慢性房颤导管消融策略的原则和个体化治疗

目前,慢性房颤导管消融的成功率及复发率均不尽人意。由于缺乏统一术式,慢性房颤消融采用的是肺静脉隔离、电图靶向消融及线性消融等多术式综合策略。在房颤消融策略上,既要坚持肺静脉电隔离原则,又要体现消融术式选择和实施的个体化,阶梯消融综合术式的推出就是这种思维方法的具体运用。     

消费者对犯错品牌评价的时间打折效应及其影响因素

通过研究品牌犯错的时间打折效应,本文试图探讨潜在消费者（未购买者）对犯错品牌评价的心理倾向。实验1研究发现,随着品牌犯错事件时间距离的延伸,消费者对身体性危害-品牌犯错的评价不会改善,即没有出现时间打折效应,而对功能性危害-品牌犯错的评价则逐渐提高,从而表现出时间打折效应。但实验2研究进一步发现,随着品牌犯错事件相关性的增强,功能性危害-品牌犯错的时间打折效应也消失。结论：潜在消费者对犯错品牌评价的心理倾向表现为“消费者防御”,并且身体性危害-品牌犯错启动的消费者防御要强于功能性危害。     

应激性抑郁样行为发生中海马5-羟色胺1A受体的作用及其对NMDA受体和AMPA受体的调节

为探讨慢性不可预见性温和应激(chronic unpredictable mild stress, CUMS)诱发抑郁样行为发生中海马5-羟色胺1A受体(5-hydroxytryptamine receptor 1A, 5-HT1AR)表达与作用, 及其对谷氨酸N-甲基-D-天冬氨酸(N-methyl-D-aspartic acid, NMDA)受体和α-氨基羟甲基异恶唑丙酸(α-amino-3-hydroxy-5- methylisoxazole-4-propionic acid, AMPA)受体的影响。通过建立CUMS动物模型, 给应激抑郁模型大鼠海马微量注射5-HT1A受体激动剂、给正常大鼠海马微量注射5-HT1A受体拮抗剂, 测量大鼠体重变化率, 并采用糖水偏爱测试、旷场实验和悬尾实验等方法对大鼠进行行为学检测, 运用Western blot和ELISA方法检测大鼠海马组织中5-HT1AR和NMDAR和AMPAR的关键亚基的表达以及磷酸化水平。结果显示, 与对照组相比, CUMS组大鼠表现出抑郁样行为, 海马5-HT1AR、AMPA受体的GluR2/3亚基表达及磷酸化明显降低, NMDA受体的NR1和NR2B亚基表达及磷酸化显著增加; 正常大鼠海马微量注射5-HT1A受体拮抗剂WAY100635, 动物行为学表现及AMPA受体、NMDA受体表达及磷酸化水平均与CUMS组相同; 注射5-HT1A受体激动剂8-OH-DPAT能逆转应激诱导的上述改变。以上结果表明, CUMS诱发抑郁样行为与海马5-HT1AR表达下降, AMPAR表达量及磷酸化水平降低, NMDAR表达量及磷酸化水平升高有关。5-HT通过5-HT1AR产生抗抑郁作用。5-HT1AR激动剂抗抑郁作用与降低NMDAR表达量及磷酸化水平, 提高AMPAR表达量及磷酸化水平密切相关。     

成败反馈对大学生核心自我评价的影响：任务重要性、外向性的调节作用

该研究以247名大学生为被试,采用2（反馈类型：成功、失败）×2（任务重要性：重要任务、不重要任务）×2（外向性：内向、外向）组间设计探讨成败反馈对大学生核心自我评价的影响,以及任务重要性和外向性在其中的调节作用。结果表明：（1）反馈类型、任务重要性和外向性对核心自我评价变化的主效应及三者的交互作用效应均显著。（2）成败反馈与任务重要性对核心自我评价变化存在显著的交互作用;简单效应分析表明,在失败反馈条件下,执行重要任务被试核心自我评价的下降幅度显著大于执行不重要任务被试核心自我评价的下降幅度。（3）成败反馈与外向性对核心自我评价变化存在显著的交互作用;简单效应分析显示,在失败反馈条件下,外向被试核心自我评价的下降幅度显著小于内向被试。（4）在失败反馈条件下,任务重要性和外向性对核心自我评价的变化存在交互作用。     

Trying and the Arguments from Total Failure

New Volitionalism is a name for certain widespread conception of the nature of intentional action. Some of the standard arguments for New Volitionalism, the so-called arguments from total failure, have even acquired the status of basic assumptions for many other kinds of philosophers. It is therefore of singular interest to investigate some of the most important arguments from total failure. This is what I propose to do in this paper. My aim is not be to demonstrate that these arguments are inconsistent or that total failure and naked tryings are metaphysically impossible. Rather, my aim is be to build a case against the possibility of naked, independently existing tryings, by questioning how well we understand the scenarios invoked in their favour. Thus, rather than attempting to present a definitive metaphysical refutation of New Volitionalism, I attempt to diminish or demolish its underlying motivation.

