参与式教学方法在妇产科学教学中的应用

本文探讨了参与式教学方法在妇产科学教学中的应用，发现参与式教学方法提高了学生的学习兴趣和积极性，有利于促进学生个性发展和知识面拓展，培养了学生的创新能力，活跃了课堂气氛，增加了学生与教师的交流机会，融洽了师生关系。但是，参与式教学方法消耗时间过多，不宜推广到每一堂课。     

Some considerations on middle ear cholesteatoma in ‘foreign workers’*

The treatment of cholesteatoma in patients without a permanent residence or in medically underdeveloped countries presents a serious problem in middle ear surgery. Methods which erradicate disease safely and reduce the risk of recurrence to a minimum are necessary. We differentiate 3 clinical types of cholesteatoma: 1 Retraction of Shrapnell's membrane or in the postero-superior quadrant with very little cholesteatoma lateral to the ossicles. A transcanal technique is used to evert the cholesteatomatous pocket into the meatus intact, followed by reconstruction of the outer attic wall. 2 Circumscribed cholestatoma lateral and often also medial to the ossicles. Combined approach tympanoplasty is used in such cases. 3 Marginal perforations with large cholesteatomas, situated medial to the ossicular chain. For these ears, classical radical mastoidectomy is the method of choice. (Radical mastoidectomy also has to be performed in all cases of type II, where luxation of the matrix in toto has failed.) Results: No recurrence has been detected in cases where follow-up was possible.     

Injuries in Youth Hockey

In brief Although popular reporting would indicate otherwise, overall injury rates in youth hockey have decreased during the past decade. Most injuries that do occur are not serious, but those that are demand prompt and skillful attention: The alarming increase in head, neck, and spine injuries, in addition to the death of a young player struck in the anterior chest by a high-velocity puck, emphasizes the need for a structured on-ice approach to stabilizing and managing injuries ranging from musculoskeletal to life-threatening. More injuries could be avoided by analyzing more injury data, improving both protective equipment and rink design, teaching injury prevention, and strictly enforcing the rules.     

Psychiatric symptomatologies and disorders related to epilepsy and antiepileptic medications

Introduction: Psychiatric comorbidities (such as depression, anxiety, psychosis, inattention, obsession, personality traits, aggression and suicide) are frequent in patients with epilepsy and have a significant impact on medical management and quality of life.

Areas covered: A literature search was performed in MEDLINE for epidemiological, longitudinal, prospective, double-blind clinical trial studies published between 1990 and 2011 using the following words: epilepsy, antiepileptic drugs (AEDs), behavioral/emotional/psychiatric comorbidities, suicide and aggression. In this review, the author discusses: i) the characterization and prevalence of behavioral disturbances associated with epilepsy, ii) variables correlated with behavioral comorbidities which include: psychosocial-, clinical- and treatment-related variables, iii) the complex mechanisms of behavioral comorbidities associated with epilepsy, which include both psychosocial (functional) and organic; the process of epileptogenesis, neuronal plasticity, abnormalities in hypothalamic-pituitary axis and neurotransmitters and pathways are fundamental determinants, iv) the negative psychotropic effects of AEDs and their mechanisms and v) the suggested biopsychosocial model of management (pharmacological and non-pharmacological).

Expert opinion: The relationship between psychiatric disorders and epilepsy has relevant therapeutic implications which should be directed towards a comprehensive biopsychosocial approach that focuses on the whole person rather than simply on the disease process.     

Generalized ℋ︁2 model approximation for differential linear repetitive processes

This paper investigates the generalized ??₂ model approximation for differential linear repetitive processes (LRPs). For a given LRP, which is assumed to be stable along the pass, we are aimed at constructing a reduced‐order model of the LRP such that the generalized ??₂ gain of the approximation error LRP between the original LRP and the reduced‐order one is less than a prescribed scalar. A sufficient condition to characterize the bound of the generalized ??₂ gain of the approximation error LRP is presented in terms of linear matrix inequalities (LMIs). Two different approaches are proposed to solve the considered generalized ??₂ model approximation problem. One is the convex linearization approach, which casts the model approximation into a convex optimization problem, while the other is the projection approach, which casts the model approximation into a sequential minimization problem subject to LMI constraints by employing the cone complementary linearization algorithm. A numerical example is provided to demonstrate the proposed theories. Copyright © 2010 John Wiley & Sons, Ltd.     

