“荷兰假说”带给我们的启示——对哮喘和COPD认识的争论

1961年,Orie教授提出荷兰理论,认为哮喘与慢性阻塞性肺疾病(COPD)为同一病种而具有不同表现.而当前理论认为二者为独立疾病而有相似表现.争议持续至今已整整50年.哮喘与COPD的重叠现象一直让临床医生感到困惑,并带来临床的一些实际问题.我们期待更多的研究以及将来的指南给予更明确的阐述.     

老年COPD并发自发性气胸的临床分析

老年慢性阻塞性肺疾病（COPD）并发自发性气胸,起病隐匿,症状不典型,病情进展快,易引起严重的呼吸衰竭而危及生命,应引起重视。为探讨老年COPD并发自发性气胸的临床特点,现收集本院1995年～2004年此类患者共62例,分析报告如下。     

COPD病理机制的认识进展

慢性阻塞性肺疾病(COPD)是一个古老的疾病,构成人类严重的疾病负担。随着医学的进步,近50年COPD的概念不断演化,病因机制得到进一步的揭示,其中感染发挥重要作用,目前趋向性地认为COPD是一种多脏器的疾病,涉及肌肉功能障碍、营养不良、能量代谢异常等,同时也涉及严重的心理的紊乱。     

老年COPD并发自发性气胸的临床分析

老年慢性阻塞性肺疾病(COPD)并发自发性气胸,起病隐匿,症状不典型,病情进展快,易引起严重的呼吸衰竭而危及生命,应引起重视.为探讨老年COPD并发自发性气胸的临床特点,现收集本院1995年～2004年此类患者共62例,分析报告如下.     

COPD病理机制的认识进展

慢性阻塞性肺疾病(COPD)是一个古老的疾病,构成人类严重的疾病负担.随着医学的进步,近50年COPD的概念不断演化,病因机制得到进一步的揭示,其中感染发挥重要作用,目前趋向性地认为COPD是一种多脏器的疾病,涉及肌肉功能障碍、营养不良、能量代谢异常等,同时也涉及严重的心理的紊乱.     

吸烟与慢性阻塞性肺疾病基因易感性的辩证思考

慢性阻塞性肺疾病（COPD）是严重危害人们身体健康的疾病。吸烟是慢性阻塞性肺疾病主要的发病因素,然而。不是所有吸烟者都患有COPD,只有约加％发生。目前,许多研究表明,吸烟者发展为COPD患者与其基因易感性相关,综述了COPD的多种基因易感性,以期深入了解吸烟与COPD的关系,为COPD的预防和治疗提供依据。     

瘦素与慢性阻塞性肺疾病患者营养不良和呼吸肌疲劳的关系探讨

目前大量研究表明血清瘦素在慢性阻塞性肺疾病（COPD）患者营养不良病理生理机制中发挥重要作用,COPD患者多伴有呼吸肌疲劳,严重呼吸肌疲劳最终导致呼吸衰竭而危及生命,本文旨在综述瘦素、营养不良及呼吸肌疲劳之间的联系,以期从新的角度和细胞因子水平来探讨呼吸肌疲劳,为临床治疗呼吸肌疲劳,最终治疗呼吸衰竭提供新的方向。     

瘦素与慢性阻塞性肺疾病患者营养不良和呼吸肌疲劳的关系探讨

目前大量研究表明血清瘦素在慢性阻塞性肺疾病(COPD)患者营养不良病理生理机制中发挥重要作用,COPD患者多伴有呼吸肌疲劳,严重呼吸肌疲劳最终导致呼吸衰竭而危及生命,本文旨在综述瘦素、营养不良及呼吸肌疲劳之间的联系,以期从新的角度和细胞因子水平来探讨呼吸肌疲劳,为临床治疗呼吸肌疲劳,最终治疗呼吸衰竭提供新的方向.     

