166例冠心病患者活动平板试验中室性心律失常的分析

探讨冠心病患者冠状动脉狭窄程度与室性心律失常的关系,用Mar-quette Case16型活动平板系统测试,采用改良的Bruce方案。结果显示,偶发室早在单支狭窄和多支狭窄中无明显差异,恶性室性心律失常发生率在多支狭窄中较单支狭窄明显增高。冠心病患者出现的恶性室性心律失常提示病变严重或预后较差。     

166例冠心病患者活动平板试验中室性心律失常的分析

探讨冠心病患者冠状动脉狭窄程度与室性心律失常的关系,用Mar-quette Case16型活动平板系统测试,采用改良的Bruce方案.结果显示,偶发室早在单支狭窄和多支狭窄中无明显差异,恶性室性心律失常发生率在多支狭窄中较单支狭窄明显增高.冠心病患者出现的恶性室性心律失常提示病变严重或预后较差.     

关于甲状腺结节处理的一些思考

人群中甲状腺结节发病率很高,多数均为良性病变,但需要结合病史、临床症状、体征、甲状腺功能检查、超声及甲状腺细针抽吸细胞学(FNAC)检查,以排除恶性肿瘤。针对无恶性征象的甲状腺结节患者可以定期随访,必要时行外科手术治疗。     

关于甲状腺结节处理的一些思考

人群中甲状腺结节发病率很高,多数均为良性病变,但需要结合病史、临床症状、体征、甲状腺功能检查、超声及甲状腺细针抽吸细胞学(FNAC)检查,以排除恶性肿瘤.针对无恶性征象的甲状腺结节患者可以定期随访,必要时行外科手术治疗.     

电击信号应激对大鼠体液免疫及内分泌功能的影响

研究了足电击及以电击装置为信号刺激所诱发的情绪应激对大鼠原发性体液免疫反应及内分泌的影响。 结果表明每天１０分钟,共６天的足电击对大鼠抗特异性抗原ＯＶＡ的原发性体液免疫反应无明显作用,而此电击作 用结合每天１０分钟,共８天的情绪应激则可显著降低大鼠体液免疫反应及脾脏指数。同时该应激可显著提高大鼠 血儿茶酚胶和皮质酮水平。该研究证明了情绪应激对大鼠体液免疫功能的调节作用,并对交感神经系统和下丘脑－ 垂体－肾上腺（ＨＰＡ）轴在其中所起的作用进行了初步探讨。     

“A型性格”和冠心病之间可能的生理学机制

“A型性格”在冠心病发病因素中起着重要作用。“A型性格”的主要特点是性情急躁,常有时间紧迫感,争强好胜,攻击性强……一般认为心理——社会因素可激发一连串的神经内分泌反应,引起一定的生理和生化变化。如果这种反应和变化反复或长时间持续,就能损伤心血管功能,导致冠心病。据研究,可以看到有两条神经内分泌途径说明“A型性格”和冠心病之间的生理学机制,一条是交感——肾上腺——髓质系统,另一条是垂体——肾上腺——皮质系统。这两条神经内分泌系统都可以由明显的环境、行为和认知刺激所激活,并且根     

空肠恶性神经鞘瘤致肠梗阻1例分析

恶性神经鞘瘤又称神经纤维肉瘤,肢体躯干为其好发部位,发生在小肠者较少见,发生于小肠者多见于回肠。小肠恶性神经鞘瘤所产生的症状与肿瘤的大小、部位、生长方式等有关。临床表现不典型,常表现为腹痛、肠道出血、肠梗阻、腹内肿块、肠穿孔、类癌综合征等中的一种或几种症状。现报道小肠恶性神经鞘瘤导致肠梗阻1例,并结合复习以往相关文献进行讨论总结,以提高临床医生对小肠恶性神经鞘瘤的认识及鉴别能力,为临床中提高小肠恶性神经鞘瘤的诊断率提供借鉴。     

急性心理性应激诱发的神经内分泌反应及其影响因素

急性心理性应激源分别通过下丘脑-脑垂体-肾上腺轴(hypothalamus–pituitary–adrenal axis,HPAA)和交感神经-肾上腺髓质轴(sympathetic-adrenal medulla axis)诱发神经内分泌反应。唾液皮质醇被认为是检测急性心理性应激所诱发的HPA轴反应的稳定指标。以特里尔社会应激测试(Trier Social Stress Test,TSST)及其变式作为应激源, 以HPA轴的反应作为应激指标, 影响个体在急性心理性应激情境中发生特异性神经内分泌反应的因素主要包括人口统计学、环境和应激频率三大方面, 未来应加强急性心理性应激所诱发的神经内分泌反应的纵向研究。     

