阿托伐他汀对冠状动脉斑块的疗效

观察不同剂量的阿托伐他汀对冠状动脉斑块形成患者血脂水平及斑块的影响。方法：150例经多层螺旋CT（MSCT）及冠脉造影确诊的冠状动脉斑块形成患者被随机分为阿托伐他汀低剂量组（10mg/d）、中剂量组（20mg/d）、高剂量组（40mg/d）,每组50例,疗程16周,于治疗前后分别检测血脂及冠脉斑块大小及狭窄程度。结果：与治疗前比较,治疗16周后三组TC、TG水平均有明显下降;与低、中剂量组比较,高剂量组LDL-C[（3.52±0.43）mmol/L比（3.13±0.41）mmol/L比（2.23±0.52）mmol/L]、TC[（5.06±0.65）mmol/L比（4.51±0.61）mmol/L比（3.97±0.50）mmol/L]、TG[（2.02±0.86）mmol/L比（1.96±0.94）mmol/L比（1.57±0.77）mmol/L]水平明显下降,HDL-C[（1.23±0.20）mmol/L比（1.25±0.17）mmol/L比（1.30±0.21）mmol/L]水平明显升高,且斑块大小明显缩小[（9.82±1.93）mm2比（8.90±1.87）mm2比（7.00±1.81）mm2],P均〈0.05;同时,高剂量组冠状动脉狭窄程度较中、低剂量组有明显改善（70%比60%比57.1%,P〈0.05）。结论：阿托伐他汀能有效改善血脂水平,大剂量疗效更佳,且能显著缩小冠脉斑块和狭窄。     

The therapeutic relationship in telephone-delivered support for people undertaking rehabilitation: a mixed-methods interaction analysis

Abstract

Purpose: The aim of this study was to identify communication features that may affect the development of the therapeutic relationship during telephone support sessions for people undertaking self-directed therapy. Methods: Recorded telephone support sessions of 61 people with chronic dizziness were analysed for communication behaviour using the Roter Interaction Analysis System (RIAS). Working alliance was assessed and was correlated with the RIAS to determine whether communication behaviour affected the therapeutic relationship. Thematic qualitative analysis of support sessions was then carried out to explore the content of sessions with high or low levels of person-centredness. Results: The level of person-centredness was related to the therapeutic relationship. High person-centred sessions were more likely to address concerns and include therapist reassurances about the safety of the treatment and its side effects. Conclusion: It is possible for rehabilitation therapists to build a strong therapeutic relationship very quickly and over the telephone. Person-centred communication is important for the development of the therapeutic relationship during telephone-delivered support. This research suggests how person-centred communicative behaviours, such as reassurance, encouragement and approval could be incorporated into practice.

• Implications for Rehabilitation

• Person-centred communication is important for the development of a strong therapeutic relationship during support for self-directed rehabilitation.

• It is possible for rehabilitation therapists to build a strong therapeutic relationship very quickly and over the telephone.

• Positive communication behaviours such as encouragement, approval, reassurance of safety, and responsiveness to participant cues aid the therapeutic relationship.

     

The theory of previewing: Preventive caregiver-infant psychoeducational groups—Part I

The rising incidence of caregiver-infant dyads seeking intervention for interactional failure underscores the pressing need for prevention models. Previewing, a prospectively-oriented developmentally-based approach, may offer techniques that can deter the emergence of conflict between caregivers and their infants. Group formats have been shown to be especially appropriate settings for applying previewing techniques. While the group format has proven effective in identifying and resolving conflict in caregiver-infant dyads, its effectiveness as a preventive measure needs to be highlighted. The group's receptiveness to previewing techniques, coupled with the effectiveness of these strategies for preventing interactional failure, suggests that group therapy involving caregiver-infant dyads can function as an effective prevention model.     

Methylphenidate and Interpersonal Relationships of Children with Attention Deficit Hyperactivity Disorder

Abstract: In order to clarify the effects of methylphenidate on interpersonal relationships of children with attention deficit hyperactivity disorder (ADHD), data from sociometric tests conducted in 28 classes to which ADHD children belonged was analyzed, comparing patients who had a history of methylphenidate treatment with those who had not. It was suggested that ADHD children with a history of methylphenidate treatment had more favorable votes and fewer unfavorable ones than those without it. However, there were more isolated children among ADHD children with methylphenidate treatment than in those without it. The results are discussed in the light of previous findings in the literature and a hypothesis for methylphenidate induced isolation is proposed.     

The creative balance: The therapeutic relationship and thematic issues in trauma resolution

A case example of the psychotherapeutic treatment by a male therapist of a female incest survivor is presented in the present paper. The case illustrates how the evolution of the therapeutic relationship critically contributed to the resolution of thematic issues that defined the therapeutic work. The case also illustrates the use of hypnosis in facilitating the integration of traumatic memories and themes. The importance of a creative balance between autonomy and connection in the therapeutic alliance is emphasized. Data for the case include narrative material written by the client over the course of the therapy.This article was accepted for publication under the Editorship of Charles R. Figley.     

