安脑丸与艾司西酞普兰联合治疗脑卒中后抑郁患者的临床效果

目的探讨脑卒中后抑郁患者经安脑丸与艾司西酞普兰联合治疗的临床应用价值。方法选取我院在2013年2月至2015年2月间收治的86例脑卒中后抑郁患者的临床资料,将患者随机分为两组,各43例。两组患者均接受常规治疗,对照组在常规治疗基础上采用艾司西酞普兰治疗,观察组在常规治疗基础上给予安脑丸与艾司西酞普兰联合治疗,比较两组患者的治疗效果与不良反应发生情况。结果 1观察组有41例患者治疗有效,总有效率为95.35%。对照组有34例患者治疗有效,总有效率为79.09%,两组对比有统计学意义(P<0.05)。2观察组不良反应为2.33%,对照组不良反应发生率为4.66%,对比无统计学意义(P>0.05)。结论安脑丸与艾司西酞普兰联合应用在脑卒中后抑郁患者治疗中的应用价值较高,有利于改善患者的病情,对其神经恢复有促进作用,值得临床推广应用。     

艾司西酞普兰联合氟西汀治疗老年脑卒中后抑郁的疗效及对海马脑源性神经营养因子-酪氨酸蛋白激酶受体B通路的影响

目的探讨艾司西酞普兰联合氟西汀治疗老年脑卒中后抑郁的疗效及对海马脑源性神经营养因子(BDNF)-酪氨酸蛋白激酶受体B(TrkB)通路的影响。方法选取2018年1月至2021年12月武警山东省总队医院收治的脑卒中后抑郁患者89例作为研究对象,按照治疗方法不同分为两组。对照组(n=44)采用氟西汀治疗,观察组(n=45)采用艾司西酞普兰联合氟西汀治疗。比较两组临床疗效,汉密尔顿抑郁量表(HAMD)、Barthel评分,血清BDNF、TrkB水平及成本-效果。结果观察组治疗有效率(91.11%)高于对照组(75.00%)(χ^(2)=4.121,P<0.05)。治疗后,观察组HAMD评分低于对照组,Barthel评分及血清BDNF、TrkB水平高于对照组(P<0.05)。观察组成本-效果低于对照组(P<0.05)。结论艾司西酞普兰联合氟西汀治疗老年脑卒中后抑郁疗效显著,能有效改善患者抑郁症状,提高生活自理能力,调控血清BDNF、TrkB水平,且经济性更佳。     

氢溴酸西酞普兰联合心理治疗对抑郁症的临床研究

目的观察氢溴酸西酞普兰联合心理治疗对抑郁症的疗效。方法对80例符合标准的抑郁症患者随机分成两组,一组是给予氢溴酸西酞普兰联合心理治疗(研究组,n=41),另一组为氢溴酸西酞普兰治疗(对照组,n=39),疗程6周。用汉密顿抑郁量表(HAMD)在治疗前、1、2、4、6周末评定疗效。结果两组总体疗效有显著差异性,心理干预组(研究组)抗抑郁显效更快,治愈率、临床显效率明显高于对照组。结论合并心理治疗不仅可以加快抑郁症状缓解的速度,而且本身心理治疗对抑郁症有一定的疗效,明显提高抑郁症的治疗效果,值得临床推广。     

艾司西酞普兰与氟哌噻吨美利曲辛治疗广泛性焦虑的对照研究

目的比较艾司西酞普兰与氟哌噻吨美利曲辛治疗广泛性焦虑症的疗效及不良反应。方法将符合诊断标准的98例广泛性焦虑患者随机分为两组,分别服用艾司西酞普兰或氟哌噻吨美利曲辛,观察6周,于治疗前和治疗6周后以汉密尔顿焦虑量表(HAMA)、焦虑自评量表(SAS)、临床疗效总评(CGI-SI)评定疗效,以副反应量表(TESS)评定不良反应。结果两组患者临床疗效比较无统计学意义(P>0.05),但艾司西酞普兰组躯体焦虑因子评分明显优于氟哌噻吨美利曲辛组(P<0.05)。两组不良反应发生情况差异无统计学意义(P>0.05)。结论艾司西酞普兰是治疗广泛性焦虑症的安全有效药物,更适用于伴有躯体焦虑症状的广泛性焦虑患者。     

