基于经络学说探析卒中后抑郁的发病机制＊

脑卒中后抑郁（Post-stroke Depression，PSD）是一种情志疾病，本病的发病机制不明确从而制约了其治疗，PSD的发病与经络密切相关，但对其研究较少。本研究创新性地从经络学角度探讨PSD的发病机制，提出PSD的发病与多条经脉相关，尤其是足厥阴肝经，为PSD机制的揭示奠定了经络学基础，为本病的防治提供了新的思路和方法。     

Stress habituation,body shape and cardiovascular mortality

High cardiovascular mortality is well documented in lean phenotypes exhibiting visceral fat accumulation. In contrast, corpulent phenotypes with predominantly subcutaneous fat accumulation display a surprisingly low mortality. The term ‘obesity paradox’ reflects the difficulty in understanding the biological mechanisms underlying these clinical observations. The allostatic load model of chronic stress focuses on glucocorticoid dysregulation as part of a ‘network of allostasis’ involving autonomic, endocrine, metabolic, and immune mediators. Here, we expand upon the energetic demands of the brain and show that ‘habituators’ and ‘non-habituators’ develop divergent patterns of fat distribution. Central to this process is the recurrent rise in the cerebral energy need (arousal) that non-habituators experience during chronic stress. These neuroenergetic alterations promote visceral fat accumulation, subcutaneous fat loss, and atherogenesis with subsequent cardiovascular events. Habituators are more or less protected against such cardiovascular complications, but there is a metabolic trade-off that we shall discuss in the present paper.     

浅谈“百病皆在调气血”在哈氏妇科的应用

气血理论是中医重要理论，妇科疾病应首调其气血，哈氏妇科是全国中医妇科十大流派之一，诊治疾病独具特色，哈孝廉教授宗古人"百病皆在调气血"思想，治疗崩漏、产后身痛、滑胎等妇科常见疾病，疗效显著，值得深入学习与探讨。     

A mechanism for gratitude development in a child

Most scholars consider gratitude as a moral emotion, with only few seeing it as a character trait. As a result, no systematic mechanism has ever been attempted to develop gratitude in children. Given the social issue of widespread lack of gratitude in the one-child generations of China, this article attempts to outline a mechanism of parental moral education for gratitude development. The mechanism is underpinned by love, induction and discipline; and theoretically justified in accordance with key psychological and sociological theories, such as Piaget's theory of moral development, Kohlberg's moral stages theory, attachment theory, Hoffman's internalisation theory, Rest's social justice theory and Baumrind's parenting styles theory. The benefits and potential risks of each strategy of the mechanism are addressed.     

Les théories du complot : l’envers du mythe totémique dans le lien social

ObjectivesThe current explosion of conspiracy theories is an undeniable dimension of present-day social bonds. We aim to understand some of the unconscious stakes underlying the conspiratorial ideation and to shed light upon the reasons why it is a topical issue in our modern society.MethodsBy relying on psychoanalytical knowledge that allows us to study the psychic functions of the myth, we will compare different conspiracy formations to those of the mythical narrative to bring into resonance these two fictional modalities. Freud's totemic myth, through its structure, sheds a particular light on the functions that regulate jouissance and that organize history, as well as social bonds.ResultsThe conspiracy discourse will prove to be the underside of the Freudian myth of Totem and Taboo. The text presenting the myth of the primal horde will reveal the structure of the conspiracy discourse as its negative. Indeed, this myth offers a symbolic ur-fiction, and its imaginary counterpart determines the conspiratorial grammar based on the question: “who profits from the crime?” As in a hall of mirrors, the countless conspiracies will appear as the shadow of a crime, always returning in an imaginary mode due to a lack of symbolization. The system that the conspiracy theory seeks to unveil will then be regarded as the reverse of an arrangement structured by the myth.DiscussionWe discuss the link between scientific discourse and the intensification of conspiracy theories’ presence in our modern society. Indeed, Lacan notices how the mythical dimension is repressed by scientific discourse. Such repression would produce, as a result, imaginary versions of the myth. Thus, the conspiracy theory will be regarded as a structural effect of scientific discourse rather than as anti-science.ConclusionsThe conspiracy theory turns out to be a social symptom linked to scientific discourse. It is the social staging of damage suffered that transforms the coordinates of a symbolic loss, no longer organized by a myth, into an imaginary stolen jouissance.     

Implementation of Telehealth: Normalization Process Theory and NoMAD-Ex.

This nurse practitioner–led project facilitated integration of telehealth services in a women’s clinic. Normalization Process Theory and the Normalization Measures Development (NoMAD) instrument were identified as tools. The NoMAD survey was augmented with a request for 2–3 sentences of explanation for each item. These data were then evaluated using inductive content analysis to identify specific facilitators and barriers. Results were presented to an interdisciplinary team charged with the responsibility of making modifications to the existing telehealth workflow. The resultant workflow was piloted for 30 encounters and statistically significant improvement in average NoMAD score was demonstrated on repeat survey.