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患者男，7岁，主“因遗尿4年，加重6个月”来诊。患儿平素易感冒，白天小便次数较多，夜间遗尿，每晚1~2次，呼之难醒，面色无华，食欲不振，大便溏薄。舌偏淡，脉缓细。查体：一般可，咽（-），心肺（-），腹软，肝脾未触及，外阴无包茎、无畸形。

结合该病例，叙述正确的是（）

A.应仔细询问病史

B.鼓励患儿消除怕羞和紧张情绪，建立起战胜疾病的信心

C.对患儿要耐心教育引导，切忌打骂、责罚，应重视突然发生的剧烈头痛

D.患儿白天玩耍勿过度，睡前避免饮水过多

E.夜间尿湿后要及时更换裤褥，保持干燥及外阴部清洁

F.针刺治疗可选用关元、中极、膀胱俞、三阴交

答案

参考答案：A, B, D, E, F

名词解释

学业成败的归因
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What’s your earliest memory Do you remember learning to walk The birth of a sibling Nursery school Adults rarely remember events from much before kindergarten, just as children younger than 3 or 4 seldom recall any specific experiences (as distinct from general knowledge). Psychologists have floated all sorts of explanations for this “childhood amnesia”. The reductionists appealed to the neurological, arguing that the hippocampus, the brain region responsible for forming memories, doesn’t mature until about the age of 2. But the reigning theory holds that since adults do not think like children, they cannot access childhood memories. Adults are struck with grown-up “schema”, the bare bones of narratives. (46)When they riffle through the mental filing cabinet in search of fragments of childhood memories to hang on this narrative skeleton, according to this theory, they don’t find any that fit. It’s like trying to find the French word in an English index.
Now psychologist Katherine Nelson of the City University of New York offers a new explanation for childhood amnesia. (47)She argues that children don’t even form lasting, long-term memories of personal experiences until they learn to use someone else’s description of those experiences to turn their own short-term, fleeting recollections into permanent memories. In other words, children have to talk about their experiences and hear others talk about them — hear Mom recount that days’ trip to the dinosaur museum, hear Dad re- member aloud their trip to the amusement park.
Why should memory depend so heavily on narrative Nelson marshals evidence that the mind structures remembrances that way. (48)Children whose mothers talk about the day’s activities as they wind down toward bedtime, for instance, remember more of the day’s special events than do children whose mothers don’t offer this novelistic framework. Talking about an event in a narrative way helps a child remember it. (49)And learning to structure memories as a long-running narrative, Nelson suggests, is the key to a permanent “autobiographical memory”, the specific remembrances that form one’s life story. (What you had for lunch yesterday isn’t part of it; what you ate on your first date with your future spouse may be.)
Language, of course, is the key to such a narrative. Children learn to engage in talk about the past. The establishment of these memories is related to the experience of talking to other people about them. (50)In particular, a child must recognize that a retelling — of that museum trip, say — is just the trip itself in another medium, that of speech rather than experience. That doesn’t happen until the child is perhaps four or five. By the time she’s ready for kindergarten she’ll remember all sorts of things. And she may even, by then, have learned’ not to blurt them out in public.
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