内观认知疗法对医学生焦虑水平、自我效能感和应对方式的干预及机制

目的:探究内观认知疗法对医学生焦虑水平、自我效能感和应对方式的影响,并考察医学生内观认知疗法干预、自我效能感、应对方式和焦虑水平间的关系,以期为医学生心理健康教育工作和NCT疗法的作用机制研究提供理论支持。方法:采用随机数字表法将70名符合筛选标准的研究对象随机分配到内观认知疗法组和心理健康教育组,每组35人。内观认知疗法组接受为期7天的内观认知疗法干预,心理健康教育组接受相同时间的常规心理健康教育,最终共68人完成试验(内观认知疗法组34人,心理健康教育组34人)。干预前后使用SAS、GSES、SCSQ量表对两组研究对象进行测评。结果:①干预前,内观认知疗法组与心理健康教育组在焦虑,自我效能感,积极和消极应对方式得分上均不存在显著差异。②干预后,内观认知疗法组焦虑得分显著降低(t=5.835;P<0.01),自我效能感和积极应对方式得分均显著升高(t=2.289,4.668;P<0.05),消极应对方式得分不存在显著差异,干预前后心理健康教育组在上述所有量表得分中均不存在显著差异。③干预后,内观认知疗法组自我效能感和积极应对方式得分显著高于心理健康教育组(t=2.653,3.122;P<0.01),焦虑得分显著低于心理健康组(t=2.562;P<0.05)。④中介效应检验方面,内观认知疗法既可以直接影响医学生焦虑水平(β=-0.293,95%CI=-3.755~0.008),也可以通过自我效能感的中介作用(β=-0.307,95%CI=-0.612~-0.028)、积极应对方式的中介作用(β=0.140,95%CI=-0.293~-0.004)及自我效能感和积极应对方式的链式中介作用(β=0.222,95%CI=-0.553~-0.022)间接影响医学生焦虑水平。结论:内观认知疗法是一种能够有效降低医学生焦虑水平的干预手段,既能直接缓解焦虑,也能通过提高医学生自我效能感水平,改善积极应对方式间接降低医学生焦虑水平。

不同植物生长调节剂对冬小麦生长及产量的影响

为考察不同植物生长调节剂对农作物生长状况及产量的影响,以氨基寡糖素、复硝酚钠和胺鲜酯为处理药剂,以复合肥(18-15-12)为药剂载体,于冬小麦播种前底施于土壤,测定了不同生育时期冬小麦的株高、主根长、须根数、分蘖数、叶片数、顶节长、穗长、旗叶长、颖果数等指标。结果表明:氨基寡糖素在冬小麦前期能促苗生根,中期能促叶、增加分蘖数,提高冬小麦产量;复硝酚钠主要表现在中后期能促进冬小麦株高和旗叶的生长;胺鲜酯在冬小麦前期对茎叶、须根数,在中期对顶节长、颖果数具有促进作用,但后期对顶节长、旗叶长和颖果数有抑制作用;复硝酚钠和胺鲜酯均会降低冬小麦产量。

世界建筑遗产的保护

时间：2012/7/10星期五晚19：00地点：湖南大学建筑学院一楼大报告厅主讲人：黄运昇Y.S.Huang美国弗吉尼亚大学终身教授主持人：陈飞虎教授,湖南大学建筑学院副院长/博导在2012年春季学期即将结束时,来自美国弗吉尼亚大学的黄运昇教授访问了湖南大学建筑学院,并为师生带来了一场有关＂世界建筑遗产保护＂的学术讲座。从巴黎圣母院到中国的长城,从法国的雨果（Hugo）到西班牙的梅里美（ProsperMerimee）,黄教授深入浅出的讲述了世界建筑遗产保护的起源、发展和现状。西方建筑遗产保护的思想起源于雨果等一些著名的作家的思考,如雨果认为不管未来的建筑是怎样的,新建的建筑不能割裂历史。梅里美不仅仅是一位文学家。

深圳大学学府医院交通规划分析与评价

本文通过对深圳大学学府医院基地本身和外围交通状况的研究,从宏观和微观两个层面进行剖析,从交通规划方案研究的必要性、特点及总体要求、交通规划目标及原则、交通系统优化、规划构想以及交通规划终极目标——人性化关怀等方面进行阐述大型三甲医院设计中交通问题的方方面面,从而提出目前大型医院停车难,交通拥堵的方法及对策。

