幽门螺杆菌根除治疗与胃癌预防

幽门螺杆菌感染是胃癌发生的重要危险因素,目前研究集中在根除幽门螺杆菌是否能预防胃癌的发生,以及胃早癌内镜切除术后给予预防性根除幽门螺杆菌治疗能否降低胃癌的复发率,本文将就胃癌预防与根除幽门螺杆菌治疗的相关文献作一分析。     

从幽门螺杆菌致病机制中看病因与病因推断中的辩证思维

幽门螺杆菌是定植于胃部的细菌,人群感染率高达50%以上,幽门螺杆菌感染是慢性胃炎、胃十二指肠溃疡和胃癌及胃黏膜相关淋巴瘤的重要病因,但对幽门螺杆菌的致病机制研究并不透彻,影响临床结局的因素有很多,除了幽门螺杆菌感染和其分泌的毒力因子外,宿主的基因易感性、细胞因子的多态性和环境饮食等也是主要原因。通过分析幽门螺杆菌与胃癌的因果关系,可以在认识论的基础上把握疾病的本质规律,指导疾病诊疗。     

幽门螺杆菌根除治疗与胃癌预防

幽门螺杆菌感染是胃癌发生的重要危险因素,目前研究集中在根除幽门螺杆菌是否能预防胃癌的发生,以及胃早癌内镜切除术后给予预防性根除幽门螺杆菌治疗能否降低胃癌的复发率,本文将就胃癌预防与根除幽门螺杆菌治疗的相关文献作一分析.     

幽门螺杆菌相关性胃炎的时空特征研究

研究幽门螺杆菌导致胃黏膜病理损伤表现的多样性与年龄的关系。进行胃镜检查的患者,排除其它脏器疾病,测定尿素酶表达程度,观察黏膜损伤情况并取病理。结果是不同程度尿素酶表达的幽门螺杆菌感染性胃炎表现不同的病理特征;年龄、幽门螺杆菌感染时间及生活事件是相互作用的原因。幽门螺杆菌特征性慢性感染过程及其致病方式使胃黏膜的病理变化有了多样性,高尿素酶表达的幽门螺杆菌引起的增生性病灶乃至隆起性病变的机会随年龄增加及胃黏膜的病理变化而增长。     

幽门螺杆菌相关性胃炎的时空特征研究

研究幽门螺杆菌导致胃黏膜病理损伤表现的多样性与年龄的关系.进行胃镜检查的患者,排除其它脏器疾病,测定尿素酶表达程度.观察黏膜损伤情况并取病理.结果是不同程度尿素酶表达的幽门螺杆菌感染性胃炎表现不同的病理特征;年龄、幽门螺杆菌感染时间及生活事件是相互作用的原因.幽门螺杆菌特征性慢性感染过程及其致病方式使胃黏膜的病理变化有了多样性,高尿素酶表达的幽门螺杆菌引起的增生性病灶乃至隆起性病变的机会随年龄增加及胃黏膜的病理变化而增长.     

诺贝尔医学奖与幽门螺杆菌

瑞典皇家科学院宣布了今年的化学、物理和医学诺贝尔奖获得者.获得医学奖的是两位澳大利亚科学家.他们因发现幽门螺杆菌而荻奖.就幽门螺杆菌的实验研究过程和临床应用作一简介.     

幽门螺杆菌感染与胃肠外疾病的关系

流行病学研究显示幽门螺杆菌可能与某些胃肠外疾病发生有关,根除治疗可能缓解缺铁性贫血、ITP、酒糟鼻等疾病的临床症状和实验室异常。从粥样硬化相关心血管疾病、血液系统疾病、皮肤病的研究结果看,尽管有证据显示该类疾病患者幽门螺杆菌感染率高于普通人群,但二者是因果还是伴随现象仍不得而知,同时尚无根除治疗远期效果的报道。对相关胃肠外疾病是否需要进行幽门螺杆菌检测和治疗尚无定论。鉴于流行病学研究的局限性和发病机制的不确定性,对二者关系应持慎重态度,避免对幽门螺杆菌检测和根除治疗的过度滥用。二者关系的阐明有待机制研究的进展。     

