人性的自白——论日本私小说中张扬的自我意识

私小说在日本近代文坛占主流地位,在日本几乎所有的近现代作家都创作过私小说,而探究私小说中封闭的自我环境的成因是研究私小说的主要途径。从真实性、传统性、封闭性、社会性四个方面进行研究有助于全面阐述封闭的自我环境的成因,进而深入剖析私小说中自白的人性。

治疗性沟通对老年脑卒中病人自我感受负担的影响

[目的]探讨治疗性沟通对老年脑卒中病人自我感受负担(SPB)的影响。[方法]采用随机数字表法将60例存在SPB的老年脑卒中病人分夫妇为为两组各30例,对照组给予常规护理及一般性沟通,干预组在此基础上给予治疗性沟通,采用自我感受负担量表(SPBS)评价干预效果。[结果]干预后两组病人SPB总分、照护负担维度、情感负担维度得分以及SPB程度比较差异有统计学意义(P<0.01或P<0.05)。[结论]治疗性沟通能有效减轻老年脑卒中病人的自我感受负担。

The strength model of self-control revisited:Linking acute and chronic effects of exercise on executive functions

Since the 1960＇s, hundreds of articles have been published on the effects of exercise on cognition and more recently on executive functions. A large variety of effects have been observed： acute or long-lasting, facilitating or debilitating. Several theoretical frameworks have been proposed to explain these effects with plausible mechanisms. However, as yet none of these models has succeeded in unifying all the observations in a single framework that subsumes all effects. The aim of the present review is to revisit the strength model of self-control initiated by Baumeister and his colleagues in the 1990＇s in order to extend its assumptions to exercise psychology. This model provides a heuristic framework that can explain and predict the effects of acute and chronic exercise on effortful tasks tapping self-regulation or executive functions. A reconsideration of exercise as a self-control task results from this perspective. A new avenue for future research is delineated besides more traditional approaches.

Chronic morphine drinking establishes morphine tolerance, but not addiction in Wistar rats

Objective： Some animal models apply morphine in the drinking water to generate addiction, but related reports are not free of conflicting results. Accordingly, this study aimed to figure out if chronic consumption of morphine in the drinking water can induce morphine addiction in Wistar rats. Methods： For 3 weeks, the animals received a daily morphine dose of 35 mg/kg by offering a calculated volume of sugar water （5% sucrose） with morphine （0. l mg/ml） to each rat; animals receiving just sugar water served as controls. Immediately after the treatment phase, the tail immersion test was used to check for morphine tolerance, and all animals were then kept on tap water for one week （withdrawal phase）. Afterwards, all rats were allowed to choose their drinking source by offering two bottles, containing sugar water without and with morphine, simultaneously for two days （preference phase）. Results： While the chronic consumption of morphine led to a reduction in body weight and to morphine tolerance, the morphine-treated Wistar rats did not show any preference for the opiate-containing sugar water. Conclusion： Body weight loss and tolerance do not reveal a condition of drug craving, and current animal models should be re-evaluated regarding their potential to establish morphine addicted animals.

Comparative Analysis of Five Different Homologous Feeder Cell Lines in the Ability to Support Rhesus Embryonic Stem Cells

In our previous study, five homologous feeder cell lines, Monkey ear skin fibroblasts （MESFs）, clonally derived fibroblasts from the MESFs （CMESFs）, monkey oviductal fibroblasts （MOFs）, monkey follicular granulosa fibroblast-like （MFGs） cells, monkey follicular granulosa epithelium-like （MFGEs） cells, were developed for the maintenance of rhesus embryonic stem cells （rESCs）. We found that MESFs, CMESFs, MOFs and MFGs, but not MFGEs, support the growth of rhesus embryonic stem cells. Moreover, we detected some genes that are upregulated in supportive feeder cell lines by semi-quantitative PCR. In the present study, we applied the GeneChip Rhesus Macaque Genome Array of Affymetrix Corporation to study the expression profiles of these five feeder cell lines, in purpose to find out which cytokines and signaling pathways were important in maintaining the rESCs, mRNAs of eight genes, including GREM2, bFGF, KITLG, DKK3, GREM1, AREG, SERPINF1 and LTBP1, were found to be upregulated in supportive feeder cell lines, but not in MFGE. The results indicate that many signaling pathways may play redundant roles in supporting the undifferentiated growth and maintenance of pluripotency in rESCs.

