肉芽肿小叶性乳腺炎的治疗进展

肉芽肿小叶性乳腺炎(GLM)又称为肉芽肿性乳腺炎、特发性肉芽肿小叶性乳腺炎。到目前为止,该病的确切病因及发病机制不明确,病理诊断是其诊断的"金标准",其治疗方式也是多种多样,亦无统一疗效评价指标。通过CNKI、Pubmed等国内外搜索引擎查询文献,结合笔者的临床经验,发现目前治疗GLM的方式主要有手术治疗和药物治疗。手术治疗的关键在于手术时机的把握和手术方式的选择,手术方式不同其疗效亦存在差异;药物治疗主要包括糖皮质激素治疗、糖皮质激素联合免疫抑制治疗、单纯抗生素治疗、抗结核治疗、单纯中医中药治疗及中西医结合治疗等。以往认为,GLM发病率低下,容易误诊为乳腺癌,其治愈率低、复发率高。近年来,GLM发病率呈现明显上升趋势,治愈率与首诊首治密切相关。采取外科为主的综合治疗可以显著提高治愈率,病灶扩大切除术联合Ⅰ期乳房成型术是降低手术复发率和减少乳房外形损伤的关键,而手术时机最为重要。     

催眠治疗的辩证法问题

在运用催眠治疗成功的病例中 ,都有一个从健康———心理障碍 (或疾病 )———健康的发展过程 ,其中 ,心理障碍 (或疾病 )是对健康的否定 ,后一个健康又是对心理障碍 (或疾病 )的否定。整个过程反映了否定之否定规律的作用 ,反映了患者在“自己发展自己 ,自己完善自己。”1　催眠治疗使患者“自己发展自己”催眠治疗是在良好医患关系的基础上 ,催眠师将患者引入催眠状态 ,并对其进行心理分析与治疗 ,了解其被遗忘的压抑很深的创伤性体验与致病的心理矛盾与冲突。鼓励其发泄隐痛 ,讲清楚苦恼的内心感受 ,通过暗示方法 ,教育患者正确对待自己…     

医生主动放弃治疗的法律问题

医生对身患绝症,没有治疗效果的病人主动放弃治疗给法律带来了三方面的冲击。法律在放弃治疗问题上的革命否定了对该类病人的“治疗”是真正意义上的治疗,否定了延长此类病人的存活期限一定符合病人利益的主张,甚至否定了此类病人的生命权益。在我国有关放弃治疗立法中,应注意对放弃治疗的定义、对象、决定的作出者以及放弃治疗的例外作出界定,设立放弃治疗宣查委员会,在法律上规定其职能,。     

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.     

胸腰段爆裂性骨折的手术策略选择

胸腰段爆裂性骨折是最常见的脊柱损伤之一,而手术治疗是其主要的治疗方式,选择最优的手术路径、做出最佳的临床抉择,是其治疗的首要目标。本文对胸腰段爆裂性骨折的不同手术入路方式及其特点做了比较和探讨,认为以最优化为原则,选择一期后路小切口有限减压的手术方式,是治疗胸腰段爆裂性骨折的最佳手术策略。     

常染色体显性多囊肾手术治疗的临床决策

多囊肾去顶减压术是目前治疗常染色体显性多囊肾的主要手术方式.为了探讨多囊肾去顶减压术的临床效果,本文对81例常染色体显性多囊肾患者进行研究,分析其术后肾功能和症状改善情况.本文旨在客观评价多囊肾去顶减压术,并指出选择适当的手术时机是获得满意疗效的关键,为临床决策提供了依据.     

乳腺癌患者减重干预的研究进展

目前研究认为,肥胖是乳腺癌的预后不良因素之一,肥胖可能增加女性乳腺癌的发病率和病死率,降低乳腺癌手术、化疗及放疗的治疗效果。减重干预是减轻体重、改善肥胖的有效途径。近年来,研究发现减重有助于延缓肥胖小鼠乳腺癌的进展与转移,可能降低肥胖者乳腺癌的发病率与病死率,调节肥胖乳腺癌患者的血清标志物水平,并对肥胖乳腺癌患者的生命质量、饮食行为、生活方式等产生积极影响。减重干预有望成为肥胖的乳腺癌长期存活者的重要辅助治疗手段。     

常染色体显性多囊肾手术治疗的临床决策

多囊肾去顶减压术是目前治疗常染色体显性多囊肾的主要手术方式。为了探讨多囊肾去顶减压术的临床效果,本文对81例常染色体显性多囊肾患者进行研究,分析其术后肾功能和症状改善情况。本文旨在客观评价多囊肾去顶减压术,并指出选择适当的手术时机是获得满意疗效的关键,为临床决策提供了依据。     

