完美主义与基督教信仰

目的 考察个体的宗教信仰与完美主义心理之间的关系。方法 采用质的研究方法，对两位受访者（分别为功能障碍型完美主义与健康的完美主义）追行个案研究。结果 两名受访者的基督教（新教）信仰封其完关主义的负面倾向有所矫正，受访者的人际关系和自我认知因为宗教信仰而有所改善。结论 基督教（新教）信仰有利于修正受访者自体表象与权威客体表象的关系。在象征意义上，“上帝”的概念可以理解为“较好的”权威客体表象。     

医改尚未成功,路在何方?

目前我国医疗制度改革尚未取得成功,这与计划经济向市场经济转轨这历史时期及卫生工作的特殊性有关,出现问题,甚至失误,在所难免。提出(1)医改的目的是确保全国人民健康,人人享有医疗保健。(2)把卫生系统推向市场,医疗机构商业化,不是医改的方向。(3)预防为主,健全预防医学制系。(4)国家增加投入。(5)制定公立及私立医院各项制度,保护医务人员的合法权益。(6)加强社区基层医疗机构的建设。     

Current-distance relations of axons mediating circling elicited by midbrain stimulation

Stimulation of mediocaudal midbrain in rats produces ipsiversive circling due to the stimulation of longitudinal axons. The refractory periods of these axons were measured by delivering trains of conditioning and testing pulses via a single electrode at various conditioning-testing (C-T) intervals. As C-T interval increased from 0.3 to 2.0 ms, the frequency required to produce a constant amount of circling halved. The current-distance relations of these axons were measured by placing two electrodes lateral to one another, and delivering conditioning pulses via one electrode and testing pulses via the second electrode. The required frequency decreased less at C-T intervals in the refractory period range using two electrodes rather than using a single electrode. This partial refractoriness suggests that only part of the axons were stimulated by both electrodes. The refractoriness increased as current increased or as interelectrode distance decreased. The overlap in the fields of stimulation at each current was calculated from the refractoriness observed in single and double electrode experiments. The results suggest that the axons mediating circling have a wide range of thresholds rather than a single threshold. The current required to activate an axon is roughly equal to K X r2, were K is a constant and r is the radial distance from electrode to axon. K must range from 400 to at least 3000 microA/mm2, to account for the circling data. For axons mediating medial forebrain bundle self-stimulation3, K must range from 1000 to at least 6400 microA/mm2. Estimation of the K distribution allows calculation of the effects of electrode size, placement and current on the recruitment of axons with different thresholds.     

搞好护患关系 提高护理服务满意度

近年来随着环境污染的日益加重,恶性肿瘤发病率逐年上升,从2000年至2004年我科收治病人1 632例,其中初治者648例,复治者有984例。复治病人的增加与医学科学不断发展,医疗护理技术水平不断提高,病人生存期不断延长有关。随着患者维权意识的增强,临床上常出现一些医疗纠纷,往往许多纠纷的切入点是护理不到位。笔者从事肿瘤内科临床护理工作多年,得出如下经验:加强护患关系是减少护患纠纷、提高社会效益及提高中晚期肿瘤患者生存质量的非常重要的环节。古人云“知己知彼,百战百胜”,如何搞好护患关系,是护理工作的重点。1对护理服务对象的评估…     

Excitability properties of medial forebrain bundle axons of A9 and A10 dopamine cells

A9 and A10 units identified as dopaminergic were recorded with extracellular micropipettes. The units were antidromically activated by electrical stimulation at the level of the preoptic area. The absolute refractory periods ranged from 1.2 to 2.5 ms. During the 2–8 ms of the relative refractory period, conduction was slower than normal by up to 1.5 ms. The time constant, C, of the strength-duration curve ranged from 0.4 to 0.6 ms. The current (I)-distance (D) relationship, tested by moving the stimulating electrode past the axon, was approximately parabolic (I = K D exp 2), with the constant of the equation, K, ranging from 900 to 2000 μA/mm exp 2, for 0.5 ms pulses. This relationship allows calculation of the radius of the field of dopamine axon excitation at any current. These high K values show that axons of dopamine cells cannot be activated unless high current densities are derivered, even when electrodes are placed near the axons. These data allow determination of the extent to which dopamine axons can be the directly activated substrates for behaviors, such as self-stimulation and circling, which are evoked by electrical stimulation of the medial forebrain bundle or internal capsule.     

