门静脉高压症的外科治疗观

门静脉高压症的外科治疗主要有门体静脉断流术和门体静脉分流术,这两种手术方式反映了唯物辩证法的对立统一规律。辩证唯物主义认为,人的认识过程是实践、认识、再实践、再认识,循环往复以至无穷的发展过程。随着实践的深入,医疗技术的进步,医疗设备的更新,近来兴起了分流加断流联合手术、TIPSS及肝移植术治疗门脉高压症。     

门静脉高压症的外科治疗观

门静脉高压症的外科治疗主要有门体静脉断流术和门体静脉分流术,这两种手术方式反映了唯物辩证法的对立统一规律.辩证唯物主义认为,人的认识过程是实践、认识、再实践、再认识,循环往复以至无穷的发展过程.随着实践的深入,医疗技术的进步,医疗设备的更新,近来兴起了分流加断流联合手术、TIPSS及肝移植术治疗门脉高压症.     

门脉高压症治疗观点之辩

对立统一规律是辩证法的实质,在唯物辩证法的理论体系中占有核心地位。门脉高压症的外科治疗有分流术与断流术两种不同的手术方法,这两种方法从治疗机制上看是矛盾的,用对立统一观来认识这两种手术的联系并揭示门脉高压外科治疗发展的哲学依据。     

肝硬化门脉高压症断流术后感染的防治策略

肝硬化门脉高压症断流术后感染的防治策略可概括为:增强机体免疫力,重视无菌操作,预防性使用抗生素,积极治疗出现的感染。常见术后感染包括:膈下积液、脓肿,自发性腹膜炎(SBP)或腹水感染,门静脉血栓性静脉炎,切口及其他部位感染,真菌感染,脾切除术后爆发性感染和脾热。     

肝硬化门脉高压症断流术后感染的防治策略

肝硬化门脉高压症断流术后感染的防治策略可概括为:增强机体免疫力,重视无菌操作,预防性使用抗生素,积极治疗出现的感染.常见术后感染包括:膈下积液、脓肿,自发性腹膜炎(SBP)或腹水感染,门静脉血栓性静脉炎,切口及其他部位感染,真菌感染,脾切除术后爆发性感染和脾热.     

标本兼治 惩防结合

《反腐保廉与社会发展》一书的出版,有利于进一步推进我国社会的发展,做好反腐保廉工作。而标本兼治,可以说是解决这些矛盾和问题的基本指导原则。对于反腐败而言,我们也必须以此作为指导。这里,所谓“标”是指已经出现的腐败现象;所谓“本”是指腐败现象产生的根源。标和本是一个事物的两个方面,二者是不可分割的统一体。治标和治本互为促进、相辅相成。治标,就是要惩治业已存在的腐败现象;治本,就是要逐步铲除腐败现象得以滋生蔓延的土壤。从治标入手,查处一批大案要案,狠刹各种不正之风,有效遏制腐败现象泛滥的势头,可以使反腐败斗争见到成效,有利于反腐败的深入发展和进行深层次的治理。而治本则更具有根本性、长久性、规范性,通过治本才能有效地巩固治标的成果,并通过坚持不懈的努力,逐步     

CT门脉血管成像对肝硬化食管胃静脉曲张治疗的价值评估

内镜治疗方法是目前处理肝硬化门脉高压引起的食管胃底静脉曲张重要的手段。然而,静脉曲张存在不同的分流特征可影响治疗方法的选择及预后的效果。回顾性分析肝硬化门脉高压患者CT门静脉成像特点,测量门静脉主干及脾静脉、胃左静脉、肠系膜上静脉等主要分支管径,记录门脉侧支循环开放的具体位置、曲张程度及数量,比较CT成像结果与胃镜分型特点,并进行统计学和临床分析。多层螺旋CT门静脉成像(CTPV)可以清晰显示门脉系统和侧支血管,并可详细了解分流的解剖学特征,准确确定分流类型,对于血管管径的测量也具有很好的准确性。CTPV检查对于食管胃底静脉曲张治疗方法选择、用药剂量以及预后评估有较大临床意义。     

