中国人群脂肪肝主要影响因素的荟萃分析

为系统评价中国居民脂肪肝发病的主要危险因素,检索文献数据库,收集国内1997年～2008年有关脂肪肝发病危险因素的16篇文献,利用Meta分析方法,进行综合统计分析,累计病例7200例,对照11884例。结果超重（23≤BMI〈25）、肥胖（BMI≥25）、过量饮酒、吸烟、高脂饮食、食用蔬菜、饮绿茶、爱好运动、运动少、高脂血症、高HDL—Ch、低HDL-Ch、高血压、高血糖、高血总胆固醇（≥6．5mmol／L）及糖尿病合并0R值（95％CI）分别为1．68（0．68～3．90）、5．01（3．23～7．76）、3．52（1．52～8．15）、1．18（1．01～1．37）、2．82（1．50～5．31）、0．45（0．37～0．55）、0．52（0．43～0．64）、0．32（0．14～O．74）、3．49（1．26～9．65）、4．91（2．69～8．96）、0．31（0．17～0．57）、2．14（1．50～3．03）、2．19（1．43～3．35）、2．75（1．66～4．58）、2．96（0．26～32．98）、2．29（1．30～4．01）。结论为目前影响中国人群脂肪肝发生的危险因素依次为肥胖、高脂血症、饮酒、运动少、高脂饮食、高血糖、糖尿病、高血压、低HDL—Ch和吸烟;保护因素为饮用绿茶,食用蔬菜,以及高HDL—ch;尚不能确定与中国人脂肪肝发生的相关性因素为超重和高血胆固醇。     

导言:血脂异常如何合理防治——一个争论的话题

<正>血脂异常是指血浆中脂质数量和质量的异常,是指血浆中胆固醇和(或)甘油三酯水平超过正常,同时还有高密度脂蛋白胆固醇水平的下降,血脂通常以脂蛋白的结合形式存在,所以血脂异常通常称为脂蛋白异常血症。血脂异常是动脉粥样硬化的独立危险因素,它与高血压、糖尿病、肥胖、吸烟等危险因素互相作用,促进全身动脉硬化的     

胰岛素抵抗与非酒精性脂肪性肝病

非酒精性脂肪性肝病是一种以肝细胞脂肪变性和脂肪贮积为病理特征但无过量饮酒史的临床综合征.肥胖、2型糖尿病和高脂血症被认为是非酒精性脂肪性肝病的重要危险因素.有研究表明胰岛素抵抗与非酒精性脂肪性肝病密切相关.脂质代谢异常、氧应激反应、瘦素、脂联素等与胰岛素抵抗的发生有相互作用,也影响着非酒精性脂肪肝病的发生发展.胰岛素抵抗在非酒精性脂肪性肝病发病机制上的作用以及与胰岛素抵抗相关的发病因素值得关注.通过体育锻炼与控制饮食热量逐渐减轻体重,并配合血糖及血脂的控制对非酒精性脂肪性肝病患者十分重要.     

胰岛素抵抗与非酒精性脂肪性肝病

非酒精性脂肪性肝病是一种以肝细胞脂肪变性和脂肪贮积为病理特征但无过量饮酒史的临床综合征。肥胖、2型糖尿病和高脂血症被认为是非酒精性脂肪性肝病的重要危险因素。有研究表明胰岛素抵抗与非酒精性脂肪性肝病密切相关。脂质代谢异常、氧应激反应、瘦素、脂联素等与胰岛素抵抗的发生有相互作用,也影响着非酒精性脂肪肝病的发生发展。胰岛素抵抗在非酒精性脂肪性肝病发病机制上的作用以及与胰岛素抵抗相关的发病因素值得关注。通过体育锻炼与控制饮食热量逐渐减轻体重,并配合血糖及血脂的控制对非酒精性脂肪性肝病患者十分重要。     

国外冠心病A型行为类型研究概况

引言心血管系统疾病,是自二十世纪以来对人类的健康和生命构成最大威协的主要疾病之一。尤其是冠心病(CHD)在许多国家的发病率或死亡率都位居前列。由冠心病所造成的社会经济损失和精神负担都是难以估量的。数十年来,世界各国和医学界为防治冠心病进行了巨大的努力。其中病因研究的一个重要方面,就是寻找,确定各种可能导致冠心病的危险因素。目前一致公认的危险因素有:高血清胆固醇、高血压、吸烟、肥胖和糖尿病、缺乏锻炼以及家族史。     

