青少年“无聊症候群”问题探讨

为了探讨我国学校青少年“无聊症候群”问题的有关现状及成因,选取浙江省4个地区7所中学的613名中学生为研究对象,采用自编量表进行调查。研究发现：(1)“无聊症候群”问题在青少年群体中具有较高比例;(2)男生总体平均得分显著地高于女生;(3)城区中学学生总体平均得分显著地高于乡镇中学学生;(4)独生子女与非独生子女总体上无显著性差异;(5)六个年级间总体上无显著性差异。     

Assessing the Predictive Accuracy of hMLH1 and hMSH2 Mutation Probability Models

Hereditary nonpolyposis colorectal cancer (HNPCC) is characterized by a susceptibility to colorectal and extra-colonic cancers. Several guidelines exist for the identification of families suspected of having HNPCC, however these guidelines lack adequate sensitivity and specificity. In an attempt to improve accuracy for the detection of individuals with HNPCC, the Wijnen pre-test probability model (1998) and Myriad Genetics Laboratory prevalence table (2004) were developed. Here we evaluate the Wijnen model and Myriad table at predicting the presence of a mutation in individuals undergoing genetic testing for HNPCC. Forty-nine patients who had undergone genetic testing for germline mutations in hMLH1 and/or hMSH2 were part of our analysis. Our results revealed that the revised Bethesda guidelines performed with the highest sensitivity for germline mutations (94.4%), however the specificity was low (12.9%). Using a 10.0% mutation probability threshold, the Wijnen model and Myriad table had sensitivities of 55.6 and 60.0%, respectively and specificities of 54.8 and 23.8%, respectively. The Wijnen model and Myriad table were poor predictors of mutation prevalence, which is shown by the areas underneath their corresponding receiver operator characteristic curves (0.616 and 0.400, respectively). The results of this study demonsrate that neither the Wijnen model nor the Myriad table are sensitive or specific enough to be used as the only indication when to offer genetic testing for HNPCC.     

Impaired verbal short-term memory in Down syndrome reflects a capacity limitation rather than atypically rapid forgetting

Individuals with Down syndrome suffer from relatively poor verbal short-term memory. Recent work has indicated that this deficit is not caused by problems of audition, speech, or articulatory rehearsal within the phonological loop component of Baddeley and Hitch's working memory model. Given this, two experiments were conducted to investigate whether abnormally rapid decay underlies the deficit. In a first experiment, we attempted to vary the time available for decay using a modified serial recall procedure that had both verbal and visuospatial conditions. No evidence was found to suggest that forgetting is abnormally rapid in phonological memory in Down syndrome, but a selective phonological memory deficit was indicated. A second experiment further investigated possible problems of decay in phonological memory, restricted to item information. The results indicated that individuals with Down syndrome do not show atypically rapid item forgetting from phonological memory but may have a limited-capacity verbal short-term memory system.     

The development of responses to people and a toy in infants with down syndrome

The behavior of eight infants with Down syndrome was observed biweekly from 8 to 24 weeks and monthly up to 48 weeks. At each visit the infants were presented with their mother, a female stranger, and a rattle puppet that were alternately active and passive. Each condition lasted 60 s. The results showed that by 4 months of age the infants began to differentiate, in the proportion of time they looked, smiled, and vocalized, between people and the toy. They did not discriminate, however, between mother and female stranger and between the active and passive adults until the second half of the first year. In particular, whereas normal infants usually show distress toward passive or “still-face” adults, the infants in this study continued to vocalize, at times even with smiling faces. The implications of these atypical aspects of the social development of infants with Down syndrome for their subsequent nonverbal communicative development are discussed.     

糖皮质激素联合中医温阳法治疗原发性肾病综合征系统评价

系统评价糖皮质激素联合温阳法治疗原发性肾病综合征的效果.检索PubMed、Cochrane Library、CNKI、CBM、万方、维普,查找糖皮质激素联合温阳法与单用糖皮质激素比较,治疗原发性肾病综合征的随机对照试验（RCTs）.按照Cochrane手册5.1.0,采用RevMan5.2.0软件进行Meta分析.最终纳入4个RCTs,共272例患者.经Meta分析,糖皮质激素联合温阳法可能在升高血浆白蛋白,降低24h尿蛋白定量、降血脂、改善血液流变学,提高临床疗效等方面有积极作用.但对减少激素副作用、降低疾病复发率缺乏证据.     

急性呼吸窘迫综合征肺泡塌陷与肺复张的意义

大量肺泡塌陷是急性呼吸窘迫综合征(ARDS)病理生理改变的基础,可导致顽固性低氧血症、肺泡表面活性物质丢失、呼气气流受限、去复张性肺损伤、肺部感染和生物性肺损伤。积极的实施肺开放策略,实现塌陷肺泡的复张具有重要的临床意义。肺复张导致肺泡过度膨胀、循环干扰,以及肺泡难以复张因素的存在,使肺泡完全复张可能并不必要。在避免肺泡塌陷危害与肺复张的局限性之间寻求平衡,才能使肺复张确立其在ARDS治疗中的恰当地位。     

Depression After Mild Traumatic Brain Injury: A Review of Current Research

Research pertaining to the occurrence of depression and/or depression symptomatology after a Mild Traumatic Brain Injury (MTBI) was reviewed. We found that methodological differences such as the criteria used to assess MTBI and depression, time that elapsed since brain injury, and control group variations confounded comparisons across studies. Nevertheless, the studies are consistent with at least a 35% prevalence of, and left frontal damage with depression after MTBI, an overlap of symptoms of depression and Postconcussion Syndrome (PCS), and indicate that depression can continue for many years following the injury. Our conclusion is that MTBI is the triggering event for a set of pathophysiological changes and a concomitant depressive episode in a vulnerable subset of the population. Due to a paucity of research, it cannot be definitively concluded that the underlying substrates of depression seen after MTBI and clinical depression are the same. Implications for future investigations are discussed.