活体肝部分移植术后中、长期管理

0　引言　 1989- 0 7全球首例活体肝部分移植术成功以来 ,这一手术先后在 30余个国家和地区开展 ,至 1996 - 0 8全球累计总例数已愈 70 0例 ,我院于 1997- 0 6 - 30在日本京都大学Tanaka Koichi教授的指导下 ,成功地开展了 1例活体肝部分移植术 ,至今患者已健康生存 1.5 a,现就其术后中长期管理结合文献总结如下 :1　临床资料1.1　病例　患者为 10岁女性 ,诊断为先天性弥漫性肝内胆管囊性扩张症、复发性胆管炎、肝硬变症 ,1997- 0 6 - 30在全麻下行活体肝部分移植术 ,供体为患儿 40多岁的父亲 ,手术顺利 ,术后早期临床资料已作过报告 [1 ] …     

Interpeduncular fossa sign: CT criterion of subarachnoid hemorrhage

A retrospective study of 100 cerebral computed tomography scans interpreted as displaying subarachnoid hemorrhage was undertaken to determine the frequency of blood in the interpeduncular fossa as a useful radiographic sign. The results indicate that the interpeduncular fossa sign is second only to blood in the Sylvian fissure-circular sulcus area as a reliable indicator of subarachnoid hemorrhage on CT scans.     

Searching Choices: Quantifying Decision‐Making Processes Using Search Engine Data

When making a decision, humans consider two types of information: information they have acquired through their prior experience of the world, and further information they gather to support the decision in question. Here, we present evidence that data from search engines such as Google can help us model both sources of information. We show that statistics from search engines on the frequency of content on the Internet can help us estimate the statistical structure of prior experience; and, specifically, we outline how such statistics can inform psychological theories concerning the valuation of human lives, or choices involving delayed outcomes. Turning to information gathering, we show that search query data might help measure human information gathering, and it may predict subsequent decisions. Such data enable us to compare information gathered across nations, where analyses suggest, for example, a greater focus on the future in countries with a higher per capita GDP. We conclude that search engine data constitute a valuable new resource for cognitive scientists, offering a fascinating new tool for understanding the human decision‐making process.     

Nonpharmacologic intervention in acute alcohol withdrawal

The importance of nonpharmacologic and pharmacologic interventions in the treatment of alcohol withdrawal is not known. A randomized, double-blind, placebo-controlled trial was conducted with 41 patients in alcohol withdrawal in an emergency department. The patients received either supportive care (10 min of standardized assessments, reassurance, reality orientation, and nursing care an hour) with three doses of sublingual lorazepam 2 mg every 2 hr (21 patients, drug group) or supportive care with three doses of sublingual placebo every 2 hr (20 patients, no-drug group). Immediately before each drug dose, the clinical course of alcohol withdrawal was assessed hourly by the Clinical Institute Withdrawal Assessment for Alcohol (CIWA-A). Interraters reliability in using CIWA-A was high. After each assessment, supportive care was given for 10 min before each dose. After completion of a 7-hr initial phase, patients were discharged and reassessed daily for 5 days. Thirty-seven patients (90.2%) improved in the initial phase. Treatment failures (CIWA-A greater than 10) were more common in the patients treated without drug (3/20, 15%) than in those treated with drug (1/21, 4.8%). Overall variations in intergroup CIWA-A scores during the initial phase were not significant. The rate of improvement of CIWA-A scores over the first 2 hr after drug was slightly faster in patients receiving lorazepam than in the control group. CIWA-A scores were the same during follow-up. These results indicate that most outpatients in mild to moderate alcohol withdrawal without medical complications improve without drug therapy in the emergency department setting.     

Restrictions on biological adaptation in language evolution

Language acquisition and processing are governed by genetic constraints. A crucial unresolved question is how far these genetic constraints have coevolved with language, perhaps resulting in a highly specialized and species-specific language “module,” and how much language acquisition and processing redeploy preexisting cognitive machinery. In the present work, we explored the circumstances under which genes encoding language-specific properties could have coevolved with language itself. We present a theoretical model, implemented in computer simulations, of key aspects of the interaction of genes and language. Our results show that genes for language could have coevolved only with highly stable aspects of the linguistic environment; a rapidly changing linguistic environment does not provide a stable target for natural selection. Thus, a biological endowment could not coevolve with properties of language that began as learned cultural conventions, because cultural conventions change much more rapidly than genes. We argue that this rules out the possibility that arbitrary properties of language, including abstract syntactic principles governing phrase structure, case marking, and agreement, have been built into a “language module” by natural selection. The genetic basis of human language acquisition and processing did not coevolve with language, but primarily predates the emergence of language. As suggested by Darwin, the fit between language and its underlying mechanisms arose because language has evolved to fit the human brain, rather than the reverse.     

Determination of the solute removal index for urea by using a partial spent dialysate collection method

In 22 hemodialysis patients, during a dialysis session, the solute removal index (SRI) for urea obtained from the use of a partial spent dialysate collection method was compared with that derived from the use of a total spent dialysate collection technique. The partial spent dialysate collection method was used to harvest a small representative sample of the total spent dialysate. The volumes of spent dialysate collected by the partial and the total spent dialysate collection methods were 1.7 +/- 0.4 L and 129.6 +/- 15.3 L, respectively. The total amount of urea nitrogen removed by dialysis as estimated by the partial spent dialysate collection method was similar to that determined by the total spent dialysate collection approach. As a result, the SRI value for urea obtained by the partial spent dialysate collection method (namely, 63% +/- 8%) correlated very well (r = 0.95, P < 0.001) with that derived by the total spent dialysate collection technique (namely, 62% +/- 8%). Our data suggest that it is feasible to use a simple partial spent dialysate collection method to obtain SRI results in patients treated with hemodialysis.