倡导科学决策 建立医患诚信

本期“临床决策研究”栏目由陶贵周等撰写的“从冠心病主要危险因素的流行特点谈医学模式的转变”通过大量的数据资料,对冠心病危险因素的流行特点及危害、危险因素的控制情况、干预冠心病危险因素效益评估及医疗经济学与冠心病的预防进行了论述。作者指出,冠心病是由遗传、环境和不良生活习惯等多因素综合所致,在冠心病的诸多危险因素中,吸烟、高血压、高胆固醇血症、糖尿病和肥胖等被认为是最重要的,而这些主要危险因素是可以预防和控制的。因此,采取积极有效的预防策略来降低乃至消除引起冠心病的危险因素,是最基础、最重要的措施。     

代谢综合征:动脉粥样硬化危险因素的聚集

代谢综合征是动脉粥样硬化危险因素的聚集状态,包括肥胖、高血压、血糖异常、血脂紊乱等,共同的病理基础是肥胖和胰岛素抵抗.高胰岛素血症、脂肪因子、高血糖、血脂异常和高血压导致内皮细胞损伤和血管炎症,促进动脉粥样硬化发展.提高对代谢综合征的认识有助于从整体观念出发防治肥胖带来的相关疾病.     

代谢综合征：动脉粥样硬化危险因素的聚集

代谢综合征是动脉粥样硬化危险因素的聚集状态,包括肥胖、高血压、血糖异常、血脂紊乱等,共同的病理基础是肥胖和胰岛素抵抗。高胰岛素血症、脂肪因子、高血糖、血脂异常和高血压导致内皮细胞损伤和血管炎症,促进动脉粥样硬化发展。提高对代谢综合征的认识有助于从整体观念出发防治肥胖带来的相关疾病。     

特殊类型的脑血管病

脑血管疾病发病率和病死率均很高,严重危害人类健康。高血压,糖尿病,吸烟,肥胖是脑血管病公认的危险因素,除此之外,一些特殊类型脑血管病另有特点,如与遗传、感染、自身免疫关系密切,本文将对其进行具体介绍。     

德州地区进展性缺血性脑卒中相关危险因素的研究

探讨进展性缺血性脑卒中(SIP)的相关危险因素.选择德州市人民医院1999年～2009年163例SIP患者,首先对18个变量行单因素分析,然后对阳性变量行多因素Logistic逐步回归分析,筛选SIP发生的相关危险因素.高血压史、感染、加拿大卒中量表(CNS)评分、高血糖、TG、纤维蛋白原、脑水肿、颈动脉粥样硬化性狭窄、同型半胱氨酸和D-二聚体10个变量与SIP发生显著相关(P<0.05);脑水肿、颈动脉粥样硬化性狭窄、高血糖、感染、高纤维蛋白原水平和同型半胱氨酸6个因素是SIP发生的危险因素.脑水肿、颈动脉粥样硬化性狭窄,高血糖、感染、高纤维蛋白原在SIP发生中具有重要作用,为临床治疗提供了理论依据.     

Together – apart: in touch in a time of separation

This paper explores the experience of working as a Jungian analyst through the various phases of the global COVID-19 pandemic, examining the importance of the physical containing space alongside the analyst’s internal mind and how technology can both help and hinder understanding. A number of clinical vignettes illustrate the challenge of communicating over a distance, paying particular attention to the way countertransference phenomena can become re-attuned. Reference is made to mythology and symbols of hope, and consideration given to the meaning and purpose of the pandemic.     

The Possibility of Meaning in Human Evolution

Science undermines the certitude of non-naturalistic answers to the question of whether human life has meaning. I explore whether evolution can provide a naturalistic basis for existential meaning. Using the work of philosopher Daniel Dennett and scientist Ursula Goodenough, I argue that evolution is the locus of the possibility of meaning because it has produced intentionality, the matrix of consciousness. I conclude that the question of the meaning of human life is an existentialist one: existential meaning is a product of the individual and collective tasks human beings undertake.     

