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广州天河做人流手术一般要多少钱网上乐园广州白云引产一般要花多少钱

2019年09月19日 08:14:32    日报  参与评论()人

广州白云看人流哪里医院好广州长安医院输卵管恢复手术怎么样好不好One day in the fall of 1981, eight men in their 70s stepped out of a van in front of a converted monastery in New Hampshire. They shuffled forward, a few of them arthritically stooped, a couple with canes. Then they passed through the door and entered a time warp. Perry Como crooned on a vintage radio. Ed Sullivan welcomed guests on a black-and-white TV. Everything inside — including the books on the shelves and the magazines lying around — were designed to conjure 1959. This was to be the men’s home for five days as they participated in a radical experiment, cooked up by a young psychologist named Ellen Langer.1981年秋季的一天,新罕布什尔州一座经改建的修道院前,八名70多岁的老年男子走下了面包车。他们步履蹒跚,其中一些人像关节炎患者一样弯腰驼背,还有两位拄着拐杖。他们进门后,就像进入了一条时间隧道。老式收音机里传来佩里·科莫(Perry Como,人称“C先生”,美国歌手、电视明星)的低声吟唱。黑白电视机上,埃德·沙利文(Ed Sullivan,美国作家和电视节目主持人)正向嘉宾们表示欢迎。这里的一切——包括书架上的书和四下里散落的杂志——都是为营造出1959年的氛围而设计和布置的。在五天的时间里,这里将成为这些老人暂时的家园。他们所参与的,是年轻的心理学家埃伦·兰格(Ellen Langer)精心策划的一项“激进实验”。The subjects were in good health, but aging had left its mark. “This was before 75 was the new 55,” says Langer, who is 67 and the longest-serving professor of psychology at Harvard. Before arriving, the men were assessed on such measures as dexterity, grip strength, flexibility, hearing and vision, memory and cognition — probably the closest things the gerontologists of the time could come to the testable biomarkers of age. Langer predicted the numbers would be quite different after five days, when the subjects emerged from what was to be a fairly intense psychological intervention.虽然受试者们的健康状况都相当不错,但衰老已经在他们身上留下了痕迹。“那时还没有‘75岁是新的55岁’这样的概念,”兰格说,如今67岁的她是哈佛大学任职时间最长的心理学教授。这些老人在抵达实验地点之前接受了一系列检查,如灵巧性、握力、柔韧性、听觉和视觉、和认知功能——当年,这些很可能是老年学家掌握的最接近年龄测试生物标志物的指标。兰格预测,五天之后,当受试者们结束大强度心理干预的时候,这些指标都将大为改观。Langer had aly undertaken a couple of studies involving elderly patients. In one, she found that nursing-home residents who had exhibited early stages of memory loss were able to do better on memory tests when they were given incentives to remember — showing that in many cases, indifference was being mistaken for brain deterioration. In another, now considered a classic of social psychology, Langer gave houseplants to two groups of nursing-home residents. She told one group that they were responsible for keeping the plant alive and that they could also make choices about their schedules during the day. She told the other group that the staff would care for the plants, and they were not given any choice in their schedules. Eighteen months later, twice as many subjects in the plant-caring, decision-making group were still alive than in the control group.在此之前,兰格已经进行了两项涉及老年患者的研究。其中一项发现,在奖励的激励下,处于减退早期阶段的养老院老人能够在测试中获得更好的成绩。这说明,在许多情况下,对外界漠然被错误地当作大脑退化。在另一项如今被公认为社会心理学经典的研究中,兰格将室内植物分发给两组养老院老人。她告诉其中一组老人他们要负责养活这些植物,并允许他们对自己的作息安排做出选择。而另一组老人则被告知,植物有工作人员照顾,且他们没有得到作息安排上的任何选择。18个月后,关怀植物、并能对自己的作息时间表做出决策的那一组仍然健在的老人是对照组的两倍。To Langer, this was evidence that the biomedical model of the day — that the mind and the body are on separate tracks — was wrongheaded. The belief was that “the only way to get sick is through the introduction of a pathogen, and the only way to get well is to get rid of it,” she said, when we met at her office in Cambridge in December. She came to think that what people needed to heal themselves was a psychological “prime” — something that triggered the body to take curative measures all by itself. Gathering the older men together in New Hampshire, for what she would later refer to as a counterclockwise study, would be a way to test this premise.在兰格看来,这些据显示了当时的生物医学模式——即心灵和身体分道而驰——陷入了认识误区。12月,当我在她位于马萨诸塞州剑桥的办公室里见到她时,她说,当时医学界相信“病原体侵入是导致人体患病的唯一途径,而要恢复健康,也惟有摆脱病原体”。她逐渐产生的一个设想是,人需要某种心理上的“触发刺激”来自行痊愈,也就是触发身体自行动用所有的康复手段。让上文提到的老年男性汇聚新罕布什尔州,进行她后来所称的“逆时针”研究,就是测试这个假设的一种方式。The men in the experimental group were told not merely to reminisce about this earlier era, but to inhabit it — to “make a psychological attempt to be the person they were 22 years ago,” she told me. “We have good reason to believe that if you are successful at this,” Langer told the men, “you will feel as you did in 1959.” From the time they walked through the doors, they were treated as if they were younger. The men were told that they would have to take their belongings upstairs themselves, even if they had to do it one shirt at a time.她要求实验组的老人不要止步于对旧时光的缅怀,而是要让自己穿越回去,栖息于其中——“从心理层面尝试做回22年前的自己,”兰格向我描述道。她还对他们说:“我们有很好的理由相信,如果你们能成功地做到这一点,你们会觉得自己还是1959年的那个人。”从他们进门的那一刻起,他们就被当做年轻人对待。他们被告知,他们必须自己把行李搬上楼去,哪怕他们一次只拿得动一件衬衫。Each day, as they discussed sports (Johnny as and Wilt Chamberlain) or “current” events (the first U.S. satellite launch) or dissected the movie they just watched (“Anatomy of a Murder,” with Jimmy Stewart), they spoke about these late-#39;50s artifacts and events in the present tense — one of Langer’s chief priming strategies. Nothing — no mirrors, no modern-day clothing, no photos except portraits of their much younger selves — spoiled the illusion that they had shaken off 22 years.每天,他们讨论着体育(约翰尼·尤尼塔斯[Johnny as,曾获国家橄榄球联盟最有价值球员]或威尔特·张伯伦[Wilt Chamberlain,前美国NBA联盟职业篮球运动员])和“时事”(美国发射第一枚卫星),或是评析刚刚看过的电影(詹姆斯·斯图尔特[Jimmy Stewart]主演的《桃色血案》[“Anatomy of a Murder”])——他们使用现在时态谈论这些50年代末的物品和事件,这也是兰格主要的“触发刺激”策略之一。不会有任何东西,包括镜子和现代装,来扰乱这种“时光倒流22年”的幻觉,即使有照片,那也是他们自己年轻时的肖像。At the end of their stay, the men were tested again. On several measures, they outperformed a control group that came earlier to the monastery but didn’t imagine themselves back into the skin of their younger selves, though they were encouraged to reminisce. They were suppler, showed greater manual dexterity and sat taller — just as Langer had guessed. Perhaps most improbable, their sight improved. Independent judges said they looked younger. The experimental subjects, Langer told me, had “put their mind in an earlier time,” and their bodies went along for the ride.在这段小住结束时,这些老人再度接受了检查。实验组在多项指标上远远优于对照组。后者之前就来到了这所修道院,但研究人员只鼓励他们回忆过去,而没有要求他们想象自己重返年轻时代。实验组老人的身体柔韧性更强,手部更加灵巧,坐姿时腰背也挺得更直——正如兰格所猜测的那样。也许最不可思议的是,他们的视力也有所改善。独立的评委表示他们看上去更年轻了。兰格告诉我,实验组受试者“让自己的心境回到了年轻时代”,他们的身体也随之调整。The results were almost too good. They beggared belief. “It sounded like Lourdes,” Langer said. Though she and her students would write up the experiment for a chapter in a book for Oxford University Press called “Higher Stages of Human Development,” they left out a lot of the tantalizing color — like the spontaneous touch-football game that erupted between heretofore creaky seniors as they waited for the bus back to Cambridge. And Langer never sent it out to the journals. She suspected it would be rejected.实验结果太棒了,简直让人难以置信。“听起来就像卢尔德(法国南部小镇,著名朝圣地,相传人们可以在那里治愈一切疾病——译注)一样,”兰格说。虽然她和她的学生们在牛津大学出版社(Oxford University Press)出版的《人类发展的较高阶段》(Higher Stages of Human Development)中用一个章节的篇幅介绍这项实验,但他们省略了很多动人的情节,例如,在等巴士返回剑桥时,这些之前很僵硬,仿佛一动就会咯吱作响的老骨头自发组织了一场触身式橄榄球赛。出于对退稿的担心,兰格没敢将这些内容写在投稿给刊物的文章中。After all, it was a small-sample study, conducted over a mere five days, with plenty of potentially confounding variables in the design. (Perhaps the stimulating novelty of the whole setup or wanting to try extra hard to please the testers explained some of the great improvement.) But more fundamental, the unconventionality of the study made Langer self-conscious about showing it around. “It was just too different from anything that was being done in the field as I understood it,” she said. “You have to appreciate, people weren’t talking about mind-body medicine,” she said.毕竟,这只是为期五天的一个小样本研究,设计中存在大量潜在混淆的变量。(或许是整个实验令人振奋的新颖性,或者是受试者为了取悦测试者而格外努力,这些都可能在一定程度上解释某些指标的显著改观。)但更为根本的是,这项研究的标新立异使兰格不太好意思到处展示。“在我看来,这跟该领域当时在进行的研究工作相去太远,”她说。“要知道,那时没有人谈论身心医学(mind-body medicine)。”Langer did not try to replicate the study — mostly because it was so complicated and expensive; every time she thought about trying it again, she talked herself out of it. Then in 2010, the B broadcast a recreation, which Langer consulted on, called “The Young Ones,” with six aging former celebrities as guinea pigs.兰格没有尝试重复这项实验,主要是因为它太复杂,成本也太高,每次她产生再试一次的念头,她都劝阻了自己。直到2010年,英国广播公司(B)聘请兰格担任顾问,重复了这项实验,并将其做成一档节目,名为“年轻一代”(The Young Ones),把六位年迈的前名星当作实验对象。The stars were squired via period cars to a country house meticulously retrofitted to 1975, right down to the kitschy wall art. They emerged after a week as apparently rejuvenated as Langer’s septuagenarians in New Hampshire, showing marked improvement on the test measures. One, who had rolled up in a wheelchair, walked out with a cane. Another, who couldn’t even put his socks on unassisted at the start, hosted the final evening’s dinner party, gliding around with purpose and vim. The others walked taller and indeed seemed to look younger. They had been pulled out of mothballs and made to feel important again, and perhaps, Langer later mused, that rekindling of their egos was central to the reclamation of their bodies.