非选择性β受体阻滞剂在门静脉高压患者中的应用

门静脉高压是肝硬化患者最常见的并发症,而门静脉高压所致的食管胃底静脉曲张破裂出血则是肝硬化患者最常见的死亡原因。非选择性β受体阻滞剂是目前用于降低门静脉高压以预防食管胃底静脉曲张破裂出血和再出血的一线药物,非选择性β受体阻滞剂可通过降低门脉血流量,从而降低门脉压力,然而,近年来有报道提示非选择性β受体阻滞剂可增加门脉高压患者的死亡率。本文将对非选择性β受体阻滞剂的作用及其在门静脉高压患者中临床运用做一综述。     

试论当代中国邪教孳生、蔓延的社会文化根源

当代中国邪教的孳生和蔓延不是偶然的,而且有其深刻的国际根源、社会根源、文化根源或思想认识根源以及历史根源的。深刻认识当代中国邪教孳生和蔓延的种种根源,无论对于邪教的“治本”工程和“治标”工程,都是绝对必要的。     

CT门静脉成像在食管胃静脉曲张栓塞术后的应用价值

探讨CT门静脉成像(CTP)在食管胃底静脉曲张栓塞术后疗效评价中的价值。23例门静脉高压上消化道出血患者采用经皮经肝食管胃底曲张静脉栓塞术(PTVE),用TH胶栓塞食管胃底曲张静脉及其相关侧支循环血管。栓塞前、后各进行了CT门静脉成像检查,观察TH胶的位置、范围和曲张静脉的残存情况。CT门静脉成像显示23例食管胃底曲张静脉及相关侧支血管内可见TH胶充填,TH胶位置准确、固定,无移位、游走现象,5例可见曲张静脉残留。CT门静脉成像可以直观显示和评价食管胃底静脉曲张栓塞的治疗效果。     

侵袭性垂体腺瘤的个性化治疗

近10多年来,不断有新的方法应用于临床治疗食管胃底静脉曲张破裂出血并取得很大进展,如药物的联合应用、经颈内静脉肝内门体分流术、经内镜食管曲张静脉套扎术及硬化剂注射术、冠状静脉栓塞术、肝移植等。对以上治疗方法及其利弊、选择原则等进行了分析。     

癫痫诊治中医患同盟建立的实践与策略

通过对肝硬化者行超声检测,预测食管静脉出血,结果显示,出血组门静脉及胃左静脉管径均增粗,但胃左静脉更明显,门静脉血流速减慢而胃左静脉增快;出血组胃左静脉均呈离肝血流,其分流指数明显增大。胃左静脉的管径及血流速与门静脉比较具有显著的变化,其分流指数和血流方向在预测出血方面具有更大的价值。     

Integrative Therapie von narzisstisch gestörten Patienten

The psychotherapy of patients with a narcissistic personality disorder continues to be a psychotherapeutic challenge. There is still no psychotherapeutic program for the treatment of these patients which integrates different psychotherapeutic methods and strategies. Therefore the therapy of narcissistic patients remains difficult and only few psychotherapists voluntarily meet the challenge of treating such patients. In this article an integrative psychotherapeutic concept for the treatment of narcissistic patients using psychotherapeutic methods of different psychotherapeutic schools is presented. This integrative concept includes basic strategies such as working with the therapeutic alliance, schema work and activation of resources. On the other hand specific modules for different core symptoms of these patients are proposed. With this article the authors hope to contribute to a new conceptualization of the psychotherapy of narcissistic patients.     