Living up to high standards and psychological distress

We argue and demonstrate that setting high standards, an essential aspect of perfectionism, is not associated with maladaptive responses in and of itself. Rather, our findings suggest that people's responses to their perceptions that they consistently fail to meet their own standards are maladaptive. More importantly, in the present survey study (n = 293), we extend previous research by showing that low personal standards and the perception that others are imposing high standards on the self operate in concert to strengthen the link between perceived discrepancy and psychological distress. Furthermore, in support of our moderation‐mediation model, regression analyses provided evidence for the mediating role of generalised self‐efficacy beliefs. Copyright © 2008 John Wiley & Sons, Ltd.     

特质性与情境性调节定向匹配效应的一致性

研究试图探讨基于不同性质的调节定向(特质性调节定向和情境性调节定向)而达成的匹配所导致的效应是否一致。实验一、二均采用2(调节定向：促进、防御)×2(信息框架：积极、消极)被试间设计, 分别考察了两种匹配对信息说服效果(包括信息价值评价、情绪强度、行为意向3项指标)的影响。MANOVA检验表明, 实验一中信息价值评价、情绪强度2项指标上的交互作用显著, 实验二中信息价值评价、情绪强度和行为意向3项指标上的交互作用显著; 这表明, 基于两种不同性质的调节定向所达成的匹配在对信息价值评价和情绪强度的影响上具有一致的效应, 但在对行为意向的影响上具有不一致的效应。这一结果对于理解两种不同性质的调节定向之间的差异以及基于两者而达成的两种调节匹配之间的差异具有较为重要的意义。     

Spirituality and Healthy Lifestyle Behaviors: Stress Counter-balancing Effects on the Well-being of Older Adults

The goal of this study was to examine stress-ameliorating effects of religiosity, spirituality, and healthy lifestyle behaviors on the stressful relationship of chronic illness and the subjective physical well-being of 221 older adults. We also investigated whether the intervening variables functioned as coping behaviors and orientations or as adaptations in late life. Guided by the stress paradigm, path analysis was used to assess these relationships in a stress suppressor model and a distress deterrent model. No suppressor effects were found; however a number of distress deterrent relationships were detected. Spirituality, physical activities, and healthy diet all contributed to higher subjective physical well-being, as counter-balancing effects, in the distress deterrent model. The findings have implications for future research on the role of spirituality, religiosity and lifestyle behaviors on the well-being of chronically ill older adults. Findings also support the need for studying different dimensions of religiosity and spirituality in an effort to understand coping versus adaptation in behaviors and orientations. Gracie H. Boswell, Ph.D., M.Ed. (Case Western Reserve University) and (M. Ed.- Kent State University). She is a Carolina Program in Health and Aging Research Scientist at the Institute on Aging- University of North Carolina at Chapel Hill. Her research interests have been social gerontology and quality of life, emphasizing religiosity/spirituality. Eva Kahana, Ph.D. (University of Chicago) is Pierce T. and Elizabeth D. Robson Professor of Humanities and Director of the Elderly Care Research Center- Case Western Reserve University. Her research concentration has been the sociology of aging (coping & stress and institutionalization). Peggye Dilworth-Anderson, Ph.D. (Northwestern University) is Director- Center for Aging and Diversity, Institute on Aging, Professor- School of Public Health, Department of Health Policy and Administration at University of North Carolina at Chapel Hill. Her research interests have been caregiving and minority health disparities.     

慢性腹痛

慢性腹痛病史较长,性质不定。引起慢性腹痛的原因很多,除器质性疾病外,一些功能性疾病也引起,如最终找不出具体原因,则可称之为功能性腹痛综合征。诊断比较困难,也容易误诊,甚至误治,外科医生应特别慎重。误诊的思维原因包括对引起慢性腹痛的原因认识不全面,思维惰性,辩证思维不周密和思维简化等。     

呼吸危重症临床决策中的若干问题

在临床实践中,呼吸危重症的诊断和治疗存在着一些不同的观点。就其中某些热点问题,如慢性阻塞性肺疾病合并哮喘的诊断和机械通气的指征、肺栓塞的诊断、急性呼吸窘迫综合征的治疗、呼吸重症监护病房的建设和呼吸危重症的伦理学问题进行阐述,以期提高对呼吸危重症的认识。