这些明星们被老式轿车送到了一幢精心改建成1975年风格(甚至包括那个时期俗气的墙面艺术)的乡间别墅。一周后,他们重新露面,一个个都显得青春焕发,就像当年兰格实验中那些年逾七旬的老人一样。他们的检测指标也出现明显改善。有个人进去时还坐着轮椅,出来时却可以自己拄着拐杖行走了。还有一位,一开始就连穿袜子也要别人帮忙,到实验结束前夕却操办了告别晚宴,意志坚定精神抖擞地忙进忙出。其他人步行时腰杆也挺得更直,确实看起来年轻多了。他们不再被束之高阁,而是再次觉得自己重要,有价值。后来兰格想到,唤醒自我意识也许在他们身体重现活力的神奇变化中起到了核心作用。The program, which was shown in four parts and nominated for a Bafta Award (a British Emmy), brought new attention to Langer’s work. Jeffrey Rediger, a psychiatrist and the medical and clinical director of Harvard’s McLean Hospital, was invited by a friend of Langer’s to watch it with some colleagues last year. Rediger was aware of Langer’s original New Hampshire study, but the made-for-TV version brought its tantalizing implications to life.这档分四集播出的节目获得了英国电影学院奖(Bafta Award,相当于英国的艾美奖[Emmy])提名,并引发人们对兰格的研究产生新的关注。去年,兰格的一个朋友邀请哈佛大学医学院教学附属麦克莱恩医院(Harvard’s McLean Hospital)的精神病学家、医务和临床主任杰弗里·雷迪格(Jeffrey Rediger)与同事们一起观看了这档节目。雷迪格早就对兰格当年在新罕布什尔州进行的研究略知一二,但这个为电视制作的版本生动展现了该项研究的诱人影响。“She’s one of the people at Harvard who really gets it,” Rediger told me. “That health and illness are much more rooted in our minds and in our hearts and how we experience ourselves in the world than our models even begin to understand.”“兰格是哈佛大学里真正懂行的几个人之一,”雷迪格告诉我。“也就是说,健康和疾病在更大程度上植根于我们的思想和心情,以及我们在世上如何体验自己,而这是现有医学模式根本不理解的。”Langer’s house in Cambridge was as chilly as a meat locker when we arrived together, having walked from campus, last winter. The back door had been left open all day so that her aging, coddled Westie, Gus, could relieve himself in the yard. (Langer’s partner, Nancy Hemenway, who normally would be at home, was away.) Gus has a brain tumor. “He was supposed to be dead over a year ago,” Langer said. “But I think he might outlive us all.”去年冬天,我和兰格从校园里一起步行到她家去,房子里冷得好像冷藏室一样。后门整天敞开着,好让她宠爱的那条老西高地白梗犬格斯(Gus)可以自由地跑到院子里去玩。(兰格的伴侣,南希·海明威[Nancy Hemenway]通常在家,但那天正好出去了。)格斯患有脑肿瘤。“照说它在一年前就会死,”兰格说。“但我觉得它说不定比我们所有人都活得久。”In the kitchen, Langer began laying out wide noodles for a lasagna she was making for an end-of-term party. It was the last time she would meet with her students for a while; they were about to scatter for the winter break, and she was leaving for a sabbatical in Puerto Vallarta, Mexico, where she and Nancy have another home. (Langer planned to Skype into weekly lab meetings.)兰格在厨房里忙活着,拿出宽面条准备做意大利千层面,好在期末聚会上招待大家。这是今后一段时间内她最后一次跟自己的学生碰面了——寒假开始后,大家将各奔东西,而她准备动身前往墨西哥的巴亚尔塔港休长假,她和南希在那里还有一个居所。(兰格计划通过Skype参与每周一次的实验室会议。)“Family recipe?” I asked of the dinner.“这是家传的菜谱吗?”我问起了晚餐。“I don’t follow recipes — you should know that,” she said. She piled on an immoderate amount of cheese. “Besides, if I blow it, what’s going to be the cost?” Langer said. “Is it anyone’s last meal?” She added, “My students aren’t going to love me if my lasagna’s no good?”“我从不拘泥于菜谱的——这你知道,”她一边说,一边往面上大量地堆奶酪。“再说,就算我搞砸了又怎么样?这又不是谁最后的晚餐;就算我做的千层面不好吃,难道我的学生们就会因此不爱戴我?”Langer was born in the Bronx and went to N.Y.U., becoming a chemistry major with her eye on med school. That all changed after she took Psych 101. Her professor was Philip Zimbardo, who would later go to Stanford and investigate the effects of authority and obedience in his well-known prison experiment. Human behavior, as Zimbardo presented it, was more interesting than what she’d been studying, and Langer soon switched tracks.兰格出生于布朗克斯,在纽约大学攻读化学专业,想着以后进医学院。然而,在她听了《心理学101》(Psych 101)课之后,一切都改变了。她师从的菲利普·津巴多(Philip Zimbardo)教授后来去斯坦福大学任教,并在著名的监狱实验中研究了权威和从的影响。兰格从津巴多教授的讲课中发现,人类行为比她之前学的东西更有意思,于是她很快换了专业。She went on to graduate work at Yale, where a poker game led to her doctoral dissertation on the magical thinking of otherwise logical people. Even smart people fall prey to an “illusion of control” over chance events, Langer concluded. We aren’t really very rational creatures. Our cognitive biases routinely steer us wrong. Langer’s notion that people are trained not to think and are thus extremely vulnerable to right-sounding but actually wrong notions prefigured many of the tenets of “behavioral economics” and the work of people like Daniel Kahneman, who won a Nobel Prize in economic sciences. But unlike many researchers who systematically work out one concept until they own it, Langer’s peripatetic mind quickly moved on to other areas of inquiry. “I was never — and maybe this is a character flaw — the type of person who is going to take one idea and beat it to death,” she said. “Part of that is that I have so many ideas. If whatever it is I’m excited about now doesn’t happen, it doesn’t matter, because there’s always the next possibility.”她的研究生阶段在耶鲁大学(Yale)度过,在那里,一场扑克游戏给了她启迪,使她写出一篇有关通常讲究逻辑的人们迸发突发奇想的士论文。兰格的结论是:即使聪明人也容易陷入对于偶然事件的“控制错觉”。我们真的算不上一种高度理性的生物。认知偏见经常将我们导向错误的方向。兰格认为,人们养成了不假思索的习惯,这使他们很容易被似是而非的理念误导。这一观念的形成早于许多流派的“行为经济学”,也早于诺贝尔经济学奖得主丹尼尔·卡尼曼(Daniel Kahneman)等人的研究。但与许多锲而不舍地钻研某个概念、直到它为自己所有的研究者不同,兰格的思维经常信马由缰地转向其他研究领域。“我从来不是能追着一个问题打破砂锅问到底的人,或许这是一种性格缺陷,”她说。“部分原因是我总是有太多的想法。如果现在让我激动不已的东西没能搞出名堂,那没关系,因为始终存在下一个可能性。”By the 1970s, Langer had become convinced that not only are most people led astray by their biases, but they are also spectacularly inattentive to what’s going on around them. “They’re just not there,” as she puts it. When you’re not there, Langer reasoned, you’re very likely to end up where you’re led. She set up a number of studies to show how people’s thinking and behavior can easily be manipulated with subtle primes.到了20世纪70年代,兰格逐渐确信,多数人不仅被自己的偏见带上歧途,还对身边发生的事情极其漫不经心。就像她所说的,“他们就是心不在焉。”兰格的推理是,当你心不在焉的时候,你很容易被牵着走。她设立了多项研究,旨在揭示人们思路和行为很容易被细微的“触发刺激”所操纵。In one, she and her colleagues found that office workers were far more likely to comply with a ridiculous interdepartmental memo if it looked like other official memos. In another, created with her Yale mentor, Robert Abelson, they asked behavioral and traditional therapists to watch a of a person being interviewed, who was labeled either “patient” or “job applicant,” and then evaluate the person. The behavioral therapists regarded the interviewee as well adjusted regardless of whether they were told the person was a patient or an applicant. But the traditional therapists found the interviewee labeled “patient” significantly more disturbed. Even trained observers “were mindlessly led by the label,” Langer says.在一项研究中,她和同事们发现,只要看起来跟其他官方的内部通知差不多,哪怕是一份内容荒谬的跨部门通知,也会让上班族们照办。在另一项与她在耶鲁大学的导师罗伯特·艾贝尔森(Robert Abelson)合作创建的研究中,他们要求行为治疗师和传统治疗师观看某个身份被标注为“患者”或“求职者”的人接受采访的视频,然后对此人做出评估。无论是对所谓的“患者”还是“求职者”,行为治疗师认为这位受访者相当自如得体。但是在传统治疗师眼里,“患者”身份的受访者明显更加不安。兰格指出,这说明,即使训练有素的观察者“也很容易被标签搞得没头没脑”。If people could learn to be mindful and always perceive the choices available to them, Langer says, they would fulfill their potential and improve their health. Langer’s technique of achieving a state of mindfulness is different from the one often utilized in Eastern “mindfulness meditation” — nonjudgmental awareness of the thoughts and feelings drifting through your mind — that is everywhere today. Her emphasis is on noticing moment-to-moment changes around you, from the differences in the face of your spouse across the breakfast table to the variability of your asthma symptoms. When we are “actively making new distinctions, rather than relying on habitual” categorizations, we’re alive; and when we’re alive, we can improve. Indeed, “well-being and enhanced performance” were Langer’s goals from the beginning of her career.兰格表示,如果人们能够学会多留点心,始终察觉到身边可以把握的选择,那么,他们将能充分发挥自己的潜能,并改善自己的健康。兰格所说的达到专注状态的技巧与在当今大行其道的东方式“正念禅修”不同,后者是对你的脑海中飘过的思想和感受达到不加评判的认知。而兰格强调的是留心你身边每时每刻的细微变化,从早餐桌对面配偶脸色的差异,到你的哮喘症状的改变。当我们在“积极主动发现新的差别,而不是依赖于习惯性的”分类时,我们会真正觉得自己活着;而当我们觉得自己活着,我们就能改善。的确,在职业生涯伊始,兰格就以“福祉和增强的表现”为目标。Martin Seligman in the past two decades has come to be recognized as the father of positive psychology. Tal Ben-Shahar, who taught a popular undergraduate course at Harvard on the subject until 2008, calls Langer “the mother of positive psychology,” by virtue of her early work that anticipated the field.过去20年里,马丁·赛里格曼(Martin Seligman)被公认为积极心理学之父。而凭借其在该领域的早期研究工作,兰格被2008年之前在哈佛大学讲授一门深受欢迎的本科课程的塔尔·班夏哈(Tal Ben-Shahar)誉为“积极心理学之母”。