Narcotrend监测下右美托咪定对冠心病患者麻醉诱导期血流动力学的影响

观察Narcotrend监测下右美托咪定联合丙泊酚靶控输注用于冠心病患者非心脏手术麻醉诱导时对血流动力学的影响.合并冠心痛行非心脏手术患者40例,随机分为两组：Dex组（n=20,患者在诱导前静脉泵注右美托咪定0.5μg/kg,15min内输注完毕）,对照组（n=20,等量生理盐水,方法同Dex组）.记录给药前后及诱导期间患者的血流动力学变化.对照组在气管插管即刻以及气管插管3min后血流动力学指标值均高于插管前,气管插管5min后平均动脉压（MAP）低于插管前（P＜0.05）,Dex组无明显差异.麻醉诱导前15min静脉注射0.5μg/kg右美托咪定可以使冠心病患者丙泊酚靶控输注诱导期间血流动力学更加平稳.     

阿尔茨海默病的诊治新进展

流行病学数据的更新表明阿尔茨海默病（A D ）已成为全球健康问题。早期应用生物标志物的AD新诊断标准广泛应用和临床试验不断失败的鲜明反差提示AD治疗的艰巨性。AD和其他慢性疾病的共病研究不断深入。生活方式干预作为非药物治疗备受重视。     

基层医院实施《诊疗与防控手足口病指南》的困境

探讨实施卫生部所颁发的手足口病诊疗与防控指南存在的难点.通过实践,依据指南,笔者将近几年工作中所遇到处理各种肠道病毒感染病例存在的问题加以分析,列出实施指南存在诸多临床及非临床的影响因素,包括：（1）上报、隔离引起的矛盾;（2）诊断、治疗、转诊引起的矛盾;（3）处理肠道病毒71型（EV71）感染、疱疹性咽峡炎等与手足口病的矛盾.较多的矛盾令基层医院依照目前的指南难以良好地开展工作,期待更完善的指南以及各地医疗主管部门制定切合实际的、可行的、各种具体的防控预案.     

Effects of telephone support on exercise capacity and quality of life in patients with chronic obstructive pulmonary disease: a meta-analysis

The aim of this meta-analysis was to evaluate the effects of disease education or pulmonary rehabilitation programs assisted with telephone support on physical capacity and quality of life (QOL) in chronic obstructive pulmonary disease (COPD) patients. A systematic search of PubMed, Embase, Web of Science and The Cochrane Library was conducted until May 2017. Randomized controlled trials (RCTs) examining the effects of telephone-assisted intervention versus a control group on exercise tolerance and QOL in patients with COPD were included. Two independent authors assessed the methodological quality of the trials using the Cochrane risk of bias tool. A meta-analysis was conducted with the Revman5.3 to quantify the effects of telephone-assisted interventions on walking capacity and QOL. In total, 10 studies involving 1037 participants were included. Due to the effect of telephone-assisted interventions, statistically significant results were found on Saint-George’s Respiratory Questionnaire (SGRQ) symptom scores [standard mean difference (SMD) ?.18, 95% confidence interval (CI) ?.33, ?.03, p-value .02)], SGRQ impact scores [SMD ?.35, 95% CI ?.60, ?.10, p-value .006)], SGRQ activity scores [SMD ?.30, 95% CI ?.45, ?.15, p-value < .0001)], SGRQ total score [SMD ?.36, 95% CI ?.51, ?.21, p-value < .00001)]. The effects on 6-min walk test (6MWT) and all Chronic Respiratory Questionnaire (CRQ) subscales were not significant (p > .05) based on the insufficient evidence. In conclusion, the role of telephone-assisted interventions in the management of COPD remains equivocal. Some encouraging results were seen with regard to SGRQ symptom, SGRQ impact, SGRQ activity and SGRQ total score. We believe that more methodologically rigorous large-scale randomized controlled trials are necessary to answer this study question.     

Both fearful and happy expressions interact with gaze direction by 200 ms SOA to speed attention orienting

Attention orienting towards a gazed-at location is fundamental to social attention. Whether gaze cues can interact with emotional expressions other than those signalling environmental threat to modulate this gaze cueing, and whether this integration changes over time, remains unclear. With four experiments we demonstrate that, when perceived motion inherent to dynamic displays is controlled for, gaze cueing is enhanced by both fearful and happy faces compared to neutral faces. This enhancement is seen with stimulus-onset asynchronies ranging from 200–700?ms. Thus, gaze cueing can be reliably modulated by positive expressions, albeit to a smaller degree than fearful ones, and this gaze–emotion integration impacts behaviour as early as 200?ms post-cue onset.     

