骨源性因子ucOCN在运动抗抑郁中的作用机制

羧化不全骨钙素(ucOCN)是骨中成骨细胞分泌的特异性蛋白, 因其在调控神经发育、神经可塑性等中的重要角色而受到神经科学领域关注。“骨-脑”串联“对话”是骨内分泌-神经介导的应答系统, ucOCN透过血脑屏障后介导单胺类神经递质、神经内分泌、神经免疫、神经再生及基因表达等机制, 进而作用于海马CA3区、扣带回等脑区功能发挥来调节抑郁发生及改善。而ucOCN作为骨源性力学刺激敏感基因, 运动上调其表达后进入血液循环, 通过介导5-HT/GABA分泌、HPA轴功能、炎症反应、神经营养因子(BDNF等)表达或信号途径(如GSK3β/β-catenin、TLR4/miR-223/NLRP3等)激活等来实现“骨串联脑”, 发挥运动抗抑郁作用。通过对骨源性因子ucOCN介导脑区功能变化从而实现运动抗抑郁的作用机制进行探讨、梳理, 一方面有助于更深入了解骨内分泌功能, 另一方面为抑郁发生、改善和运动抗抑郁研究提供新的理论基础和研究思路。     

工作记忆的神经振荡调控：基于神经振荡夹带现象

工作记忆的神经振荡机制研究是当前记忆领域的研究热点之一。那么, 神经振荡仅仅是工作记忆过程的伴随现象, 还是直接参与并调控了工作记忆的加工过程?已有研究发现, 大脑内部的神经振荡活动在外界节律性刺激的驱动下, 逐步与外界刺激节律相位同步化, 这一现象被称为“神经振荡夹带”。重复经颅磁刺激(repetitive Transcranial Magnetic Stimulation, rTMS)和经颅交流电刺激(transcranial Alternating Current Stimulation, tACS)干预研究基于此现象, 对大脑局部脑区施加节律性磁、电刺激, 进而调控工作记忆过程中特定频段的神经振荡活动、跨频段的神经振荡耦合或跨脑区的神经振荡相位同步, 为神经振荡参与工作记忆加工提供较为直接的因果证据。未来研究需考虑从脑网络的角度出发, 调控多个脑区之间的神经振荡活动, 进一步考察神经振荡对工作记忆的影响。此外, 还需注意探索和优化rTMS/tACS调控工作记忆的刺激方案, 并辅以客观的脑电记录, 提高该类研究的有效性和可重复性, 最终达到提高工作记忆能力的目的。     

孤独症儿童动作发展障碍的神经机制

动作发展障碍(Developmental motor disorders)是孤独症谱系障碍的常见特征。通过系统回顾孤独症儿童动作发展障碍的神经科学研究, 发现γ-氨基丁酸和5-羟色胺浓度的改变及γ-氨基丁酸相关蛋白和Shank蛋白的表达异常不仅会损害中枢神经系统的发育, 而且还能导致突触兴奋性与抑制性失衡, 进而改变孤独症儿童小脑和大脑皮层运动区的功能连接。孤独症儿童小脑、基底神经节和胼胝体结构的改变对全脑的连通性产生了负面影响。神经生化机制和脑结构的异常共同导致了脑功能的异常, 最终造成孤独症儿童的动作发展障碍。此外, 动作发展障碍与孤独症核心症状共同的神经基础主要包括镜像神经元系统紊乱, 丘脑、基底神经节和小脑异常以及SLC7A5和PTEN 基因突变。未来研究需要关注与运动密切相关的其他神经递质, 如乙酰胆碱和多巴胺; 探索动作发展障碍神经网络的动态机制及其形成; 剖析该障碍的神经机制和自闭症核心症状神经机制的相互作用。     

经颅电刺激与视功能调控

经颅电刺激(Transcranial Electrical Stimulation, TES)通过电极将特定模式的低强度电流作用于大脑头皮以调控皮层活动, 是一种非侵入、无创的神经刺激方法。根据刺激电流的模式的不同, TES分为经颅直流电刺激(tDCS), 经颅交流电刺激(tACS)和经颅随机电刺激(tRNS)。TES能对视功能诸如光幻视阈值、视野、对比敏感度、视知觉运动等进行一定程度上的调控, 并且能够与传统的视觉知觉学习训练相结合以调控视觉功能。对于不同的视觉功能, 不同的TES参数和模式的调控效果有所不同。     