支气管哮喘诊断和治疗的哲学启示

1　支气管哮喘诊断和治疗的发展演化支气管哮喘 (Ｂｒｏｎｃｈｉａｌａｓｔｈｍａ)简称哮喘 (Ａｓｔｈ ｍａ) ,是一种古老的疾病 ,表现为反复发作性的气喘、胸闷、咳嗽、咳痰 ,可在短时间内自行缓解或经药物治疗而缓解 ,缓解时可完全恢复正常。早在 2 50 0～ 30 0 0年以前人们就已认识到气道阻力增高可以引起呼吸困难。但由于当时对本病的病因、病理缺乏认识 ,对本病的治疗只能是凭经验用一些简单的草药治疗。随着对呼吸系统的深入研究 ,对支气管哮喘的研究也有了很大的进展。 2 0世纪 50年代末至 70年代初 ,人们把支气管哮喘定义为 :发作性…     

用转化思维指导中西医治疗子宫内膜异位症

子宫内膜异位症为育龄妇女常见疑难疾病.本文在临床实践中,先分析目前中西医各自相关理论的局限,再分别采用对方的理论视角审视己方的观察结果,得出结论认为病因病机是机体全身适应性降低导致自身原有的生理因子表现为病理作用,在生殖系统即为内膜异位的各种病症,治疗原则均不应是单单拮抗相关的病理因子,而应该调和包括雌激素在内的各种因子以增强机体的适应能力,进而设计个体化的中西药治疗方案,进行分阶段、恢复生理节律为目的,精确调理生殖激素的治疗.     

A Review of Cognitive Behavioral Therapy for Panic Disorder in Patients with Chronic Obstructive Pulmonary Disease: The Rationale for Interoceptive Exposure

Panic disorder commonly co-occurs in patients with chronic obstructive pulmonary disease (COPD), and translational interventions are needed to address the fear of physiological arousal in this population. This paper examines the utility of interoceptive exposures (IE), a key component of cognitive behavioral therapy (CBT) for panic disorder, in patients with comorbid panic and COPD. Our translational review of the literature suggests that IE is supported by both cognitive- and learning-theory perspectives of panic, and that the breathing exercises associated with IE are safe and highly compatible with existing pulmonary rehabilitation exercises for COPD. Unfortunately, few research studies have examined the use of CBT to treat anxiety in COPD patients, and none have included IE. Given the strong theoretical and empirical support for the use of IE, we suggest that mental health providers should consider incorporating IE into CBT interventions for patients with comorbid panic and COPD.     

特应性皮炎与过敏进程

过敏性疾病已成为备受关注的社会问题,包括特应性皮炎、食物过敏、过敏性鼻炎、过敏性哮喘等,其发生和发展一直是学术界和社会公众高度关注的话题。变态反应症状可表现在皮肤、胃肠道、鼻腔、支气管等不同部位,流行病学研究发现各类过敏性疾病的出现呈现从儿童湿疹、食物过敏逐渐向过敏性鼻炎、过敏性哮喘发展的过程,婴儿或儿童早期出现的伴高IgE的特应性皮炎往往预示着未来会发生其他过敏性疾病,这种现象被称为变态反应性疾病的自然进程又称过敏进程,即“AllergyMarch”。本文就特应性皮炎与过敏进程的相关研究进行回顾与讨论,以期引起社会各界对特应性皮炎的重视。     

过敏性鼻炎和支气管哮喘治疗的统一性与整体观

过敏性鼻炎和支气管哮喘是常见的上下气道联合炎性疾病。尽管其治疗手段多样,效果良好,但由于目前对过敏性鼻炎的认识及重视程度不够,治疗现状并不乐观。从哲学上辩证统一的认识过敏性鼻炎和支气管哮喘的治疗,并以现代整体医学的观点分析两者的同一性,为临床实践中针对两者进行整体治疗提供理论依据。     

儿童支气管哮喘诊断的几点思考

支气管哮喘（以下简称哮喘）是小儿常见的慢性气道疾病。5岁及以下儿童哮喘的诊断极为困难,是富有挑战性的;因为诊断只能依靠临床判断、症状评价和体征分析。病毒感染所至的喘息在婴幼儿期很常见,与哮喘鉴别较困难。目前还没有诊断婴幼儿期哮喘的特异检测手段和方法,因此诊断需要综合考虑,包括反复喘息的类型、特异体质病史、哮喘危险因素、长期随访、广泛鉴别诊断和观察对支气管舒张剂及抗炎治疗的反应。     

Is artefactualness a value-relevant property of living things?

