1797例大肠癌患者临床及病理特点分析

目的了解近年来不同性别及不同年龄段大肠癌临床及病理等特点。方法回顾性调查我院2005年1月~2010年3月共1797例经病理确诊的大肠癌患者,统计其年龄、性别、城乡分布及癌肿部位、病理类型等。结果大肠癌发病呈老年化趋势,大于40岁的中老年组占绝大多数,达到92.7%,青年组仅占7.3%;不同性别及不同年龄段的各部位结肠癌发生率构成比无显著性差异,P>0.01;不同性别组的大肠癌病理特点无显著性差异,青年患者中黏液腺癌和印戒细胞癌所占比例较高,有统计学差异(P<0.01);直肠癌仍是原发性结直肠癌最常见的部位,腺癌是最常见的病理类型。结论通过对大肠癌的临床及病理特点的研究,揭示其发病及诊断的依据,有助于医务人员建立合理的治疗体系,帮助患者治愈疾病。     

结肠直肠切除术后保留肛门括约功能手术的适应症

目的研究结肠直肠切除术后保留肛门括约肌功能手术的适应症。方法对78例进行结肠直肠切除术并保留肛门括约肌治疗的患者的临床效果进行观察,根据结果分析行结肠直肠切除术后保留肛门括约功能手术的适应症。结果所有患者的手术进行顺利,无术中突发死亡情况,手术切口吻合处愈合情况良好,吻合口未发现有肠内容物漏出。所有患者的肛门生理功能未见明显损伤。结论结肠直肠切除术后保留肛门括约功能手术对于患有结肠黏膜疾病、病程＞10年全结肠炎有广泛纤维化或活检有上皮异型生长者、溃疡性结肠炎穿孔和不能制止的下消化道出血、中毒性结肠炎、结肠腺瘤性息肉病、结肠腺瘤性息肉病等患者具有很好的治疗效果。     

CT引导下经皮肺部肿瘤穿刺活检的临床效果

目的探讨CT引导下经皮肺部肿瘤穿刺活检的临床效果。方法选取我院60例患者,在CT引导下经皮肺部肿瘤进行穿刺活检。将标本进行组织病理学和细胞学分析,研究组织病理诊断,观察穿刺活检成功率。结果 60例患者中取材成功有58例,成功率为96.7%,组织病理学诊断阳性为50例诊断率为83.3%,细胞学诊断确定为阳性40例,诊断率为66.7%。结论 CT引导下经皮肺部肿瘤进行穿刺活检对于肺部肿块和周围性病灶能够很好的定位,准确率非常高。     

乳腺非肿块病变的超声诊断

目的探讨乳腺非肿块病变的超声诊断表现。方法对2010年5月至2011年5月采取超声检查方法并通过手术或穿刺活检病理检查得到确诊的50例乳腺非肿块病变患者的临床资料进行回顾性分析。结果非肿块乳腺病变的50例患者中,病理显示34例(68.0%)为恶性病变,16例(32.0%)为非恶性病变。超声显示36例(72.0%)具有片状低回声表现,为1级;11例(22.0%)具有含散在微钙化片状低回声区表现,为2级;3例(6.0%)具有微钙化呈散在或簇状分布表现,为3级。结论超声诊断具有较高的敏感度及较低的特异度,临床应结合多种影像学方法对乳腺非肿块病变进行辨别,确有需要时可采取超声引导下穿刺活检方法进行确诊。     

64排螺旋CT扫描对结肠癌的诊断价值

目的探讨64排螺旋CT扫描对结肠癌的诊断价值。方法回顾性分析36例经手术或结肠镜病理证实的结肠癌患者的CT影像资料,观察肿瘤的部位、大小、形态、周围侵犯及远处转移情况,判断肿瘤分期。结果 36例患者中升结肠癌15例,横结肠癌7例,降结肠癌5例,乙状结肠癌9例。CT表现为病变段肠壁局限性不规则增厚或环形增厚、管腔内外软组织肿块、局部管腔不规则狭窄,增强扫描病变部位出现明显不均匀强化,可见周围浸润及转移征象。结论64排螺旋CT扫描能够较准确地显示病变部位、与周围结构关系、有无邻近器官侵犯及有无远处转移,对结肠癌的诊断及分期有重要价值,为临床手术方案的制订提供可靠依据。     