对外汉语教学中真实情景的创设

在对外汉语课堂教学中创设真实情景,既不同于学生课外用汉语进行的日常交际,也不同于课堂组织的模拟情景,而是建立在师生之间或学生之间为获取信息而进行的交际活动。建立信息差是创设真实情景的主要方法。在具体教学中可采用个人关联法和看图说话的方式灵活运用。

Proxy signature scheme for ID-based original signers and certificate-based proxy signers

To realize delegation between different users in a mixed cryptosystem,a proxy signature scheme for ID-based original signers and certificated-based proxy signers（PSS-ID-CER）is defined.Using the bilinear properties of the pairings and the characters of key generations of certificate-based cryptosystems and ID-based cryptosystems,a construction for such a scheme is also presented.To prove the security of the proposed scheme,a general security model for this scheme under adaptive chosen-PKG,chosen-ID,chosen-delegation,chosen-ProxySigner-public-key,chosen-proxy-key and chosen-message attack is defined.The proposed scheme is provably secure under the random oracle model and the hardness assumption of computational Diffie-Hellman problem.

《红楼梦》语词三题

本文考察了《红楼梦》中"家的""三曹对案""通书"的含义,并由此对《红楼梦》的作用、源流及其艺术创造作了阐说。

旅顺口的旧官邸与新住宅,新旧建筑的并存与发展——谈旅顺开世嘉年小区规划设计

结合开世嘉年小区的规划设计,探讨了在历史地段的再生途径之一,即植入新居住职能,同时探讨了在规划设计中对于历史建筑保护的一种处理方式和态度,以及对于历史遗留原生态树木的保护及合理利用方式。同时结合度假类住宅的产品定位,建筑设计在对西班牙建筑风格的创作上进行了创新。

Rate of local tumor progression following radiofrequency ablation of pathologically early hepatocellular carcinoma

AIM To evaluate whether pathologically early hepatocellular carcinoma(HCC) exhibited local tumor progression after radiofrequency ablation(RFA) less often than typical HCC.METHODS Fifty pathologically early HCCs [tumor diameter(mm): mean, 15.8; range, 10-23; follow-up days after RFA: median, 1213; range, 216-2137] and 187 typical HCCs [tumor diameter(mm): mean, 15.6; range, 6-30; follow-up days after RFA: median, 1116; range, 190-2328] were enrolled in this retrospective study. The presence of stromal invasion(namely, tumor cell invasion into the intratumoral portal tracts) was considered to be the most important pathologic finding for the diagnosis of early HCCs. Typical HCC was defined as the presence of a hyper-vascular lesion accompanied by delayed washout using contrastenhanced computed tomography or contrast-enhanced magnetic resonance imaging. Follow-up examinations were performed at 3-mo intervals to monitor for signs of local tumor progression. The local tumor progression rates of pathologically early HCCs and typical HCCs were then determined using the Kaplan-Meier method.RESULTS During the follow-up period for the 50 pathologically early HCCs, 49(98%) of the nodules did not exhibit local tumor progression. However, 1 nodule(2%) was associated with a local tumor progression found 636 d after RFA. For the 187 typical HCCs, 46(24.6%) of the nodules exhibited local recurrence after RFA. The follow-up period until the local tumor progression of typical HCC was a median of 605 d, ranging from 181 to 1741 d. Among the cases with typical HCCs, local tumor progression had occurred in 7.0%(7/187), 16.0%(30/187), 21.9%(41/187) and 24.6%(46/187) of the cases at 1, 2, 3 and 4 years, respectively. Pathologically early HCC was statistically associated with a lower rate of local tumor progression, compared with typical HCC, when evaluated using a log-rank test(P = 0.002). CONCLUSION The rate of local tumor progression for pathologically early HCCs after RFA was significantly lower than that for typical HCCs.

