慢性前列腺炎认识和治疗的困惑与提高疗效的策略

针对我国慢性前列腺炎发病率高、疗效差的困惑,全面系统地分析慢性前列腺炎基础和临床目前所面临的问题,探讨其规范化诊治程序和提高临床疗效的策略。对提高治疗决策因素结合方法论进行探讨,引导医生从减少患者痛苦、减轻经济负担的角度,探索较为合理的治疗方案,以提高治疗决策实施率,促进和谐的现代医患关系形成,提高慢性前列腺炎治疗效果。     

高层次医学影像技师培养与临床水平的提高

随着我国经济飞速发展,医疗技术日新月异,综合医院从国外引进的影像设备越来越先进,而影像技术人员普遍存在学历、职称偏低、知识结构老化等问题,高层次医学影像技术人才出现断层,限制了新技术的高级临床应用和开发。急需培养知识面宽、基础扎实、素质高、能力强的复合型、实用型影像专业技术人才。建议加强高层次医学影像技术人才的培养,以适应新时期综合医院医学发展对影像技术人才的要求。     

社区卫生服务中医发展战略

在社区卫生服务中发挥中医药优势,不仅能够提高人民健康水平,而且能够促进机构自身发展,用管理学的SWOT（斯沃特）战略分析法分析了当前中医药在社区卫生服务发展中的优势与劣势、外部机会与威胁,对其发展面临的问题作了综合性的剖析,并提出相应的发展策略。     

Matching and oddity relational learning by pigeons (<Emphasis Type="Italic">Columba livia</Emphasis>): transfer from color to shape

Relational learning, as opposed to perceptual learning, is based on the abstract properties of the stimuli. Although at present there is no doubt that pigeons are capable of relational behavior, this study aims to further disclose the conditions under which it occurs. Pigeons were trained in an outdoor cage on a matching-to-sample or an oddity-from-sample task, with colored cardboard stimuli presented horizontally. The apparatus involved three sliding lids on which the stimuli were drawn and which, when displaced, revealed the reinforcement. The lids were either adjacent to each other or somewhat separated. Training sessions involved two colors, and test sessions six different colors (same dimension test), or six different shapes (different dimension test). One group of birds trained under the ‘adjacent’ condition failed when tested with new stimuli, but succeeded in both dimension tests after training under the ‘separate’ condition. Two other groups of birds succeeded in all tests after training under the latter condition. These results show that depending on procedural details, pigeons are or are not able to transfer from one visual dimension to another, thus extending previous related findings.     

不同条件下拟合指数的表现及临界值的选择

在本模拟研究中设计了6种样本容量,6种因子载荷,和4种评分等级,并考察了正态和非正态分布两种情况。采用的错误模型为参数误置（真模型中每个因子各由5个题目来测量,错误模型中则是第一个因子由6个题测量,另两个因子各由4个和5个题来测量,即有一个因子载荷被误置）模型。结果发现（1）样本量、载荷量、评分等级数和分布形态都对GOF的取值确有影响。其中分布形态的影响最大。NNFI、IFI在不同条件下的平均值是最稳定的,其次是CFI、RMSEA和SRMR。它们都算是值得推荐的GOF,尤其是NNFI和IFI。（2）在正态分布中,当样本量≥1000时,根据NNFI、IFI、CFI、RMSEA、SRMR对模型是否拟合做出判断时有很低的两类错误率,在样本量<1000时则不理想。在偏态条件下无论选择哪个GOF两类错误率都很高。（3）采用2指数策略在很多情况下也不能显著降低两类错误率。（4）由于在数据分布非正态,或正态但样本量<1000时是难判断模型是否拟合的。因此我们提出了2界值策略。即为每个GOF确定上下两个界值。低于下界值时可判断模型是不正确的,而高于上界值时则可判断模型是正确的。GOF取值处于上下界值之间时难以判断模型是否拟合,只能说越高拟合的可能性越大。这时就要通过跨样本验证和增加样本量来确定模型是否正确     

An intervention study of the effects of the coping strategy of "finding positive meaning" on positive affect and health

