3种功能性消化不良药物治疗方案的成本-效果分析

目的:评价3种功能性消化不良药物治疗方案的成本-效果。方法:将125例患者随机分成3组,A组为多潘立酮,B组为多潘立酮+盐酸多塞平,C组为多潘立酮+法莫替丁,均口服给药观察疗效,并进行成本-效果分析。结果:A、B、C组成本分别为792.56元、800.12元、803.76元;有效率分别为51.17%、82.50%、71.43%;成本-效果比分别为15.49、9.70、11.25;B、C组相对于A组的增量成本-效果比分别为0.24、0.55。结论:B方案为较佳治疗方案。     

旅客列车德国小蠊防治的研究

目的探讨控制旅客列车德国小蠊危害的防治措施.方法调查德国小蠊对不同列车、不同车厢的危害程度,以及对常用杀虫剂的抗性情况,研究将两种杀虫剂混配的效果,并用于现场防治.结果德国小蠊危害严重,对10种杀虫剂均产生不同程度抗性,三氯杀虫酯和敌敌畏分别与菊酯类混配增效不明显,0.025%右旋苯氰菊酯与0.025%顺式氯氰菊酯混配室内效果比单独的顺式氯氰菊酯效果好,前者对德国小蠊全部击倒时间为14 min,24h死亡率80%;后者全部击倒时间为20min,24h死亡率只有23.3%.混配制剂现场防治结果表明0.025%右旋苯氰菊酯与0.025%顺式氯氰菊酯混配制剂优于氟氯氰菊酯单剂,杀灭率分别为84.76%,47.71%.而混配制剂对硬座车厢的保护较好,对餐车车厢的保护较差.结论单独的化学防治难以达到控制列车上德国小蠊危害的目的,尤其是对餐车化学防治技术难以发挥优势.     

Treatment development: Can we find a better way?

The present paper argues that traditional approaches to treatment development, including a technological approach, a stage model, and existing inductive approaches such as functional analysis are inadequate in various ways. Treatment developing needs to focus more on theoretical development, practicality, and the fit with clients and practitioners. We argue that progress requires greater philosophical clarity, and steps to ensure a connection between philosophy of science assumptions and an analytic agenda which fits naturally with applied psychology. Theoretical progress requires distinguishing between clinical and basic models and harmonizing their relationship, and more focus on the manipulable context of action. Applied psychology needs to join in a common cause with basic psychology in domains of mutual interest, and develop basic analyses and mid-level terms that can be both scientifically progressive and clinically useful. Issues of practicality, capacity for dissemination, and public health impact need to be considered at the beginning and throughout treatment development. Issues of effectiveness, change processes, mediation, moderation, training, active components, and similar issues should be part of the evaluation system from the beginning. It is time to create a more coherent approach to treatment innovation.     

Both memory and attention systems contribute to visual search for targets cued by implicitly learned context

Environmental context learned without awareness can facilitate visual processing of goal-relevant information. According to one view, the benefit of implicitly learned context relies on the neural systems involved in spatial attention and hippocampus-mediated memory. While this view has received empirical support, it contradicts traditional models of hippocampal function. The purpose of the present work was to clarify the influence of spatial context on visual search performance and on brain structures involved memory and attention. Event-related functional magnetic resonance imaging revealed that activity in the hippocampus as well as in visual and parietal cortex was modulated by learned visual context even though participants’ subjective reports and performance on a post-experiment recognition task indicated no explicit knowledge of the learned context. Moreover, the magnitude of the initial selective hippocampus response predicted the magnitude of the behavioral benefit due to context observed at the end of the experiment. The results suggest that implicit contextual learning is mediated by attention and memory and that these systems interact to support search of our environment.     