Langer came to believe that one way to enhance well-being was to use all sorts of placebos. Placebos aren’t just sugar pills disguised as medicine, though that’s the literal definition; they are any intervention, benign but believed by the recipient to be potent, that produces measurable physiological changes. Placebo effects are a striking phenomenon and still not all that well understood. Entire fields like psychoneuroimmunology and psychoendocrinology have emerged to investigate the relationship between psychological and physiological processes. Neuroscientists are charting what’s going on in the brain when expectations alone reduce pain or relieve Parkinson’s symptoms. More traditionally minded health researchers acknowledge the role of placebo effects and account for them in their experiments. But Langer goes well beyond that. She thinks they’re huge — so huge that in many cases they may actually be the main factor producing the results.兰格认为,增强福祉的途径之一是利用各种各样的安慰剂。安慰剂并不只是伪装成药物的糖丸(尽管那确实是字面上的定义);没有危害、接受者相信有效,能够产生可测量的生理变化的任何干预措施都可称为安慰剂。安慰剂效应是一种引人注目的现象,至今仍未获得很好的理解。目前已经涌现出了心理神经免疫学和精神内分泌学等完整的研究领域,专门探讨心理与生理过程之间的关系。神经科学家试图跟踪记录当仅凭期望就减轻疼痛或缓解帕金森氏病症状时,大脑中究竟发生了哪些变化。意识较为传统的医学研究人员承认安慰剂效应的作用,并在自己的实验中计入这些效应。但兰格走得更远。她认为,安慰剂效应是巨大的——在许多情况下,它们实际上可能是产生结果的主要因素。As an example, she points to a study she conducted in a hair salon in 2009. She got the idea from a study undertaken nearly a decade earlier by three scientists who looked at more than 4,000 subjects over two decades and found that men who were bald when they joined the study were more likely to develop prostate cancer than men who kept their hair. The researchers couldn’t be sure what explained the link, though they suspected that androgens (male hormones including testosterone) could be affecting both scalp and prostate. Langer had another theory: “Baldness is a cue for old age,” she says. “Therefore, men who go bald early in life may perceive themselves as older and may consequently be expected to age more quickly.” And those expectations may actually lead them to experience the effects of aging. To explore this relationship between expectations of aging and physiological signs of health, Langer and her colleagues designed the hair-salon study. They had research assistants approach 47 women, ranging in age from 27 to 83, who were about to have their hair cut, colored or both. They took blood-pressure ings. After the subjects’ hair was done, they filled out a questionnaire about how they felt they looked, and their blood pressure was taken again. In a paper published in 2010 in the journal Perspectives on Psychological Science, they reported that the subjects who perceived themselves as looking younger after the makeover experienced a drop in blood pressure.她援引自己2009年在一家美发沙龙进行的研究作为例。该研究的灵感来源于近10年前三位科学家进行的另一项研究,他们在20年期间追踪调查了4000多名受试者,发现在加入研究时秃顶的男性比头发丰茂的男性更容易患前列腺癌。研究人员不能肯定这种关联从何而来,但他们怀疑这也许是因为雄激素(包括睾酮)对头皮和前列腺都有影响。兰格则提出了另一种理论:“脱发是衰老的暗示之一。因此,早早秃顶的男性可能感觉自己更老,结果预期自己会更快衰老。”而这种预期实际上可能导致他们遭遇衰老效应。为了探讨对衰老的预期与健康的生理体征之间的这种关系,兰格和她的同事们设计了一项在美发沙龙进行的研究。他们让研究助理们去接触来美发沙龙剪发、染发或者先剪后染的47名女性(其年龄从27岁到83岁不等),并记录下她们的血压读数。受试者们做好发型之后,就各自对自己外貌的观感填写了一份调查问卷,并再次测量血压。在这篇2010年发表于《心理科学透视》(Perspectives on Psychological Science)期刊的论文中,他们报告称,那些认为自己在做好发型后显得更加年轻的受试者血压有所下降。A few years earlier, Langer and one of her students, Alia Crum, conducted a study, published in the journal Psychological Science, involving 84 hotel chambermaids. The maids had mostly reported that they didn’t get much exercise in a typical week. The researchers primed the experimental group to think differently about their work by informing them that cleaning rooms was fairly serious exercise — as much if not more than the surgeon general recommends. Once their expectations were shifted, those maids lost weight, relative to a control group (and also improved on other measures like body mass index and hip-to-waist ratio). All other factors were held constant. The only difference was the change in mind-set.几年前,兰格和她的学生阿莉娅·克拉姆(Alia Crum)进行了一项研究,并发表在《心理科学》(Psychological Science)杂志上。该研究涉及84名酒店客房女务员。她们大多报告称,自己在典型的一周工作期间没有什么锻炼机会。研究人员引导实验组的女务员换一种心态看待自己的工作,告诉她们:打扫房间其实是一种强度不小的锻炼,运动量不比卫生局局长所建议的要少。在她们的预期改变后,这些女务员的体重相对于对照组有所减轻(其他指标,如身体质量指数[BMI]和腰臀比也有所改善)。其他所有因素都保持恒定。唯一变化的只有受试者的心态。Critics hunted for other explanations — statistical errors or subtle behavior changes in the weight-loss group that Langer hadn’t accounted for. Otherwise the outcome seemed to defy physics. “To which I would say, ‘There’s no discipline that is complete,’ ” Langer responds. “If current-day physics can’t explain these things, maybe there are changes that need to be made in physics.”批评者寻找其他解释,如统计错误,或者兰格未能计入的体重下降组的细微行为变化。否则,那样的结果似乎有悖于物理学。“对此我想说,‘没有一个学科是绝对完美的’,”兰格回应道。“如果当代的物理学无法解释这些现象,也许是物理学本身需要一些改变了。”In the course of her career, Langer says, she has written or co-written more than 200 studies, and she continues to churn out research at a striking pace. Just before winter break, in her final meeting with two dozen or so students and postdocs, Langer went around the table checking the progress of nearly 30 experiments, all of which manipulated subjects’ perceptions. Some used a special clock that could be set to run at half-speed or double-speed. In one study, sleeping subjects were fooled, upon awakening, into thinking they had more or less sleep than they actually did. She posits that the scores on measures of short-term memory and reaction time will vary accordingly, regardless of how long the subjects actually slept. In a yet-to-be-published diabetes study, Langer wondered whether the biochemistry of Type 2 diabetics could be manipulated by the same psychological intervention — the subjects’ perception of how much time had passed. Her theory was that the diabetics’ blood-glucose levels would follow perceived time rather than actual time; in other words, they would spike and dip when the subjects expected them to. And that’s what her data revealed. When a student emailed her with the results this fall, she could barely contain her excitement. “This is the beginning of a psychological cure for diabetes!” she told me.兰格说,在她的职业生涯中,她已经独立撰写或与他人合作撰写了200多篇研究论文,如今她继续以惊人的速度发表大量研究。就在寒假前,她与二十多个学生和士后最后一次开会时,兰格围着桌子检查着近30项实验的进展,这些实验都涉及操纵受试者的感知。一些实验使用了特制的时钟,这些钟能够以正常时钟的一半速度或者两倍速度运转。在某一项研究中,受试者一觉醒来后受到蒙骗,让他们以为自己睡得比实际时间更久或者更短。兰格设想,这些受试者的短期记忆和反应时间等指标的得分将发生相应变化,而无论他们的实际睡眠时间有多长。在一项尚未发表的糖尿病研究中,兰格想知道2型糖尿病患者的生化检查结果是否也能通过同样的心理干预——即受试者对于已经过去了多长时间的感知——来操纵。她的理论是,糖尿病人血糖水平会跟随受试者感知到的时间(而不是实际时间)波动;换句话说,它会按照受试者的预期上升或者下降。而实验数据揭示的情况正是这样。今年秋天,当学生通过电子邮件向她报告实验结果时,她几乎无法抑制自己内心的激动。她告诉我说:“这是用心理疗法治疗糖尿病的开端!”Some of the new experiments rely on variables that change self-perception. In a study using avatars, scheduled to take place at the popular gaming facility Second Life, subjects will watch a digital version of themselves playing tennis and gradually getting thinner from the exertion. Langer is exploring whether watching an avatar will have a physiological effect on the real person. “You see yourself, you’re playing tennis,” Langer said. “The question is: Will people lose weight? We’ll see.”有些新实验依赖于改变自我感知的变量。在一项拟在流行的虚拟游戏世界“第二人生”(Second Life)中进行的研究中,受试者将观看自己的数字化身打网球,并因为体力消耗而逐渐变得苗条起来。兰格希望研究观察化身会否对真人造成生理影响。“你看到自己在打网球,”兰格说。“问题是:人们会因此减肥么?我们拭目以待。”Some of Langer’s colleagues in the academy see her as a valuable force in psychology, praising her eccentric intelligence and ingenious study designs. Steven Pinker, the writer and Harvard professor, told me that she filled an important niche within the school’s department, which has often harbored “mavericks with nontraditional projects,” including “B. F. Skinner’s utopian novels and manifestoes and Herb Kelman’s encounter groups between Arab and Israeli activists — not to mention Timothy Leary and Richard Alpert,” who would become Ram Dass.兰格在学术圈内的一些同事肯定了她在心理学领域的价值和影响力,赞赏她的独到智慧和巧妙研究设计。哈佛大学教授和作家史蒂文·平克(Steven Pinker)告诉我,她在学院内部占有重要的一席之地,该学院经常育出“搞出非传统项目的特立独行者”,包括“伯尔赫斯·弗雷德里克·斯金纳(B. F. Skinner)的乌托邦小说和宣言、赫布·克尔曼(Herb Kelman)组织的让阿拉伯与以色列活动人士汇聚一堂的会心小组——更不用说蒂莫西·利里(Timothy Leary)和理查德·阿尔珀特(Richard Alpert,已更名为拉姆·达斯[Ram Dass])了。”But Langer’s sensibility can feel at odds with the rigors of contemporary academia. Sometimes she will give equal weight to casually hatched ideas and peer-reviewed studies. She spoke loosely to me of her New Hampshire counterclockwise study as having been “replicated” three times — in Britain, the Netherlands and South Korea. But none of these were lab experiments. They were events made for television. The study that arguably made Langer’s name — the plant study with nursing-home patients — wouldn’t have “much credibility today, nor would it meet the tightened standards of rigor,” says James Coyne, professor emeritus of psychology at the University of Pennsylvania medical school and a widely published bird dog of pseudoscience. (Though, as Coyne also acknowledges, “that is true of much of the work of the ’70s, including my own concerning depressed persons depressing others.”) Langer’s long-term contributions, Coyne says, “will be seen in terms of the thinking and experimenting they encouraged.”