静息态脑功能连接在不同认知状态老年人中的应用

目的探讨不同认知状态老年人静息态脑功能连接情况。方法收集阿尔茨海默病患者（AD组）13例、轻度认知功能障碍患者（MCI组）12例、认知正常老年人（对照组）13例，进行磁共振扫描，应用局部一致性（ReHo）方法确定种子点，并进行静息态功能连接分析。结果在静息状态下，AD组和MCI组患者的后扣带回区域、额叶内侧、前额叶背外侧和顶叶部分区域的ReHo均较高。与对照组相比，MCI患者左侧颞叶（颞下回及颞中回）、海马旁回及右侧枕叶舌回、皮层下的部分脑区ReHo显著降低；而右侧额叶（额上回、额中回及中央前回）、顶上小叶及左侧梭状回、颞上回、额下回的部分脑区ReHo显著增高。AD患者变化更加明显，额叶-顶叶，颞叶-脑岛，颞叶-枕叶之间的长距离连接降低，但是额叶内部和枕颞间、丘脑及颞叶间的功能连接增高，3组间差异有统计学意义（P＜0.05）。结论3组不同认知状态老年人的功能连接不同，有助于AD、MCI患者及正常老年人的鉴别诊断。     

罗布麻叶总黄酮提取物对抑郁模型大鼠抗抑郁作用的研究

目的探讨罗布麻叶（AVL）总黄酮提取物对实验性抑郁大鼠的抗抑郁作用。方法将105只大鼠随机分为7组,每组15只。正常对照组：仅给予0.9%氯化钠溶液;抑郁模型组：抑郁造模开始时给予0.9%氯化钠溶液;抑郁大鼠AVL总黄酮提取物低、高剂量预防组（40mg/kg、80mg/kg）：抑郁造模前1周灌胃给予相应剂量的药物,直至造模结束;抑郁大鼠AVL总黄酮提取物低、高剂量治疗组（40mg/kg、80mg/kg）：于抑郁造模后1周灌胃给予相应剂量的药物,直至造模结束;抑郁大鼠氟西汀治疗组（20mg/kg）：抑郁造模后1周予灌胃给药,直至造模结束。采用慢性不可预知性轻度应激（CUMS）方法建立抑郁模型。观察应激前后各组大鼠矿场实验垂直运动次数及水平运动总路程的差异;液质联检分析各组大鼠在应激前后脑内海马及前额叶皮层单胺类神经递质,包括去甲肾上腺素（NE）、多巴胺（DA）和5-羟色胺（5-HT）水平的变化。结果与正常对照组相比,抑郁模型组大鼠在旷场实验中的垂直运动次数及水平运动总路程均明显减少（均P＜0.01）;与抑郁模型组比较,氟西汀组垂直运动次数及水平运动总路程均明显增加（均P＜0.01）;AVL总黄酮提取物预防和治疗各组,与抑郁模型组相比,垂直运动次数及水平运动总路程均有增加,尤以高剂量预防组增加最为明显（P＜0.01）。与正常对照组相比,抑郁模型组在大鼠海马组织及前额叶皮层均有DA、NE、5-HT水平下降,差异均有统计学意义（均P＜0.05）;氟西汀组与抑郁模型组比较,海马组织DA、5-HT水平明显增高（P＜0.01）,前额叶皮层DA、NE、5-HT水平均增高（均P＜0.05或0.01）;AVL总黄酮提取物高剂量预防组与抑郁模型组比较,海马组织5-HT水平增高（均P＜0.01）,前额叶皮层DA、NE、5-HT水平均增高（均P＜0.05）。结论AVL总黄酮提取物具有抗大鼠抑郁作用,有剂量-效应关系,高剂量预防组抗抑郁效应与氟西汀治疗组相似,可能通过提高大鼠海马组织5-HT及前额叶皮层NE、DA、5-HT水平达到抗抑郁作用。     

