新生儿缺氧缺血性脑病治疗误区及程序化干预策略

新生儿缺氧缺血性脑病（hypoxicischemic encephalopathy,HIE）主要是指围生期窒息导致的缺氧缺血性脑损伤（hypoxicischemic brain damage,HIBD）。多年来对HIE的干预存在较多争论,本文辩证分析了目前国内HIE治疗的误区,提出对于HIE的干预,需要从机理入手。缺氧缺血事件的不同阶段有不同的矛盾,而且这些矛盾是动态变化的,辩证的对待不同阶段所面临的矛盾是确定干预措施的基础,主张在时间窗内、急性期后、新生儿期后等不同的时间段内采取针对性强、连续的干预策略,初步提出程序化干预的概念。     

新生儿缺氧缺血性脑病治疗误区及程序化干预策略

新生儿缺氧缺血性脑病(hypoxicisehemic encephalopathy,HIE)主要是指围生期窒息导致的缺氧缺血性脑损伤(hypoxicischemic brain damage,HIBD).多年来对HIE的干预存在较多争论,本文辩证分析了目前国内HIE治疗的误区,提出对于HIE的干预,需要从机理入手.缺氧缺血事件的不同阶段有不同的矛盾,而且这些矛盾是动态变化的.辩证的对待不同阶段所面临的矛盾是确定干预措施的基础,主张在时间窗内、急性期后、新生儿期后等不同的时间段内采取针对性强、连续的干预策略,初步提出程序化干预的概念.     

脑中风患者的反应时间研究

本文研究了79例脑梗塞、脑出血病人的简单反应时间(SRT)与选择反应时间(CRT).结果表明脑血管疾病患者不但反应时间(RT)延长;而且相应RT 差异系数也增大。基底节区域的损害同样可以导致RT 延长。左脑损伤组与右脑损伤组的RT 作业水平差异不显著。SRT 测验中,脑损伤体积的大小与RT 延长有明显的正相关的趋势。     

精神分裂症患者的前瞻记忆比较研究

近年来有越来越多的心理学家从神经心理学角度对前瞻记忆进行研究,其中涉及较多的是正常被试与脑损伤患者之间的前瞻记忆比较。本文则针对目前关注比较少的精神分裂症这种特殊的脑损伤病人,通过对28名精神分裂症患者与30名正常被试在一定试验条件下进行前瞻记忆研究,试图发现其与正常被试在前瞻记忆的水平、影响因素以及自我评价方面的差异并分析其原因。     

关于矛盾态度的研究述评

矛盾态度是个体对同一客体同时存在的积极和消极评价与情感。本文主要阐述了矛盾态度的概念界定与测量方法,矛盾态度的相关因素与基本特性,以及矛盾态度对信息加工、行为意图和实际行为的影响。最后,文章指出矛盾态度的界定与测量还需扩展,对引发矛盾的客体、矛盾态度特性有待深入研究。     

矛盾含义探讨

在矛盾、矛盾实质以及矛盾类型等问题的探讨和研究中,经常看到这样一些提法:“太阳和地球的矛盾”,“原子核和电子的矛盾”,“氢和氧的矛盾”等等。这里,矛盾究竟是指太阳和地球等物质实体自身,还是指太阳和地球等物质实体之间的关系呢?在有些论者那里出现了“忽而此、忽而彼”的现象。还有,一些人在讲生与死、好与坏、正确与错误、先进与落后等矛盾时,也常常出现矛盾含义理解上的混乱。我们认为,正确理解矛盾的含义,是个关系到正确认识矛盾、分析矛盾和解决矛盾的重要理论问题,应该搞清楚。     

中医院市场定位的两难选择及其对策

中医院的市场定位处于两难选择之中:中医药技术的潜在优势与现实局限性的矛盾、中医院管理者的价值取向与现实窘况的矛盾、中医院发展历史沉淀与市场竞争的矛盾、政府的中医药政策自身存在的矛盾等。这些矛盾涉及多方行为和利益主体,必须深化改革,以实现中医院的良性发展。     

是精英性还是大众化——谈当代水墨的出路之争

本文就20世纪90年代当代水墨艺术中精英性与大众化的矛盾这个问题,陈述当代水墨艺术面临的种种困境(即传统与创新的矛盾、笔墨形式与当代观念的矛盾、东西方文化之间的矛盾,而这三种矛盾又是相互关联的,并共同构成了精英性与大众化的矛盾),梳理各种立场的观点,提出自己的看法。     