Prophylactic stenting for esophageal stricture prevention after endoscopic submucosal dissection

Endoscopic submucosal dissection (ESD) of superficial esophageal cancer has been increasingly used as an alternative to surgery because it is minimally invasiveand has a high rate of en bloc resection. However, a high rate of esophageal stricture is observed after ESD for large lesions, which can dramatically decrease the patient's quality of life. Stricture prevention is necessary to allow for endoscopic therapy to expand. We, herein, review the most recent evidence and discuss the role of the metallic self-expandable stent and the biodegradable stent in esophageal stricture prevention. Limited studies suggested that prophylactic stenting could reduce the stricture rate without increasing the number of complications. In addition, the number of bougie dilation procedures was significantly lower with stent placement. Esophageal stenting is a promising option for post-ESD stricture prevention. However, current evidence is too preliminary to formulate practice standards. Future studies are needed to further validate the efficacy and safety of prophylactic stenting and determine the best strategy for stricture prevention. Stent migration is the most common complication. A new stent that has advantages of a low migration rate and minimal tissue reaction will need to be developed. Therefore, randomized controlled trials with long-term follow-up periods are required before prophylactic stenting could be considered a valid option to prevent post-ESD stricture.

Self-development of the Teachers and Improvement on EnglishTeaching

For a long time, there have been extensive and deep studies and researches about how to upgrade the level of language education in universities. Now people have realized that the key factor that influences the language education most is teachers＇ self-development and the promotion of teachers＇ personalities. A new teaching concept -- reflective teaching has become very popular in the educational circles. It emphasizes that students should become positive and active learners while teachers should bear more dynamic and capacities for self-development.

Qualitative analysis of compassion fatigue and coping strategies among nurses

Objectives:Nurses are considered to be at risk of experiencing compassion fatigue,which can affect their personal and professional lives.The aim of this study was to investigate stressful factors contributing to the development of compassion fatigue in nurses,their experiences of compassion fatigue,and the coping strategies they used to cope with compassion fatigue.Methods:The convenience sample of 86 nurses fromCentral Europewas recruited via social networking sites during the pandemic of COVID-19.Data collection was conducted via an online battery of questionnaires which included open-ended questions on the stressful factors,experiences,and coping strategies for compassion fatigue.The data were analysed using a theoretical thematic analysis based on Figley’s descriptions of compassion fatigue.The initial datawas read several times to identify recurring statements.Each statement was then categorized into the emerging domains,subdomains,categories,and subcategories.Results:The results of our study show that stressful factors,experiences,and coping strategies for compassion fatigue in nurses in Central Europe could be related to cognitive,emotional,behavioural,somatic,personal relations,spiritual,and work-related symptoms of compassion fatigue as identified by Figley and that these may resemble experiences of nurses in North America,Japan,and Spain.Conclusion:This study provides a detailed overview of the stressful factors,experiences,and coping strategies for compassion fatigue,which could be used to develop an early screening tool and interventions for alleviating compassion fatigue and for preventive adaptation of the health care system.