TST治疗直肠类癌22例总结分析

类癌是消化道常见恶性肿瘤之一,其生长速度缓慢,恶性程度低。直肠类癌在消化道类癌中发病率逐年上升,已成为消化道类癌发病之首,常见直肠肿瘤之一,其治疗手段多样,手术方式可大可小,尚无统一规范指南。本文通过回顾性分析大连市中心医院肛肠科5年间收治的22例行选择性直肠黏膜切除吻合术(TST)治疗的直肠类癌患者的临床资料,总结该手术方式优缺点,得出该术式手术效果理想,值得临床广泛推广应用的结论。     

后纵韧带骨化患者手术方式的选择及临床效果分析

通过研究颈椎后纵韧带骨化患者的不同手术方式对术后效果的影响,回顾性对分别行前路、后路手术治疗的颈椎后纵韧带骨化患者127例进行5年～10年的随访并依据手术前后不同时期的影像学结果及神经功能改善情况进行分析,探讨椎管狭窄率和颈椎序列变化等因素对手术方式的选择及术后疗效的影响。结果显示,前路手术组术后能够维持并改善颈椎前凸...     

Champ et effets de la négation argumentative: contre-argumentation et mise en cause

An argument can be taken as an operation of justification or as the product of this operation. But what about a counter-argument? This article is based on the hypothesis that there exists an operation of argumentative negation, which is both the argumentative and the negative equivalent of the operation of justification. Justification and argumentative negation necessarily act on assertions, for they are active at the level of the epistemic modalities of statements. As an operation, a counter-argument can thus be described, as the application of an argumentative negation; as a product, it can be described as an argument the conclusion of which shows traces of negative modality. Two uses of argumentative negation are distinguished here: counter-argumentation and calling into question. The former can lead only to assertive conclusive statements, but the latter can also lead to directives or commissives. This leads the authors to introduce the notion of pseudo-argument, besides those of argument and counter-argument. It is shown in particular that when a pseudo-argument is rejected, argumentative negation has the effect of making evident an underlying argument. With respect to the latterit functions as a counter-argumentation, whereas with respect to the illocutionary act accomplished by the conclusive statement, it functions as a calling into question of a condition of satisfaction for this act. This article also defines certain characteristics of argument, proposes criteria for identifying argumentative negation in polemical conversations, and distinguishes four modes of counter-argumentation.     

汉语句子-图片信息整合的眼动测量

采用眼球追踪-分析法考察了“句子-图片”验证范式下句图信息整合过程中句式和语义关系类型的作用。实验结果表明：（1）汉语句子-图片信息整合过程中,句图继时呈现没有消除语义失配效应,注视次数、总注视时间显著增加,瞳孔直径扩大。语义失配会显著干扰句法难度低的句式的句图信息整合。（2）句式影响句子-图片信息的整合过程,注视次数、总注视时间、瞳孔直径随句法难度增加而增加。（3）汉语句图信息整合过程中,语义失配效应受句式影响,表现出任务的特异性,这说明成分比较模型不具有一般性     

Internal Negation and the Principles of Non-Contradiction and of Excluded Middle in Aristotle

It has long been recognized that negation in Aristotle’s term logic differs syntactically from negation in classical logic: modern external negation attaches to propositions fully formed, whereas Aristotelian internal negation forms propositions from sentential constituents. Still, modern external negation is used to render Aristotelian internal negation, as may be seen in formalizations of Aristotle’s semantic principles of non-contradiction and of excluded middle. These principles govern the distribution of truth values among pairs of contradictory propositions, and Aristotelian contradictories always consist of an affirmation and a denial. So how should we formalize a false denial? In the literature, we find that a false denial is formalized by means of two negation signs attached to a one-place predicate. However, it can be shown that this rendering leads to an incorrect picture of Aristotle’s principles. In this paper, I propose a solution to this technical problem by devising a formal notation especially for Aristotelian propositions in which internal negation is differentiated from external negation. I will also analyze both principles, each of which has two logically equivalent forms, a positive and a negative one. The fact that Aristotle’s principles are distinct and complementary is reflected in my new formalizations.     

中风病简化辨证的哲学思考

中风病分阴证和阳证为纲辨治,不但有是充分的实践依据和理论基础,而且符合哲学的否定之否定定律。从中风病简化辨证的必要性,中风病阴阳辨证的发展,中风病的病因病机、证候属性可从阴阳两方面认识,中风病阴阳为纲辨证方法符合哲学否定之否定定律4方面进行了论述。     

