甲亢合并急性冠脉综合征的临床及冠脉特点研究

探讨甲亢合并急性冠脉综合征（ACS）患者的临床及冠状动脉病变特点.选取2010年1月至2013年6月于我院住院诊断的甲亢合并ACS患者（甲亢组）64例及甲状腺功能正常的ACS患者（对照组）56例,分析其临床及冠脉病变特点.甲亢组静息性心绞痛、高血压、糖尿病的发生率,纤维蛋白原（FIB）、氨基末端B型利钠肽前体（NT-proBNP）水平、零病变及冠状动脉痉挛比例明显高于对照组（P＜0.05）,低密度脂蛋白胆固醇（LDL-C）、总胆固醇（TC）水平明显低于对照组（P＜0.05）.甲亢合并ACS患者常发生静息性心绞痛,冠心病危险因素与甲状腺功能正常患者有所不同,零病变及冠脉痉挛比例高,冠状动脉痉挛可能是其发生急性心肌缺血的重要机制.     

神经营养素3在小儿哮喘中表达的临床意义

神经营养素3（NT-3）参与了神经系统的发育和功能发挥.最近研究发现它在呼吸系统疾病,尤其是哮喘的发病中也发挥重要作用.本课题采用酶联免疫吸附实验（ELISA）检测哮喘各组和正常对照组血清中NT-3的表达水平;用NT-3体外刺激正常人外周血单核细胞（PBMC）,采用ELISA法检测培养上清中IL-6和TNFα的表达水平.结果显示,与对照组相比,在哮喘组血清中NT-3的表达水平明显增高;并且它在哮喘发作期和缓解期中的表达量也要高于正常组;另外,NT-3可以显著促进PBMC分泌IL-6和TNFα.以上结果提示,可以将NT-3在小儿哮喘患者血清中的表达水平作为诊断病变过程的标记物,并且NT-3在维持气道高反应性方面也起到一定作用.     

老年糖代谢异常患者血浆NT—proBNP与血管内皮功能早期监测意义

通过检测老年糖代谢异常患者的血浆N末端血清脑钠肽前体（NT—proBNP）水平与肱动脉血管内皮依赖性舒张功能（FMD）,探讨其早期监测意义。共77例观察对象,其中12例血糖正常的健康老人为对照组,65例老年糖代谢异常组患者根据空腹血糖（FBG）和糖耐量2小时（0GTT2h）血糖水平分为空腹血糖受损组（IFG）14例、糖耐量受损组（IGT）23例和2型糖尿病组（DM）28例。各组均检测血浆NT—proBNP水平和无创超声监测FMD。随着血糖代谢异常程度加重,比较正常组,糖代谢异常组的血浆NT—proBNP水平升高（P〈0．01）,FMD调节下降（P〈0．01）;糖代谢异常发展过程中,IFG阶段FMD即出现舒张失调（P〈0．05）;IGT阶段血浆NT-proBNP水平升高有意义并达到无症状心衰诊断标准（P〈0．01）,且FMD出现舒张过度调节,提示收缩和舒张功能双向调节不良。空腹血糖升高增加血管内皮依赖性舒张功能损害,当FBG合并（或）餐后血糖升高,血浆NT—proBNP水平升高可以成为早期预测慢性无症状心功能不全的危险因素。因此,关注老年糖代谢异常早期阶段进程,并联合血浆NT—proBNP水平和血管内皮依赖性舒张功能监测,不仅对靶器官保护具有早期预警意义,而且是临床控制血糖管理的重要而简易的方法之一。     

p27和Cyclin E在子宫内膜腺癌中的表达及相关性分析

探讨p27和cyclinE蛋白表达在子宫内膜腺癌的发生、发展中的关系。采用免疫组织化学sP法,测定20例正常子宫内膜、10例不典型增生、40例内膜腺癌中p27、cyclin E蛋白的表达情况。p27蛋白在正常子宫内膜与内膜腺癌的阳性表达比较差异有显著性（P〈0．05）;cyclinE蛋白在正常子宫内膜与不典型增生及子宫内膜腺癌的表达相比较差异均有显著性（P〈0．05）。在子宫内膜腺癌中p27阳性表达率与cyclin E阳性表达率之间存在反向关系。     