Predictive factors for the failure of endoscopic stent-instent self-expandable metallic stent placement to treat malignant hilar biliary obstruction

AIM To investigate the factors predictive of failure when placing a second biliary self-expandable metallic stents(SEMSs). METHODS This study evaluated 65 patients with an unresectable malignant hilar biliary obstruction who were examined in our hospital. Sixty-two of these patients were recruited to the study and divided into two groups: the success group, which consisted of patients in whom a stent-in-stent SEMS had been placed successfully, and the failure group, which consisted of patients in whom the stent-in-stent SEMS had not been placed successfully. We compared the characteristics of the patients, the stricture state of their biliary ducts, and the implemented endoscopic retrograde cholangiopancreatography(ERCP) procedures between the two groups.RESULTS The angle between the target biliary duct stricture and the first implanted SEMS was significantly larger in the failure group than in the success group. There were significantly fewer wire or dilation devices(ERCP catheter, dilator, or balloon catheter) passing the first SEMS cell in the failure group than in the success group. The cut-off value of the angle predicting stent-in-stent SEMS placement failure was 49.7 degrees according to the ROC curve(sensitivity 91.7%, specificity 61.2%). Furthermore, the angle was significantly smaller in patients with wire or dilation devices passing the first SEMS cell than in patients without wire or dilation devices passing the first SEMS cell. CONCLUSION A large angle was identified as a predictive factor for failure of stent-in-stent SEMS placement.

Self-expanding metallic esophageal stents:A long way to go before a particular stent can be recommended

We agree that the covered self-expanding metal stents (SEMSs) fare better than the uncovered stents as recurrent dysphagia due to tumor ingrowth is common with uncovered stent. Recent American College of Gastroenterology Practice Guideline on the Role of Esophageal Stents in Benign and Malignant Diseases concludes that SEMSs cannot be routinely recommended in conjunction with chemo-radiation. The comparison of ultraflex and choostent in the Italian study found no difference in the palliation of dysphagia, rate of complications and survival rate.

The Fragmentation of the Female Selfhood in The Flight From the Enchanter

Iris Murdoch is a renowned female novelist and philosopher in the 20th century English literature. In her literary creation, she has a preference for male narration and holds a reserved attitude to women＇s movements with reluctance to be considered as a feminist writer, which permits her realistic depiction of female characters and dispassionate thought on women＇s problems. This paper, with the interpretation and redefinition of the concepts as consciousness, identity, and self in Murdoch＇s philosophy, analyzes the fragmented self of three female figures in The Flight from the Enchanter （1956） respectively from the perspectives of self-consciousness, identity, and self and reveals that the fragmentation of female selfhood is mainly due to the overwhelming male dominance in the gender relationship.

Super-hydrophobic and Self-cleaning PVDF Film Fabricated by Chemical Bath Deposition

Self-cleaning surfaces have received a great deal of attention recently,both in theoretical studies and commercial applications.The self-cleaning surface of lotus leaf is hydrophobic and rough,showing a micro-and nano-scale morphology.The micro-reliefs of lotus leaf were mimicked using polyvinylidene fluoride(PVDF)film and nano-scale peaks on the top of the micro-reliefs were implemented by the reaction between methyltrichlorosilane and the reactive groups of PVDF film treated by oxygen plasma.A lotus-leaf-like surface of the PVDF film was clearly observed by scanning electronic microscopy(SEM)and atomic force microscope(AFM).Elemental composition analysis by X-ray photoelectron spectroscopy(XPS)revealed that the material of the nanostructure of PVDF film was polymethylsiloxane.The superhydrophobic property of the mimicked self-cleaning surface was validated by the water contact angle and sliding angle on the lotus-leaf-like PVDF film,which were 156.6° and 4°,respectively.In this case,water droplets can easily move across the PVDF film surface,carrying dirt particles away,leaving no contamination.

Safety and efficacy of self-expandable metallic stents in malignant small bowel obstructions

In this report, we present 3 cases of malignant small bowel obstruction, treated with palliative care using endoscopic self-expandable metallic stent(SEMS) placement, with the aim to identify the safety and efficacy of this procedure. Baseline patient characteristics, procedure methods, procedure time, technical and clinical success rates, complications, and patient outcomes were obtained. All 3 patients had pancreatic cancer with small bowel strictures. One patient received the SEMS using colonoscopy, while the other 2 patients received SEMS placement via double balloon endoscopy using the through-the-overtube technique. The median procedure time was 104 min. The technical and clinical success rates were 100%. Post-treatment, obstructive symptoms in all patients improved, and a low-residue diet could be tolerated. All stents remained within the patients until their deaths. The median overall survival time(stent patency time) was 76 d. SEMS placement is safe and effective as a palliative treatment for malignant small bowel obstruction.

