将糖化血红蛋白控制在7．0％以下是否更安全

2008年一项针对2型糖尿痛强化血糖控制对心血管病变研究（ACCORD）发现,对于病程在10年左右,30％存在心血管疾病的2型糖尿病人群,利用现有手段努力实现血糖“正常化”,即糖化血红蛋白（A1C）〈6．0％并没有减少糖尿病全因死亡。人们开始重新思考对2型糖尿病是否还需要强调强化血糖控制、血糖控制的目标多少为宜。中华医学会糖尿病学分会也在今年重新修订了其《中国2型糖尿病防治指南》的A1C控制目标,A1C目标由原来的6．5％提高到7．0％。那么这一改变对2型糖尿病患者来讲到底有多大意义呢？ACCORD强化降糖治疗终止后的随访研究发现强化组患者在血糖控制目标与标准治疗组相似的情况下,全因死亡率并没有随之减少。因此,需要重新检视2型糖尿病防治策略。     

Word recognition in child second language learners: Evidence from cognates and false friends

We studied how Dutch children learned English as a second language (L2) in the classroom. Learners at different levels of L2 proficiency recognized words under different task conditions. Beginning learners in primary school (fifth and sixth grades) and more advanced learners in secondary school (seventh and ninth grades) made lexical decisions on words that are similar for English and Dutch in both meaning and form (“cognates”) or only in form (“false friends”). Cognates were processed faster than matched control words by all participant groups in an English lexical decision task (Experiment 1) but not in a Dutch lexical decision task (Experiment 2). An English lexical decision task that mixed cognates and false friends (Experiment 3) led to consistently longer reaction times for both item types relative to controls. Thus, children in the early stages of learning an L2 already activate word candidates in both of their languages (language-nonselective access) and respond differently to cognates in the presence or absence of false friends in the stimulus list.     

糖尿病“达标”教育对控制2型糖尿病的影响

为评价"达标"教育对新诊断2型糖尿病(T2DM)监测及控制水平的影响,选取新诊断T2DM患者90例,随机分为两组,实验组进行"控制目标"认知教育,对照组不进行。治疗6个月后,比较两组控制水平。结果实验组与对照组相比,血糖、血压、体重监测及主动拜访专业医生的频次显著为高,血糖、血压、胆固醇控制显著为好。提示对新诊T2DM患者进行"达标"教育可提高DM监测频次及控制水平。     

前列腺素E2及其在肾脏调控中的作用

前列腺素E2(PGE2)是最主要的前列腺素化合物,参与几乎所有的细胞代谢活动并介导多种不同的生理病理功能。PGE2的生物学效应是通过与不同的EP受体结合从而激活不同的信号转导通路来实现的。因为各类EP受体在肾脏的高分布,所以近来PGE2在肾脏中的作用日趋引起人们的重视。     

维生素D_3及其受体的临床意义

1,25-(OH)2D3是维生素D在体内发挥生理作用的活性形式。活性维生素D3通过与细胞内特异性维生素D受体结合,除了具有调节钙磷代谢的功能外,还发现其可预防和治疗骨质疏松、心血管疾病、自身免疫性疾病和一些肿瘤等。然而,维生素D缺乏在人群中非常普遍。     

西藏老年病房2型糖尿病患者的血糖管理

西藏老年2型糖尿病患者有着知晓率低、病程长、慢性并发症多、其他相关疾病多等特点。加强糖尿病教育、控制饮食、合理用药、注意相关疾病的处理和个体化治疗是血糖管理的有效方案。     

Le burnout chez les infirmières en cancérologie : Une approche contextuelle du modèle exigences-contrôle-soutien

The current investigation, studying the burnout among oncology nurses, was guided by the Demand Control Support model (Karasek & Theorell, 1990). However, in accordance with scholars claiming for a context-specificity in occupational stress research, we first conducted 3 semi-structured focus groups to identify the specific sources of demands, control and support experienced by oncology nurses. The scale established from this analysis, (as well the other study variables), had been answered by 144 oncology nurses. Factorial analyses revealed 4 latent factors: “job demands”, “patient demands”, “support” and “control”. Then, hierarchical regression analyses indicated that job demands, control and support predicted significant proportions of burnout, in particular emotional exhaustion. We also observed a moderator effect of social support. Furthermore, the situation-specific stressors, that is, those relating to difficult relationships with patients, made significant contributions to burnout, supporting the claim of augmenting the components of the Demand Control Support model with stressors that are more situation- specific.     

La tarification à l’activité (T2A) : Quelles transformations pour l’activité du personnel infirmier ? Etude exploratoire

This article presents an exploratory study, which attempts to analyse the changes which have occurred in the professional life of nurses in France since the introduction of the system of payment per medical act (T2A). The theoretical background is provided by theories on the activity. The T2A system is intended to provide a means of or ganising nursing care. The main results of qualitative analysis undertaken show above all changes in the way nurses’ work is organised (pace, rhythm, productivity, value for money and turnover). The more intense workload mentioned by the nurses concerns above all an increase in technical and administrative activity rather than any personal interaction with the patients, which appears to have suffered from the changes. The repercessions identified by the nursing staff include frustration, a loss of meaning in their work and a lower standard of nursing care provided.     

Digit ratio (2D:4D) and sensation seeking: New data and meta-analysis

Previously reported associations between low (male-typical) digit ratio (2D:4D), a putative pointer to prenatal testosterone exposure, and high (male-typical) sensation seeking have been inconsistent across studies (alternately present for men, women, either sex, or neither). Addressing this question again in three new studies (N = 198, 188, 1118) produced similarly erratic findings. Meta-analysis of the entire literature (13 studies with nearly 3000 individuals, including unpublished accounts) showed that the current cumulative evidence does not support any negative correlations between 2D:4D and sensation seeking traits. The only significant meta-analytical finding was for right-hand 2D:4D and the experience seeking facet of sensation seeking in both sexes, but this effect accounted for merely 0.4% attributable variance, and moreover was directionally opposite to expectation (i.e., a positive correlation). Discussed are inherent limitations of narrow-scoped approaches (such as via 2D:4D) for elucidating the biological bases of individual difference variables with evidentially intricate neurochemical underpinnings (such as sensation seeking).     

中晚明阳明学的格物之辩

对《大学》中“格物”观念的不同理解与诠释,可以反映朱子学与阳明学这理学传统两大典范的基本差异。但中晚明阳明学“格物”观念的发展却呈现出较为复杂的面貌。由中晚明不同阳明学者的格物之辩可见,中晚明阳明学的“格物”观表现为两种不同的取向。一种以聂双江、王宗沐、王艮以及刘蕺山等人为代表,将“格物”完全收缩到自我意识的领域,不免取消了“格物”这一经典用语本身所具有的面对客观事物的致思方向。另一种以王龙溪、周海门、欧阳南野、王塘南等人为代表,通过将“物”理解为意向性中的对象或者作为各种实际生活行为的“事”,使“格物”工夫不再是一种单纯自我意识的孤立活动,而是展开于自我与外界事物的关系结构与互动过程。在后者看来,如果说朱子学的“格物”“忘内求外”而不免“逐物”的话,前者则又“务内遗外”而不免“绝物”。作为一种既不“逐物”又不“绝物”的“合内外”工夫,后者其实是阳明晚年成熟“格物”思想的继承和发扬,反映了阳明学在与朱子学互动过程中由反对到吸收的动向。并且,这一动向在中晚明一些朱子学者的“格物”观处也有鲜明的体现。