高血压脑出血急诊救治现状与进展

高血压脑出血是指在高血压的情况下发生的脑实质内出血。目前急诊综合救治中内科药物和外科手术治疗为主要的两种方法。内科治疗只适用于轻度脑出血和有手术禁忌证及配合急诊外科手术的综合救治,外科手术多用在中、重度脑出血病人治疗中。近年来开展的一种在CT下三维定位脑内血肿清除术,以其定位准确,脑损伤小,在急诊救治方面取得了一定效果,有待于进一步发展。     

Further evaluation of methods to identify matched stimulation

The effects of preferred stimulation on the vocal stereotypy of 2 individuals were evaluated in two experiments. The results of Experiment 1 showed that (a) the vocal stereotypy of both participants persisted in the absence of social consequences, (b) 1 participant manipulated toys that did and did not produce auditory stimulation, but only sound-producing toys decreased his vocal stereotypy, and (c) only noncontingent music decreased vocal stereotypy for the other participant, but sterotypy paradoxically increased when toys were presented with music. Using a three-component multiple schedule, the results of Experiment 2 showed that the vocal stereotypy of both participants remained below preintervention levels following the removal of auditory stimulation and that 1 participant's vocal stereotypy increased following the removal of contingent reprimands. These patterns suggest that auditory stimulation functioned as an abolishing operation for vocal stereotypy and reprimands functioned as an establishing operation for vocal stereotypy. Together, the two experiments provide a method for identifying alternative stimulation that may substitute for automatically reinforced behavior.     

Cortical Language Mapping in Epilepsy: A Critical Review

One challenge in dominant hemisphere epilepsy surgery is to remove sufficient epileptogenic tissue to achieve seizure freedom without compromising postoperative language function. Electrical stimulation mapping (ESM) of language was developed specifically to identify essential language cortex in pharmacologically intractable epilepsy patients undergoing left hemisphere resection of epileptogenic cortex. Surprisingly, the procedure remains unstandardized, and limited data support its clinical validity. Nevertheless, ESM for language mapping has likely minimized postoperative language decline in numerous patients, and has generated a wealth of data elucidating brain–language relations. This article reviews the literature on topographical patterns of language organization inferred from ESM, and the influence of patient characteristics on these patterns, including baseline ability level, age, gender, pathology, degree of language lateralization and bilingualism. Questions regarding clinical validity and limitations of ESM are discussed. Finally, recommendations for clinical practice are presented, and theoretical questions regarding ESM and the findings it has generated are considered.     

Electrical stimulation of the pedunculopontine tegmental nucleus in freely moving awake rats: time- and site-specific effects on two-way active avoidance conditioning

The pedunculopontine tegmental nucleus (PPTg) is involved in the regulation of thalamocortical transmission and of several functions related to ventral and dorsal striatal circuits. Stimulation of the PPTg in anesthetized animals increases cortical arousal, cortical acetylcholine release, bursting activity of mesopontine dopaminergic cells, and striatal dopamine release. It was hypothetized that PPTg stimulation could improve learning by enhancing cortical arousal and optimizing the activity of striatal circuits. We tested whether electrical stimulation (ES) of the PPTg, applied to freely-moving awake rats previously implanted with a chronic electrode, would improve the acquisition and/or the retention of two-way active avoidance conditioning, and whether this effect would depend on the specific PPTg region stimulated (anterior vs posterior) and on the time of ES: just before (pre-training) or after (post-training) each of three training sessions. The treatment consisted of 20 min of ES (0.2 ms pulses at 100 Hz; current intensity: 40-80 microA). The results showed that (1) this stimulation did not induce either any signs of distress nor abnormal behaviors, apart from some motor stereotyped behaviors that disappeared when current intensity was lowered; (2) pre-training ES applied to the anterior PPTg improved the acquisition of two-way active avoidance, (3) no learning improvement was found after either post-training ES of the anterior PPTg, or pre- and post-training ES of the posterior PPTg. The results give support to a role of PPTg in learning-related processes, and point to the existence of functional PPTg regions.     

