手术治疗单一局部复发或远处转移病灶乳腺癌的临床观察

探索手术治疗单一局部复发或唯一远处转移病灶乳腺癌的临床价值。收集2006年6月至2013年6月湖南省人民医院乳甲外科收治的64例局部复发或术后远处转移乳腺癌患者,其中28例为单发病灶病例。根据是否采取了包含手术的综合治疗,将其分为手术组与非手术组。回顾性分析两组的临床资料和随访数据,分析手术治疗局部复发或远处转移乳腺癌有无临床意义。结果28例都采取了含化疗的综合治疗,8例局部单发病灶与9例远处单一脏器转移病例进行了手术治疗。手术组的局部缓解率与控制率明显优于非手术组,均为100％。两组无进展生存时间（PFS）和总生存时间（（）S）比较,手术组明显长于非手术组;但在单一远处脏器转移手术组中0S没有优势。2年生存率方面手术组与非手术组比较有统计学意义。对于术后单一局部复发病灶或唯一远处脏器转移的乳腺癌患者,采取含手术的综合治疗方案能带来明显的PFS优势,若有手术机会和条件成熟,手术仍是不应放弃的有效治疗方法。     

部分线索对记忆提取的影响:认知抑制能力的作用

在回忆时,以刚刚学过的部分项目作为提取线索,被试的回忆成绩反而比没有任何线索时的回忆成绩差,这一现象被称为部分线索效应。该效应通常被认为是抑制执行控制过程对非线索项目记忆表征强度抑制的结果。本研究以Stroop效应量(实验1)和工作记忆容量(实验2)为指标,从个体差异角度考察了认知抑制能力对部分线索效应的影响。结果发现,Stroop效应量与部分线索效应各指标呈显著负相关,Stroop效应量越小,部分线索效应各指标的值越大;工作记忆容量与部分线索效应各指标呈显著正相关,高工作记忆容量个体的部分线索效应各指标的值也更大。结果表明,认知抑制能力越强,部分线索对回忆的破坏作用越大,研究结果支持部分线索效应的提取抑制假说。     

基于不对称区间估计的有调节的中介模型检验

有调节的中介模型是中介过程受到调节变量影响的模型。评介了基于Bootstrap不对称置信区间和贝叶斯不对称可靠区间进行有调节的中介模型检验的3种方法, 包括亚组分析法、差异分析法和系数乘积法。模拟研究发现, 偏差校正的百分位Bootstrap置信区间和无先验信息的贝叶斯可靠区间在有调节的中介模型检验中表现相当, 都优于百分位Bootstrap置信区间的表现。建议使用系数乘积法进行第一阶段或第二阶段被调节的中介模型检验, 使用差异分析法进行两阶段被调节的中介模型检验, 并用一个实际例子演示如何用不对称区间估计检验有调节的中介模型。随后评述了3种有调节的中介模型检验方法在国内心理学的应用现状, 并展望了检验的拓展方向。     

简化的联合再认范式中情绪对错误记忆影响的年龄差异

以康奈尔情绪DRM词表为主要实验材料, 使用简化的联合再认范式(DRM范式的变式), 结合多项式加工树建模的统计手段, 对34名年轻人(23 ± 2岁)和28名老年人(68 ± 5岁)的再认记忆进行比较, 以考察不同年龄组中情绪效价对错误记忆的作用机制。结果发现材料的情绪效价对错误记忆的影响存在显著年龄差异：(1) 积极情绪能够有效降低老年人的错误记忆, 其作用机制为积极情绪增强了老年人的字面痕迹而减弱了要点痕迹提取; (2) 消极情绪能够有效地降低年轻人的错误记忆, 其作用机制为消极情绪使年轻人反应偏向降低, 但不影响其记忆痕迹的提取。结果表明, 简化的联合再认范式下, 情绪效价对错误记忆的效应存在明显的年龄差异：老年人表现出积极情绪降低错误记忆的积极偏向; 年轻人表现出消极情绪降低错误记忆的消极偏向; 情绪效应对错误记忆的认知机制存在年龄差异。     

老子之道及其创生因子探究

"道"是老子哲学体系中的核心,老子不仅提出虚空的道是宇宙的本体,是无法用语言来描述的,而且说明道是混成之物,即道是有精妙的内部结构属性的,并从不同的侧面说明了认识"道"是混成之物的路径。道是由无限创生因子混融而成的系统,宇宙在创生及万物演化的过程中,道或无限的创生因子始终起着根本性的作用,即宇宙间的一切事物现象都是道所为。道是由创生因子混融而成的思想观点,可为现代宇宙论的发展提供新的思维维度,为科学探索真空世界的奥秘提供新的研究途径,推进现代宇宙学的进步。     