盐酸氟西汀治疗脑卒中后抑郁的Meta分析

目的：探讨盐酸氟西汀治疗脑卒中后抑郁的疗效。方法采用计算机检索系统对万方数据库、维普期刊以及中国期刊全文数据库、SCIE、Embase、Medline等与盐酸氟西汀治疗脑卒中后抑郁相关的随机对照试验进行检索,并对相关分析文献进行收集,自156篇相关文章中选出6篇进行随机对照试验,将采用盐酸氟西汀治疗的患者作为治疗组并进行Meta分析。结果治疗组患者取得了更加理想的临床治疗效果,两组患者治疗后汉密尔顿抑郁量表评分以及神经功能缺损评分差异均有统计学意义（P＜0.05）。结论对脑卒中后抑郁患者行盐酸氟西汀治疗效果更佳。     

艾司西酞普兰与文拉法辛治疗抑郁障碍的成本-效果分析

目的对常用的抗抑郁药物艾司西酞普兰与文拉法辛治疗抑郁障碍进行成本-效果分析。方法将78例符合《中国精神障碍分类与诊断标准》（第三版）抑郁发作诊断标准的抑郁障碍患者随机分为两组,分别给予艾司西酞普兰或文拉法辛治疗8周,观察两组治疗方案的疗效及安全性,运用药物经济学的成本-效果分析方法进行评价。结果艾司西酞普兰、文拉法辛组治疗药品成本分别为663.04元和1164.80元;有效率分别为82.05%和84.62%;不良反应发生率分别为30.77%和28.21%。结论根据药物经济学评价,艾司西酞普兰组优于文拉法辛组。     

帕罗西汀联合奥氮平治疗老年精神分裂症伴抑郁的效果观察

目的探讨帕罗西汀联合奥氮平治疗老年精神分裂症伴抑郁的临床疗效。方法选取2014年10月至2016年10月丹东市第三医院收治的老年精神分裂症伴抑郁患者98例为研究对象,采用随机数字表法分为研究组和对照组,每组49例。对照组患者口服奥氮平和氢溴酸西酞普兰进行治疗,研究组患者口服奥氮平和帕罗西汀进行治疗;采用阳性和阴性症状量表(PANSS)评分和汉密尔顿抑郁量表(HAMD)评分进行评价,并比较患者用药后的不良反应。结果两组患者治疗前PANSS评分及HAMD评分比较,差异无统计学意义(P>0.05),治疗后研究组患者阴性因子评分及PANSS评分、HAMD评分明显低于对照组,差异有统计学意义(P<0.05);对照组患者头痛、恶心呕吐、乏力的发生率分别为6.1%、8.2%、12.2%,研究组分别为8.2%、10.2%、16.3%,两组不良反应发生率差异无统计学意义(P>0.05)。结论帕罗西汀联合奥氮平治疗老年精神分裂症伴抑郁患者的临床疗效确切。     

老年脑卒中后抑郁症及神经功能康复的临床治疗探讨

目的对老年脑卒中后抑郁症及神经功能康复的临床治疗进行探讨分析。方法随机选取2012年6月至2013年6月我院收治的老年脑卒中后抑郁症患者72例,将其平均分为两组,均给予常规神经系统药物及康复治疗。在此基础上,对照组采用茴拉西坦治疗,研究组采用氟西汀治疗,并对两组临床资料进行回顾性分析。结果治疗前,两组SDS及MESSS评分比较无明显差异(P>0.05);治疗后,两组患者SDS及MESSS评分均优于治疗前,且组间比较,研究组优于对照组,差异均具有统计学意义(P<0.05)。结论临床中,采用氟西汀治疗老年脑卒中后抑郁症疗效较为显著,能有效改善患者抑郁情绪,促进神经功能进一步恢复,进而提升患者生活质量,值得在临床中广泛推广应用。     

进展性脑卒中患者小剂量尿激酶临床治疗效果分析

目的探讨进展性脑卒中患者采用小剂量尿激酶临床治疗的效果。方法选择我院2009年5月至2011年5月收治的进展性脑卒中患者80例,随机分为两组,对照组40例采用低分子肝素治疗,观察组40例采用小剂量尿激酶治疗,就两组临床资料进行回顾性分析。结果两组治疗后2周SSS评分均有下降表现,但观察组下降幅度高于对照组,差异有统计学意义(P<0.05)。两组出凝血时间、血小板计数在治疗前后无明显变化,差异无统计学意义(P>0.05)。观察组总有效率为90%,对照组为85%,两组均无严重不良反应发生,比较差异均无统计学意义(P<0.05)。结论进展性脑卒中患者采用小剂量尿激酶治疗,可显著改善神经功能缺损,确保临床治疗的有效率,提高患者的生存质量。     