超声引导下腹膜穿刺活检的临床价值

目的通过分析不明原因腹水患者的病因及其诊断方法,探讨超声引导下腹膜活检的临床价值。方法选取我院不明原因腹水患者112例,应用穿刺活检针对上述患者行超声引导经皮腹腔穿刺腹膜活检,标本送病理检查,必要时行免疫组化进一步确诊。结果 112例患者均经一次穿刺成功,经病理证实腹膜间皮瘤43例,结核性腹膜炎32例,转移性腺癌29例,淋巴瘤1例,腹膜假黏液腺瘤1例,未见明显异常6例,一次穿刺活检成功率为100.0%,经腹膜活检明确腹水病因的诊断率为94.6%。结论经皮穿刺腹膜活检对不明原因腹水的诊断,特别是对腹膜间皮瘤、转移癌和结核性腹膜炎的鉴别诊断,具有重要价值。超声引导下腹膜活检,安全可靠,操作简便,无并发症发生,诊断准确率高,为临床治疗提供依据。     

探讨多层螺旋CT对急性结肠出血诊断的应用价值

目的探讨多层螺旋CT对急性结肠出血诊断的应用价值。方法对9例急性结肠出血患者进行多层螺旋CT检查,同时结合相关文献进行回顾性分析。结果在9例患者中,多层螺旋CT确诊出血部位7例,出血显示率77.8%。2例多层螺旋CT未发现出血灶及异常。结论多层螺旋CT对急性结肠出血具有重要的临床应用价值。     

超声联合核磁共振检查诊断乳腺癌的效率及经济性分析

目的：结合病理组织学探讨联合应用彩色超声成像和核磁共振（MRI）对乳腺癌的诊断价值。方法：回顾性分析经手术或组织学活检病理证实的74例乳腺癌患者（97个病灶）及良性肿块70例患者（75个病灶）的术前彩色超声成像及核磁共振检查资料,比较两种检查方法及联合应用的诊断效率,同时与病理组织学结果对照。结果：超声、核磁共振及两者联合应用,对乳腺癌诊断的敏感性分别为76．3％、82．5％和87．6％,特异性分别为92．0％、88．0％和96．0％,符合率分别为83．1％、84．9％和91．3％,统计学分析比较无显著性差异（P〉0．05）。两种检查方法及联合应用的经济性分析显示,采用超声检查,其费用支出仅为MRI的约1／10,为联合应用法的约1／11;如都实施穿刺病理检查,则超声穿刺法的费用支出较MRI或联合法节约一半以上。结论：超声、核磁共振检查对乳腺癌的诊断都具有较高的特异性和敏感性,而联合检查可以有效地提高符合率。考虑到经济性效率,采用超声结合病理穿刺诊断乳腺癌更适于高危人群筛查。     

回盲部肿瘤并发生急性阑尾炎20例

目的就回盲部肿瘤并发生急性阑尾炎20例进行分析。方法选取2009年11月至2013年11月收治的20例回盲部肿瘤并存急性阑尾炎患者,手术过程中发现有16例患者由于并存阑尾炎故行右半结肠一期切除术,另外4例患者均为首次行手术切除阑尾,在手术后出现不同程度的黑便、血便、消瘦、腹痛等症状,在行电子结肠镜、钡灌肠或B超检查后再次手术。结果本组20例患者全部为回盲部结肠腺癌,有15例患者被诊断为阑尾炎,有1例患者术后出现阑尾残端炎:1例自动出院,3例好转,16例治愈。结论为了避免由于回盲部肿瘤并存急性阑尾炎而出现漏诊、误诊情况,应在术前对中老年阑尾炎患者进行详细、细致的全面检查,术中对患者的病情进行仔细探查,术后对患者后期状态进行随访。     

超声影像与肝穿刺活检病理检查在肝纤维化诊断中的应用价值

目的探讨超声影像与肝穿刺活检病理检查在肝纤维化诊断中的应用价值。方法收集我院住院的180例肝纤维化患者资料,分别采取超声影像与肝穿刺活检病理检查,观察诊断肝纤维化的相符率。结果无明显变化的肝回声相符率为65.9%;肝实质回声增粗相符率为64.2%;肝回声增粗明显相符率为20.8%;肝脏弥散性损伤相符率为95.5%;早期肝硬化相符率为60.0%。结论在临床中可将超声影像诊断作为肝纤维化检测的一种常用方法。     

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.     

Bayesian estimation of duration models: An application of the multiperiod probit model

The multiperiod probit model is presented and Bayesian estimation using the Gibbs sampler with data augmentation is described. As an empirical illustration, the multiperiod probit model is then used to estimate a duration model using employment duration data for the Canadian province of New Brunswick. Bayesian estimation with unobserved heterogeneity is shown to be a simple extension of estimation of a duration model with no unobserved heterogeneity. More importantly, perhaps, some numerical problems encountered by other authors using Maximum Likelihood are avoided.I would like to thank M. Baker, G. Koop, A. Melino and D. Poirier for helpful comments and discussions. I would also like to thank M. Baker for providing his data.     

