胆道术后胃功能性排空障碍治疗体会

探讨胆道术后胃功能性排空障碍的诊治经验。回顾性分析32例胆道术后胃功能性排空障碍病例。结果32例胃功能性排空障碍发生于术后5天～10天,经保守治疗后均痊愈。胆道术后胃功能性排空障碍是胃的功能性病变,经综合保守治疗是可以治愈的。     

胸腰段爆裂性骨折的手术策略选择

胸腰段爆裂性骨折是最常见的脊柱损伤之一,而手术治疗是其主要的治疗方式,选择最优的手术路径、做出最佳的临床抉择,是其治疗的首要目标。本文对胸腰段爆裂性骨折的不同手术入路方式及其特点做了比较和探讨,认为以最优化为原则,选择一期后路小切口有限减压的手术方式,是治疗胸腰段爆裂性骨折的最佳手术策略。     

False-positive tangible outcomes of functional analyses

Functional analysis (FA) methodology is the most precise method for identifying variables that maintain problem behavior. Occasionally, however, results of an FA may be influenced by idiosyncratic sensitivity to aspects of the assessment conditions. For example, data from several studies suggest that inclusion of a tangible condition during an FA may be prone to a false-positive outcome, although the extent to which tangible reinforcement routinely produces such outcomes is unknown. We examined susceptibility to tangible reinforcement by determining whether a new response was acquired more readily when exposed to a tangible contingency relative to others commonly used in an FA (Study 1), and whether problem behavior known not to have a social function nevertheless emerged when exposed to tangible reinforcement (Study 2). Results indicated that inclusion of items in the tangible condition should be done with care and that selection should be based on those items typically found in the individual's environment.     

胸部双源性疾病外科治疗的临床决策

胸部双源性疾病随人口的老龄化而逐年增加,而老年人的心肺及各种脏器功能随年龄的增长逐渐衰退,并发症多,手术风险大,对此类病人的外科治疗如何做出正确的临床医疗决策?我们以循证医学理论为基础,努力做到临床医疗决策的科学性,治疗方案的合理性,大胆尝试,逐步从分期手术向一期手术过渡,既达到了解决病人疾苦,救治病人的目的,又解决了医疗需求的增加和卫生资源短缺的矛盾,取得了满意的效果,降低了医疗成本,节约了医疗资源,产生了明显的社会和经济效益。     

中国古代学者论志意本质

中国古代的意志理论非常丰富,从志意概念、志意本质、志意关系、志意功能到志意的培养诸方面都有涉及。本研究着重讨论中国古代学者关于意志本质的观点。     

The production and recognition of typological argumentative text markers

A series of experiments on children and adults were conducted to define the features and workings of argumentative discourse. Oral and written arguments were analyzed for the complexity of the argument support structure and the presence of typological argumentation markers (certainty modals, value judgments, etc.). Subjects were asked to assess the argumentativity of texts that did or did not contain typical argumentation markers. At about age ten, children can produce and recognize a ‘minimal argumentative structure,’ in which the speaker takes a stance and supports it with text that derives its argumentativity from the presence of this stance). However, full mastery of the negotiation process, that involves acknowledgment of the opponent's stance (generally through the use of counterarguments) is not present before the ages of 15 to 16. The minimal argumentative structure continues to develop with age and gain complexity. Certain situations are more conductive to the production of elaborate argumentative discourse, such as a genuinely controversial topic with an unfamiliar adult addressee whose stance is not known and whose reaction is thus unpredictable. Here speakers produce complex arguments while still leaving room for negotiation. Overall, certain argumentation markers can be identified in all argumentative text. these markers can be used to characterize stages of development of argumentative discourse. A number of issues remain unexplored, including: What other (implicit...) devices do speakers use to convince their audience? Why is the capacity to put argumentation in writing acquired at such a late stage of development?     

人类视觉系统获取颜色恒常性的认知操作特性

以光度测量为基础,采用心理物理学方法,探讨人类视觉系统获取颜色常性的认知特性。共进行了两个实验。实验一,探讨颜色对比对获取颜色常性的认知操作过程的作用。结果发现,视觉系统可根据已适应了的对比参照作用,而校正（或补偿）由于外界照明变化而引起的物理色度变化。实验二,探讨视觉经验对人类视觉系统获取颜色常性的作用。结果发现,颜色常性不仅是一种视觉低层次、自动完成的补偿,而且涉及高层次的意识活动。     

手术同意书的相关法律问题

医患双方都非常重视手术同意书,从法理角度分析,手术同意书是患者知情同意权利和医方告知义务的体现;符合民事法律要件的合法有效的手术同意书,证明了医患之间告知与知情同意权的实现.对手术同意书的法律性质及法律效力进行探究,有助于维护医患双方的合法权利.     

Using choice to increase on-task behavior in individuals with traumatic brain injury

An ABA'B design was used to evaluate the effects of choice on task engagement for 3 adults who had been diagnosed with traumatic brain injury. A yoked-control condition, in which tasks that were selected by each participant were assigned subsequently to that participant by a trainer, was implemented to help distinguish between the effects of task preference and choice. The results for all 3 participants indicated that permitting individuals to choose from a list of tasks increased on-task behavior.     

特殊类型的无骨折脱位型颈髓损伤治疗分析

为了探讨多节段后纵韧带骨化伴颈椎间盘突出的无骨折脱位型颈髓损伤的治疗,回顾了本院收治的4例多节段后纵韧带骨化伴颈椎间盘突出的无骨折脱位型颈髓损伤患者的临床资料,并结合相关文献报道进行分析。结果显示,4例患者均早期行前后路联合手术椎管减压,3例患者行预防性气管切开,4例患者术后随访时间6个月～48个月,平均随访24个月。固定节段均获骨性融合,内固定物无松动、断裂;后路手术无再关门现象。术后神经功能评价按Frankel分级,均有1个～2个级别恢复,术前A级2例,B级2例;术后B级2例,C级1例,D级1例。提示对于多节段后纵韧带骨化伴颈椎间盘突出的无骨折脱位型颈髓损伤早期行前后路联合手术减压;预防性气管切开可获得良好的治疗结果。