Support groups for parents with an adult child suffering from bipolar disorder

Confronted with the disconcerting behaviour exhibited by their children, parents of bipolar patients are in severe distress. Research focuses on the study of the ‘burden’ that the pathology puts on caregivers, owing to their experience of depression, sometimes combined with the presence of hostile attitudes and negative affects. In France, parents of adult patients encounter an initial specific difficulty: they are not systematically included in the care management system. Thanks to the initiative of an association of psychiatrists and psychoanalysts, the authors set up a psychoanalytic support group for the parents of ‘bipolar’ adults. The diagnosis of a bipolar disorder is established by a psychiatrist within a medical structure. Support groups for parents do exist in France, but their experiences have not led to scientific publications on this specific topic. Existing publications focus on other types of pathology and other therapeutic approaches. In this article, we will highlight how this type of psychoanalytic support group, with operating rules based on the theoretical work of Anzieu, can help parents of patients with bipolar disorders. Group participants accepted the principle of a research study that maintained their anonymity. We collected and analysed qualitative data from the first year of the group, so we highlight the specific difficulties of these parents, faced with chronic disease. The relevance of our qualitative study also resides in the data collected over a period of time, enabling us to see the progress made, and encouraging us to reflect on the place of psychoanalytic groups for parents, as well as on the care management of this pathology.     

School Perceptions of Children Raised by Grandparents

Increasing numbers of children raised by grandparents are students in schools. Their substitute family structure and precursors to the emergence of this family structure have implications for the children's school performance. Research suggests teachers view these children as at risk for difficult school functioning. The aforementioned judgment is problematic because teacher expectations, attributions, and biases are associated with stereotype threat that impacts student performance adversely. The author compares children raised by grandparents with children raised by parents and foster parents. The author examines the children's perceptions of their teachers' views of their school performance. He also examines the children's general feelings about school. Participants in the study were 6,550 students in Grades 6–8 from the nationally representative Health Behaviour in School-aged Children survey. Nonparametric statistical analyses reveal children raised by grandparents believe teachers' view their school performance negatively when compared with children living with both parents. Strategies are described to improve the children's performance in school and to foster favorable teacher perceptions.     

Self-compassion and responses to negative social feedback: The role of fronto-amygdala circuit connectivity

ABSTRACT

Self-compassion has been shown to have significant relationships with psychological health and well-being. Despite the increasing growth of research on the topic, no studies to date have investigated how self-compassion relates to neural responses to threats to the self. To investigate whether self-compassion relates to threat-regulatory mechanisms at the neural level of analysis, we conducted a functional MRI study in a sample of college-aged students. We hypothesized that self-compassion would relate to greater negative connectivity between the ventromedial prefrontal cortex (VMPFC) and amygdala during a social feedback task. Interestingly, we found a negative correlation between self-compassion and VMPFC-amygdala functional connectivity as predicted; however, this seemed to be due to low levels of self-compassion relating to greater positive connectivity in this circuit (rather than high levels of self-compassion relating to more negative connectivity). We also found significant relationships with multiple subcomponents of self-compassion (Common Humanity, Self-Judgment). These results shed light on how self-compassion might affect neural responses to threat and informs our understanding of the basic psychological regulatory mechanisms linking a lack of self-compassion with poor mental health.     

Force versus fury: Sex differences in the relationships among physical and psychological threat potential,the facial width‐to‐height ratio,and judgements of aggressiveness

Individuals with larger facial width‐to‐height ratios (FWHRs) are judged as more threatening, and engage in more threat‐related behavior, than do individuals with smaller FWHRs. Here we identified components of threat potential that are related to the FWHR. In Study 1, the FWHR was correlated positively with physical threat potential (bicep size) in women and with both physical and psychological (anger proneness) threat potential in men. Behavioral aggression was measured in a subset of these participants using the Point Subtraction Aggression Paradigm (costly aggression) and a Money Allocation Task (non‐costly aggression). Psychological (but not physical) threat potential predicted non‐costly aggression and physical (but not psychological) threat potential predicted costly aggression. In Study 2, a separate set of participants judged the anger proneness, strength, or aggressiveness of male participants photographed in Study 1. Participants’ judgements of all three characteristics were associated with the FWHR, and there were sex differences in how aggressiveness was conceptualized (for women, aggressiveness was associated with anger proneness, for men, aggressiveness was associated with strength). These results are consistent with the hypothesis that the FWHR may be an adaptation to cue the threat potential of men.