The dorsomedial frontal cortex of the macaca monkey: fixation and saccade-related activity

Summary The activity of 249 neurons in the dorsomedial frontal cortex was studied in two macaque monkeys. The animals were trained to release a bar when a visual stimulus changed color in order to receive reward. An acoustic cue signaled the start of a series of trials to the animal, which was then free to begin each trial at will. The monkeys tended to fixate the visual stimuli and to make saccades when the stimuli moved. The monkeys were neither rewarded for making proper eye movements nor punished for making extraneous ones. We found neurons whose discharge was related to various movements including those of the eye, neck, and arm. In this report, we describe the properties of neurons that showed activity related to visual fixation and saccadic eye movement. Fixation neurons discharged during active fixation with the eye in a given position in the orbit, but did not discharge when the eye occupied the same orbital positions during nonactive fixation. These neurons showed neither a classic nor a complex visual receptive field, nor a foveal receptive visual field. Electrical stimulation at the site of the fixation neurons often drove the eye to the orbital position associated with maximal activity of the cell. Several different kinds of neurons were found to discharge before saccades: 1) checking-saccade neurons, which discharged when the monkeys made self-generated saccades to extinguish LED's; 2) novelty-detection saccade neurons, which discharged before the first saccade made to a new visual target but whose activity waned with successive presentations of the same target. These results suggest that the dorsomedial frontal cortex is involved in attentive fixation. We hypothesize that the fixation neurons may be involved in codifying the saccade toward a target. We propose that their involvement in arm-eye-head motor-planning rests primarily in targeting the goal of the movement. The fact that saccaderelated neurons discharge when the saccades are self initiated, implies that this area of the cortex may share the control of voluntary saccades with the frontal eye fields and that the activation is involved in intentional motor processes.     

以重点监控药品管理促进合理用药水平提升

通过开展以“合理用药”为核心的重点监控药品管理,促进合理用药水平提升。采取事后处方点评及处方前置审核,建立和完善重点监控药品管理方案,对不合理用药进行拦截、宣教、绩效处罚、限量采购、约谈等,实现了重点监控药品规范化管理。实践后,不合理医嘱减少,处方点评合格率提升,辅助用药种类减少。认为建立重点监控药品管理的相关制度及流程,对提升合理用药水平有一定促进作用。     

PBL学习方法在静脉用药配置中心（PIVAS）药师审核医嘱中的应用

目的 提高静脉用药配置中心药师审核医嘱水平,提高临床合理用药,提升医院药学服务质量.方法 探索将＂以问题为基础＂的学习方法 （PBL）引入到静脉用药配置中心药师审核医嘱的具体过程中.结果 全面激发了药师学习知识的兴趣和主动性,提高了药师分析和解决临床实际问题的能力.结论 药师的学习是多元化的,PBL学习方法 能调动学习者的主动性和积极性,促进学习者不断思考,有助于培养自学能力、综合分析能力,有利于提高发现问题、解决问题的能力,并培养良好的学习习惯.     

HIV/AIDS主要临床测查工具简评

HIV/AIDS给患者带来了心理、生理、社会、家庭等多方面的问题 ,心理学家和临床工作者根据临床经验修订和编制了多方面的临床测查工具 ,本文着重介绍了情绪、症状、心理卫生方面心理测量学指标较好的几个测查工具 ,以供国内学者研究之用     

Intolerance of uncertainty and obsessive-compulsive symptom expression

Background and objectivesResearch suggests a relationship between intolerance of uncertainty (IU) and obsessive-compulsive disorder (OCD), though this has been limited to self-report measures of OCD symptoms. The current investigation examined the relationship between IU and multiple symptom domains of OCD using self-report and in vivo assessments of OC symptoms.MethodsFive separate studies are presented in which undergraduate students (N = 603) were administered a self-report measure of IU and tasks related to either ordering and arranging, checking, washing, contamination avoidance, or neutralization.ResultsIntolerance of uncertainty was found to be significantly related to each self-report measure of the OCD symptom domains (ps < .01). Further, IU was predictive of performance on all in vivo tasks (ps < .05) except one concerning neutralizing/harm-related obsessions.LimitationsThis study relied on an unselected sample and was correlational in design.ConclusionsThe current study demonstrates that IU is related to multiple OC symptom dimensions. Future experimental research is warranted to evaluate the causal role of IU in OCD.     

