镇静与镇痛在ICU机械通气患者中的应用变化

探讨ICU内机械通气患者应用镇痛剂、镇静剂及肌松剂的情况及其对机械通气和预后的影响。回顾性分析我院中心ICU2006年、2007年收治的244例行有创机械通气治疗超过48h患者的临床资料,并将患者分为2006年组和2007年纽,用统计软件分析患者在年龄、性别、入ICU时APACHEⅡ评分、血糖、血浆白蛋白、基础疾病,气管插管时间、机械通气时间、ICU住院天数、镇痛与镇静剂应用的时间、机械通气时是否使用肌松剂、Ramsay评分及病死率方面是否存在差别。统计分析显示2006年组和2007年组在年龄、性剐、入ICU时APACHEⅡ评分、血糖、血浆白蛋白、是否使用肌松剂及基础疾病方面无差别;与2006年组相比2007年组患者气管插管时间、机械通气时间及ICU住院天数均缩短,镇痛与镇静剂应用时间均缩短,Ramsay评分降低,病死率下降。提示对机械通气的危重症患者应合理使用镇痛剂与镇静剂。     

王岱舆的“天命有三品”论与儒家的天命观

王岱舆作为明末清初四教（儒、释、道、回）皆通的伊斯兰著名学者,他提出的“天命有三品”论,既适应了当时以儒家为主流文化的背景,也保持了其独特的伊斯兰性,在巧妙地处理与儒家天命观分歧的同时,又开放地拿儒家文化为己所用,从而为两种文明都赢得了宽松的环境,使得两种文明能够共存、共荣、共同发展。本文从王岱舆天命观与儒家天命观的介绍入手,分析其与儒家天命观的契合与分歧。     

Haptic perception of wetness

In daily life, people interact with textiles of different degrees of wetness, but little is known about the mechanics of wetness perception. This paper describes an experiment with six conditions regarding haptic discrimination of the wetness of fabrics. Three materials were used: cotton wool, sponge-structured viscose and thin viscose. Two ways of touching were investigated: static touching, in which only thermal cues were available, and dynamic touching, in which additional mechanical cues were available. For dynamic touching, average Weber fractions for discrimination were around 0.3, whereas for static touching, they ranged from 0.34 to 0.63. The results show that people can make use of the additional mechanical cues to significantly improve their discrimination performance. There was no significant difference between Weber fractions for the three materials, showing that wetness can be judged as a separate perceptual quantity, independent of the material.     

Effects of anxiety,a cognitive secondary task,and expertise on gaze behavior and performance in a far aiming task

ObjectivePrevious studies focused on investigating the separate effects of anxiety, cognitive load, and expertise on perceptual-motor performance, but the combined effects of these factors have not been studied yet. The objective of the current study was to investigate these factors in combination.DesignEleven expert dart players and nine novices performed a dart throwing task in low-anxiety (LA) and high-anxiety (HA) conditions with and without a secondary task.MethodTo manipulate anxiety the dart throwing task was performed low (LA) and high (HA) on a climbing wall with and without the secondary counting backwards task. Performance and efficiency of task execution and gaze behavior were assessed.ResultsThe anxiety manipulation evoked a decrease in dart performance, but only for the novices. Increases in mental effort and dart times and a decrease in response rate on the secondary task were observed for both groups. This shows that there were decreases in processing efficiency with anxiety. Most important, the anxiety-induced decrease in performance for the novices was accompanied by final fixations on the target that were substantially shorter and deviated off the target earlier. The dual task did not affect performance.ConclusionAnxiety affects efficiency and sometimes performance in far aiming tasks. Changes are accompanied by changes in gaze behavior, particularly the final fixation on the target. All in all, findings provide support for Attentional Control Theory as a suitable framework to explain the effects of anxiety, a cognitive secondary task, and expertise in far aiming tasks.