工作记忆的神经振荡调控：基于神经振荡夹带现象

工作记忆的神经振荡机制研究是当前记忆领域的研究热点之一。那么, 神经振荡仅仅是工作记忆过程的伴随现象, 还是直接参与并调控了工作记忆的加工过程?已有研究发现, 大脑内部的神经振荡活动在外界节律性刺激的驱动下, 逐步与外界刺激节律相位同步化, 这一现象被称为“神经振荡夹带”。重复经颅磁刺激(repetitive Transcranial Magnetic Stimulation, rTMS)和经颅交流电刺激(transcranial Alternating Current Stimulation, tACS)干预研究基于此现象, 对大脑局部脑区施加节律性磁、电刺激, 进而调控工作记忆过程中特定频段的神经振荡活动、跨频段的神经振荡耦合或跨脑区的神经振荡相位同步, 为神经振荡参与工作记忆加工提供较为直接的因果证据。未来研究需考虑从脑网络的角度出发, 调控多个脑区之间的神经振荡活动, 进一步考察神经振荡对工作记忆的影响。此外, 还需注意探索和优化rTMS/tACS调控工作记忆的刺激方案, 并辅以客观的脑电记录, 提高该类研究的有效性和可重复性, 最终达到提高工作记忆能力的目的。     

基于驱动与控制相互作用的成瘾冲动性结构与机制

物质成瘾者具有明显的冲动性特征, 表现为难以戒断的成瘾物质使用。这种行为的产生除了抑制控制的问题外, 源于多个维度的驱动力也是重要的原因。低弱的抑制力无法抵挡驱力的作用, 出现不平衡状态, 形成难以控制的渴求下的强迫性用药或习惯性用药行为倾向。驱动力来源于多方面, 奖赏效应, 通过条件作用形成的S-R式相关线索反应以及感觉寻求等人格特质; 控制成分则包括了反应抑制与无法延迟满足的执行控制功能。     

正念训练对康复期精神分裂症患者抑制控制的影响

探究正念训练对康复期精神分裂症患者正念觉知水平和抑制控制能力的影响。选取54名康复期精神分裂症住院患者随机分为正念组和对照组。对照组予以常规康复治疗,正念组在常规康复治疗基础上进行8周正念训练。结果发现：（1）在正念觉知方面,正念组后测得分显著高于前测,对照组前后测得分无显著差异;正念组后测得分显著高于对照组。（2）在抑制控制方面,正念组后测Stroop任务反应时显著低于前测,对照组前后测反应时无显著差异;正念组后测反应时显著低于对照组。结果表明,正念训练有助于提高康复期精神分裂症患者正念觉知水平和改善其抑制控制能力。     

永嘉学派略论——以叶适为中心

作为儒学的一脉,永嘉学派在漫长的演化过程中形成了其展开的脉络和系统。与宋代主流的理学相对,永嘉学派趋向于以"实"拒"虚"。这里的"实"主要包括两个方面:其一,"以物用而不以己用",即从外部对象出发,而不仅仅根据人的主观想法和意念去行动;其二,注重事功之学和经世致用。与之相联系,永嘉学派主张"事上理会",扬弃"无验于事者"。"事"体现了价值层面的追求。从形而上的层面来看,价值层面的追求在中国文化中往往与"道"相联系,但永嘉学派同时把普遍意义上作为价值原则和价值理想的"道"与人的"日用常行"或日常生活紧密地联系起来。永嘉学派对践行、对人所做的"事"、对"道"与日用常行之间结合的注重,同时关联着另一个引人瞩目的概念,即"势"。进一步看,永嘉学派的"事功之学"与人格完善的这种要求之间,存在内在的逻辑关联:叶适提出的"内外交相成"这一观念,便十分集中地彰显了永嘉学派既注重于外在的事功,又肯定人自身的完善这一特点。     

Therapy with Families in China: Cultural Factors Influencing the Therapeutic Alliance and Therapy Goals

Rapid economic and social development in China is producing opportunities for a better standard of living for many families but also is associated with significant stress. Family therapy is one of the forms of mental health services that have become increasingly available. Western-derived models of family therapy are being used and adapted to meet the cultural traditions and needs of Chinese families. This article describes a variety of Chinese cultural factors that can influence the establishment of therapeutic alliances with family members (communication styles, collectivist values, family roles, and structure) and those that can shape family therapy interventions by addressing contextual factors affecting Chinese families (economic development, migration patterns, academic pressure, and changing gender roles for women). Suggestions are offered for using cultural sensitivity to address these factors tactfully to build strong therapeutic alliances and help families cope with significant life stresses.     