脑转移瘤的综合治疗策略及最新进展

脑转移瘤,亦称颅内转移瘤,是成人最常见的颅内肿瘤。随着人口老龄化,影像学检查发现微小病灶能力的提高及系统治疗的改善,脑转移瘤的发病率呈逐渐升高趋势。然而,脑转移瘤患者的预后却不容乐观,目前对于脑转移瘤、特别是多发脑转移瘤仍无规范的治疗方法。因此,本文将综合近年来国内外手术、放疗、化疗、分子靶向治疗、免疫治疗等治疗脑转移瘤相关的临床研究及2015年版最新美国国立癌症综合网络(NCCN)指南,对脑转移瘤、特别是多发脑转移瘤的规范化治疗进行探讨。     

多囊卵巢综合征高胰岛素血症现象的哲学思考

多囊卵巢综合征高胰岛素血症现象的哲学思考南京大学临床学院妇科（２１０００２）吴效科，苏延华，张祖暄多囊卵巢综合征（ＰＣＯＳ）是妇科常见生殖内分泌失调，其临床特征是卵巢雄性激素过多及长期无排卵。一般人认为其发病是下丘脑－垂体－卵巢轴功能异常的内分泌失调...     

Effects of simultaneous oral-intragastric ingestion on meal patterns and satiety in humans

Simultaneous oral-intragastric ingestion of a liquid diet was compared with oral ingestion for 15-21 days in four males or normal weight, 18-21 years old. All the subjects are significantly more (M= 222 cm3 or kcal [930 kJ] per meal, p less than .025) during simultaneous compared with oral lunches and dinners. Subjects reduced the size and frequency of breakfasts and snacks, which were always ingested orally, however, and did not gain weight. In a second experiment, the same four subjects ate significantly more (M-177 cm3 more, p less than .001 at lunch when the rate of ingestion was 200 cm3/min compared with 100 cm3/min regardless of route (oral, intragastric or simultaneous). They also ate significantly more (M=135 cm3 more, p less than 0.25) during simultaneous meals compared with oral or intragastric meals ingested at the same rate. Thus, rate of ingestion and oral stimulation are important determinants of meal size in humans.     

The Syracuse strains,selectively bred for differences in active avoidance learning,may be models of genetic differences in trait and state anxiety

The derivation of the Syracuse high- and low-avoidance strains is described. The behavioral characterization of the high- and low-avoidance phenotypes is summarized and it is concluded that the SLA/Bru strain is best described as having higher state and trait anxiety than their SHA/Bru counterparts. Although the behavioral covariates of the high- and low avoidance phenotypes are consistent, the covariation of the endocrine system normally thought to be involved in stress, is anomalous. The SLA/Bru rats, which are behaviorally more anxious than the SHA/Bru animals, show hypertrophy of the adrenal glands but reduced synthesis and release of the stress-related corticosterone than the SHA/Bru animals. This dissociation of the behavioral and endocrine measures of anxiety appears to be genetic, since a selective genetic analysis, involving F2 and high and low backcross segregating generations, indicates that both the behavioral and endocrine covariates cosegregate with the avoidance phenotypes. These data suggest that the expected association of behavioral and endocrine measures of anxiety is correlational, not causal.     

单纯性肾囊肿外科手术适应证的选择

单纯性肾囊肿是临床常见的肾脏疾病之一,临床常采用去顶减压术治疗,但外科治疗的适应证目前尚不统一。除症状性肾囊肿及由囊肿引起尿路梗阻外,对于高血压病合并肾囊肿者,如囊肿直径大于5cm,考虑囊肿有可能对高血压产生影响,因此,有必要采取外科治疗措施;但如果不合并高血压,是否一定需要治疗有待进一步探讨。肾囊肿对肾功能影响目前尚无定论,对于小于60岁的肾囊肿患者其肾功能下降可能与肾脏原发病变有关,应积极查找病因并密切随访。对于肾囊肿Bosniak分型为Ⅰ、Ⅱ、ⅡF型的患者,可以不需要手术治疗,密切随访;对于Ⅲ、Ⅳ型患者,应进行外科手术治疗。     

Journal of experimental psychology: human perception and performance

We examined the nonveridicality of visual direction produced by monocular viewing. In Experiment 1, 19 subjects pointed to a small light and moved a small light to their subjective median plane. The extent of constant error under monocular and binocular viewing conditions differed in both tasks (p less than .001). The monocular-binocular difference was larger when the viewing distance was 25 cm than when it was 50 cm (p less than .01). Also, correlations between phoria and monocular-binocular differences ranged from .58 to .77, depending on viewing distances and tasks. The effects of phoria within the context of Hering's .001). The monocular-binocular difference was larger when the viewing distance was 25 cm than when it was 50 cm (p less than .01). Also, correlations between phoria and monocular-binocular differences ranged from .58 to .77, depending on viewing distances and tasks. The effects of phoria within the context of Hering's .001). The monocular-binocular difference was larger when the viewing distance was 25 cm than when it was 50 cm (p less than .01). Also, correlations between phoria and monocular-binocular differences ranged from .58 to .77, depending on viewing distances and tasks. The effects of phoria within the context of Hering's principle of visual direction can account for these results. In Experiment 2, the same subjects adapted to phoria-induced error by placing a finger over a monocularly viewed target. The difference in their pointing responses before and after the task were reliable (p less than .005), and the correlations between phoria and the pre- to posttest differences were .45 and .77, depending on the number of adaptation trials. We argue that all monocular experiments dealing with visual direction should control for these effects.     