Scenarios and creativity: Thinking in new boxes

To be creative and make change happen, leaders must do more than simply ‘think outside the box’, as the traditional business manuals suggest, using the popular American expression. After all, the space outside the box is infinitely expansive. Moreover, there can be no guarantee that a solution to the problem will be found. The answer: ‘Think in new boxes.’ This requires developing the right new box; in other words, useful new models, a helpful new approach to a problem. That is the real art of practical creativity. This short article outlines the approach (Thinking in New Boxes) and its application to classic scenario planning with a few examples. The authors also present the ‘Expressway to Scenarios’, an approach that wins in impact and practicality what it loses in deep analysis, by having top executives involved in key steps.     

On the Role of Paradigms in Understanding Economic Globalization

Any adequate analysis of economic globalization necessarily requires fundamental understanding of the worldviews underlying the views expressed with respect to the nature and role of economic globalization. This paper is based on the premise that any worldview can be associated with one of the four basic paradigms: functionalist, interpretive, radical humanist, and radical structuralist. It argues that any view expressed with respect to economic globalization is based on one of the four paradigms or worldviews. It, therefore, discusses four views with respect to the nature and role of economic globalization which correspond to the four broad worldviews. The paper emphasizes that the four views expressed are equally scientific and informative; they look at the nature and role of economic globalization from a certain paradigmatic viewpoint. Emphasizing this example in the area of economic globalization, the paper concludes that there are opportunities for each paradigm to benefit from contributions coming from the other three paradigms.     

A Humean theory of choice of which rationality may be one consequence

For the reader who considers economic theory of choice as a special case of a more general theory of action, Hume's discussion of the determinants of action in the Treatise of Human Nature (1739?–?40), in the Enquiry on Human Understanding (1748) and in the Dissertation on Passions (1757) deserves attention. However, according to some modern commentators, Hume does not seem to have given any evidence that would favour what nowadays we would consider as the kind of rationality involved in modern theories of rational choice. On the contrary, this paper arrives at the conclusion that consistency between preferences and choice, like the usual properties of completeness and transitivity, may be considered as outcomes of a mental process, described by means of a decision algorithm that aims to represent Hume's theory of choice.     

The concept of freedom and its relation to economic development--a critical appreciation of the work of Amartya Sen

Following a brief review of the conception of freedom as employedin economic discourse, this paper focuses on the evolution ofthe concept of freedom in the work of Amartya Sen. It tracesthe development of Sen's thought from the capability analysisof the late 1970s to his more recent separation of freedom intoits opportunity and process aspects. While broadly appreciativeof Sen's development of the concept of positive freedom, thepaper identifies some difficulties arising from his definitionof capability as a set of options as well as from his separationof the opportunity and process aspects of freedom. Aspects ofthe relationship between Sen's conception of freedom and thatof Marx are discussed briefly in the context of Sen's recentdiscussion of the market as a source of freedom.     

How chaebol restructuring after the 1997 crisis has affected corporate decision and performance in Korea: debt financing,ownership structure,and investment

ABSTRACT

Korean chaebol firms, characterized by excessive debt financing and overinvestment, experienced restructuring after the 1997 crisis. By reducing debt financing and thus overinvestment, they tried to reorganize financing structure and ownership structure. Chaebols’ debt reduction turns out to have improved performance. However, polarization between chaebol and non-chaebol firms has become more significant. Even after the crisis, firms that give higher cash flows to a controlling shareholder take more capital investment, indicating that agency problems still exist within chaebols. Chaebol-affiliated firms continue to be more active in R&D than non-chaebol firms. However, the pattern is limited to the group of top 10 chaebols after the crisis.

Abbreviations: KFTC: Korea Fair Trade Commission     

Types of technology

Technology is a concept rife with confusion. Here, I argue that technologies can be distinguished as a combination of type of producer and an idealized artefact life history. Using this definition, a number of technologies are identified. The first technology historically, in the Protostomes, was the production of individual or family dwellings. Next came objects such as spider webs for trapping prey. Stigmergy followed, with the social insects, as a collective endeavour to construct a mega-structure using simple rules of accretion. Some birds and primates began to make tools, or simple technological objects whose function is closely related to their form. Humans are distinguished by their ability to make machines. Traditional technology took place once people voluntarily organised into groups with specialised knowledge to produce more complex objects and structures. Monumental objects like ceremonial pyramids came with the command economies of the early agrarian societies, which also resulted in a new category of artefact, the network. Finally, with modern civilizations came ad hoc accretion, or population-level adding-on, to make truly complex technological systems. Developing a theoretical framework within which artefacts, production processes and ways of interacting with them are identified should help the study of technology to become more scientific.