度洛西汀与文拉法辛治疗老年首发抑郁症伴疼痛的临床研究

目的比较度洛西汀与文拉法辛治疗老年首发抑郁症伴疼痛的临床疗效和不良反应。方法将80例符合ICD-10中度抑郁发作诊断标准并伴躯体疼痛的老年首发抑郁症患者按随机数字表法分为度洛西汀组和文拉法辛组，分别给予度洛西汀与文拉法辛治疗，疗程8周。采用17项汉密尔顿抑郁量表（HAMD）、视觉模拟评分量表（VAS）评定疗效，采用不良反应量表（TESS）及实验室检查评定不良反应。结果度洛西汀组总有效率为72.5%，文拉法辛组总有效率为73.7%，差异无统计学意义（P＞0.05）。度洛西汀组治疗第1周末HAMD、VAS分值低于文拉法辛组，差异有统计学意义（P＜0.05）。两组患者不良反应发生率的差异无统计学意义（P＞0.05），但度洛西汀组心血管不良事件发生率低于文拉法辛组（P＜0.05）。结论度洛西汀和文拉法辛缓释剂治疗老年首发抑郁症伴疼痛的患者均有效，度洛西汀组心血管相关不良事件发生率较少，对老年患者安全有效，耐受性好。     

原发性三叉神经痛患者伴发焦虑抑郁及睡眠障碍的临床研究

目的调查首次诊断为原发性三叉神经痛患者伴发抑郁焦虑情况及睡眠质量,并初步探讨疼痛评分与焦虑抑郁程度的相关性。方法收集61例首次诊断为原发性三叉神经痛并未经正规治疗患者以及55例年龄、性别相匹配的健康体检者（正常对照组）的人口学资料,应用视觉模拟量表（VAS）进行疼痛评分,采用汉密尔顿焦虑量表（HAMA）、汉密尔顿抑郁量表（HAMD）及匹兹堡睡眠指数量表（PSQI）分别进行焦虑、抑郁及睡眠质量的评估,采用简易智能精神状态量表（MMSE）和蒙特利尔认知评估量表（MoCA）进行研究对象认知功能评定,对评分结果及各量表的相关性进行分析。结果两组患者在性别、年龄、受教育年限、吸烟饮酒比率方面的差异均无统计学意义（均P＞0.05）;原发三叉神经痛患者中存在抑郁症状22例（36.1%）,焦虑症状17例（27.8%）,睡眠障碍15例（24.6%）。原发性三叉神经痛患者MoCA评分明显低于正常对照组,HAMA评分、HAMD评分和PSQI评分均高于对照组,差异均有统计学意义（均P＜0.01）;而两组间MMSE评分的差异无统计学意义（P＞0.05）。三叉神经痛患者的疼痛评分与HAMA评分、HAMD评分均呈正相关（均P＜0.01）。结论三叉神经痛患者伴随较高比例的抑郁和焦虑,且与疼痛评分成正相关,更容易发生睡眠障碍。     

急性脑梗死患者脑微出血的发病情况及其危险因素分析

目的探讨急性脑梗死患者脑微出血的发病情况及其危险因素。方法选择急性脑梗死患者75例,男51例,女24例,年龄42～83（64.9±10.8）岁。行头颅CT、磁敏感成像（SWI）检查,依据脑微出血检出的结果分成阳性组（23例）与阴性组（52例）,比较两组的一般资料,探讨脑微出血发病的危险因素。结果SWI检查的检出率比CT检出率高（χ2=27.17,P＜0.05）。阳性组年龄、高血压病、糖尿病患病率均较阴性组高,差异均有统计学意义（均P＜0.05）;两组性别、血脂异常、心房颤动、冠心病、吸烟、饮酒情况比较,差异均无统计学意义（均P＞0.05）。logistic回归分析显示年龄增长、高血压病是脑微出血的独立危险因素（P＜0.05）。结论急性脑梗死患者合并存在脑微出血的比例高,SWI检查是检测脑微出血的敏感方法,年龄大、高血压病与脑微出血的发生密切相关。     

