论边缘儿童产生的成因及其游戏治疗

边缘儿童是在普通学前教育机构中,游离于集体边缘、言行举止介于正常与异常边缘的儿童.生态系统的失衡是导致边缘儿童产生的根本原因,家庭生态的失衡是儿童边缘化的诱因,同伴欠缺加剧了儿童的边缘化倾向,教师忽视加深了儿童边缘化的程度.游戏是帮助边缘儿童表达问题的重要途径,游戏治疗具有改善边缘儿童现状的功能.通过创设满足儿童需要的新环境,改善与修复已有的生态环境,以"家长参与"、"同伴介入"、"教师关注"等干预方式,修复或改善边缘儿童的生态环境系统,使边缘儿童的问题得以缓解或消除,使边缘儿童因顺应生态系统的平衡而逐渐回归到正常的同伴群体.     

电针对血管性痴呆大鼠学习记忆能力及脑血流量的影响

目的：观察电针对血管性痴呆(vascular dementia，VD）模型大鼠学习记忆能力和局部服血流量（regional cerebral blood flow,rCBF )的影响。方法：用双侧颈总动脉反复缺血－再灌注结合腹腔注射硝普钠法，并配合行为学测试确定模型。术后7d电针百会、大椎、足三里（双）治疗。用跳台法评价各组大鼠不同时期的学习记忆能力，治疗后测定各组大鼠顶叶有海马rCBF。结果：VD大鼠在电针治疗后的行为学测试成绩明显提高（P＜0．01），其低下的大脑顶叶及海马rCBF水平明显改善（P＜0．01）。结论：电针对VD大鼠的学习记忆能力有显的改善作用；电针能促使机体低灌流的缺血服组织灌流水平恢复，可能有助于与学习记忆相关的传导环路的修复。     

ALMOST,BUT NOT QUITE: THE FAILURE OF NEW YORK'S GET STATUTE

The quandary of Jewish women unable to remarry because of their husbands’ refusal to grant them religious divorces is a real problem affecting real people. Husbands are wielding this lopsided power to “extort” money from their wives, obtain favorable child custody settlements, property settlements, and child support payments. The burgeoning divorce rate is certain to exacerbate this problem. Already, this situation has garnered international attention. In the wake of New York's legislative attempt to remedy this problem, countries, including the United Kingdom and Australia, have promulgated legislative solutions to this dilemma. New York is the only state in the United States to pass such a statute. Unfortunately, New York's statute is flawed because it is of limited applicability and still allows for situations in which the Jewish wife is civilly divorced but religiously married. This Note proposes amending New York's statute to make it applicable to any and all divorce proceedings and to any barrier to remarriage. This Note will further recommend that the proposed amended statute should be adopted worldwide.     

中药透皮疗法对哮喘豚鼠肺M受体的影响

目的：探讨中药透皮治疗哮喘的作用机制。方法：采用Hutson法豚鼠哮喘模型，治疗组隔日诱喘后用中药敷贴30min，对照组诱喘后隔日采用9g/L氯人溶液浸润纱布或0．5g/L醋酸地塞米松霜敷贴，比较记录诱喘潜伏期，2周后处死，取肺组织，用放射本基竞争结合法比较M受体表达状况。结果：中药透皮治疗能显延长哮喘豚鼠诱喘潜伏期，减轻发作程度，下调哮喘豚鼠肺组织M受体含量，结论：2次实验结果提示，降低M受体含量是中药循经敷贴治疗哮喘的重要机制之一。     

补肾活血通络针刺法联合中药熏洗疗法治疗肝肾亏虚型膝骨关节炎临床观察

目的 观察补肾活血通络针刺法联合中药熏洗疗法治疗老年性膝骨关节炎（knee osteoarthritis,KOA）的临床疗效。方法 将76例KOA患者按照随机数字表法分为对照组和观察组,每组38例;对照组采用西医常规治疗,观察组在对照组治疗基础上采用补肾活血通络针刺法联合中药熏洗疗法治疗;观察两组患者治疗前后视觉模拟量表（visual analogue scale,VAS）评分,西安大略和麦克马斯特大学骨关节炎指数（the Western Ontario and McMaster University osteoarthritis index,WOMAC）,Lequesne MG评分,关节液白细胞介素（interleukin,IL）-1β、IL-6、肿瘤坏死因子（tumor necrosis factor,TNF）-α水平,血清环氧化酶-2（cyclooxygenase-2,COX-2）、基质金属蛋白酶-3（matrix metalloproteinase-3,MMP-3）水平的变化情况及临床疗效。结果 两组患者治疗后VAS评分、WOMAC、Lequesne MG评分均较治疗前显著降低（P＜0.05）,且观察组降低程度较对照组更显著（P＜0.05）。两组患者治疗后关节液IL-1β、TNF-α、IL-6水平,血清COX-2、MMP-3水平均较治疗前显著降低（P＜0.05）,且观察组降低程度较对照组更显著（P＜0.05）。观察组疗效优于对照组（P＜0.05）。结论 补肾活血通络针刺法联合中药熏洗疗法可显著改善KOA患者临床症状,减轻疼痛,改善膝关节功能。     

