SNOMED CT概念关系表达与语义检索

详细阐述SNOMED CT基于概念的组织框架、表示模式、关系模型、表达规则等,初步探索SNOMED CT在医疗数据表达、语义检索方面的应用,为研究制定我国临床诊疗术语标准提供参考借鉴,进一步推动临床医疗数据的处理、挖掘与分析研究。     

罗库溴铵以限时法和预注法行快速气管插管的比较

目的 比较罗库溴铵以限时法和预注法行快速气管插管的条件、肌松效应及对循环系统的影响。方法 限时（Ⅰ、Ⅱ）组诱导前30秒静注0.6mg/kg罗库溴铵,诱导后45秒（I）、60秒（Ⅱ）行气管内插管,预注（Ⅲ）组诱导前2分钟预注0.06mg/kg罗库溴铵（诱导量0.54mg/kg）,诱导后60秒行气管内插管。记录拇内收肌诱发颤搐反应的抑制和恢复过程,评价各组插管效果。结果气管内插管条件各组间无明显差异;气管内插管时T1抑制百分比Ⅲ组明显小于其他各组;各且对循环系统的都很小。结论 罗库溴铵以限时法行快速气管插管较预注法为佳。     

Enhanced inflammatory hyperalgesia after recovery from burn injury

Severe burn induces severe pain. While chronic as well as acute pain syndromes are reported, the peripheral mechanisms of burn-induced chronic pain syndromes have not been studied. We tested the hypothesis that burn induces plastic changes in primary afferent nociceptors that predispose to chronic pain states. Mechanical nociceptive thresholds were measured using the Randall–Selitto paw-withdrawal test in male Sprague-Dawley rats, before and following a small (<1% total body surface area) partial-thickness thermal injury to the dorsal surface of one hind paw. This burn induced mechanical hyperalgesia, which lasted over 2 weeks. After recovery, local injection of prostaglandin E2 (PGE₂), to mimic re-injury, induced an enhanced and markedly prolonged mechanical hyperalgesia compared to the hyperalgesic effect of PGE₂ in the control contralateral paw. This prolonged PGE₂-induced hyperalgesia was reversed by a selective inhibitor of protein kinase C-epsilon (PKC). Our findings suggest PKC as a peripheral mechanism for burn-induced chronic pain syndromes.     

大数据背景下电子病历信息模型语义构建分析

电子病历信息模型语义构建经历了从核心数据集方法、模块化方法到两层建模方法的发展过程,它们通常不是独立使用的,现阶段研究的许多模型标准往往是几种方法结合使用。一般来说,在顶层设计时,首先建立电子病历信息模型的框架结构（即参考模型）、必备元素（即核心数据集）和模型构建的实施规范,然后在框架结构标准下建立各医学概念、医学专业以及各科室专用的信息原型。     

Validity of an eyetracking method for capturing auditory–visual cross-format semantic priming

Introduction: Semantic priming paradigms are important for understanding lexical–semantic processing and the nature of linguistic deficits accompanying language performance in neurologically impaired individuals such as people with aphasia. Reaction-time-(RT)-based traditional semantic priming tasks entail potential confounds, especially problematic when applied to people with aphasia, who may have concomitant neurocognitive challenges that limit task performance. Some of these confounds include requirements of following complex instructions, making metalinguistic judgments, and using speech or limb-based motor actions to indicate overt responses. Eyetracking methods have great potential for avoiding some of these confounds. We tested the validity of an eyetracking method in capturing semantic priming in an auditory–visual cross-format priming paradigm (auditory word prime–visual image target).

Method: A total of 72 neurologically unimpaired adults participated in two phases: a stimulus development phase using traditional priming (n = 32) and an experimental eyetracking phase (n = 40). Each phase included two conditions, representing distinct levels of prime–target semantic relatedness: unrelated and related. Mean RT data from the traditional priming (stimuli development) phase guided image selection for the eyetracking experiment. Eyetracking indices of fixation duration and latency of fixation were recorded to capture semantic priming in the eyetracking experiment.

Results: Eye fixation data indicated that images related to auditory primes were attended to earlier and attracted significantly greater visual attention than unrelated images. These results mirrored RT data from the traditional priming method, which showed faster RT latencies and more accurate naming performance for related images than for unrelated images.

Conclusions: Results support the validity of eyetracking indices of semantic priming and offer a robust testing protocol for future studies in this line of research. Current clinical relevance for people with aphasia is highlighted. Further empirical testing of the psychometric properties of the eyetracking measures in various semantic priming contexts is recommended.     

