循证医学与喉癌治疗的临床决策

循证医学(Evidence-based medicine,EBM)的飞速发展正逐渐渗透到基础医学和临床医学的各个领域。目前喉癌治疗的临床决策还存在很多不规范和不合理的问题。这要求用循证医学的原则来指导和规范喉癌治疗的临床决策,以期能在目前条件下提高病人的治疗效果、降低医疗费用及提高生活质量。     

瑶医学“心肾相交论”内涵及临床指导意义

“心肾相交论”是瑶医药理论的脏腑生命观,心主要的功能是主宰其他脏腑的生理机能,对人的心理活动也进行调节;肾是气血化生之根源.如果心功能受损,那么其调节作用减弱,瑶医的整体观内涵得不到体现,人体作为一个整体的属性就不复存在,人体就会进入病理状态,甚至危及生命.对于肾,瑶医学认为人的出生、生长、发育和成熟直至衰老死亡的过程,是肾“气化”功能由盛到衰的自然过程.“心肾相交论”强调心肾功能的正常是人保存生命最基本的前提.通过探讨“心肾相交论”的学术思想,用以指导临床医疗实践,提高对瑶医药理论的认识.     

Beyond Body Size: Focusing on Body Functionality to Improve Body Image Among Women Who Have Undergone Bariatric Surgery

This study investigated a novel technique to improve body image among women who have undergone bariatric surgery—namely, by having them focus on their body functionality (everything the body can do, rather than how it looks). Participants were 103 women (M_age = 46.61) who had undergone bariatric surgery 5–7 months prior to the study. They were randomized to the 1-week online intervention, comprising three functionality-focused writing exercises (Expand Your Horizon; Alleva et al., 2015), or to a wait-list control group. Body appreciation, appearance and functionality satisfaction, body awareness, self-objectification, self-esteem, and self-kindness were assessed at pretest, posttest, and at 1-week and 3-month follow-up. Multilevel modeling analyses showed that, compared to the control, the intervention group experienced improved body appreciation at posttest, and these improvements persisted at both follow-ups. These findings were nonsignificant when intent-to-treat analyses were performed. Both available case and intent-to-treat analyses showed that all participants experienced improvements in facets of body image across time. Qualitative analyses of participants’ responses to the intervention writing exercises provided more insight. Via coding reliability thematic analysis, we identified 11 themes that together provide evidence that intervention participants experienced facets of a more positive body image, while also facing challenges to their body image and well-being. Together, findings suggest that focusing on body functionality may contribute to improved body image among women who have undergone bariatric surgery, but effects may be nuanced compared to prior functionality research among general samples of women. The study was registered retrospectively (ClinicalTrials.gov; identifier NCT04883268).     

脑死亡=死亡生物医学定律的逻辑论证

心脏具有顽固自律性、可多次复苏性、功能可人工替代性、可多次置换性四大特点,因而已失去作为死亡判定权威器官的地位.而大脑由于具有统领性、损坏后不可恢复性、功能不可替代性、全脑不可置换性四大特点,已替代心脏成为死亡判定的靶器官.脑死亡=死亡在相当长时期内都将是一个严格的科学定义.     

海绵窦区病变外科处理策略

为探讨海绵窦区病变的外科治疗策略,回顾性分析了58例不同性质的海绵窦病变病例的临床资料、治疗方法和治疗效果,发现根据病变的不同性质和不同的生长方式个性化地采用不同的治疗方法可在最大限度治愈病变的同时,保护颅神经的功能,获得良好的治疗效果.     

个体化角膜屈光手术的探讨

对个体化角膜屈光手术这一屈光矫正领域的新理念和新方法进行探讨,提出医务工作者要勇于思想创新;以辩证思维看问题;关注社会需求,正确处理以人为本与追求经济利益的关系;加强多学科交叉合作和复合型人才的培养,才能推动个体化角膜屈光手术不断向更高层次迈进。     

心导管技术的发明与诺贝尔奖之启示

德国医生维尔纳·福斯曼(Werner.Forssmann,1904-1979)因其对心导管技术的创造所做的里程碑式的贡献而荣膺1956年度生理学和医学诺贝尔奖.回顾福斯曼创造心脏导管技术的历程带给我们一些启示:科学研究需要强烈的探索欲为动力,无畏的探索精神为保障,科学的辩证法思想为指导.     

全胸腔镜肺癌切除术在肺癌治疗中的应用

本文概述了全胸腔镜肺癌切除术的发展史、适应证、手术方法及临床疗效,证实全胸腔镜下肺癌切除术是一种安全、微创且疗效确切的手术,是未来肺癌外科治疗的主要手段之一,也将成为一个新的研究热点。此外,还展望了全胸腔镜下肺癌切除术的发展方向。     

A revaluation of the adaptiveness of avoidant and vigilant coping with surgery

Abstract

It has been assumed that an avoidant coping style is less adaptive in patients coping with surgery than a vigilant coping style. Empirical evidence, however, has indicated the contrary. This article, therefore, revaluated the adaptiveness of these coping styles. A review of the literature yielded three conditions of the situation that determine the adaptiveness of coping: controllability of the situation, time-reference and interpretational set. Problem-focused coping, vigilance, active coping and monitoring seem to be more adaptive in controllable situations; emotion-focused coping, avoidance, blunting and passive coping more adaptive when little control is possible. For short-term adaptation, avoidance seems the more adaptive strategy, whereas in the long run vigilance is a better strategy. Regarding interpretational set, avoidance seems more adaptive when patients have to cope with the emotional value of the event; vigilance seems more adaptive when coping with sensory elements of the event. Implications of the situational conditions for the adaptiveness of coping with surgical stress and consequences for future research are discussed.     

口腔颌面外科医疗实践中的过度医疗

通过对口腔颌面外科几种常见疾病的具体诊疗行为进行分析,从医疗技术本身探讨过度医疗的原因,认为评价一种医疗行为是否过度需要客观、全面、动态的标准,科学的认识和掌握疾病的客观规律并获得最优疗效的诊疗方案是避免过度医疗发生的可靠保证之一.