Early life Adversity,functional connectivity and cognitive performance in Schizophrenia: The mediating role of IL-6

ObjectiveExposure to childhood trauma (CT) is associated with cognitive impairment in schizophrenia, and deficits in social cognition in particular. Here, we sought to test whether IL-6 mediated the association between CT and social cognition both directly, and sequentially via altered default mode network (DMN) connectivity.MethodsThree-hundred-and-eleven participants (104 patients and 207 healthy participants) were included, with MRI data acquired in a subset of n = 147. CT was measured using the childhood trauma questionnaire (CTQ). IL-6 was measured in both plasma and in toll like receptor (TLR) stimulated whole blood. The CANTAB emotion recognition task (ERT) was administered to assess social cognition, and cortical connectivity was assessed based on resting DMN connectivity.ResultsHigher IL-6 levels, measured both in plasma and in toll-like receptor (TLR-2) stimulated blood, were significantly correlated with higher CTQ scores and lower cognitive and social cognitive function. Plasma IL-6 was further observed to partly mediate the association between higher CT scores and lower emotion recognition performance (CTQ total: β_indirect −0.0234, 95% CI: −0.0573 to −0.0074; CTQ physical neglect: β_indirect = −0.0316, 95% CI: −0.0741 to −0.0049). Finally, sequential mediation was observed between plasma IL-6 levels and DMN connectivity in mediating the effects of higher CTQ on lower social cognitive function (β_indirect = −0.0618, 95% CI: −0.1523 to −0.285).ConclusionThis work suggests that previous associations between CT and social cognition may be partly mediated via an increased inflammatory response. IL-6′s association with changes in DMN activity further suggest at least one cortical network via which CT related effects on cognition may be transmitted.     

切开复位内固定治疗Pilon骨折疗效的影响因素分析

目的 探讨影响切开复位内固定治疗Pilon骨折复位和功能恢复的相关因素.方法 84例Pilon骨折患者均采用切开复位内固定治疗,随访结束评价骨折复位和功能恢复,采用单因素和多因素Logistic分析疗效影响因素.结果 84例患者骨折全部愈合,中位时间5.0个月,并发症发生率、骨折复位率、功能恢复率分别为28.57％、84.52％、77.38％,骨折复位与功能恢复呈正相关（P＜0.05）.年龄、合并腓骨骨折仅对功能恢复影响显著,开放性骨折仅对骨折复位影响显著（P＜0.05）,骨折类型及并发创伤性关节炎对骨折复位、功能恢复均有显著影响（P＜0.05）.结论 切开复位内固定治疗Pilon骨折的骨折复位效果与软组织损伤程度、骨折类型及并发创伤性关节炎等因素有关,功能恢复与年龄、合并腓骨骨折、骨折类型及并发创伤性关节炎等因素有关.     

Functional connectivity of the attention networks is altered and relates to neuropsychological outcomes in children with prenatal alcohol exposure

Cognitive and functional brain alterations can occur in children with prenatal alcohol exposure (PAE). We examined the functional connectivity (FC) among regions within and between attention networks, and whether inter- and intranetwork FC moderated cognition in children with PAE (n = 37; age 12.8 ± 2.8 years) and nonexposed controls (n = 40; age 13.2 ± 2.8 years). Participants completed standardized attention and executive functioning tasks and resting state functional MRI. Inter- and intra-network FC and graph-theoretical metrics were calculated among attention network regions. Relative to controls, PAE was associated with reduced FC between the left temporoparietal junction and left ventral frontal cortex and anterior insula/frontal operculum (aI/fO), and between the left intraparietal sulcus and bilateral aI/fO. PAE was associated with increased FC between the right precuneus and intraparietal lobes, the right anterior prefrontal cortex and left ventral frontal cortex and aI/fO, and the left thalamus and dorsal frontal cortex. Graph-theoretical metrics did not differ by group. FC predicted cognitive performance, negatively in the children with PAE and positively in controls. Increased intra-network together with reduced internetwork FC suggests inefficient network specialization and impaired long-range FC among attention network regions after PAE. Results further suggest that those alterations may underlie attention and executive dysfunction in children with PAE.