咳嗽变异性哮喘患儿白三烯水平与白三烯受体拮抗剂疗效的相关研究

目的探讨不同白三烯（LT）水平的咳嗽变异性哮喘（CVA）患儿接受白三烯受体拮抗剂（LTRA）治疗后体内LT水平变化与临床疗效的关系。方法以本地300例同年龄儿童所测定的尿LTE4值（25.17±14.26）ng/L作为基础对照,将使用LTRA孟鲁司特治疗的67例CVA患儿按LTE4水平是否高于基础对照水平的2SD,分成LTRA-高（H）组25例和LTRA-低（L）组42例,治疗1个月后观察尿LTE4水平变化和临床疗效;采用相同方法将使用吸入糖皮质激素（ICS）氟替卡松治疗的60例患儿分成ICS-H组20例和ICS-L组40例进行对照。结果所有CVA患儿尿LTE4水平与基础对照相比均有统计学差异（均P＜0.05）;在接受2种不同方法治疗1个月后,LTRA-H组、LTRA-L组和ICS-H组患儿尿LTE4水平均有明显下降（均P＜0.05）,但ICS-L组无明显变化（P＞0.05）。LTRA组与ICS组总体疗效相当（P＞0.05）;LTRA-H组疗效优于LTRA-L组（P＜0.05）,LTRA-L组与ICS-H组、ICS-L组疗效均无统计学差异（均P＞0.05）。结论 CVA患儿采用LTRA和ICS治疗总体疗效相当;体内LT水平与LTRA临床疗效密切相关,LT水平高者疗效优于低者;尿LTE4检测可以作为临床选用LTRA的指标。     

下肢静脉曲张腔内激光治疗与传统剥脱手术治疗的远期疗效对比研究

目的 比较静脉腔内激光治疗（EVLT）和传统剥脱手术治疗下肢静脉曲张（VVLE）的远期疗效。方法 选取VVLE患者120例,随机分为EVLT 组与对照组,每组各60例。EVLT组采用EVLT治疗,对照组采用传统剥脱手术治疗。分别对两组患者手术并发症、术后1、2、3 年复发率以及术后生活质量进行对比评价。结果 术后3 个月EVLT 组患者生活质量调查表（CIVIQ）评分显著高于对照组（P＜0.05）,术后6 个月两组患者CIVIQ 评分比较则无统计学差异（P＞0.05）。EVLT 组患者术后皮下瘀血、感觉麻木、硬结、皮下脂肪液化感染的发生率均显著低于对照组（均P＜0.01）,皮肤灼伤的发生率则高于对照组（P＜0.05）,两组患者静脉炎的发生率无统计学差异（P＞0.05）;两组患者术后1、2、3年复发率比较均无统计学差异（均P＞0.05）。结论 应用EVLT治疗VVLE 手术并发症少,患者术后恢复较快,远期疗效理想,值得临床推广应用。     

急性等容血液稀释对外伤性颅内血肿患者的脑保护作用

目的探讨急性等容血液稀释（ANH）对外伤性颅内血肿患者的脑保护作用。方法56例外伤性颅内血肿患者按随机数字表法分为血液稀释组（H组）28例和对照组（C组）28例。H组于术前行ANH,目标红细胞压积（Hct）为30％。两组患者分别于术前（T0）、手术开始后2h（T1）抽取静脉血测定血液流变学指标、脑组织氧代谢指标、S-100B蛋白浓度。结果两组患者T0时的全血黏度高切、全血黏度中切、全血黏度低切、血浆黏度、红细胞聚集指数、红细胞刚性指数的差异均无统计学意义（均P＞0.05）。T1时, H组上述各指标均明显低于C组,两组间的差异均有统计学意义（均P＜0.05）。T0时,两组患者乳酸（VLAC）、颈内静脉球血氧饱和度（SjvO2）、动脉-颈内静脉球部血氧含量差（Da-jvO2）的差异均无统计学意义（均P＞0.05）;T1时,两组患者的SjvO2均有所降低,且H组高于C组,两组间的差异有统计学意义（P＜0.05）;而VLAC、Da-jvO2较T0时均升高,且H组低于C组,两组间的差异有统计学意义（P＜0.05）。T0时,两组患者的血清S-100B蛋白浓度的差异无统计学意义（P＞0.05）;T1时,两组患者的差异有统计学意义（P＜0.05）。结论 ANH可以降低血液黏度,减少血清中S-100B蛋白浓度,改善脑外伤后脑组织氧代谢紊乱,具有一定的脑保护作用。     

