微创小切口手术治疗单纯性阑尾炎患者的临床疗效

目的：探讨微创小切口手术治疗单纯性阑尾炎患者的临床疗效。方法选取2010年1月至2014年1月南京中医药大学附属常州市中医院普外科收治的单纯性阑尾炎患者资料150例,按随机数字表法将其分为观察组与对照组,各75例。观察组患者行微创小切口手术治疗,对照组患者行常规阑尾切除手术治疗,比较两组患者的手术指标、并发症发生情况及治疗效果。结果观察组患者手术时间、术后排气时间以及住院时间均明显短于对照组,术中出血量明显少于对照组,差异均有统计学意义（均P＜0.05）;观察组患者术后发生感染、皮下积液、肠梗阻发生率均明显低于对照组,差异有统计学意义（P＜0.05）;观察组患者治疗优良率为94.7%,明显优于对照组的85.3%,差异有统计学意义（P＜0.05）。结论采用微创小切口手术治疗单纯性阑尾炎效果明显、经济实惠。     

腹腔镜及传统术式治疗卵巢囊肿临床对比研究

目的比较腹腔镜及传统术式治疗卵巢囊肿的临床疗效和安全性。方法选取2011年6月至2012年6月我院收治的卵巢囊肿患者80例进行回顾性分析,随机分成观察组和对照组,每组40例,观察组采用腹腔镜治疗,对照组采用传统开腹手术治疗,观察两组手术情况、术后复发率、术后发热率、术后镇痛情况的不同。结果两组在手术时间上无显著差异（P＞0.05）;观察组在术后出血量、肛门排气时间、住院时间上明显少于对照组（P＜0.05）;观察组术后发热率明显高于对照组（P＜0.05）,镇痛药物使用明显少于对照组（P＜0.05）;两组在术后复发率上无显著差异（P＞0.05）。结论腹腔镜治疗卵巢囊肿具有出血量少、创伤小、患者恢复快、疼痛小等优点,效果显著,值得临床推广。     

宫腹腔镜联合治疗输卵管性不孕患者的临床疗效

目的：探讨宫腹腔镜联合治疗输卵管性不孕患者的临床疗效。方法选取吉林省人民医院妇产科2011年1月至2012年1月收治的输卵管性不孕患者资料150例,根据手术方法的不同将其分为观察组和对照组,观察组患者采用宫腹腔镜联合治疗,对照组患者采用输卵管通液术进行治疗。比较两组患者的术后输卵管复通率以及妊娠率。结果观察组患者术后复通66例,复通率为88.0%;对照组患者术后复通45例,复通率为60.0%,差异有统计学意义（P＜0.05）;随访2年,观察组患者妊娠率明显高于对照组,差异有统计学意义（P＜0.01）。结论宫腹腔镜联合治疗输卵管性不孕患者效果明显。     

老年急性胆囊炎患者感染幽门螺杆菌的临床分析

目的：探讨老年急性胆囊炎患者的治疗方法及幽门螺杆菌（Hp）感染与胆囊炎发生的关系。方法选择克孜勒苏柯尔克孜自治州人民医院收治的急性胆囊炎老年患者1416例,按随机数字表法将其分为对照组和观察组,各708例,两组患者均给予药物保守治疗无效后,对照组患者采用腹腔镜胆囊切除术,观察组患者在B型超声引导下行经皮经肝胆囊穿刺引流术（PTGD）。比较两组患者的临床疗效、术后血清生化指标,Hp 阳性与 Hp 阴性胆囊炎患者胆囊黏膜胃上皮化生情况及胆囊黏膜匀浆炎性因子水平。结果经手术治疗,观察组患者临床症状消失率明显高于对照组,并发症发生率明显低于对照组,引流管拔除时间、住院时间均明显短于对照组,差异均有统计学意义（均P＜0.05）;观察组患者的IL-1、IL-6、IL-8、WBC水平均明显低于对照组,差异均有统计学意义（均P＜0.05）;Hp阳性患者胆囊黏膜胃上皮化生率、胆囊黏膜匀浆IL-1、IL-6、IL-8水平均明显高于Hp阴性患者,差异均有统计学意义（均P＜0.05）。结论 B型超声引导下行PTGD术治疗老年急性胆囊炎患者可取得明显的临床疗效,创伤小、并发症少,且胆囊内Hp感染可能是诱发老年急性胆囊炎的重要因素。     

丹参酮治疗冠心病患者的临床疗效

目的：探讨丹参酮治疗冠心病患者的临床疗效。方法收集广东省佛山市顺德区杏坛社区卫生服务中心2011年2月至2014年5月收治的120例冠心病患者临床资料,依据治疗措施不同将患者分为对照组（40例）和观察组（80例）,对照组患者给予常规治疗,观察组患者在对照组基础上应用丹参酮治疗,比较两组患者的心电图疗效、临床治疗效果。结果观察组患者心电图疗效为100.0%,明显高于对照组的72.5%,差异有统计学意义（P＜0.05）;观察组患者总有效率为100.0%,明显高于对照组的75.0%,差异有统计学意义（P＜0.05）。结论丹参酮治疗冠心病可明显改善患者的临床症状,提高临床疗效。     