小剂量和常规剂量化疗药物经导管动脉内化疗栓塞后肝癌细胞坏死及凋亡的比较研究

目的　研究经导管动脉内化疗栓塞 (TACE)中应用小剂量和常规剂量化疗药物后肝细胞癌 (HCC)细胞坏死及细胞凋亡的情况。方法　 3 0例中晚期HCC患者接受超选择性TACE治疗 ,A组 (12例 )给予小剂量化疗药物 :肿瘤瘤径小于 5cm者给予丝裂霉素 (MMC) 2～ 4mg;在 5～ 8cm间者给予MMC 4～ 6mg ,表柔比星 (EPI) 10mg;大于 8cm者给予MMC 6～ 8mg ,EPI 10mg ,卡铂 (CBP)10 0mg ;B组 (18例 )给予常规剂量化疗药物 :MMC 10mg,CBP 3 0 0mg ,EPI 40mg。经导管向供血动脉内注入碘油 化疗药物乳化剂 ,随后用明胶海绵 (GS)或聚乙烯醇 (PVA)微球栓塞该动脉。TACE后切除病灶 ,分别行病理检查和原位细胞凋亡检测评估肿瘤细胞坏死及凋亡程度。另 2 0例切除病灶前未行TACE者 (C组 )为对照组。结果　A、B、C组肿瘤坏死程度分别为 (90 5± 9 0 ) %、(87 9± 9 5 ) %和6 0 % (0 %～ 2 5 0 % )。A、B两组间差异无显著性意义 (χ2 =0 3 45 ,P >0 0 5 )。A、B组分别与C组比较 ,差异均有显著性意义 (χ2 分别为 2 1 897和 2 7 891,P值均 <0 0 0 1)。A、B两组凋亡指数 (% )分别为 9 0 % (3 0 %～ 2 0 0 % )和 10 0 % (5 0 %～ 2 0 0 % ) ,两组间差异无显著性意义 (χ2 =0 3 46,P >0 0 5 ) ,但均明显高于对照组 5 0 % (1 0     

Aggression and Dominance: The Roles of Power and Culture in Domestic Violence

In the past few decades, it has become increasingly clear to social scientists and policy makers alike that violence within the family is all too common and carries enormous costs to individuals, families, and society as a whole. Numerous controversies exist in the field, particularly with regard to what factors are significant in the etiology and development of violence between intimate partners. This article focuses on relationship power as a critical construct to consider in domestic violence, as it encompasses aspects of social, dyadic, and individual functioning. The literature on the construct of power and its relationship to domestic violence is reviewed and then placed in cultural context, followed by a discussion of future directions for research on and treatment issues in power and violence.     

祖国医学与现代医学运动系统解剖术语比较

目的阐释运动系统祖国医学解剖学术语与现代医学解剖学术语的对应关系及其异同.方法查阅资料,制作卡片,比较二者异同.结果祖国医学与现代医学运动系统解剖术语所指结构,在名称上有较大差异,而在形态、功能上差异不大.结论很多运动系统现代医学解剖术语来源于祖国医学解剖术语,二者既有相同之处,又有不同之处.     

The effects of a continuing medical education programme in interpersonal communication skills on doctor practice and patient satisfaction in Trinidad and Tobago

This study investigates the effects of a brief training programme on the communication skills of doctors in ambulatory care settings in Trinidad and Tobago. Evaluation of doctor performance is based on analysis of audiotapes of doctors with their patients during routine clinic visits and on patient satisfaction ratings. A pre-test/post-test quasi-experimental study design was used to evaluate the effects of exposure to the training programme. Doctors were assigned to groups based on voluntary participation in the programme. Audiotapes of the 15 participating doctors (nine trained and six control) with 75 patients at baseline and 71 patients at the post-training assessment were used in this analysis. The audiotapes were content-coded using the Roter Interaction Analysis System (RIAS). Doctors trained in communication skills used significantly more target skills post-training than their untrained colleagues. Trained doctors used more facilitations in their visits and more open-ended questions than other doctors. There was also a trend towards more emotional talk, and more close-ended questions. Patients of trained doctors talked more overall, gave more information to their doctors and tended to use more positive talk compared to other patients. Trained doctors were judged as sounding more interested and friendly, while patients of trained doctors were judged as sounding more dominant, responsive and friendly than patients of untrained doctors. Consistent with these communication differences, patient satisfaction tended to be higher in visits of trained doctors.     

记忆增强肽ZNC(C)PR类似物的结构-活性关系(英文)

ZNC(C)PR是大鼠脑中具有促进学习记忆作用的神经肽,本文按前文2D-NMR测 定结构和活性比较的结果以及分子动力学的关 类似物加以验证。结果与预则相符,即一定系式计算了45个ZNC(C)PR类似物的能量和紧密度的分子结构是表现活性所必需的。可能的结构趋向,从理论上探讨了各残基对稳定结构的贡献,并据此设计和合成了5个新的