The visual discrimination of shape by Octopus: The effects of stimulus size

Octopuses were trained in a successive situation to discriminate between vertical and horizontal rectangles: Group S was trained with rectangles of side length 5 × 1 cm., Group M with 10 × 2 cm. rectangles, and Group L with 20 × 4 cm. rectangles. The larger the shapes used, the more readily were they discriminated, both in terms of speed of learning and of the asymptote of performance. After training, each group was given transfer tests with the two pairs of rectangles not used in training and with two further pairs of 2.5 × 0.5 cm. and 40 × 8 cm. The results can be summarized in three generalizations: (1) When the size of a shape is changed, performance is worse than on the original training shape. (2) The bigger the change in proportionate size, the less transfer is shown. (3) For corresponding changes of proportionate size, there is better transfer to larger shapes than to smaller. These generalizations are supported by data from earlier experiments on the question of transfer to different sized shapes: some of these data were reworked and are presented in detail here. The theoretical implications of the results are discussed.     

Statistical requirements for properly investigating a null hypothesis

Issues involved in the evaluation of null hypotheses are discussed. The use of equivalence testing is recommended as a possible alternative to the use of simple t or F tests for evaluating a null hypothesis. When statistical power is low and larger sample sizes are not available or practical, consideration should be given to using one-tailed tests or less conservative levels for determining criterion levels of statistical significance. Effect sizes should always be reported along with significance levels, as both are needed to understand results of research. Probabilities alone are not enough and are especially problematic for very large or very small samples. Pre-existing group differences should be tested and properly accounted for when comparing independent groups on dependent variables. If confirmation of a null hypothesis is expected, potential suppressor variables should be considered. If different methods are used to select the samples to be compared, controls for social desirability bias should be implemented. When researchers deviate from these standards or appear to assume that such standards are unimportant or irrelevant, their results should be deemed less credible than when such standards are maintained and followed. Several examples of recent violations of such standards in family social science, comparing gay, lesbian, bisexual, and transgender families with heterosexual families, are provided. Regardless of their political values or expectations, researchers should strive to test null hypotheses rigorously, in accordance with the best professional standards.     

Sex differences in static lifting strengths at full range exertion heights in a young Taiwanese sample

This study evaluated sex differences in static lifting strengths (LS) at various exertion heights. Healthy adult young men (n=50; M age=23.4 yr., SD=2.3) and women (n=50; M age=22.5 yr., SD=2.8) were used as participants, and their static lifting strengths were measured at various heights (10 to 150 cm, in increments of 10 cm). Repeated measures ANOVA indicated that the strength profiles were significantly different. When the exerting height was less than or equal to 80 cm, the strengths of women were approximately two-thirds that of the men. Participants adopted a nearly erect posture at above 80 cm, and the weakness of women's upper extremities and disadvantageous posture were directly reflected in reduced strength values relative to men. One potential implication is that, because of the relatively lower isometric lifting strength for young Taiwanese women, caution should be exercised in the weight limit when lifting heights above the hip level, especially when above the shoulder level.     

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。     

Evidence for an integration theory of visual masking

When letters are superimposed upon a pattern of black and white squares, they are easier to identify when the pattern is regular than when it is random. If backward masking consists of the superimposition of a masking pattern upon the decaying visual trace of a target display, a regular pattern should be less effective as a backward mask than a random pattern. This was found to be so for both multiple-letter and single-letter displays. This result is predicted by an integration theory of visual masking but not by an interruption theory.     

Neuromuscular responses to platform perturbations in power- versus endurance-trained athletes

The purpose was to assess differences in postural response characteristics between two groups of elite athletes having power or endurance training. Participants were all men and included power- (M age = 21 yr., SD = 3, n = 12) and endurance-trained (M age = 22, SD = 3, n = 12) athletes. Muscle response characteristics and center of pressure measures were recorded during recovery from Fast (10 cm at 80 cm/sec.) and Slow (10 cm at 20 cm/sec.) horizontal platform perturbations. In response to Fast perturbations, power-trained athletes responded with significantly shorter times to stabilize the center of pressure, shorter muscle-contraction onset times, and larger muscle response amplitudes than endurance-trained athletes. This suggests power-trained athletes are more effective than endurance-trained athletes in responding to balance threats such as slips and trips in daily life and that power training should be studied to improve balance control of balance-impaired populations.