拜登政府的美日印澳四方安全合作构想述评

2017年美日印澳四方安全对话重启以来,马拉巴尔2020军演是美日印澳四国首次举行的联合军演。马拉巴尔2020军演折射出美日印澳四国针对中国的意愿及合作新进展。美日印澳四方安全合作是美国印太战略的基础和牵制中国崛起的重要机制,在近几年持续获得进展。美日印澳四国在安全领域加强合作,对四国与中国双边关系产生深远影响。马拉巴尔2020军演后,原本紧张的中印及中澳关系继续恶化。美国进一步推动与中国的竞争。美日印澳四国不但在安全领域针对中国,还营造不利于中国的国际舆论。拜登上台后,美日印澳四方安全合作继续强化。拜登比特朗普更重视与盟友合作,借由与日印澳三国磋商推动美日印澳四方安全合作机制化和常态化并走向准军事联盟。美日印澳四国明确表示不会在政治与安全领域停止针对中国,但是在经贸领域基于自身利益考量将改善对华关系。美日印澳四方安全合作升级对中国安全环境及国家利益构成严重威胁。拜登政府正在强化针对中国的印太地区多边安全架构。美国试图在外交层面让中国陷入孤立态势,在安全层面对中国形成战略包围。拜登政府的美日印澳四方安全合作构想将让中国面临更加复杂的外交局面,更加险恶的安全态势。     

调任复元灸法治疗脑卒中后感觉性失语临床研究

目的 观察调任复元灸法结合头皮针和舌面点刺治疗脑卒中后感觉性失语的临床疗效。方法 将55例脑卒中后感觉性失语患者随机分为治疗组28例和对照组27例。对照组给予头皮针和舌面点刺治疗,治疗组在对照组基础上给予调任复元灸法治疗，疗程为4周。观察并比较两组临床疗效及治疗前后言语功能评分。结果 两组临床疗效分布比较，治疗组优于对照组（P＜0.05)。治疗前两组患者自发谈话、理解、复述、命名功能评分比较，差异无统计学意义(P＞0.05)。治疗后治疗组各评分均明显提高(P＜0.05)；对照组自发谈话、理解和复述评分均明显提高(P＜0.05)，而命名评分无明显变化（P＞0.05）。两组治疗前后理解、复述、命名评分和总积分差值比较，差异有统计学意义(P＜0.05)。结论 调任复元灸法治疗脑卒中后感觉性失语具有良好疗效，可改善患者言语功能。     

针刺三重穴加放血疗法治疗后循环缺血性眩晕临床观察

目的 观察针刺三重穴加放血疗法治疗后循环缺血性眩晕的临床疗效。方法 将40例后循环缺血性眩晕患者随机分为治疗组（20例）和对照组（20例）,治疗组采用针刺三重穴加放血疗法治疗,对照组采用颈项针治疗,两组均连续治疗3周,观察眩晕改善情况、眩晕障碍量表评分及椎-基底动脉血流动力学指标的变化情况。结果 治疗组临床疗效有优于对照组的趋势,但疗效分布比较,差异无统计学意义（P>0.05）。两组患者治疗后眩晕障碍量表评分较治疗前均显著降低（P<0.05）,治疗组治疗前后各项评分降低程度较对照组更为明显（P<0.05）。两组患者治疗后椎-基底动脉血流动力学指标与治疗前比较,差异具有统计学意义（P<0.05）,两组患者治疗前后各项指标差值比较,差异均有统计学意义（P<0.05）。结论 针刺三重穴加放血疗法能显著改善后循环缺血性眩晕患者的临床症状,减轻眩晕障碍对日常生活的影响,改善椎-基底动脉血流动力学状态。     

Integration of the Family Therapy Specialist into Public School Pupil Personnel Services

SUMMARY

The integration of a full-time family counseling specialist into the Pupil Personnel Service (PPS) Team of the modern public school is described. The roles of the present specialists are delineated as well as the problems inherent within the present Pupil Personnel Services Team. Inclusion of a family counseling specialist on the PPS Team would help schools avoid the antagonist position they find themselves in when a family opposes their suggestions and interventions. In such cases, the PPS Team attempts to wrest control of the case from the parents which subjugates the family, limiting the family's inherent resilience and strength. The family comes to resent the PPS Team, seeing them as blameful and controlling. Conversely, the PPS Team comes to resent the family, claiming it is “dysfunctional” in some way and using diagnostic labels to satisfy themselves that their “expert” actions are justified. This antagonist position in the schools arises more out of fear of litigation than good case management. We propose a new integration of family system and school system. Creation of a family counseling specialist who is highly trained in systems, narrative and structural/strategic family therapy could ameliorate this antagonist problem. Numerous functions for such a new specialty are listed as well as suggestions for including this member into PPS Team work.     

双黄连粉针湿敷治疗急性湿疹临床观察

目的 观察双黄连粉针湿敷治疗急性湿疹的临床疗效。方法 将符合纳入标准的70例急性湿疹患者随机分为对照组和治疗组，每组各35例。两组患者均接受抗组胺药物治疗，口服富马酸氯马斯汀口服液；治疗组同时采用双黄连粉针湿敷治疗，对照组采用3％硼酸洗液湿敷。结果 治疗组总有效率显著优于对照组（91.43% vs 74.29%，P<0.05）。结论 双黄连粉针湿敷治疗急性湿疹，方法简便、安全，值得临床推广。