图片学习测验在识别老年人轻微认知功能损害中的作用

目的　分析图片学习测验在识别老年人轻微认知功能损害 (MCI)中的作用。方法　选择符合MCI诊断标准的老年人 4 8例与正常对照组 5 6名完成图片学习测验、简易智能状态检查、听觉词语学习测验及多种非记忆测验。结果　图片学习测验的 3个记忆指标 (图片短时记忆、延迟记忆和学习记忆 )在MCI与正常对照组之间有非常显著的差异。已经给出这三个图片记忆指标区分MCI与正常老年人的划界分、敏感性和特异性。结论　图片记忆操作简便、信度和效度好 ,可以作为临床医师筛选MCI的有效工具     

Transmitter Release Associated with Long-term Synaptic Depression in Rat Corticostriatal Slices

Using a corticostriatal slice preparation, we have recently shown that tetanic stimulation of the corticostriatal pathway produces long-term depression (LTD) of striatal excitatory synaptic transmission. In the present study we have analysed the relationship between LTD and the striatal release of different endogenous transmitters. Samples of perfusate were collected via a small cannula placed just above the surface of the striatal slice close to the recording electrode, and were analysed by HPLC. The high-frequency stimulation (100 Hz, three trains, 3 s duration, 20 s intervals) used to induce LTD caused a significant but transient increase in the release of both excitatory (aspartate and glutamate) and inhibitory (glycine and GABA) amino acid transmitters. Tetanic stimulation also produced a significant, but transient increase in the release of endogenous dopamine. We conclude that the tetanic stimulation of the corticostriatal pathway is able to induce a large but transient release of excitatory amino acids and of dopamine, whose participation in the induction of striatal LTD has been demonstrated previously. Moreover, the maintenance of this form of synaptic plasticity does not seem to require a sustained change in transmitter release.     

Functional Anatomy of Visuomotor Skill Learning in Human Subjects Examined with Positron Emission Tomography

The present study was designed to examine patterns of regional cerebral blood flow (CBF) associated with the learning of a repeated visuomotor sequence both in the early and late phases of the acquisition process. In addition, changes in blood flow related to the implicit versus explicit aspects of learning such a skill were investigated. Fourteen normal control subjects were scanned while performing the task (i) in both early and advanced learning stages of the visuomotor sequence; (ii) after having acquired explicit knowledge of the sequences; and (iii) in two control conditions (perceptual and random sequence). Subtraction of the random condition from the highly learned condition revealed specific areas of activity in the right ventral striatum and dentate nucleus of the cerebellum. Blood flow changes in the right hemisphere were also seen in the medial posterior parietal and prestriate regions, as well as in the anterior cingulate cortex. Finally, once the subjects had acquired explicit knowledge of the embedded sequence that was presented in the highly learned condition, increased CBF activity was observed only in the mid-ventrolateral frontal area in the right hemisphere. These findings confirm that both the striatum and the cerebellum are involved in the implicit acquisition of a visuomotor skill, especially in the advanced stages of the learning process, and furthermore that the ventrolateral prefrontal cortex contributes preferentially to the declarative aspect of this task.     

Neuropsychological correlates of learning disabilities: Subtype identification by the tryon clustering method

Since Samuel Orton's (1937) assertion that dyslexia reflects abnormal brain organization, the relationship of learning disabilities to brain dysfunction has been the topic of considerable debate. Recently, learning-disabled individuals have been studied in conjunction with those known to have neurological dysfunction, in a search for common subtypes. In the present study, a population of 177 children, ages 9-0 to 14-0, were assessed on an augmented version of the Children's Halstead-Reitan Battery. One hundred twenty-nine Ss were learning-disabled, 37 of whom also had verified brain damage. The remaining 48 children had neither learning disabilities nor evidence of brain damage. Patterns of neuropsychological performance were determined using Tryon's clustering methods. The procedure yielded six subject clusters: (A) and (B)—children with low general intellectual ability; (C) children who are clumsy and lethargic; (D) children with language dysfunction; (E) children with faulty spatial orientation; and (F) children with no detectable neuropsychological deficits. These clusters were similar to those identified by investigators who have used other subject-clustering methods. Brain-damaged individuals were more prevalent in some clusters (e.g., A and B) than in others (e.g., E and F), and substantial numbers of learning disabled subjects were also found in clusters where brain-damaged individuals tended to cluster, indicating similar neuropsychological profiles. The cluster structure was validated by comparison with subtypes identified by other investigators, as well as by tests of association between clusters with exogenous factors (e.g., history of prematurity; seizures).     

Validity of a hinged constant force probe and a similar, immobilised probe in untreated periodontal disease

The validity of a hinged constant force probe (0.25 N) was compared with that of a similar but immobilised instrument, using the same interchangeable tip for both (0.64 mm diameter; 2 mm divisions). 60 sites were measured on teeth which were extracted subsequently, in patients with untreated periodontal disease, and the connective tissue attachment level was used as validity criterion. The clinical measurements of both probes correlated well with each other, but they differed significantly from the post-extraction connective tissue attachment level measurements, indicating a point 1.2 mm coronally to this, on average. A companion investigation of intra-operator probing depth reproducibility with the 2 probes, was undertaken in 14 patients, at 2 visits separated by 1 week in each case. All patients had untreated periodontal disease. A difference between probes was found at the first visit, but not at the second; the immobilised probe showed a difference between visits, reducing mean probing depth slightly at the second; when the immobilised probe was used first, there was a difference between probes. Further analysis of the results indicated that there was greatest agreement between probes when the constant force probe had been used before the immobilised probe at the second visit. The results suggested that these probes indicated a point above the connective tissue attachment level, related to pocket morphology, and that there was a moderate learning effect due to operator use of the constant force probe, which modified use of the immobilised probe.     

Remodeling Adult Nursing

This article describes a nursing education experience in which a critical thinking approach was planned and implemented. Background discussion on critical thinking concepts and related research provides a foundation for presentation of the Mackie teaching model. The model uses a community-based, family-centered scenario as the basis for developing problemfocused nursing intervention skills from a holistic viewpoint. Role expectations of students and faculty are outlined, and related implementation difficulties, together with their resolution strategies, are described. Evaluation methods and outcomes are reviewed in the conclusion.     

以问题为中心的病案教学法在临床核医学中的实践

目的 设计以问题为中心的病案小组讨论教学法，在临床核医学核素治疗见习的教学实践中进行验证和评价。方法 总结近几年在临床核医学见习带教中的问题与缺陷；以病案引入问题，教师引导，进行小组讨论；评价教学效果。结果 临床核医学及其教学具有不同于其它临床学科的鲜明特点和规律；经改革的教案，收到学生和教师的良好反馈。结论 以问题为中心的病案小组讨论教学法，切合临床核医学见习实际，有效可行。     

Basic sciences in problem-based learning and conventional curricula: students' attitudes

The purpose of this study was to compare the attitudes toward basic sciences of students in a preclinical problem-based curriculum and a conventional lecture-based curriculum at the end of their second year of medical school. The results showed that the PBL class had more positive attitudes toward basic sciences than students in the conventional class. These results may reflect a learning environment where students meet many scientist role models as teachers and where basic science is learnt in the context of clinical problems.