冠心病多支血管病变完全血运重建的长期疗效观察

为分析冠心病多支血管病变(MVD)患者经皮冠状动脉介入治疗(PCI)进行完全血运重建术后长期的临床疗效,我们收集了2004年5月~2008年5月589例接受PCI的冠心病患者,其中实施完全性血运重建(CRV)461例(78.3%),不完全性血运重建(IRV)128例(21.7%),对比分析两组病例PCI术后随访1年以上的结果。结果显示IRV组患者中完全闭塞病变、3支血管病变的比例均高于CRV组(P0.01);CRV组PCI成功率明显高于IRV组(94.8%vs87.5%,P0.05)。提示多支冠状动脉病变完全性血运重建能够获得更好的长期临床疗效论。     

中药在心血管疾病中应用现状与反思

具有悠久历史的中医药在现代医学中有鲜明的时代特点。心血管疾病是现代社会严重威胁生命及健康的病患。本文总结分析了古老中药在现代心血管疾病中应用的现状,并深入分析其影响因素,从而提出扬长避短的未来心血管疾病应用中药的思路。     

青年颈心综合征避免误诊为冠心病的临床诊疗策略

通过对临床收集的187例青年(≤45岁)颈心综合征患者的临床资料进行分析。探讨青年颈心综合征临床误诊为冠心病的原因及避免误诊的诊疗策略。目的在于帮助临床医师对青年颈心综合征进行识别,注意如何与冠心病心绞痛相鉴别,对防止病情延误,尽早明确诊断积极治疗,排除冠心病,减少诊疗费用及避免冠脉造影的风险意义很大。     

错误相关负波（ERN）在精神病理学研究中的应用

错误相关负波（error-related negativity, ERN）是由行为错误诱发的一种脑电波成分,最大峰值在错误反应之后的50ms左右,偶极子源定位于前扣带回（anterior cingulate cortex, ACC）附近。错误加工（error processing）的经典研究范式中出现的ERN成分可能反映了ACC具有错误检测、冲突监控、强化学习、情绪动机等功能。大量研究表明过度的和不足的错误相关脑活动（hyperactive and hypoactive error processing）可能分别与精神病理学的内化性和外化性障碍（internalizing and externalizing disorders）相关联。内化性和外化性障碍的内表型（endophenotype）的研究,还存在许多值得进一步探索的问题。     

冠心病理想治疗方式的选择

冠心病的治疗包括针对高危因素病因和临床并发症的综合治疗。其中,药物治疗主要包括：抗凝／抗血小板、控制血压和调脂等。血管重建术主要包括：介入、搭桥、“杂交”手术和分子生物学治疗。药物治疗是冠心病各种治疗方法的基础,而血管重建术是现代治疗冠心病的重要手段。如何合理地选择治疗方案是临床医师面临的重要课题。     

冠心病的外科治疗

首例成功的冠状动脉旁路移植术（CABG）手术完成于1960年,随着体外循环技术的成熟,CABG手术得以不断发展。20世纪90年代,以非体外循环下冠脉旁路移植术（0PCAB）为代表的微创冠脉搭桥手术逐渐应用于临床,并取得满意的临床效果。尽管冠脉介入技术（PCI）以其创伤小的优点在冠心病的治疗方面蓬勃发展,但是CABG在远期通畅性方面仍然占据优势地位,因此CABG仍然是冠心病治疗的效果确定的一种方法。     

A systematic examination of different parameters of presession exposure to tangible stimuli that maintain problem behavior

We examined the effects of three different presession conditions on tangibly maintained problem behavior for 2 students with autism, using individual-participant multielement designs. First, an analogue functional analysis demonstrated that problem behavior was maintained by access to tangible items. Next, topographies of item rejection were identified. Finally, students were exposed to (a) brief access, (b) no access, and (c) satiation to the tangible items prior to tangible sessions. The results demonstrated high levels of problem behavior following the brief-access and no-access presession conditions and low levels of problem behavior following the satiation condition. The findings are discussed in the context of how satiation might best be defined for these sorts of evaluations.     

颈动脉病变的治疗现状

颈动脉病变尤其是颈动脉狭窄治疗上的分歧,颈动脉内膜切除术受欧美学者推崇,颈动脉支架成形技术受国内学者青睐,本文就近年来的文献复习发现颈动脉内膜切除术和颈动脉支架成形术各有相宜的适应证,各有优缺点,根据各自医院的设备条件、医师对颈动脉内膜切除术和颈动脉支架成形术熟悉程度来开展工作,对颈动脉狭窄治疗均有益处,存在的问题和困...     

Integrative problem-centered metaframeworks therapy I: core concepts and hypothesizing

Over the last 20 years psychotherapy and family therapy have been inundated with a plethora of empirically validated treatments for particular disorders. That trend will increase. Psychotherapists will increasingly be exhorted and ultimately required to integrate empirical data and multicultural competence into their practice. Additionally, individual psychotherapy's default dominance of psychotherapeutic discourse needs to integrate and come to theoretical and clinical terms with the implications of the growing body of research demonstrating the validity and value of a multisystemic perspective. This article (and its companion article) presents a comprehensive, integrative, multisystemic, and empirically informed psychotherapeutic perspective to help therapists and psychotherapy trainers successfully address these challenges-Integrative Problem Centered Metaframeworks (IPCM) Therapy. This first article presents and illustrates IPCM's theoretical foundation, core concepts, and "case formulating" components. It delineates a Blueprint for the practice and teaching of 21st century psychotherapists who can meld science and art into best practice.