右侧脑发育不全患者启动效应与智力水平分离

采用 ＷＭＳ－ＣＲ． ＷＩＳＣ－ＣＲ和４项内隐记忆任务（偏好、自由联想、字根补笔和字辨认）观察一例右侧脑发育不全患者和两正常对照组被试的智商、记忆商和启动效应。发现该患者智力发育迟滞、记忆功能严重损伤,但启动效应正常。提示右侧脑发育不全患者启动效应与智力测验结果分离。由于启动效应是人类的一种重要的无意识习得能力,因此该研究表明智力发育迟滞者或脑损伤患者仍可能存在较好的无意识习得能力,这对特殊教育和临床脑损伤患者康复有一定的参考价值;同时该研究提示当前智力测验未能反映大脑功能的无意识方面,提出今后的智力测验应包括无意识习得能力的测量。     

协商民主在化解社会矛盾中的价值导向与对策思考

化解社会矛盾是构建和谐社会的重要内容。当前社会矛盾呈现从隐性走向显性,从单一走向叠加,从温和走向对抗的状态,有效化解社会矛盾并做到矛盾不累积、不蔓延、不激化是当前社会建设领域的一个关键性任务。而协商民主倡导理性表达和有序参与,主张通过对话、沟通、协商来凝聚共识,被实践证明是有效化解社会矛盾的一种较好形式。要充分认识协商民主在化解社会矛盾中的价值与作用。要进一步完善相关协商机制、创新协商平台,建立完善协商的法治保障,切实提升公民的协商意识和协商能力,从而提升协商民主在化解社会矛盾中的作用。     

Characteristics of recovery of drawing ability in left and right brain-damaged patients

Drawings of a "person" were obtained from 21 patients with left brain damage (LBD) and 13 patients with right brain damage (RBD) at hospital discharge and 1 month postdischarge, corresponding to 2-4 and 6-8 weeks postonset, respectively. Early LBD drawings were simplistic and often incoherent. Most were placed in the upper left quadrant of the page. RBD drawings were scattered, fragmented, and elaborately detailed. Many showed evidence of left-sided neglect. The resolution of drawing disability also differed between the two groups: LBD subjects recovered drawing abilities more rapidly and more completely than RBD subjects. These differences in drawing characteristics and in the resolution of drawing disability were discernable for experienced neuropsychologists.     

自闭症谱系障碍者面孔识别的神经机制

自闭症谱系障碍（ASD）是一种心理状况的谱系障碍,其症状是社交及沟通上的广泛性异常、异常局限性的兴趣和高度重复性的刻板行为。包括自闭症、亚斯伯格症候群和待分类的广泛性发展障碍3类。研究主要以事件相关电位和功能性磁共振成像两种技术为线索,通过深入分析ASD患者在面孔识别认知过程中脑的异常变化,探讨其面孔识别障碍的神经机制问题。研究表明,ASD患者面孔识别能力的损伤主要与N170、N300、P400和Nc等ERPs成份异常及梭状回面孔区和杏仁核的低激活有关。研究推论ASD患者面孔识别障碍是多个异常脑区联合作用的结果,且主要受异常脑区的数量和损伤程度的影响。     

湖北省智力残疾现状分析及预防对策

以湖北省第二次全国残疾人抽样调查的资料为依据,对智力残疾发生率、智力残疾等级、智力残疾的致残原因等现状进行分析。农村组智力残疾率明显高于城市组;三、四级智力残疾比率明显高于一、二级智力残疾比率;智力残疾的主要致残原因为遗传性疾病和脑疾病。说明智力残疾的康复任务仍很重,需要社会及政府的广泛重视。     

Neuropsychological functioning and social functioning of survivors of pediatric brain tumors: evidence of nonverbal learning disability.

The purpose of the study was to examine if survivors of pediatric brain tumors exhibit a pattern of performance consistent with nonverbal learning disability (NVLD) and to explore the relationship between neuropsychological and social functioning in these children. A comprehensive neuropsychological battery and objective measures of psychosocial function designed to assess NVLD were administered to 15 survivors of brain tumors, ages 8-12 years. Despite the small sample size, a trend for better verbal skills compared to nonverbal skills was found using composite scores. Parents reported significant social deficits and a tendency for greater internalizing behavior problems as expected in NVLD. Additionally, there was a trend for a positive association between nonverbal scores and social function. Further research is needed to determine if the NVLD pattern observed is attributable to white matter damage of the right hemisphere. Routine neuropsychological and psychosocial assessment and intervention are indicated.     

