人工肝支持系统治疗肝衰竭的研究进展

目前肝衰竭发病率和病死率仍然较高,肝衰竭成为威胁患者生命的严重疾病。基于肝脏具有强大再生能力,人工肝支持系统作为一种“过渡”措施,为肝衰竭患者的肝功能恢复赢得时间。人工肝支持系统根据性质不同分为非生物型人工肝、生物型人工肝和混合型人工肝。目前非生物型人工肝已在肝病治疗领域被广泛应用,但生物型及混合型人工肝的临床应用还存在很多问题需要进一步研究和解决。因此本文对人工肝的作用、临床应用现状、存在问题及研究进展进行综述。     

Autonomic and subjective responsivity to emotional images in people with dissociative seizures

People with dissociative seizures (DS) report a range of difficulties in emotional functioning and exhibit altered responding to emotional facial expressions in experimental tasks. We extended this research by investigating subjective and autonomic reactivity (ratings of emotional valence, arousal and skin conductance responses [SCRs]) to general emotional images in 39 people with DS relative to 42 healthy control participants, whilst controlling for anxiety, depression, cognitive functioning and, where relevant, medication use. It was predicted that greater subjective negativity and arousal and increased SCRs in response to the affective pictures would be observed in the DS group. The DS group as a whole did not differ from controls in their subjective responses of valence and arousal. However, SCR amplitudes were greater in ‘autonomic responders’ with DS relative to ‘autonomic responders’ in the control group. A positive correlation was also observed between SCRs for highly arousing negative pictures and self‐reported ictal autonomic arousal, in DS ‘autonomic responders’. In the DS subgroup of autonomic ‘non‐responders’, differences in subjective responses were observed for some conditions, compared to control ‘non‐responders’. The findings indicate unaffected subjective responses to emotional images in people with DS overall. However, within the group of people with DS, there may be subgroups characterized by differences in emotional responding. One subgroup (i.e., ‘autonomic responders’) exhibit heightened autonomic responses but intact subjective emotional experience, whilst another subgroup (i.e., ‘autonomic non‐responders’) seem to experience greater subjective negativity and arousal for some emotional stimuli, despite less frequent autonomic reactions. The current results suggest that therapeutic interventions targeting awareness and regulation of physiological arousal and subjective emotional experience could be of value in some people with this disorder.     

The effect of force-controlled biting on human posture control

Several studies have confirmed the neuromuscular effects of jaw motor activity on the postural stability of humans, but the mechanisms of functional coupling of the craniomandibular system (CMS) with human posture are not yet fully understood. The purpose of our study was, therefore, to investigate whether submaximum biting affects the kinematics of the ankle, knee, and hip joints and the electromyographic (EMG) activity of the leg muscles during bipedal narrow stance and single-leg stance. Twelve healthy young subjects performed force-controlled biting (FB) and non-biting (NB) during bipedal narrow stance and single-leg stance. To investigate the effects of FB on the angles of the hip, knee, and ankle joints, a 3D motion-capture system (Vicon MX) was used. EMG activity was recorded to enable analysis of the coefficient of variation of the muscle co-contraction ratios (CVR) of six pairs of postural muscles. Between FB and NB, no significant differences were found for the mean values of the angles of the ankle, knee, and hip joints, but the standard deviations were significantly reduced during FB. The values of the ranges of motion and the mean angular velocities for the three joints studied revealed significant reduction during FB also. CVR was also significantly reduced during FB for five of the six muscle pairs studied. Although submaximum biting does not change the basic strategy of posture control, it affects neuromuscular co-contraction patterns, resulting in increased kinematic precision.     

Motor imagery ability and internal representation of movement in children with probable developmental coordination disorder

It has been hypothesised that deficits in the functioning of the mirror neuron system (MNS) and internal modelling may contribute to the motor impairments associated with DCD. These processes can be explored behaviourally through motor imagery paradigms. Motor imagery proficiency of children with and without probable DCD (pDCD) was examined using a complex hand rotation task to explore whether motor imagery strategies could be used during more complex tasks. Forty-four boys aged 7–13 years participated, 22 with pDCD (mean = 9.90 years ± 1.57) and 22 controls (mean = 9.68 years ± 1.53). Participants completed the task twice: with and without motor imagery instructions. Stimuli were presented in two rotational axes – palm/back, and eight 45° rotational steps. Both groups showed evidence of following the biomechanical and postural constraints of actual movements. Responses of children with pDCD were slower and less accurate than controls, with group differences increasing alongside task complexity. A greater impact of biomechanical constraints for accuracy was observed in the DCD group. The response characteristics of children with pDCD likely reflects a reduced capacity to mentally manipulate a body schema and reduced visuo-motor processing capabilities. Behaviourally, these processes are linked to MNS and internal modelling function, suggesting deficits in these systems may contribute to the movement difficulties characteristic of DCD.     

Pluralism and values in education in Hungary – changes between 1990 and 2012

Value transmission is a fundamental task of schools. However, the question arises as to how far prevailing political and social conditions shape the functioning of a country or a region’s school system. In other words: what effect do they have on the choice of values to be transmitted at schools? Are there any fundamental social values that are shared by different cultures at different times? Are there values that exist independently of social and political systems? These questions have a special relevance in Eastern and Central European countries like Hungary where political and social changes in the twentieth century had a crucial effect on the set of values that were transmitted by the school system. The aim of this study is to describe how the value transmitting role of the Hungarian school system has changed as a consequence of political transformations in recent decades.     

Diversity and unity of modularity

Since the publication of Fodor's (1983) The Modularity of Mind, there have been quite a few discussions of cognitive modularity among cognitive scientists. Generally, in those discussions, modularity means a property of specialized cognitive processes or a domain-specific body of information. In actuality, scholars understand modularity in many different ways. Different characterizations of modularity and modules were proposed and discussed, but they created misunderstanding and confusion. In this article, I classified and analyzed different approaches to modularity and argued for the unity of modularity. Modularity is a multidimensional property consisting of features from several dimensions specifying different aspects of cognition. Among those, there are core features of modularity, and these core features form a cross-dimensional unity. Despite the diverse and liberal characterizations, modularity contributes to cognitive science because of the unity of the core features.     

消化内镜医师培训的现状及计算机模拟训练系统的应用

传统的以患者为基础的消化内镜医师培养模式已不能适应消化内镜的快速发展和病患对内镜操作技术的高要求,通过多媒体和虚拟现实技术建立的计算机辅助的内镜模拟训练系统相对于传统的消化内镜医师培训方式是一个巨大进步,它能帮助初学者较快掌握消化内镜诊疗操作的基本技能,使各级消化内镜培训中心的规范化教学成为可能.但是,模拟内镜训练必须结合实际病例的操作才能巩固从模拟内镜得到的内镜操作技能.本文总结了目前消化内镜医师培训的现状,重点对消化内镜模拟训练系统在内镜医师培训中的作用和存在的问题进行探讨,并提出了自己的观点.