Changes in PM2.5 sensitivity to NOx and NH3 emissions due to a large decrease in SO2 emissions from 2013 to 2018

The authors evaluated and compared the behavior of PM2.5 with respect to NOx and NH3 emission changes in high(the year 2013)and low(the year 2018)SO2 emission cases.Two groups of simulations were conducted based on anthropogenic emissions from China in 2013 and 2018,respectively.In each group of simulations,a respective 25%reduction in NOx and NH3 emissions were assumed.A sensitivity factor(β)was defined as the relative change in PM2.5 concentration due to 1%change in NOx or NH3 emissions.In the high SO2 emissions case,PM2.5 was more sensitive to NH3(0.31)emissions change than NOx(0.21).Due to the significant decrease in SO2 emissions from the high to low SO2 emissions case,the sensitivity of PM2.5 to NOx increased to 0.33,while its sensitivity to NH3 decreased to 0.22.The result implies that now and in the future,PM2.5 is/will be less sensitive to NH3 emissions change,while NOx emissions control is more effective in reducing the surface PM2.5 concentration.Seasonally,in the low SO2 emissions case,the sensitivities of PM2.5 to NOx and NH3 in winter were higher than those in summer,indicating that to dealwith severewinter hazemore attention should be paid to the emissions control of inorganic PM2.5 precursors,especially NOx.

OBSERVATIONAL ANALYSIS OF ASYMMETRIC DISTRIBUTION OF CONVECTION ASSOCIATED WITH TROPICAL CYCLONES “CHANCHU” AND “PRAPIROON” MAKING LANDFALL ALONG THE SOUTH CHINA COAST

Observational data of mesoscale surface weather stations and weather radars of Guangdong province are employed to analyze the asymmetric distribution of convection prior to, during and after landfall for tropical cyclones of Chanchu and Prapiroon making landfall on the south China coast in 2006. The results showed that strong convection is located in the eastern and northern sectors of the landfalling Chanchu and Prapiroon, namely in the front and right portions of the TC tracks, for a period of time starting from 12 h prior to landfall to 6 h after it. Their convection also had distinct differences in the vertical direction. The analysis indicated that although the landfall of Chanchu and Prapiroon has the same asymmetric distribution of convection, the causes are not exactly the same. The asymmetric distribution of convection in the case of Chanchu is mainly correlated with the impacts of a strong environmental vertical wind shear, low-level horizontal wind shear, and low-level convergence and divergence. In the case of Prapiroon, however, the asymmetric distribution of convection is mainly associated with the impacts of low-level convergence and divergence.

Asymmetric dimethylarginine:A novel biomarker of gastric mucosal injury?

Nitric oxide(NO),a multifunctional endogenous gas molecule,is metabolized from L-arginine by enzymatic reaction in the presence of nitric oxide synthase.NO,an important gas signaling molecule,is a gastric mucosa protective factor that contributes significantly to maintain normal gastric mucosa integrity.NO increases gastric mucosa blood flow,regulates the secretion of mucus and bicarbonate,and inhibits the secretion of gastric juice.Asymmetric dimethylarginine(ADMA) has been identified as the major endogenous inhibitor of nitric oxide synthase.The function of ADMA is to decrease NO production via inhibiting nitric oxide synthase activity.Besides inhibiting NO synthesis,ADMA also directly induces oxidative stress and cell apoptosis,and participates in inflammation reaction.Its systemic accumulation was observed in conjunction with several cardiovascular and metabolic diseases.ADMA also mediates gastric ulcer injury induced by ethanol,stress,helicobacter pylori and indomethacin.The mechanism of ADMA directly producing adverse effect in gastric mucosa is incompletely understood.It is widely accepted that NO bioavailability decrease is the majority reason.Promotion of apoptosis and aggravation of inflammation may be other important mechanisms of ADMA-induced gastric injury.ADMA might be a novel clinical and experimental biomarker related to gastric mucosa disorder.Although therapeutic tool targeting to ADMA is available in multiple cardiovascular diseases,it is unknown in gastrointestinal disease.The strategy to inhibit ADMA is beneficial to gastric ulcer induced by ethanol in rats.Thus,ADMA might be a candidate of therapeutic target in gastric mucosa damage.

Asymmetric Crying Facies with Multiple Congenital Malformations： a Case Report

ASYMMETRIC crying facies （ACF） is characterized by facial asymmetry only when crying. It may present as an exclusive symptom, or be con-comitant with other congenital malformations nd even some fatal birth defects. Clinically, ACF is fea-tured by drooping of the intact corner of the mouth during crying, while the face appears symmetric at rest. The facial nerve function is symmetric, as determined by frowning, forehead wrinkling, eye closure, and nasolabial fold depth. When ACF alone is present, the cause is often compression of the mandibular branch of the facial nerve that is prob-ably due to birth trauma or abnormal fetal posture in utero. ACF with other congenital anomalies is usually caused by hypoplasia of the depressor anguli oris muscle （DAOM） on one side of the mouth.

