体现实践成果，引领未来方向:国际妇产科联盟2018年宫颈癌分期解读

一直以来,国际妇产科联盟(International Federation of Gynecology and Obstetrics,FIGO)的宫颈癌分期都是临床分期。但随着诊断技术的发展、手术方式的进步以及对宫颈癌预后的了解加深,过去的FIGO分期已不能很好地推测宫颈癌预后及指导临床治疗选择。因此,FIGO在2009年宫颈癌分期的基础上,引入了近10年来宫颈癌诊治的新进展,形成了2018年宫颈癌分期。新的分期主要体现在肿瘤大小的分层更加细化,且纳入了淋巴结转移情况。本文对FIGO的2018年宫颈癌分期变化及其临床意义进行解读。     

The School Dropout

This paper provides a commentary on Philip Cushman's “A Burning World, an Absent God: Midrash, Hermeneutics, and Relational Psychoanalysis.” Cushman creatively uses the rabbinic midrash as a model hermeneutic and dialogic tradition for contemporary psychoanalysis as an alternative to fundamentalist interpretation. I agree with Cushman's goal, but I find that he places greater emphasis on absence over presence, narrative over law, transcendence over immanence, change over continuity, revolution over evolution, construction over discovery, and individual freedom and autonomy over community and tradition. I believe that it is just this leaning to one side that leaves him defensive about the collapse to relativism. Holding these poles in greater tension and valuing both sides of these polarities offers a dialectical model that serves contemporary psychoanalysis better as a hermeneutic, dialogical, contextual, and dialectical model for interpretation.     

Alcohol consumption and discounting

This study addresses whether discounting of future rewards may have an impact on alcohol consumption and propensity to alcohol-related harms, by applying survey data among young people whose drinking career hardly may have affected their time preferences. Analyses from a school survey among 17,000, over 13–17 year olds in Norway showed that discount rates were positively associated with drinking frequency and intoxication frequency when age, gender, impulsivity and disposable income were controlled for. Moreover, the results suggested that having made choices under the influence of alcohol leading to a negative outcome (deliberate self-harm, drunk-driving, vandalism or use of narcotics) was significantly more prevalent among those with high-discount rates compared to others, also when controlling for alcohol consumption, age, gender and impulsivity. The results are discussed in relation to the potential role of discounting in pathways to addictive behaviour.     

Professionals’ Perspectives about the Challenges of Using Interpreters in Child Sexual Abuse Interviews

Interpreters play a crucial role in many investigative interviews with child complainants of sexual abuse; however, little has been written about the interpreting process from the perspective of the interviewers. This study elicited interviewers’ perspectives about the challenges of using interpreters, with the aim of understanding how investigative interviews could be improved. The participants consisted of 21 investigative interviewers and prosecutors of child abuse cases (from a range of jurisdictions) who use interpreters on a regular basis. Thematic analysis of semi-structured interviews with the professionals about the interpreting process revealed two main challenges particular to child abuse interviews, namely the interpreters’ lack of preparedness to deal with the traumatic and sensitive nature of children's abuse histories, and an insufficient understanding of ‘best-practice’ child interview process. The recommendations focus on the need for more specialised training for, and screening of, interpreters, and more extensive use of pre-conferencing to familiarise children with the interpreter-mediated interview process.     

Distanciation in Ricoeur's theory of interpretation: narrations in a study of life experiences of living with chronic illness and home mechanical ventilation

Within the caring science paradigm, variations of a method of interpretation inspired by the French philosopher Paul Ricoeur's theory of interpretation are used. This method consists of several levels of interpretation: a naïve reading, a structural analysis, and a critical analysis and discussion. Within this paradigm, the aim of this article is to present and discuss a means of creating distance in the interpretation and the text structure by using narration in a poetic language linked to the meaning of the text. Ricoeur's 'Hermeneutical function of distanciation' will be introduced, and this concept of distanciation will be illustrated with reference to narrations from a study of patient's life experiences living with chronic illness and home mechanical ventilation in Denmark. Distanciation in the interpretation objectifies the text, and narration in a poetic language creates a particular kind of mediation in the interpretation. That narration represents an interpreted understanding of the whole, which facilitates an appropriate and evocative presentation of the interpreted data. This way of objectifying the text through narration can contribute yet another perspective to Ricoeur's rich and varied theory of interpretation.     

