Neurocognitive profiles of preterm infants randomly assigned to lower or higher hematocrit thresholds for transfusion

Objective: Preterm infants are frequently transfused with red blood cells based on standardized guidelines or clinical concerns that anemia taxes infants' physiological compensatory mechanisms and thereby threatens their health and well-being. The impact of various transfusion guidelines on long-term neurocognitive outcome is not known. The purpose of this study is to evaluate long-term neurocognitive outcome on children born prematurely and treated at birth with different transfusion guidelines.

Methods: Neurocognitive outcomes were examined at school age for 56 preterm infants randomly assigned to a liberal (n?=?33) or restrictive (n?=?23) transfusion strategy. Tests of intelligence, achievement, language, visual-spatial/motor, and memory skills were administered. Between-group differences were assessed.

Results: Those in the liberal transfusion group performed more poorly than those in the restrictive group on measures of associative verbal fluency, visual memory, and reading.

Conclusions: Findings highlight possible long-term neurodevelopmental consequences of maintaining higher hematocrit levels.     

The relationship between blushing propensity,social anxiety and facial blood flow during embarrassment

To investigate blushing in relation to blushing propensity scores and core elements of social anxiety, facial blood flow was monitored in 86 normal volunteers during an embarrassing task (singing a children's song). Increases in facial blood flow were greater in women than men, as were scores on the Blushing Propensity and Fear of Negative Evaluation scales. In addition, high scores on the Blushing Propensity and Social Interaction Anxiety scales were associated with large increases in facial blood flow during singing. However, this appeared to be due primarily to social anxiety because the association between blushing propensity scores and changes in facial blood flow disappeared when social interaction anxiety scores were taken into account. These findings suggest that people generally base their beliefs about blushing on cues other than changes in facial blood flow. Social anxiety may augment increases in facial blood flow during embarrassment, independently of expected or perceived blushing.     

Event-related cerebral hemodynamics reveal target-specific resource allocation for both “go” and “no-go” response-based vigilance tasks

Transcranial Doppler sonography was used to measure cerebral blood flow velocity (CBFV) in the right and left cerebral hemispheres during the performance of a 50-min visual vigilance session. Observers monitored a simulated flight of unmanned aerial vehicles for cases in which one of the vehicles was flying in an inappropriate direction relative to its cohorts. Two types of vigilance tasks were employed: a traditional task in which observers made button press (“go”) responses to critical signals, and a modification of the traditional task called the Sustained Attention to Response Task (SART) in which “go” responses acknowledged nonsignal events and response withholding (“no-go”) signified signal detection. Signal detections and global CBFV scores declined over time. In addition, fine-grained event-related analyses revealed that the detection of signals was accompanied by an elevation of CBFV that was not present with missed signals. As was the case with the global scores, the magnitude of the transient CBFV increments associated with signal detection also declined over time, and these findings were independent of task type. The results support the view of CBFV as an index of the cognitive evaluation of stimulus significance, and a resource model of vigilance in which the need for continuous attention produces a depletion of information-processing assets that are not replenished as the task progresses. Further, temporal declines in the magnitude of event-related CBFV in response to critical signals only is evidence that the decrement function in vigilance is due to attentional processing and not specific task elements such as the required response format.     

实验诊断临床思维程序的必要性及其内容

为提高临床实验诊断的效率和准确性,提出编写“实验诊断临床思维程序”的观点。从实验诊断学的特性及发展趋势方面论述了该程序的必要性,并初步拟定了包括项目选择、结果判断和结果应用三个部分的实验诊断临床思维程序。     

血液透析患者体重和血流量与透析充分性的因果关系分析

通过测定维持性血液透析患者的体重和在线血流量、采用在线尿素清除率监测（on-line clearance monitoring,OCM）法测Kt／V值及单室尿素动力模型DaugirdasⅡ公式计算Kt／V值的两种方法,探讨患者体重和血流量与透析充分性之间的因果关系。结论为两种方法测得的血液透析患者的体重和血流量均与Kt...     

