关于“医学检验”向“检验医学”转变的思考

“医学检验”伴随着临床化学、临床血液学、临床微生物学、临床免疫学、临床分子诊断学等学科的发展,进一步走向深化与细化。然而检验与临床之间隔阂愈演愈烈的现状,显示出还原论指导思想下的“医学检验”模式将难以适应现代医学的发展趋势,进而向着以系统论为哲学指导思想的“检验医学”模式的转变,其间正经历着一场由还原论到系统论、再实现还原论与系统论辩证统一的演化过程。     

Parent Reports and Laboratory Assessments of Child Temperament: A Comparison of Their Associations With Risk for Depression and Externalizing Disorders

Parent reports and laboratory assessments of child temperament traits were compared in terms of their associations with 2 indices of risk for future maladjustment: maternal history of depression and disruptive school behavior. A community sample of 99 pre-school-aged children completed a standardized battery of laboratory tasks designed to tap positive emotionality (PE) and anger. Parent reports of child temperament were collected, and maternal history of depression was assessed using structured clinical interviews. An average of 18.5 months after the initial laboratory assessment, teacher reports of disruptive school behavior were collected. Structural equation models were used to test the association between the 2 assessment approaches of child temperament and maternal history of depression and disruptive school behavior. Laboratory measures and parent reports of anger were equally good at predicting disruptive school behavior, while laboratory measures of PE showed stronger associations with maternal history of depression than parent report.     

Providing an escape option reduces retaliatory aggression

The purpose of this study was to examine whether providing an explicit means to escape future attacks by a provocative fictitious participant reduces retaliatory aggression. Using a laboratory measure of aggression (the Point Subtraction Aggression Paradigm), 25 participants were given the opportunity to earn points with monetary value on a fixed ratio (FR) 100 schedule, and to subtract points from a fictitious participant on an FR 10 schedule. Aggressive responding was defined as the number of point subtraction responses by the participant. Aggressive responding also produced intervals free from further attack by the fictitious participant. Provocation was manipulated by having the fictitious person subtract points from the participant. Each participant next completed the same task with an explicit FR 10 escape response option added. The escape option produced intervals free from attack identical to the aggressive option, but without taking points away from the fictitious participant. Results indicate that the availability of an escape response attenuated aggressive behavior in response to provocation. Aggr. Behav. 00:000–000, 2005. © 2005 Wiley‐Liss, Inc.     

社会支持与心血管反应的实验室研究概述

从20世纪70年代起国内外学者开始兴起了对社会支持的研究,而对社会支持与心血管健康的关系研究一直都是社会支持研究领域中的重要课题。本文回顾了社会支持在心血管反应的实验室研究中操作性的定义;实验室研究中社会支持与心血管健康的关系、社会支持对心血管反应作用的影响因素、社会支持的作用机制、社会支持的测量方法及社会支持与心血管反应实验室研究的局限性。     

检验医学的医学伦理学思考

检验医学发展迅速,然而对其医学伦理学的思考却常被人忽视。本文对日常检验工作中存在的伦理学问题进行了初步探讨,从检验机构设置、检验项目管理、日常检验工作及检验与,临床的沟通等方面思考了当今检验医学领域医学伦理学的现况。加强检验医学的医学伦理学建设,真正体现出对患者的人文关怀。     

重视人文关怀,促进检验科管理及服务水平的提高

在当前检验医学日趋呈现＂人文缺失＂的背景下,提出加强检验人员人文素质教育的必要性及紧迫性,并重点阐明以患者需求为导向,提高检验科人性化服务的具体措施。     

Responding to allegations of scientific misconduct

Institutions in France are not yet well prepared to respond to allegations of scientific misconduct. Following a serious allegation in late 1997. INSERM,* the primary organization for medical and health-related research in France, began to reflect on this subject, aided by scientists and jurists. The conclusions have resulted in establishing a procedure to be followed in cases of alleged misconduct, and also in reinforcing the application of good laboratory practices within each laboratory. Guidelines for authorship practices and scientific assessment must also be considered. Even though each institution must remain responsible for responding to allegations of scientific misconduct within its doors, INSERM would like to see national, European, and international co-ordination about the methods of such response. Institut National de la Santé et de la Recherche Médicale (eng. French National Medical Research Institute) is known as INSERM. An earlier version of this paper was presented at a symposium, Scientific Misconduct: An International Perspective, organised by The Medical University of Warsaw, 16 November, 1998.     