精神分裂症患者6～11岁子女行为问题及相关因素对照研究

目的探讨精神分裂症患者6~11岁子女行为问题及相关因素。方法对山东省11所精神病医院(科)1999年6月~2000年6月间住院,符合中国精神疾病分类方案与诊断标准第2版修订本精神分裂症诊断的患者6~11岁子女(研究组)217名及正常人群子女(对照组)191名,采用自编心理卫生相关问题调查表(包括50个项目),Achenback儿童行为问题问卷(CBCL),进行登门调查,对照研究。结果研究组男、女童CBCL总分为(10.05±7.83)及(11.26±14.07),差异无显著性(P>0.05),但男女童研究组均高于对照组,差异极显著(P<0.00)。CBCL因子得分及家庭环境、教养情况,研究组与对照组比较,差异有显著性。结论精神分裂症患者6~11岁子女行为问题较多,受生物、心理、社会等多方面因素影响。     

Analgesic dose-response relation in cervical epidural block

The relationship between the age and the spread of analgesia from different epidural anesthetic doses was examined by studying analgesic dose responses in cervical epidural analgesia. Two different anesthetic doses (5ml or 10ml) of 2% mepivacaine were injected into the cervical epidural space at a constant pressure (80mmHg) using an intravenous apparatus, and the spread of analgesia to pinprick was assessed. The significant correlation was found between the patients age and the number of spinal segments blocked (5ml:r = 0.8498, P < 0.01, 10ml:r = 0.5988, P < 0.01). The inverse linear relationship was found between the patients age and the segmental dose requirement (5ml:r = –0.6754, P < 0.01, 10ml:r = –0.5784, P < 0.01). Patients under 39 years of age showed a direct relationship between the dose injected and the number of spinal segments blocked, enabling prediction of the number of segments blocked with a given dose of local anesthetic. Doubling the epidural dose approximately doubled the number of spinal segments blocked. The analgesic dose-response relation in patients over 60 years of age differed from that in patients under 39 years of age and doubling the epidural dose did not double the number of spinal segments blocked. Progressively more extensive analgesia was obtained from a given dose of local anesthetic with advancing age. It was difficult to limit the extent of analgesia by injecting a smaller dose of local anaesthetic in the elderly.(Hirabayashi Y, Matsuda I, Inoue S et al.: Analgesic dose-response relation in cervical epidural block. J Anesth 2: 22–27, 1988)     

Mechanics and Ca2+-sensitivity of human detrusor muscle bundles studied in vitro

Mechanical properties of isolated smooth muscle strips from human urinary bladder were investigated in vitro. Bladder tissue was obtained from tumour-free wall regions of bladders from male patients undergoing cystectomy for bladder carcinoma. In intact muscle strips, activated with high-K⁺ solution, half-maximal force occurred at about 0.9 mm extracellular [Ca²⁺]. The length-active force relation was determined and the muscle strips were fixed for light and electron microscopy at optimal length for active force (I_o). The maximal active force per unit smooth muscle cross-sectional area was 208±49 mN/mm², n= 6. Chemically skinned preparations were obtained by treatment with triton X-100. These preparations had a steep [Ca²⁺]-force relation in the micromolar range which was influenced by calmodulin. The skinned preparations could be maximally activated by irreversible thiophosphorylation of the regulatory light chains. The force-velocity relation was determined in the maximally activated skinned muscle at 22 °C at 0.5 1_o. When the muscle was shortened by 10%, force was reduced by 35% whereas the maximal shortening velocity was little affected.     

人体肠道生物力学特性的研究

为探讨人体肠道的生物力学特性，采用电子拉伸机对人体肠道进行一维拉伸试验。结果表明，人体肠道应力-应变关系为指数函数关系。人体肠道各段的指数系数a值接近，但材料常数C有一定的差异，说明肠道各段应力-应变趋势是一致的。在一定应力下，肠道各段轴向与环向的相对伸长率是不同的，表明人体肠道具有各向异性的特性。在一定应变下，肠道各段的增量弹性模量不同，结肠增量弹性模量相对较小，因而更容易发生变形。本研究为肠道内窥镜机器人的研制提供了理论基础。     

Correlation of MRT imaging with real-time axiography of TMJ clicks

There is a series of tools useful for gathering diagnostic information on patients with temporomandibular joint disorders. Tracings of the joint movement (axiography) provide useful information about the motion of the joints. Since the availability of electronic axiographic tracers, the movement of the condyles can be resolved with high resolution both in space and in time. In order to obtain information about the anatomical relation of the joint surfaces and the disc, magnetic resonance tomography imaging (MRI) is routinely carried out. It is common practice to take MR images of the joints with the mouth closed and fully open. In order to correlate the MR images with the axiographic tracings, a series of images can provide much more information. In this study we examined patients with distinct temporomandibular joint (TMJ) clicks. In one case, the click occurs once a day, while in the other case the click happens every time the mouth is opened. In order to obtain information about both motion and anatomical relation of the TMJ at and around the position where the clicks occur, we recorded a series of MRI scans with the mouth gradually opened and before and after joint clicks. Real-time axiographic tracings during the click were taken with an optimized system where the polar moments were reduced as much as possible to follow the movement during the click. These tracings were correlated with the MRI scans to determine the exact internal conditions of the TMJ and the changes during the click. In particular cases, the additional information provided by this procedure can be useful in deciding whether and which therapeutic intervention is advisable.