血压正常的超重和肥胖人群的肾功变化

为了探讨健康体检中血压正常的超重和肥胖人群的肾功有无变化。对3756例体检者测量身高、体重、血压,检测各项生化指标,计算肾小球滤过率（GFR）、体质指数（BMI）。结果显示：男性的eGFR较女性低。年龄与eGFR相关性强。消除了性别和年龄的影响后,分析表明随着体质指数的升高,eGFR逐渐降低,而肌酐却无差异。我们发现血压正常的超重和肥胖人群体检虽肌酐正常,但eGFR却明显下降,表明存在肾功损害,故我们需早期识别,定期复诊,防止肥胖相关性肾病发生。     

后纵韧带骨化患者手术方式的选择及临床效果分析

通过研究颈椎后纵韧带骨化患者的不同手术方式对术后效果的影响,回顾性对分别行前路、后路手术治疗的颈椎后纵韧带骨化患者127例进行5年～10年的随访并依据手术前后不同时期的影像学结果及神经功能改善情况进行分析,探讨椎管狭窄率和颈椎序列变化等因素对手术方式的选择及术后疗效的影响。结果显示,前路手术组术后能够维持并改善颈椎前凸...     

围手术期患者的抗栓治疗

抗栓治疗的患者接受外科手术时面临栓塞和出血双重风险,本文就临床常用抗栓药物的药理特性、围手术期患者抗栓治疗需要注意的问题以及解决方案作一概述。     

贝叶斯推理中的“自击中率参照抑制”

本文旨在研究贝叶斯推理中基础比率、击中率起作用的机制。通过设置肝炎情境、中彩情境的贝叶斯推理问题,同时操作基础比率和击中率的水平,考察449名大学生被试的概率估计情况。结果表明,总体上,贝叶斯推理中的基础比率和击中率均起作用,表现为后验概率估计值随基础比率水平的提高而增加,随击中率水平的提高而增加。然而,在低基础比率的中彩情境中,后验概率估计值先随击中率的增加而增加;之后却随击中率水平的继续提高而显著降低,出现自击中率参照抑制。这似乎说明,击中率在贝叶斯推理中并非一致地起作用,而可能与推理者的知识经验对击中率加工的调节有关。     

鼻咽癌治疗方法的比较

鼻咽癌是我国南方省市最常见的头颈恶性肿瘤,放疗为其首选治疗方案,但患者五年生存率仍然不高。本文阅读国内外对鼻咽癌多种治疗方案的报道,结合湘雅医院、湘雅二医院对鼻咽癌某些治疗方案,通过分析对比不同治疗方案的疗效、患者生存质量及费用,讨论该病的最佳治疗方案,以期能在目前条件下提高鼻咽癌患者的治疗效果及生存质量。     

权近《天人心性合一之图》研究

韩国有着悠久的学《易》历史,早在汉代,中国儒学便已传入其国。到李朝时期,作为易学一部分的易图学研究就已经达到了相当高的水平。代表人物是高丽末期、李朝初期的哲学家权近。他在中国易学家周敦颐《周氏太极图》的影响下,创制了《天人心性合一之图》。《天人心性合一之图》与《周氏太极图》的轮廓大体相同,都是黑白相间、酷似人形,反映了太极为本、阴阳互补、天人合一的特征。但《天人心性合一之图》又有它独特的一面,将伦理、心性等问题纳入易学体系,完成对前者的超越。由此可见,中韩易学文化融合的过程中,既有借鉴和吸收,又有创新和超越。     

IABP在心脏直视手术围术期低心排的应用

为了探讨主动脉内球囊反搏（IABP）治疗心脏手术围术期低心输出量综合征（LCOS）的临床疗效,对16例心脏手术围术期LCOS患者,经过股动脉放置IABP导管于降主动脉内进行左心辅助治疗,IABP治疗前、后监测患者连续有创动脉收缩压（SABP）、有创平均动脉压（MABP）、中心静脉压（CVP）、动脉血氧分压（PaO2）、心率（HR）、尿量和血管活性药物的使用。结果显示,IABP辅助治疗时间25h～116h,平均（78．5±40．5）h。行IABP治疗后,SABP、MABP、PaO2较术前明显提高（P〈0．05）,HR、CVP明显下降（P〈0．05）,尿量增加,血管活性药物使用量明显减少（P〈0．05）,12例患者心功能好转而脱离IABP,11例（69．3％）存活,4例死于心源性休克,1例死于多器官功能不全综合征（MODS）。提示正确及时地使用IABP能明显改善心脏手术围术期LCOS患者的血流动力学指标,减少血管活性药物的使用,建议对有适应证者应尽早应用,适时撤离。     

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。     

Depression in Women with Heart Disease: The Importance of Social Role Performance and Spirituality

Compared with men, women are more likely to experience depression, and depression increases risk of morbidity and mortality in individuals with heart disease. Psychosocial interventions have been developed for depressed patients with heart disease; however, women's experience of chronic disease differs from men's and women may benefit from interventions tailored to address their difficulties. Spirituality and social roles have been related to depressive symptoms in other populations. To identify the relationship between depression and spirituality and social role performance (i.e., role concerns, role rewards and confidence in ability to fulfill roles) in women with heart disease, we assessed depressive symptoms, spirituality, social role functioning and medical history in 125 women with heart disease. After controlling for age and severity of medical conditions, spirituality, role confidence and role concerns were significantly associated with depressive symptoms. Consideration of spirituality and aspects of social role performance may be important when developing psychosocial interventions for depressed women with heart disease.     

Effects of nutritive and non-nutritive sucking on infant heart rate variability during the first 6 months of life

The effects of eating on heart rate variability (HRV) differ between adults and newborns. This may reflect the impact of suckling on the overall psychophysiological and autonomic nervous system maturation. The purpose of the present study was to explore whether the reactions of HRV during feeding change towards the adult pattern during the first 6 months of life. In addition, the effects of non-nutritive and nutritive sucking on heart rate (HR) and HRV were compared. The participants were 23 infants on whom recordings were performed as newborns and at 6, 12 and 24 weeks old. Nutritive sucking caused an increase in HR and a decline in HRV. The results were consistent with previous reports of a decrease in high frequency components of HRV during feeding in newborns, reflecting a decrease in parasympathetic activity. This response was apparent in all four ages studied, and remained similar throughout the 6-month period. However, age as an independent factor seemed to influence both HR and HRV. Pacifier sucking had no significant effects on HRV at any age. The results demonstrate the physical strain that sucking imposes on the baby, with a specific autonomic nervous system response involved. We consider this response an essential part of the overall psychophysiological maturation of infants.