Ischemic or toxic injury: A challenging diagnosis and treatment of drug-induced stenosis of the sigmoid colon

A 48-year-old woman was admitted with 15-mo history of abdominal pain, diarrhea and hematochezia, and 5-mo history of defecation difficulty. She had been successively admitted to nine hospitals, with an initial diagnosis of inflammatory bowel disease with stenotic sigmoid colon. Findings from computed tomography virtual colonoscopy, radiography with meglumine diatrizoate, endoscopic balloon dilatation, metallic stent implantation and later overall colonoscopy, coupled with the newfound knowledge of compound Qingdai pill-taking, led to a subsequent diagnosis of ischemic or toxic bowel disease with sigmoid colon stenosis. The patient was successfully treated by laparoscopic sigmoid colectomy, and postoperative pathological examination revealed ischemic or toxic injury of the sigmoid colon, providing a final diagnosis of druginduced sigmoid colon stenosis. This case highlights that adequate awareness of drug-induced colon stenosis has a decisive role in avoiding misdiagnosis and mistreatment. The diagnostic and therapeutic experiences learnt from this case suggest that endoscopic balloon expansion and colonic metallic stent implantation as bridge treatments were demonstrated as crucial for the differential diagnosis of benign colonic stenosis. Skillful surgical technique and appropriate perioperative management helped to ensure the safety of our patient in subsequent surgery after long-term use of glucocorticoids.

CD133^+ gallbladder carcinoma cells exhibit self-renewal ability and tumorigenicity

AIM： To identify cancer stern cells （CSCs） in human gallbladder carcinomas （GBCs）. METHODS： Primary GBC cells were cultured under serum-free conditions to produce floating spheres. The stem-cell properties of the sphere-forming cells, including self-renewal, differentiation potential, chemoresistance and tumorigenicity, were determined in vitro or in vivo. Cell surface expression of CD133 was investigated in primary tumors and in spheroid cells using flow cytometry. The sphere-colony-formation ability and tumorigenicity of CD133＋ cells were assayed.floating spheroids were generated from primary GBC cells, and these sphere-forming cells could generate new progeny spheroids in serum-free media. Spheroid cells were differentiated under serum-containing conditions with downregulation of the stem cell markers Oct-4, Nanog, and nestin （P 〈 0.05）. The differentiated cells showed lower spheroid-colony-formation ability than the original spheroid cells （P 〈 0.05）. Spheroid ceils were more resistant to chemotherapeutic reagents than the congenetic adherent cells （P 〈 0.05）. Flow cytometry showed enriched CD133＋ population in sphereforming cells （P 〈 0.05）. CD133＋ cells possessed high colony-formation ability than the CD133 population （P 〈 0.01）. CD133＋ cells injected into nude mice revealed higher tumorigenicity than their antigen-negative counterparts （P 〈 0.05）. CONCLUSION： CD133 may be a cell surface marker for CSCs in GBC.

Inhibition of lung cancer stem cells self-renewal and tumorigenicity by lentivirus-delivered Bmi1 shRNA

Objective： The aim of the study was to observe the effect of Bmil reduction on the self-renewal and tumorigenicity ability of lung cancer stem cells （LCSCs） in human lung adenocarcinoma. Methods： Human lung adenocarcinoma cells A549 were consecutively passaged in NOD/SCID mice treated with Paclitaxel weekly. The proportions of LCSCs in A549 cells and the cells from the third passage （A549-3rd） were compared. The expression of Bmil in LCSCs was silenced by intratumoral injection with lentivirus-delivered Broil small hairpin RNA （shRNA）. RT-PCR and Western blot were used to test the mRNA and protein expressions of Broil in LCSCs. The protein level of p16INK4A was analyzed by Western blotting. The self- renewal and tumorigenicity ability of LCSCs were evaluated by counting the sphere formation rate in serum-free medium and the tumor formation rate in NOD/SCID mice. Results： In vivo passaging ofA549 cells under chemotherapy pressure enriched for LCSCs. The expression of Broil in LCSCs increased. Down-regulation of Bmil by RNA interference resulted in reduced self-renewal and tumorigenicity ability of LCSCs and paralleled the increased expression of p16INK4A, a Bmil target. Conclu- sion： Broil regulates self-renewal and tumorigenicity of LCSCs by silencing some target genes, including p16INK4A.

