自身抗体与疾病预测

研究显示,在一些自身免疫性疾病出现临床症状之前,患者血液内就会出现某些自身抗体,检测这些自身抗体可以预测机体日后的患病几率,在疾病的预防和控制等方面具有重要意义.本文将对部分疾病中预示性自身抗体的研究进展及用自身抗体预测疾病的价值和面临的挑战等问题作一综述.     

自身抗体检测新技术及其临床应用

自身抗体的检测在自身免疫性疾病（A ID ）的诊断,判断疾病的严重程度及评价疗效方面拥有十分重要的临床意义。随着免疫检测技术的进步,新的自身抗体特异性靶抗原被发现,自身抗体的检测技术也越来越多,出现如何评估自身抗体检测方法及诊断价值的新问题。本文介绍自身抗体检测的新技术及自身抗体检测技术的发展趋势,评估自身抗体检测方法应用现状,分析了临床自身抗体检测技术的优缺点,让临床实验室更加合理有效选择自身抗体检测技术。     

导言：应重视消化系统自身免疫性疾病的诊治

自身免疫性疾病是指机体对自身抗原发生免疫反应而导致自身组织或器官损害所引起的疾病。有10％的人一生可患有这样或那样的该类疾病。根据其发病器官和发病机制的不同分为：（1）器官特异性自身免疫性疾病,其特点为组织器官的病理损害和功能障碍仅限于抗体或致敏淋巴细胞所针对的某一器官,如溃疡性结肠炎（ulcera—tivecolitis,UC）、原发性胆汁性肝硬化（primarybiliarycirrhosis,PBC）等;（2）系统性自身免疫性疾病,     

天然自身抗体的研究及其哲学思考

天然自身抗体（NAA）是指在没有任何抗原主动免疫的情况下，正常机体内存在的针对一种或多种自身抗原的抗体，具有多种功能。自Landsteier提出正常人血清中存在NAA以来，人们对NA的认识由浅到深。有研究认为天然自身抗体的基本功能为调控正常机体的自身反应，维持免疫自稳态的平衡，阻止病理性自身免疫的发生。     

述评中国心理学思想史的研究动向

中国心理学思想史研究现已出现了四大新动向：对自身价值作新的探索、进一步完善方法系统、努力提高研究深度和注重古为今用等,章对它们一一作了简要的述评。     

天然自身抗体研究中的辩证思想

根据Ｂｕｒｎｅｔ的“克隆选择学说”(ｃｌｏｎａｌｓｅｌｅｃｔｉｏｎｔｈｅｏｒｙ) ,具有自身反应性的淋巴细胞克隆在胚胎发育过程中被清除 ,正常机体内不存在针对自身抗原成分的自身抗体 ;而体内一旦出现自身抗体 ,将导致自身免疫性疾病的发生。因此 ,自身抗体是病理性的 ,是“可怕的自身毒素 (ｈｏｒｒｏｒａｕｔｏｔｏｘｉｃｕｓ)”。但是目前大量的资料表明 ,正常健康个体的血清内确实广泛存在针对自身抗原成分的免疫球蛋白[1,2 ] ,即天然自身抗体 (ｎａｔｕｒａｌａｕｔｏａｎｔｉｂｏｄｙ ,ＮＡＡ) ;而且 ,ＮＡＡ种类繁多 ,甚至免疫…     

主体性和真理

这是福柯在法兰西学院的课程(1980-1981)提要.福柯毕生都在探讨主体如何进入真理游戏之中这个一以贯之的论题.创造主体性历史的方式,除了强制性实践在癫狂者与非癫狂者、病人与健康者、犯人与守法者之间作出的二分法,除了经验科学向活着的、讲着话的和劳动着的主体提供其位置以外,本文提出了第三种途径:自身的关切、自身的技术、自身对自身的管制.     

广义自身心理学人格发展理论述评

自身是人格的核心,其发展取决于个体遗传特征与自身对象环境的相互作用.如果自身对象人格健全,就能满足个体的自身对象需要,自身对象在满足个体自身对象需要方面不可避免的疏忽只会使个体遭受适度挫折,适度挫折促使个体通过变形性内化获得原来由自身对象为其行使的心理功能,从而形成自身结构.使自身--自身对象关系从原始走向成熟.广义自身心理学的人格发展理论超越了古典精神分析、自我心理学和对象关系理论的人格发展观,但过分强调早期自身对象关系对人格发展的决定作用,忽视个体遗传特征和社会文化因素对人格发展的影响.     

