乙肝疫苗苦参素拉米夫定联合治疗慢性乙型肝炎的临床研究

目的探讨乙肝疫苗苦参素拉米夫定联合治疗慢性乙型肝炎的临床疗效。方法随机选择62例慢性乙型肝炎患者分为治疗组31例,苦参素0.2tidpo。疗程7～9个月,乙肝疫苗60ug,每15天1次,皮下注射,疗程12个月,拉米夫定0.1qdpo.疗程12个月。对照组31例单用拉米夫定0.1qdpo。疗程12个月。疗程中定期检测血常规、谷丙转氨酶(ALT)、HBeAg、抗-HBe、HBV、DNA。结果全部患者完成1年治疗。治疗组ALT复常率,HBeAg/抗-HBe血清转换率、HBVDNA阴转率明显高于对照组(分别为80.6%和51.6%,P<0.05;45.2%和19.4%,P<0.05;77.4%和51.6%,P<0.05)。结论乙肝疫苗、苦参素、拉米夫定联合治疗慢性乙型肝炎疗效优于单用拉米夫定。     

Linguistic considerations in the treatment of bilinguals.

Language is intimately connected with most aspects of human development. Because of this pervasive quality, language is incorporated as part of the individual's coping mechanisms, and at times it may even serve a definite defensive role. This investigation examines research and clinical data regarding the language independence phenomenon as it relates to the treatment of bilingual patients. Attempts are made to describe the way the bilingual individuals mobilize (shift) their languages under anxiety-producing conditions and how this shifting of languages can be utilized by these individuals as part of their coping mechanisms. There can be both positive and negative implications for treatment. In this regard, the article illustrates how the linguistic shifting may further reinforce defenses such as intellectualization, splitting, and isolation of affect. Linguistic shifting can also be technically introduced by monolingual clinicians to advance the therapeutic process. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Combining group-based trajectory modeling and propensity score matching for causal inferences in nonexperimental longitudinal data.

A central theme of research on human development and psychopathology is whether a therapeutic intervention or a turning-point event, such as a family break-up, alters the trajectory of the behavior under study. This article describes and applies a method for using observational longitudinal data to make more transparent causal inferences about the impact of such events on developmental trajectories. The method combines 2 distinct lines of research: work on the use of finite mixture modeling to analyze developmental trajectories and work on propensity score matching. The propensity scores are used to balance observed covariates and the trajectory groups are used to control pretreatment measures of response. The trajectory groups also aid in characterizing classes of subjects for which no good matches are available. The approach is demonstrated with an analysis of the impact of gang membership on violent delinquency based on data from a large longitudinal study conducted in Montréal, Canada. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Therapists' helpful and unhelpful situations with LGBT clients: An exploratory study.

The purpose of this exploratory study was to identify a broad range of variables that characterize psychotherapists' perceptions of helpful and unhelpful therapy experiences of lesbian, gay, bisexual, and transgender individuals. In-depth, semistructured interviews were conducted with a diverse sample of 14 psychotherapists to identify such variables and patterns among them. Results suggest that a wide range of variables, including the therapeutic relationship, therapist response to the client's sexual orientation/gender identity, type of presenting concern, and the therapy environment, may affect the therapy experiences of this population. The data also suggest that factors such as ethnicity, gender identity, therapy needs, and socioeconomic status should be considered when providing mental health services to this population. Clients dealing with multiple types of marginalization may be particularly challenging for practitioners. Implications for future research and clinical practice are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

沥青路面开裂破坏及防治措施

改革开放以来,我国的公路交通建设迅速发展,修建了大量的高等级公路,尤其是近几年,铺筑了大量的高等级沥青路面,但也应看到,不少沥青路面出现了各种病害,早期损伤相当严重,本文简要介绍了沥青路面主要常见病害之一的路面开裂问题,并提出了一些防治措施。     

Screen time: Clinical notes regarding Meissner's (2006) chronically late patient.

This communication is a commentary on William W. Meissner's presentation (see record 2006-20697-003) of a patient who chronically came late for sessions. The time duration of analytic work-relatively restricted per hour yet potentially limitless in overall duration-represents an existential paradox that is fundamental to the basic representational qualities of mental experience, and inherent in a mute way in the analytic frame. It is to be expected that the latent temporal elements of the patient's conflicts will inevitably challenge this aspect of the frame, subtly coercing patient and analyst to recreate these novel dimensions. If the analyst is too cautious regarding the inevitability of countertransference reactions to such a patient, important developmental opportunities may be missed. I suspect that the chronic lateness and absence that characterized the work with this patient screened an early, nonmentalized trauma that had torn a hole in the foundations of the patient's sense of time, and was inadvertently expressed by Meissner in an entirely atypical manner. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Melatonin for Neonatal Encephalopathy: From Bench to Bedside

Neonatal encephalopathy is a leading cause of morbidity and mortality worldwide. Although therapeutic hypothermia (HT) is now standard practice in most neonatal intensive care units in high resource settings, some infants still develop long-term adverse neurological sequelae. In low resource settings, HT may not be safe or efficacious. Therefore, additional neuroprotective interventions are urgently needed. Melatonin’s diverse neuroprotective properties include antioxidant, anti-inflammatory, and anti-apoptotic effects. Its strong safety profile and compelling preclinical data suggests that melatonin is a promising agent to improve the outcomes of infants with NE. Over the past decade, the safety and efficacy of melatonin to augment HT has been studied in the neonatal piglet model of perinatal asphyxia. From this model, we have observed that the neuroprotective effects of melatonin are time-critical and dose dependent. Therapeutic melatonin levels are likely to be 15–30 mg/L and for optimal effect, these need to be achieved within the first 2–3 h after birth. This review summarises the neuroprotective properties of melatonin, the key findings from the piglet and other animal studies to date, and the challenges we face to translate melatonin from bench to bedside.     

Role of Melatonin in Schizophrenia

Schizophrenia is a chronic mental disease that disturbs several cognitive functions, such as memory, thought, perception and volition. Schizophrenia’s biological etiology is multifactorial and is still under investigation. Melatonin has been involved in schizophrenia since the first decades of the twentieth century. Research into melatonin regarding schizophrenia has followed two different approaches. The first approach is related to the use of melatonin as a biological marker. The second approach deals with the clinical applications of melatonin as a drug treatment. In this paper, both aspects of melatonin application are reviewed. Its clinical use in schizophrenia is emphasized.     

Pattern of change in prolonged exposure and cognitive-processing therapy for female rape victims with posttraumatic stress disorder.

Curve estimation techniques were used to identify the pattern of therapeutic change in female rape victims with posttraumatic stress disorder (PTSD). Within-session data on the Posttraumatic Stres Disorder Symptom Scale were obtained, in alternate therapy sessions, on 171 women. The final sample of treatment completers included 54 prolonged exposure (PE) and 54 cognitive-processing therapy (CPT) completers. For both PE and CPT, a quadratic function provided the best fit for the total PTSD, reexperiencing, and arousal scores. However, a difference in the line of best fit was observed for the avoidance symptoms. Although a quadratic function still provided a better fit for the PE avoidance, a linear function was more parsimonious in explaining the CPT avoidance variance. Implications of the findings are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)