药物性肝损伤的发病机制

药物性肝损伤（DILI）可分为直接肝毒性和特异质性肝损伤（IDILI）.IDILI发生率较低,个体发病存在易感因素,在动物模型中很难复制.同时,IDILI缺乏可靠的临床诊断标准,使其发病机制的研究受到限制.近年来关于IDILI的发病机制,主要在遗传易感性、代谢途径、宿主免疫、线粒体毒性和胆道损伤等方面取得进展,各种发病机制的深入研究和相互关系的阐明,或将揭示IDILI的真正致病机制.     

肥胖和/或NAFLD患者的药物性肝损伤

与药物有关的肝毒性是一个严重的健康问题,广泛影响着患者、医疗机构和政府监管机构.另外,由于久坐的生活方式和热量过度摄取,我们还面临着肥胖和非酒精性脂肪性肝病（NAFLD）的流行和困扰,因为肥胖和/或NAFLD提高各种疾病的风险,成为影响公众健康的又一个主要问题,这些患者平均使用药物的量远高于非肥胖患者.越来越多的证据表明,某些药物能够增加肥胖和NAFLD患者药物诱发肝损伤（DILI）的风险.因此,我们应该重视和防治肥胖和NAFLD患者DILI的发生.     

中西医结合治疗儿童过敏性紫癜和预防相关肾损害的临床研究

过敏性紫癜是儿童常见的免疫系统疾病。西医治疗过敏性紫癜已形成常规模式,并有一定疗效,但也有一定局限性。本病易反复,易损伤肾脏,严重时可导致紫癜性肾炎。本文拟研究中西医结合方法治疗过敏性紫癜及预防肾脏损伤的临床效果。研究表明,中西医结合治疗该病存在一定优势,能有效治疗过敏性紫癜,并降低肾脏损害及紫癜性肾炎的发生率。但应看到本研究结论主要是通过临床经验取得,样本量小,未进行远期随访,缺乏系统深层次实验室论证,还有待进一步研究。     

致癌因素与机体相互作用的损伤与抗损伤反应

损伤与抗损伤是机体对病因作出的一种防御性反应.正确地认识其在疾病发生发展过程中的作用,不仅有助于现代医学阐明疾病的发生机制,而且有利于传统医学提高辩证施治的效果.本文旨在探讨癌症致病因素与机体相互作用的抗损伤反应中的辩证关系,可望逐步提高医者在临床实践中运用唯物辩证法和方法论的自觉性.     

Detecting performance invalidity in children: Not quite as easy as A,B, C, 1, 2, 3 but automatized sequences appears promising

In adult populations, embedded performance validity indicators are well established, as they are time efficient, resistant to coaching, and allow for more continuous monitoring of effort than standalone measures. Although several recent studies have demonstrated the appropriateness of using standalone validity tests with school-age children, a paucity of pediatric work has examined embedded indicators. The present study investigated the value of a simple automatized sequences task to detect performance invalidity in 439 clinically referred patients with mild head injury aged 8 through 17 years. Sixteen percent of the participants failed the Medical Symptom Validity Test (MSVT). Thirteen percent failed the MSVT and also performed below established cutoffs on either the Test of Memory Malingering or Wechsler Digit Span subtest. The group classified as providing invalid data performed significantly worse than the group passing the MSVT across all sequencing conditions. Sensitivity and specificity for the total time on the sequencing task compared favorably to data produced for many respected adult-based embedded indicators (i.e., sensitivity around 50% when specificity ≥ 90%). Classification statistics for any embedded performance validity test can be expected to be worse in more severely affected populations; however, the current sequencing task appears to have value in detecting invalid performance in relatively high-functioning older children and adolescents. The fact that the task takes less than a couple of minutes to administer makes it especially appealing.     

