乙型肝炎病毒相关性肾炎抗病毒治疗进展

乙型肝炎病毒（HBV）相关性肾炎是与HBV感染相关的肾脏疾病,病理类型多为膜性肾病、膜增殖性肾小球肾炎等,临床表现常为肾病综合征或大量蛋白尿。由于发病机理尚不清楚,既往多采用激素等免疫抑制剂治疗,但临床效果不理想。由于该病和HBV感染有关,随着抗病毒药物治疗慢性乙型肝炎病毒感染取得较好疗效,已有研究应用干扰素、拉米夫定...     

气道管理与呼吸机相关性肺炎防治策略

气道管理是机械通气过程中的关键技术,人工气道管理各个环节的处理,关系到机械通气的顺利进行,对呼吸机相关性肺炎(VAP)有不同程度的直接或间接的影响。气道管理的策略应该注重局部和整体的关系,在全身调整的基础上细致地管理气道的各个环节,体现气道管理的艺术。本文结合最新的临床研究证据阐明气道管理与VAP防治的策略。     

Involuntary Rotations of a Steering Device Induced by Voluntary Rotations of the Head and Maintained Eccentric Head Positions

In a series of 4 experiments, the authors examined involuntary rotations of a steering device (handlebar or wheel) that were associated with periodic head rotations and eccentric head positions. Periodic head rotations resulted in isodirectional involuntary rotations of a horizontally arranged steering device of very small amplitude. When the orientation of a steering wheel was changed to vertical and to a backward tilt, the involuntary rotations were in the opposite direction. That pattern of results is consistent with the assumption that small movements of the shoulder girdle, which are associated with head turns and which cannot be prevented by mechanical immobilization of the shoulder, are propagated to the wheel, but is not consistent with previous suggestions that involuntary rotations of a steering device can result from the action of the tonic neck reflex. Effects that correspond to the pattern of the tonic neck reflex were found only when a spring-centered handlebar was held in an eccentric position; maintenance of the eccentric position was facilitated when the participant's head was turned in the opposite direction. The findings strongly suggest that head movements can result in involuntary movements of a steering device via different mechanisms.     

我国乙肝抗病毒治疗现状与思考

针对目前乙肝的抗病毒治疗现状以及临床用药的情况,对目前乙肝抗病毒治疗中存在的问题进行思考,就如何选择治疗方法提出医疗原则,认为治疗应该体现安全、有效、经济的原则。     

The paired associate learning task: Is it an externally valid instrument for assessing methylphenidate response in children with attention deficit disorder?

The Paired Associate Learning Task (PAL-T) is a laboratory-based instrument commonly used for assessing psychostimulant response (and specifically cognitive nonresponse or toxicity) in children with Attention Deficit Disorder/Hyperactivity (ADDH). The present study examined the PAL-T's sensitivity in detecting overall and between-dose methylphenidate (MPH) effects, its operating characteristics, and its relationship with academic performance in 36 children with ADDH who underwent a placebo controlled trial of MPH at four dose levels. Children's PAL-T performance under active medication resembled but was uncorrelated with direct observations of their academic performance in the classroom. Negative predictive power (NPP) rates indicated that cognitive nonresponse to MPH did not portend a poor response in children's academic efficiency under identical dose conditions in the classroom. Clinical implications are discussed.The authors are grateful to the undergraduate and graduate student members of the Children's Learning Clinic who assisted with the conduct of this study.     

长期机械通气患者的气道管理方法初探

探讨ICU长期机械通气患者人工气道的管理方法及其对预后的影响。回顾性分析我院中心ICU2006年1月至今4例连续机械通气时间大于3个月患者的临床资料,总结人工气道管理经验。通过加强气道管理,可以明显减少抗菌药物的应用,有效改善预后。4例患者中1例成功撤机封管出院,2例至今仍生存,1例死亡。提示具体有效的呼吸道管理措施是减少呼吸机相关性肺炎、延长患者生命及提高治愈率的保证。     

项目表述效应的统计控制：以中文版生活定向测验为例

本研究以中文版生活定向测验（LOT-R）为例,使用CTCM和CTCU方法进行建模,旨在探讨中文表述的量表中是否存在项目表述效应以及影响项目表述效应的特质因素。采用中文版生活定向测验等量表组成的问卷对334名大学生进行测试。结果表明,中文版LOT-R存在项目表述效应,是一种反向题的项目表述效应,也可称为语言标签效应;在分离了反向题项目表述效应后,发现中文版LOT-R只存在乐观因子,而不再有悲观因子。这表明乐观-悲观同属于一种人格特质,而非两种不同的人格特质;反向题项目表述效应是一种结构性误差,会导致量表结构的扭曲。研究还发现担心错误和父母期望与反向题项目表述效应存在显著的负相关,表明越是担心错误或父母期望水平越高的被试,他们对反向题的项目表述效应（语言标签效应）越小。社会赞许性对反向题项目表述效应没有影响。     

On the bilingual advantage in conflict processing: Now you see it, now you don’t

We report two experiments exploring more in detail the bilingual advantage in conflict resolution tasks. In particular, we focus on the origin of the bilingual advantage on overall reaction times in the flanker task. Bilingual and monolingual participants were asked to perform a flanker task under different task versions. In Experiment 1, we used two low-monitoring versions where most of the trials were of just one type (either congruent or incongruent). In Experiment 2, we used two high-monitoring versions where congruent and incongruent trials were more evenly distributed. An effect of bilingualism in overall reaction times was only present in the high-monitoring condition. These results reveal that when the task at hand recruits a good deal of monitoring resources, bilinguals outperform monolinguals. This observation suggests that bilingualism may affect the monitoring processes involved in executive control.     

随机截距因子分析模型在控制条目表述效应中的应用

本研究用中文修订版罗森博格自尊量表(RSES-R)考察随机截距因子分析模型在控制条目表述效应时的表现。用RSES-R和过分宣称问卷组成的量表调查621名中学生。结果表明,随机截距模型在建模时,拟合指数良好、因子方差与负荷合理,自尊因子分与RSES-R总分有极高相关,表明该模型能有效分离RSES-R得分的特质与表述效应。分离的表述效应因子分与受测者的自我提升水平具有显著但较弱的相关,表明表述效应与自受测者的社会赞许性有共同的成分。     

血浆纤维蛋白原水平在胃癌诊断中的临床意义

通过检测血浆纤维蛋白原（FIB）水平及血清肿瘤相关物质（TAM）水平,探讨血浆FIB在胃癌患者中的水平及临床意义.结果显示：胃癌患者较胃良性肿瘤、健康体检者的FIB、TAM水平高（P＜0.05）,后二者比较差异无统计学意义（P＞0.05）;FIB和TAM在胃癌中的水平与临床分期、淋巴结转移、远处转移有关,其差异均有统计学意义（P＜0.05）,而与年龄、性别、分化程度无关（P＞0.05）;FIB与TAM水平具有相关性（r=0.65,P＜0.05）.因此,血浆FIB水平有望成为胃癌患者有临床价值的标志物.