多巴胺D2受体参与调节感觉门控的机制

精神分裂症是一种常见的病因不明的精神疾病。大量文献表明精神分裂症患者所表现出来的认知紊乱和思维异常等症状与感觉门控功能的缺失有密切的关系, 感觉门控是指在充满刺激的环境中, 从外界的感觉信息中过滤无关的感觉信息然后执行与注意力相关的认知过程, 以对显著的刺激做出反应。研究感觉门控的经典范式是震惊反射的前脉冲抑制。研究发现多巴胺D₂受体可以参与调控前脉冲抑制的过程, 但是多巴胺D₂受体参与调控前脉冲抑制的机制仍不清楚。探讨多巴胺D₂受体参与调控感觉门控即前脉冲抑制的关键脑区、神经环路及分子机制, 有利于促进对精神分裂症感觉门控功能的深入研究。     

发展性阅读障碍与小脑异常：小脑的功能和两者的因果关系

发展性阅读障碍(下文简称为“阅读障碍”)不仅会影响个人的终身发展, 还会对社会造成沉重的经济负担, 深入探讨相关的神经机制, 对实现阅读障碍的早期预测和干预十分重要。以往关于阅读障碍神经机制的模型多集中于大脑, 近些年的研究发现, 阅读障碍也与小脑异常有关, 但到目前为止我们仍不清楚两者的关系。通过总结最新的研究进展, 我们发现小脑在阅读障碍中可能发挥着多种功能, 且小脑异常与阅读障碍可能互为因果。在此基础之上, 我们提出了“阅读中小脑与大脑的功能映射假说”, 旨在从一个全新的角度揭示小脑与阅读的关系, 以及两者与大脑的关系。相关内容对全面揭示阅读障碍的神经机制, 以及小脑在高级认知加工中的作用, 具有重要的启示意义。     

大脑电刺激在听觉语言加工研究中的应用

大脑电刺激是历史悠久但近年来才广泛应用在人类被试上的实验技术。通过对颅内刺激位点进行电刺激, 并分析引发的暂时性行为功能变化和记录位点的电位活动, 大脑电刺激技术可以揭示认知加工过程中脑区内的功能作用与脑区间的有效连接。通过对听觉语言加工过程相关的丘脑、听觉皮层、高级语言皮层进行电刺激, 现有研究发现了各个脑区的不同功能特点以及不同脑区间的信息传递机制, 为进一步探索听觉语言加工的神经机制提供了新的视角。     

抑郁症认知功能障碍的神经生物学研究进展

作为严重的精神疾病之一,认知功能障碍可能是抑郁症(MDD)的核心症状和重要发病原因之一,严重影响着MDD的临床治愈和心理社会功能的恢复,目前已经受到广泛的关注。MDD患者的认知功能障碍主要表现在注意力不集中、信息处理和工作记忆能力减弱以及控制执行功能的严重不足等。神经影像学与生物学标志物等研究结果已经证实MDD认知功能的异常。了解MDD的认知功能障碍及其神经生物学标志物,对于了解MDD发病机制以及制定个性化治疗方案具有重要意义。     

经颅直流电刺激在注意缺陷多动障碍治疗中的应用

经颅直流电刺激(tDCS)治疗注意缺陷多动障碍(ADHD)主要是选取患者的背外侧前额叶(DLPFC)作为刺激区域, 通过调节其皮层兴奋性, 从而缓解其ADHD的症状和改善其受损的认知功能。针对tDCS在ADHD治疗研究中的问题, 未来可从有效性、确定最佳刺激参数、个体差异、不同亚型及与其他疗法联合使用等五个方面来进一步研究。     

奖赏学习对视觉注意的调控

经过学习获得的奖赏预测性可以改变相关刺激的显著性,进而影响个体对该刺激的知觉加工与注意选择。探究奖赏学习在注意调节中的神经机制有利于理解人类的适应性行为。近期研究发现,大脑不仅可以增强具有奖赏显著性刺激所在空间位置或相应特征的表征,还可以通过注意抑制机制减弱具有奖赏显著性的刺激在初级视觉皮层的神经表征,从而减少对它的注意分配。这些研究提示奖赏信号在调节认知控制、优化行为过程中的重要作用。     