Previous research has shown that positive affect (PA) is associated with the coping strategies of "searching for and finding positive meaning." The purpose of this study was to investigate the relationship between the coping strategy of "finding positive meaning" and PA using an intervention method. Additionally, inasmuch as previous research has revealed that PA is associated with physical and mental health status, the current study measured health status in order to carry out a preliminary test as to whether PA increased by the intervention can also improve health. Participants in the intervention group (Japanese graduate students; 13 men and 16 women) reported the most stressful event during the past 3 days and its positive meaning, while those in the control group (13 men and 15 women) reported the most stressful event alone. Both groups reported twice a week for 5 successive weeks using e-mails. Three questionnaires, the Japanese version of the Positive and Negative Affect Schedule scales for measuring positive and negative affects (NA), the situational version of the General Coping Questionnaire for coping strategies, and the Japanese version of the General Health Questionnaire for health status, were administered to all participants just before the start of the intervention, after the conclusion of the intervention, and at the 5-week follow-up session. Results revealed that the "finding positive meaning" coping strategy and PA were enhanced by the intervention in the follow-up for men and women with no changes in NA. For the health scales of the General Health Questionnaire, no significant group-related effects were observed. Thus, the intervention had no significant influence on NA or health status. Implications of these findings for future research are discussed along with a few limitations in this study.     

PIGEONS (COLUMBA LIVIA) APPROACH NASH EQUILIBRIUM IN EXPERIMENTAL MATCHING PENNIES COMPETITIONS

The game of Matching Pennies (MP), a simplified version of the more popular Rock, Papers, Scissors, schematically represents competitions between organisms with incentives to predict each other's behavior. Optimal performance in iterated MP competitions involves the production of random choice patterns and the detection of nonrandomness in the opponent's choices. The purpose of this study was to replicate systematic deviations from optimal choice observed in humans when playing MP, and to establish whether suboptimal performance was better described by a modified linear learning model or by a more cognitively sophisticated reinforcement‐tracking model. Two pairs of pigeons played iterated MP competitions; payoffs for successful choices (e.g., “Rock” vs. “Scissors”) varied within experimental sessions and across experimental conditions, and were signaled by visual stimuli. Pigeons' behavior adjusted to payoff matrices; divergences from optimal play were analogous to those usually demonstrated by humans, except for the tendency of pigeons to persist on prior choices. Suboptimal play was well characterized by a linear learning model of the kind widely used to describe human performance. This linear learning model may thus serve as default account of competitive performance against which the imputation of cognitively sophisticated processes can be evaluated.     

影响决策的情感因素——后悔理论的研究述评

情感因素在决策中起着重要的作用。本文对决策中最重要的情感因素——后悔因素的研究发展及其成果做了归纳总结,同时也将一些零散的发现整合在一起,使之更加系统化。后悔情绪对决策的影响作用不容忽视,作为决策理论之一的后悔理论在决策理论中的重要地位日益凸显出来。未来的研究将仍旧主要集中在其对决策的影响方面。后悔理论成为理性决策的一个可替代理论,已为时不远。     

Criterion knowledge: A moderator of using the recognition heuristic?

The recognition heuristic (RH) claims that people base inferences on recognition only. This has been questioned by several studies which found that additional knowledge was influential. However, in some of these studies, participants' additional knowledge might have encompassed criterion knowledge thus rendering any inferential strategy superfluous. The present study was therefore designed to test the effect of criterion knowledge on use or non‐use of the RH. Eighty‐one participants made pair‐wise comparisons with respect to the size of Belgian cities and also provided estimates of the cities' actual size. We found that relative criterion knowledge (i.e., knowledge about the relative position of an object on the criterion dimension) did indeed play some role, but its exclusion left the main critical findings intact, nonetheless. We thus conclude that previous studies conducted in the paradigm of natural recognition should not be generally refuted by the argument of participants possessing criterion knowledge. Copyright © 2009 John Wiley & Sons, Ltd.     

下咽癌治疗的临床决策

下咽癌是一种预后较差的头颈部肿瘤。目前下咽癌治疗的临床决策还存在很多不规范和不合理的问题。运用循证医学的原则来指导和规范下咽癌治疗的临床决策,以期提高患者的治疗效果、降低医疗费用及提高生活质量。