幽门螺杆菌感染的免疫防治

幽门螺杆菌感染与慢性胃炎、消化性溃疡、胃癌及胃黏膜相关性淋巴瘤有关。疫苗是防治幽门螺杆菌感染切实可行的方法。近年来新的防治和根除幽门螺杆菌感染的疫苗正在开发并取得了很大的进展。本综述结合本室研制Hp疫苗的研究基础,简要概述疫苗保护性抗原的筛选、黏膜免疫佐剂及接种途径、Hp疫苗的保护性免疫机制、Hp感染动物模型的建立及Hp疫苗人体临床试验等方面的研究进展。     

幽门螺杆菌感染的免疫防治

幽门螺杆菌感染与慢性胃炎、消化性溃疡、胃癌及胃黏膜相关性淋巴瘤有关.疫苗是防治幽门螺杆菌感染切实可行的方法.近年来新的防治和根除幽门螺杆菌感染的疫苗正在开发并取得了很大的进展.本综述结合本室研制Hp疫苗的研究基础,简要概述疫苗保护性抗原的筛选、黏膜免疫佐剂及接种途径、Hp疫苗的保护性免疫机制、Hp感染动物模型的建立及Hp疫苗人体临床试验等方面的研究进展.     

幽门螺杆菌感染与胃肠外疾病的关系

流行病学研究显示幽门螺杆菌可能与某些胃肠外疾病发生有关,根除治疗可能缓解缺铁性贫血、ITP、酒糟鼻等疾病的临床症状和实验室异常.从粥样硬化相关心血管疾病、血液系统疾病、皮肤病的研究结果看,尽管有证据显示该类疾病患者幽门螺杆菌感染率高于普通人群,但二者是因果还是伴随现象仍不得而知,同时尚无根除治疗远期效果的报道.对相关胃肠外疾病是否需要进行幽门螺杆菌检测和治疗尚无定论.鉴于流行病学研究的局限性和发病机制的不确定性,对二者关系应持慎重态度,避免对幽门螺杆菌检测和根除治疗的过度滥用.二者关系的阐明有待机制研究的进展.     

传统、浮躁、道德及其它--医域随感

多年来我一直从事外科医、教、研和科室管理工作,并兼任一些专业杂志的编辑和审稿工作.记不清楚由什么时候开始,逐渐感觉到平时熟悉的情况出现了一些微妙的变化,特别是近几年,可能是市场经济大环境的影响或是社会上漂浮的灰尘飞落到医院和学术界,不太寻常的现象似有所增多.其中有些情况均为所见所闻,间或偶尔与同道议论过,现结合当前事态发展,重新认识一下,可能有益无害.     

非传统理念指导下的传统技术导致应用医学重大课题的突破--关于2005年诺贝尔生理学或医学奖

发现幽门螺杆菌(Helicobacter pylori,以下简称Hp)导致慢性胃炎和消化性溃疡,是沃伦和马歇尔获得2005年诺贝尔医学奖的原因.他们在1982年得出的这一假说,违反了关于这一类慢性病传统的发病机制理念.可能因为这一理念的反传统性,其假说被世界同行基本接受大概经历了20年时间.值得强调的是,对HP的观察、分离、培养、鉴定和人体试验,以及它与疾病相关的诊断、治疗、临床流行病学等研究,应用的都是传统的医学技术.从而表明,即使到了20世纪80年代,传统技术仍能导致诺贝尔奖级科研成果的出现.     

Scientific Productivity and Idea Acceptance in Nobel Laureates

We investigated how new ideas become accepted for Nobel laureates in science. Archival data were collected for 204 Nobel laureates from 1980 to 2009 in physics, chemistry, and medicine or physiology. Acceptance was evaluated for Nobel laureates by Prize area and three key publications in the Nobel laureates' publishing careers: (a) first publication concerning their Nobel idea (FN), (b) highest cited publication concerning their Nobel idea (HN), and (c) last publication concerning their Nobel idea (LN). Acceptance was defined primarily in terms of academic prestige for the journal articles (journal impact factors, article citation counts, Eigenfactor scores [journal impact and journal citations] and journal‐cited half‐life ratings). We found that acceptance for these publications mostly followed LN < FN < HN for all measures and Prize areas—except for physics on impact factor only, which followed FN < LN < HN, as hypothesized. In sum, recent ideas are least accepted rather than original ideas even for established and eminent Nobel laureates.     

诺贝尔医学奖与俄罗斯的遗憾

通过对1901～2004年诺贝尔医学奖的复习分析,发现俄罗斯(前苏联)这个大国,在整个20世纪里102次的医学奖颁发中,只获得2人次,与它的大国地位很不相称.试图分析其获奖特少的历史原因并汲取教训.     

