Self‐reflection and self‐practice in training of Cognitive Behaviour Therapy: an overview

The present paper deals with a developing training element in cognitive behaviour therapy (CBT), the self‐practice of therapeutic techniques and the self‐exploration of the person of the therapist. Initially, the current status of this training element in CBT is discussed, and a short note on its terminology is presented. Then an overview of the most important objectives of self‐practice and self‐reflection in CBT, and the concepts and methods of practice of this element is given. The concepts focus on two major aims, the self‐exploration of the person of the therapist within and beyond his or her therapeutic practice, and the self‐application of therapeutic techniques (= self‐practice). In the second part of the paper empirical studies related to the outcome of self‐reflection and self‐practice on the development of the therapist and her or his therapeutic practice are reviewed. The few empirical studies show that trainees experience in their own view substantial professional and personal gains from this training tool, with the professional impact being more important than the personal one. The most important outcomes evaluated by subjective data from the trainees are improvements in self‐insight and self‐awareness and a better understanding of the therapist's role and the therapeutic change process. Additionally, a better understanding of CBT methods and of general therapeutic skills, such as empathy and role‐taking‐competencies, are reported by the trainees. The paper comes to the conclusion that self‐exploration and self‐practice are important components of CBT training. Consequences and recommendations for its integration into training courses for CBT are discussed as well as the necessity for more research in this area. Copyright © 2002 John Wiley & Sons, Ltd.     

小儿先心病心电图P波,QRS波时限,振幅与左房和肺动脉压力的相关分析

小儿先心病术后左房夺和肺动脉压力的监测在ＩＣＵ中十分重要。心电图是论断和评价心脏疾患的常用方法。本文分析了３２例小儿先心病手术前后（伴肺动脉高压１６例）６个肢体导联心电图中Ｐ波和ＱＲＳ波时限总和及振幅总和与左房、肺动脉压力的关系。结果表明两者均有良好的相关性（ｒ＝０．８５￣０．８８，ｒ＝０ｍ７４￣０．８０，Ｐ〈０．０１），该法简单、方便，可广泛开展，尤其在术后未放置ＰＡ和ＬＡ管或在ＩＯＵ中已拨除Ｌ     

注射类药物应表述等渗浓度稀释量和静注最大浓度参考的意见

中国药品标准编辑部： 因贵刊旨在服务于药品标准事宜，所以是中国药典、药理学和药物学的进一步诠释者和其药品政策与法规的说明者、代言者。因此笔者对注射类药物的说明书提两点补充意见供参考，并希望能得到指正。     

病毒性肝炎病人血浆VitE水平及其临床意义

观测了急性肝炎和重症肝炎病人血浆ＶｉｔＥ及Ｌｐｏ水平及其动态变化。急性肝炎和重症肝炎病人血浆ＶｉｔＥ低于对照组，Ｌｐｏ高于对照组，均以重症肝炎更明显，且死亡病例血浆ＶｉｔＥ低于存活者。部份病人口服ＶｉｔＥ不能提高其血浆水平，并随病情加重而逐渐降低。讨论了病毒性肝炎病人血浆ＶｉｔＥ降低与Ｌｐｏ升高的关系及其临床意义，认为动态观测血浆ＶｉｔＥ可作为判断重症肝炎病情进展及预后的参考。     

城市污灌废水的致突变性检测及色谱/质谱分析

应用Ames致突变试验,对比研究了武汉市易家墩、黄孝河污灌区污灌废水与土壤的致突变性。同时应用色谱/质谱(GC/MS)分析技术。测定了主要污水中有机污染物的化学组成。结果表明:罗家渠废水的致突变活性最强;受各条污水灌溉的土壤的致突变活性顺序与相应废水的强弱顺序一致;罗家渠废水中致突变致癌物主要是萘、联苯等。     

