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31.
Intraductal papillary mucinous tumor (IPMT) of the pancreas is characterized by slow growth and a relatively favorable prognosis, however, invasive cancer originating in an IPMT is associated with a poor prognosis. Although various parameters in imaging modalities have been advocated to differentiate between benign IPMN and malignant ones, it is not easy to obtain definite diagnosis based on these parameters. Peroral pancreatoscopy (POPS) allows a clear and direct visualization of the pancreatic duct, providing useful information regarding tumor nature in IPMT. The authors have studied the usefulness of POPS in the diagnosis of IPMT. Nevertheless, its usefulness is not necessarily widely accepted and the significance of POPS is still controversial. In this review, the authors intended to address the diagnostic value of POPS and to clarify its role in the diagnosis of IPMT. The authors think treatment of IPMT can be improved by introducing POPS because the determination of surgical procedure as well as the area of resection based on the preoperative diagnosis of the involvement of the main pancreatic duct and branch duct is inevitable.  相似文献   
32.
Despite numerous studies of approach- and avoidant mindsets, relatively little research has addressed the impact of such motivational orientations on performance and emotion in a real-time, multi-task setting. A laboratory simulation is reported that examines the influence of an induced approach-centered, an avoidance-centered, and a “neutral” motivational mindset upon multiple aspects of task performance, self-regulatory cognition, and affect. Undergraduate females randomly assigned to one of three mindset conditions performed a simulated automobile drive across one practice and two experimental trials. Dependent measures included divided attention, behavioral indicators of driving “cautiousness” in relatively safe straight roadway sections as well as during more risk-filled driving, multiple aspects of self-regulatory thinking (including self-monitoring, intended effort, and self-administered consequences), and positive and negative affect. Results revealed that the avoidant mindset produced poorer executive attention (i.e., fewer correctly detected divided attention events), more “cautious” driving behavior and reduced performance variability (i.e., greater control) when driving on presumably safe, straight roadway sections, lower self-reports of intended effort, and greater negative affect relative to the approach mindset. Results are intepreted within a self-regulation-centered motivational framework. Implications of the multi-task simulation for the study of normal and disordered adjustment are considered.  相似文献   
33.
肿胀法超声抽吸术治疗腋臭83例疗效观察   总被引:1,自引:0,他引:1  
目的观察肿胀法超声抽吸术治疗液臭的效果,寻找一种治疗腋臭的新方法。方法在腋窝毛发区皮下注入肿胀液80~100ml,经5mm大小切口将超声探头在腋部皮下组织快速移动,直到皮肤发红发热为止,再用负压抽吸被乳化的皮下组织加压包扎。结果83例受术者,术后6~12个月随访,效果良好者76例(91.5%),有效5例(6.25%),无效2例(2.25%)。结论肿胀法超声抽吸术治疗腋臭,操作简单,不留瘢痕,安全有效,是目前治疗腋臭较为理想的方法。  相似文献   
34.
机械通气治疗小儿急性肺损伤   总被引:1,自引:0,他引:1  
目的:探讨小儿急性肺损伤(ALI)的临床治疗。方法:对本院综合ICU1998年4月至2002年4月发生的22例小儿ALI的临床治疗情况进行回顾性分析。结果:本组22例小儿ALI采用呼吸末正压机械通气(PEEP)联合大剂量甲基强的松龙冲击治疗,有效率为86.36%;3例死亡,死亡率为13.64%,死于多器官功能不全综合征(MODS)。结论:机械通气治疗小儿ALI应选择最佳PEEP,动态监测动脉血气指标和X线胸片,在综合治疗基础上加用大剂量甲基强的松龙冲击治疗能收到较好的疗效。  相似文献   
35.
论我国医患冲突成因及和谐关系构建   总被引:6,自引:3,他引:3  
目前我国医患之间的矛盾与冲突,实质上是新时期我国社会矛盾在卫生工作中的具体表现,反映了社会群体在经济状况、价值取向、角色意识、道德水平、法律法规等多方面的矛盾与冲突。和谐医患关系应是构建我国和谐社会的内容之一。和谐医患关系的构建需要完善的社会医疗保障体系建立、国家卫生行政管理加大、财政补偿合理投入、医疗服务质量提高、医学知识教育普及与提高、媒体理性传播、社会大众道德控制水平提升,法律法规完善等全方位的努力,有赖于医事主体双方及全社会的关注与通力改善。  相似文献   
36.
