辩证思维在重症急性胰腺炎治疗中的运用

重症急性胰腺炎的治疗水平在近几十年已有了很大的发展,但是SAP的死亡率依然居高不下,严重威胁患者生命。这类患者的病情复杂,需要运用多种治疗方法进行综合救治。从多种治疗方法中选择合适的方法并进行合理的治疗很难准确把握,需要我们用哲学的思维来看待胰腺炎的诊治,辩证地对其进行有针对性的治疗,从而提高重症急性胰腺炎的治疗水平。     

合理应用运动平板试验与冠脉CT诊断冠心病临床策略分析

本文针对临床诊断冠心病的两种常用手段即运动平板试验和冠脉CT进行分析,鉴于目前临床普遍存在重视采用冠脉CT,甚至达到滥用的地步,而逐渐忽视平板运动试验的现象,紧密结合临床,客观分析两者的特点,阐述各自优缺点。希冀通过本文以帮助临床医师正确选择应用,避免偏颇,最终达到将两者有机的结合,真正适合临床需要,提高冠心病患者的检出率,有利于更好地对冠心病进行二级预防。     

急性肺损伤生物标志物研究进展

急性肺损伤是临床常见的呼吸系统急危重症,是多个危险因素直接或间接引起肺部损伤的连续病理过程,低氧血症为其特征,其发病机制复杂,病亡率高,目前临床上仍缺乏有效的早期诊断方法,严重影响了疾病的预后,因此需寻找一个简单有效的诊断方法,如血清生物标志物的测定等来帮助本病的诊断以取得更好的疗效。     

Brief Report: Self-Objectification and Esteem in Young Women: The Mediating Role of Reasons for Exercise

In this study we investigated the interrelationships between self-objectification, reasons for exercise, body satisfaction, body esteem, and self-esteem. A questionnaire that assessed each of these constructs was completed by 104 female participants between the ages of 16 and 25 who exercised regularly at a fitness center. Self-objectification and appearance-related reasons for exercise were significantly negatively related to body satisfaction, body esteem, and self-esteem, and functional reasons for exercise were positively related to each of these outcome measures. Self-objectification also predicted the reasons women exercise. More important, reasons for exercise were found to mediate the relationships between self-objectification and body satisfaction, body esteem, and self-esteem. It was concluded that objectification theory can be extended usefully into the realm of exercise and that, among women who exercise, motivations for exercise account for the reduced body satisfaction and self-esteem for women high on self-objectification.     

急性重症胰腺炎的抗生素治疗策略

继发性感染是导致急性重症胰腺炎(severe acute pancreatitis,SAP)高病死率最重要的因素。继发感染的微生物多为革兰阴性菌。选用抗菌药物需兼顾病原菌敏感性及抗菌药物穿透血胰屏障能力,合理选择用药方式;对于CT证实有胰腺坏死的急性重症胰腺炎,可预防性使用抗生素;氟康唑可作为经验性抗真菌治疗的首选药物。     

An Exercise in Psychological Growth*

The author presents a case report followed by a self- assessment exercise which was generated spontaneously in collaboration with the patient herself during the treatment process. The lists of questions, designed to provoke thought and stimulate maturation, were found to be quite helpful especially in making important life decisions. It is proposed as a learning tool and template for use by those confronting similar issues. Lois Gerby, MA, is a psychologist and family therapist in private practice, 32 Hapalmach St., Suite 32/7, Jerusalem, Israel 92542 (jack.friedman@mail.mcgill.ca). *Translation by Yacov Friedman and Haim Sherrf.     

急性有氧运动对认知表现的影响

急性有氧运动是持续时间在10~60分钟的一次有氧运动。急性有氧运动可暂时性地改变感觉敏感度、记忆、执行功能等认知功能, 但其对不同认知功能的影响效果存在差异, 干预结果受到个体体适能水平、运动强度和运动类型等因素的调节。目前用于解释急性有氧运动影响认知表现的理论有唤醒理论、前额叶功能衰退理论、神经内分泌模型和神经营养因子假说。未来的研究应加强对急性运动发挥作用机制的探究, 更多关注身心运动、团体运动等不同运动形式的干预效果, 以期为长期“运动处方”的开具提供依据。     

Can a before-school physical activity program decrease bullying victimization in disadvantaged children? The Active-Start Study

Background/ObjectiveTo test the effectiveness of an 8-week before-school physical activity program to reduce bullying victimization among a group of socially disadvantaged children in the Active-Start study.MethodA non-blinded randomized controlled trial was conducted in three public schools classified as highly vulnerable and located in a deprived area of Santiago (Chile). A total of 5 classes participated, totaling 170 fourth grade children. The intervention was delivered before starting the first school-class (8:00–8:30 a.m.). The program lasted for 8 weeks. Primary outcome measurement on bullying victimization was assessed by the CUBE questionnaire at baseline and post-intervention.ResultsThere was a statistically significant reduction in the probability of suffering physical bullying (OR= 0.18, 95% CI, 0.04-0.82; p= .027) and verbal bullying (OR=0.13, 95% CI, 0.02-0.97; p= .046) after the 8-week program.ConclusionsParticipation in an 8-week before-school physical activity intervention implemented in schools located in a disadvantaged district in Santiago (Chile) resulted in lower levels of bullying victimization among study participants. The Active-Start program may be a feasible and potentially scalable intervention option to improve the climate and pro-sociality environment at schools.     

Some Diagnostic Observations of Post-September 11, 2001 Crisis Groups

Crisis groups following the September 11 attack in New York were an opportunity to learn about people in crisis. The many groups that were formed to assist individuals' return to work, school, and home offered opportunities to observe how people managed their personal crises. While diagnoses such as Post-traumatic Stress Disorder were used, they offer no help in understanding group dynamics and individual behavior in groups. In this paper a psychoanalytic group orientation is offered to help learn about the impact of such terrible crises on individuals and the use of psychoanalytically oriented groups to aid in their path to recovery.     

急性应激与风险倾向：兴奋易感性的调节作用

为探索应激对决策的作用机理及其个体差异,减少工程作业中因应激导致的决策失误,本研究采用特里尔社会应激测试和气球模拟风险任务考察应激反应与应激下风险倾向的关系,并探索兴奋易感性在其中的调节作用。研究结果表明,应激下个体的皮质醇反应越大,行为越冒险。且这一作用受到兴奋易感性的调节：兴奋易感性较高的个体,应激下皮质醇反应越大,行为越冒险;而兴奋易感性较低的个体,其皮质醇变化不能预测风险倾向。该发现提示了兴奋易感性在应激影响中的重要作用,也为高压岗位的人员选拔提供了科学启示。