Conspecific aggression influences food carrying: Studies on a wild population of Rattus norvegicus

Laboratory rats, like many other animal species, transport food. Their behavior is influenced by factors such as food size, the time required to eat, travel distance, travel difficulty, and the availability of cover, etc. Recent versions of optimal foraging theory suggest that species that display such behavioral patterns do so in order to minimize risk to predation while at the same time maximizing food gain. Nevertheless, it is not clear that this explanation applies to rats, nor is it easy to investigate this problem in a laboratory. The results of the present study on urban feral rats show that their food handling behavior is similar to that of domestic rats. The results also suggest that food carrying can serve defensive as well as communicative functions. Aggression around food sources was high. Smaller rats always carried food and some large rats infrequently carried food, suggesting that the food carrying by smaller, subordinate rats may help them avoid conspecific aggression. The rats also vigorously attempted to steal food that was carried home by conspecifics. This result suggests that food carrying can redistribute food resources and inform conspecifics about food availability. The results demonstrate the utility of multilevel behavioral analysis and also demonstrate that for rats, food transport has functions other than predator avoidance, including avoidance of conspecific aggression and communication about food availability. © 1996 Wiley-Liss, Inc.     

Laboratory measures of aggressive responding in male parolees with violent and nonviolent histories

Males on parole were recruited into a study to determine the external validity of the ©Point Subtraction Aggression Paradigm, a laboratory procedure for measuring human aggressive responding. Subjects were assigned to either a violent or nonviolent group based on their criminal record and the Brown History of Violence Questionnaire. Subjects participated in six 25-min sessions and completed a series of questionnaires. During the laboratory sessions subjects were given two response options: 1) Pressing button A to accumulate points exchangeable for money, and 2) pressing button B which ostensibly subtracted points from another fictitious person. Responding on button B was defined as aggressive since it resulted in the ostensible delivery of an aversive stimulus to another person. Results indicated that the subjects in the violent group emitted significantly more aggressive responses than subjects in the nonviolent group. The two groups also differed on psychometric measures of aggression. This study provides external validity for this laboratory measurement of human aggressive responding, even among males with very similar backgrounds. © 1996 Wiley-Liss, Inc.     

Children’s competitive peer aggression during reward and punishment

Behavior‐disordered children (N = 65) competed with a presumed unknown peer on consecutive administrations of an analogue aggression task of instrumental aggression (blocking the opponent’s game) and hostile aggression (sending the opponent a noise). The first administration as a reward‐only, nonpunishment condition. The second administration contained both reward and punishment conditions. Results indicated clear differences on aggressive responding during conditions of reward and punishment. Significant correlations were found between instrumental aggression during reward across the two administrations, whereas correlations between aggression during reward and aggression during punishment were nonsignificant. Teacher ratings of Covert‐Proactive Aggression correlated with analogue task instrumental aggression but not with hostile aggression on both administrations. Aggression during punishment was significantly correlated with Continuous Performance Test inattention and impulsivity scores, suggesting that impulsivity and inattention may play an important role in children’s ability to inhibit aggression during cues for punishment. These data indicate the utility of a laboratory analogue procedure to assess conditions associated with childhood aggression and to further our understanding of childhood aggression subtypes. Aggr. Behav. 27:1–13, 2001. © 2001 Wiley‐Liss, Inc.     

