Problems in the "evidence" of "evidence-based medicine"

The potential influence of racially or ethnically diverse cultural perspectives on patient compliance with post-transplant treatments is discussed. Domains of competency regarding culturally sensitive clinical practice are outlined to assist providers in better understanding the perspectives that may influence the views and behavior of culturally diverse patients.     

图像中的"他者"

"自我"与"他者"所标榜的二分逻辑结构在本质上是同一性恩雏使然的结果,由此决定了文明与蒙昧、正统与异端、男人与女人的差异被确立并延续了下来,它们作为同一性思维在种族、信仰、性别层面上的具体衍生物,经由视觉图像获得了不同程度地传播与表征.鉴于此,本文着力从上述三个方面,就图像与同一性观念的内在相关性分层加以评述,旨在强调图像作为由来已久的一种视觉符号,持续不断地与意识形态、政治权力、性别身体等范畴发生着关联,是我们解读"自我"与"他者"关系的重要凭据.     

"Born from the flank"--discussion concerning "cesarean section" in animals in the Talmud

We determined growth hormone (GH) and insulin-like growth factor I (IGF-I) levels after a 3 h infusion of escalating doses of growth hormone-releasing hormone (GHRH(1-29)) followed by a bolus injection in hypopituitary patients with marked differences in pituitary features at magnetic resonance imaging (MRI) in order to evaluate further the contribution of MRI in the definition of pituitary GH reserve in GH-deficient patients. Twenty-nine patients (mean age 14.5 +/- 4.0 years) were studied. Group I comprised 13 patients: seven with isolated GH deficiency (IGHD) (group Ia) and six with multiple pituitary hormone deficiency (MPHD) (group Ib) who had anterior pituitary hypoplasia, unidentified pituitary stalk and ectopic posterior pituitary at MRI, Group II consisted of eight patients with IGHD and small anterior pituitary/empty sella, while in group III eight had IGHD and normal morphology of the pituitary gland. Growth hormone and IGF-I levels were measured during saline infusion at 08.30-09.00 h, as well as after infusion of GHRH (1-29) at escalating doses for 3h: 0.2 micrograms/kg at 09.00-10.00 h, 0.4 micrograms/kg at 10.00-11.00 h, 0.6 micrograms/kg at 11.00-12.00 h and an intravenous bolus of 2 micrograms/ kg at 12.00 h. In the group I patients, the peak GH response to GHRH(1-29) was delayed (135-180 min) and extremely low (median 2mU/l). In group II it was delayed (135-180 min), high (median 34.8 mU/l) and persistent (median 37.4 mU/l at 185-210 min). In group III the peak response was high (median 30.8 mU/l) and relatively early (75-120 min) but it declined rapidly (median 14.4 mU/l at 185-210 min). In one group I patient, GH response increased to 34.6 mU/l. The mean basal value of IGF-I levels was significantly lower in group I (0.23 +/- 0.05 U/ml) than in groups II (0.39 +/- 0.13U/ ml, p < 0.01) and III (1.54 +/- 0.46 U/ml, p < 0.001) and did not vary significantly during the GHRH(1-29) infusion. The present study demonstrates that the impaired GH response to 3 h of continuous infusion of escalating doses of GHRH(1-29) was strikingly indicative for pituitary stalk abnormality, strengthening the case for use of GHRH in the differential diagnosis of GH deficiency. The low GH response, more severe in MPHD patients, might be dependent on the residual somatotrope cells, while the better response (34.6 mU/l) in the group Ia patients might suggest that prolonged GHRH infusion could help in evaluating the amount of residual GH pituitary tissue. Pituitary GH reserve, given the GH response to GHRH infusion in GH-deficient patients with small anterior pituitary/empty sella, seems to be maintained.     

《诗经·关雎》英译之我见——兼论语篇把握在汉诗英译中的重要性

<诗经>是我国文学史的光辉起点,也是我国现实主义文学的开端.作品以抒情诗为主流,开拓性地运用了赋、比、兴等表现手法,具有很高的艺术成就,对后世文学创作产生了重大而深远的影响.<关雎>是<诗经>中具有代表性的作品,是汉文化文学宝库中的珍品,因此,翻译工作者都不遗余力地将它译介国外.许渊冲先生、韦利先生是<诗经>翻译的佼佼者,分析研究他们的译诗策略,对于总结汉语古典文学西译的经验,构建现代翻译理论,自然有着不可忽略的益处.     

"Superstition" in the Skinnerian.

