IMPROVING THE PEER INTERACTIONS OF STUDENTS WITH EMOTIONAL AND BEHAVIORAL DISORDERS THROUGH SELF-EVALUATION PROCEDURES: A COMPONENT ANALYSIS AND GROUP APPLICATION

We conducted two experiments examining the effects of a self-evaluation package on the peer interactions of students described as emotionally or behaviorally disordered. Experiment 1 assessed the additive effects of various components of a self-evaluation package on the frequency of inappropriate and appropriate peer interactions. The components assessed were rewards alone, rewards plus discussion, and self-evaluation plus rewards. Results showed limited effectiveness when rewards alone and rewards plus discussion were implemented. However, substantial improvements in peer interactions were observed when the self-evaluation component was added. Experiment 2 examined the efficacy and feasibility of the procedures when implemented in a group setting. Students in three classrooms served as participants. Direct observation data collected for 8 of the participants showed the procedures to be effective in improving peer interactions when implemented in a group context.     

THE TREATMENT OF SEVERE BEHAVIOR PROBLEMS IN SCHOOL SETTINGS USING A TECHNICAL ASSISTANCE MODEL

We evaluated the feasibility of local school personnel conducting functional analysis and reinforcement-based treatment procedures within actual classroom settings. Following an initial in-service workshop on functional assessment and differential reinforcement procedures, on-site technical assistance was provided two to four times per month to local school personnel working in transdisciplinary teams. Overall results suggest that local school personnel were able to implement all procedures adequately with periodic technical assistance. In addition, functional analysis was effective in identifying individual maintaining contingencies, the derived treatments were effective, and the results were maintained throughout the approximate 18 months of this investigation.     

丙种球蛋白治疗成人重症心肌炎的临床观察

观察丙种球蛋白对成人重症心肌炎的治疗效果及对预后的影响。回顾性分析该院自2009年1月至2010年10月治疗的成人急性重症心肌炎33例,分为丙种球蛋白组（丙球组）及常规治疗组（对照组）。丙种球蛋白组给予患者丙球2g／kg,2天～3天内静脉滴入,同时给予常规治疗;对照组患者给予常规治疗。结果治疗后丙球组优于对照组（P〈0...     

患者的依从性与治疗效果——对两例急性会厌炎使用硬管放大喉镜检查的体会

为了提高无呼吸困难的急性会厌炎患者对治疗的依从性,对两名明确诊断为急性会厌炎,因自觉症状轻而忽视该病、拒绝接受医生治疗意见的患者,本着医患之间相互理解与信任的原则,非常规地应用冷光源硬管放大喉镜成像技术对患者进行检查,让患者观察到自身病变的影像,充分认识治疗的必要性,积极配合医生治疗,取得良好治疗效果。     

3例误诊为急性冠脉综合征实施介入诊治死亡病例的启示

探讨3例被误诊为急性冠脉综合征（ACs）而急诊实施介入诊治死亡病例的,搭床特点及误诊原因,提高对ACS的诊断意识。收集我院比较典型的3例误诊死亡病例进行回顾性分析。3例死亡病例中1例为肺栓塞、1例为主动脉夹层动脉瘤（AD）、1例为流行性出血热,3例均实施了冠状动脉造影,1例于前降支植入了1枚支架。ACS患者临床表现复杂,误诊原因多为首诊医师思路狭窄,应充分利用现代影像技术,仔细分析临床症状和体征,可减少误诊死亡的发生。     

重症感染非抗感染措施的思考

近年来严重感染与感染性休克治疗策略的主要进展是对强化血糖控制、糖皮质激素等疗法的再评价。同时,也出现了诸如血管加压素、他汀类药物、选择性口腔/肠道脱污染等新的治疗措施,并取得了一定成果。本文对相关研究进展进行综述,以阐明集束化策略和管理水平的提高可能是最终降低重症感染病死率的关键。     

重型颅脑损伤围术期亚低温治疗路径——循证医学指导下的治疗抉择

早期动物实验研究表明亚低温能减轻脑损伤后的继发性损害,促进神经功能恢复,然而对其临床疗效不同研究结果不完全一致。本文应用循证医学思想,检索和评价国内外文献,为重型颅脑损伤患者制定了围术期亚低温实施方案。随访结果表明,亚低温可改善患者预后。     

急性一氧化碳中毒高压氧治疗的中美指南比较

急性一氧化碳（carbonmonoxide,CO）中毒是中美最常见的意外中毒原因之一。高压氧能促进碳氧血红蛋白解离,加速体内CO排出,明显缩短CO半清除时间,是治疗急性CO中毒的一种重要治疗方法。比较中美现有急性CO中毒治疗指南及推荐意见。发现其中在高压氧治疗应用的适应证、具体方案、治疗费用等方面有很大差异。我们对此差异进行比较分析,为临床治疗及科研提供参考,也对通过进一步研究以充分证实高压氧治疗急性CO中毒的有效性,制订高压氧治疗最佳方案提出展望。     

急性肺损伤与急性呼吸窘迫综合征的诊断与治疗策略

急性肺损伤（ALI）和急性呼吸窘迫综合征（ARDS）是多个危险因素直接或间接引起肺部损伤的连续病理过程,以表现低氧血症为特征,ARDS是ALI严重末期的表现。低流量、呼气末正压（PEEP）保护性通气的措施可明显改善氧和,减轻机械通气肺损伤,降低病死率,明显优于传统通气方式。     

Effects of morphine hydrochloride on social encounters between male mice

The effects of a single injection of morphine hydrochloride (0.3, 0.6, or 1.25 mg/kg) or physiological saline (0.9% NaCI) on the agonistic behaviour elicited by isolation in male mice were examined. Individually housed mice were exposed to anosmic “standard opponents” 30 minutes after drug administration, and the encounters were videotaped and evaluated using an ethologically based analysis. Morphine (at 0.6 and 1.25 mg/kg) significantly and dose-dependently decreased time spent in offensive (“threat” and “attack”) and “digging” behaviours but markedly increased “non-social exploration” without a significant increase of “immobility.” The lowest dose was completely ineffective in producing changes in any of the behaviours studied. It is concluded that these results present a specific ethopharmacological profile characterized by suppression of aggressive behaviour, increase in non-social explotation, and no evident impairment of motor activity. © 1993 Wiley-Liss, Inc.