系统性红斑狼疮的临床决策

系统性红斑狼疮是临床上表现最复杂多变的疾病之一,其诊断、评价、患者教育、治疗及随访工作中既要遵循临床决策的共同法则,又有其特殊之处.减少误诊漏诊、正确看待和应用各种临床指南和病情评价方法以及提高诊疗水平的关键,是应用临床决策学的方法进行综合分析、评价、再分析和再评价,并且要贯穿患者的终生.     

系统性红斑狼疮的临床决策

系统性红斑狼疮是临床上表现最复杂多变的疾病之一,其诊断、评价、患者教育、治疗及随访工作中既要遵循临床决策的共同法则,又有其特殊之处。减少误诊漏诊、正确看待和应用各种临床指南和病情评价方法以及提高诊疗水平的关键,是应用临床决策学的方法进行综合分析、评价、再分析和再评价,并且要贯穿患者的终生。     

系统性红斑狼疮误诊的反思

系统性红斑狼疮是一种极为复杂的自身免疫性疾病,临床表现变化多端,早期误诊率高.对1328例系统性红斑狼疮误诊病例进行分析,剖析了该病的本质及特征,并探讨导致误诊的原因,提出了预防误诊的对策,以期提高对本病的早期诊断.     

系统性红斑狼疮误诊的反思

系统性红斑狼疮是一种极为复杂的自身免疫性疾病,临床表现变化多端,早期误诊率高。对1328例系统性红斑狼疮误诊病例进行分析,剖析了该病的本质及特征,并探讨导致误诊的原因,提出了预防误诊的对策,以期提高对本病的早期诊断。     

Body Image and Sexuality in Women With and Without Systemic Lupus Erythematosus

The purpose of the present study was to investigate relationships among sexual dissatisfaction, body image, and physical and psychological functioning in 54 women with systemic lupus erythematosus (SLE) and a demographically similar comparison sample of 29 healthy women. For women with SLE, sexual dissatisfaction was positively correlated with fatigue, depressive symptoms, and feelings of physical attractiveness. No significant differences existed between women with SLE and healthy women with respect to sexual dissatisfaction or body image. Our results suggest that the impact of disease on body image and sexual dissatisfaction are greatest when levels of fatigue and depressive symptoms are high.     

系统性红斑狼疮的感染现状及治疗决策

系统性红斑狼疮是一种侵及全身结缔组织的自身免疫性疾病,疾病本身就可以导致免疫力下降从而导致感染的发生,然而与此同时,治疗狼疮的药物(糖皮质激素和免疫抑制剂)及新型治疗方法更加大了感染的风险,其间的矛盾不言而喻,因此治疗上药物的取舍与剂量大小的选择显得尤为重要.     

系统性红斑狼疮病因病理与防治的思考

系统性红斑狼疮(SLE)是一种临床表现有多系统损害症状的慢性系统性自身免疫病.虽然对SLE的病因、病理的研究有了较大的进展,但SLE的治疗并不理想,目前仍然有约10%的患者在发病5年内死亡.从哲学角度对SLE的病因、病理与防治中存在的问题进行了综合分析,并为SLE的临床实践和进一步研究提供了思路.     

系统性红斑狼疮的感染现状及治疗决策

系统性红斑狼疮是一种侵及全身结缔组织的自身免疫性疾病,疾病本身就可以导致免疫力下降从而导致感染的发生,然而与此同时,治疗狼疮的药物(糖皮质激素和免疫抑制剂)及新型治疗方法更加大了感染的风险,其间的矛盾不言而喻,因此治疗上药物的取舍与剂量大小的选择显得尤为重要。     

糖皮质激素治疗系统性红斑狼疮中“度”的把握

系统性红斑狼疮是一种与遗传、免疫、种族、环境等因素有关的侵犯多系统结缔组织的全身性自身免疫性疾病。该病多器官受累,症状重且复杂,病情反复缓解和发作,故本病的治疗是一个长期的过程,需要终身治疗。糖皮质激素在系统性红斑狼疮的治疗中为最关键的药物,糖皮质激素的剂量、合理运用及“度”的掌握是治疗疾病成败的关键。     

糖皮质激素治疗系统性红斑狼疮中"度"的把握

系统性红斑狼疮是一种与遗传、免疫、种族、环境等因素有关的侵犯多系统结缔组织的全身性自身免疫性疾病.该病多器官受累,症状重且复杂,病情反复缓解和发作,故本病的治疗是一个长期的过程,需要终身治疗.糖皮质激素在系统性红斑狼疮的治疗中为最关键的药物,糖皮质激素的荆量、合理运用及"度"的掌握是治疗疾病成败的关键.     

认知和情绪冲突的监控与解决：来自轻度认知损伤的证据

轻度认知损伤(mild cognitive impairment, MCI)是介于正常老化和痴呆之间的过渡阶段。近年来, 执行控制的损伤被认为是MCI的核心特征之一。当前, 在MCI执行控制的领域内, 对冲突监控与解决的特征及其神经机制的研究较少。本研究拟通过认知及情绪冲突实验范式, 结合脑成像技术, 探讨遗忘型MCI (amnestic MCI, aMCI)认知和情绪冲突的监控与解决的特征及相应的脑激活模式; 通过对比aMCI和正常老年人在认知和情绪冲突任务中激活的神经环路, 考察aMCI是否在执行加工的神经网络上存在激活异常。在上述研究基础上, 研究者拟探讨aMCI在执行控制的冲突监控与解决上是否存在一般性的损伤机制, 同时试图寻找aMCI在执行控制的冲突监控与解决方面的认知及神经生物学标记。这对深入理解痴呆的发病进程并有针对性的开展痴呆的早期识别与干预具有重要的理论意义和实践意义。     