阿伦特的良心观——良心与自身关系

20世纪30年代兴起的极权主义导致欧洲全面的道德崩溃和良心危机,从根本上质疑了传统的良心观和道德信念。阿伦特以纳粹军官艾希曼为典型,分析了极权主义体制中的良心危机及个体原因。在此基础上,她重新审视良心概念,认为在道德中思考比良心更为根本。思考本质上是独在中的自我对话,以自身和谐为第一原则;它激活良心,使其发挥道德功能。在道德事务中,良心是人和自身的关系,意味着自身思考、自身判断和自身负责。阿伦特的自我学良心观强调个体自身在良好生活和道德中的主导地位与根本责任,捍卫了良心概念,有益于重塑道德信念。     

作为自身激发的时间和自身的时间特征

本文首先对康德在《纯粹理性批判》中提出的“时间”概念进行了存在论的解读,认为时间在其本质上是指它自身的纯粹激发,而作为纯粹的自身激发,它就构成了主体性自身的有限性本质。这就是说,作为纯粹的自身激发,时间只是一种有限的纯粹直观,而这种直观正是纯粹概念(知性概念)的基础。其次,本文还分析了有限自身的时间特征。由于这种时间特征原初作为预先发生的“前-构成”被包含在一切认同之中,所以,纯粹感性(时间)和纯粹理性都应被包含在这同一个本质的统一性之中,由于这个本质,才使得人的主体性在其整体性上的有限性成为可能。     

Cognitive and Emotional Abnormalities in Systemic Lupus Erythematosus: Evidence for Amygdala Dysfunction

Systemic lupus erythematosus (SLE) is a multi-system autoimmune disorder characterized by the production of autoantibodies. Approximately 30-50?% of patients produce autoantibodies directed against N-Methyl-D-aspartic acid receptors (NMDARs). Once they have gained access to brain tissue, these autoantibodies bind to the NR2A subunit of the NMDARs and synergize with glutamate to cause excitatory, non-inflammatory cell death or alter neuron function. Both humans with SLE and animal models of SLE have shown structural and functional damage to the amygdala. The amygdala is a brain region important for processing the emotional relevance of stimuli in the environment. It also serves to modulate perception, attention, and memory to facilitate the processing and learning of relevant stimuli. Research has linked amygdala damage to deficits in emotional memory and emotional behavior. Individuals with SLE often exhibit emotional dysregulation, such as lability and depression; however, the behavioral impact of possible amygdala dysfunction has yet to be studied in this population. The purpose of this review is to 1) examine possible associations between SLE, anti-NMDAR antibodies, amygdala damage, and emotional processing deficits and 2) to identify the clinical, social, and treatment implications for individuals with SLE who suffer from deficits in emotional processing.     

Affective and cognitive attitudes,uncertainty avoidance and intention to obtain genetic testing: An extension of the Theory of Planned Behaviour

To ensure successful implementation of genetic screening and counselling according to patients best interests, the attitudes and motives of the public are important to consider. The aim of this study was to apply a theoretical framework in order to investigate which individual and disease characteristics might facilitate the uptake of genetic testing. A questionnaire using an extended version of the Theory of Planned Behaviour was developed to assess the predictive value of affective and cognitive expected outcomes, subjective norms, perceived control and uncertainty avoidance on the intention to undergo genetic testing. In addition to these individual characteristics, the predictive power of two disease characteristics was investigated by systematically varying the diseases fatality and penetrance (i.e. the probability of getting ill in case one is a mutation carrier). This resulted in four versions of the questionnaire which was mailed to a random sample of 2400 Norwegians. Results showed genetic test interest to be quite high, and to vary depending on the characteristics of the disease, with participants preferring tests for highly penetrant diseases. The most important individual predictor was uncertainty avoidance.     

