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81.
In this paper, I analyse issues related to the estimation of a common break in a large panel of time series data. Each series in the panel consists of a linear time trend and a random error. The linear time trend is subject to a break that occurs at the same date for all series. The error term is cross‐sectionally correlated through a factor structure. The break date is estimated jointly with the common factors. In particular, two break date estimators are analysed: the first is obtained as an iterative solution while the second is obtained as a global solution. The asymptotic properties of these estimators are analysed under both global and local asymptotic frameworks. These two estimators are shown to be asymptotically equivalent and to achieve a faster rate of convergence than the simple break date estimator that does not take common factors into account. The limiting distributions of the proposed break date estimators are provided so that asymptotically valid confidence intervals can be formed. Monte Carlo simulation results are provided to support the theoretical results.  相似文献   
82.
目的:探讨儿童踝关节背屈在步行中后期完成足廓清动作的重要性分析。方法将100例存在异常步态患儿随机分成两组,一组作为治疗组给予加强摆动相中后期踝关节背屈活动的康复训练,另一组作为对照组只给予常规康复训练。结果特别加强踝关节背屈训练组步行时足廓清动作显著改善,异常步态明显纠正。结论踝关节背屈对步行中后期完成足廓清动作进而纠正异常步行姿势有重要作用。  相似文献   
83.
目的:分析阿托伐他汀临床常见问题,为合理用药提供科学依据。方法通过对我院2008年1月~2012年12月期间出现的29例阿托伐他汀不良反应的患者临床资料进行分析,总结阿托伐他汀临床用药常见问题,并提出合理用药措施。结果60岁以上老年患者出现阿托伐他汀不良反应者较高,所占比例为69.0%;患者不良反应发生时间均为药物服用后30min~3个月之内。联合用药患者中服用2~4种药物的患者有21例,所占比例为72.4%。临床不良反应以骨骼、肌肉损害最为常见,所占比例为48.3%。结论阿托伐他汀临床实际用药过程中应加强对患者血液、皮肤、肝、胆等方面的观察与监测,避免患者出现不良反应问题。  相似文献   
84.
IntroductionAlthough cystic duct variation is quite common, duplication of cystic duct is an extreme rare variant. We report a case of double cystic duct with literature review. A 33-year old female presented with right upper quadrant pain of three day duration, associated with nausea and poor appetite. The patient reported previous three attacks of right upper quadrant pain within the last two years. On examination: Murphy's sign was positive and the right upper quadrant was tender. Abdominal ultrasound showed multiple gall stones. Oesophago-gastro- duodenoscopy was normal. Under general anesthesia, four port formal laparoscopy was done, double cystic duct was found. Histopathological examination showed features of chronic cholecystitis.Conclusiondouble cystic duct is a very rare variant of the cystic duct anomaly. Identification pre or intraoperatively is very important to prevent ductal injury.  相似文献   
85.
Ingested foreign bodies are a fairly common otorhinolaryngological emergencies encountered in Malaysia. The vast majority of these foreign bodies are fish bones which most commonly are impacted at the level of the cricopharynx. Rarely, however, a foreign body may migrate extraluminally and may even extrude subcutaneously. We report a rare occurrence where a fish bone not only migrated extraluminally, it was found to have migrated into the common carotid artery and the internal jugular vein and required surgical removal.  相似文献   
86.
经十二指肠镜括约肌切开胆总管结石的处理(附168例报告)   总被引:1,自引:0,他引:1  
目的:采用各种方法处理不同大小的胆总管结石。方法:于1986年3月至1996年9月经内镜括约肌切开(EST)治疗胆总管结石168例,其中单颗结石63例,2颗结石56例,3颗以上结石49例,最多一例8颗结石,结石的直径为5~25mm不等。结果:165例(98.2%)切开成功,3例失败。161例(95.8%)结石排出,其中96例(59.6%)结石自然排入肠道,57例(35.4%)采用网篮或气囊取出结石,6例(3.7%)采用碎石网篮碎石后排出,2例(1.2%)经震波碎石后排出。术后出现胃肠道出血1例(0.6%),胰腺炎1例(0.6%),胆管炎3例(1.8%)。48例术后行胃肠钡餐检查,43例胆道内无钡剂返流,2例胆道内有积气,3例有钡剂返流入胆道,但无临床症状。结论:EST是目前治疗胆管结石的重要手段之一。  相似文献   
87.

Background

Measurement of the common bile duct (CBD) is considered a fundamental component of biliary point-of-care ultrasound (POCUS), but can be technically challenging.

Objective

The primary objective of this study was to determine whether CBD diameter contributes to the diagnosis of complicated biliary pathology in emergency department (ED) patients with normal laboratory values and no abnormal biliary POCUS findings aside from cholelithiasis.

Methods

We performed a prospective, observational study of adult ED patients undergoing POCUS of the right upper quadrant (RUQ) and serum laboratory studies for suspected biliary pathology. The primary outcome was complicated biliary pathology occurring in the setting of normal laboratory values and a POCUS demonstrating the absence of gallbladder wall thickening (GWT), pericholecystic fluid (PCF) and sonographic Murphy's sign (SMS). The association between CBD dilation and complicated biliary pathology was assessed using logistic regression to control for other factors, including laboratory findings, cholelithiasis and other sonographic abnormalities.

Results

A total of 158 patients were included in the study. 76 (48.1%) received non-biliary diagnoses and 82 (51.9%) were diagnosed with biliary pathology. Complicated biliary pathology was diagnosed in 39 patients. Sensitivity of CBD dilation for complicated biliary pathology was 23.7% and specificity was 77.9%.

Conclusion

Of patients diagnosed with biliary pathology, none had isolated CBD dilatation. In the absence of abnormal laboratory values and GWT, PCF or SMS on POCUS, obtaining a CBD measurement is unlikely to contribute to the evaluation of this patient population.  相似文献   
88.
通过列举具体疾病,分析产科疾病编码中常见的三类问题,包括出现在孕产期不同时期的同一疾病名称,其疾病诊断命名和疾病编码不同;引发同一种疾病状态的致病因素很多,在产科疾病编码过程中必须要具体区分引发疾病产生的具体原因;某些疾病临床表现近似,诊断编码归类时容易混淆.初步探讨了产科疾病编码的一些特点,分析产生编码错误的原因并且提出了减少编码错误的措施,希望能够减少在产科疾病编码过程中出现类似错误,提高产科疾病编码的正确率.  相似文献   
89.
采用常规取石技术仍未能取出的结石,被认为是处置"困难"的胆总管结石。现将我院收治的1例处置困难的胆总管结石患者治疗经过和治疗体会报道如下。  相似文献   
90.
Treatment guidelines state that cognitive–behavioral therapy (CBT) and interpersonal therapy are the best-supported psychotherapies for bulimia nervosa (BN) and that CBT is the preferred psychological treatment for binge eating disorder (BED). However, no meta-analysis which both examined direct comparisons between psychological treatments for BN and BED and considered the role of moderating variables, such as the degree to which psychotherapy was bona fide, has previously been conducted Thus, such an analysis was undertaken. We included 77 comparisons reported in 53 studies. The results indicated that: (a) bona fide therapies outperformed non-bona fide treatments, (b) bona fide CBT outperformed bona fide non-CBT interventions by a statistically significant margin (only approaching statistical significance for BN and BED when examined individually), but many of these trials had confounds which limited their internal validity, (c) full CBT treatments offered no benefit over their components, and (d) the distribution of effect size differences between bona fide CBT treatments was homogeneously distributed around zero. These findings provide little support for treatment specificity in psychotherapy for BN and BED.  相似文献   
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