The effects of reinforcer magnitude on timing in rats

The relation between reinforcer magnitude and timing behavior was studied using a peak procedure. Four rats received multiple consecutive sessions with both low and high levels of brain stimulation reward (BSR). Rats paused longer and had later start times during sessions when their responses were reinforced with low-magnitude BSR. When estimated by a symmetric Gaussian function, peak times also were earlier; when estimated by a better-fitting asymmetric Gaussian function or by analyzing individual trials, however, these peak-time changes were determined to reflect a mixture of large effects of BSR on start times and no effect on stop times. These results pose a significant dilemma for three major theories of timing (SET, MTS, and BeT), which all predict no effects for chronic manipulations of reinforcer magnitude. We conclude that increased reinforcer magnitude influences timing in two ways: through larger immediate after-effects that delay responding and through anticipatory effects that elicit earlier responding.     

新形势下医院药学的困境与发展

全面分析在当前新的形势下医院药学发展处在转型期所面临的实际困难。正确认识目前医院药剂科在人才队伍建设和知识结构上存在的不足,以及自身拥有的专业技术优势等。明确今后工作的重点在于深入临床贴近患者,向临床药学服务方向发展,同时不断提高临床药学科研水平,促进医院药学事业更高、更快发展。     

The role of the right posterior parietal cortex in temporal order judgment

Perceived order of two consecutive stimuli may not correspond to the order of their physical onsets. Such a disagreement presumably results from a difference in the speed of stimulus processing toward central decision mechanisms. Since previous evidence suggests that the right posterior parietal cortex (PPC) plays a role in modulating the processing speed of a visual target, we applied single-pulse TMS over the region in 14 normal subjects, while they judged the temporal order of two consecutive visual stimuli. Stimulus-onset-asynchrony (SOA) randomly varied between -100 and 100 ms in 20-ms steps (with a positive SOA when a target appeared on the right hemi-field before the other on the left), and a point of subjective simultaneity was measured for individual subjects. TMS stimulation was time-locked at 50, 100, 150, and 200 ms after the onset of the first stimulus, and results in trials with TMS on right PPC were compared with those in trials without TMS. TMS over the right PPC delayed the detection of a visual target in the contralateral, i.e., left hemi-field by 24 (+/-7 SE) ms and 16 (+/-4 SE) ms, when the stimulation was given at 50 and 100 ms after the first target onset. In contrast, TMS on the left PPC was not effective. These results show that the right PPC is important in a timely detection of a target appearing on the left visual field, especially in competition with another target simultaneously appearing in the opposite field.     

自我提高还是自我增强？解释水平理论的观点

以概念启动和情境启动的方式分别激活了可能自我知觉和当前自我知觉,借以检验对自我提高动机和自我增强动机的影响。结果发现：（1）相对于当前自我,可能自我启动后,个体对自我的评价更低,更乐意接受反馈,也更能注意到测试对自己的帮助;（2）一年级学生在读了明星学生的新闻后对自己的评价更低,对明星的评价更高;四年级学生则相反。这表明,消极反馈和可能自我的同时出现引发了自我提高动机,消极反馈和当前自我共同激活了自我提高动机。     

对我国肝移植现状的系统化思考

阐述了我国肝移植的现状及新时期肝移植的新特点,用系统的观点分析了我国肝移植实施中存在的问题,提出了今后如何系统化发展我国肝移植事业的几点设想。     

青少年家庭义务感的研究

本研究采用家庭义务感问卷对711名高一和高三的城乡青少年进行了调查,考察当前青少年家庭义务感的基本特征.结果表明,(1)青少年总体上具有较强的家庭义务感;(2)农村青少年比城市青少年更为重视“未来对家庭的支持”;女青少年比男青少年更重视当前与未来对家庭的支持,以及对家人的尊敬;独生与非独生青少年的家庭义务感无显著差异;(3)在“当前对家庭的支持”与“未来对家庭的支持”方面,青少年的义务感高于他所感知到的父母的期望,但在“对家人的尊敬”上,青少年的态度与父母的期望间无显著差异.