In the case of some tasks, implicit responses produce better results than overt ones. Overt responding is not an essential feature of programmed instruction and, in fact, may even be a deleterious one in some cases. Being informed of the correctness of response before making it resulted in more efficient learning than being informed after making the response. "This story has three morals, but they are all very simple. The first is that not all the features of a gadget are dictated by theoretical principles. The second is that what works beautifully in one context may not work so beautifully in another. The third moral is that superstitious behavior is not restricted to pigeons." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

从权势和等同关系看"小姐"一词在社会称谓中的应用

称谓语是说话人用来称呼与其对话者的用语."小姐"一词是当代汉语语言生活中的一个极为常见的称谓语,因此在"权势"和"等同"语义对立模式基础上,分析"小姐"称谓语的历史演化、语用特点以及交际功能.     

Cancer in the "cold" breast thermogram

The hallmark of the normal breast thermogram is relative symmetry of vascular configuration and thermal content with preservation of the breast contour. Accepted criteria of abnormality are predicated upon graphic and thermal asymmetry with emphasis placed upon elevated temperature, an increase in the number of discernible vessels, and distorted vascular patterns. The association of a confirmed breast cancer and an avascular thermogram has been labeled a false negative. Avascularity ("cold" breast), particularly in the lower half, with normal vessels in the same location of the opposite breast is suggested as an additional characteristic of abnormality. Illustrative cases are presented.     

Radiation-induced pneumonitis in the "nonirradiated" lung

OBJECTIVE: To describe six cases of radiation-induced organizing pneumonitis occurring outside the direct radiation field and to review clinical, radiologic, and histologic aspects of this entity. MATERIAL AND METHODS: We present detailed case reports of six women, with a mean age of 62.8 years (range, 50 to 75), who had received radiation therapy (mean dose, 6,560 cGy) for breast cancer. RESULTS: From 6 to 17 months (mean, 8.8) after the completion of radiotherapy, recurrent and migrating lung infiltrates were detected outside the radiation field in the six study patients. Three patients had pronounced respiratory symptoms, whereas the rest were minimally symptomatic or asymptomatic. Thoracic computed tomography showed dense alveolar infiltrates. Bronchoalveolar lavage in two patients revealed lymphocytosis (25% and 19%), and lung biopsy in five patients demonstrated a histologic pattern consistent with bronchiolitis obliterans organizing pneumonia. Even though the symptomatic patients showed prompt resolution of their symptoms and roentgenographic abnormalities after systemic corticosteroid therapy, the lung infiltrates recurred after corticosteroid therapy was discontinued. CONCLUSION: These six cases, including their prompt response to corticosteroid therapy, provide additional evidence that irradiation damages lung tissue outside of the direct treatment field and suggest that an immunologically mediated lymphocytic alveolitis may be responsible for the recurrent migratory organizing pneumonitis.     

Extension of the "elephant trunk" technique in complex aortic pathology: the "bidirectional" option

BACKGROUND: The "elephant trunk" technique, using a free-floating vascular prosthesis, was originally described to facilitate a subsequent operation on the downstream aorta. We developed an additional refinement of this technique, called the "bidirectional elephant trunk." This option may represent an interesting tool in more complex aortic operations, especially when the descending aorta has to be replaced first in patients with concomitant pathology of the ascending aorta or of the aortic arch. METHODS: The initial operation is performed through a left thoracotomy. The proximal elephant trunk is created by invaginating the future aortic arch graft into the descending aortic graft. The proximal anastomosis between the doubled graft and the proximal descending aorta is performed first. During construction of the distal anastomosis, a distal elephant trunk may be inserted likewise. If the aortic arch and ascending aorta have to be replaced later, this second step is performed through a median sternotomy. The free-floating arch graft is pulled out of the proximal descending aorta with a nerve hook, unfolded, and used for total arch replacement. RESULTS: This technique was used successfully in 3 patients without mortality. No major complications were observed excepted persistent hoarseness in a patient with preoperative paresis of the recurrent nerve. No perfusion problems due to the unfolding of the free-floating graft occurred during the second operation. CONCLUSIONS: The bidirectional elephant trunk technique is an interesting option that may be suitable for patients presenting with a complex pathology of the whole thoracic aorta when the descending segment has to be replaced first.     

On the Use of "Relationship" and "Among" in Psychological Writing.

Comments on the expression "relationships among (several) variables" occurring frequently in contemporary psychological writing. The author states that while this expression is acceptable enough, there is nothing so commendable about it that it should be preferred to the more nearly correct "relations between (several) variables." The author states that after picking a journal at random and reading through the summaries of all the papers and notes, there appears to be a growing tendency to use the term relationship in preference to relation and the term among (several) in preference to between (several). He then states what he believes to be the proper use of these terms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Weak measurements" and the "quantum time-translation machine" in a classical system