Effects of a symptom management intervention based on group sessions combined with a mobile health application for persons living with HIV in China:A randomized controlled trial

Objective:This study aims to evaluate the effects of a symptom management intervention(SMI)based on symptom management group sessions combined with a mobile health(mHealth)application(app)on the knowledge of symptom management,the certainty of symptom self-management,symptom severity,symptom distress,medication adherence,social support,and quality of life among persons living with HIV(PLWH)in China.Methods:A parallel randomized controlled trial with 61 PLWH was conducted in Shanghai,China.The participants in the control group(n¼30)downloaded the Symptom Management(SM)app according to their needs and preferences,and received routine follow-ups.The participants in the intervention group(n¼31)were guided to download and use the SM app,and received four tailored weekly group sessions at routine follow-ups.Each group session lasted for approximately 2 h and targeted one of the major modules of the SM app.All the outcomes were assessed at baseline and post-intervention.The study was registered with the Chinese Clinical Trial Registry(ChiCTR1900024821).Results:The symptom management knowledge and certainty of symptom self-management were significantly improved after the intervention(all P<0.01).Compared with the control group,the scores of symptoms reasons knowledge score improved 11.47 points(95%CI:3.41,19.53)and scores of symptoms self-management knowledge score improved 12.80 points(95%CI:4.55,21.05)in the intervention group after controlling for covariates.However,other outcomes did not show statistically significant differences between the intervention group and the control group(P>0.05).Conclusion:The SMI could improve PLWH’s symptom management knowledge and certainty of symptom self-management.Multi-center studies with larger sample sizes and longer follow-ups are needed to further understand the effects of SM app on ameliorating symptom severity and symptom distress.More innovative strategies are also needed to promote and maintain the sustainability of the SM app.

A Feminist Analysis of Protagonists＇ Self-development in O Pioneers： and My Antonia

This paper focuses on pioneer women＇s development of the self from the perspective of feminism in 0 Pioneerst. （1913） and My A ntonia （1994）. As rigid social connections and concepts restrict women＇s autonomy and freedom, they must transform themselves and the world in order to survive. In order to analyze pioneer women＇s process of self-growth in the special period, the author of this paper compares and contrasts the specific situation, and analyzes the characteristics of the protagonists in the above two novels. Through analysis, the authuor concludes that pioneer women always create a nurturing and gracious atmosphere in their household. Practically, these women successfully transmit the old civilization to the newly established homestead.

A Comparative Study of British and American Feminist Criticism

Feminism generally agree that their goals are to expose patriarchal premises and resulting prejudices, to promote discovery and reevaluation of literature by women, and to examine social, cultural, and psychosexual contexts of literature and literary criticism. comparatively speaking; British Feminist criticism emphasizes the women＇s self-awareness, social critical function and prefers traditional realistic techniques. While American feminism approaches focuses on self-expression and feminine identity.

Women＇s repression, rebellion and quest for the ＂true self＂： Theyellow wallpaper as the epitome of the female Gothic novel

As a genre that expressed women＇s dark protests, fantasies and the fear, female Gothic was not theorized until the late 1960s, and before its theorization, this convention was adopted by many women writers in their works. Charlotte Perkins Gilman＇s The yellow wallpaper is one of the many examples. As the epitome of female gothic, The yellow wallpaper utilized the female gothic conventions--the grotesque symbol of yellow wallpaper, the hysteric narrative format and the archetype image of madwoman, to express women＇s status of her time--their repression, rebellion and quest for the ＂true self＂.