施动感双层结构的发展

施动感是个体在自主运动过程中对自身行为产生的主体性体验,揭示其发展过程对了解自我意识的形成具有重要意义。三阶段模式全面概括了施动感的发展过程。婴儿形成动作预测、建立动作-效果联结以及与养育者良好的人际互动对施动感的发展起着重要作用。未来施动感发展研究应从多种施动感生成理论出发,改进婴幼儿施动感的测量范式,探索施动感发展与社会认知发展、自闭症症状的关联。     

Code of Ethics of the National Society of Genetic Counselors: Explication of Revisions

The Code of Ethics (COE) of the National Society of Genetic Counselors (NSGC) was adopted in 1992. In 2004, the NSGC leadership appointed the Code of Ethics Work Group (COEWG) to consider revisions to the NSGC COE based on advice from the NSGC legal counsel, and to consider additional changes given growth in the scope of genetic counseling practice since the adoption of the original COE. After input from the NSGC membership, changes to the COE addressing the recommendations of the NSGC legal counsel were approved in December 2004. The COEWG then reviewed ethical codes and codes of professional conduct from 22 professional organizations, deemed to have similar goals and philosophies to the NSGC, searching for themes that encompassed genetic counseling practice that might not yet be addressed in the NSGC COE. Additional revisions to the COE were proposed, and after feedback from the NSGC membership, the revised COE was approved in January 2006 by majority vote of full members of the NSGC. The explications for the 2004 and 2006 revisions are presented.     

医学哲学是临床医学创新的不竭动力

受诸多复杂因素的影响,现代医学在取得巨大成就的同时,也有自身的局限与不足.医学哲学是医学精神的精华.哲学的本质是批判,是创新,是全面地、发展地认识问题,促进事物前进、发展.哲学是医学创新的不竭动力,确定医学的历史方位,引导医学的未来发展方向,是解决当代医学前沿中难点、热点问题的钥匙,促进临床医学模式"以疾病为中心"向"以病人为中心"和"以健康为中心"模式转变.     

An investigation of aspects of the cry of pain model of suicide risk: the role of defeat in impairing memory

AIM: Feelings of defeat and deficits in autobiographical memory are thought to be central to the formation of suicidal thoughts and behaviours. However, no work has established the role of defeat, specifically, in directly leading to memory problems. This study sought to assess whether a defeating event and associated defeated mood impaired memory for a story. METHOD: Participants were from a student population. Those in the experimental condition (n=37) experienced an event which was designed to induce defeat prior to both the encoding and verbal retrieval of a story. Participants in control condition (n=37) experienced no such defeating event. Visual analogue scales of five mood states were taken at baseline, prior to encoding and prior to retrieval. RESULTS: Participants in the experimental condition reported increased feelings of defeat following baseline, and recalled fewer story units relative to the control condition. DISCUSSION: These results show that appraising an event as defeating increased subsequent defeated mood and led to impaired episodic memory, independently of low mood in general, thus suggesting a causal role of a specific negative mood state on impaired memory. Implications for clinical research are discussed.     

Developmental Timing of Onsets of Disruptive Behaviors and Later Delinquency of Inner-City Youth

A longitudinal sample of 306 males were followed with annual interviews over 4 years to evaluate the role of the timing of onset of different types of disruptive behaviors in predicting later arrest rates. In particular, we applied the Developmental Pathways model to explain progressions from less serious to more serious behaviors and progression along three types of disruptive pathways defined as Overt, Covert, and Authority Conflict behaviors. Results indicated that the sequences and the prognostic properties hypothesized for the model were supported. Most youth showed a progression from behaviors expected to occur earlier to those expected to come later according to the model. In addition, these results showed that onset timing of most types of behavior as well as rapidity of reaching more serious behavior related to arrest rate. This cross-validation extends the model to a high risk inner-city population and to Latino youth. One notable exception to the general trend found was that violence did not always follow earlier involvement in less serious offenses and did not seem to show the same onset timing relation to risk for arrests. Social-ecological differences in the precipitants of violence in the inner-city compared to other developmental settings, as well as the possibility that multiple forms of violence have differing underlying causes, may explain this exception. The model's generality suggests it has utility for guiding and discriminating risk better than simply noting the frequency, seriousness, or onset timing of delinquency.     

