下肢深静脉血栓患者预防性置入下腔静脉滤器的临床决策

下肢深静脉血栓的患者,预防性置入下腔静脉滤器,可有效预防致命性肺栓塞。但致命性肺栓塞的发生率低,滤器置入是侵入性手术,术后需长期抗凝。下肢深静脉血栓患者是否常规置入滤器,临床上仍存在争议。本文对目前我国下腔静脉滤器置入现状进行分析,提出除一些特殊情况外,滤器置入不应作为一种常规,为临床决策提供参考。     

下肢深静脉血栓形成的治疗进展

下肢深静脉血栓形成在欧美是一种比较常见的疾病,在我国随着临床医师意识的加强及诊疗水平的提高,其发病率也逐年上升。下肢深静脉血栓形成的危害是其并发症一肺栓塞和血栓形成后综合征,肺栓塞是临床上导致死亡的一个重要原因,而血栓形成后综合征严重影响患者的生活质量及工作能力,故其治疗成为一个热门话题。本文对下肢深静脉血栓形成的治疗...     

关于监测深低温停循环主动脉手术期间脊髓缺血性损伤的思考

脊髓缺血再灌注损伤（spinal cord ischemic reperfusion injury,SCIRI）是深低温停循环（deep hypothermic circulatoryarrest,DHCA）主动脉手术期间一种致命性的并发症,它对患者和其家属及医务人员带来严重的身心危害。在DHCA主动脉手术期间早期监测...     

人类社会认知的神经机制:来自社会脑研究的证据

社会认知是指从环境互动的过程中推测他人意图、情感和思想等内部状态的心理加工过程。社会脑假说认为,包括人类在内的灵长类大脑内肯定存在着一个旨在认识和理解他人表情的神经机制,在社会交往中通过该中枢迅速处理与他人相互作用的各种信息。本文通过回顾社会脑的构成与基本功能,镜像神经元的发现及功能,以及社会脑、镜像神经元对社会认知影响的相关研究,提出了人类社会认知不同于其他物种的三个主要区别。     

The associated nontargets effect: Evidence of nontarget processing at and beyond the level of letter recognition

In four visual search tasks participants were asked to make a target response if either of two targets was present and to make a nontarget response if neither target was present. Some target-absent displays included only nontarget stimuli or features that never occurred in the same displays as targets, whereas other target-absent displays included nontarget stimuli or features that did sometimes occur with targets. Nontarget responses were reliably faster in the former case than in the latter. This “associated nontargets effect” indicates that nontargets are not simply classified as nontargets but in addition are discriminated from one another. Current visual search models may underestimate the degree to which nontargets are processed during search.     

Transcranial Doppler Ultrasonography Monitoring of Cerebral Hemodynamics During Performance of Cognitive Tasks: A Review

The examination of blood flow velocity (BFV) changes during the performance of mental tasks is one of the applications of transcranial Doppler (TCD) ultrasonography. The purpose of this review is to summarize the results of the functional TCD literature, to investigate the effects of methodological differences between studies, and to provide guidelines for future research. It is concluded that larger series of more homogeneous groups concerning age and handedness, and stricter criteria for subject selection and laboratory setting are required. The implication of quantitative and qualitative performance measures and psychological parameters (motivation, anxiety, and task anticipation) could also yield important information. We recommend future agreement upon a more standardized methodology. TCD promises to be a useful tool to provide further insight into the cerebral organization and temporal reactivity of the human brain.     

The relation of learning disabilities to the long-term outcomes of concussion

ObjectiveThis study sought to cross-sectionally evaluate the relation between learning disorders (LD) and long-term concussion outcomes.MethodSeventy-three asymptomatic male university athletes (23 history of concussion with LD; 24 history of concussion no LD; 26 controls) completed the Beck Depression Inventory-2 (BDI-II), the Profile of Mood States (POMS), the Cogstate battery, and an Oddball task during which event-related brain potentials were recorded.ResultsConcussed athletes with LD exhibited greater depressive symptoms (BDI-II), greater total mood disturbance (POMS), decreased accuracy on the One-Card Learning and the N-back task (Cogstate), decreased accuracy on the Oddball task, and reduced ERN amplitude relative to both the concussed athletes without a LD and controls. Concussed athletes with LD also exhibited prolonged P3 latency relative to controls. Irrespective of LD, concussed athletes exhibited increased anger-hostility and decreased Pe amplitudes relative to controls. No differences were observed in P3a amplitude or latency.ConclusionHaving LD may be a significant factor moderating the neurophysiological, cognitive and psycho-affective outcomes of concussion, and may explain a significant portion of the persistent deficits observed by researchers and clinicians.     

The mind-brain relationship: the emergent self

This paper explores the mind-brain relationship, using insights from contemporary neuroscience. It seeks to investigate how our brains become who we are, how subjective experience arises. In order to do this some explanation is given of the basic concepts of how the brain produces our subjective mental life. Current neuropsychological and neurobiological understanding of early brain development, memory, emotion and consciousness are explored. There is also an attempt at mapping the mind-brain-self relationship from a uniquely Jungian perspective. Clinical material is included in order to show the relevance of these insights to our work in the consulting room, arguing the value of the affect-regulating, relational aspects of the analytic dyad that forge new neural pathways through emotional connection. Such experience forms the emotional scaffolding necessary for the emergence of reflective function.