急性重症胰腺炎的抗生素治疗策略

继发性感染是导致急性重症胰腺炎(severe acute pancreatitis,SAP)高病死率最重要的因素。继发感染的微生物多为革兰阴性菌。选用抗菌药物需兼顾病原菌敏感性及抗菌药物穿透血胰屏障能力,合理选择用药方式;对于CT证实有胰腺坏死的急性重症胰腺炎,可预防性使用抗生素;氟康唑可作为经验性抗真菌治疗的首选药物。     

急性有氧运动对认知表现的影响

急性有氧运动是持续时间在10~60分钟的一次有氧运动。急性有氧运动可暂时性地改变感觉敏感度、记忆、执行功能等认知功能, 但其对不同认知功能的影响效果存在差异, 干预结果受到个体体适能水平、运动强度和运动类型等因素的调节。目前用于解释急性有氧运动影响认知表现的理论有唤醒理论、前额叶功能衰退理论、神经内分泌模型和神经营养因子假说。未来的研究应加强对急性运动发挥作用机制的探究, 更多关注身心运动、团体运动等不同运动形式的干预效果, 以期为长期“运动处方”的开具提供依据。     

Shaping exhale durations for breath CO detection for men with mild mental retardation

Roll, Higgins, and Badger (1996) used a carbon monoxide (CO) detector to determine whether participants smoked in a smoking-cessation study. We sought to replicate their work with adults with mild mental retardation. However, verbal instructions were inadequate to establish stable exhalations of sufficient durations for reliable and accurate CO evaluation. This report describes a shaping procedure that enabled 3 of 4 participants to achieve 20-s exhalation durations.     

Some Diagnostic Observations of Post-September 11, 2001 Crisis Groups

Crisis groups following the September 11 attack in New York were an opportunity to learn about people in crisis. The many groups that were formed to assist individuals' return to work, school, and home offered opportunities to observe how people managed their personal crises. While diagnoses such as Post-traumatic Stress Disorder were used, they offer no help in understanding group dynamics and individual behavior in groups. In this paper a psychoanalytic group orientation is offered to help learn about the impact of such terrible crises on individuals and the use of psychoanalytically oriented groups to aid in their path to recovery.     

急性应激与风险倾向：兴奋易感性的调节作用

为探索应激对决策的作用机理及其个体差异,减少工程作业中因应激导致的决策失误,本研究采用特里尔社会应激测试和气球模拟风险任务考察应激反应与应激下风险倾向的关系,并探索兴奋易感性在其中的调节作用。研究结果表明,应激下个体的皮质醇反应越大,行为越冒险。且这一作用受到兴奋易感性的调节：兴奋易感性较高的个体,应激下皮质醇反应越大,行为越冒险;而兴奋易感性较低的个体,其皮质醇变化不能预测风险倾向。该发现提示了兴奋易感性在应激影响中的重要作用,也为高压岗位的人员选拔提供了科学启示。     

预期错误与急性应激对不同强度恐惧记忆提取消退的影响

在条件性恐惧记忆再巩固模型下, 预期错误被证明是引发记忆不稳定的必要条件, 但其在不同强度恐惧记忆下的作用尚不明确。对于高强度可能导致的提取无效, 缺乏相应的探索以寻找解决办法, 而应激(stress)在其中发挥的作用值得探索。本研究考察人类被试中, 预期错误在不同强度恐惧记忆下的作用, 以及提取之后施加外源性应激对于消退进程的影响。结果发现, 对于较弱的恐惧记忆, 单个预期错误提取后消退可显著抑制恐惧自发恢复; 而对于较强恐惧记忆, 单个预期错误不能提取恐惧记忆进入再巩固, 已消退的记忆还会复发; 且在该种情况下, 如果在提取后施加外源性急性应激, 会进一步增大恐惧恢复。     

WHAT IS CLIMATE CHANGE DOING TO US AND FOR US?

What are we doing to our climate? Emissions from fossil fuel burning have raised carbon dioxide concentrations 35 percent higher than in the past millions of years. This increase is warming our planet via the greenhouse effect. What is climate change doing to and for us ? Dry regions are drier and wet ones wetter. Wildfires have increased threefold, hurricanes more violent, floods setting record heights, glaciers melting, and seas rising. Parts of Earth are increasingly uninhabitable. Climate change requires us to act as a global community. Climate justice enjoins emitters to pay the social‐environmental costs of fossil fuel burning. This would expedite green solar, wind, and next‐generation nuclear energy sources. Individuals should conserve resources, waste less food, and eat a plant‐rich diet.     

SOIL CARBON TRANSFORMATIONS

Climate change is a wicked problem with causes and consequences overlapping with other wicked problems and no single solution (Hulme 2015). For example, the frequent droughts associated with climate change exacerbate another major problem facing humanity as we enter the Anthropocene: how to produce adequate food to feed a growing population without increasing pollution or “more food with low pollution (MoFoLoPo)” (Davidson et al. 2015). Soils represent an intersection of these two wicked problems, because they are integral to food production through agriculture and also are an important component of global climate models. Recent focus in the field of soil carbon cycling has facilitated a transformation in our understanding of the processes that control this important resource. This understanding is critical to responding to both wicked problems.     

Reperfusion of Specific Brain Regions by Raising Blood Pressure Restores Selective Language Functions in Subacute Stroke

We report a series of six single subject studies examining the effects of pharmacological blood pressure elevation on regional brain perfusion and language function. Previous reports indicate that hypoperfusion of specific brain regions, as delineated by magnetic resonance perfusion weighted imaging (PWI), is associated with disruption of selective lexical functions. On this basis, we hypothesized that reperfusion of the same regions, in the absence of infarct in that region, would restore the associated lexical function. We present five patients with impaired lexical-semantics associated with poor perfusion, but not infarction, of Brodmann's area 22 (BA 22), and one patient with impaired lexical-semantics and a superimposed deficit in retrieving the phonological representations of words, associated with poor perfusion Brodmann's area 37 (BA 37) as well as BA 22. Each patient was treated with induced blood pressure elevation to increase perfusion of the ischemic and dysfunctional tissue. Daily testing of naming and comprehension, with stimulus sets matched for frequency, familiarity, and length, showed improved lexical-semantics in the patients who showed reperfusion of BA 22 and improved oral naming (but not lexical-semantics) in the patient who showed reperfusion of BA 37. These cases illustrate that loss of function with hypoperfusion of a circumscribed area of the brain, and recovery of the same function with improved perfusion of that brain region, can reveal brain/language relationships prior to reorganization after brain injury.     

Evaluating the Etiology of Anxiety Sensitivity: Relation to Cardiovascular Perception and Reactivity

A large body of research has suggested that anxiety sensitivity (AS) acts as a specific vulnerability factor in the development of anxiety pathology. More recently, attention has turned to the etiology of AS per se. The present study tested several related etiological hypotheses derived from Expectancy theory. S. Reiss and R. J. McNally (1985) originally proposed that greater physiological reactivity would increase risk for developing heightened AS. Reactive individuals are believed to have greater opportunity to perceive unpleasant bodily perturbations, thereby increasing the likelihood that concerns and fears could be attached to the sensations. Nonclinical participants (N = 86) completed physical (e.g., orthostatic) and biological (e.g., 35% CO₂) challenges and a heart beat perception task. AS was not related to heart beat perception but was related to greater tonic heart rate and greater diastolic blood pressure (DBP) reactivity to both the challenges. Higher DBP and higher heart beat accuracy interacted to predict higher AS.