原发性醛固酮增多症的临床实践与分析

探讨原发性醛固酮增多症(原醛)临床特点及诊治方面的经验,以早期诊断、根治,改善预后。对确诊的原醛53例临床资料(临床特征、实验室检查、影像学检查、病理类型、治疗情况)进行回顾性研究。男女比为1：1.65,30～49岁年龄段最多。50.9%高血压首发,15.1%低钾血症首发,并发高心痛9.4%,尿毒症1.9%,脑卒中13.2%。肾素-血管紧张素-醛固酮(RAA)系统激素检查,血浆醛固酮/血浆肾素活性比值(ARR)＞200者80.7%,ARR＞400者占半数,血浆醛固酮(PAC)＞140pg/ml者占84.6%。CT及MRI阳性率高。术后病理肾上腺皮质腺瘤占85%,结节性增生占15%(其中原发性肾上腺增生占12.5%)。手术后血压及血钾均较前改善,非手术者口服安体舒通有效。原醛是可治性内分泌性高血压之一,建议高血压和/或低血钾者应常规检查RAA系统激素,并争取行影像学检查,以使原醛得到早期诊治,改善预后。     

孕妇非产科手术麻醉的评估和思考

临床上约有1%~2%的孕妇在孕期接受非产科手术麻醉;因孕期生理改变和手术麻醉对孕妇、胎儿的影响,加之妊娠合并心脏病、糖尿病等特殊病例以及现代腔镜手术、无痛人流特殊技术等复杂因素,为确保孕妇与胎儿安全,术前充分的评估、恰当的麻醉方法、药物选择与术中调控是我们必须重视与思考的课题。     

台湾人工生殖技术管制之回顾与前瞻

台湾地区人工生殖技术的管制先后经历了道德管制和行政管制两个阶段,目前正积极总结各阶段管制模式的成败得失,努力构造《人工生殖法》的原则和框架,以提高人工生殖技术管制的合法性和有效性。     

医学人性化的现实思考

当前,在医学领域尤其是临床医疗领域存在着严重的"人性淡漠"趋势,严重阻碍医学自身的健康发展,而且产生恶劣的社会影响.从医患关系、医学与人性的关系以及医学人性化的需求,深入剖析了医学人性化的重要性.     

Temporal Discounting Mechanisms of Future‐oriented Coping: Evidence from Delay Discounting and Task Prioritization Paradigms

Four studies were conducted to examine the relationship between future‐oriented coping and temporal discounting under different situational conditions. In Study 1, 138 participants were primed with either stressful or neutral stimuli, followed by a delay‐discounting task. In Study 2, 118 participants were primed with either stressful or neutral stimuli, followed by a task‐prioritization activity. The results of both studies indicated that future‐oriented coping had a significant negative association with temporal discounting or the number of rational choices in the neutral‐priming condition, but the relationship was not significant in the stress‐priming condition. In Study 3, qualitative data revealed that the major reason for shifting choices from larger but later payoffs to smaller but sooner rewards in a stressful condition was to reduce the stressful mood, create a positive mood, and promote a sense of accomplishment. This explanation was corroborated by Study 4, in which one group was allowed to choose an immediate payoff and the other group was blocked from choosing that immediate payoff. We confirmed that post‐test anxiety was significantly lower in the immediate payoff group compared with the delayed‐payoff group in proactive and preventive coping, using pre‐test anxiety as a covariate. Preventive coping helped to reduce anxiety levels in a stressful condition only when there was a choice to obtain an immediate payoff. These findings underscore the relationship between future‐oriented coping and temporal discounting, as well as the flexibility of discounting in the face of stress. Copyright © 2015 John Wiley & Sons, Ltd.     

不确定性和预期有效性对运动方向感知决策的影响

环境中的运动刺激往往多变, 更好的方向感知需要同时依赖当前信息和先验信息。然而, 当前刺激的不确定性与先验线索的预期有效性在运动方向感知决策中如何整合尚不清楚。研究采用随机点运动范式, 要求被试判断散点群的整体运动方向, 方向一致的散点为相干点, 其比例越低, 不确定性越高。实验1比较了不同相干点比例下的感知准确度。根据实验1的结果, 选出20%和60%的相干点比例分别对应实验2中散点群的高、低不确定性水平。实验2比较了高、低不确定性和高、低预期有效性(线索正确预测目标的概率)下的感知准确度。结果发现, 随着不确定性的降低和预期有效性的增加, 感知准确度显著提高; 预期效应(高、低有效性下感知准确度的差异)随不确定性的提高而增加。结果表明, 先验信息与感觉信息能在运动方向感知决策中整合。研究为双重控制机制(DMC)理论下主动性与反应性控制协同工作的观点提供了实证支持, 并为交通事故的解释与预防提供了理论依据。     

性激素对人类择偶偏好的影响

择偶是一种重要的心理、社会和文化现象,婚恋择偶除了会受当下社会文化习俗等人文因素的影响,也受到个体生理机制的影响。本文聚焦热点,从进化心理学的角度阐述性激素对人类择偶偏好的影响。女性的择偶偏好受生理周期激素变化的影响,男性的择偶则会因为体内睾酮含量的不同而发生变化。性激素不仅影响人的心理和行为,还会影响人类择偶决策的神经机制。未来的相关研究应关注生理周期的测定方法、被试的文化背景和个体间的差异等。     

群组发展模型——干预研究的新方法

群组发展模型(group-based trajectory model,GBTM)是一种用于研究群体异质性的新方法,旨在识别群体内遵循不同发展轨迹的亚组,并描绘亚组成员特征。这一模型为干预研究提供了新的研究视角,群组发展模型不仅可以探讨干预是否引起分组比例变化,也关注干预对个体的发展轨迹的影响,并评估干预对不同轨迹组的效果差异。     

When pooping babies become more appealing: the effects of nonconscious goal pursuit on experienced emotions

In this report, we argue that the intensity of the emotions people experience is partly determined by the goals they nonconsciously pursue, and that this effect is functional in nature: Emotions are modulated in ways that may increase the probability of goal achievement. To test this hypothesis, we primed female participants with a motherhood goal and then measured their level of disgust in response to mildly disgusting pictures. Priming led to a reduction of disgust in response to goal-relevant stimuli (e.g., pictures of babies with runny noses) but not goal-irrelevant stimuli. This effect was moderated by the women's probability of conception, a proxy of their ability to pursue the motherhood goal.