Clock drawing performance and brain morphology in mild cognitive impairment and Alzheimer's disease

The Clock Drawing Test (CDT) is a widely used instrument in the neuropsychological assessment of Alzheimer's disease (AD). As CDT performance necessitates several cognitive functions (e.g., visuospatial and constructional abilities, executive functioning), an interaction of multiple brain regions is likely. Fifty-one subjects with mild cognitive impairment, 23 with AD and 15 healthy controls underwent high-resolution magnetic resonance imaging. Optimized voxel-based morphometry (VBM) was performed to investigate the putative association between CDT performance and gray matter (GM) density throughout the entire brain. In the first step of analysis (p<.001, uncorrected), VBM revealed a reduced GM density in numerous cortical (temporal lobe, frontal lobe, parietal lobe, cerebellum) and subcortical (thalamus, basal ganglia) brain regions to be associated with poorer CDT performance. When corrected for multiple comparisons (p<.01), the associations remained significant predominantly in the left temporal and--less pronounced--the right temporal lobe. VBM demonstrated CDT performance to depend on the integrity of widely distributed cortical and subcortical areas in both brain hemispheres with accentuation in the left-sided temporal lobe region.     

The Swedish National Adult Reading Test (NART-SWE): a test of premorbid IQ

The purpose of this study was to construct a Swedish version of the National Adult Reading Test (NART-SWE), a test for assessment of premorbid IQ, and to investigate its validity and reliability on healthy controls and patients with mild Alzheimer's disease. As Swedish pronunciation rules are fixed, NART-SWE was constructed using loan words. NART-SWE has satisfactory psychometric properties: Inter-rater and retest reliability as well as internal consistency are very high. The NART-SWE demonstrates face validity. In addition, high correlation with IQ was obtained. A significant model emerged when using NART-SWE to predict IQ. Furthermore, no significant differences were observed when comparing performance for healthy controls' with that of patients with Alzheimer's disease on NART-SWE. It does appear that reading of irregular words is intact in mild Alzheimer's disease.     

揭开“看牙难、看牙贵”的面纱

患者对现有分科看牙模式的失望和对牙科医疗机构的商业化模式的疑问,产生了“看牙难、看牙贵”的感叹。通过14年的全科牙医诊疗体系的实践,从结构影响结果的哲学角度提出全科牙医教育培训体系的建立和牙科产业链调整的设想。通过对历史上全科牙医的回顾,推测全科牙医和专科牙医的互补形式,将成为中国牙科医疗体系的“新式样”。通过对牙科医疗机构运行机制的分析提出了改善的建议。     

论医院实行单病种限价的伦理学价值

从单病种限价在医院内部管理机制等方面的作用出发,探讨了实施单病种限价的伦理价值基础和伦理学意义。认为单病种限价政策能促使医院形成“以人为本”的管理理念,切实维护患者利益,培养医务人员的医德素质,促使医院重视德源资产和品牌形象的建设,强化医务人员精益求精的科学精神,取信于民并帮助医院树立诚信的道德形象,是医院可持续发展的可取途径。     

框架效应及其认知机制的研究进展

框架效应违背了不变性原则,是描述性决策理论违背规范性理论的经典异像。以亚洲疾病问题为代表的经典框架效应又称作风险选择框架效应,此外还包括特征框架效应等不同类别。框架效应受损益值类型和大小等社会线索影响。除展望理论可以解释其认知机制外,模糊痕迹理论和概率心理模型等也对此加以解释。框架效应的脑机制在大脑右半球和杏仁核等区域。文章最后对全文做了总结及展望。     

Socioeconomic Differences in Psychosocial Factors Contributing to Coronary Heart Disease: A Review