微创血肿清除术治疗高血压脑出血患者的临床疗效

目的：探讨微创血肿清除术治疗高血压脑出血患者的临床疗效。方法选取2012年6月至2014年6月收治的高血压脑出血患者136例,按就诊顺序编号分为对照组和观察组,每组68例。对照组患者给予神经内科综合治疗,观察组患者在其基础上行微创血肿清除术治疗,比较两组患者的临床疗效和治疗前后的神经功能缺损评分（CSS）。结果两组患者治疗前CSS评分比较差异无统计学意义（P＞0.05）,治疗第7天和第14天,观察组患者的CSS评分均低于对照组,差异有统计学意义（P＜0.05）。观察组患者的治疗总有效率为77.9%,病死率为5.9%;对照组患者的治疗总有效率为55.9%,病死率为19.1%,差异有统计学意义（P＜0.05）。结论微创血肿清除术治疗高血压脑出血的临床疗效较好,可改善患者的神经功能,降低病死率。     

头孢呋辛钠治疗肺气肿感染老年患者的临床疗效

目的：探讨头孢呋辛钠治疗肺气肿感染老年患者的临床疗效。方法选取60例在抚松县人民医院就诊的老年肺气肿感染患者资料,按随机数字表法将其分为观察组和对照组,各30例,分别采用头孢呋辛钠与青霉素抗感染治疗,比较两组患者的治疗效果。结果观察组患者的总有效率为93.3%,明显高于对照组的76.7%,差异有统计学意义（P＜0.05）;观察组患者的临床症状消失时间、体温血象恢复时间、胸部X线片表现消失时间均明显短于对照组,差异均有统计学意义（均P＜0.05）。结论头孢呋辛钠在老年肺气肿感染的治疗中可发挥重要作用,有助于提高患者的治疗效果,改善临床症状。     

曲美他嗪治疗心力衰竭患者的临床疗效

目的：探讨心力衰竭患者应用曲美他嗪治疗的临床疗效。方法将108例心力衰竭患者完全随机分为对照组和观察组,各54例。对照组患者行传统治疗,观察组患者在对照组基础上给予曲美他嗪治疗,比较两组患者的治疗效果。结果观察组患者治疗总有效率为96.3%,明显高于对照组的79.6%,两组比较差异有统计学意义（P＜0.05）;观察组患者不良反应发生率为11.1%,明显低于对照组的22.2%,两组比较差异有统计学意义（P＜0.05）。结论应用曲美他嗪治疗心力衰竭患者,临床效果明显,不良反应少。     

瑞芬太尼在腹腔镜手术患者麻醉处理中的应用价值

目的：探讨瑞芬太尼在腹腔镜手术患者麻醉处理中的应用价值。方法选取行腹腔镜手术患者70例,按随机数字表法将其分为观察组与对照组,各35例,观察组患者采用全凭静脉麻醉,对照组患者给予静吸复合麻醉,比较两组患者的血流动力学指标、清醒时间与拔管时间及不良反应发生率。结果观察组患者于T2时DBP、SBP、HR明显低于对照组,差异有统计学意义（P＜0.05）;观察组患者的清醒时间、拔管时间均明显短于对照组,差异均有统计学意义（均P＜0.05）;观察组患者的不良反应发生率为8.6%,明显低于对照组的85.7%,差异有统计学意义（P＜0.05）。结论在腹腔镜手术麻醉中应用瑞芬太尼,能有效维持患者术中的血液动力学稳定,减少术后不良反应的发生,具有起效快、作用时间短等优点。     

腹腔镜胆囊切除治疗急性胆囊炎的临床疗效

目的探讨腹腔镜胆囊切除在急性胆囊炎治疗中的临床疗效。方法以2012年6月至2013年6月我院收治的76例急性胆囊炎患者为研究对象,随机分为两组。试验组患者采用腹腔镜胆囊切除治疗,对照组患者采用常规胆囊切除治疗。比较两组患者的手术时间、手术出血量、治疗效果等,评价两种方法的疗效。结果试验组患者的手术时间和手术出血量明显少于对照组,两组对比差异有统计学意义（P〈0.05）;试验组患者的治疗效果好于对照组,但两组疗效对比差异无统计学意义（P〉0.05）。结论腹腔镜胆囊切除用于急性胆囊的治疗能够缩短手术时间,减少术中出血量,具有较好的治疗效果。     

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.”     

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.     

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.     

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.