构建学习型军队医院的策略

作介绍了该院制定合理的共同愿景，激发医院员工的学习愿望；建设学习型的领导班子，带动员工自觉学习；强化学习过程管理，不断提高学习效果；处理“学”与“用”的关系，保证学习型组织管理模式长久运行等一系列构建学习型医院的基本做法，为探索医院管理新模式提供了参考。     

Linear relationship between the maintenance of hippocampal long-term potentiation and retention of an associative memory.

The hypothesis that the maintenance or decay of an associative memory trace after an extended retention interval is a function of the residual strength of the synapses originally strengthened during learning was examined in a classical conditioning paradigm in which high-frequency stimulation of a hippocampal input--the medial perforant path--served as a conditioned stimulus. Rats received perforant path stimulus-foot shock pairings while engaged in a previously acquired food-motivated lever-pressing task. Conditioned suppression of lever pressing was the behavioral measure of learning and retention of the association. Stimulus trains to the perforant path at an intensity above the threshold for eliciting a population spike induced long-term potentiation of synaptic transmission in the dentate gyrus. Synaptic potentials recorded extracellularly in the dentate gyrus were subsequently monitored for 31 days to examine quantitatively the decay of synaptic potentiation, a period after which retention of the learned association was assessed. All rats learned the association to a similar extent and displayed equivalent amounts of long-term potentiation by the end of conditioning. A slowly decaying function of synaptic potentiation was observed in remembering rats, i.e., rats with high retention performance after the 31-day learning-to-retention interval, while forgetting was associated with a rapid decay of long-term potentiation. Behavioral performance at the long-term memory test was linearly correlated with the amplitude of long-term potentiation maintained just prior to the retention test. The results favor the hypothesis that long-term associative memory depends, at least in part, on the maintenance of elevated synaptic strengths in the pathway activated during learning and suggest a role for the lasting component of long-term potentiation in the maintenance of memory.     

Independent learning among general practice trainees: an initial survey

Self-directed learning is a natural way for adults to learn. Vocational training for general practice is a preparation for unsupervised clinical work that will be supported, in the main, by continuing medical education. This study uses the Self-Directed Learning Readiness Scale to investigate factors influencing readiness for such learning among a sample of general practice trainees. Three principal factors emerged from analysis: enjoyment and enthusiasm for learning; a positive self-concept as a learner and a factor suggesting the possibility of a 'reproducing' orientation to learning. These factors may reflect approaches to learning in general rather than these adopted for professional learning, but offer helpful pointers for the development of both vocational training and of continuing medical education.     

治疗血浓度下抗癫(癎)药对未成熟脑发育影响的实验研究

目的 探讨抗癫(癎)药物(AEDs)在治疗血浓度下对未成熟脑发育的影响.方法 以AEDs血浓度达到临床治疗稳态血浓度为实验剂量,设立健康幼鼠及成年SD大鼠氯硝西泮(CNP)、苯巴比妥(PB)、丙戊酸(VPA)、托吡酯(TPM)实验组及正常对照组(各18只).AEDs灌胃5周,于停药后次日、2周及1个月末,行Morris水迷宫及穿梭箱测试.停药当天记录体重、脑重,海马及额叶组织行苏木素-伊红(HE)、尼氏染色及电镜观察.结果 (1)停药后次日及2周的穿梭箱实验,幼鼠CNP和PB组逃避潜伏期明显长于对照组.即使停药后1个月,幼鼠CNP[(6.05±2.04)s]及PB组[(5.81±1.75)s]与对照组的差异仍有统计学意义[(4.75±2.43)s,P＜0.01].而停药后2周,成年鼠各AEDs组与对照组已无差异;(2)Morris水迷宫实验,分别于停药后次日、2周及1个月,幼鼠CNP和PB组登平台潜伏期均长于对照组.而成年鼠各组登平台潜伏期于停药后2周已无差异;(3)幼鼠CNP组脑重(1.67±0.04)g,PB组脑重(1.66±0.04)g,较对照[(1.75±0.06)g]轻;(4)神经元广泛变性坏死,神经细胞数[CNP组为(76.87±18.60)个/200倍视野,PB组(72.60±17.26)个/200倍视野]较对照少[(109.13±33.73)个/200倍视野,P＜0.01];(5)停药1个月后,PB组幼鼠神经元超微结构仍异常.结论 长期服用PB、CNP可引起未成熟脑学习记忆功能及脑组织病理学持续异常,PB对未成熟脑的损伤存在可能是不易恢复的.     