干细胞移植治疗冠心病的现状与未来

冠心病仍然是全球的主要死亡原因。其所造成的心肌梗死及慢性心力衰竭对生活质量的影响和由此造成的高额医疗费用促使我们不断寻求新的医疗措施。近几年有关干细胞用于心肌梗死后心肌再生、心肌内新生血管形成,可能还会改善梗死后的心功能的研究成为心脏病学研究的最热门领域。尽管干细胞治疗有可能使心力衰竭的治疗得到彻底的革命,但仍有部分问题需要澄清。已发表的各个研究结果设计不尽相同,致使对该项治疗的效果较难得出一致的结论。但这些研究都强调干细胞治疗在未来心血管疾病的治疗中可能会发挥较大的作用。干细胞治疗与药学、外科及介入治疗的结合会显著改善冠心病患者的预后。     

The Aβ oligomer hypothesis for synapse failure and memory loss in Alzheimer's disease

Alzheimer's disease (AD) is the 3rd most costly disease and the leading cause of dementia. It can linger for many years, but ultimately is fatal, the 6th leading cause of death. Alzheimer's disease (AD) is fatal and affected individuals can sometimes linger many years. Current treatments are palliative and transient, not disease modifying. This article reviews progress in the search to identify the primary AD-causing toxins. We summarize the shift from an initial focus on amyloid plaques to the contemporary concept that AD memory failure is caused by small soluble oligomers of the Aβ peptide, toxins that target and disrupt particular synapses. Evidence is presented that links Aβ oligomers to pathogenesis in animal models and humans, with reference to seminal discoveries from cell biology and new ideas concerning pathogenic mechanisms, including relationships to diabetes and Fragile X. These findings have established the oligomer hypothesis as a new molecular basis for the cause, diagnosis, and treatment of AD.     

The super-ego, the voice of the self and the depressive position

The Freudian concept of the super–ego and Jung's idea of a primary moral reaction in the unconscious – the voice of the self – are compared. From its origin the superego is connected with human destructiveness, but for Jung individual conscience is based on a collision between the ego and the inner world of archetypes. With reference to Neumann's 'New Ethic', some implications of Jung's idea of the unconscious ambiguity of good and evil are discussed. Finally an attempt is made to relate the concept of the primary moral reaction to a developmental and clinical framework, notably Klein's depressive position, but only a partial integration is possible.     

Theory and method of self-assertion training

Lack of assertiveness is considered, in the sense of the theoretical concept of Ullrich de Muynck and Ullrich, to be due to such components as 1. abnormal attitude toward oneself, 2. fear of criticism and failure, and 3. inadequately developed social skills; after this, the term 'assertiveness' is defined. Previous therapeutical approaches to the remedying of unassertiveness and the underlying theoretical assumptions are critically examined and discussed with particular reference to their effectiveness. These include the training programs developed by Salter and Wolpe which are characterized by certain onesidedness as well as the concept of Ullrich de Muynck and Ullrich, which has a sound theoretical basis and a rather differentiated or specialized structure. Reference is also made to the author's own research projects.     

Treatment of Anxiety Disorders With Comorbid Depression: A Survey of Expert CBT Clinicians

Cognitive-behavioral therapy (CBT) is an empirically supported psychological treatment for anxiety disorders. These treatments have primarily been developed to target primary anxiety disorders, despite the fact that these disorders frequently co-occur with a diagnosis of depression. Empirical evidence provides guidance regarding how to treat an individual with a primary anxiety disorder with comorbid depression; however, there is limited data regarding how to translate these findings into clinical practice. Improving our understanding of how CBT is currently being used in practice among experts is integral to learning whether modifications to protocols lead to more or less effective treatments. Accordingly, we surveyed expert CBT clinicians about their assessment and treatment approaches and what challenges they face in formulating and treating mood and anxiety comorbidity. Most experts reported that their assessment includes a semistructured interview and self-report measures to determine breadth and hierarchical ordering of comorbidity severity. Symptom severity, client's goals, temporal onset of disorders, presence of suicide risk, and potential for early treatment success were reported as factors to consider when deciding where to begin treatment. Almost three quarters of experts surveyed indicated that they usually take some type of sequential treatment approach when treating primary anxiety disorders with comorbid depression. The top three reported challenges associated with treating comorbid presentations were client's motivation/energy, hopelessness/pessimism, and ongoing need for risk assessment. Implications for the nature and timing of CBT interventions in “real-world” clinical practice are discussed.