临床方法依然是神经内科医师最重要的诊断法宝

通过7例疑难、危重患者的诊治过程说明临床方法的重要性,在神经科疾病研究中尤为突出。忽视细致的病史采集和体查,常导致了诊疗的失误;面对种目繁多的检查,更需要以临床方法选择之;临床逻辑思维能力非常重要,正确的临床思维出新知。在实验室检查方法越来越多的今天,临床方法是神经内科医师最重要、方便、快捷、有效的诊断法宝,具有不可替代性。     

临床检验科人文精神缺失及对策的思考

当今随着经济和社会的发展,在现有的医学教学模式、医疗体制和分配制度下,医院临床检验科越来越推崇医学技术主义和追求高额的经济利益,致使临床检验医生人文精神日益缺失,医生与患者之间最具人性的本质已被淹没,医患矛盾日益增加和凸显。如何以患者需求为导向,让患者满意,这迫切地需要在临床检验科加强人文素质教育,培育检验医生的“医者仁心”大医情怀,以减少和预防医患矛盾的发生,这是检验科管理者应该急需思考的问题。     

Twin study of laboratory-induced aggression

The aim of this study was to explore genetic and environmental contributions to laboratory-induced aggressive behavior. On a sample of 478 adult twins (316 monozygotic), the Competitive Reaction Time Task was used for aggression induction. The results showed that the initial, basic level of aggression could be explained by both shared (45%) and nonshared environmental factors (55%), while only nonshared environmental factors (100%) had a significant influence on changes in aggression as provocation increased. Genetic factors had no influence on laboratory-induced aggression. The results highlight the importance of environmental factors in shaping situation-specific aggressive responses to provocation.     

Does sport have intrinsic value?

This paper considers the suggestion, central to McFee's (2004 Mcfee, Graham. 2004. Sport, Rules and Values: Philosophical Investigations into the Nature of Sports, London: Routledge. [Crossref] , [Google Scholar]) moral laboratory argument, that sport is intrinsically valuable. McFee's position is outlined and critiqued and various interpretations of intrinsic value found in the philosophical literature are considered. In addition, Morgan's (2007 Morgan, William J. 2007. Caring, final ends and sports. Sport, Ethics and Philosophy, 1(1): 7–21. [Taylor & Francis Online] , [Google Scholar]) claim that sport is an appropriate final end is considered and partially accepted. The paper draws a number of terminological distinctions and concludes that sport does not have intrinsic value as traditionally conceived, but that this is of little consequence with regard to the role of sport as a moral laboratory.     

Organization of sex-typical patterns of defense during food protection in the rat: The role of the opponent's sex

Feeding rats defend a food item from an approaching conspecific by turning away, laterally, about 180°. Females and males use a different composition of movements and stepping patterns to perform these defensive dodges. This study was designed to examine the role of the robber's sex on the execution of sex-typical patterns of dodging. All subjects were tested with a partner of each sex. During dodging, females used the female-typical pattern of pivoting around the pelvis, and males used the male-typical midbody pivot, irrespective of the robber's sex. These findings show that the sex-typical patterns of dodging are not determined by the sex of the partner. Females and males however, differed in how they were oriented towards a same sex robber at the end of the dodge. This suggests that while male and female robbers must pose different defensive problems, these differences are dealt with by modifying the sex-typical pattern of dodging rather than by switching to the dodge pattern of the opposite sex. This further suggests that the differences in the composition of the dodge pattern in males and females are not due to extrinsic contingencies, but rather, are due to intrinsic differences in the sex-typical organization of defensive motor patterns. Aggr. Behav. 23:197–214, 1997.© 1997 Wiley-Liss, Inc.     