然而,兰格的这种感性有时会与当代学术界的严谨格格不入。有时候,她会对信手拈来的灵感和经过同行评议的研究给予同等份量。她含糊地告诉我,她在新罕布什尔州做过的“逆时针”研究,已经在英国、荷兰和韩国“重复”了三次。但这些都不是在严格的实验室条件下开展的实验,而是为制作电视节目而搞的活动。宾夕法尼亚大学(University of Pennsylvania)医学院心理学荣誉退休教授、经常发表文章揭露伪科学的詹姆斯·科因(James Coyne)称,当年那项可以说令兰格成名的研究(养老院老人与植物),“在今天看来并没有多少可信度,也不会满足如今收紧之后的严谨标准。”(但科因也承认,“20世纪70年代的大多数工作,包括我自己的那项‘抑郁症患者可导致其他人抑郁’的研究,也是这种情况。”)科因表示,兰格的长期贡献“将体现于它们所鼓舞的思维和实验”。Four years ago, Langer and her colleagues published in Psychological Science a study that came closest in spirit to the original counterclockwise study in New Hampshire. Here, too, the placebo was a health prime, a situational nudge. They had two groups of subjects go into a flight simulator. One group was told to think of themselves as Air Force pilots and given flight suits to wear while guiding a simulated flight. The other group was told that the simulator was broken and that they should just pretend to fly a plane. Afterward, they gave each group an eyesight test. The group that piloted the flight performed 40 percent better than the other group. Clearly “mind-set manipulation can counteract presumed physiological limits,” Langer said. If a certain kind of prompt could change vision, Langer thought, there was no reason, that you couldn’t try almost anything. The endgame, she has said many times since, is to “return the control of our health back to ourselves.”四年前,兰格及其同事在《心理科学》上发表了一项研究,这是与新罕布什尔州“逆时针”研究在精神上最接近的一项研究。这项研究的安慰剂仍是某种健康触发刺激,某种情景暗示。研究者把两组受试者分别送入飞行模拟器,要求其中一组受试者设想自己是空军飞行员,并让他们在操纵模拟飞行时穿着飞行。而另一组受试者则被告知,模拟器坏了,他们只需要假装在操纵飞机。随后,两组人接受了视力测试。结果“飞行员组”的检测结果比另一组高出40%。兰格总结道,显然“操纵心态可以抵消假定的生理局限”。如果某种提示可以改变视力的话,兰格认为,那就没理由不敢尝试几乎任何东西。在那之后,她多次表示,终极目的是将“健康的控制权交还给我们自己”。Last spring, Langer and a postdoctoral researcher, Deborah Phillips, were chatting when the subject of the counterclockwise study came up. Over the more than 30 intervening years, Langer had explored many dimensions of health psychology and tested the power of the mind to ease various afflictions. Perhaps it was finally time to run the counterclockwise study again. But if they did, she wanted to raise the stakes: Could they shrink the tumors of cancer patients? Langer often says she has no clue where her ideas come from — but in this case it was crystal clear: Metastatic breast cancer killed her mother at 56, when Langer was 29.去年春天,兰格和士后研究员德拉·菲利普斯(Deborah Phillips)在聊天时谈起了“逆时针”研究。自那以来的30多年里,兰格探索了健康心理学的多个层面,做了很多利用思维的威力来缓解各种病痛的试验。也许现在终于到了再次进行“逆时针”的时候了。但是,如果真的要做,这次她想要加大赌注:他们能够缩小癌症患者的肿瘤么?兰格常说,她不知道自己那些稀奇古怪的想法从何而来,但这一次,她的灵感源泉显而易见:在她29岁时,她的母亲因转移性乳腺癌去世,享年仅56岁。Phillips suggested that perhaps they should start with early-stage cancers, ones perceived as more curable, but Langer was firm: It had to be a big, common killer that traditional Western medicine had no answer for. She settled on Stage 4 metastatic breast cancer. Treatment of such cases is usually framed in terms of so-called comfort care. “The medical world has given up on these people,” Langer says.菲利普斯提出,或许她们应当从被认为治愈希望较大的早期癌症着手,但兰格的态度很坚决:必须是一种死亡率较高、常见、传统的西方医学束手无策的癌症。最后,她选择了4期转移性乳腺癌。此类病例的治疗通常被框定于所谓“舒适护理”的范畴。兰格说:“医学界已经放弃了这些患者。”The study, which is planned for the spring, is designed to include three groups of 24 women with Stage 4 breast cancer who are in stable condition and undergoing hormonal therapy. Two groups will gather at resorts in San Miguel de Allende, Mexico, under the supervision of Langer and her staff. The experimental group will live for a week in surroundings that evoke 2003, a date when all the women were healthy and hopeful, living without a mortal threat hanging over them. They will be told to try to inhabit their former selves. Few clues of the present day will be visible inside the resorts or, for that matter, outside them. In the living areas, turn-of-the-millennium magazines will be lying around, as will DVDs of films like “Titanic” and “The Big Lebowski.” San Miguel de Allende, which has historically been a place known for its nearby healing mineral springs, is a Unesco World Heritage Site, and many of its buildings look as they did a few hundred years ago. “The whole town is a time capsule,” Langer says. (The other group at San Miguel will have the support of fellow cancer patients but will not live in the past; a third group will not experience any research intervention.)该研究计划将在春季开展,设计招募三组患有4期乳腺癌、病情稳定且正在接受激素治疗的妇女,每组24人。其中两个组将在墨西哥圣米格尔德阿连德的度假胜地集合,接受兰格和她手下研究人员的监管。实验组将“穿越”回2003年——也就是她们仍然身体健康,人生尚未被死亡阴影笼罩,对未来充满憧憬的年代——在这样的环境中生活一周。她们将被告知尽量做回当年的自己。度假区内部不会出现任何与当下有关的东西(就此而言,度假区外也将是这样)。生活区里摆放的将是世纪之交之时的杂志,还有《泰坦尼克号》(Titanic)和《谋杀绿脚趾》(The Big Lebowski)等电影DVD。圣米格尔德阿连德素以其附近具有神秘治愈能力的矿物温泉而著称,被联合国教科文组织列为世界遗产(Unesco World Heritage Site),这里的许多建筑看起来与几百年前一样。兰格说:“该镇宛如一个时间胶囊。”(圣米格尔的另一组受试者将得到癌症病友的持,但不会穿越回过去;第三组则不会受到任何研究干预。)As with the original counterclockwise experiment, subjects will be tested before and after on relevant measures — in this case the size of their tumors and the levels of circulating proteins in their blood known to be made by cancer cells — in addition to variables like mood and energy and pain levels. The experimental group will bring with them the same kinds of primes that the New Hampshire men did, like photographs of their younger selves. “We won’t make them haul their bags up the stairs,” Langer says. But otherwise they will be nudged to do all they can for themselves.与最初的“逆时针”实验一样,受试者在实验前后会接受相关指标的检测,这一次主要检测的是肿瘤的大小和血液中已知由癌细胞产生的循环蛋白的水平,此外还有情绪、精力以及疼痛程度等变量。实验组还会像当年新罕布什尔州实验的参与者那样,携带一些帮助营造当年氛围的触发刺激,如自己年轻时的照片。“我们不会要求她们自己把行李搬上楼,”兰格说,但在其他方面会鼓励她们尽可能自立。The staff will encourage the women to think anew about their circumstances in an attempt to purge any negative messages they have absorbed during their passage through in the medical system. This is crucial, Langer says, because just as the mind can make things better, it can also make things worse. The nocebo effect is the flip side of the more positive placebo effect, and she says that one of the most pernicious nocebo effects can occur when a patient is informed by her doctor that she is ill. The diagnosis itself, Langer says, primes the symptoms the patient expects to feel. “You change a word here or there, and you get vastly different results,” Langer says. She told me about a yet-to-be-published study she did in 2010 that found that breast-cancer survivors who described themselves as “in remission” were less functional and showed poorer general health and more pain than subjects who considered themselves “cured.”研究人员将鼓励这些妇女换一种方式思考自己的处境,力求摒弃她们之前在医疗系统接受治疗期间吸收的负面信息。兰格表示,这一点至关重要,因为正如心态可以让事情向更好的方向发展,它也可能使事情变得更糟。反安慰剂效应是更为积极的安慰剂效应的另一面。兰格称,最糟糕的反安慰剂效应之一可能发生在患者从医生那里得知自己患病的消息时。兰格说,诊断本身就是患者预期自己将会感受到的种种症状的触发刺激。“如果你在这里或那里换一个词,结果可能截然不同,”她表示。她向我介绍了一项她在2010年进行、但尚未发表的研究。该研究发现,与自认为已经“治愈”的乳腺癌幸存者相比,那些认为自己“处于缓解期”的患者身体功能和整体健康状况都较差,还往往感到更加疼痛。So there will be no talk of cancer “victims,” nor anyone “fighting” a “chronic” disease. “When you’re saying ‘fighting,’ you’re aly acknowledging the adversary is very powerful,” Langer says. ; ‘Chronic’ is understood as ‘uncontrollable’ — and that’s not something anyone can know.”因此,实验中将不会提到癌症“受害者”,或者与“慢性”疾病“战斗”。“当你使用‘战斗’这个词时,你已经承认了对手非常强大,”兰格表示。“而‘慢性’往往被理解为‘无法控制’——这不是可以让受试者知道的事情。”Of course, the subjects hope to get better, and everything about the setup is nudging them in that direction. So the study becomes a kind of open placebo experiment. Langer has long believed it’s possible to get people to gin up positive effects in their own body — in effect, to decide to get well. Last fall, she tested that proposition, but in reverse: She recruited a number of healthy test subjects and gave them the mission to make themselves unwell. The subjects watched s of people coughing and sneezing. There were tissues around and those in the experimental group were encouraged to act as if they had a cold. No deception was involved: The subjects weren’t misled, for example, into thinking they were being put into a germ chamber or anything like that. This was explicitly a test to see if they could voluntarily change their immune systems in measurable ways.每个受试者当然都希望自己好转,整个实验的设计都是为了鼓励她们进入好转的轨道。因此,可以说这项研究是某种公开的安慰剂实验。长期以来,兰格一直相信,有可能让人们激发自己体内的积极效应,换句话说就是“决定”让自己好起来。去年秋天,她从反面对这个命题进行了测试:她招募了一批健康的受试者,并交给他们一个任务:让自己感觉不舒。受试者们观看了人们咳嗽和打喷嚏的视频,周围放了很多纸巾,研究人员鼓励实验组像感冒时那样行为。这项实验没有任何欺骗成分:比如受试者没有受到误导,以为自己身处病菌室之类。这是一场明确的试验,目的是看看他们能否以可衡量的方式从主观上改变自己的免疫系统。