine transplantation does not aim at saving lives but supporting the possibility to...     

Cluttering upgraded

The articles in this special edition have been scrutinized for new information on the problem of cluttering. The etiology of the disorder is still a riddle, but we now seem to know more about its relationship to learning disorders. Cluttering is not only a fluency and language disorder, but pragmatic rules are also violated by clutterers.

The most encouraging advances presented in this special edition are within assessment and therapy. New diagnostic instruments have been developed. The widely accepted view of a poor prognosis for clutterers has been partly refuted, even if we still only have a couple of case studies showing long-time effects of therapy. Recommendations for further research and development are suggested.     

Visual illusions with acute and obtuse angles: Configurational effects and observer strategies

In three experiments, it is demonstrated that the negative Poggendorff illusions that Restle (1969) and others have reported are a special case, that, in general, acute- and obtuse-angle effects are the same, that there are additional special cases which modulate the illusion, but only slightly, and that these special cases derive from particular configurations which impose other effects, including observer strategies, on the basic illusion. These additional effects do not bear necessarily upon the fundamental explanation of the illusion. The experiments also show that effects obtained with amputated illusory figures are not linearly additive. Recent experiments that have measured apparent oblique separation in the Poggendorff figure and have found large obtuse-angle but small, or negative, acute-angle effects are also discussed. It is argued that these experiments have not demonstrated that the two dependent variables-alignment and length judgments-are correlated, or that one error causes the other; and it is argued that uinaHolland’s theory of parallel attraction to explain the illusion is not tenable.     

Student to Student Support Teams for Special Services Delivery

Student to student support teams can be used to provide special services in schools. These teams, which have potential as a viable intervention approach for the 1990s, provide unique but beneficial challen~es for special services practitioners and administrators. In this aitde, issues pertinent to implementation of student to student support teams are discussed.     

2D location biases depth-from-disparity judgments but not vice versa

Visual cognition in our 3D world requires understanding how we accurately localize objects in 2D and depth, and what influence both types of location information have on visual processing. Spatial location is known to play a special role in visual processing, but most of these findings have focused on the special role of 2D location. One such phenomena is the spatial congruency bias, where 2D location biases judgments of object features but features do not bias location judgments. This paradigm has recently been used to compare different types of location information in terms of how much they bias different types of features. Here we used this paradigm to ask a related question: whether 2D and depth-from-disparity location bias localization judgments for each other. We found that presenting two objects in the same 2D location biased position-in-depth judgments, but presenting two objects at the same depth (disparity) did not bias 2D location judgments. We conclude that an object’s 2D location may be automatically incorporated into perception of its depth location, but not vice versa, which is consistent with a fundamentally special role for 2D location in visual processing.     

Metaphilosophy in the Systems of Metatheories

This article discusses the essence and form of various types of metatheory, paying special attention to metaphilosophy. It suggests the idea of the metatheoretical model—a completely new approach in philosophical discussion—and considers this concept with regard to the Platonic model and the Rhodian model. These models permit two different systems of metatheoretical construction. The paradigms of modern science allow the formation of metatheories that help further the development of logical, mathematical, and similar sciences. The Rhodian model allows the discovery of methods that are helpful in building certain types of theory, as well as suggesting and examining theories that have special metatheoretical features and revealing their common features and differences with regard to other theories. The article discusses the complicated problem of the interrelation between philosophy and metaphilosophy and shows that metaphilosophy is also philosophy, not in the sense that metaphilosophy is a special part of philosophy but rather in the sense that metaphilosophy is a special kind of functioning of philosophy itself.