Psychosocial factors have been shown to play an important role in the aetiology of coronary heart disease (CHD). A strong association between CHD and socioeconomic status (lower-level education, poor financial situation) has also been well established. Socioeconomic differences may thus also have an effect on psychosocial risk factors associated with CHD, and socioeconomic disadvantage may negatively affect the later prognosis and quality of life of cardiac patients. The aim of this study was to review the available evidence on socioeconomic differences in psychosocial factors which specifically contribute to CHD. A computer-aided search of the Medline and PsycINFO databases resulted in 301 articles in English published between 1994 and 2007. A comprehensive screening process identified 12 empirical studies which described the socioeconomic differences in CHD risk factors. A review of these studies showed that socioeconomic status (educational grade, occupation or income) was adversely associated with psychosocial factors linked to CHD. This association was evident in the case of hostility and depression. Available studies also showed a similar trend with respect to social support, perception of health and lack of optimism. Less consistent were the results related to anger and perceived stress levels. Socioeconomic disadvantage seems to be an important element influencing the psychosocial factors related to CHD, thus, a more comprehensive clarification of associations between these factors might be useful. More studies are needed, focused not only on well-known risk factors such as depression and hostility, but also on some lesser known psychosocial factors such as Type D and vital exhaustion and their role in CHD.     

The Psychosocial Vulnerability Model of Hostility as a Predictor of Coronary Heart Disease in Low-income African Americans

The current study examined social support and stress as mediators of the hostility—coronary heart disease (CHD) relationship as suggested by the psychosocial vulnerability model in a sample of low-income African Americans. Among 95 CHD patients and 30 healthy controls, hostility was negatively correlated with social support, but was not related to minor stress. CHD patients endorsed higher levels of hostility; however, the relationship between hostility and CHD status was diminished once stress and social support were included in the model. This study lends partial support for the psychosocial vulnerability model of hostility in African Americans, but suggests that the relationship between hostility and stress may be impacted by socioeconomic status.     

Rigidity in social and emotional memory in the R6/2 mouse model of Huntington's disease

Four experiments were conducted to examine social and emotional memory in the R6/2 transgenic mouse model of Huntington’s disease. First, R6/2 mice were tested in a social transmission of food preference task where they had to acquire a preference for a flavoured food (acquisition) and subsequently to learn a preference for a different flavour (shifted reinforcement). R6/2 mice performed well in the acquisition trial. However, they were impaired in the shifted reinforcement trial and perseverated on the first preference learned. Second, mice were trained in an inhibitory avoidance paradigm, with either one or two footshocks delivered during the training. WT mice given one footshock showed retention levels lower than those of mice trained with two footshocks. By contrast, there was no difference in retention levels of R6/2 mice given either one or two footshocks. Third, mice were tested in an active avoidance task that paired a mild footshock with a warning light. R6/2 mice had a strong age-dependent deficit in this task. Finally, mice were tested in a conditioned taste aversion task that paired a saccharine solution with a nausea-inducing agent (LiCl). R6/2 mice displayed normal aversion, however this was not extinguished following repeated exposure to saccharine solution alone. Our data show that while R6/2 mice have functional hippocampus-based memory, they have deficits in striatum-based memory skills. Further, social and emotional memories appear to be encoded in a rigid way that is not influenced by subsequent learning or by arousal levels.     

出血性脑血管病介入治疗进展

出血性脑血管病的介入栓塞治疗由于血管内辅助技术与各种栓塞材料的综合应用取得快速发展,主要有以下三个方面：（1）生物修饰弹簧圈、封堵球囊和支架技术的应用使复杂颅内动脉瘤的介入治疗成为可能;（2）非粘附性液体栓塞剂的应用提高了脑动静脉畸形和硬脑膜动静脉瘘的单纯栓塞治愈率;（3）带膜支架在颅底部巨大动脉瘤和创伤性动静脉瘘取得开创性应用。     

经皮肺活检对肺部病变的诊断价值

经皮肺活检技术应用已有100多年历史。随着影像技术的不断进步,目前已发展成为肺部疾病的重要诊断技术。本文综述了经皮肺活检对肺部病变的诊断价值。并探讨和比较了不同引导技术的特点,以及适应症、并发症及其处理。