Motor-Skill Learning in Alzheimer’s Disease: A Review with an Eye to the Clinical Practice

Since elderly people suffering from dementia want to go on living independently for as long as possible, they need to be able to maintain familiar and learn new practical skills. Although explicit or declarative learning methods are mostly used to train new skills, it is hypothesized that implicit or procedural techniques may be more effective in this population. The present review discusses 23 experimental studies on implicit motor-skill learning in patients with Alzheimer’s disease (AD). All studies found intact implicit motor-learning capacities. Subsequently, it is elaborated how these intact learning abilities can be exploited in the patients’ rehabilitation with respect to the variables ‘practice’ and ‘feedback.’ Recommendations for future research are provided, and it is concluded that if training programs are adjusted to specific needs and abilities, older people with AD are well able to (re)learn practical motor skills, which may enhance their autonomy.     

Early Detection of Memory Impairment in Alzheimer’s Disease: A Neurocognitive Perspective on Assessment

We propose that the earliest neuropsychological detection of Alzheimer’s disease (AD) can be informed by current views about the neuropathogenesis of AD and cognitive models of memory and its neurobiological substrates. The primary impairment in early AD is encoding/consolidation, resulting from medial temporal lobe (MTL) pathology. On theoretical and empirical grounds, paired associate learning (PAL) appears to be the ideal paradigm for detecting MTL dysfunction in early AD. It has not been embraced as a test of choice, however, and this critical review discusses why the paradigm may have not fulfilled its potential. We suggest that a new PAL variant, ‘associate-recognition’, may prove to be clinically efficacious.     

Depressed and Anxious COPD Patients: Predictors of Psychotherapy Engagement from a Clinical Trial

This study examined patient-level factors associated with engagement in mental health treatment in a sample of medically ill patients with clinically significant symptoms of depression and/or anxiety. A total of 248 patients was enlisted from a randomized controlled trial of cognitive-behavioral therapy for depression and anxiety in patients with chronic obstructive pulmonary disease (COPD). Logistic regression analysis was used to predict mental health engagement, defined as attending at least one intervention session. Results indicated that patient-perceived mastery over COPD was negatively related to mental health engagement. Further, mastery was the only significant predictor of mental health engagement after controlling for patient demographic characteristics, severity of COPD, depression, and anxiety. To improve engagement for medically ill patients with comorbid mental health difficulties, clinicians should explore patients’ attitudes about their mental health within the context of their perceived ability to cope with their medical disease.     

中医药对牙周病的研究和治疗思路

中医药对牙周病的研究和治疗已有悠久的历史,它与牙周基础治疗结合可以获得良好的治疗效果,可弥补单纯西医在治疗牙周病时偏重局部的缺陷。对中医药对牙周病研究和治疗的历史和进展情况作了简要综述,并就中医药对牙周病的治疗思路和中西医结合治疗牙周病的科学合理性进行了探讨。     

关于慢性乙肝病毒携带者治疗问题的商榷

从乙型肝炎病毒(HBV)在体内存在的不同阶段、乙型肝炎发病机制及目前抗病毒治疗现状对慢性乙肝病毒携带者治疗问题进行了初步探讨,提出了绝大多数慢性乙肝病毒携带者不需要治疗的理由,以指导患者和医务人员解决相关问题。     

强化降脂治疗的理性思考

他汀类药物因具有丰富的循征医学证据而成为一种不可缺少的预防和治疗冠状动脉粥样硬化性心脏病的降脂药物。近年来对高危患者提出强化降脂的概念,然而大剂量的他汀类药物的使用可能伴随着更多副作用及低效价比等问题。因此辨证地对待强化降脂的治疗策略是必要的。     

浅谈脂肪肝的诊治策略

脂肪肝已成为威胁国人健康仅次于病毒性肝炎的第二大肝病。通过对脂肪肝发病机制、发病原因、诊断方法和防治措施的深入研究,能够确定行之有效的诊治策略。针对病因和(或)诱因进行预防,走出在脂肪肝治疗上的误区,对遏制脂肪肝的日益严重的发病趋势和降低医疗费用有着十分重要的意义。     

我国公共卫生中的伦理学问题

在公共卫生研究中重点探讨了伦理审查、研究对象选择、知情同意、保护研究对象隐私、对研究对象的适当补偿等方面的伦理学问题;在公共卫生实践中重点探讨了传染病防治、疾病监测、计划免疫、疾病筛查及卫生资源配置领域中的伦理学问题。重视这些问题并参照一定的伦理学原则将有助于解决问题,更好地促进公共卫生事业的发展,促进人群健康。     

神经颗粒素与脑老化、疾病及应激关系

神经颗粒素是一种神经元特异性、Ca2＋敏感性的鈣调蛋白（CaM）结合蛋白,是蛋白激酶C的突触后底物,与信号传导和长时程增强（LTP）有关。这是一种新发现的脑特异性蛋白质。主要分布在前脑和海马,在皮质、海马CA1-CA3区、齿状回、纹状体和杏仁核中高表达。在大脑发育的不同阶段,神经颗粒素在脑内的含量和分布区域会发生变化,其生物学作用受到国内外学者的关注。近年来国外学者开始对神经颗粒素与脑老化、疾病及应激关系进行考查。该文将着重介绍对神经颗粒素在脑老化、疾病和应激过程中所扮演的角色的研究工作及其新发现,目的是对脑与行为关系的理解及有关的脑机制的研究提供一个新的视点。     

慢性乙型肝炎诊治现状中值得注意的几个问题

慢性乙型肝炎已成为目前我国最为重要的危害人类健康的传染病之一,其防治刻不容缓。由于缺乏特效药,在诊治中存在一些问题,需科学引导。