实时三维超声联合右心声学造影评价肺源性心脏病患者右心室收缩功能的价值

目的应用实时三维超声心动图探讨肺源性心脏病患者右心室收缩功能的价值，比较右心造影对测值的影响。方法选择肺源性心脏病代偿组、失代偿组、正常对照组各20例分别进行造影前、后实时三维超声的采集成像，计算右心室舒张末容积（RVEDV）、右心室每博输出量（RVSV）和右心室射血分数（RVEF），并根据心内膜是否清晰可辨分为心内膜边界清晰者、心内膜边界欠清晰者，比较两者三维超声参数的组间差异。结果代偿组、失代偿组RVEDV较对照组均明显增加，RVEF值减低（均P＜0.01），代偿组与对照组RVSV差异无统计学意义（P＞0.05），但失代偿组RVSV与代偿组、对照组差异有统计学意义（P＜0.05）；失代偿组RVEDV较代偿组明显增大，RVEF明显减低（均P＜0.01）。心内膜边界欠清晰者造影后较造影前RVEDV、RVEF差异均有统计学意义（均P＜0.05）。结论实时三维超声能够客观地反映肺源性心脏病代偿期与失代偿期右心室收缩功能的变化，右心声学造影改善了心内膜边界的可识别性，提高了右心室收缩功能测值的可靠性。     

替吉奥联合奥沙利铂一线治疗晚期食管癌的研究

目的 探讨奥沙利铂（OXA）联合替吉奥胶囊一线治疗晚期食管癌的疗效及不良反应。方法 将35 例采用OXA联合替吉奥胶囊（SOX 方案）化疗的晚期食管癌患者设为治疗组,32 例行顺铂（DDP）联合氟尿嘧啶（DF 方案）化疗的患者设为对照组。观察及随访两组患者的近、远期疗效及不良反应。结果 治疗组及对照组的近期有效率分别为62.9%和37.5%,比较有统计学差异（P＜0.05）,疾病控制率分别为85.7%和65.6%,组间比较无统计学差异（P＞0.05）。治疗组的中位生存期（12.4 个月）与对照组（10.4 个月）相比有统计学差异（P＜0.05）,两组患者1年生存率分别为54.3%和34.4%,2 年生存率分别为5.7%和0.0%,两组间均无统计学差异（字2=2.680、2.654,均P＞0.05）。在不良反应方面,两组患者的血液学、消化道不良反应及肝功能损害比较无统计学差异（均P＞0.05）,治疗组神经系统不良反应发生率高于对照组（P＜0.05）。结论 OXA 联合替吉奥（SOX 方案）治疗晚期食管癌疗效较为肯定,患者耐受良好。     

Informational acquisition and cognitive models

Life forms must organize information into cognitive models reflecting the outside environment, and in a complex and changing environment a life form must constantly select and organize this mass of information to avoid slipping into a chaotic cognitive state. The task of developing and maintaining adaptive cognitive models can be understood through two processes, crucial to regulating the interconnections between environmental elements. The inclusion and exclusion of information follows a process designated by P and the process by which cognitive models change is designated by K. Higher order concepts are created by reducing the interconnections between elements to a minimal number to avoid cognitive chaos. © 2004 Wiley Periodicals, Inc. Complexity 9:31–37, 2004     

Math clubs and their potentials: making mathematics fun and exciting. A case study of a math club

The purpose of this study is to describe the results obtained from a survey whose goal was to examine the combination of variables that have contributed to the success of a middle school math club. This is a case of a middle school in which the students are extremely successful in mathematics, and where the majority of the students voluntarily attend its math club. The results of the study show that the students have positive attitudes about mathematics and the club, and that some of the reasons that influenced them to attend the club were those of being with friends and eating donuts at the club. The results were similar for students of both genders and all grades. In addition, since positive attitudes are associated with higher levels of math achievement, such clubs have the potential to encourage students to enrol in additional mathematics classes while in high school, as well as pursuing mathematics related careers.     

A Comparison of TIMSS Items Using Cognitive Domains

The results of international assessments such as the Trends in International Mathematics and Science Study (TIMSS) are often reported as rankings of nations. Focusing solely on national rank can result in invalid inferences about the relative quality of educational systems that can, in turn, lead to negative consequences for teachers and students. This study seeks an alternative data analysis method that allows for improved inferences about international performance on the TIMSS. In this study, four classroom teachers categorized a sample of TIMSS items by the cognitive domains of knowing and applying using the definitions provided by the TIMSS 2011 Assessment Frameworks. Items of different cognitive domains were analyzed separately. This disaggregation allowed for more valid inferences to be made about student performance. Results showed almost no significant difference between the performance of U.S. students and the students of five other nations. Additionally, no differences were observed in U.S. students' performance on knowing items and applying items, although students from some sample nations performed significantly better on knowing items. These results suggest that policy makers, educators, and citizens should be cautious when interpreting the results of TIMSS rank tables.     