Caspase-6 activity predicts lower episodic memory ability in aged individuals

Caspase-6 (Casp6), a cysteinyl protease that induces axonal degeneration, is activated early in Alzheimer Disease (AD) brains. To determine whether Casp6 activation is responsible for early cognitive impairment, we investigated the abundance of Casp6 activity, paired helical filament–1 (PHF-1) phosphorylated Tau and amyloid beta peptide (Aβ) pathology by immunohistochemistry in the hippocampal formation of aged non–cognitively impaired (NCI) individuals. Casp6 activity was restricted to the entorhinal cortex (ERC) and CA1 regions of the hippocampus. Pathology scores were then correlated with cognitive scores obtained within 1 year of death. Regression analyses revealed that ERC and CA1 Casp6 activity were the main contributor to lower episodic memory performance, whereas ERC PHF-1 pathology predicted lower semantic and working memory performance. Aβ did not correlate with any of the cognitive tests. Because Casp6 activity and PHF-1 pathology are intimately associated with AD pathology and memory decline is an early event in AD, we conclude that Casp6 activity and PHF-1 immunoreactivity in ERC identifies aged individuals at risk for developing AD.     

The differential dependence of abstract and concrete words upon associative and similarity-based information: Complementary semantic interference and facilitation effects

We report mirror-image effects of interference and facilitation in the semantic processing of identical sets of abstract and concrete words in a patient F.B.I. with global aphasia following a large left middle cerebral artery stroke. Interference was elicited when the tasks involved comprehending the spoken form of each word, but facilitation was found when the patient read aloud the written forms of the same words. More importantly, irrespective of whether the dynamic effect was one of facilitation or interference, effects of semantic association were observed for abstract words, whilst effects primarily of semantic similarity were observed for concrete words. These results offer further neuropsychological evidence that the more abstract a word, the greater its dependence upon associative information and the smaller its dependence upon similarity-based information. The investigations also contribute to a converging body of evidence that suggests that this theory generalizes across different experimental paradigms, stimuli, and participants and also across different cognitive processes within individual patients. The data support a graded rather than binary or ungraded model of the relationships between concreteness, association, and similarity, and the basis for concrete words’ greater dependence upon similarity-based information is discussed in terms of the development of taxonomic structures and categorical thought in young children.     

自我构念启动效应下大学生自尊与生活满意度的关系

目的:考察不同自我构念启动情境下大学生自尊和生活满意度间的动态关系。方法:选取大学生183名随机分为独立构念启动组(n=58)、互依构念启动组(n=65)和对照组(n=59)。3组阅读不同的启动阅读材料进行构念启动,完成启动任务后立即用自尊量表(SLSC)测评能力自尊和价值自尊,用生活满意度量表(SWLS)测评生活满意度。用多元回归分析并比较能力自尊、互依自尊对生活满意度的预测作用。结果:在独立构念启动组,能力自尊正向预测生活满意度(β=0.48);在互依构念启动组,价值自尊正向预测生活满意度(β=0.35);在对照组,能力自尊和价值自尊对生活满意度的预测作用均无统计学意义(均P>0.05)。结论:大学生在独立和互依构念启动情境下会分别倚重能力自尊、价值自尊来预测生活满意度,提示个体在不同情境下将会以不同的方式评价和体验生活幸福感。     

B‐cell modulation of dendritic‐cell function: Signals from the far side

An appropriate immune response against a specific pathogen requires finely orchestrated interactions between the various cell populations within the immune system. At the same time, immunological tolerance to self must be maintained. DCs play an essential role in achieving these dual requisites. They coordinate adaptive immunity by integrating signals directly emanating from both infectious agents and cells of the immune system. Many such signals, especially those from innate cells and T cells, have been extensively characterized. In contrast, little is known about how B cells modulate function of DCs. B cells produce a variety of cytokines, including IL‐10 and IL‐6, which are known to influence DC function. In addition, Igs constitute the major secretory products of terminally differentiated B cells (plasma cells). DCs express various types of receptors for binding Ig, such as Fc receptors and C‐type lectin receptors. In accordance, Igs can regulate DC function depending on the receptors engaged. Here, we review the emerging immunomodulatory role of cytokines and Ig secreted by B cells. We discuss the evidence for how these B‐cell‐derived factors may shape the adaptive immune response by directly acting on DCs.     

The Influence of refractoriness upon comprehension of non-verbal auditory stimuli

An investigation of non-verbal auditory comprehension in two patients with global aphasia following stroke is reported. The primary aim of the investigation was to establish whether refractory access disorders can affect non-verbal input modalities. All previous reports of refractoriness, a cognitive syndrome characterized by response inconsistency, sensitivity to temporal factors and insensitivity to item frequency, have involved comprehension tasks which have a verbal component. Two main experiments are described. The first consists of a novel sound-to-picture and sound-to-word matching task in which comprehension of environmental sounds is probed under conditions of semantic relatedness and semantic unrelatedness. In addition to the two stroke patients, the performance of a group of 10 control patients with non-vascular pathology is reported, along with evidence of semantic relatedness effects in sound comprehension. The second experiment examines environmental sound comprehension within a repetitive probing paradigm which affords assessment of the effects of semantic relatedness, response consistency and presentation rate. It is demonstrated that the two stroke patients show a significant increase in error rate across multiple probes of the same set of sound stimuli, indicating the presence of refractoriness within this non-verbal domain. The implications of the results are discussed with reference to our current understanding of the mechanisms of refractoriness.