高血压脑出血微创治疗及手术时机的决策探讨

为了比较幕上高血压脑出血传统开颅与微创治疗的效果及其并发症,并对其手术时机进行探讨,对30例传统开颅组和104例微创治疗组进行对比研究.结果显示,术后6个月微创治疗组致残率及肺部感染发生率较传统开颅组明显为低(P<0.05);早期(8h～24h)手术死亡率较超早期(<8h)明显为低(P<0.05).因此,微创治疗能够有效降低高血压脑出血患者的致残率和术后并发症的发生率,其手术时机适宜选择在早期.     

重症感染非抗感染措施的思考

近年来严重感染与感染性休克治疗策略的主要进展是对强化血糖控制、糖皮质激素等疗法的再评价。同时,也出现了诸如血管加压素、他汀类药物、选择性口腔/肠道脱污染等新的治疗措施,并取得了一定成果。本文对相关研究进展进行综述,以阐明集束化策略和管理水平的提高可能是最终降低重症感染病死率的关键。     

医患沟通技能的培养及意义

医疗过程不应被看作是单一的技术过程,需要关注医学技术以外的诸多因素,医患沟通就是其中一个很重要的方面.讨论了培养医患沟通技能的意义在于增加病人满意度、提高依从性、提高临床疗效与工作效率、减少纠纷等,并介绍了医患沟通过程中的主要技巧,以期对临床医患沟通教育起到积极作用.     

孔、孟所论“圣人”异同考

孔子心目中的"圣人"要求德、位兼备,而在孟子那里则更加注重于对德的要求。孟子所论"圣人"与孔子有所不同,可以说是孟子因应了从"犹秉周礼"至"杀人盈城"这一现实的形势、因应了"距杨墨"这一思想层面的形势以及为更加便于教化等因素影响而造成的。于孔子、孟子之间,从郭店楚简《五行》篇"德之行"五与"行"四等论述看,其中就已有了突出"圣"之德性的趋势。     

白玉蟾融通三教之内丹性命思想论析

金丹派南宗第五祖白玉蟾以丹论名著于世,融通三教是其内丹性命思想的最突出特征之一。他援儒入道,摄禅融老,强调炼形以养神、明心见性以合道,究其实质是欲以道为本,融合三教思想于一炉,锻造出更为成熟圆融的内丹性命论。故其丹学呈现出圆熟、简要、通俗等特点,对后学影响深远,并对于南宗内丹学的实践与传播,以及南宗教派的发展壮大具有重要意义。     

中国文化价值观和未来时间取向对幸福感的影响

幸福感是个体根据自定的标准对其生活质量的整体性评估。本研究探讨了中国文化价值观对大学生幸福感的影响,并揭示了时间取向在中国文化价值观和幸福感间的中介作用。结果表明,中国文化价值观可分为刻苦上进、自然知足、重视家庭、谦逊克己、团结和谐、正义利他、服从权威和中庸守序等八个维度;自然知足、正义利他和谦逊克己与幸福感显著正相关,并通过未来取向的中介作用影响幸福感体验。     

Intrapersonal and Ecodevelopmental Factors Associated with Smoking in Hispanic Adolescents

We examined how relationships among intrapersonal (i.e., attitudes and beliefs about smoking) and ecodevelopmental (i.e., family, school, and peer) factors influence risk for lifetime smoking in immigrant Hispanic adolescents. Our sample was comprised of 223 immigrant Hispanic adolescents and their families and was drawn from 3 middle schools in a single school district. Data collected is a result of adolescent and parent completed questionnaires as well as county school data (i.e., GPA, teacher reported effort and conduct, absences). Results indicated only poor school functioning, peer smoking, and lack of perceived harm concerning smoking were directly related to adolescent lifetime smoking. Poor school functioning and peer smoking mediated the relationship between family functioning and adolescent smoking. Implications of these results for the design of smoking preventive interventions for immigrant Hispanic adolescents are discussed.     

儿童注意缺陷多动障碍(ADHD)的“冷”“热”执行功能

近30多年来,对注意缺陷多动障碍(ADHD)的认知缺损机制的关注一直停留在"冷"执行功能领域,为更全面地揭示其执行缺损机制,文章旨在从"冷""热"执行功能的角度来探讨ADHD的缺陷。论文简要回顾了注意缺陷多动障碍的界定、生理基础和若干理论模型,着重阐述ADHD儿童在经典"冷""热"两类执行功能任务上的表现差异。总结认为ADHD儿童并非在所有类型的"热"执行任务上表现落后,ADHD儿童的表现要视情感和动机的卷入对不同任务情景的作用性质是消极还是积极而定,文章也比较分析了几位研究者相关的理论解释。     

自我同一性研究的新模型——双环模型

自Erikson提出自我同一性的概念以来,它一直是发展心理学的重要课题,这方面的实证研究主要基于Marcia提出的同一性状态模型。随后的研究者Luyckx等人不断整合和改进状态模型,并结合自我关注领域对反思型自我关注和沉浸型自我关注的区分,提出了双环模型的理论。双环模型理论认为,广度探索、深度探索、沉浸探索、做出承诺和认同承诺五个维度构成了自我同一性形成和发展的两个环——"承诺形成环"和"承诺评价环",两个环之间不断地发生着动态的交互作用,其结果造成了自我同一性形成和发展的6种状态:达成,早闭,沉浸延缓,轻松混淆,扩散混淆和未分化。     

Adult Attachment,Dependence, Self‐Criticism,and Depressive Symptoms: A Test of a Mediational Model

ABSTRACT Attachment anxiety is expected to be positively associated with dependence and self‐criticism. However, attachment avoidance is expected to be negatively associated with dependence but positively associated with self‐criticism. Both dependence and self‐criticism are expected to be related to depressive symptoms. Data were analyzed from 424 undergraduate participants at a large Midwestern university, using structural equation modeling. Results indicated that the relation between attachment anxiety and depressive symptoms was fully mediated by dependence and self‐criticism, whereas the relation between attachment avoidance and depressive symptoms was partially mediated by dependence and self‐criticism. Moreover, through a multiple‐group comparison analysis, the results indicated that men with high levels of attachment avoidance are more likely than women to be self‐critical.