Cerebral blood flow differences between long-term meditators and non-meditators

We have studied a number of long-term meditators in previous studies. The purpose of this study was to determine if there are differences in baseline brain function of experienced meditators compared to non-meditators. All subjects were recruited as part of an ongoing study of different meditation practices. We evaluated 12 advanced meditators and 14 non-meditators with cerebral blood flow (CBF) SPECT imaging at rest. Images were analyzed with both region of interest and statistical parametric mapping. The CBF of long-term meditators was significantly higher (p < .05) compared to non-meditators in the prefrontal cortex, parietal cortex, thalamus, putamen, caudate, and midbrain. There was also a significant difference in the thalamic laterality with long-term meditators having greater asymmetry. The observed changes associated with long-term meditation appear in structures that underlie the attention network and also those that relate to emotion and autonomic function.     

When choices give in to temptations: Explaining the disagreement among importance measures

Respondents’ overt statements of relative importance rarely correspond to weights derived from a regression analysis of their decisions. This paper conjectures that differential effects of high-level goals on importance beliefs and choices can explain these discrepancies. It is argued that the goal to justify decisions influences importance beliefs more than choices whereas the goal to assess preferences accurately affects choices more than importance beliefs. It is also argued that differential effects of high-level goals on importance statements and choices vary as a function of whether decision-maker controls the information flow and the extent of prior knowledge and experiences with choice options. These predictions were tested within the context of a contraceptive decision-making task. Choices among contraceptives made the justification goal salient to subjects by requiring tradeoffs between attributes that are either considered rational or tempting in making such decisions (e.g., health risks vs. pleasure/convenience). As predicted, subjects assigned larger importance weights to rational attributes in their subjective evaluations than in their choices whereas the impact of tempting attributes was stronger for choices than for subjective importance evaluations. Moreover, these observed discrepancies between importance measures were reduced in favor of rational attributes when subjects controlled the information flow and could not access their prior experiences. Overall, the results suggest that, although tempting attributes affect choices, decision makers appear to be unwilling to acknowledge the impact of tempting attributes on their decisions in judging attribute importance.     

Situation-Specific Scripts for Threat in Blood Fearful and Nonfearful Individuals

Self-schemata for threatening situations were examined in blood fearful and nonfearful individuals. In the context of 5 scenarios involving blood, injections, hospitals, or injury, participants listed events that they typically experience in these situations or events that occur when they witness another individual in these situations. Blood fearful and nonfearful individuals generally listed sequences of events corresponding to a similar macrostructure. However, blood fearful individuals included more negative emotional and physiological events than nonfearful individuals, and several of their sequences reflected higher levels of fear and lower levels of positive affect. These results suggest that the self-schemata of blood fearful individuals for situations involving harm or threat consist of both normal and maladaptive elements.     

降压达标对器官保护的作用

高血压作为心血管事件的重要危险因素,长期发展可导致重要器官的损害及心脑血管事件的发生。目前提倡理想的降压药物除了具有良好的降压作用外,应当具有一定的器官保护作用,降压的获益体现在对器官的保护及对心脑血管事件的降低方面。     

仁者仁医 世之楷模——著名医学家裘法祖院士的行医之道

2004年12月6日,中国科学院院士、著名外科学家、华中科技大学教授、博士生导师、中共党员、同济医学院创始人裘法祖被授予“人民医学家”荣誉称号,这是湖北省人民政府在裘教授迎来九十华诞暨从医65周年之际送给他的一份精美礼物。这位医术精湛、医德高尚、为我国医学事业做出了杰出贡献的著名医学家,受到了人民群众的高度评价和尊重,也为广大的科技工作者,尤其是医学教育和医疗卫生工作者,树立了光辉的榜样。裘教授从医60多年来,不仅以其精湛的医术点燃了无数人的生命之灯而享誉海内外,他的高尚医德同样也赢得了社会的普遍赞誉而成为世之楷模。