液基细胞学和高危型HPV DNA检测对宫颈癌前病变筛查的作用

目的：评价单独和联合高危型人乳头状瘤病毒（HPV）DNA检测和宫颈液基细胞学检查对宫颈癌前病变筛查的效果。方法：对广东医学院附属医院妇科门诊1152名妇女进行宫颈癌前病变筛查,采用液基细胞学检查（TCT）和第二代杂交捕获试验（HC-Ⅱ）检测高危型HPV DNA,以宫颈活检的组织病理学结果为确诊标准。结果：高危型HPV DNA检测CINⅡ、Ⅲ的敏感度、特异度、阳性预测值、阴性预测值分别为91.82%、73.96%、5.16%、99.91%。宫颈细胞学筛查CINⅡ、Ⅲ,以ASCUS为分界点的上述四值分别是90.50%、79.87%、12.15%、99.57%;以LSIL为分界点的上述四值分别是71.52%、89.76%、11.04%、99.45%;以HSIL为分界点的上述四值分别是47.25%、98.32%、32.24%、99.18%。高危型HPV DNA检测联合细胞学检查的上述四值分别是98.84%、73.35%、5.23%、100.00%。结论：单独应用上述两种筛查方法有较高的敏感度和阴性预测值,联合应用后敏感度和阴性预测值进一步提高,但特异度未能提高。     

熄风通络胶囊治疗缺血性中风急性期的临床研究

痰瘀是中风病发病的基础，气血逆乱是发病的关键，风夹痰瘀痹阻脉络是中风病急性期的基本病理，熄风通络法是中风病的根本治法。本文通过对熄风通络胶囊治疗缺血性中风急性期的临床研究，观察急性缺血性中风病人60例，并与维脑路通片相对比，结果发现，治疗组在改善症状、促进肢体功能恢复、降血脂、改善血流变、降低纤维蛋白原方面明显优于对照组（P〈0．05）。     

新疆阜康市1999年碘盐监测结果分析

对新疆阜康市碘盐批发企业、零售商店、居民户三个环节进行碘盐监测，合格率分别为90.6%、88.0%和95.6%，对不同学校学生家用食盐进行碘盐监测。结果表明不同种类形态的碘盐合格率有显差异。粗制、大粒盐是影响碘盐合格率的主要因素。     

抗病毒治疗的艾滋病患者加强心理干预对检查依从性及CD4+T细胞计数的影响

目的对抗病毒治疗的艾滋病患者采用加强心理干预,探讨对患者服药随访检查依从性及CD4+T淋巴细胞计数的影响。方法选择珠海市定点医院抗病毒治疗的艾滋病患者30例,以2007年9月—2008年1月告知定期随访检查为干预前组,以2008年2—8月进行加强心理干预为干预后组,比较干预前后患者检查依从率及CD4+T淋巴细胞计数有无差异。结果艾滋病患者干预前后血液生化检查及CD4+T淋巴细胞检查的依从率比较,差异均有统计学意义(P<0.05)。干预前后CD4+T淋巴细胞计数比较,差异有统计学意义(P<0.01)。结论采用加强心理干预后能明显提高艾滋病患者抗病毒治疗的检查依从性,亦能提高CD4+T淋巴细胞的水平。     

加强病案管理人员在复印病案中的防范意识

在病案借阅复印过程中病案管理人员的责任心至关重要,把好病案复印这一关,同样能减少和防范医疗纠纷的发生,能够起到防微杜渐的作用,通过工作实例说明,以期与同仁共勉。