Affective and cognitive attitudes, uncertainty avoidance and intention to obtain genetic testing: an extension of the Theory of Planned Behaviour

To ensure successful implementation of genetic screening and counselling according to patients best interests, the attitudes and motives of the public are important to consider. The aim of this study was to apply a theoretical framework in order to investigate which individual and disease characteristics might facilitate the uptake of genetic testing. A questionnaire using an extended version of the Theory of Planned Behaviour was developed to assess the predictive value of affective and cognitive expected outcomes, subjective norms, perceived control and uncertainty avoidance on the intention to undergo genetic testing. In addition to these individual characteristics, the predictive power of two disease characteristics was investigated by systematically varying the diseases fatality and penetrance (i.e. the probability of getting ill in case one is a mutation carrier). This resulted in four versions of the questionnaire which was mailed to a random sample of 2400 Norwegians. Results showed genetic test interest to be quite high, and to vary depending on the characteristics of the disease, with participants preferring tests for highly penetrant diseases. The most important individual predictor was uncertainty avoidance.     

从进化观点看应激对健康的影响

从进化的观点解释了不同生物体应对应激的不同行为策略及其生理基础,和由此引起的对不同应激性疾病易感性的差异。行为策略和生理基础的差异使得一定环境条件下引发的应激反应对不同个体产生了不同的非稳态获益和代价（非稳态负荷)。非稳态的获益和代价影响了健康和疾病间的平衡：攻击性个体由于非稳态调质失调,更可能出现冲动控制障碍、高血压、自身免疫性疾病、慢性疲劳状态等;反之,非攻击性个体由于非稳调质过度释放,更易发生焦虑障碍、抑郁症、代谢综合症等     

Introduction to the special section on health and cognitive function.

Numerous factors related to health and diseases have been studied in relation to cognitive function. It has been shown that across the life span, systemic medical diseases can negatively impact cognitive function. Factors that influence the development of medical diseases, such as poor health habits, biological risk factors, hormones, genetic factors, exposure to environmental toxins, and certain treatments for disease, can also have an adverse effect on cognitive function. Conversely, factors such as high levels of education, good health habits, and some treatments for disease can be protective. Included in this special section are 6 empirical articles that examine the relation of health or disease to cognitive function.     

系统性红斑狼疮的感染现状及治疗决策

系统性红斑狼疮是一种侵及全身结缔组织的自身免疫性疾病,疾病本身就可以导致免疫力下降从而导致感染的发生,然而与此同时,治疗狼疮的药物(糖皮质激素和免疫抑制剂)及新型治疗方法更加大了感染的风险,其间的矛盾不言而喻,因此治疗上药物的取舍与剂量大小的选择显得尤为重要。     

The Confluence of Psychiatric Symptoms and Neurodegenerative Disease: Impact on Genetic Counseling

Hereditary neurodegenerative diseases can present with a psychiatric prodrome that overlaps with psychiatric symptoms that are not primary to these diseases. When individuals present for predictive testing while experiencing such symptoms, clinicians including genetic counselors, must proceed with caution and evaluate each situation on a case-by-case basis. Legitimate reasons may exist for moving forward with testing. Additionally predicting the consequences of testing is unrealistic so that the clinicians must do their best to prepare patients for both positive and negative results. A multidisciplinary team following the Huntington disease protocol remains the gold standard care for predictive testing for such patients. We discuss 3 case histories that demonstrate the complex nature of genetic counseling and testing in the presence of psychiatric symptoms, whether emanating from the disease itself or the results of living in an affected family.     

Handedness and immune function

Geschwind, Galaburda, and Behan (GBG) have suggested that in utero levels of testosterone influence both cerebral and immune system developments (Geschwind and Behan, 1982; Geschwind and Galaburda, 1984; Geschwind and Galaburda, 1985). According to this theory, high levels of testosterone result in greater incidences of left-handedness, deviations from standard distribution of cerebral functions (known as anomalous dominance), and increased autoimmune dysfunction. While the original data supported these assertions, more recent tests of the hypothesis have been equivocal. One criticism of these studies is that the definition of both handedness and anomalous dominance are too vague. It was one of the aims of this project to investigate and clarify the GBG model by examining four different aspects of handedness as well as a more direct measure of anomalous dominance. In order to extend the GBG model, degree of left-handedness, general immune system functioning, and current testosterone levels were also examined. First, it was predicted and found that left handers had a higher incidence of autoimmune diseases in their immediate families than did right handers. Second, those left handers with an incidence of at least one autoimmune disease were more strongly left-handed than were those with no incidence of autoimmunity. Finally, it was observed that higher testos terone levels were supportive of general immunity. The present findings both support and expand the GBG model.