Facet-level analysis of the relations between personality and laboratory aggression

Multiple reviews and meta-analyses have identified the low pole of the Five-Factor Model (FFM) Agreeableness (also called Antagonism) as the primary domain-level personality correlates of aggression across self-report and behavioral methodologies. In the current study, we expand on this literature by investigating the relations between FFM facets and aggressive behavior as measured by laboratory competitive reaction time tasks (CRTTs). Across three samples (total N = 639), we conducted weighted mean analyses, multiple regression analyses, and dominance analyses to determine which FFM facets were the strongest predictors of aggression within and across domains. These analyses suggested that facets of Agreeableness were among the strongest consistent predictors of CRTT aggression, including Sympathy (r = −.21) and Cooperation (r = −.14), but facets from other FFM domains also yielded meaningful relations (e.g., Anger from Neuroticism; r = .17). We conclude by discussing these results in the context of controversies surrounding laboratory aggression paradigms and emphasizing the importance of considering small effect sizes in the prediction of societally harmful behavior like aggression.     

婴儿气质的实验室观察与母亲报告的一致性及其影响因素研究

本研究采用呈现三种性质物品的实验室观察法与母亲报告法,考察203名6个月婴儿在积极情绪和消极情绪的一致性。结果表明:(1)在正性情境下,实验室观察的积极、消极情绪与母亲报告的消极情绪显著相关;(2)母亲的抑郁倾向与两种气质测查方法测查的婴儿消极情绪的一致性正相关显著;婴儿性别在一定程度上调节着母亲养育压力与两种方法测查婴儿积极情绪的一致性。     

Analytic flexibility in laboratory aggression paradigms: Relations with personality traits vary (slightly) by operationalization of aggression

Competitive reaction time tasks (CRTTs) have been used widely in social science research, but recent criticism has been directed at the flexible quantification strategies used with this methodology. A recent review suggests that over 150 different quantification strategies have been used in this literature, and there is evidence to suggest that different operationalizations can affect the results and interpretations of experiments using CRTTs. In the current investigation, we reanalyze data from four existing samples from two different sites (total N = 600) to examine how the relations between a range of personality traits and aggression vary based on how aggression is operationalized. Our results suggest that there is a modest degree of heterogeneity in effect size and direction for these relations, and that effect size and direction were most consistent for traits more generally related to lab aggression (e.g., psychopathy, low Five-Factor Model agreeableness). In addition, profile matching analyses suggest that different operationalizations yield empirical correlates that are quite similar to one another, even when quantifying absolute rather than relative similarity. These results were consistent across site, methodology, and type of sample, suggesting that these issues are likely generalizable across most labs using CRTTs. We conclude with suggestions for future directions, particularly emphasizing the need for adequately-powered samples, and for researchers to preregister a plan for how CRTT data will be analyzed.     

实验诊断临床思维程序的必要性及其内容

为提高临床实验诊断的效率和准确性,提出编写“实验诊断临床思维程序”的观点。从实验诊断学的特性及发展趋势方面论述了该程序的必要性,并初步拟定了包括项目选择、结果判断和结果应用三个部分的实验诊断临床思维程序。     

Analysis of the targets and tactics of conspecific attack and predatory attack in northern grasshopper mice onychomys leucogaster

Comparisons of tactics of fighting between species are often difficult to make since the body targets attacked may differ. Thus it becomes difficult to assess whether differences in fighting tactics are due to species-specific differences in the tactics themselves or due to the different targets attacked. A solution to this problem is to analyse the tactics of a species that attacks different targets under different circumstances. In this way, differences in tactics can be more readily attributed to differences in targets. In this study, resident male northern grasshopper mice (Onychomys leucogaster) were tested against intruding male conspecifics and against laboratory mice (Mus musculus domesticus). Conspecifics were mainly bitten on the lower dorsum, whereas prey were bitten and killed by bites to the nape of the neck. Therefore, it was possible to analyze the tactics of attack by grasshopper mice when attacking different body targets. For example, in order to defend the lower dorsum and the nape, both intruding conspecifics and prey adopted an upright defensive posture. Resident grasshopper mice used the lateral attack tactic to gain access to the lower flanks but not the nape. This illustrates that the lateral attack tactic is not merely a tactic suitable for overcoming the upright defense tactic, but is used in this context only when the target attacked is on the opponent's posterior dorsum. Such withinpecies comparison enables the identification of the contextual rules which govern the use of fighting tactics. © 1992 Wiley-Liss, Inc.