Gender and Science: Women Nobel Laureates

Women and their creativity are underrepresented in science. To date, few women have been awarded the Nobel Prize in science. Eleven female Nobel laureates in physics, chemistry and physiology/medicine between 1901 and 2006 were compared with 37 males who received the Nobel Prize in the same area one year prior and one year after the women. Data analyzed included birth order, marital status, children, awards (Fulbright, Rhodes, and number of honorary awards received), highest education level and Nobel mentor. Results indicated that female Nobel laureates were significantly less likely to marry and have children. When female laureates had children, they had significantly fewer children than male laureates. Female laureates also had fewer publications than their male counterparts. Our findings suggest that eminent women scientists tend to choose the pursuit of scientific discovery over starting families more often than eminent male scientists. More resources are needed in order to nurture and enhance the recruitment and retention of women in science, technology, engineering and mathematics (STEM).     

生物化学与诺贝尔奖

生物化学是一门重要的基础学科,与医学具有紧密的联系.20世纪,诺贝尔奖60多次颁发给了生物化学领域,说明了生物化学的重要性.通过阐述生物化学与诺贝尔奖的关系来说明生物化学对科学发展特别是医学的巨大推动作用.     

纳米医学的哲学迷思

自诺贝尔医学奖设立以来,就没有一个真正的中国本土科学家获奖,其因素是多方面的,教育方法的颠覆,科研态度的浮躁,科研政策的困扰和科研资源的散落是其中最重要的四大因素。另外,人文素养的缺乏和一些传统的思维理念的局限,对此也有不小的影响。     

Discussion of Petri Meronen's paper, "The Return of Narcissism: Heinz Kohut in the Context of the History of Ideas"

In the 100-year-old history of the Nobel Prize in medicine or physiology, there are several fields whose practitioners have not received the prize. Among the unlucky candidates for the Nobel Prize, Sigmund Freud (18561939) is probably the most prominent and best known. He is also the one proposed for the prize during the longest period of time, almost a quarter of a century, or more precisely, between 1915 and 1938. In this article I will examine the nominations of Freud and the evaluations of his work by what is perhaps the most science centered of medical institutions, the Nobel Committee for Physiology or Medicine. I will place these in the context of the reception of Freud's work by Swedish psychiatrists. Here the influence of the most prominent psychiatrist at the time, Bror Gadelius, deserves special attention.     

Arrhenius vs. Ehrlich on immunochemistry: Decisions about scientific progress in the context of the Nobel prize

This study forms part of a larger research project examining the election process for the Nobel prizes for Physiology or Medicine at the Karolinska Institute in Stockholm, and the role and function of the prizes in early 20th century Swedish and international medicine. The purpose of the study is to clarify the decision-making process which led to the Nobel prize for Paul Ehrlich in 1908, ‘for work on immunity’. His award was preceded by the most dramatic conflict within the prize authority concerning any prizewinner prior to World War I, and thus is apt to illuminate both the implicit and explicit criteria and the strategies used in the prize deliberations. Ehrlich's chemical ideas on the immune response were criticized by the physical chemist Svante Arrhenius who recommended the application of his disciplines's methods and principles on immunological problems. This criticisms were brought into the Nobel prize debate by J.E. Johansson, a physiologist who asserted that Ehrlich's research was of little scientific value and therefore not worthy of a prize. Yet the majority of the Institute, led by its chairmam, the chemist K.A.H. Mörner, succeeded in awarding Ehrlich. An analysis of the controversy shows it to be primarily based upon (1) a difference of scientific styles between the antagonists, resulting in incongruous definitions of immunology as a research field, and of the proper aims and methods of immunological studies. Other factors influencing the final decision were (2) the Institute's negative reaction to what was considered an intrusion in medical Nobel prize matters by a chemist, (3) Arrhenius' and Johansson's diverging views on what kind of work should be awarded a prize, and (4) Johansson's position as a non-conformist at the Karolinska.     

RNA干扰现象研究获诺贝尔奖的启示

RNA干扰现象是目前生命科学领域的研究热点。由于RNA干扰具有十分重要的理论和应用价值,因此该现象在揭示后仅8年其研究者就获得了诺贝尔生理与医学奖。通过回顾RNA干扰现象的发现历程,可以为今后的科研探索过程提供许多有益的启示。