In the study, which is ongoing, 40 percent of the experimental group reported cold symptoms following the experiment, while 10 percent of those in control group did. Buoyed, Langer ordered further analysis, looking for more concrete proof that they actually caught colds by testing their saliva for the IgA antibody, a sign of elevated immune-system response. In February, the results came in. All of the experimental subjects who had reported cold symptoms showed high levels of the IgA antibody.在这项仍在进行的研究中,40%的实验组受试者报告在实验后出现感冒症状,而对照组中仅有10%的人报告感冒症状。这一结果令兰格大受鼓舞。她要求进行进一步的分析,通过检测受试者唾液中的IgA抗体水平(免疫系统反应升高的表征),寻找他们确实患了感冒的更确凿据。今年2月,结果出来了。报告出现感冒症状的所有受试者的IgA抗体水平都较高。Placebo effects have aly been proven to work on the immune system. But this study could show for the first time that they work in a different way — that is, through an act of will. “As far as we know today, the placebo responses in the immune system are attributable to unconscious classical conditioning,” says the Italian neuroscientist Fabrizio Benedetti, a leading expert in placebo effects. In Benedetti’s experiments, a suggestion planted in the minds of test subjects produced physiological changes directly, the way a dinner bell might goose the salivary glands of a dog. (In one study, healthy volunteers given a placebo — a suggestion that any pain they experienced was actually beneficial to their bodies — were found to produce higher levels of natural painkillers.) “There’s no evidence that expectations play a role as well,” Benedetti says. Langer plans to further analyze the subjects’ saliva to see whether they actually have the rhinovirus and not just elevated IgA.此前已经实安慰剂效应可作用于免疫系统。但这项研究可能首次展示这种效应以一种不同的方式(即一种意志行为)发挥作用。安慰剂效应的权威专家、意大利神经学家法布里齐奥·贝内代蒂(Fabrizio Benedetti)表示:“据我们目前所知,免疫系统中的安慰剂反应可归因于无意识的经典条件反射。”在贝内代蒂的实验中,植入受试者思维中的心理暗示直接引起了生理反应,就像晚餐铃引发的唾液腺分泌一样。(在一项研究中,健康的志愿者得到这样一种安慰剂:一种心理暗示,让他们以为自己所经受的任何疼痛其实都有益于身体健康。结果,他们体内产生的天然镇痛剂水平有所提高。)贝内代蒂指出:“尚无据表明预期也能发挥作用。”现在,兰格计划进一步分析受试者的唾液,看其中是否确实存在鼻病毒,而不只是偏高的IgA抗体水平。The implications of the open placebo — that is, we know the sugar pill is just a sugar pill, but it still works as medicine — are tantalizing. If placebo effects can be harnessed without deception, it would remove many of the ethical issues that surround placebo work. In a study published in the journal Plos One in 2010, Ted Kaptchuk, a professor of medicine at Harvard Medical School, and his colleagues administered a placebo labeled “placebo” to a test group of patients suffering from irritable bowel syndrome. Their symptoms declined significantly as compared with a no-treatment control group. “At some level everybody realizes they themselves are the placebo,” Langer says.公开安慰剂(即我们知道自己用的只是糖丸,但它还是会产生药物的效果)的潜在影响是十分诱人的。如果无需欺骗就能收到安慰剂的效果,困扰安慰剂研究的很多伦理问题将不复存在。在2010年发表于《公共科学图书馆期刊》(PLOS One)的一项研究中,哈佛医学院教授特德·卡普特查克(Ted Kaptchuk)及其同事们给予患有肠易激综合征的试验组患者标有“安慰剂”字样的安慰剂。与无治疗的对照组相比,他们的症状显著减轻了。兰格说:“在某种程度上,每个人都意识到自己就是安慰剂。”Langer’s cancer study has had to clear the hurdles of three human-subjects ethics boards — one from Mexico, one from Harvard’s psychology department and, for a time, one from the University of Southern California’s medical school, where until recently Debu Tripathy, an oncologist who is recruiting subjects for Langer’s study, was a professor of medicine. In June, progress stalled when the board at U.S.C. asked that the language be tweaked. “There’s so much stuff that’s totally outrageous in this world,” Langer told me at the time. “They want me to add a consent form for the people to sign saying there’s no known benefit to them. But that just introduces a nocebo effect!” (The study now has to clear the ethics board at the University of Texas M.D. Anderson Cancer Center in Houston, where Tripathy presently works.)兰格的癌症研究在启动之前必须得到三个人类受试者伦理委员会的批准。这三个机构一个位于墨西哥,一个位于哈佛大学心理学系,南加州大学(University of Southern California, U.S.C.)医学院一度也是其中之一,为兰格的研究招募受试者的肿瘤学家德布·崔帕蒂(Debu Tripathy)直到不久前一直是那里的医学教授。今年6月,当南加州大学的委员会要求他们对所用的语言“稍加改进”后,该项目陷入了停滞。“实验的很多内容对这个世界是离谱的,”当时兰格对我表示。“他们要我增加一份同意书,让受试者签字声明:他们知道该实验对他们没有任何已知的益处。但是,这恰恰引入了一个反安慰剂效应!”(目前该研究需要得到位于休斯敦的得州大学安德森癌症中心[University of Texas M.D. Anderson Cancer Center]的伦理委员会的批准,崔帕蒂现在在那里工作。)Like the men in New Hampshire, Langer’s cancer patients in San Miguel will pass a richly diverting week. In this case, art classes, cooking classes and writing classes will help distract them from the brute d of their circumstances and re-engage them in life. The terror of late-stage cancer can be as debilitating as the physical reality, Tripathy says. Some sufferers, he says, show symptoms akin to PTSD. There’s strong evidence that the support of other people boosts the quality of life for cancer patients. There’s less evidence that it improves their health prospects.就像新罕布什尔州研究中的老人那样,兰格的圣米格尔研究中的癌症患者也将度过精纷呈的一周。这一次将开设美术课、烹饪课和写作课,帮助她们分散对自己病情的极度恐惧,重新投入生活。崔帕蒂表示,像身体现实那样,对晚期癌症的恐惧本身也可能削弱患者的能力。他说,有些患者表现出类似于创伤后应激障碍(PTSD)的症状。目前已经有强有力的据表明,其他人的持可大大提高癌症患者的生活质量,但这种持能够改善患者健康前景的据相对较少。I asked Tripathy whether there’s any precedent for what Langer is trying to do. “Well, there are many examples in medicine where improvement in the emotional state seems also to bring about some improvement in the disease state,” he said. “We know, for example, that Tibetan monks can meditate and lower their blood pressure. People with hypertension, they embark on behavioral changes, and you can see the improvement in the medical indexes, like fewer heart attacks. But cancer? That’s a harder thing to fathom.”我向崔帕蒂请教兰格试图进行的研究有没有任何先例。“嗯,医学上情绪状态的改善似乎带来病情改善的例子还挺不少的,”他说。“例如,我们知道,西藏僧侣可以通过打坐冥想降低血压。高血压患者在做出行为改变后,医学指标会有所改善,比如,心脏病发作减少了。至于癌症,那就更难说清楚了。”Positive psychology doesn’t have a great track record as a way to fight cancer. Indeed, when James Coyne and colleagues followed 1,093 people with advanced head-and-neck cancer over nine years, they found even the most optimistic subjects lived no longer than the most pessimistic ones.积极心理学在对付癌症方面的记录并不太好。的确,詹姆斯·科因和他的同事曾经对1093名晚期头颈癌患者进行长达九年的随访,结果发现,即使是最乐观的受试者也并不比最悲观者活得长。Some cancer patients respond to interventions better than others, Tripathy notes. “But even with high-dose chemotherapy, you rarely see ‘complete response,’ which is total disappearance” of advanced breast cancer. “So if we saw anything like that, boy, that would hit the medical journals in a hurry.”崔帕蒂指出,有些癌症患者对干预的反应好于其他人。“不过,即使是使用大剂量化疗,你也很少能看到‘完全反应’,即(晚期乳腺癌)完全消失……所以,如果我们能看到那样的结果,那很快会在医学期刊上引起轰动。”One day in Puerto Vallarta in February, Langer sat on the patio of her hillside home. An iguana the length of a celery rib scooted across a high railing, and the dogs went bananas. “That’s Ada,” Langer said. “Or is it Ida? There are two — it’s hard to tell them apart.” When the iguanas first appeared and began devouring the hibiscus, Langer was startled. Now she and Nancy feed them petals for lunch. “That’s the way it is,” she said. “You can be scared. You give it a name, and then it’s a pet.”2月的一天,兰格坐在她位于巴亚尔塔港的山景房的露台上。一条有芹菜茎那么长的鬣鳞蜥飞快地翻越了高高的栏杆,几只狂躁不已。“这是埃达,”兰格说。“是艾达吗?它们有两个,很难分得清。”当鬣鳞蜥第一次出现,并开始狼吞虎咽地吃芙蓉花时,兰格吓了一跳。现在,她和南希自在地把花瓣喂给它们吃。“事情就是这样的,”她说。“你可能会害怕。你也可以给它取个名字,让它变成一只宠物。”Langer peered out over the deep blue sea, in the direction of a lagoon, where early in her career she conducted experiments on whether dolphins were more likely to want to swim with mindful people. In the last few days, she had been exchanging emails with a writer who wanted to come stay with her for a couple of weeks, taking notes for a screenplay for a Hollywood biopic.兰格凝视着环礁湖方向上深蓝色的大海,在她的职业生涯早期,她曾做实验研究海豚是否更愿意跟处于正念状态的人一起游泳。在过去的几天里,她在与一位作家互通电子邮件,那人想要和她一起待上一两个星期,为一部好莱坞传记片的剧本采集素材。Langer told me that she chose San Miguel for her new counterclockwise study primarily because the town had made “an offer I couldn’t refuse.” A group of local businesspeople, convinced of the value of having Langer’s name attached to San Miguel, arranged for lodging to be made available free to Langer. They also encouraged her to build a Langer Mindfulness Institute, which will take part in research and run retreats. (A local developer donated a beautiful casa, next to his Nick Faldo-designed golf course, to serve as staff quarters for the institute.) Starting sometime next year, adults will be able to sign up for a paid, weeklong counterclockwise experience, presumably with a chance at some of the same rejuvenative benefits the New Hampshire test subjects enjoyed.兰格告诉我,她选择在圣米格尔进行新的“逆时针”研究,主要是因为该镇提供的优厚条件让她“无法拒绝”。一群当地商人深信将兰格的名字与圣米格尔联系在一起将很有价值,于是他们为兰格的实验安排了免费住宿。他们还鼓励她建设一座兰格正念研究所(Langer Mindfulness Institute),既开展研究,又运营静思休养之地。(当地的一位开发商还捐赠给她一栋精美的城堡,用作研究所员工的宿舍,这座城堡位于他那由尼克·佛度[Nick Faldo,英国职业高尔夫球手]设计的高尔夫球场旁边。)从明年的某个时候开始,成年人将可以报名参加为期一周的“逆时针”付费体验,想必将和新罕布什尔州实验的受试者们一样,有机会享受某些返老还童的益处。