INVASIVE MUCORMYCOSIS WITH GASTRIC INVOLVEMENT IN A PATIENT WITH SEVERE ATHEROMATOUS VASCULAR DISEASE

Gastric mucormycosis involvement is a rare condition that usually occurs in inmunocompromised patients and frequently has a fatal outcome. We report the case of a 73‐year‐old woman admitted to the intensive care unit with severe bleeding after an acute pulmonary disease. Upper endoscopy disclosed wide and deep necrotic ulcers in the body and fundus of the stomach and greenish exudates with the antrum and the duodenum undamaged. Autopsy revealed an invasive mucormycosis and a severe atheromatosis. Several predisposing factors for mucormycosis infection have been reported until now. We postulate that ischemic gastritis could be a predisposing factor for colonization of zygomycete.     

对孙真人《养生铭》的现代诠释(二)

(续)亥寝鸣云鼓,寅兴漱玉津。妖邪难犯己,精气自全身。在这一节里,孙思邈郑重提出了两条养生的具体措施“:鸣云鼓”和“潄玉津”,并且指出了它们与正常睡眠和祛邪防病、保精全神的关系。何谓“鸣云鼓”?就是叩齿。何时鸣云鼓?孙氏也明确规定了时间“,亥”时,即夜晚的21～23时。在《千金方》中,孙氏还提出过早晨叩齿的方法,曰“:每旦以一撮盐纳口中,以暖水含,揩牙及叩击百遍,为之不绝,不过五日,口齿即牢密”。可见,孙氏对叩齿与护齿的关系看得是很重的。叩齿何益?用现代的话说,它可以增强牙齿的力量和防病、抗病能力,促进牙周组织及根尖组织…     

Prognostic role of alveolar-arterial oxygen pressure difference in acute pulmonary embolism.

BACKGROUND: This study investigated the utility of the alveolar - arterial oxygen pressure difference (AaDO (2)) in predicting the short-term prognosis of acute pulmonary embolism (PE). METHODS AND RESULTS: This study retrospectively enrolled 114 consecutive patients with acute PE, diagnosed by either spiral computed tomography or high probability ventilation - perfusion lung scans. During the first 24 h of admission, all patients had initial artery blood gas collected under room air. Patient exclusion criteria were chronic lung disease, septic emboli, and moderate and low probability lung scans. Patients were assigned to 2 groups based on either 30-day death or a 30-day composite event. Receiver operating characteristic analyses was used to determine the AaDO(2) cut-off value for predicting primary and composite endpoints. Statistical analysis demonstrated significant differences in AaDO(2) between the 30-day composite endpoint group and the 30-day composite event-free survival group (p=0.012). The AaDO(2) had a strong trend between the 30-day death group and the survival group (p=0.062). The best cut-off value for AaDO(2) was 53 mmHg and using this, the positive predictive value for 30-day death was 25% and the negative predictive value was 92%. For the 30-day composite endpoint, the positive predictive value for AaDO(2) was 35%, and the negative predictive value was 84%. In this study, thrombocytopenia was also an indicator of poor prognosis for patients with acute PE. CONCLUSION: The AaDO(2) measurement is a highly useful and simple measurement for predicting short-term prognosis in patients with acute PE. It has high negative predictive value and moderate positive predictive value for 30-day death and 30-day composite event. Aggressive thrombolytic treatment strategies should be considered for patients with an initial poor prognostic parameter (ie, AaDO(2) >or=53 mmHg).     

脱细胞尿道及其海绵体基质制备的实验研究

目的 探索脱细胞尿道及其海绵体基质的制备方法。方法取健康壮年兔完整尿道及其海绵体组织，以Triton-X100与NH3H2O联合提取法进行脱细胞处理。标本做HE染色，组织学观察分析脱细胞效果。结果脱细胞处理11天后，成功获得脱细胞及其海绵体基质，所得基质外观良好。HE染色观察无细胞存在。弹力纤维排列规整，间隙较大，结构无破坏。结论利用Triton-X100与NH3H2O联合提取法可成功制备完整无细胞尿道及其海绵体基质，为尿道再造修复提供崭新思路。