Artefacts are often regarded as being mere things that possess only instrumental value. In contrast, living entities (or some subset of them) are often regarded as possessing some form of intrinsic (or non-instrumental) value. Moreover, in some cases they are thought to possess such value precisely because they are natural (i.e., non-artefactual). However, living artefacts are certainly possible, and they may soon be actual. It is therefore necessary to consider whether such entities should be regarded as mere things (like most non-living artefacts) or as possessing intrinsic value (like many, if not all) living entities. That is, it is necessary to determine whether artefactualness is a value-relevant property with respect to the intrinsic value of living things.     

Kali's child and Krishna's lover: An anatomy of Ramakrishna's Caritas Divina

The famous 19th-century Bengali saint Shri Ramakrishna Paramahamsa has almost universally been regarded as a Shakta (sometimes confused with Tantrika) devotee of the Mother Goddess Kali. His association with the Kali temple at Daksineshvar, in the northern suburb of Calcutta, has no doubt been a powerful argument behind his Shakta/Tantrika affiliation. This paper argues that Ramakrishna was essentially a bhakta (devotee) in the Vaisnava tradition and his cultural and family inheritance. His idea of the divine and his career and logia as a priest and a saint provide ample justification to consider him essentially a Vaisnava whose spiritual battle-cry was to demand to have dalliance with God.     

Kali's child and Krishna's lover: An anatomy of Ramakrishna's Caritas Divina

The famous 19th‐century Bengali saint Shri Ramakrishna Paramahamsa has almost universally been regarded as a Shakta (sometimes confused with Tantrika) devotee of the Mother Goddess Kali. His association with the Kali temple at Daksineshvar, in the northern suburb of Calcutta, has no doubt been a powerful argument behind his Shakta/Tantrika affiliation. This paper argues that Ramakrishna was essentially a bhakta (devotee) in the Vaisnava tradition and his cultural and family inheritance. His idea of the divine and his career and logia as a priest and a saint provide ample justification to consider him essentially a Vaisnava whose spiritual battle‐cry was to demand to have dalliance with God.     

An approach to the study of determiners in early language development

The definite and indefinite articles (the and a) are usually regarded as being a contrastive system. Either the or a is required with a noun, depending on certain semantic and pragmatic considerations. Developmental research views the child as progressively attaining appropriate (adult) use of the two forms. However, both historical and recent developmental evidence indicates that the articles should be incorporated into a total system of determination, including both verbal and nonverbal determiners. A single experiment is described to show 3-year-old children's use of the articles (and other determiners). Several functions of the articles within the two conditions of the experimental context were elicited, as were other verbal (e.g., this, that) and nonverbal (e.g., a point) determiners. It is argued that instead of regarding the child's use of the articles as correct or incorrect, we should look at the form and function of those determiners used and omitted and consider why they are elicited.     

氟化物防龋引发的哲学思考

龋病被世界卫生组织(WHO)列为当代危害人类健康的三大非传染性疾病之一.氟化物可用于预防龋病已得到世界一直公认,但氟过量却可引起氟牙症、氟骨症等氟中毒性疾病,如何适度用氟一直是人们关心的问题.     

Emotion and adherence to treatment in people with asthma: An application of the emotional Stroop paradigm

This study explored whether an emotional Stroop paradigm might represent an appropriate means of assessing individuals' emotional representations of asthma. In addition, the opportunity was taken to investigate whether emotional representations of asthma, as assessed by this method, were associated with adherence to inhaled preventative medication. An asthma Stroop task was devised which comprised three sets of stimuli: asthma symptom words, general negative words, and neutral words. Three groups of participants were compared on their performance on this task: individuals with asthma, individuals without asthma, and individuals without asthma who had been primed about the condition. It was found that individuals with asthma experienced significantly more interference when colour‐naming the asthma symptom words, but not when colour‐naming the general negative words. Furthermore, their performance on the asthma Stroop task was associated with self‐reported adherence levels. Specifically, individuals who reported the highest and lowest levels of adherence displayed more interference when colour‐naming the asthma symptom words than individuals with intermediate levels of adherence. It is concluded that the emotional Stroop paradigm might provide an objective and sensitive means of assessing individuals’ emotional representations of illness. Additionally, it is proposed that emotional responses to illness should be assessed and included in research designed to explain health behaviours and, furthermore, that such research should not assume that any relationship between emotional representations and health behaviours will be linear.