Diagnostic value of gadobenate dimeglumine-enhanced hepatocyte-phase magnetic resonance imaging in evaluating hepatic fibrosis and hepatitis

AIM To evaluate the diagnostic value of gadobenate dimeglumine(Gd-BOPTA)-enhanced hepatocyte-phase magnetic resonance imaging(MRI) in evaluating hepatic fibrosis and hepatitis.METHODS Hepatocyte-phase images of Gd-BOPTA-enhanced MRI were retrospectively evaluated in 76 patients with chronic liver disease. These patients were classified into five groups according to either the histopathological fibrosis stage(S0-S4) or the histopathological hepatitis grade(G0-G4). The relative enhancement ratio(RE) of the liver parenchyma in the T1-vibe sequence was calculated by measuring the signal intensity before(SI pre) and 90 min after(SI post) intravenous injection of Gd-BOPTA using the following formula: RE =(SI post-SI pre)/SI pre. One-way analysis of variance was used to compare the difference between the relative RE in the hepatocyte phase(REh) and the stage of hepatic fibrosis and the grade of hepatitis. Pearson's productmoment correlation analysis was used to evaluate the relationship between the REh and the levels of serologic liver functional parameters.RESULTS According to histopathological hepatic fibrosis stage, the 76 patients were classified into five groups: 16 in S0, 15 in S1, 21 in S2, 9 in S3, and 15 in S4 group. According to histopathological hepatitis grade, the 76 patients were also classified into five groups: 0 in G0, 44 in G1, 22 in G2, 8 in G3, and 2 in G3 group. With regard to the stage of hepatic fibrosis, REh showed significant differences between the S2 and S3 groups and between the S2 and S4 groups(P < 0.05), but no significant difference was observed between the other groups. With regard to the grade of hepatitis, REh showed significant differences between the G1 and G2 groups and between the G1 and G4 groups(P < 0.05), but no significant difference was observed between the other groups. Increased REh showed correlations with decreased serum levels of TB, ALT and AST(P < 0.05). CONCLUSION To some extent, measuring the REh using Gd-BOPTAenhanced MRI might be a noninvasive technique for assessing the stage of hepatic fibrosis. This method is able to differentiate no/mild hepatitis from advanced hepatitis. TB, ALT and AST levels can predict the degree of liver enhancement in the hepatocyte phase of Gd-BOPTA-enhanced MRI.

体育产业对江西省区域经济发展的影响研究

本文阐述了体育产业的概念,通过对江西省体育产业结构现状的分析,阐述了体育产业对江西省区域经济的影响,并在此基础上提出体育产业将为江西省经济持续发展发挥更重要的作用。

Site-specific Vulnerability Assessment for Debris Flows: Two Case Studies

Here the vulnerability is defined as the potential total maximum losses due to a debris flow damaging event for a specific debris flow fan. The vulnerability is classified into property vulnerability and population vulnerability. Assessment indexes include the assets of buildings, traffic facilities, lifeline works, personal properties, and land resources for property vulnerability; age, education, and wealth of the inhabitants, natural population growth rate, and population density for population vulnerability. The vulnerability is expressed as the sum of the transformed values of the losses of property and population. Two study cases with post-fact damages by historic debris flow events in Sichuan of SW China are presented.

Can Fundus Fluorescein Angiography be Performed for Diabetic Patients on Oral Metformin

Metformin is a kind of biguanide hypoglycemic agent that has been widely used in patients with diabetes mellitus. In clinical practice, whether metformin should be stopped before Fundus fluorescein angiography （FFA） remains largely unclear. Some endocrinologists suggest stop metformin before FFA. However, ophthalmologists do not always adopt this opinion in their practice. This situation may lead to disputes between physicians and patients. This article analyzed contrast-induced nephropathy（CIN） and the related contrast agent, as well as the adverse reactions of fluorescein angiography. It pointed out that the discrepancy may be caused by misunderstanding of contrast agents used in FFA. For angiography using iodine contrast agent, metformin must be stopped because of the increased possibility of CIN, while for FFA using fluorescein sodium, no CIN has been reported yet. Therefore, the authors believe FFA is safe for diabetic patients with oral metformin and it is unnecessary to stop metformin before the examination.