恐惧的代价：疼痛恐惧、心理忧虑和躯体化对疼痛感知预测作用的比较

首次在无痛群体中比较疼痛恐惧、心理忧虑和躯体化对疼痛感知的预测作用大小及调节和中介关系。以多个同类量表得分的Z分数加和作为三者的因子分,以冷压痛觉测验（CPT）疼痛指标（阈限、耐受性、强度、不愉快度）为目标变量,通过分层回归及调节和中介作用分析,发现疼痛恐惧对疼痛不愉快度的预测作用最强,心理忧虑对疼痛体验（强度、不愉快度）的预测作用被疼痛恐惧完全中介,躯体化只有在高疼痛恐惧条件下才显著负向预测疼痛不愉快度。综上,疼痛恐惧是三因素中预测CPT疼痛体验的主要因素。     

p27和Cyclin E在子宫内膜腺癌中的表达及相关性分析

探讨p27和cyclinE蛋白表达在子宫内膜腺癌的发生、发展中的关系。采用免疫组织化学sP法，测定20例正常子宫内膜、10例不典型增生、40例内膜腺癌中p27、cyclin E蛋白的表达情况。p27蛋白在正常子宫内膜与内膜腺癌的阳性表达比较差异有显著性（P〈0．05）；cyclinE蛋白在正常子宫内膜与不典型增生及子宫内膜腺癌的表达相比较差异均有显著性（P〈0．05）。在子宫内膜腺癌中p27阳性表达率与cyclin E阳性表达率之间存在反向关系。     

急性前壁心肌梗死患者直接PCI后阿托伐他汀不同用药剂量疗效比较

为探讨直接经皮冠状动脉介入治疗（PCI）首次急性前壁心肌梗死患者,在不同剂量他汀药物治疗后住院期间疗效比较,纳入首次诊断为急性前壁心肌梗死并接受直接PCI治疗的患者140例,随机分为强化治疗组和对照组。强化治疗组入院时顿服阿托伐他汀80mg,术后40mg／晚,直至出院;对照组口服阿托伐他汀20mg／晚。术前及术后、出院前测定心肌标记物,术前及出院前测定血浆氨基末端B型利钠肽前体（NT—proBNP）,采用彩色多普勒超声检测左室射血分数（LVEF）的变化,同时记录住院期间主要心脏不良事件（MACEs）的发生。结果出院时LVEF值差异无统计学意义（P=0．249）,NT—proBNP出院前较术前升高,对照组升高显著（P=0．000）。组间比较NT—proBNP,对照组显著高于强化组（P=0．020）。住院期间两组患者无MACEs发生。首次急性前壁心肌梗死患者直接PCI后,强化阿托伐他汀治疗短期内可改善左心功能。     

儿童注意力检测单片机的研制及动态分析指标的试用

儿童注意力的测量途径包括家长或教师评定法、行为观察法、生理检测法及实验室测量法等。在实验室测量法中,持续性操作测试（CPT技术）是主要的测量范式。传统的CPT技术主要应用漏报率和误报率作为评价指标。但是,由于注意不是静态的,而是一个高度动态和波动的过程,漏报率和误报率还不足以反映注意状态的动态变化。近年来的国外研究发现,把注意作为一个动态的现时过程来评估,以儿童在作业中反应状态的波动情况作为新的指标能提供更有价值的信息。本研究以此为依据,开发研制了基于CPT技术的儿童注意力检测单片机SCM-CPT测试仪,在测试结果处理上采用了新的动态分析指标,在98名普通小学生中进行了试用,并为新指标建立了参考性评价标准。     