Bartter综合征的研究进展

Bartter综合征（BS）是一种内分泌与肾脏功能紊乱的遗传代谢性疾病,分子遗传学表明为离子通道基因突变所致,各年龄段均可发病,主要见于儿童时期,临床罕见。因为许多临床医师对本痛缺乏认识而易延误诊治。若能及时治疗,可较好地控制病情,改善患儿生活质量,减少后遗症的发生率和病死率。近年来,BS的发病率有逐渐上升趋势。因此,本文对BS的发病机制、临床表现、诊断与治疗的研究现状做一总结,旨在提高临床医师对本病的认识,争取做到早诊断早治疗,改善患儿预后。     

成人肱骨髁间髁上骨折的手术治疗体会

观察经尺骨鹰嘴截骨入路双柱铜板治疗肱骨髁间髁上骨折临床疗效。13例肱骨髁间髁上骨折患者经尺骨鹰嘴截骨入路双柱钢板治疗,结果13例患者获9个月～14个月的随访,末次随访肱骨髁间髁上及尺骨鹰嘴骨折均获得骨性愈合;2例合并尺神经原发损伤经对症处理及神经营养治疗6个月后症状消失,1例患者出现肘关节周围骨化性肌炎,肘关节屈曲僵硬畸形Mayo肘关节功能评分优8例,良3例,可1例,差1例,优良率达84．6％。因此,在肱骨髁间髁上骨折的手术治疗中尺骨鹰嘴截骨入路对于显露骨折断端固定方便可靠,对于促进骨折愈合,肘关节的早期功能锻炼有良好的临床疗效。     

“无主胚胎”的处理方式及其伦理争论

随着辅助生殖技术的不断发展,越来越多暂时不需要进行移植的胚胎存放在生殖医学中心.然而,由于各种伦理争议及社会舆论压力,生殖中心往往会困惑于“无主胚胎”的处理.2013年6月,美国生殖医学协会伦理委员会对“无主胚胎”进行了确切的定义并给出了处理意见和指导原则,结合我国实际国情,从“无主胚胎”定义、“无主胚胎”现状、“无主胚胎”的处理方式及伦理争议、对生殖中心的建议四个方面进行阐述,以求为生殖中心在“无主胚胎”处理方面提供相应帮助.     

骨搬移重建微循环的哲学启示

自前苏联Ilizarov医生发现慢性牵拉后组织再生的“张力 应力法则”至今,骨外固定系统已逐渐完善并形成了一种全新的骨科治疗体系.骨搬移技术对物质发展的根本规律、生物学的基础研究、自然重建理念的形成、多种外科疾病的诊治思路和诊疗方法皆产生了重要影响.本文从医学与哲学的角度,论述了骨搬移技术的发展、对牵拉区域微循环的重建及其中包含的哲学思想,为骨搬移技术治疗骨科及血管外科系统疾病提供了医学与哲学上的思路和方法.     

Local intracortical circuitry not only for feature binding but also for rapid neuronal responses

Neurons of primary sensory cortices are known to have specific responsiveness to elemental features. To express more complex sensory attributes that are embedded in objects or events, the brain must integrate them. This is referred to as feature binding and is reflected in correlated neuronal activity. We investigated how local intracortical circuitry modulates ongoing-spontaneous neuronal activity, which would have a great impact on the processing of subsequent combinatorial input, namely, on the correlating (binding) of relevant features. We simulated a functional, minimal neural network model of primary visual cortex, in which lateral excitatory connections were made in a diffusive manner between cell assemblies that function as orientation columns. A pair of bars oriented at specific angles, expressing a visual corner, was applied to the network. The local intracortical circuitry contributed not only to inducing correlated neuronal activation and thus to binding the paired features but also to making membrane potentials oscillate at firing-subthreshold during an ongoing-spontaneous time period. This led to accelerating the reaction speed of principal cells to the input. If the lateral excitatory connections were selectively (instead of “diffusively”) made, hyperpolarization in ongoing membrane potential occurred and thus the reaction speed was decelerated. We suggest that the local intracortical circuitry with diffusive connections between cell assemblies might endow the network with an ongoing subthreshold neuronal state, by which it can send the information about combinations of elemental features rapidly to higher cortical stages for their full and precise analyses.