1例射频消融术后并发肺栓塞的抢救配合及护理   总被引:2,自引:0,他引:2  
总结1例射频消融术后并发肺栓塞的抢救配合及护理体会,认为肺栓塞患者一旦发生晕厥,应立即行心肺复苏,以确保有效的循环和呼吸,尽早溶栓,改善临床症状。积极的抢救、熟练的配合、良好的护理是此患者康复的关键,同时术后早期生命体征的监测、并发症的预防、合理饮食、适当活动及休息对预防肺栓塞的发生也是很重要的。  相似文献   
37.
目的:窦道是通达组织深部的盲管性创道,时发时愈,迁延日久.是临床工作者常见的问题,治疗十分困难;为探索窦道的新的治疗途径,开展了微波治疗窦道的临床研究.方法:微波组:采用微波热机局部照射 外科常规换药治疗;根据病变部位分别选择直径为10cm或16cm的辐射器,辐射器距窦道口距离为3cm~5cm,隔1d或隔2d治疗1次,每次30 min,10次为1个疗程,微波治疗功率为70W,治疗结束观察治疗效果.对照组:按外科常规换药治疗.结果:微波组痊愈率98%,好转率2%,总有效率100%;对照组痊愈率37.5%,有效率37.5%,无效率25%,总有效率75%;结论:微波治疗窦道不愈患者具有简单、安全、方便、疗效独特等优点.  相似文献   
38.
BACKGROUND: Dermatofibrosarcoma protuberans (DFSP) is a rare malignant tumour of the skin, with an estimated incidence of 0.8 to five cases per 1 million people per year. OBJECTIVE: To study epidemiological, immunohistochemical and clinical features, delay in diagnosis, type of treatment and outcome of DFSP from 1982 to 2002. METHODS: Using data from the population-based cancer registry, 66 patients with pathologically proved DFSP were included (fibrosarcomatous DFSP were excluded). Each patient lived in one of the four departments of Franche-Comté (overall population of 1 million people) at the time of diagnosis. The main data sources came from public and private pathology laboratories and medical records. The rules of the International Agency for Research on Cancer were applied. RESULTS: The estimated incidence of DFSP in Franche-Comté was about three new cases per 1 million people per year. Male patients were affected 1.2 times as often as female patients were. The trunk (45%) followed by the proximal extremities (38%) were the most frequent locations. DFSP occurred mainly in young adults between 20 and 39 years of age. Mean age at diagnosis was 43 years, and the mean delay in diagnosis was 10.08 years. Our 66 patients initially underwent a radical local excision. Among them, 27% experienced one or more local recurrences during 9.6 years of follow-up. There was one regional lymph node recurrence without visceral metastases. These recurrences were significantly related to the initial peripheral resection margins. We observed a local recurrence rate of 47% for margins less than 3 cm, vs. only 7% for margins ranging from 3 to 5 cm [P=0.004; OR=0.229 (95%, CI=0.103-0.510)]. The mean time to a first local recurrence was 2.65 years. Nevertheless, there was no death due to the DFSP course at the end of the follow-up, and the final outcome was favourable. CONCLUSION: Our study emphasizes the importance of wide local excision with margins of at least 3 cm in order to prevent local recurrence. However, the recent development of inhibitors of signal transduction by the PDGFB pathway should soon modify the surgical strategy, which is often too mutilating.  相似文献   
39.
目的:运用软硬腭前移的手术方法扩大鼻咽下口,改善因鼻咽部狭小致阻塞性睡眠呼吸暂停综合征患者的呼吸暂停症状。方法:手术切除硬腭后份使其缩短、悬雍垂软腭成形并将软腭拉向前,扩大鼻咽下口。结果:患者术后自觉症状及客观评价疗效满意。结论:软硬腭前移鼻咽下口扩大显著改善鼻咽下口狭小导致的阻塞性睡眠呼吸暂停患者的症状。  相似文献   
40.
Preventing unintended pregnancies through access to modern family planning could avert 20-35% of maternal deaths, saving the lives of more than 100,000 women each year. Obstacles to wider access still exist, but they may be overcome by overt policy commitment to reproductive health services, partnership between stakeholders, community involvement and quality programs.  相似文献   
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