定量CT评价骨折愈合的有效性

目的 探讨定量CT(quantitative computed tomography,QCT)评价骨折愈合的有效性和准确性.方法 将24只健康新西兰兔随机数字表法分为A组(骨折愈合组,右胫骨中段横形骨折,用克氏针内固定)和B组(不愈合组,右胫骨中段横断骨折,制作5 mm骨缺损后以骨蜡封填断端和髓腔),分别于第2,4,8,12周各处理3只兔:先摄两侧胫骨X线片,拔出克氏针及定量CT检测,之后处死动物,将骨折段切取行组织学分析.以X线片和组织学表现为骨折愈合及不愈合的金标准,以受试者工作特征曲线(ROC)分析定量CT检测参数的评价效能,并以健侧胫骨相应节段为对照,观察定量CT参数结果的变化趋势.结果 A组X线片和组织学证实骨折在第2,4周骨折线清晰,为纤维骨痂填充,8～12周骨折线模糊至消失,骨皮质恢复完整连续性.B组X线片和组织学在第2、4周骨折线清晰,骨化不活跃,8～12周骨折线仍存在,骨细胞和骨小梁稀少.将定量CT检测结果进行ROC分析显示,材料学参数骨痂骨密度(BMD)、骨痂骨矿含量(BMC)的曲线下面积(准确度)为0.781和0.750,结构学参数横截面积(CSA)和截面惯性矩(CSMI)的曲线下面积(准确度)为0.781和0.469(P<0.05),材料学参数和结构学参数乘积引伸所得的横截面积力学强度指数(BSICSA)、截面惯性矩力学强度指数(BSICSMI)的曲线下面积(准确度)分别为0.913和0.813(P<0.05),BMD、CSA、BSICSA三者曲线下面积(准确度)分别为0.905,0.921,0.905(P<0.05).结论 定量技术测量骨折局部形态具有区分和反映骨折愈合与骨折不愈合模型及过程的潜能,所筛选出具有准确度的参数有BMD、CSA和BSICSA,这些参数具有准确、特异的优越性.     

临床试验统计分析报告通用的SAS生成方法

目的应用SAS软件编制不受变量类型及数量限制的、用于生成临床试验统计分析报告的通用程序。方法为了解决不同类型的变量同时分析、不同来源的结果同时表述的问题，分别提出了应用宏变量定义矩阵标识以及按照给定算法合并输出数据集的方法。结果通过矩阵标识的建立，将离散变量和连续变量的统计分析结合到一起，使得一次同时分析的变量数在理论上达到无穷。通过所给出的算法，将来自不同SAS过程的分析结果合并到一起，使表格式样的自由性多样性得以实现。结论使用所提出的生成统计分析报告的通用办法，使得统计分析结果的表述更加灵活、适应性更强。     

外语学习焦虑对英语口译教学的影响及对策研究

在英语口译教学中，有诸多情感因素影响学生，外语学习焦虑是其中最重要的因素，会对学生学习产生很大的负面影响。本文通过分析焦虑心理的定义、分类、及其对英语口译教学的影响及焦虑产生的原因，提出了克服和减轻学生焦虑心理的可行性策略。     

One voice, different tunes: issues raised by dual analysis of a segment of qualitative data

Qualitative data analysis is a complex and contested part of the research process that has received limited theoretical attention. This paper explores the relationship between the way in which data are analysed and the nature of findings that emerge. It does this in response to demands to recognize the multiple voices that inform representations of reality, and debates about whether the interpretation of data reveals or constructs meaning. A small segment of data provided by one informant is subjected to both thematic and narrative analysis and the different perspectives that emerge are discussed with reference to whether different kinds of analysis lead to different kinds of meaning being imputed to the same text. The paper suggests that, rather than provide a unified and ever-more refined version of 'reality', the use of dual or multiple analysis helps to elucidate alternative interpretations of the data which might escape consideration with the use of a single approach.