原发性骨肉瘤中EGFR和C—erbB-2的表达及其意义

检测20例原发性骨肉瘤和10例骨纤维结构不良中EGFR和C-erbB-2的表达;两者在骨肉瘤中表达的阳性率分别为50%和40%（P＜0.05）,而在骨纤维结构不良中分别为10%和0%（P＜0.05）;骨肉瘤中EGFR和C-erbB-2表达均高于骨纤维结构不良,且呈正相关,这为骨肉瘤的诊疗提供了理论依据。     

胰岛素样生长因子结合蛋白3mRNA在肾癌中的表达

为探讨胰岛素样生长因子结合蛋白3（IGFBP-3）mRNA在肾癌（RCC）中的表达,采用半定量RT-PCR方法进行检测,检测56例RCC组织标本及56例癌旁组织标本中IGFBP-3的表达。结果显示RCC与癌旁组织之间IGFBP-3表达差异有显著性（P〈0.05）,IGFBP-3在透明细胞癌的强阳性表达,高于其他病理类型（P均〈0.05）,并与病理分级相关。因此,IGFBP-3在RCC组织中的表达具有显著性,其在肾透明细胞癌中的强阳性表达具有特异性。     

Acute exposure to stress improves performance in trace eyeblink conditioning and spatial learning tasks in healthy men

The present study investigated the effects of acute stress exposure on learning performance in humans using analogs of two paradigms frequently used in animals. Healthy male participants were exposed to the cold pressor test (CPT) procedure, i.e., insertion of the dominant hand into ice water for 60 sec. Following the CPT or the control procedure, participants completed a trace eyeblink conditioning task followed by a virtual navigation Morris water task (VNMWT). Hypothalamic-pituitary-adrenocortical (HPA) axis and sympathetic autonomic system (SAS) activity were assessed by measuring salivary cortisol, heart rate, and skin conductance at selected timepoints. Results revealed positive effects of stress on performance in both tasks. The stress group showed significantly more conditioned blinks than the control group during acquisition of trace eyeblink conditioning. The stress group also performed significantly better in the VNMWT than the control group, with the former showing significantly fewer failures to locate the hidden platform in the allotted time and smaller heading errors than the latter. Regression analyses revealed positive relationships between HPA axis and SAS activity during stress and eyeblink conditioning performance. Our results directly extend findings from animal studies and suggest potential physiological mechanisms underlying stress and learning.     

Facial expressions are more easily produced on the upper-lower compared to the right-left hemiface

Clinical research has concentrated on differences in intensity of expression between the right and left hemiface as a means to assess hemispheric differences in motor control. However, observations by social psychologists suggest that control of facial expression may be organized predominantly across the upper-lower hemiface because during social interactions individuals may produce brief facial blends of emotions, in which the upper and lower face display a different emotion. Full facial versus upper/lower and right/left facial blends of emotion were posed by 20 subjects, 10 men and 10 women ranging in age from 20 to 37 years. The subjects rated the difficulty of each pose on a 5-point Likert scale. Digital photographs of the poses were taken and the full and half-facial poses were shown in random order to four judges who indicated what pose was being performed. The results were very robust and confirmed that facial blends of emotion are more easily and accurately posed on the upper-lower than on the right-left hemiface. Our results are consistent with recent anatomical studies showing separate cortical areas for motor control of the upper versus lower face in primates. Based on recent research exploring hemispheric differences in perceiving facial blends of emotion, the left hemisphere may be more involved with modulating lower facial expressions and the right hemisphere more involved with modulating upper facial expressions.     