Distance stability analysis in multidimensional scaling using the jackknife method

Stability or sensitivity analysis is an important topic in data analysis that has received little attention in the application of multidimensional scaling (MDS), for which the only available approaches are given in terms of a coordinate‐based analytical jackknife methodology. Although in MDS the prime interest is in assessing the stability of the points in the configuration, this methodology may be influenced by imprecisions resulting from the inherently necessary Procrustes method. This paper proposes an analytical distance‐based jackknife procedure to study stability and cross‐validation in MDS in terms of the jackknife distances, which is not influenced by the Procrustes method. For each object, the corresponding jackknife estimated points are considered as naturally clustered points, and stability and cross‐validation are analysed in terms of the MDS distances arising from the jackknife procedure, on the basis of a weighted cluster‐MDS algorithm. A jackknife‐relevant configuration is also proposed for cross‐validation in terms of coordinates, in a cluster‐MDS framework.     

Psychological strengths and subjective well-being in South African white students

This study investigated the role of individual resources, notably self-efficacy, gratitude, and hope, in subjective well-being of white dormitory students at a historically white institution of higher learning. Using a convenience sample of white students (N?=?227), we tested the role of generalised self-efficacy, gratitude, and hope as indicators of a latent factor, labelled personal resources, in a structural equation model with subjective well-being as the latent output variable, measured by self-esteem and satisfaction with life. Path analyses indicated a reasonable fit between the data and our hypothesised theoretical model which proposed positive relations between levels of generalised self-efficacy, gratitude, dispositional hope, self-esteem and satisfaction with life. White students were psychologically doing well, considering above-midpoint levels obtained for levels of generalised self-efficacy, gratitude, dispositional hope, and satisfaction with life However, scores obtained for self-esteem and adult dispositional hope were below the mid-point and neutral respectively, indicating that White students do not agree that they experience high levels of these two psychological strengths. White female students experienced higher levels of hope, gratitude, and life satisfaction, while no significant gender differences were found for generalised self-efficacy and self-esteem. The results of this study highlight the potential for using psychological strengths to promote well-being in racially diverse students.     

Fostering Strength and Resiliency in Same-Sex Couples

Abstract

Same-sex couples are presented widiin tiieir cultural contexts to examine how those contexts might influence me strength and resilience of their relationships. We are particularly interested in the ability of the couple relationship to fulfill family functions that serve the social, psychological, and physical needs of each of the partners and society (Patterson, 2002a). Three family functions: family formation and membership, nurturance and socialization, and protection of vulnerable members, are particularly germane to same-sex couples. We examine several topic areas related to these three functions in order to assist clinicians in identifying factors that may prohibit same-sex couples from becoming and remaining strong and resilient.     

抑郁的多基因遗传基础

抑郁具有复杂的、非孟德尔式的多基因遗传模式, 但是目前多数抑郁的遗传研究集中于考察单个候选基因, 不能全面揭示遗传因素的作用机制。近年来, 多基因遗传得分研究和基因−基因交互研究分别为抑郁的多基因累加效应和交互效应提供了新的证据。多基因不仅直接影响抑郁, 还通过与环境因素的交互作用影响抑郁的发生发展, 并且这一复杂交互作用存在性别差异。抑郁的内表型研究发现多基因可能通过认知因素、人格、压力荷尔蒙等间接影响个体的抑郁水平。未来研究应更加关注多基因与多种环境因素如何相互作用影响抑郁, 探索多基因遗传机制的性别差异, 考察多基因对抑郁影响随年龄的发展动态变化。     

和谐医患命运共同体建设的思考

医患关系作为医疗诊治活动中最主要的关系,是以医护人员为核心的群体与以患者为核心的群体之间的关系。近来,医患关系在一定程度上的对立以及由此引发的社会公共事件激起了广泛的社会反响。旨在通过构建人类命运共同体对医患关系的启示,结合社会现实和医患关系实际,从医患双方生命至重的理念统一、防病治病的过程统一、平等尊重的人文情怀统一以及权利义务的关系统一等方面,对当前医患关系进行深入分析,对“和谐医患命运共同体”的建设加以阐释,以期对医患关系的深入探讨提出可行性的建议和支持。