文本表述和结构对小学生数学应用题表征的影响

以450名小学生为被试,探讨了文本表述和结构对小学生数学应用题表征成绩的影响。采用2(难度)×2(题材熟悉度)×5(措辞类型)×3(年级)四因素混合设计。结果表明:不同文本表述和结构对小学生解决数学应用题的影响不因年级的不同而不同;概念性措辞问题和情境性措辞问题都促进了小学生数学应用题的表征成绩;在容易问题中,额外信息对表征成绩影响较大;在较难问题中,数学运算关系难度对表征成绩影响较大;当解决文本背景较简单的标准措辞问题时,题材熟悉度对小学生的理解产生较大影响;文本长度对问题解决的影响取决于所增加的文本是否对理解问题的句法关系和语义情景有益。     

Depression in primary Sjögren’s syndrome: a systematic review and meta-analysis

There is substantial uncertainty regarding the prevalence of depression in Primary Sjögren’s syndrome (pSS). We conducted a systematic review aiming to evaluate the association of pSS with depression. PubMed, Web of Science, VIP, CNKI and Wanfang database were searched to find the published literatures (from these databases established to October 2016). Studies were screened according to inclusion and exclusion criteria and the qualities of included studies were evaluated. The data was analyzed using Revman5.2 software. A total of 12 studies including 1917 patients were eligible for inclusion in the systematic review and meta-analysis. In this meta-analysis, Severity of depression was assessed using psychometric measures, such as PHQ-9; HADS; CES-D; Zung depression scale and BDI. The result revealed that pSS was associated with an increased prevalence of depression (summary odds ratio (OR) = 5.36, 95% CI: 4.05–7.09, P < 0.01). The depression score in pSS patients (standardized mean difference (SMD) = 1.47, 95% CI: 0.81–2.12, P < 0.01) were higher than in the control group. Depression is highly prevalent in pSS than in healthy controls. Early recognition and appropriate intervention are therefore essential to reduce the negative impact of depression on the patient’s quality of life and outcome of their disease.     

Systemic lupus erythematosus is associated with negatively variable impacts on domains of sleep disturbances: a systematic review and meta-analysis

Sleep disturbances are common in systemic lupus erythematosus (SLE), but the features of sleep disturbances are not well understood. The aim of this study was to identify the impact of SLE on specific sleep quality domains and to determine its prevalence and associations. We performed a systematic review and meta-analysis to compare the sleep outcomes of individuals with SLE and healthy controls. PubMed, MEDLINE, EMBASE, Cochrane Library, Web of Science CNKI, VIP, CNKI and Wanfang database were searched to find the published literatures (from these databases established to May 2017). Studies were screened according to inclusion and exclusion criteria and the qualities of included studies were evaluated. The data was analyzed using Revman5.3 software. Score of the Pittsburgh Sleep Quality Index (PSQI) scoring system was used as the outcome measurement, and mean differences (MD) with 95% confidence intervals (CI) were calculated. Five studies were included, including 350 SLE and 1396 healthy controls. A total of 5 studies including 827 patients were eligible for inclusion in the systematic review and meta-analysis. In this meta-analysis, each domain of the PSQI score: subjective sleep quality (MD, .58; 95% CI, .26, .89), sleep latency(MD, .47; 95% CI, .21, .73), sleep duration (MD, .36; 95% CI, .13, .58), habitual sleep efficiency (MD, .58; 95% CI, .32, .84),sleep disorders (MD, .56; 95% CI, .34, .77), use of sleep medication (MD, .56; 95% CI, .33, .80), daytime dysfunction (MD, .57; 95% CI, .11, 1.04) and the global score (MD, 3.59; 95% CI, 1.37, 5.80) were higher in SLE women than healthy controls. Furthermore, subjective sleep quality and habitual sleep efficiency were most severely affected especially. It demonstrated that targeted interventions should be done to improve their sleep quality. Early recognition and appropriate intervention are essential to reduce the negative impact of sleep disturbances on the patient’s sleep quality and outcome of their disease.     