High effortful control is associated with reduced emotional expressiveness in young children

The current study tested the claim that trait effortful control (EC), the ability to suppress a dominant response to perform a subdominant response, is associated with children’s emotion expression. Participants were 206 community children between the ages of 3 and 7 years. Children completed a battery of 10 laboratory tasks to assess temperamental differences in EC, as well as positive and negative emotionality. We report on bivariate associations between laboratory-assessed and parent-reported EC and laboratory-assessed emotions of different valences and intensity levels. Children coded as high in lab-assessed EC exhibited fewer total emotional expressions (positive and negative emotions), and engaged in lower intensity expressions than children lower in EC. Parent-reported EC measures were weakly associated with laboratory measures of emotion.     

Psychotherapeutic Interventions for Symptom Reduction in Veterans With PTSD: An Observational Study in a Residential Clinical Setting

Cognitive processing therapy (CPT) and eye movement desensitization and reprocessing (EMDR) therapy were compared for veterans in a posttraumatic stress disorder (PTSD) residential program (N = 51) who received individual EMDR and group CPT, individual CPT and group CPT, or trauma group exposure (TGE) therapy. Analyses revealed an overall significant difference on posttest measures of the PTSD Checklist for individual EMDR/group CPT and individual CPT/group CPT when compared to TGE, with no significant difference found between EMDR and CPT. Depression scores were significantly decreased between pre- and posttest for patients who received individual EMDR/group CPT. Results support EMDR and CPT as clinically effective and complementary treatments in residential PTSD treatment programs.     

A meta-analytic review of cognitive processing therapy for adults with posttraumatic stress disorder

Numerous studies have demonstrated the efficacy of cognitive processing therapy (CPT) for treating posttraumatic stress disorder (PTSD). Two prior meta-analyses of studies are available but used approaches that limit conclusions that can be drawn regarding the impact of CPT on PTSD outcomes. The current meta-analysis reviewed outcomes of trials that tested the efficacy of CPT for PTSD in adults and evaluated potential moderators of outcomes. All published trials comparing CPT against an inactive control condition (i.e. psychological placebo or wait-list) or other active treatment for PTSD in adults were included, resulting in 11 studies with a total of 1130 participants. CPT outperformed inactive control conditions on PTSD outcome measures at posttreatment (mean Hedges’ g = 1.24) and follow-up (mean Hedges’ g = 0.90). The average CPT-treated participant fared better than 89% of those in inactive control conditions at posttreatment and 82% at follow-up. Results also showed that CPT outperformed inactive control conditions on non-PTSD outcome measures at posttreatment and follow-up and that CPT outperformed other active treatments at posttreatment but not at follow-up. Effect sizes of CPT on PTSD symptoms were not significantly moderated by participant age, number of treatment sessions, total sample size, length of follow-up, or group versus individual treatment; but, older studies had larger effect sizes and percent female sex moderated the effect of CPT on non-PTSD outcomes. These meta-analytic findings indicate that CPT is an effective PTSD treatment with lasting benefits across a range of outcomes.     

A study of the effects of cranial electrical stimulation on attention and concentration.

There have been several anecdotal accounts that cranial electrical stimulation (CES) enhances attention and the ability to learn new tasks in a normal population, but only one published investigation confirms that CES improves attention using the Alpha Stim CES (Madden and Kirsch, 1987). The purpose of this study was to corroborate the findings of Madden and Kirsch, using more precise measures of attention, such as a Continuous Performance Test (CPT). A pretest and posttest CPT was given to two groups using the LISS CES device. The control group consisted of twenty-one subjects who received the placebo treatment. The experimental group of thirty-one subjects received twenty minutes of CES. Four measures of the CPT show significant gains in attention: Number of Hits, p =.010 Hit RT ISI Change, p =.016, Risk Taking, p =.055; and Attentiveness, p =.054. Based on subjects who demonstrated improvement by one standard deviation on two different measures of the CPT, thirty-one percent of the experimental group improved versus four percent of the control group. The use of CES as a method of increasing attention is a promising area that requires further investigation.     

