超声心动图与心血管造影X线引导下先心病介入封堵治疗的比较

目前先天性心脏病介入治疗已成为介入心脏病学的新热点,而先心病介入治疗离不开影像学引导,目前临床上常用的影像学引导方式主要有超声心动图和心血管造影两种,本文针对两者优缺点,从治疗方式、疗效、费用等方面进行比较,为临床治疗思路提供借鉴。     

古埃及疾病医治理念透析

疾病医治理念是古埃及文明的重要组成部分。古埃及人针对不同类别疾病有着相应的医治理念：药物、魔法与意志是内科疾病的医治理念;河渠原理是医治外科疾病的理念;对于治疗心理疾病主要是寻求神灵的拯救;预防疾病的理念是保持圣洁。挖掘、梳理这些医治理念,可以加强医学史的学科建设,对某些疾病的治疗有参考价值。     

Issues Involving Informed Consent for Research Participants with Alzheimer’s Disease

Alzheimer’s disease is the most common form of dementia which is estimated to impact 350,000 people over 65 years of age in Canada. The lack of effective treatment and the growing number of people who are expected to be diagnosed with Alzheimer’s disease in the near future are compelling reasons why continued research is in this area is necessary. With additional research, there needs to be greater recognition of the complexity of seeking ongoing informed consent from those with Alzheimer’s disease. This complexity is because the impairment of memory and cognitive ability does not diminish in a linear manner, but rather fluctuates between periods of impairment and relatively normal cognitive lucidness. There is limited discussion in the guidelines of those progressing from early stages of Alzheimer’s disease who have intermittent cognitive function. Guidelines to research and Research Ethics Boards require further development to facilitate researcher including those with Alzheimer’s disease while protecting this growing pool of potential participants.     

特质性与情境性调节定向匹配效应的一致性

研究试图探讨基于不同性质的调节定向(特质性调节定向和情境性调节定向)而达成的匹配所导致的效应是否一致。实验一、二均采用2(调节定向：促进、防御)×2(信息框架：积极、消极)被试间设计, 分别考察了两种匹配对信息说服效果(包括信息价值评价、情绪强度、行为意向3项指标)的影响。MANOVA检验表明, 实验一中信息价值评价、情绪强度2项指标上的交互作用显著, 实验二中信息价值评价、情绪强度和行为意向3项指标上的交互作用显著; 这表明, 基于两种不同性质的调节定向所达成的匹配在对信息价值评价和情绪强度的影响上具有一致的效应, 但在对行为意向的影响上具有不一致的效应。这一结果对于理解两种不同性质的调节定向之间的差异以及基于两者而达成的两种调节匹配之间的差异具有较为重要的意义。     

Impulsivity as a predictor of newly-diagnosed peptic ulcer disease: A prospective cohort study

We examined the role of impulsivity in the development of peptic ulcer disease (PUD). The subjects were initially healthy 4636 hospital employees aged 19–62 who responded to a questionnaire on personality, health habits, mental health, and PUD in 1998 and 2000. We used multivariate logistic analyses to determine the relationship between impulsivity and newly-diagnosed PUD among those employees who did not have PUD at baseline. Impulsivity was assessed with the Karolinska Scale of Personality. High level of impulsivity was associated with increased 2-year incidence of doctor-diagnosed PUD after adjustment of age, gender, education and shift work (odds ratio = 2.42, 95% confidence interval = 1.21–4.82). Additional adjustment for the effects of smoking, alcohol consumption, BMI, physical activity, minor psychiatric morbidity and diagnosed depression and other psychiatric disease had little effect on this relationship. The present study suggests that impulsivity may be a risk factor for the development of PUD.     

Spirituality and Healthy Lifestyle Behaviors: Stress Counter-balancing Effects on the Well-being of Older Adults

The goal of this study was to examine stress-ameliorating effects of religiosity, spirituality, and healthy lifestyle behaviors on the stressful relationship of chronic illness and the subjective physical well-being of 221 older adults. We also investigated whether the intervening variables functioned as coping behaviors and orientations or as adaptations in late life. Guided by the stress paradigm, path analysis was used to assess these relationships in a stress suppressor model and a distress deterrent model. No suppressor effects were found; however a number of distress deterrent relationships were detected. Spirituality, physical activities, and healthy diet all contributed to higher subjective physical well-being, as counter-balancing effects, in the distress deterrent model. The findings have implications for future research on the role of spirituality, religiosity and lifestyle behaviors on the well-being of chronically ill older adults. Findings also support the need for studying different dimensions of religiosity and spirituality in an effort to understand coping versus adaptation in behaviors and orientations. Gracie H. Boswell, Ph.D., M.Ed. (Case Western Reserve University) and (M. Ed.- Kent State University). She is a Carolina Program in Health and Aging Research Scientist at the Institute on Aging- University of North Carolina at Chapel Hill. Her research interests have been social gerontology and quality of life, emphasizing religiosity/spirituality. Eva Kahana, Ph.D. (University of Chicago) is Pierce T. and Elizabeth D. Robson Professor of Humanities and Director of the Elderly Care Research Center- Case Western Reserve University. Her research concentration has been the sociology of aging (coping & stress and institutionalization). Peggye Dilworth-Anderson, Ph.D. (Northwestern University) is Director- Center for Aging and Diversity, Institute on Aging, Professor- School of Public Health, Department of Health Policy and Administration at University of North Carolina at Chapel Hill. Her research interests have been caregiving and minority health disparities.     

慢性腹痛

慢性腹痛病史较长,性质不定。引起慢性腹痛的原因很多,除器质性疾病外,一些功能性疾病也引起,如最终找不出具体原因,则可称之为功能性腹痛综合征。诊断比较困难,也容易误诊,甚至误治,外科医生应特别慎重。误诊的思维原因包括对引起慢性腹痛的原因认识不全面,思维惰性,辩证思维不周密和思维简化等。     

呼吸危重症临床决策中的若干问题

在临床实践中,呼吸危重症的诊断和治疗存在着一些不同的观点。就其中某些热点问题,如慢性阻塞性肺疾病合并哮喘的诊断和机械通气的指征、肺栓塞的诊断、急性呼吸窘迫综合征的治疗、呼吸重症监护病房的建设和呼吸危重症的伦理学问题进行阐述,以期提高对呼吸危重症的认识。     

骨科疾病诊治中的临床思维

医学哲学是对医学科学成就总的概括,并以此为基础探讨生命活动和病程的一般规律,研究医学科学的思维方式,直至疾病预防、诊断治疗。同时研究辩证规律和范畴在医学科学中的表现,从而指导骨科医师解决在骨科疾病诊治中遇到的诸多问题,并有助于形成正确的临床思维。结合临床工作体会,探讨医学哲学在骨科疾病诊治临床思维中的应用。     

从能量观疾病

能量在机体的各种离子、分子、细胞、器官、组织、系统间协调分布,共同维持着健康状态。某一病因作用于人体后,“协调分布”会被不同程度地打破,当超过一定的阈值,就会产生疾病。对于人体,各种能量的直接表现形式和能量的携带者——各种营养物质,都与疾病之间有着千丝万缕的联系。从“能量”角度,我们既可进一步探讨尚未阐述清楚的疾病发生机制,又可以设计更为完美的治疗方案与医学仪器。