腹部闭合性肾损伤66例诊治体会

目的：探讨闭合性肾损伤的诊断和治疗方法。方法：对66例闭合性肾损伤的临床资料进行回顾性分析。结果：66例肾损伤中,Ⅰ级11例,Ⅱ级25例,Ⅲ级17例,Ⅳ级12例,Ⅴ级1例,伴有合并伤27例。保守治疗49例,手术治疗17例,其中包括选择性肾动脉栓塞治疗5例。治愈64例,死亡2例。结论：1）CT、B超检查准确率高,是诊断肾损伤的主要方法;2）迅速而正确的病情评估是治疗的关键;3）大多数腹部闭合性肾损伤可以采取保守治疗;4）选择性肾动脉栓塞创伤小,止血迅速有效,可作为Ⅲ级肾损伤的首选治疗方法,亦可作为肾修补术后继发性出血的治疗措施。     

山水优游与南宋遗民词风貌

南宋遗民词人,以群体隐逸的空前规模,带来了隐逸文化在宋元之际的空前繁荣。他们的山水优游活动,作为遗民词人隐居生活中的重要内容之一,对他们的思想感情、创作范式产生了深刻的影响,表现了遗民词人在特定历史时期的独特情感、心路历程和生活体验,使群体的创作共性凸现出来,呈现出统一、鲜明的创作风貌,词体文学的表现功能,因此也得到了极大程度的拓展。     

Effects of childhood multiple maltreatment experiences on depression of socioeconomic disadvantaged elderly in Brazil

Childhood maltreatment is a risk factor for depression in nonelderly individuals. We investigated the effect of childhood abuse and neglect on the development of geriatric depression and its severity in socioeconomically disadvantaged individuals. A cross-sectional study investigated 449 individuals aged 60–103 years sorted by data using the enrollment list health coverage from the city of Porto Alegre, Brazil. The fifteen-item Geriatric Depression Scale was used to assess depression. The Childhood Trauma Questionnaire was used to identify emotional and physical neglect, in addition to emotional, physical, and sexual abuse. Geriatric depression was associated with emotional and physical abuse and neglect. Emotional abuse and neglect, as well as physical abuse, increased the odds of an individual developing severe depression. Correlations were observed for combined forms of maltreatment, with two to five maltreatment types producing mild to moderate symptoms. Similar trends were observed for severe symptoms in a limited number of cases. The cross-sectional design limit causal inference. Retrospective measurement of childhood maltreatment may increase recall and response bias. Late-life depression and its severity significantly correlated with the extent of childhood emotional and physical abuse and neglect. Thus, research should focus on supporting trauma survivors late in life, particularly when they come from low or middle income countries because these patients have higher rates of depression in elderly populations.     

The science of pedagogy in Soviet Estonia (1944–1991): resilience in the face of adversity

This article examines how education unfolded as a science in Estonia in the period 1944–1991, i.e. from the second Soviet occupation to the fall of the USSR. Historical analysis of the way prominent scholars and institutions succeeded in overcoming the adverse conditions of that period is conducted by viewing their respective contributions through two theoretical lenses: cultural trauma theory to explore the adversities they had to contend with, and resilience theory to explain how those challenges were overcome. Through these means an account is constructed of how individuals and institutions succeeded in preserving the national Estonian and inter-war European legacy of educational philosophy, in the process confronting and countering adverse socio-cultural-political conditions.     

《五号屠场》的荒诞艺术与精神创伤

美国当代作家库尔特·冯内古特最有代表性的后现一代小说《五号屠场》,以其独特的荒诞艺术揭露了战争带来的精神创伤。深化了反战的主题。蓦     

谈武术教学中的膝关节损伤及预防措施与治疗方法

本文对武术教学中膝关节损伤(骨骼劳损) 的病发原理、损伤原因、诊断、治疗方法以及预防措施等,进行了较为全面的论述。以引起武术教学工作者和学主足够重视.     

如何引导中职学生矫正过去的心理创伤

面对中职学生这样一个特别需要关注的群体,笔者从家庭教育、学校教育和社会偏见等方面分析了学生过去所受的心理创伤,并提出了引导中职学生矫正过去的心理创伤的三条途径:一、进行"自我省察";二、运用"生命线"回溯;三、写"情绪日记",希望对矫正中职学生过去的心理创伤有所帮助。     

Comorbidity of PTSD in anxiety and depressive disorders: Prevalence and shared risk factors

The present study aims to assess comorbidity of posttraumatic stress disorder (PTSD) in anxiety and depressive disorders and to determine whether childhood trauma types and other putative independent risk factors for comorbid PTSD are unique to PTSD or shared with anxiety and depressive disorders. The sample of 2402 adults aged 18–65 included healthy controls, persons with a prior history of affective disorders, and persons with a current affective disorder. These individuals were assessed at baseline (T0) and 2 (T2) and 4 years (T4) later. At each wave, DSM-IV-TR based anxiety and depressive disorder, neuroticism, extraversion, and symptom severity were assessed. Childhood trauma was measured at T0 with an interview and at T4 with a questionnaire, and PTSD was measured with a standardized interview at T4. Prevalence of 5-year recency PTSD among anxiety and depressive disorders was 9.2%, and comorbidity, in particular with major depression, was high (84.4%). Comorbidity was associated with female gender, all types of childhood trauma, neuroticism, (low) extraversion, and symptom severity. Multivariable significant risk factors (i.e., female gender and child sexual and physical abuse) were shared among anxiety and depressive disorders. Our results support a shared vulnerability model for comorbidity of anxiety and depressive disorders with PTSD. Routine assessment of PTSD in patients with anxiety and depressive disorders seems warranted.     

Engaging foster parents in treatment: A randomized trial of supplementing Trauma-focused Cognitive Behavioral Therapy with evidence-based engagement strategies

The goal of this study was to examine the impact of supplementing Trauma-focused Cognitive Behavioral Therapy (TF-CBT; Cohen et al., 2006) with evidence-based engagement strategies on foster parent and foster youth engagement in treatment, given challenges engaging foster parents in treatment. A randomized controlled trial of TF-CBT standard delivery compared to TF-CBT plus evidence-based engagement strategies was conducted with 47 children and adolescents in foster care and one of their foster parents. Attendance, engagement, and clinical outcomes were assessed 1 month into treatment, end of treatment, and 3 months post-treatment. Youth and foster parents who received TF-CBT plus evidence-based engagement strategies were more likely to be retained in treatment through four sessions and were less likely to drop out of treatment prematurely. The engagement strategies did not appear to have an effect on the number of canceled or no-show sessions or on treatment satisfaction. Clinical outcomes did not differ by study condition, but exploratory analyses suggest that youth had significant improvements with treatment. Strategies that specifically target engagement may hold promise for increasing access to evidence-based treatments and for increasing likelihood of treatment completion.