Occult white matter damage contributes to intellectual disability in tuberous sclerosis complex

Whether patients with tuberous sclerosis complex (TSC) have brain normal-appearing white matter (NAWM) damage and whether such damage contributes to their intellectual disability were examined in 15 TSC patients and 15 gender- and age-matched healthy controls using diffusion tensor imaging (DTI). Histogram and region of interest (ROI) analyses of the mean diffusivity (MD) and fractional anisotropy (FA) were performed in the NAWM. Correlations between diffusion indices and the full-scale intelligence quotient (FSIQ) and normalized lesion volume were also investigated. Compared with controls, both histogram and ROI analyses showed significant (P < .05) increased MD and decreased FA in the NAWM of TSC patients. In TSC patients, some of the histogram- and ROI-derived diffusion indices of the NAWM were correlated with FSIQ (P < .01), but none of them were correlated with the normalized lesion volume. These findings indicate that TSC patients have occult damage in the NAWM, which might be an important neural basis for intellectual disability in these patients.     

Weak coherence,no theory of mind,or executive dysfunction? Solving the puzzle of pragmatic language disorders

Deficits in pragmatic language ability are common to a number of clinical populations, for example, right-hemisphere damage (RHD), Autism and traumatic brain injury (TBI). In these individuals the basic structural components of language may be intact, but the ability to use language to engage socially is impaired. Despite the nature of these difficulties being well documented, exactly what causes these difficulties is less clear. Furthermore, the current status of causal explanations for pragmatic difficulties across these populations is divergent and sometimes contradictory. This paper explores the empirical validity of three theories that attempt to explain pragmatic language impairment. It is recommended that a new, more convergent approach to investigating the causes of pragmatic language disability be adopted.     

Violence in deaf and hard-of-hearing people: A review of the literature

The few available studies on the relationship of hearing loss to violence indicate that the prevalence of brain damage, learning disability, communication disorders, educational retardation, unemployment, and underemployment in the deaf and hard-of-hearing population creates frustration which tends to manifest in disproportionate aggression, violence, and hostility. Relative to prevalence, hearing-impaired people are overly represented in the prison population, which is the major datum the literature on violence and hearing loss yields. Other than 12 studies and an American Speech and Hearing Association Committee report documenting the fact, there is an amazing paucity of literature on hearing loss and violence. The reasons for this deficit of information are discussed and ways to remediate the problem are suggested.     

Discrepancy between radiographic damage and functional disability in elderly people with osteoarthritis: the role of pain coping strategies

The aim of this study is twofold. First, to assess the level of agreement between radiographic damage and functional disability in older people with osteoarthritis. And second, to assess the role of coping skills and sensory pain parameters as sources of disagreement between these variables. To achieve this objective we assess, in a sample of 104 older people with osteoarthritis, the following variables: functional capacity, radiographic damage, pain coping strategies, pain intensity, pain frequency and pain duration. The results show a non-linear relationship between radiographic damage and functional disability, modified by the levels of the two variables. There was maximum agreement between low levels of radiographic damage and of functional impairment, whilst agreement decreased for moderate and high levels of radiographic damage. Certain coping strategies may help to explain this disparity.     

Walking and periventricular leukomalacia: locomotor characteristics and brain imaging (MRI)

The aim of the present study was to compare the walking abilities in infants with and without periventricular leukomalacia and to see whether the severity of the brain damage was related to locomotor outcome of the infants at 12 and 18 months. 47 newborns were included in the study based on white matter abnormalities on ultrasound. Magnetic resonance imaging (MRI) recordings during the neonatal period were used to identify and quantify the location and severity of the brain lesions. Locomotor outcome was assessed in terms of disability at 12 and 18 months. The quality of walking, including global and segmental gait parameters, was measured for the infants who could walk independently at 18 months and compared to a group of healthy control infants. The number of children who could walk was related to the extent of white matter abnormalities seen on the neonatal MRI, but the quality of walking was not.     

重型颅脑损伤围术期亚低温治疗路径——循证医学指导下的治疗抉择

早期动物实验研究表明亚低温能减轻脑损伤后的继发性损害,促进神经功能恢复,然而对其临床疗效不同研究结果不完全一致。本文应用循证医学思想,检索和评价国内外文献,为重型颅脑损伤患者制定了围术期亚低温实施方案。随访结果表明,亚低温可改善患者预后。