以计算机为基础的教学(CBE)在护理领域的应用现状

随着计算机和网络技术的普及应用，以计算机为基础的教育(Computer Based Education，CBE)特别是多媒体课件的应用在护理教育中越来越受重视。然而，我国CBE在护理领域的应用尚处于起步阶段，也存在着一些缺陷和不足，有待于进一步完善。     

多巴胺受体的结构和功能

多巴胺是大脑中含量最丰富的儿茶酚胺类神经递质。多巴胺作为神经递质调控中枢神经系统的多种生理功能。多巴胺系统调节障碍涉及帕金森病，精神分裂症，Tourette综合征，注意力缺陷多动综合征和垂体肿瘤的发生等。本文综述了多巴胺受体的共同特征和各个受体的独特特征，以及它们在中枢神经系统的分布和功能，重点强调了多巴胺受体与学习记忆的关系。     

妊娠压力对大鼠子代早期空间学习记忆能力的影响

【目的】探索妊娠期精神压力对大鼠子代早期空间学习、记忆能力的影响。【方法】实验采取产前束缚压力,建立妊娠期大鼠精神压力暴露模型。然后对子代进行Morris水迷宫测试,分析妊娠期压力对子代早期学习和记忆的影响及性别间的差异,同时检测实验前、后子鼠的血清肾上腺酮的变化。【结果】①在隐蔽平台试验中,对照组的平均潜伏期较实验组短,但差异无显著性(F=0.599,P>0.05)。②在保持力试验中,对照组在原平台所在象限逗留的时间大于实验组,差异有显著性(F=4.588,P<0.05)。③子代血清肾上腺酮的测定结果表明:水迷宫测试前,实验组和对照组相比,差异无显著性(F=0.169,P>0.05);实验后,实验组血清肾上腺酮比对照组高,差异具有显著性(F=6.098,P<0.05)。【结论】①妊娠压力可导致子代学习,记忆能力的改变;②妊娠压力造成子代在应激情况下血清肾上腺酮的过度分泌。③妊娠压力对子代的影响没有明显性别差异。     

Effects of haloperidol on the multitrial partial reinforcement extinction effect (PREE): evidence for neuroleptic drug action on nonreinforcement but not on reinforcement

Two experiments investigated the effects of haloperidol (0.1 mg/kg) on the partial reinforcement extinction effect (PREE). In experiment 1 two groups of rats were trained to run in a straight alley using six trials/day with an intertrial interval (ITI) of 5–8 min. The continuously reinforced (CRF) group received food reward on every trial. The partially reinforced (PRF) group was rewarded on a quasi-random 50% schedule. All animals were then tested in extinction. Haloperidol was administered in a 2 × 2 design, i.e., drug-no drug in acquisition and drug-no drug in extinction. In experiment 2 two groups of rats were trained to press a lever in an operant chamber using a discrete trial procedure of ten trials/day with an ITI of 60 s. The CRF group was rewarded on each trial and the PRF group was rewarded on a quasi-random 50% schedule. Haloperidol was administered for 22 days prior to the start of the PREE procedure as well as throughout acquisition and extinction. The PREE, i.e., increased resistance to extinction of PRF as compared to CRF animals, was obtained in both experiments in all drug conditions. In both experiments haloperidol increased the rate of extinction. Experiment 1 revealed that this effect was entirely dur to the administration of the drug in extinction, independently of the drug condition in acquisition. In contrast to previous results in a one trial/day procedure, the administration of haloperidol to CRF animals did not increase resistance to extinction, failing to support the notion that neuroleptics attenuate the rewarding properties of reinforcement.     

Organization and physiology of thesubstantia nigra

Summary A comprehensive review of the literature on the anatomy, electrophysiology and pharmacology of thesubstantia nigra is presented. A diagram is developed taking into account the interneuronal interactions of neurotransmitters and receptors that control firing rates and neurotransmitter releases. The central features of the diagram are a positive dopaminergic feedforward process and a positive feedback mechanism mediated by extrasynaptic substance P diffusing from striatal terminals to dopaminergic dendrites of thezona compacta neurons. This loop can enhance the transmission of information from thestriatum through thepars reticulata output neurons. The loop is controlled at the level of zona compacta neurons by a negative feedback supported by the dendritic release of dopamine and boosted by pedunculopontine activation mediated by muscarinic receptors. The output of the loop is controlled by two negative feedforward processes, both involving GABAergic striatonigral afferents. Application of the model to pharmacological studies of diverse behaviors including seizures, turning, and conditioned behaviors reveals unforseen relationships and may offer insights into, and directions for, further analysis of the mechanisms and functions involved.     

Experiences and perceived roles of occupational therapists working with children with special learning needs during transition to school: A pilot study

Occupational therapists provide support to children with special learning needs and their families during the child's transition from early childhood to mainstream school. Little has been documented regarding the role and experiences of occupational therapists working with children, families and teachers during transition in an Australian context. Six paediatric occupational therapists from one geographical area in New South Wales were interviewed and asked to relay their role and experiences when providing a service to children with special learning needs during their transition to school. Participants described their role to include: preparing the child for school; working with school personnel; and providing parental support. Although participants described both positive and negative experiences, among the negative experiences were: limited time to provide a service; recommendations to school personnel not being followed; school personnel not being supportive; feeling uncomfortable in the classroom; and limited involvement in planning. Participants described a role which is consistent with current school-based occupational therapy practice; however, in the participants' experience, there was a gap between the ideal service and what participants were able to provide. This included limited collaboration with teachers.