A good death from the perspective of healthcare providers from the internal medicine department in Shanghai:A qualitative study

Objective:This study aimed to explore the understanding of healthcare providers working in the internal medicine department in Shanghai regarding a good death.Methods:The data of the study was collected using face-to-face semi-structured interviews.Through purposive sampling,16 physicians and 13 nurses who had experiences of caring for adult patients with life-threatening illnesses at the end-of-life stage in Shanghai were interviewed.The interviews were analyzed using qualitative content analysis.Results:Six characteristics of a good death emerged:no suffering,companionship and care,no worries or concerns,dying with dignity,involvement and acceptance,and less impact on the family.Eighteen categories were identified:dying without experiencing suffering;being relieved of symptoms and suffering;being relieved of psychological suffering;avoiding the use of futile treatment and resuscita-tion;being cared for and accompanied by family;receiving good health care;having a meaningful life without regrets;making good arrangements for family issues;having a chance to say goodbye;having a quality life before death;dying in a decent environment;the personal will to be respected;maintaining the integrity of the body;death of the patient being accepted by the family and healthcare providers;the death occurred despite the best efforts to care for the patient;limited financial and care burden;shortly affected quality of life of the patient;and improved family cohesion.Conclusion:Family members’early involvement in caring for patients at the end-of-life stage helps achieve a good death.For patients with a terminal illness,avoiding unnecessary medical treatment and resuscitation could be the first step in achieving better patient death and promoting the development of advanced care planning in the mainland of China.

CIRCLE DETECTION USING FAST FINDING AND FITTING (FFF) ALGORITHM

This paper describes a Fast Finding and Fitting (FFF)Algorithm based on the geometric symmetry of the circle. A comparison with other circle detection approaches, in par- ticular the Hough Transform and its extensions is presented. A method to determine a rele- vant estimation of accuracy is also given. Experiments show that FFF possesses advantages in memory usage, high speed, reliability and accuracy are also presented.

Cullin 4A is associated with epithelial to mesenchymal transition and poor prognosis in perihilar cholangiocarcinoma

AIM To explore the functional role of cullin 4A(CUL4A), a core subunit of E3 ubiquitin ligase, in perihilar cholangiocarcinoma(PHCC).METHODS The expression of CUL4 A in PHCC cell lines was evaluated by Western blot and quantitative reverse transcription-polymerase chain reaction. Immunohistochemistry(IHC) was adopted to investigate the relationship between CUL4 A expression and clinicopathological characteristics of PHCC. Univariate analysis and multivariate regression analysis were performed to analyze the risk factors related to overall survival(OS) and progression-free survival(PFS) of PHCC patients. Wound healing, Transwell and Matrigel assays were utilized to explore the function of CUL4 A in PHCC metastasis. Furthermore, expression of epithelial to mesenchymal transition(EMT) markers was verified in cells with CUL4 A knockdown or overexpression. The relationship between CUL4 A expression and E-cadherin expression was also analyzed by IHC assay. Finally, the role of ZEB1 in regulating CUL4 A mediated PHCC was detected by IHC, Western blot, Transwell and Matrigel assays.RESULTS CUL4 A overexpression was detected in PHCC cell lines and clinical specimens. Clinicopathological analysis revealed a close correlation between CUL4 A overexpression and tumour differentiation, T, N and TNM stages in PHCC. Kaplan-Meier analysis revealed that high CUL4 A expression was correlated with poor OS and PFS of PHCC patients. Univariate analysis identified the following four parameters as risk factors related to OS rate of PHCC: T, N, TNM stages and high CUL4 A expression; as well as three related to PFS: N stage, TNM stage and high CUL4 A expression. Further multivariate logistic regression analysis identified high CUL4 A expression as the only independent prognostic factor for PHCC. Moreover, CUL4 A silencing in PHCC cell lines dramatically inhibited metastasis and the EMT. Conversely, CUL4 A overexpression promoted these processes. Mechanistically, ZEB1 was discovered to regulate the function of CUL4 A in promoting the EMT and metastasis.CONCLUSION CUL4 A is an independent prognostic factor for PHCC, and it can promote the EMT by regulating ZEB1 expression. CUL4 A may be a potential therapeutic target for PHCC.