Langer says she is in conversation with health and business organizations in Australia about establishing another research facility that would also accept paying customers, who will learn to become more mindful through a variety of cognitive-behavioral techniques and exercises. She has aly opened a mindfulness institute in Bangalore, India, where researchers are undertaking a study to look at whether mindfulness can stem the sp of prostate cancer.兰格说,她也正在与澳大利亚的一些保健和商业组织商谈建立第二家研究机构,该机构也将接受付费客户,他们将通过多种认知行为技巧和练习来学习变得更加专注。她已经在印度班加罗尔开设了一家正念研究所,那里的研究人员正在进行一项研究,探讨正念能否阻止前列腺癌的扩散。Langer makes no apologies for the paid retreats, nor for what will be their steep price. (This, too, is calculated: In the absence of other cues, people tend to place disproportionate value on things that cost more. Dan Ariely, a psychologist at Duke, and his colleagues found that pricier placebos were more effective than cheap ones.) To my question of whether such a nakedly commercial venture will undermine her academic credibility, Langer rolled her eyes a bit. “Look, I’m not 40 years old. I’ve paid my dues, and there’s nothing wrong with making this more widely available to people, since I deeply believe it.”兰格不认为这种静养机构将会收费,而且价格高昂有什么错。(这一点其实也是经过盘算的:在缺乏其他暗示的情况下,人们倾向于超出比例地注重比较昂贵的东西。杜克大学[Duke]心理学家丹·艾瑞里[Dan Ariely]及其同事们发现,价格较高的安慰剂比便宜安慰剂更有效。)我问她,此类明显商业化的项目会不会削弱她的学术可信度?兰格微微转了转她的眼睛。“你看,我不是40岁的人了。我已经做出了自己该做的贡献,再说,将它推广给更多的人并没有什么不妥,因为我深信它一定有效。”Medical colleagues have asked Langer if she is setting herself up to fail with the cancer study — and perhaps underappreciating the potential setbacks to her work. It’s also possible that subjects who don’t improve could feel more demoralized by the experience. In her memoir, “Bright-sided,” the journalist Barbara Ehrenreich wrote scorchingly about the sunshine brigade that bombarded her with “positive thinking” as she suffered through breast cancer. Under those conditions, patients who don’t get better might feel as if they themselves were somehow to blame.医学界的同事们问兰格,她这项癌症研究会不会弄巧成拙,害自己栽个跟头?或许她低估了自己一辈子的研究成果因此遭遇挫折的潜在风险?还有一个可能性是,病情没能好转的受试者因这一体验而更加意志消沉。记者芭芭拉·埃伦赖希(Barbara Ehrenreich)在她的回忆录《失控的正向思考》(Bright-sided)中,尖锐地批评了当她身患乳腺癌时,各路“阳光族”向她狂轰滥炸“积极思维”。在那种情况下,病情未见起色的患者会觉得仿佛是自己做错了什么。After a lecture in 2010, in which she’d discussed how when we talk about “fighting” cancer we actually give the disease power, a man buttonholed Langer and laid into her. His wife had died of breast cancer. “He said she had fought it, and I made it seem that it was her fault,” Langer told me.2010年,兰格在一个讲座上谈到,当我们说“与癌症战斗”的时候,我们实际上赋予了疾病威力。讲座结束后,一名男子拦住了她,劈头痛斥了她的观点。原来他的妻子死于乳腺癌。“他说她一直在与病魔抗争,而按照我的说法,似乎这全是她的错,”兰格向我转述道。Langer apologized to the man. “Those are good points, and I’m sorry I didn’t address them,” she said. “But let me explain to you that it’s the culture that teaches us that we have no control. I’m not blaming your wife; I’m blaming the culture.” Langer imagines a day when blame isn’t the first thing people reach for when things go awry. Instead, we will simply bring to bear the power of our own minds — which she believes will turn out to be far greater than we imagined.兰格向那名先生道了歉。“你说的这些都很有道理,我很抱歉我没有应对这些问题,”她说。“但请让我解释,是文化让我们觉得自己无能为力。我并没有埋怨你的妻子;我只是在谴责这种文化。”兰格梦想着有那么一天,当事情出错时,人们最先做出的反应不是责备。相反,我们将只是充分发挥自己的思维威力——她相信,这力量将比我们所想像的大得多。 /201501/351627广东人民医院几点下班 Some of us feel well-rested after a solid eight hours of sleep. For others, closer to nine feels best. For others still, a little less will do. How much sleep we prefer to get is highly subjective -- but how much sleep we need is a bit more concrete.我们中的一些人,睡足了8个小时后觉得无比神清气爽。对于另一些人来说,睡差不多9个小时为最佳。还有一些人,稍微不足这点时间刚刚好。我们更愿意睡多久是非常主观的——但是我们需要多少睡眠就是有那么一点具体有形的了。After web analytics showed the vast popularity of the How Much Sleep Do We Really Need? feature of the National Sleep Foundation#39;s (NSF) website, a panel of experts set about to reassure that the information provided there was the most accurate and up to date.网络分析显示,由国家睡眠基金会网站发起的“我们到底需要睡多久”非常受欢迎,并且专家组开始着手确定上面提供的信息,它们是最为精确的,而且是最新的数据。To do so, a panel of six sleep experts and 12 other medical experts from organizations including the American Academy of Pediatrics, the American Geriatrics Society, the American Psychiatric Association and the Society for Research in Human Development, conducted a formal literature review. The panel focused on the body of research surrounding sleep duration in healthy human subjects that had been published in peer-reviewed journals between 2004 and 2014. From the 312 articles reviewed, the experts were able to fine-tune existing sleep duration recommendations as detailed below:专家组来自美国儿科学会、美国老年医学会、美国精神医学学会、人类社会发展研究这些组织的6名睡眠专家和另外12位医学专家,拟定了一份正式的文献综述。专家组专注于2004年到2014间发表的同行评议学术期刊上,健康人体的睡眠时间议题。从312篇的文献综述中,专家们得以调整已有的睡眠时长推荐,归结具体如下。Newborns (0-3 months): 14-17 hours新生儿(0-3个月):14-17个小时Infants (4-11 months): 12-15 hours婴儿(4-11个月):12-15小时Toddlers (1-2 years): 11-14 hours刚学会走路的孩子(1-2岁):11-14个小时Preschoolers (3-5): 10-13 hours学龄前儿童(3-5岁):10-13个小时School-Age Children (6-13): 9-11 hours学龄儿童(6-13岁):9-11个小时Teenagers (14-17): 8-10 hours青少年(14-17岁):8-10个小时Young Adults (18-25): 7-9 hours青壮年(18-25岁):7-9个小时Adults (26-64): 7-9 hours成年人(26-64岁):7-9个小时Older Adults (65 ): 7-8 hours老年人(65岁以上):7-8个小时“This is the first time that any professional organization has developed age-specific recommended sleep durations based on a rigorous, systematic review of the world scientific literature relating sleep duration to health, performance and safety,” Charles A. Czeisler, Ph.D., M.D., professor of sleep medicine at Harvard Medical School and chairman of the board of the National Sleep Foundation, said in a statement.“这是第一次有专业的组织,拟写一份年龄划分的睡眠时长推荐表,其基于的是严谨的,系统的检阅全球关于健康、性能和安全考虑的睡眠时长科学文献,”查尔斯·A·斯勒医学士——哈佛医学院睡眠治疗的教授,同时也是国家睡眠基金会理事会的董事长在一份声明里说道。 /201503/362443花都妇幼保健院好不好

广州长安无痛人流要多少钱There are plenty of different ways to protect your car from theft, but one owner of a Volkswagen Transporter van decided to protect it in a novel way – by covering the new vehicle in rust-like vinyl to make it look like a hunk of junk!咱都知道要给汽车防盗的方法有很多。但是,一位大众T型车的车主却想到了一个神奇的办法 ——给车身贴上了生锈图案的乙烯膜,让车看起来如同一堆废铁。The artwork for the vinyl wrap, done by Clyde’s Wraps in Glasgow, involved taking exact measurements of the entire van。这一件乙烯膜作品来自格拉斯哥(苏格兰最大城市)的Clyde’s Wraps工作室。制作这样一副贴膜需要对整体车身进行测量。This allowed their artists to realistically model rust as if it had been formed by water running down from the vehicle’s handles, mirrors and frames。这样,艺术家们就可以逼真地模拟出生锈的效果,就像是通过水从把手,反光镜,窗框流下所形成的锈迹。“It only took 3 days for the police to pull him over to ask what was going on with all the rust,” Clyde’s Wraps write on their website. “Please note that there is nothing illegal about going to town with graphics on your vehicle but it may confuse others!”“车子上路后仅仅3天时间,警察就在路上把车拦了下来,询问这车子为何锈迹斑斑。” Clyde’s Wraps的官网上这样写道。“请注意,在车身上放一些图案不违法,但是的确会对他人形成一定的困扰。”That’s true, but in this case, it seems like that was exactly the point – and it worked!这个说法没错。但在这件事上,却恰恰达到了目的 —— 真的起到了迷惑作用! /201507/384147广州市做无痛人流哪里医院好 As South Korea struggles to contain an outbreak of Middle East respiratory syndrome that has infected close to 100 people, the country’s health care system has come under scrutiny. Experts have said that the MERS outbreak may have been fueled by a hospital system that encourages family members to take on nursing duties, reported Choe Sang-Hun, a New York Times correspondent based in Seoul.在韩国爆发的中东呼吸综合症已致近100人感染。在该国苦于遏制疫情之际,韩国的医疗系统受到了严格的检视。据时报驻首尔记者Choe Sang-Hun报道,专家称韩国的医疗系统鼓励家属承担护理病人的工作,或许助长了中东呼吸综合症的扩散。Responding on Facebook and in the comments section that accompanies the article, ers who either live or have spent time in South Korea shared their experiences of the hospitals there. Readers discussed how overcrowding and the obligations of relatives have affected them and their families. The responses have been edited and condensed for clarity.在Facebook和我们的文章板块中,居住在韩国或曾到访韩国的读者分享了他们在韩国医院中的经历。他们谈到了过度拥挤问题以及家属承担护理义务对他们和家人的影响。这些有些经过编辑,有些经过缩减,以便更加简洁明了。Twelve people and one sink十二个人一个水池I spent over three weeks in a hospital in Seoul, much of the time in a six-person room. Family members were indeed expected to perform many of the duties we would expect from nurses in the ed States. In fact every patient’s bed had a small brown cot underneath for a family member to sleep on. So in an average room at my hospital you could have up to 12 people sleeping in a room with one shared sink. It’s a crowd.我曾住在首尔的一家医院里,住了三个多星期,其中大部分时间在一个六人间里。病人家属被理所应当地认为应承担很多我们认为在美国护士会承担的工作。事实上,每个病人的病床下都附带一张供家属睡觉的棕色小床。在我住的这家医院,一间普通的病房里可能会睡着多达十二个人。水池只有一个,是共用的。的确很拥挤。