The role of specific consequences in the maintenance of three types of questions

This research replicated and extended a study by Williams, Donley, and Keller (2000). In that study, children with autism received a box with an object inside and learned to ask “What's that?,” “Can I see it?,” and “Can I have it?” to have the name of the object, to see the object, and to get the object, respectively. The purpose of the present research was to determine if the three questions (a) were three independent repertoires of behavior, (b) constituted three instances of a single functional response class, or (c) belonged to a chain of behavior. The 3 boys with autism who participated responded independently to each question when the consequences for each question were altered. This indicates that the three target responses were three independent repertoires of behavior, each one reinforced and maintained with its specific consequences. Thus, this procedure serves to teach children with autism to ask questions with flexibility according to a variable context.     

汉字:国人释梦实践的本土化面向

汉字释梦是根据梦像的视觉形象构造,寻找书写结构与其相对应的汉字,再依于汉字的本义把握梦的意义。首先依据现代心理学探讨传统梦学中汉字释梦的思想;然后对汉字释梦的可行性进行深入分析,认为梦和汉字都以表意为首要目的,都采取象形的表达方式,进而提出汉字释梦的操作思路;最后结合案例展现了汉字释梦在实践中的应用。     

Analysis of the creation of 'emptiness', of 'nothingness', in certain types of psychosis

Some psychotic patients manage to create nothingness and emptiness thanks to the amount of work their ego accomplishes. That is the paradox we find in schizophrenic patients, their ego is simultaneously weak and powerful. When we analyse how this nothingness/emptiness is created, we enter into a strange world in which the patient's ego is, in part, defective and fragmented; his or her thinking apparatus, capacity for perceiving and feeling are under attack. Yet this same ego can call on intellectual ability, imagination and tremendous energy in order to create a highly complex structure, thanks to which the psychotic individual manages to create a kind of para-organization of space by splitting 'nothingness' (the space between representations) and 'density' (a compact magma made up of many different highly-condensed representations). Both nothingness and density may give the impression that the patient is 'nowhere to be found' and therefore impossible to analyse. In this paper, I shall describe these mechanisms as they appear in the clinical material of a female psychotic patient.     

相对概念之调适

相对之原理见于大易“一阴一阳之谓道”。阴阳,宇宙相对之二大动能也。此两种相对不同之势用,互为消长、依存,推动宇宙、人生,乃有今日之大千世界。凡事物皆有正反两面,故有利则有害,有是则有非;利害同一体也,是非同一体也。于生死、寿夭、成败、得失莫不皆然,宇宙万有无不在相对原理之中,人则茫然而不知,此易学之妙用也。本文特举相对概念之大者：一曰善恶,二曰是非,三曰祸福,四曰生死,五曰寿夭,六曰得失,七曰贵贱,八曰黑白,九曰荣辱,十曰利害,十一曰忧乐,十二曰正反。此十二曰,争议之大者,而论其所以自处之道,欲人不堕入相对之迷雾中而无以自拔也。综上十二项皆物论争议之大者,执相对之两端而纷纷不息,则世界永无宁日,不如泯绝相对之概念以归于中和。孔子所谓“执其两端,用其中于民”,不仅人类和平共存,则天人亦和谐无间矣。     

Treatment of food selectivity: An evaluation of video modeling of contingencies

Many children with disabilities have feeding problems including, but not limited to, food selectivity and/or food refusal. The purpose of this study was to evaluate the effectiveness of video modeling of contingencies alone and combined with direct exposure to the contingencies in the treatment of food selectivity. Treatment procedures included sequentially introducing videos in which models consumed nonpreferred foods or were exposed to differential reinforcement or differential reinforcement plus escape extinction. In addition, during feeding sessions, participants were exposed to differential reinforcement. Results indicated that video modeling of differential reinforcement plus direct exposure to differential reinforcement may be effective at increasing consumption of some nonpreferred foods, but the results were not replicated across all foods. For one participant, consumption of one food increased with video modeling alone.