ERCP在十二指肠乳头旁憩室并胆总管结石诊治中的应用

通过回顾性分析237例十二指肠乳头旁憩室并胆总管结石患者行经内镜逆行胰胆管造影术（ERCP）治疗的资料,探讨ERCP治疗的临床疗效及安全性。结果显示十二指肠乳头位于憩室内41例,十二指肠乳头位于憩室旁196例;胆总管结石位于上段25例,中段131例,下段81例;胆总管直径小于1．0cm23例,1．Ocm～1．5cm89例,1．6cm～2．0cm106例,大于2．0cm19例。均经ERCP治疗成功,因此ERCP治疗十二指肠乳头旁憩室并胆总管结石,可操作性强、创伤小、并发症少,疗效确切,是安全、有效的治疗措施。     

桡骨小头粉碎性骨折的两种治疗方法比较分析

分析比较切开复位内固定和人工桡骨小头置换方法治疗桡骨小头粉碎性骨折（MasonⅢ型）的临床疗效。回顾分析2012年10月～2014年3月收治的24例桡骨小头粉碎性骨折（MasonⅢ型）的临床资料,其中切开复位内固定治疗17例;桡骨小头置换7例,平均随访12个月（6个月～18个月）。根据Broberg Morrey评分系统以及术后影像进行评价比较,同时比较两组住院天数以及费用。结果评价比较显示两者疗效均佳,术后两者活动度和功能评分相近,两组住院天数相近,内固定组费用更低。桡骨小头粉碎性骨折须尽早进行解剖复住功能重建,切开复位内固定和桡骨小头置换疗效相当。     

急性胰腺炎临床决策中的辩证思维观

急性胰腺炎（AP）是临床常见危重症。近年来AP诊断和治疗取得了令人瞩目的进展,及早诊断和恰当、合理的生命支持治疗极大改善了AP患者的预后。临床上AP患者病情往往复杂多变,要求在极短时间内做出正确的临床决策,科学理性的临床决策思维对AP患者的合理诊治起着非常重要的指导作用。临床医师应努力学习和充分灵活地运用辩证思维,为对AP进行科学的临床诊疗决策提供合理的思路。     

临床整合医学的必要性及实施中存在的问题——以慢性阻塞性肺疾病及其合并症的诊治为例

近年来人们逐渐认识到慢性阻塞性肺疾病(COPD)是一种全身性疾病,即COPD不仅会影响到气道和肺,还会引起一系列合并症,包括心血管疾病、骨质疏松、焦虑和抑郁、癌症、感染、代谢综合征和糖尿病等。这些合并症会显著地影响COPD疾病严重程度和预后,因而必须对COPD进行整体防控,然而COPD的上述合并症的诊治分属不同学科,所以要做好COPD的整体防控就需要相关学科进行医学整合。     

P16、CyclinDl和CDK4在结直肠癌组织中表达及意义

细胞周期过程中癌基因的激活与抑癌基因的失活等是造成细胞恶性增殖、转化的重要因素。细胞周期G1／S期各调节因子的异常改变与细胞癌变关系尤为密切。P16、CyclinDl和CDK4均为重要的细胞周期调控蛋白,任何原因导致这些蛋白异常表达时,将引起细胞周期调节失控,导致肿瘤的发生和恶性演进。结直肠癌的发生发展同上述三者关系密切。本实验通过免疫组化方法进行检测结直肠癌组织中P16、CyclinDl和CDK4三者的表达及其与结直肠癌临床指标的关系,为揭示三者在结直肠癌发生发展中的作用提供一定的实验依据。     

急性心肌梗死患者小动脉弹性指数水平与各项危险因素的关系

探讨急性心肌梗死（AMI）患者小动脉弹性指数（C2）水平与各项风险因素的关系。纳入我院心血管内科于2010年1月～2013年7月间收治的AMI患者,并纳入同期入院的不稳定心绞痛（UA）患者作为对照组,收集相关临床资料,比较不同C2水平与相关指标的关联性发现：C2等11项危险因素存在显著差异,经多因素Logistic回归...     

急性心理性应激对自我参照记忆的影响

已有研究表明急性心理性应激会导致个体的自传体记忆受损,然而急性心理性应激如何影响个体加工当前的自我相关信息,还没有研究结论,本研究旨在丰富和拓展这一领域的研究,从而更加全面深入的了解急性心理性应激对自我相关信息的影响。本研究将自我参照记忆的R/K(记得/知道)范式与特里尔社会应激测试(Trier Social Stress Test:TSST)相结合,考察59名处在不同急性心理性应激状态下的被试自我参照记忆的成绩。结果发现高应激反应组自我参照的R回忆率值显著低于低应激反应组,研究结果发现,被试在特里尔社会应激测试过程中的急性心理性应激反应越强,自我参照的R回忆率越低。结果表明急性心理性应激会抑制个体对当前自我相关信息的加工,削弱了自我参照记忆。     

Coping Style Following Acute Stress in Competitive Sport

Abstract

The purpose of this study was to ascertain coping styles among competitive athletes in response to various acute stressors. Specifically, the authors used a 134-item survey to measure approach and avoidance coping styles, with task-focused and emotion-focused coping tendencies nested hierarchically as subdimensions under each. Australian and U.S. college-aged participants indicated the extent to which they used approach, avoidance, task-focused, and emotion-focused coping strategies (a 4-factor model) in response to selected acute stressors experienced during sport competition. The authors computed confirmatory factor analysis to test the theoretically driven model. The criterion loading of .30 and above for each of the factors reduced the survey to 65 items. Findings indicated stronger links between the 2 approach constructs of task- and emotion-focused coping than between the 2 avoidance constructs of those subdimensions. The goodness-of-fit indices for the 4-factor model were 0.58 and 0.57 for Australian and U.S. samples, respectively, and .71 overall. Concomitant low correlations between the 2 approach (0.18) and the 2 avoidance dimensions (0.43) reflected relatively high residuals between stressors. In general, psychometric analyses suggest that coping style may be more prevalent in some situations than others, lending partial support for the transactional model of coping.     

Relationship between respiratory mortality and self-perceptions of aging

Although there is growing evidence that psychological factors affect an individual's susceptibility to respiratory illnesses, psychological predictors of respiratory mortality have received little attention. This study investigated whether an age-specific psychological factor, older individuals’ beliefs about their own aging, predicted the likelihood of their dying from respiratory causes (ICD-9: 460–519). The sample was composed of 620 individuals, aged 50–87 years at baseline, who participated in a longitudinal study with six waves. Our research found that individuals with higher baseline positive self-perceptions of aging were significantly less likely to die of respiratory causes over the next 23 years, after controlling for age, functional health, gender, loneliness, marital status, self-rated health, and socioeconomic status (hazard ratio?=?0.695; p?<?0.005). This is the first study to link individual beliefs about aging to cause-specific mortality. Future research is warranted to further elucidate the relationship between self-perceptions of aging and resistance to respiratory mortality.