单纯前路手术治疗无明显后方压迫的陈旧性颈椎半脱位

目的 探讨无明显后方压迫的陈旧性颈椎半脱位行单纯前路手术减压内固定的可行性及手术方法.方法 2004年5月至2006年7月收治陈旧性颈椎半脱位患者16例,受伤至手术时间均超过2个月,行前路减压,术中试图通过撑开螺钉及钛网钢板同定的运用,以获得减压固定、恢复正常序列.结果 16例患者术后均恢复正常颈椎序列及椎间隙高度,随访6-11个月,平均8.5个月,无植骨未融合及钛板螺钉松动、断裂病例.所有患者症状均得到改善,JOA评分由术前的平均13.4分恢复为最后随访时平均15.9分,改善率为69.4%.结论 对于陈旧性颈椎半脱位,后方结构已纤维愈合稳定,而且无明显后方脊髓压迫,前路减压技术完全能达到减压融合重建颈椎序列的目的 .     

经单鼻孔-蝶窦入路垂体腺瘤显微手术治疗及其策略

目的 总结采用经单鼻孔-蝶窦入路显微手术治疗垂体腺瘤的临床疗效.方法 从2003年1月至2007年12月,经单鼻孔-蝶窦入路显微手术治疗垂体腺瘤241例,并对其临床表现、肿瘤病理、肿瘤切除率、术后并发症进行总结分析.结果 垂体腺瘤241例中,全切除171例(71%),次全切除28例(11.6%),大部分切除26例(10.7%),部分切除16例(6.6%).术后多饮、多尿38例(15.8%)、术后视力一过性下降12例(4.9%)、术后脑脊液漏4例(1.6%)、一侧动眼神经损伤2例(0.8%),无死亡病例.除动眼神经损伤的2例外,其余病例的术后并发症在出院时已治愈.随访1-36个月,所有病例的临床症状均有不同程度改善.结论 经单鼻孔-蝶窦人路显微切除垂体腺瘤手术时间缩短,创伤小,手术效果好.     

Experiences of daycare children of divorce

Research shows that children of divorce are at risk of adjustment problems and school problems. In previous studies of young children of divorce, most often parents or teachers have supplied data. In this study, we explore the children's own feelings and experiences through Q methodology with visual images. The study includes 17 children of divorce and 20 living with both biological parents. Three child viewpoints were detected: the first was characterised by many happy feelings, and few sad or angry feelings. The second was more mixed with a variety of feelings. The third view was characterised by several sad and lonely feelings among adults and child. Children of divorce seemed to be more prone to end up on the two latter factors. Possible implications are discussed.     

The Monster in Between: Working with Couples in Intensive Group Treatment

ABSTRACT

In this article we elaborate on an inpatient clinical group program for couples suffering from nonpsychotic psychiatric disorders, personality disorders, and/or complex partner relational problems. In general, one of the partners has a long history in mental health care. The intervention history often includes at least some sessions of couple therapy but without sufficient success. These couples are part of that group of mental health patients that can be described as, or describe themselves as, “everything was done but nothing really helped.” The clinical inpatient couple group program was initiated in 1991 and to date (February 2004) 415 couples have been treated in 91 groups. Although our Center for Relational Problems is situated in a rural area in the northern part of the Netherlands, these couples are referred from all over the country. This proves that there is a need for highly intensive couple treatment in an inpatient setting. Nevertheless, as far as we know, this type of treatment does not exist anywhere else in the world. In this article we give details of the program and the rationale behind it.