差异教学的探讨与实践

有研究者对中小学生的IQ分数与学习成绩分数进行过大量的相关调查，结果发现两者的相关系数大致为0.5，两者只为中等相关程度。也就是说，影响学习的因素应是多方面的。而布卢姆研究认为，学生学习成绩的差异主要由三个方面的因素造成，即是认知前提行为、情感前提特性、教学质量。本文试图以布卢姆的研究结果为依据，结合自己的教学实践，从多个方位探讨应对差异、实现面向全体的教学策略。     

Mitochondrial DNA Copy Number Is Associated With Treatment Response and Cognitive Function in Euthymic Bipolar Patients Receiving Valproate

BackgroundBipolar disorder (BD) is associated with cognitive impairment and mitochondrial dysfunction. However, the associations among mitochondrial DNA copy number (MCN), treatment response, and cognitive function remain elusive in BD patients.MethodsSixty euthymic BD patients receiving valproate (VPA) and 66 healthy controls from the community were recruited. The indices of metabolic syndrome (MetS) were measured. Quantitative polymerase chain reaction analysis of blood leukocytes was used to measure the MCN. Cognitive function was measured by calculating perseverative errors and completed categories on the Wisconsin Card Sorting Test (WCST). The VPA treatment response was measured using the Alda scale.ResultsBD patients had significantly higher MCN, triglyceride, and C-reactive protein (CRP) levels, waist circumference, and worse performance on the WCST than the controls. Regression models showed that BD itself and the VPA concentration exerted significant effects on increased MCN levels. Moreover, the receiver operating characteristic curve analysis showed that an MCN of 2.05 distinguished VPA responders from nonresponders, with an area under the curve of 0.705 and a sensitivity and specificity of 0.529 and 0.816, respectively. An MCN level ≥2.05 was associated with 5.39 higher odds of being a VPA responder (P = .006). BD patients who were stratified into the high-MCN group had a higher VPA response rate, better WCST performance, lower CRP level, and less MetS.ConclusionsThe study suggests a link between the peripheral MCN and cognitive function in BD patients. As an inflammatory status, MetS might modulate this association.     

Visual impairment and refractive errors in school children in Andhra Pradesh,India

Purpose:Addressing childhood vision impairment (VI) is one of the main goals of the World Health Organization’s (WHO) combating blindness strategies. The primary aim of this study was to estimate the prevalence of VI, causes, and its risk factors in school children in Krishna district, Andhra Pradesh, India.Methods:Children aged 4–15 years were screened in schools using the 6/12 Snellen optotype by trained community eye health workers, and those who failed the test and those reported or found to have obvious eye conditions were referred to primary (VC), secondary (SC), or tertiary (TC) care centre appropriately, where they underwent a complete eye examination including cycloplegic refraction and fundus examination.Results:A total of 56,988 children were screened, of whom 51.18% were boys. The mean age was 9.69 ± 3.26 years (4–15 years). Overall, 2,802/56,988 (4.92%) children were referred to a VC, of which 632/56,988 (1.11%) required referral to SC/TC. PVA of <6/12 was found in 1.72% (95% confidence interval [CI]: 1.61–1.83). The prevalence of refractive error (corrected and uncorrected) was 2.38% (95% CI: 2.26–2.51) and myopia was 2.17% (95% CI: 2.05–2.29). In multivariable analysis, older children, those in urban schools, private schools, and children with a disability had an increased risk of VI and myopia. Additionally, the risk of myopia was higher among girls than boys. Of those referred and reached SC/TC, 73.64% were due to avoidable causes.Conclusion:Childhood VI prevalence was 1.72% in this region. Uncorrected refractive error (URE) was the major cause of VI in children. Older age, schools in urban locations, private schools, and the presence of disability were associated with the risk of VI among children.     

认知负荷理论在医疗护理领域中应用的研究进展

从认知负荷的定义、分类、测量方法以及在医疗护理领域中的应用等方面对国外最新研究进展进行综述,旨在为我国医院管理者在改善医护人员实施治疗与护理措施时认知负荷的水平发挥积极作用提供理论依据。     

清热化瘀Ⅱ号方对急性缺血性中风患者神经功能及中医证候评分的影响

目的通过观察清热化瘀Ⅱ号方对缺血性中风患者神经功能缺损评分、中医证候评分的影响,评价其对急性缺血性中风的中医证候疗效。方法选取急性缺血性中风患者72例,随机分为治疗组与对照组,每组36例。在常规治疗基础上,治疗组予清热化瘀Ⅱ号方治疗,对照组予天丹通络胶囊治疗,从K患者入院并筛选分组后开始给药,两组均治疗2周,观察并比较治疗前后两组患者神经功能缺损的评分、中医证候疗效及中医证候证候积分值。结果两组治疗前神经功能缺损评分差异无统计学意义（P〉0.05）,治疗后治疗组与对照组比较差异有统计学意义（P〈0.05或P〈0.01）。中医证候疗效总有效率治疗组为91.18%,对照组为71.43%,治疗组优于对照组（P〈0.05）,且治疗组中医证候积分减少明显优于对照组（P〈0.01）。结论清热化瘀Ⅱ号方可明显改善急性缺血性中风患者神经功能缺损评分及中医证候评分。     

Hearing impairment and hypoxia ischaemic encephalopathy: Incidence and associated factors

Objective

To establish the local incidence of hearing loss in newborns with Hypoxic Ischaemic Encephalopathy (HIE) and to identify associated risk factors.

Ethinyl estradiol 20 μg/drospirenone 3 mg 24/4 oral contraceptive for the treatment of functional impairment in women with premenstrual dysphoric disorder

Objective

To determine the effects of ethinyl estradiol (EE)/drospirenone in a 24/4 regimen (24 days of active and 4 days of inactive pills) on functional impairment (affecting work, partnership, and social activities) in women with premenstrual dysphoric disorder (PMDD).

Methods

The present study was a secondary analysis of a double-blind, randomized, parallel-design multicenter trial. Women received EE 20 μg/drospirenone 3 mg (n = 232) or placebo (n = 218) and completed the Daily Record of Severity of Problems (DRSP) scale daily.

Results

The decrease in mean scores for all 3 DRSP functional impairment items (work, partnership, and social activities) from baseline to cycle 3 mirrored changes in the total DRSP symptom score; the greatest decreases were observed in cycle 1 with further small reductions through to cycle 3. The proportional mean decreases from baseline to cycle 1 for the 3 functional items ranged from 47% to 48%. For all 3 functional items, the mean reductions from baseline to cycle 1 (but not from cycle 1 to cycles 2 and 3) were significantly greater with EE/drospirenone than with placebo (P < 0.05).

Conclusion

Ethinyl estradiol 20 μg/drospirenone 3 mg in a 24/4 regimen significantly improved functional impairment in women with PMDD. Symptoms improved in parallel.     

《中国卒中后认知障碍管理专家共识》解读

中国是卒中和痴呆的大国,卒中后认知障碍是卒中常见的并发症,不仅严重影响患者生活质量,而且显著降低卒中患者的生存时间,给家庭及社会带来了沉重的负担。卒中后早期干预可以减少血管性痴呆的发生,血管性因素的可控性为痴呆的治疗提供了新的思路。《中国卒中后认知障碍管理专家共识》将切实指导临床,使得卒中患者的生活质量得以提高。