— #48652;#47116;#46020;——#48652;#47116;#46020;Assistance from the maintenance man and Dad维修工和小孩爸爸的帮助My wife gave birth to our son in a hospital in South Korea. It was both charming and scary. After she got a C-section, she was transported to her room by the maintenance man (no mask, no scrubs, etc.). I was required to assist in moving her from the gurney to the bed. It wasn’t very graceful....我的妻子在首尔的一家医院生下了我们的孩子。这挺令人高兴,但也挺令人害怕的。在剖腹产后,她被维修工(没有面具,没有清洁等。)转移到自己的房间。我被要求帮忙把她从带有滑轮的运输床抬到她的病床上。这可不怎么优雅……— Steve Stimmel——斯蒂夫·斯提梅尔(Steve Stimmel)Lack of gloves, soap or paper towels缺手套、缺肥皂、缺纸巾I just spent three days in the hospital with my 10-month-old daughter. We paid for a double room so it was not overcrowded. However, I was responsible for all of my child’s care except for the administration of medicine via IV. This is typical. A family member is expected to stay with the patient to attend to all of his or her needs. Nurses do not do any of the personal care!我刚和十个月大的女儿在医院一起呆了三天。我们付的是双人间的钱,不太挤。不过,除了安排静脉注射的药品,照顾孩子的工作都是由我承担的。这很普遍。家属被认为应该陪在病人身边以满足他(她)所有的需要。护士不承担任何个人护理工作!None of the nurses or doctors ever wore gloves, ever. This includes the insertion of the IV and drawing blood. There was neither soap nor paper towels provided in the room’s bathroom. It was also not cleaned on a daily basis. In fact, I never saw it cleaned. I also didn’t see the nurses change the ear cover on the ear thermometer between patients. His illness was not severe, but I can see how the disease could easily sp here.没有一位护士或医生戴过手套,从来没有,包括静脉注射和抽血的时候。病房的卫生间里没有肥皂、没有纸巾,也没有人每天打扫。实际上,我从来见过卫生间干净过。我也没看到过护士更换病人交叉使用的耳温计上的耳套。虽然那个病人的病不严重,但我明白为什么疾病可以在这里轻易地传播了。— Amber Baila in Daegu, Korea——埃·拜拉(Amber Baila),韩国大邱Hygiene and overcrowding卫生不达标、过度拥挤Hygiene in hospitals in Korea is not what it should be. However, I think I can attribute this to overcrowding. I had a similar experience in a Chinese hospital, and when people are crowded, and you have to check nearly 200 patients a day, taking care of hygiene can be ignored due to exhaustion, etc.韩国医院的卫生水平不是它应该有的样子。不过,我觉得这和过度拥挤有关。我在中国的医院也有过类似的经历。在人员密集、每天需要察看近两百名病人的时候,注意环境卫生容易因为疲惫等等而被忽视。— Young Woo Kim——Young Woo KimNot enough personnel人手不足People go to the hospital even for very small things that can be handled by themselves. I am not saying typical cold or things as such, but just a discomfort makes you go and see the doctor. As a result, you don’t have enough personnel to handle all these patients and family members get involved. The problem here is that family members lack a sense of hygiene compared to those trained nurses. They break hospital regulations, and patients don’t abide by the rules.即便是患有可自行处理的一些小毛病,人们也会跑去医院。我不是在说典型性的感冒或者别的类似的毛病,而是仅仅有一丝不适人们就会跑去看医生。结果是,医院缺乏足够的人手应对全部的病人,家属只好参与其中了。问题是,和受过培训的护士相比,家属缺乏卫生意识。他们破坏医院的规章制度,病人也不遵守规定。— Young Woo Kim——Young Woo KimA referrals system is not unusual司空见惯的转院现象Getting referrals for admission into the bigger hospitals is neither a problem nor peculiarity for South Korea. Many developed countries adapt similar referrals system. In fact, the real problem would sit in the cultural background such as a lot of family members who are used to gathering to take care of or just visit the patients. They frequently and directly touch the patient without hand washing, and they return to their home via the mass transportation system.为了进入大医院而申请转院在韩国不成什么问题,也非常常见。许多发达国家采用了相似的转诊体系。实际上,真正的问题或许来自文化背景,例如家庭成员人数多,这些家属往往习惯了为照顾病人或仅仅是探望病人而聚集在一起。他们经常不洗手就直接接触病人,并搭乘大众交通工具回家。— Seok Joon Kwon——Seok Joon KwonMiserable work conditions护士糟糕的工作环境There are not enough trained nurses due to their miserable work conditions, payment that’s simply not enough to compensate that and also some social stereotype or atmosphere that regards nurses to be rather inferior than doctors. I heard in the ed States nurses are treated very differently, like real medical experts!护士的工作环境糟糕,收入也无法弥补这一点,而且社会上存在护士地位远比医生低的偏见和气氛,因为这些原因,受过训练的护士不足。我听说在美国,护士受到非常不同的待遇,他们像医学专家一样。— Hanbyul Kim——Hanbyul KimAffordable care for everyone人人负担得起基本医疗We in Korea have a great system that makes general care affordable for everyone, but it does mean there is some overcrowding and skimping on the attention that should be paid.在韩国,我们有一个很好的系统,因为它可以让每个人都负担得起基本的医疗务,不过这也的确意味着,存在过度拥挤和照顾不足的现象。Another thing is that the nurses in Korea don’t do much of the nurse work that you’d see in the ed States. When my grandfather had a stroke last year he was put in a single room with five other patients, and we had to bring in outside help to be at his bedside or else he would have been completely ignored.另一个是,在韩国,护士并不做很多你在美国看到的护士会做的事情。去年,我的祖父中风的时候,被与其他五名病人一起安排到一个单人间里,我们不得不从医院外部寻求帮助,带到他的床边,否则他就完全被无视了。— Seline Jung——Seline JungFast and reliable service快速、可靠I have had nothing but fast and reliable service from South Korean hospitals. I’d go so far as to say that their hospitals and clinics are generally much faster and more efficient at getting their patients to the correct specialist than many of their counterparts in the ed States.我在韩国的医院享受到的都是快速而可靠的务。我只能说,就把病人送到正确的专家那里而言,韩国的医院和诊所比美国的相应机构快捷而且有效率得多。— Andrew Robinson in Jeju-Do, South Korea——安德鲁·罗宾逊(Andrew Robinson),韩国济州岛Changes have been made已有改观The health care system here is excellent. In and out of the doctor’s office within 20 minutes with a bill under for consultation and prescription drugs. Even had orthopedic surgery with a four-day stay in the hospital here for 0. Not worried about MERS at the moment. Diseases sp in hospitals all the time. Nothing new. The difference here is that people were allowed to go home and move from place to place. But that’s not happening now.这里的医疗系统非常好。进出医生办公室的门也就20分钟,然后你就拥有了包含诊疗费和药费的账单,账单低于10美元。做一个整形手术并住院四天,在这里甚至也只要350美元。目前我还不担心中东呼吸综合症。疾病总是在医院里传播的。这并不新鲜。不同之处在于,人们过去被允许回家和在不同地方转来转去地就诊。现在不行了。— Michael Perez——迈克尔·佩雷斯(Michael Perez)A helpful landlord乐于助人的房东I spent two weeks in a hospital in South Korea. I had no family there so my landlord looked after me.我在一家韩国医院住过两周。我在韩国没有家属,是我的房东照顾了我。— Matthew Stroud——马修·斯特劳德(Matthew Stroud) /201506/380291广东省长安医院治疗阳痿多少钱

广州什么医院治疗宫颈糜烂HUE, Vietnam — This is a city of edifices and their ghosts.越南顺化——这座城市关乎建筑,以及与这些建筑有关的魂灵。Straddling the Perfume River in central Vietnam, Hue was the seat of the last imperial dynasty, and it has long been known for what the Nguyen emperors left behind: the imposing walled Citadel with its former palaces and pleasure gardens; the ornate royal tombs scattered across the verdant hills; and the wooden villas of their mandarins.顺化是最后一个王朝的都城所在之地,位于越南中部的香江从这里横穿而过。长期以来,它一直因为阮氏王朝的遗迹而闻名:围墙环绕的皇城庄严肃穆,里面是旧时的宫殿和宜人的花园;装饰华丽的皇家陵墓散落在翠绿的山坡各处;还有不少阮朝官员的木质别墅。These buildings have endured the infamous Hue weather — dank and misty and gray much of the year — and the brutality of modern armies. Some of the bloodiest urban combat the ed States Marines have ever faced took place in the Citadel during the 1968 Tet offensive, a battle depicted in Stanley Kubrick’s “Full Metal Jacket.”这些建筑经受住了顺化臭名昭著的天气——在这里,一年中的大部分时间都潮湿、雾气萦绕、灰蒙蒙的。它们也经受了现代军队的暴行,美国海军陆战队所面临的一些最血腥的城市战斗,就在1968年的春节攻势期间发生在皇城。斯坦利·库布里克(Stanley Kubrick)在《全金属外壳》(Full Metal Jacket)中呈现了这场战斗。The monuments have also withstood decades of rule by the Communist Party, despite being symbols of the feudal traditions the party was trying to exorcise from Vietnam.这些具有历史意义的建筑物还经受住了共产党数十年的统治,尽管它们代表着共产党试图从越南消除的封建传统。But what weather, war and ideology had not yet undone, a newer threat may: the economic boom that has been transforming the character of this central Vietnamese city of 340,000 people in recent years. Preservationists are struggling to ensure that officials, businesspeople and residents here properly protect Hue’s heritage.但那些并未被天气、战争和意识形态破坏的东西,可能会被一种新的威胁破坏。在这个位于越南中部,拥有34万人口的城市,近些年来经济的繁荣一直在改变城市的面貌。保育人士正艰难地确保当地官员、商人,以及居民保护顺化的文化遗产。A freeway now runs through hills facing the baroque tomb of Khai Dinh, a Nguyen emperor, compromising the tomb’s feng shui, or geomantic qualities. A tourist resort has been built along the Perfume, a languid, tree-lined waterway, and there is talk of apartment towers being erected within sight of the Citadel’s ramparts.如今,一条高速公路贯穿阮朝皇帝启定(Khai Dinh)巴洛克式皇陵对面的山丘,破坏了这座皇陵的风水。水流缓慢的香江沿岸绿树成荫,这里出现了一座度假村,有人在谈论要在离皇城城墙不远的地方建造公寓大楼。All the while, the city’s climate remains as persistent a threat as time.这个城市的气候也像时间一样,一直是一个持久的威胁。“The humidity makes it hard to restore,” said Truong Dinh Luat, 47, a Hue native, as he guided visitors around the Citadel on a recent morning. Bullet holes from 1968 still scarred some walls, and the rubble of fallen stonework lay in small piles in a few areas. “The workers have a tough job,” he said.“潮湿的空气使修复工作变得很困难,”47岁的当地居民张营律(Truong Dinh Luat)最近一天上午带着游客在皇城周围参观时说。他说,“工人们的工作很艰难。”一些墙壁上仍然能看到1968年留下的弹孔,一些地方还有倒塌石雕留下的成堆碎石。