Mapping emotion category boundaries using a visual expectation paradigm

Past research showing categorical perception of emotional facial expressions has relied on identification and discrimination tasks that require an explicit response via keypress. Here we report a new paradigm for investigating the category boundary of emotional facial expressions that, instead, relies on an implicit response--eye direction. Participants were trained to expect a target stimulus on a particular side of the monitor, predicted by an emotional expression on a face image. An eye-tracker then recorded eye movements of participants as they viewed novel intermediate facial-expression stimuli. Anticipatory eye movement was taken as evidence of categorisation. Results from two experiments suggest that this implicit method can be used to determine category boundaries, and that the boundaries found with this method are similar to those found with the keypress response.     

Children's ability to control the facial expression of laughter and smiling: Knowledge and behaviour

A total of 64 children, aged 7 and 10, watched a clown performing three sketches rated as very funny by the children. Two experimental conditions were created by asking half of the participants to suppress their laughter. Facial expressions were videotaped and analysed with FACS. For both ages, the results show a significant shorter duration (but not a lower frequency) of episodes of laughter and Duchenne smiles, and greater frequency of facial control movements in the suppression compared to the free expression group. The detailed results on individual facial action units used to control amusement expressions suggest hypotheses on the nature of the underlying processes. The participants' explicit knowledge of their control strategies was assessed through standardised interviews. Although behavioural control strategies were reported equally frequently by the two age groups, 10-year-olds verbalised more mental control strategies than 7-year-olds. This theoretically expected difference was not related to the actual ability to control facial expression. This result challenges the commonly held assumption that explicit knowledge of control strategies results in a greater ability to execute such control in ongoing social interactions.     

Executive Functioning, Temporal Discounting, and Sense of Time in Adolescents with Attention Deficit Hyperactivity Disorder (ADHD) and Oppositional Defiant Disorder (ODD)

Clinic-referred teens (ages 12–19) with ADHD and ODD (N = 101) were compared to community control (CC) teens, equated for age and sex, (N = 39) on a variety of psychological tasks assessing executive functioning (EF), temporal reward discounting, and time estimation and reproduction. A factor analysis reduced the EF measures to three dimensions, representing CPT Inattention, Working Memory, and CPT Inhibition. Results indicated that the ADHD group had significantly more CPT Inattention than the CC group. No differences were found for Working Memory or CPT Inhibition. The ADHD group displayed significantly greater temporal discounting of delayed hypothetical monetary rewards relative to immediate ones and manifested more impaired time reproduction, but not time estimation, than did the CC group. Main effects for level of IQ were found only on the Working Memory factor and largely did not interact with the group factor otherwise. The group differences in CPT Inattention, temporal discounting, and time reproduction were not a function of level of comorbid oppositional defiant disorder, delinquency, or anxiety–depression. Results are reasonably consistent with past research on EF and sense of time in children with ADHD and extend these findings to the adolescent age group. Problems with working memory and CPT inhibition found in prior studies of children with ADHD, however, were not evident here, perhaps owing to age-related improvements or insufficient task difficulty.     

Maternal self-efficacy, knowledge of infant development, sensory sensitivity, and maternal response during interaction

When their infants were 6 months of age, mothers were assessed for self-efficacy (low, moderate, and high illusory control) and knowledge of infant development to determine their impact on mothers' behavioral sensitivity and affect during a feeding task at 9 months (N=70). Mothers' sensory sensitivity to digital images of infants' negative and positive expressions assessed in a signal detection task at 6 months was hypothesized to mediate this relation. Mothers with moderate illusory control exhibited greatest behavioral sensitivity and positive affect. Low knowledge was associated with reduced sensitivity for mothers with low illusory control only. When viewing the negative expression, mothers with moderate illusory control and high knowledge exhibited greatest sensory sensitivity, and mothers with high illusory control and moderate/high knowledge were least sensitive. Although sensory sensitivity was not a mediating variable, its relation to both illusory control and subsequent maternal measures during feeding was informative. Although greater sensory sensitivity predicted more sensitive behavior and more positive affect, only for maternal affect was the relation independent of illusion of control effects.