Canonical Extensions and Relational Representations of Lattices with Negation

This work is part of a wider investigation into lattice-structured algebras and associated dual representations obtained via the methodology of canonical extensions. To this end, here we study lattices, not necessarily distributive, with negation operations.We consider equational classes of lattices equipped with a negation operation ¬ which is dually self-adjoint (the pair (¬,¬) is a Galois connection) and other axioms are added so as to give classes of lattices in which the negation is De Morgan, orthonegation, antilogism, pseudocomplementation or weak pseudocomplementation. These classes are shown to be canonical and dual relational structures are given in a generalized Kripke-style. The fact that the negation is dually self-adjoint plays an important role here, as it implies that it sends arbitrary joins to meets and that will allow us to define the dual structures in a uniform way.Among these classes, all but one—that of lattices with a negation which is an antilogism—were previously studied by W. Dzik, E. Or?owska and C. van Alten using Urquhart duality.In some cases in which a given axiom does not imply that negation is dually self-adjoint, canonicity is proven with the weaker assumption of antitonicity of the negation.     

Ambiguous probabilities: when does p=0.3 reflect a possibility,and when does it express a doubt?

Verbal phrases denoting uncertainty are usually held to be more vague than numerical probability statements. They are, however, directionally more precise, in the sense that they are either positive, suggesting the occurrence of a target outcome, or negative, drawing attention to its non‐occurrence. A numerical probability will, in contrast, sometimes be perceived as positive and sometimes as negative. When asked to complete sentences such as ‘The operation has a 30% chance of success, because’ some people will give reasons for success (‘the doctors are expert surgeons’), whereas others will give reasons for failure (‘it is a difficult operation’). It is shown in two experiments that positive reasons are given more often than negative ones, even for p values below 0.5, especially when the probability is higher than expected, and the target outcome is non‐normal, undesirable, and phrased as a negation. We conclude that the directionality of numerical probabilities (as opposed to verbal phrases) is context‐dependent, but biased towards a positive interpretation. Copyright © 2000 John Wiley & Sons, Ltd.     

Semantic Similarity of Alternatives Fostered by Conversational Negation

Conversational negation often behaves differently from negation as a logical operator: when rejecting a state of affairs, it does not present all members of the complement set as equally plausible alternatives, but it rather suggests some of them as more plausible than others (e.g., “This is not a dog, it is a wolf/*screwdriver”). Entities that are semantically similar to a negated entity tend to be judged as better alternatives (Kruszewski et al., 2016). In fact, Kruszewski et al. (2016) show that the cosine similarity scores between the distributional semantics representations of a negated noun and its potential alternatives are highly correlated with the negated noun-alternatives human plausibility ratings. In a series of cloze tasks, we show that negation likewise restricts the production of plausible alternatives to similar entities. Furthermore, completions to negative sentences appear to be even more restricted than completions to an affirmative conjunctive context, hinting at a peculiarity of negation.     

Effects of inversion and negation on social inferences from faces

Judgments about personality and other social characteristics based on facial appearance are remarkably consistent across individuals. However, whereas the facial cues that underpin age and sex judgments are already well understood, the physical bases for judgments of characteristics such as intelligence or trustworthiness are still unknown. Inversion and photographic negation are used here to investigate the visual processes underlying social inferences from the face and to explore whether various judgments might rely on different perceptual representations. In experiment 1, the perceptions of age, sex, attractiveness, approachability, intelligence, and trustworthiness, but not distinctiveness, were affected by inversion, and all these characteristics were affected by negation. The effects of inversion and negation were independent, suggesting that they impaired the encoding of different types of information. Moreover, an independent manipulation of hue and luminance in experiment 2 showed that the effects of negation were mainly due to the reversal of luminance values. These results are consistent with the view that information about the configuration of features (the processing of which is impaired by inversion) and information about surface properties (the processing of which is impaired by brightness negation) are both used in the perception of social characteristics from faces. In addition, the fact that there was a similar pattern of impairment across most judgments suggests that there is an initial common perceptual representation of the face, from which most characteristics are inferred.     

否定情绪词的具身动态模拟过程

实验1和实验2分别以“（不）+积极/消极情绪词”和“（不）+愤怒/悲伤情绪词”形式的情绪词语或否定短语作为实验材料,分别采取词-图匹配范式和趋近-回避范式,以否定加工的早期（250ms）和中后期（1000ms）两种探测时间,探讨否定对情绪词效价与动机维度加工是否符合否定的两步模拟假设。结果发现,否定情绪效价部分符合否定的两步模拟假设,早期以被否定的情绪状态模拟为主,即不高兴会首先激活高兴;中后期,否定消极词和积极词都被理解为积极;否定情绪动机维度并不符合否定的两步模拟假设,否定对愤怒与悲伤的趋近－回避的影响出现在否定加工中后期,否定改变愤怒的动机方向,由趋近变为回避,却没有改变悲伤的动机方向,悲伤仍表现为回避。本研究证明否定对情绪词的效价和动机维度部分符合两步模拟假设,否定情绪词有其特定的加工过程,各维度加工有所不同。