干扰素联合更昔洛韦治疗小儿流行性腮腺炎并发脑膜炎的临床疗效及安全性观察

目的探讨干扰素联合更昔洛韦治疗小儿流行性腮腺炎并发脑膜脑炎的临床效果,总结其临床意义。方法选取我院2009年6月至2011年6月期间收治的流行性腮腺炎并发脑膜炎的患儿72例,随机分为观察组和对照组各36例,观察组使用干扰素联合更昔洛韦治疗,对照组使用更昔洛韦治疗,观察比较两组治疗效果。结果观察组显效24例占66.7%,有效11例占30.5%,无效1例2.8%,总有效率为97.2%;对照组显效19例占52.8%,有效12例占33.3%,无效5例占13.9%,总有效率为86.1%,两组疗效比较差异显著(P<0.01),具有统计学意义;观察组的患者的临床症状及体征消失时间明显短于对照组(P<0.01),具有统计学意义。结论干扰素联合更昔洛韦治疗小儿流行性腮腺炎并发脑膜炎的疗效确切,明显优于单纯使用更昔洛韦治疗,其副作用小,安全性高,有效缩短治疗时间,值得临床推广使用。     

Pleasure and belief in Hume's Decision Process

Abstract

The purpose of this paper is to introduce explicitly pleasure and belief in what aims at being a Humean theory of decision, like the one developed in Diaye and Lapidus (2005a). Although we support the idea that Hume was in some way a hedonist – evidently different from Bentham's or Jevons' way – we lay emphasis less on continuity than on the specific kind of hedonism encountered in Hume's writings (chiefly the Treatise, the second Enquiry, the Dissertation, or some of his Essays). Such hedonism clearly contrasts to its standard modern inheritance, expressed by the relation between preferences and utility.

The reason for such a difference with the usual approach lies in the mental process that Hume puts to the fore in order to explain the way pleasure determines desires and volition. Whereas pleasure is primarily, in Hume's words, an impression of sensation, it takes place in the birth of passions as reflecting an idea of pleasure, whose “force and vivacity” is precisely a “belief”, transferred to the direct passions of desire or volition that come immediately before action. As a result, from a Humean point of view, “belief” deals with decision under risk or uncertainty, as well as with intertemporal decision and indiscrimination problems.

The latter are explored within a formal framework, and it is shown that the relation of pleasure is transformed by belief into a non-empty class of relations of desire, among which at least one is a preorder.     

Globalization,Neoliberalism and the attack on social security

Neoliberal political movements advocate privatization of public pension systems. Globalization imposes pressure on nations to conform to neoliberal policy views with respect to the design and structure of social insurance, including public pension systems. The paper begins with an investigation of the economic, ethical and ideological dimensions of the privatization debates in the U.S.; it argues that privatization advocates may be largely moved by ideology, since the other reasons advanced appear weak or unfounded. The second part discusses the history of Social Security, the purposes for its creation, and some of its economic effects. Differences between public and private pension systems are considered. A brief international comparison of some aspects of public pension system finance and benefit structures is presented. The final section considers the ethical, macroeconomic and distributional implications of privatization, prefunding and payroll tax funding, and argues for a pay as you go system financed with income taxes. In order to promote equity, economic security, community, and social cohesion, public pension systems should be universal in coverage. In order to reduce the inequality, income insecurity, and aged poverty generated by market economies, public pension systems ought to be progressive: benefit/contribution ratios should be inversely proportional to income, and progressive income taxes should finance the system. To promote economic growth, the systems should be financed on a pay-as-you-go basis, and should not be prefunded except for an emergency reserve. The fiscal policy recommendations partially depend upon the theory developed by Abba Lerner in the 1940s, and recently advanced by Wynne Godley and Randy Wray: Lerner's “principle of functional finance.”     

Neurally reconstructing expected utility

While the concept of “expected utility” informs many theories of decision making, little is known about whether and how the human brain might compute this quantity. This article reviews a series of functional magnetic resonance imaging (FMRI) experiments designed to localize brain regions that respond in anticipation of increasing amounts of monetary incentives. These studies collectively suggest that anticipation of increasing monetary gains activates a subcortical region of the ventral striatum in a magnitude-proportional manner. This ventral striatal activation is not evident during anticipation of losses. Actual gain outcomes instead activate a region of the mesial prefrontal cortex. During anticipation of gain, ventral striatal activation is accompanied by feelings characterized by increasing arousal and positive valence. These findings affirm the role of emotion in the anticipation of incentives, and may provide an initial step towards a neural reconstruction of expected utility.     