Phenotypic plasticity and archetype: a response to common objections to the biological theory of archetype and instinct

Since Jung’s death in 1961, scholars have attempted to integrate growing biological science data into Jungian concepts such as the collective unconscious, instincts and the archetypes. This enterprise has been challenging due to persistent false dichotomies of gene and environment occasionally arising. Recent works by Roesler (2022a, 2022b) for example, have raised objections to the biological theory of archetypes, but the objections are plagued by such dichotomies. The concept of phenotypic plasticity, however, helps to both avoid this problem as well as bridge the gap between competing theories into a more integrated model with solid biological foundations.     

When is it time to stop? When good enough becomes bad enough

This article draws on Winnicott’s concept of the good enough mother to discuss how to know whether a therapeutic situation is good enough to continue or bad enough to end. This dilemma is explored in terms of clinical syndromes, such as anorexia and pathological gambling, but focuses mainly on analyst-initiated endings, which are termed the ‘Casablanca dilemma’, based on an amplification of the ending of the film Casablanca. The author goes on to discuss such one-sided endings, drawing on interviews with 40 analysts and therapists about their clinical experience. A typology of bad enough endings is presented. The psychological differences between a good enough analysis as opposed to a bad enough one are explored through the ideas of Winnicott and Neumann.     

Kann Es Ein Argument Für Den Skeptizismus Geben? Das Epistemische Problem Der Irrtumsmöglichkeit

Summary  Is there any argument for scepticism? The epistemic problem of the possibility of error. Arguments for scepticism rest on the assumption that knowledge claims are fallible. For this reason the concept of knowledge appears to be questionable. Since it is necessary to distinguish doubts from possible doubts, the arguments for scepticism appear to be unconvincing. If we take it into account that we know something that is immune to doubt, we should draw the conclusion that, contrary to scepticism, knowledge claims have to be compatible with being fallible. Thus any knowledge claim is capable of being doubted.     

The transcendent function in Spitteler’s Prometheus and Epimetheus

In August 2020, John Beebe and Steve Myers met via Zoom to discuss their differing interpretations of psychological typology and the different sources within Jung’s writings that influenced their books: Integrity in Depth: Energies and Patterns in Psychological Type (Beebe), and Myers-Briggs Typology vs Jungian Individuation (Myers). The discussion centred on Spitteler’s epic poem Prometheus und Epimetheus, which forms the basis of chapter V of Psychological Types. This is both the largest chapter and one of two chapters that Jung highlighted in the Argentine foreword as containing the essence of the book. Jung’s book is primarily about the transformation of personality rather than the categorization of people. Although it contains a critical psychology that deconstructs the nature of consciousness, that is only one half of the book and a stepping-stone to the other half, which is the reconciliation of opposites with particular emphasis on the relation of consciousness and the unconscious. Jung assumed that readers were already familiar with Prometheus und Epimetheus, an understanding of which sheds light on the nature of the transformation that Jung described – the development of a new attitude towards attitude itself.     

Chapter 6: Biblical Foundations for a Practical Theology of Aging

SUMMARY

This article reviews Biblical sources pertaining to the elderly, particularly the frail elderly. Founded on these sources, implications for elderly with Alzheimer's Disease and other forms of dementia are addressed through a personal perspective informed by writings of Christian mystics.     

Seeing in the Dark: A View into Dissociation and Healing

In this paper, I will explore the role of art-making, the experience of trauma and dissociation, and the process of working with self-states from an analytic and creative frame. Relevant literature on dissociation, trauma, and the use of art will be discussed. A case involving my work with an adolescent girl who had experienced sexual abuse from a family member will be shared, with an emphasis on the meaningful role images played during the therapeutic process. Both Jungian and psychoanalytic models of conceptualizing and working with dissociation are included, following Donald Kalsched’s (2013) recommendation for a “binocular stance” to treatment, including both a focus on the inner, intrapsychic world and the interpersonal, relational realm, and how art images both illuminated and expressed these realms. Within the therapeutic process, art images allowed the therapist a view into the client’s unconscious process, and created a meeting ground for dissociative barriers to be gradually seen, felt and known, by both therapist and client. The experience of dissociation, in images and in session, provided a reference point for myself and my client, Taylor, to develop a shared understanding and a framework for growth.