风湿性心脏病瓣膜置换术后抗凝治疗中“度”的把握

风湿性心脏瓣膜病在世界范围内发病率极高,瓣膜置换术是目前治疗该病的主要方法,根据不同的病情及需要可置换机械瓣或生物瓣,我国患者更常选择机械瓣置换,术后生物瓣置换需抗凝3个月～6个月,而机械辩置换者需终身抗凝,故抗凝治疗非常关键。本文从辨证思维的角度分析如何在瓣膜置换术后把握好抗凝治疗。     

The trouble with halos: Invited commentary on Kim,S., & Harris,P. L. (2014). Children prefer to learn from mind‐readers. British Journal of Developmental Psychology

This commentary on Kim and Harris (2014) addresses the authors’ interpretation of the halo effect, in which 5‐ to 6‐year‐old children preferentially agreed with an informant who could read other people's minds, regardless of domain of knowledge.     

Imaginative Faith: Apocalyptic,Science Fiction Theory,and Theology

Abstract : Both pastors and academic theologians have struggled with the place of apocalyptic language and imagery within the modern worldview. Many have dismissed apocalyptic as escapist and have alleged that it is divorced from the political and social concerns at the heart of contemporary theology and practice. Yet, contemporary critical theorists have overcome similar suspicions about science‐fiction and now embrace it as a unique vehicle for thinking about the ills and the promise of contemporary culture. This essay suggests that within contemporary critical theory one finds useful tools for reading and using apocalyptic language and imagery as a means for engaging a world threatened by sin and violence.     

长柄假体置换治疗高龄粉碎性粗隆间骨折的随访研究

为了探讨长柄假体置换治疗高龄粉碎性粗隆间骨折的短期疗效,我们对31例符合要求的研究对象进行了平均22个月的随访,指标包括Charnley及Harris评分以及X-ray平片,结果最近一次X—ray观察3例出现异位骨化,无一例假体松动,Charnley分级Ⅳ级及以上90．0％,Harris评分优良率88．3％,因此长柄假体置换是治疗高龄粉碎性粗隆间骨折的理想选择之一。     

激素替代治疗对绝经妇女心脏保护效应的重新认识

激素替代疗法（HRT）已有数十年历史,但是否具有心脏保护效应一直存在争议。早期研究提示HRT可维持血管正常功能,但大样本随机对照研究却发现服用雌激素和孕激素妇女的心血管疾病较安慰剂组增加22％,这导致了HRT应用的急剧减少。而2007年妇女健康启动计划——冠状动脉钙化研究（WHI—CACS）却证实HRT能显著降低冠状动脉钙化,再次提起了人们对HRT心脏保护效应的关注。     

人工腰椎间盘置换预示了腰椎融合的终结？

腰椎间盘退变性疾患的治疗方法主要是病变椎间盘的单纯切除和腰椎融合。而人工腰椎间盘置换的出现预示了脊柱外科一个新的时代的到来。简要介绍SB charité人工腰椎间盘置换技术,并分析了其早期的临床效果及可能出现的一些并发症,总结了目前人工腰椎间盘的应用所遇到的一些问题。客观的评价人工腰椎间置换技术,为临床实践和进一步研究提供依据。     

Spiritual practices children understand: an analysis of Madeleine L’Engle’s fantasy,A Wind in the Door

The following essay is a close reading of Madeleine L’Engle’s science fantasy novel, A Wind in the Door, in which young Meg Murry travels first to outer space and then into her younger brother’s ailing cells. The novel is a fine example of high fantasy (also known as heroic fantasy) wherein a humble protagonist is called to a quest to fight a cosmic battle between good and evil. The essay analyzes specific expressions of evil in the novel: impersonality, narcissism, despair and blind empiricism. Meg’s quest demonstrates particular spiritual practices that promote spiritual maturation and the ability to overcome evil: ‘kything’, Naming, deepening and holding. L’Engle portrays these practices in a fresh way that can help both children and adults incorporate them into their day‐to‐day lives. Moreover, there are links between kything and holding and the metta and tonglen, two types of Buddhist meditation. L’Engle affirms children’s innate relational consciousness and presents spiritual practices that are relational, non‐sectarian, practical, and eminently hopeful.     

REEXAMINING SCHREBER THROUGH THE LENS OF A PRESENT‐DAY CASE: FANTASIES OF DEATH,REBIRTH, AND GENDER TRANSFORMATION

In the history of psychoanalysis, the Schreber case has long been a source of controversy. Speculations about Schreber have abounded essentially because none of the speculators, including Freud ( 1911 ), has been constrained by the reality of interactive dynamics with Schreber on the couch. This author contends, however, that knowing someone analytically must involve the transference experience. He presents the case of Z, a middle‐aged patient of his who described a fantasy that was uncannily similar to Schreber's, permitting a present‐day reexamination of the original case, as well as ongoing speculations that include the way in which live clinical material can interact with the reading of a historical document.     

The screen function of unconscious fantasy

Although being a fundamental concept in psychoanalysis, fantasy is an ambiguous term. It covers a vast field of conscious and unconscious phenomena, from daydreaming, the manifest narration of the patient’s world of imagination to unconscious fantasy and primal fantasy. Further, it introduces the delicate alternatives of imaginary versus real, subject versus object and internal versus external. Following Freud’s reflections on the ambiguity of fantasy, we arrive at an idea introduced by Freud himself, but elaborated years later by Lacan. Fantasy, accordingly, is seen as a screen which both reveals and conceals. Our aim is to demonstrate, theoretical as well as clinical, how unconscious fantasy serves as a window into not only repressed wishes and conflicts, but also the most primary scenes where the subject may not even have a specific place. Simultaneously, it is the site of protection and defence, including projection and denial, but also repetition of what we will call the identical. A clinical case will be presented to illustrate our theoretical ideas and their clinical implications.     

Psychoanalytical teamwork in a day hospital: Revisiting some preconditions for patients' subjective appropriation

Psychoanalytical 'teamwork' may be recommended for dealing with a particular kind of transference that characteristically occurs during the institutional treatment of young patients presenting psychotic or behavioural symptoms. In such cases, the degree of alienation is such that repetition is usually induced in other people (the therapists), fi lling in for fantasy construction that seems to be lacking in the patient's psyche. A case like that of 'Angel' can give some idea of this phenomenon, wherein several caregivers have to harbour fragmented and incompatible elements of the case's particular history, which are in need of more mental representation. Any subjective restitution and appropriation of these elements by the patient would require a sort of detour (often a trying one!) by way of the psychical space of caregivers whose initial task will be to 'work it through' among themselves.