The objectives of the present study were to optimize the protocol of mouse immunization with Paracoccidioides brasiliensis antigens (Rifkind's protocol) and to test the modulation effect of cyclophosphamide (Cy) on the delayed hypersensitivity response (DHR) of immunized animals. Experiments were carried out using one to four immunizing doses of either crude particulate P. brasiliensis antigen or yeast-cell antigen, followed by DHR test four or seven days after the last immunizing dose. The data demonstrated that an immunizing dose already elicited response; higher DHR indices were obtained with two or three immunizing doses; there were no differences between DHR indices of animals challenged four or seven days after the last dose. Overall the inoculation of two or three doses of the yeast-cell antigen, which is easier to prepare, and DHR test at day 4 simplify the original Rifkind's immunization protocol and shorten the duration of the experiments. The modulation effect of Cy on DHR was assayed with administration of 2.5, 20 and 100 mg/kg weight at seven day intervals starting from day 4 prior to the first immunizing dose. Only the treatment with 2.5 mg Cy increased the DHR indices. Treatment with 100 mg Cy inhibited the DHR, whereas 20 mg Cy did not affect the DHR indices. Results suggest an immunostimulating effect of low dose of Cy on the DHR of mice immunized with P. brasiliensis antigens.     

The concern for health in sexual matters in the "old society" and "new society" in China

The entire family participates in the success of the home dialysis patient. Isolation and study of discrete quantifiable aspects of behavior within the family may allow identification of patients with a greater risk of failure, thus making it possible to help such patients succeed. A single such factor, 'intrafamily identity', measured in each of 40 diverse families before one family member began a home dialysis program, was found to correlate with success in the program 1 year later. This finding also may contribute to an understanding of systematic patterns of behavior within all families, with special emphasis upon the ability of family members to cope with continuing stress.     

"Novelty" neurons in the frog auditory system

Some neurones in the torus semicircularis of paralyzed lake frogs (Rana ridibunda) exhibited strong response habituation to tonal bursts following with interstimuli intervals of 1 to 5 sec. The habituation became less evident with a devrease of the repetition rate or increase of the stimulus intensity. These units revealed the phenomenon of "postzero" habituation. The frequency selectivity of the units exhibited by their responses to the first stimulus presentation was very poor. Usually the habituation occurred within a wide frequency band, although there were some exceptions. Afther the habituation was completed, the unit's response could be elicited by tones of a different frequency. The more distant on the frequency scale the tones were, the more vigorous was the reaction. Some properties of these "novelty" units can be explained by assuming that they are multipolar neurones located in the nucleus magnocellularis of the torus.     

Long-term self-intravenous "drinking" in the rat.

Results of a series of experiments show that male Wistar albino rats, when water was available only by intravenous self-injection, learned to rehydrate by pressing a lever even after desalivation and for periods up to 90 days. It appears that hydromineral regulation was occurring about a new, lower set point for body fluid content which was necessary for the onset and maintenance of intravenous "drinking." The regulatory nature of the operant was confirmed by appropriate modulation of operant rate to amount of reinforcement per leverpress and in tonicity of self-injected fluid. There seemed to be some "motivational deficits," and these Ss did not respond for intravenous water as the oral controls did when challenged with traditional intra- and extracellular thirst stimuli. More complex stimuli (e.g., heat and salty food) led to compensatory responding. While interoceptors alone seemed capable of eliciting the defense of a homeostatic hydromineral balance, the control over the operant was less precise than for normal oral drinking. (57 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Velocity leakage" in the pigeon vestibulo-ocular reflex

The transfer characteristics of the vestibulo-ocular reflex (VOR), and of the semicircular canal primary afferents (SCPAs) that drive it, have been studied in several species. In monkeys and cats, the dominant time constant describing horizontal VOR dynamics (tau hv) is longer than that (tau c) of horizontal SCPAs. This lengthening of the time constant has been attributed to a "velocity storage" mechanism that has been modeled as a positive feedback loop in the VOR pathways. We have studied the transfer characteristics of horizontal and vertical VOR and SCPAs in unanesthetized pigeons. In this species the dominant time constants of both the horizontal and vertical VOR (tau hv and tau vv) are shorter that tau c. This finding indicates that time constants characterizing the lower frequency response of the VOR can be lengthened or shortened depending on the species. We propose that in the pigeon the "velocity leakage" mechanism can be modeled by substituting negative feedback for positive feedback in the model of the VOR pathways. Negative feedback can also account for the further shortening of tau hv and tau vv as VOR gain increases with arousal. Additionally, making the negative feedback loop nonlinear can model the dependency of lower frequency VOR phase on amplitude, and skew in VOR waveforms. Pigeon VOR and SCPA dynamics also differ in their adaptive properties and higher frequency behavior. A predominance of input from highly adaptive SCPAs is proposed to account for the increased adaptation of the vertical VOR as compared with SCPAs overall. A pure time-delay associated with VOR operation can explain the phase lag of the VOR relative to SCPAs at higher frequencies.