视觉词形加工：从脑区到神经通路

视觉词形加工是阅读机制中的重要环节。基于获得性阅读障碍的早期阅读“神经病学模型”对视觉词形加工的神经通路进行了描述。近年来,随着脑功能成像技术的发展和左梭状回中部视觉词形区的发现,研究者们对原有视觉词形加工的神经通路加以补充和修订,并提出了新的模型。该文对视觉词形加工障碍患者的神经心理学研究和正常人视觉词形加工的脑功能成像研究进行了总结,并讨论了研究的局限性,对今后该领域的发展方向进行展望     

戚继光对孙膑军队建设思想的继承和发展

戚继光对孙膑军队建设思想的继承和发展主要表现在三个方面.在练将方面,戚继光不仅继承和发展了孙膑的将领优良论,而且详细论述了孙膑所未提及的练将方法;在练兵方面,戚继光不仅继承和发展了孙膑的选兵理论和练士气理论,而且具体论述了如何训练号令、阵法和武艺等问题,这是对孙膑练兵思想的发展;在治军诸因素关系方面,戚继光在继承孙膑思想的基础上,科学地提出了自己的独到见解,从而使其军队建设思想形成了一个系统而完整的体系.     

认知负荷理论在临床诊疗中的应用探讨

认知负荷理论是近年来迅速发展起来的用于解释认知资源分配的心理学理论。临床诊疗工作本质上是医生对患者的病情信息认知加工并进行决策的过程。医生的认知负荷情况决定着医生认知加工的效率,认知加工效率决定了医生的工作效率。提高医生的认知加工效率可以通过对诊疗任务分配的调整,使诊疗任务产生的内在认知负荷与医生所能承受的认知负荷相适应,减少外在认知负荷,增加相关认知负荷三个方面来实现,从而可以提高诊疗的质量和效率,引导医生认知资源的合理分配。     

面孔生命性加工的时间进程：ERP研究

本研究采用事件相关电位技术,通过参数设计考察了大脑加工面孔生命性时的神经电活动动态进程。结果显示：非生命性面孔比生命性面孔在中央顶区诱发了更大的LPP波幅;生命性和非生命性面孔诱发的LPP波幅均显著大于中间等级（60%）面孔,提示随生命性信息增强,LPP波幅呈“U”型变化。P1和N170未表现出面孔类别差异。结果表明LPP是探测面孔生命性加工的有效成分,支持面孔生命性加工位于面孔加工的晚期阶段的观点。     

对几种临床定势思维的思考

思维定势有权威定势、从众定势、经验定势、唯书本定势、情感定势。思维定势制约我们创新思想的发展,要更好实践临床工作,必须客观评价各种思维定势,主动进行创新思维训练。本文分别对各种思维定势在临床工作中的体现、优劣进行表述,并举例说明。     

胰岛再生治疗的前景

胰岛β细胞数量减少和功能障碍是糖尿病的根本原因,现有的治疗手段主要以维持正常血糖水平为主要目的,尚无有效恢复受损胰岛功能的治愈性治疗手段。胰岛再生治疗将是一种可以恢复受损胰岛功能、改变糖尿病自然病程的崭新治疗手段。目前现有的噻唑烷二酮、肠促胰岛素及类似物、二肽基肽酶-4抑制剂等治疗,虽然不是一类新的胰岛再生药物,但其具有一定的促进胰岛再生、改善胰岛功能的作用。体外诱导β细胞再生也将为胰岛移植提供新的来源,为治愈糖尿病带来曙光。     

急诊PCI术前大剂量瑞舒伐他汀治疗对冠状动脉血流的影响

探讨PCI术前给予大剂量瑞舒伐他汀对急性ST段抬高型心肌梗死患者冠脉血流的影响.入选2010年1月至2011年6月因急性ST段抬高型心肌梗死于大连医科大学附属第二医院行急诊PCI术的患者120例.随机分为试验组,即术前给予瑞舒伐他汀20mg口服,及对照组,即术前不给予瑞舒伐他汀口服.通过TIMI帧数法比较冠脉血流情况.结果两组患者临床特点、罪犯血管、疼痛到球囊扩张时间、多支病变比例、支架类型及大小均无统计学差异.术后TIMI3级血流的比例虽无统计学差异,但试验组比对照组有增加趋势(93.5％比89.7％).PCI术后试验组与对照组相比校正TI-MI帧数明显减低(26.2±11.52比34.3士18.11),数据比较有统计学差异.急诊PCI术前给予大剂量瑞舒伐他汀对于改善急性ST段抬高型心肌梗死患者术后的冠状动脉血流是有益的.