Duplication, Growth and ‘Total Return Economics’

Maintenance consumption is an expense recovered in product prices, yet also a source of taste satisfaction which must be exhausted, rather than reinvested, from the capital affording it. This riddle is solved in the duplication rules: the cost of maintenance consumption is recovered in pay and prices, but an equal flow is exhausted from the human capital of the worker earning the pay. The rules impact tradition in several ways. If output is defined in principle as value added, then it cannot also be described as consumption plus net investment without double-counting the maintenance consumption recovered in prices. Also rate of return in the stationary state is not zero, but is the rate sufficient to offset the exhaustion of individual human capital. The rules lead to new insights into economic return, and support an argument that all growth at the scale of closure is due to productivity gain rather than to thrift.     

Interest on reserves and inflation

The payment of interest on reserves has been a common practice in inflationary economies. This policy may seem paradoxical since it involves returning part of the seigniorage, generated by the inflation process, with the intention to finance the fiscal deficit. This paper argues that the motivation for this policy can be captured by the discretionary regime, where the policymaker pays interest on reserves because he is concerned with the erosion of real liquidity by inflation, which is in part beyond his control. However, this policy is an unlikely outcome in the commitment regime, where the policymaker is in full control of inflation.     

John Stuart Mill's Theories of Wealth and Income Distribution

Although he was much influenced by David Ricardo when he wrote the classical part of his Principles , John Stuart Mill was not a Ricardian when he penned his theories of wealth and distribution. They are based on a triple foundation. First, a belief that economics is a moral discipline. Second a theory of custom-driven human behavior. Third, an empirically formed conviction that the institutions of state, education and business cooperate to structure the distribution of income. On the basis of these presuppositions, Mill formulated 1) an institutional theory of the formation of human and non-human wealth and 2) an even more institutional theory of distribution demonstrating how the aforementioned institutions malignantly skew the distribution of income to the advantage of the propertied classes and to the extreme disadvantage of the working class. As a social economist, Mill recommended institutional reforms designed to eradicate the poverty of the working class.     

Forecasting the price of gold

This article seeks to evaluate the appropriateness of a variety of existing forecasting techniques (17 methods) at providing accurate and statistically significant forecasts for gold price. We report the results from the nine most competitive techniques. Special consideration is given to the ability of these techniques to provide forecasts which outperforms the random walk (RW) as we noticed that certain multivariate models (which included prices of silver, platinum, palladium and rhodium, besides gold) were also unable to outperform the RW in this case. Interestingly, the results show that none of the forecasting techniques are able to outperform the RW at horizons of 1 and 9 steps ahead, and on average, the exponential smoothing model is seen providing the best forecasts in terms of the lowest root mean squared error over the 24-month forecasting horizons. Moreover, we find that the univariate models used in this article are able to outperform the Bayesian autoregression and Bayesian vector autoregressive models, with exponential smoothing reporting statistically significant results in comparison with the former models, and classical autoregressive and the vector autoregressive models in most cases.     

Simulating the Effect of Regulatory Systems in a Fishery, An Application to the French Driftnet Albacore Fleet

With a thin economic component, most bio-economic models of fisheries failto assess the effects of the regulation systems on firms. In order to analysethe short term consequences of different management schemes, a simulationmodel is applied to the French driftnet albacore fleet: licence allocation withdriftnet regulation, individual quotas, and individual transferable quotaswithout any input control. Vessel technology is estimated by using the datacollected, and groups of vessels are distinguished according to criteria ofperformance. We present the adjustment within firms and between groupsunder different scenarios (limited entry with and without driftnetregulation, individual quotas and individual transferable quotas allocation),and we compare their results in terms of quasi-rent value and otherindicators such as hake harvests or dolphin by-catches.     

Knowledge as a Path-Dependence Process

By following a new approach proposed by Cognitive and Neuroeconomics, this paper presents and extends that part of Hayek's theory concerning knowledge in path-dependent terms, and shows that this is a fertile theory, opening new lines of inquiry for contemporary economics. In his theory of knowledge Hayek shows that the dynamics of economic change is path-dependent, in a different and more profound way than in the rest of the path-dependent literature. This literature deals with an important controversy, which will be also discussed and its specific and original meaning will be highlighted. As it will emerge, knowledge as a path-dependent process is consistent with cognitive theories of perception and learning and it plays a more important role than is traditionally assumed. Path-dependence is in fact always present in the cognitive dimension of perception and in individual decision-making processes, as well as in the processes of organizational innovation, and even in the macro-dimension of institutional change. This revised version was published online in July 2006 with corrections to the Cover Date.