William Logan, a scholar of heritage and conservation at Deakin University in Australia, sounded an alarm over the challenges to preservation last October at a conference on wooden architecture here. He said that Hue’s monuments were at risk of losing the World Heritage Site status bestowed by Unesco, the ed Nations cultural agency.澳大利亚迪肯大学(Deakin University)遗产及保护学者威廉·洛根(William Logan)去年10月在顺化参加一场有关木质建筑的会议时对保护工作面临的挑战提出了警告。他表示,顺化的历史遗迹可能会失去联合国教科文组织(Unesco)授予的世界文化遗产的称号。“If the province fails to monitor and better manage its preservation of the monuments, the entire complex’s overall value will certainly be hugely undermined,” Professor Logan said, according to a report by Tuoi Tre News, a Vietnamese state-run newspaper.越南官方报纸《青年报》(Tuoi Tre News)报道称,洛根表示,“如果该省没能监督或更好地开展历史遗迹保护,整个遗迹的总价值肯定会遭到极大程度的损害。”Professor Logan expanded on his remarks in a telephone interview. “If the problems aren’t addressed, the World Heritage Committee can consider putting the property on the World Heritage Endangered List,” he said. “No country likes that. It’s a loss of face. It can impact negatively on tourism.”洛根教授在一次电话采访中进一步阐述了他的观点,“如果问题得不到处理,世界遗产委员会将考虑把当地的古迹列进濒危世界遗产名录”,他说,“那是任何一个国家都不想看到的。因为这是丢面子的事情,会对旅游业产生负面影响。”“Heritage is fairly low down on the list for governments — they all want development,” he added. “It’s hard to convince governments they can have heritage and development at the same time.”“文化遗产的问题对政府而言不是特别重要——他们都希望经济得到发展,”他还说,“很难让政府相信文物保护与经济发展两者之间并不相互冲突。”Tourism in Hue got a boost in 1993 when the city’s major sites were given World Heritage status. No other city in Vietnam is as boastful of this honor as Hue is. Signs outside the Citadel and the Nguyen royal tombs declare that last December, officials recognized the 30 millionth person to visit the city since the designation.1993年,这个城市的主要景点被授予了世界遗产称号,当地的旅游业得到了飞速的发展。与越南其他城市相比,没有哪一个城市比顺化更加强调这一荣誉的。皇城和阮朝皇家陵墓外的告示牌上写着,官方在去年12月宣布,这座城市迎来了自获得世界遗产称号以来的第30亿位游客。The Nguyen Dynasty made Hue its capital from 1802 to 1945. The Citadel was begun by one emperor, Gia Long, and completed 29 years later by his successor, Minh Mang, who was known in part for having had 142 children with scores of women. (Numbers vary, but some accounts say he had a total of 500 wives and concubines, kept in the Purple Forbidden City deep inside the Citadel.)阮朝从1802年至1945年间将顺化设立为都城。皇城的建造始于嘉隆皇帝,在其继任者明命皇帝在位时完工,历时29年。明命帝的一个出名事迹是和数十个女人(具体数字各方说法不一,也有说他在皇城深处的紫禁城内养着500名妻妾)生了142个子女。In lanes near the Citadel are nha ruong — wooden garden homes that once housed mandarins and other personalities of note — and more modern villas built late in the imperial period. Though not recognized as World Heritage Sites, those houses have their proud residents.皇城附近的街巷里有nha ruong——一种木结构花园住宅,曾经是官吏和其他显耀人士的宅邸——以及建造于帝国时代晚期的现代别墅。这些建筑虽然没有被确认为世界遗产,但是住在里面的居民以此为傲。“I still believe in the heritage of Hue,” said Hoang Xuan Bat, 83, as he sat in the dark living room of a European-style manor dating to 1910. “I respect its history, and want to tell foreigners about it when they visit, but I can’t speak English.”“我对顺化的文化遗产仍然有信心”,83岁的晃轩巴特(Hoang Xuan Bat)坐在一座建造于1910年的欧式庄园建筑的黑暗客厅里说。“我尊重它的历史,并且把它介绍给来此参观的外国人,但我不会说英语。”When it rains in Hue, which is often, some of the challenges to conservation become obvious. One wet morning in a throne room of the Citadel, pools of water collected on the floor in front of the gold-painted throne. More pools could be seen along a wood-planked hallway.雨水经常光顾顺化,一些文物保护的难题开始凸显。在一个下雨的早晨,皇城的一座大殿里,刷着金漆的宝座前的地面上有几处积水。铺着木板的走廊上还有更多积水。“Every time it rains, water comes down from the roof,” said Mr. Truong, the tour guide, whose father was a soldier for South Vietnam and was on home leave in Hue when the Tet offensive began. Mr. Truong said his father threw his uniform into the Perfume River to avoid repercussions as the North Vietnamese and Vietcong forces advanced, and then attached himself to the ed States Marines as an interpreter when they arrived to retake the city.“每次下雨时,都会有雨水从屋顶漏下来,”导游张庭选说。他的父亲曾是一名南越士兵,春节攻势开始时正回到顺化的家中休假,眼看北越和越共部队节节推进,父亲为避免麻烦把军扔进香江,当美国海军陆战队到达并夺回这座城市时,他做了一名随军翻译。Much of the Citadel was destroyed in the fighting, he said, but the former imperial library was not, so it was possible to restore it. Its interior has been given new wooden beams and doors, and construction workers were there during a recent visit, wearing masks and walking on a layer of sawdust.他说皇城有相当一部分毁于战火,但是前帝国图书馆却得以幸免,因此这是有可能被恢复的。在他最近的一次游览中看到,建筑内部已经重新安装了新的木梁和门,一群戴着口罩建筑工人走在一层木头碎屑上。Professor Logan said he was concerned that property developers might gain permission to build high-rise towers around the Citadel and other sensitive sites. He said nothing should be built there that extends above the treetop canopy.洛根教授说,他担心的是房地产开发商有可能取得环绕皇宫和其他敏感位置建造高楼的许可。他说在那里的建筑不应该高于树冠。At the request of the World Heritage Committee, the Hue Monuments Conservation Center, a government organization, is drafting a plan to improve conservation of the sites. Phan Thanh Hai, director of the conservation center, said that “Hue history may be the most impressive” in all of Vietnam because Hue was once the home of “many skillful craftsmen, famous poets and intellectuals.”在世界遗产委员会的要求之下,一家名为顺化古迹保护中心(Hue Monuments Conservation Center)的政府机构正在起草一项计划,旨在更好地保护古迹。中心主任潘清海(Phan Thanh Hai)说,由于曾经生活着“许许多多的能工巧匠,著名诗人和知识分子”,顺化也许是越南“最有历史底蕴的城市”。But he acknowledged that Hue’s monuments had suffered from “inappropriate management” around the historic sites, as well as “impacts from natural disaster, and from harmful insects, microorganisms as well as fungi on wooden components.”但他也承认,顺化历史遗迹周边的古迹遭受了“不恰当的管理”,此外还有“来自自然灾害、有害昆虫、微生物以及木构件上的真菌的不利影响”。Professor Logan has suggested that Vietnam try to nominate Hue for Unesco designation as a Cultural Landscape that would make a whole stretch of the city a protected site. Ideally, he said, the area would include a green wedge of land running southwest from the Citadel as well as the Perfume and the mausoleums in the south.洛根教授曾建议越南向联合国教科文组织提名顺化为文化景观(Cultural Landscape),这将使受保护的范围延伸至整个城市。在理想的情况下,他说,受保护的地区将会包括一块西南走向的绿色楔形区域,从皇城开始,沿着香江达到位于南部的陵墓群。“It’s the river that binds all the serial sites together,” he said. “Bodies were taken up and down the river to be buried.”“河流将这一系列古迹联系在了一起,”他说,“皇帝的遗体葬在河的沿岸各处。”Traditionally, an emperor who died would lie in state at the Citadel, and then would be carried by boat to a tomb that he would have had built during his lifetime. Some emperors even spent leisure time at the tombs they built, drinking wine and composing poetry. That was the case with Tu Duc, the fourth Nguyen emperor, whose tomb has a small lake with a wooden pavilion.传统上,逝世的皇帝将会先安置在皇城中供人瞻仰,然后用船运送至花费其一生时间所建造的陵墓。有的皇帝甚至会在为自己建造的陵园里度过其闲暇时间,在那里饮酒作诗。阮朝第四位皇帝嗣德就是这样,他的陵园里有一个小湖和一座木亭。Officials allowed a two-lane highway to be built toward Tu Duc’s tomb years ago, but construction was halted before it reached the mausoleum. The tomb remains intact, with a symbol made of glazed blue tiles on one wall that means “long life.”几年前官方批准了一条通往嗣德陵的双车道高速公路,但是路还没修到陵墓就停工了。陵园保存完好,其中一面墙上有用蓝色瓷砖拼成的符号,寓意“长寿”。 /201505/373687 Builders are hiring Portuguese bricklayers on #163;1,000 a week because not enough Britons can do the job.建筑商出每周1000镑雇佣葡萄牙砖瓦工,因为英国实在是缺少可用的人手。Skilled workers are in such short supply they can demand double the normal day rate of #163;100.技术娴熟的工人太稀缺了,他们可以要求每天100镑的工资翻倍。A month ago the Mail revealed that a similar labour shortage had forced the UK’s biggest sandwich manufacturer to recruit in Hungary because it could not fill its production line with local workers.一个月前,《每日邮报》报道了英国最大的三明治工厂劳动力短缺而到匈牙利去招聘,因为在当地没有足够的工人开启产品线。Portugal has become a hot spot for builders while energy firms are hiring Spanish engineers, according to James Hick of recruiters Manpower.据人力资源招聘处的詹姆斯·西克所说,能源公司正招聘西班牙工程师,而葡萄牙成为了建筑商的招聘热点。‘There is a severe shortage of skilled tradespeople in Britain – bricklayers, plumbers, electricians, mechanical engineers, HGV drivers,’ he added. ‘Where they were paying #163;500 a week at the beginning of the year, the demand for those skills means they are now paying #163;1,000 a week.“英国现在技术娴熟的工人严重稀缺——砖瓦工,水管工,电工,机械工程师,载重物货车司机,”他补充道。“在年初的时候他们还是500镑一周,现在技术需求已经让他们的工资涨到1000镑一周。”‘That pressure on skills is huge, particularly in the construction industry in the South East and London.’“技术压力是巨大的,尤其是在伦敦东南的建筑业。”He accused UK firms of halting training schemes in the downturn and being left short when construction picked up.他控诉英国公司在这种低迷期停止培训课程,而且在加快建设的时候人手不足。‘That is not something that can be resolved quickly, but companies need people who can work now, so they have had to put up pay and look elsewhere’, he added.“这不是可以马上解决的问题,但是公司需要马上能工作的人,所以他们只能提高薪水到别处找人,”他说。 /201503/362447佛山去哪间医院输精管复通广州人流价格哪里便宜

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