Paradoxes as a window to infinity

This study examines approaches to infinity of two groups of university students with different mathematical background: undergraduate students in Liberal Arts Programmes and graduate students in a Mathematics Education Master's Programme. Our data are drawn from students’ engagement with two well-known paradoxes – Hilbert's Grand Hotel and the Ping-Pong Ball Conundrum – before, during, and after instruction. While graduate students found the resolution of Hilbert's Grand Hotel paradox unproblematic, responses of students in both groups to the Ping-Pong Ball Conundrum were surprisingly similar. Consistent with prior research, the work of participants in our study revealed that they perceive infinity as an ongoing process, rather than a completed one, and fail to notice conflicting ideas. Our contribution is in describing specific challenging features of these paradoxes that might influence students’ understanding of infinity, as well as the persuasive factors in students’ reasoning, that have not been unveiled by other means.     

Interaction of intelligent and autonomous systems – part I: qualitative structuring of interaction

In this part I of the study, the development and the background of a meta-modelling technique to structure complex environments of systems is illustrated. A special situation-operator-model (SOM) developed to model the human-machine-interaction (HMI) is understood as a structuring approach modelling the interaction of intelligent systems in general. Part I of this study is structured as follows: Section 1 reflects on the term modelling with respect to the task: how to model interaction of unknown interaction partners, Section 2 briefly reviews the basics of the previously published foundations of the work and the SOM. The developed situation-operator-metamodelling approach is used to illustrate the connections between control loops and algorithms in Section 3, including a systematic view of systems' interaction mechanisms. In part II (part II available in this issue, pp. 319–339) of the contribution, the practical applications of the introduced approach are shown.     

我国股票市场的中长期回报率的过度反应

过度反应是证券市场异象之一。对沪市1993-2001年的股市交易数据,我们分为形成期1年和2年两种情况,分别检验出显著的过度反应,而且数据结果和图表显示形成期越长,随后的反转越明显,"输家组合"的平均超常收益率越高于"赢家组合"。对套利组合的风险因子回归分析仍然支持过度反应的存在。我们认为,我国证券市场还不完善的交易制度,加剧了投资者固有的认知偏差,从而导致价格超涨超跌的过度反应现象。     

Challenges of maintaining cognitive demand during the limit lessons: understanding one mathematician’s class practices

In this study, we examined five limit lessons using Mathematical Tasks Framework to understand students’ opportunities to learn cognitively challenging tasks and maintain cognitive demand during limit lessons. Our analysis of Dr A’s five lessons shows that students rarely had opportunities to maintain or increase cognitive demand. There are two main factors that shaped her instructional practices, students and time. These two factors greatly influenced how she selects and implements limit tasks in her classes. To serve her students’ needs of knowing more rules, formulas and procedures, she selected and discussed those simple tasks a lot. Although Dr A thinks challenging tasks and asking demanding questions can be potentially good instructional practices, she thinks these instructional practices would not serve her students well. With these factors, we made possible recommendations to have more student-centred teaching.     

Cognitive styles,task presentation mode and mathematical performance

This paper reports the outcomes of an empirical study undertaken to investigate the relationship of prospective teachers’ cognitive styles and levels of performance in measurement and spatial tasks. A total of 116 prospective kindergarten school teachers were tested using the VICS and the extended CSA-WA tests (Peterson 2005) in order to place them along the Verbal/Imagery and the Wholistic/Analytic cognitive style continua. The same prospective teachers were also administered a mathematical test with 6 measurement and 6 spatial tasks. The results suggest that there were no significant differences between Verbalisers-Imagers and Wholistic-Analytic prospective teachers in their performance on the spatial pictorial and textual tasks, and on the measurement textual tasks. However, there were differences between Verbalisers-Imagers and Wholistic-Analytic prospective teachers in their performance on the measurement pictorial tasks. This difference was attributed to the performance of low achievers. High achievers performed in the same way independently of their cognitive styles.     

坦克智能体的感知行为建模

首先,从战场信息感知的功能入手,提出了信息条件下坦克智能体的感知行为模型框架;然后,分析了感知行为产生的要素,建立了坦克智能体观察模型;最后,通过战场态势进一步说明建立模型的必要性。