Cognitive reserve as a moderator of responsiveness to an online problem-solving intervention for adolescents with complicated mild-to-severe traumatic brain injury

Children and adolescents with traumatic brain injury (TBI) often experience behavior difficulties that may arise from problem-solving deficits and impaired self-regulation. However, little is known about the relationship of neurocognitive ability to post-TBI behavioral recovery. To address this question, we examined whether verbal intelligence, as estimated by Vocabulary scores from the Wechsler Abbreviated Scale of Intelligence, predicted improvements in behavior and executive functioning following a problem-solving intervention for adolescents with TBI. One hundred and thirty-two adolescents with complicated mild-to-severe TBI were randomly assigned to a six-month Web-based problem-solving intervention (CAPS; n = 65) or to an Internet resource comparison (IRC; n = 67) group. Vocabulary moderated the association between treatment group and improvements in metacognitive abilities. Examination of the mean estimates indicated that for those with lower Vocabulary scores, pre-intervention Metacognition Index scores from the Behavior Rating Inventory of Executive Function (BRIEF) did not differ between the groups, but post-intervention scores were significantly lower (more improved) for those in the CAPS group. These findings suggest that low verbal intelligence was associated with greater improvements in executive functioning following the CAPS intervention and that verbal intelligence may have an important role in response to intervention for TBI. Understanding predictors of responsiveness to interventions allows clinicians to tailor treatments to individuals, thus improving efficacy.     

A Review of Research on Moral Injury in Combat Veterans

The moral injury construct has been proposed to describe the suffering some veterans experience when they engage in acts during combat that violate their beliefs about their own goodness or the goodness of the world. These experiences are labeled transgressive acts to identify them as potentially traumatic experiences distinct from the fear-based traumas associated with posttraumatic stress disorder. The goal of this article was to review empirical and clinical data relevant to transgressive acts and moral injury, to identify gaps in the literature, and to encourage future research and interventions. We reviewed literature on 3 broad arms of the moral injury model proposed by Litz and colleagues (2009) Litz, B. T., Stein, N., Delaney, E., Lebowitz, L., Nash, W. P., Silva, C., &; Maguen, S. (2009). Moral injury and moral repair in war veterans: A preliminary model and intervention strategy. Clinical Psychology Review, 29, 695–706. 10.1016/j.cpr.2009.07.003[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]: (a) the definition, prevalence, and potential correlates of transgressive acts (e.g., military training and leadership, combat exposure, and personality), (b) the relations between transgressive acts and the moral injury syndrome (e.g., self-handicapping, self-injury, demoralization), and (c) some of the proposed mechanisms of moral injury genesis (e.g., shame, guilt, social withdrawal, and self-condemnation). We conclude with recommendations for future research for veterans suffering with moral injury.     

Mindfulness and integrative self‐knowledge: Relationships with health‐related variables

This study examined how mindfulness and integrative self‐knowledge were related to health‐related issues. Men in general population (n = 103) and coronary heart disease samples (n = 101) completed the Mindful Attention Awareness Scale, the Integrative Self‐knowledge Scale, the Type 2 subscale of the Interpersonal Reactions Inventory, the Perceived Stress Scale, and the Anxiety and Depression Scales. In both samples, there was a moderate positive correlation between mindfulness and integrative self‐knowledge and they were negatively correlated with all health‐related variables. However, only integrative self‐knowledge explained independent variance in health‐related variables. Specifically, in both samples, the relationship between mindfulness and health‐related variables was mediated by integrative self‐knowledge. Mindfulness and integrative self‐knowledge are related domains of self‐awareness that are associated with a range of health‐related variables. These relationships are robust across samples drawn from general population and patients with coronary heart disease. The finding that integrative self‐knowledge explained additional variance in the health‐related variables after the contribution of mindfulness had been accounted for suggests that reflective self‐awareness in integrative self‐knowledge may make a unique contribution to the explanation of individual differences in health variables.     

Running with emotion: When affective content hampers working memory performance

This study tested the hypothesis that affective content may undermine rather than facilitate working memory (WM) performance. To this end, participants performed a running WM task with positive, negative and neutral words. In typical running memory tasks, participants are presented with lists of unpredictable length and are asked to recall the last three or four items. We found that accuracy with affective words decreased as lists lengthened, whereas list length did not influence recall of neutral words. We interpreted this pattern of results in terms of a limited resource model of WM in which valence represents additional information that needs to be manipulated, especially in the context of difficult trials.