Lupus Symptoms Inventory (LSI): Development and Validation of a Self-evaluation Inventory of the Subjective Symptoms of Systemic Lupus Erythematosus

The goal of this study was to develop a simple, easy, and quick self-report measure, the Lupus Symptom Inventory (LSI), designed to evaluate subjective symptoms of Systemic Lupus Erythematosus (SLE). The internal consistency of the LSI was tested, as well as its concordance with physician reports and serological indicators of disease activity by evaluating the self-reports of 46 patients with SLE who completed the LSI daily for a one-month period. Throughout this one-month period, parameters of serological activity and routine medical check-up were obtained. The results showed a high internal consistency of the LSI, with a Cronbach alpha of .86. Additionally, a contingency analysis showed agreement between medical report and patient self-report on the same day for six of seven lupus symptoms (difficulty breathing (p < .004), joint pain (p < .001), loss of appetite (p < .003), general malaise (p < .005), fatigue (p < .005), and skin rash (p < .018)) but not for abdominal symptoms. Finally, differences were found between LSI scores of patients with high versus low serological activity (χ²(1) = 5.302; p < .021), with the former presenting higher LSI scores than the latter. These results show that the LSI may be a reliable and valid instrument for evaluating the subjective symptoms of the disease as well as its fluctuations.     

Psychological Factors that Link Socioeconomic Status to Depression/Anxiety in Patients with Systemic Lupus Erythematosus

Our analyses examined whether reserve capacity factors would explain the relationship between socioeconomic status (SES) and symptoms of depression/anxiety in patients with systemic lupus erythematosus (SLE). We assessed disease activity, depression/anxiety symptoms, and intrapersonal and interpersonal reserve capacity measures in 128 patients with SLE. Multiple meditational analyses revealed that intrapersonal and interpersonal psychosocial aspects of reserve capacity fully mediated the relationship between SES and depression/anxiety. Lower SES was indirectly associated with higher symptoms of depression and anxiety through the effects of psychosocial resilience. Interventions aimed at improving modifiable reserve capacity variables, such as self-esteem and optimism, may improve anxious/depressive symptomatology in patients with SLE.     

Automaticity and the Amygdala: Nonconscious Responses to Emotional Faces

The human face is an evolved adaptation for social communication. This implies that humans are genetically prepared to produce facial gestures that are automatically decoded by observers. Psychophysiological data demonstrate that humans respond automatically with their facial muscles, with autonomic responses, and with specific regional brain activation of the amygdala when exposed to emotionally expressive faces. Attention is preferentially and automatically oriented toward facial threat. Neuropsychological data, as well as a rapidly expanding brain-imaging literature, implicate the amygdala as a central structure for responding to negative emotional faces, and particularly to fearful ones. However, the amygdala may not be specialized for processing emotional faces, but may instead respond to faces because they provide important information for the defense appraisal that is its primary responsibility.     

Abnormalities in Anxiety Implications for Cognitive Neuroscience

Experimantal psychopathologists have increasingly relied on the concepts methods of cognitive psychology to elucidate information-processing associated with anxiety disorders. However, research has without reference to how these abnormalities are instantiated in brain. The purpose of this article is to provide a survey of points of between the cognitive and neurobiological perspectives with regard disorders.     

杏仁体与情绪及感觉功能的关系

近来研究表明杏仁体与感觉、情绪和记忆关系密切。对恐惧条件反射的研究发现杏仁体是情绪活动的关键性结构;导致恐惧条件反射的细胞及分子机制研究征实杏仁体具有情绪学习与记忆机能;杏仁体在向中感觉信息的筛选和凋制中具有显著作用和重要意义。本文将综述这方面的进展。     

杏仁核对感觉刺激的情绪性加工:自动化过程和注意调控过程的整合

利用有限的认知资源应对多变的环境刺激,选择性注意和情绪加工一个重要的共同机制是优先化关键信息的加工。尽管情绪性刺激(特别是威胁刺激)能够影响注意资源的分配,但一些关键脑区(如杏仁核)的对情绪性刺激的加工是自动化过程还是受到注意调节一直是个有争议的问题。最新的结合高时间分辨率和高空间分辨率的神经生理记录研究表明,情绪加工的重要核团,杏仁核,对情绪性刺激的加工包含早期快速的不依赖于注意资源和认知加工负荷的自动化加工成分和晚期受到额-顶叶皮层自上而下的注意调控成分,这种功能整合证实杏仁核情绪性加工存在并行的皮层下和皮层通路。     

Verbal and Nonverbal Emotional Memory Following Unilateral Amygdala Damage

The amygdala is involved in the normal facilitation of memory by emotion, but the separate contributions of the left and right amygdala to memory for verbal or nonverbal emotional material have not been investigated. Fourteen patients with damage to the medial temporal lobe including the amygdala (seven left, seven right), 18 brain-damaged, and 36 normal controls were exposed to emotional and neutral pictures accompanied by verbal narratives. Memory for both narratives and pictures was assessed with a free recall test 24 h later. Subjects with left amygdala damage failed to show the normally robust enhancement of memory for verbal and nonverbal emotional stimuli. The group with right amygdala damage showed the normal pattern of facilitation of memory by emotion for both verbal and nonverbal stimuli despite an overall reduction in memory performance. Furthermore, subjects with left amygdala damage were disproportionately impaired on memory for emotional narratives as compared with memory for emotional pictures. The latter finding offers partial support for a lateralized and material-specific pattern of the amygdala's contribution to emotional memory.