组织型插图对不同认知方式个体说明性文本阅读的影响

采用图文相继呈现、文本逐句阅读的范式,通过反应时技术与出声思维的方法考察了组织型插图对不同认知方式个体说明性文本阅读过程与阅读结果的影响,结果发现,与单一文本相比,场独立个体在有插图条件下的阅读成绩显著提高,而阅读时间没有增加,并产生了更多的推理、细化和提问策略;而场依存个体在有插图条件下的阅读成绩显著提高,阅读时间也显著增多,而理解策略没有变化。这说明组织型插图对两种认知方式个体说明性文本的阅读均起到促进作用,但场独立个体没有因为增加组织型插图而付出更多的加工努力,而是通过调整理解策略的方式来提高阅读效果;而场依存个体在阅读过程中没有根据组织型插图调整理解策略,阅读效果的提高是以付出更多的加工努力为代价的。     

Timing of Stressful Life Events Affects Stability and Change of Neuroticism

Neuroticism is a predictor of many health problems. To study the determinants of within‐subject change in neuroticism, three hypotheses were tested: (i) subjects who experienced stressful life events (SLEs) show an increase in neuroticism; (ii) high baseline neuroticism moderated this effect; and (iii) recent SLEs had a greater impact on neuroticism than distant SLEs. Data came from the Finnish Twin Cohort. Neuroticism data were collected in 1975 and 1981 and SLEs data in 1981 (n = 21 085). By entering baseline neuroticism as a predictor for neuroticism at follow‐up, the outcome measure was change in neuroticism. Changes in neuroticism were predicted from SLE indices or their interaction with baseline neuroticism. Timing of SLEs was taken into account by distinguishing recent from distant SLEs. To control for confounding by shared genes and environments, both within‐twin pair and between‐twin pair effects were tested for monozygotic and dizygotic twin pairs separately. Neuroticism's six‐year stability was high (r = .58, p < .001). Exposure to SLEs modestly increased neuroticism (βs > .55, ps < .001), unconfounded by shared genes. This effect was not moderated by high baseline neuroticism. Recent SLEs (.09 < βs < .15) had more impact than distant SLEs (.03 < βs < .11; ps < .01). In conclusion, the findings strongly supported a model of environmentally driven SLEs causing dynamic fluctuations around a person's set point of neuroticism. Copyright © 2013 John Wiley & Sons, Ltd.     

帕金森病诊断标记物系统回顾与展望

本篇综述总结了帕金森病的诊断、鉴别诊断和病程监测的各领域的生物学标记物的研究进展。其中重点介绍了神经影像学和生物化学领域的生物学标记物,也是当前研究较为成熟的两大领域。神经影像学标记物以多巴胺能影像及非多巴胺能影像为代表,生物化学标记物为包括a一突触核蛋白在内的多种蛋白和激素,两者的结合能够有效提高疾病诊断的特异性和灵敏性。同时文章还介绍了当前研究的热点——帕金森病的前驱诊断手段,即在疾病典型的运动症状和非运动症状出现前便可预测帕金森病的诊断手段。     

炎症性肠病的药物治疗现状及进展

炎症性肠病（IBD）病程迁延反复,影响患者生活质量,耗费卫生资源。虽然传统药物如5-氨基水杨酸、糖皮质激素、免疫抑制剂等仍是目前治疗主流,但是大量有关发病机制的研究以及循证医学的发展对IBD的治疗产生了积极的推进作用。IBD的治疗正步入免疫调节的生物学时代,多种新型生物制剂的出现为IBD的治疗提供了新的策略和选择。现就目前IBD药物治疗现状以及最新进展进行综述,以期对临床IBD治疗提供参考。     

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。     

新农合制度调整前后豫北地区腹膜透析患者透析质量的比较

腹膜透析是终末期肾脏病的有效替代治疗方法之一。2012年4月,河南省对包括慢性肾衰竭在内的六种疾病的新农合报销比例做出重大调整,腹透患者主要经济花费的透析液报销比例由原来的40％提高至80％。通过研究新农合制度调整前后豫北地区腹膜透析患者的临床资料,报告了制度调整后的患者透析充分性提高,贫血、营养状况较前好转,心血管疾病发生率下降,生存质量改善的现况,论证了老龄、糖尿病、营养不良、心血管疾病、透析不充分、较低的医疗保险支付比例是影响腹膜透析患者预后的重要因素,为腹膜透析患者的预后分析提供了理论依据。     

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.     

Italian Adaptation and Confirmatory Factor Analysis of the Full and the Short Form of the Posttraumatic Growth Inventory

This study was designed to adapt and to assess the reliability and factor structure of an Italian translation of the full and short form of the Posttraumatic Growth Inventory. A sample of 1,244 Italian adults who had experienced a range of adverse life events participated in this study. Five models of the underlying structure of the Posttraumatic Growth Inventory were tested via confirmatory factor analyses. Analyses of both the short and full form of the PTGI provided support for the original correlated five-factor structure. Multigroup confirmatory factor analysis supported the invariance of the Posttraumatic Growth Inventory across gender.     

Relationship quality,divorce, and well-being: Findings from a three-year longitudinal study

Recent studies indicate that divorce sometimes is positive for subjective well-being, but we lack knowledge about the circumstances under which this is the case. Further, we lack knowledge about the possible different associations between divorce and life satisfaction (LS) vs. positive affect (PA). The current study is based on the Norwegian Mother and Child Cohort Study (MoBa). Change in LS and PA over a three-year period was examined in women who divorced and women who did not divorce (N > 37,000). Relationship quality and relationship status at follow-up were included in the models. The results indicated that divorce predicted higher LS and PA when initial relationship quality was poor. Furthermore, divorce predicted higher PA for women who, after divorce, reported being in a new romantic relationship. The associations between relationship quality and LS and PA were stronger among not-divorced than divorced women, indicating that relationship quality affects LS and PA.