女性不同时期高血压的临床特征与治疗原则

女性因在不同时期内分泌的变化使其血压变化规律与男性有异,本文阐述了女性不同时期血压的临床特征和治疗原则;妊娠前及妊娠期慢性高血压的治疗及降压药物的选择;妊娠高血压综合征的处理原则及授乳期安全哺乳方法.     

老年高血压治疗决策的个体化和系统化

高血压是严重危害老年人健康的常见病,老年人高血压临床症状及特点与中青年高血压有显著不同,在诊断治疗中应注重老年人血压升高的病理生理特点及机制,在老年高血压的治疗决策中运用个体化和系统论的原则,选择个体最优化综合治疗决策,启思和引导老年高血压研究水平的纵深发展,积极有效地改善老年人的生活质量。     

老年高血压治疗决策的个体化和系统化

高血压是严重危害老年人健康的常见病,老年人高血压临床症状及特点与中青年高血压有显著不同,在诊断治疗中应注重老年人血压升高的病理生理特点及机制,在老年高血压的治疗决策中运用个体化和系统论的原则,选择个体最优化综合治疗决策,启思和引导老年高血压研究水平的纵深发展,积极有效地改善老年人的生活质量.     

《中国高血压防治指南》2005年修订版要点解析

指南是依据流行病学和大规模随机临床试验的最佳证据而修订的。指南的要点是:从110/75mmHg开始,人群血压水平与心血管病发生危险呈连续相关;正常高值血压(120～139mmHg/80～89mmHg)应改善生活方式以预防高血压发生;2002年调查我国有1.6亿高血压患者,但知晓率、治疗年和控制率很低;降低高血压患者的血压水平是预防脑卒中及心脏事件的根本。     

《中国高血压防治指南》2005年修订版要点解析

指南是依据流行病学和大规模随机临床试验的最佳证据而修订的.指南的要点是:从110/75mmHg开始,人群血压水平与心血管病发生危险呈连续相关;正常高值血压(120～139mmHg/80～89mmHg)应改善生活方式以预防高血压发生;2002年调查我国有1.6亿高血压患者,但知晓率、治疗年和控制率很低;降低高血压患者的血压水平是预防脑卒中及心脏事件的根本.     

关于高血压病中西医结合研究的思考

中西医叶高血压病主要差别是局部与整体的认识；中药、西药对不血压病的治疗各有所长；中、西医对高血压的研究均要立足于自力理论基础之上，中西医结合研究高血压病在病机病理、治疗原则、复方应用、个体差异、非药物治疗等方面有许多共通点，这些是中西医结合的基础。     

血压的生物节律与高血压的时间治疗学

人体血压的昼夜节律现象具有重要临床意义,高血压病更尤为如此.不同降压药物或不同时间用药对血压的昼夜节律产生不同的影响.高血压时间治疗学是根据疾病发生或发作的昼夜节律特征,通过调整投药时间及/或剂量、或应用特殊制剂,调整血液或组织中的药物浓度,从而增加疗效并减少或避免不良反应的发生.时间治疗学方法有助于以最小的医疗经济学及毒副反应代价获取最佳的治疗效果.     

血压的生物节律与高血压的时间治疗学

人体血压的昼夜节律现象具有重要临床意义,高血压病更尤为如此。不同降压药物或不同时间用药对血压的昼夜节律产生不同的影响。高血压时间治疗学是根据疾病发生或发作的昼夜节律特征,通过调整投药时间及/或剂量、或应用特殊制剂,调整血液或组织中的药物浓度,从而增加疗效并减少或避免不良反应的发生。时间治疗学方法有助于以最小的医疗经济学及毒副反应代价获取最佳的治疗效果。     

大动脉炎与继发性高血压

大动脉炎(Takayasu arteritis,TA)是一种累及主动脉及其主要分支的慢性进行性非特异血管炎性疾病,多发于年轻女性.高血压是大动脉炎的常见临床表现之一,对于大动脉炎引起的继发性高血压,应给予积极的综合治疗,降压治疗的同时,活动期患者应用糖皮质激素和/或免疫抑制剂控制病情,酌情给予抗栓、抗动脉硬化等综合性治疗措施,对于稳定期患者必要时行介入或外科手术治疗以解除导致血压升高的血管病变或主动脉瓣病变.临床医师应提高对该疾病的认识以免造成误诊或漏诊.     

高血压合并糖尿病患者的降压目标及治疗

高血压合并糖尿病是冠心病致死的危险因素。有效地控制血压可以显著地降低糖尿病病人心血管事件的发病率与病死率。高血压糖尿病病人的血压控制目标为〈130／80mmHg。为了达到这一血压水平,糖尿病病人的降压治疗包括合理的非药物治疗与药物治疗。在药物治疗中应选用血管紧张素转换酶抑制剂、血管紧张素受体拮抗剂、钙离子拮抗剂和小剂量利尿剂,并且注意联合用药。     

论现象概念——解析当前物理主义与反物理主义争论的一个焦点

现象概念是当前心灵哲学里物理主义和反物理主义争论的一个焦点,但尚未引起国内学界的重视。本文打算首先分析现象概念引起关注的主要原因。其次,参考最新的研究文献,考察现象概念的三个基本特性(孤立性、指称物在场、首尾相接),概述物理主义和反物理主义围绕现象概念而进行的主要争论。并在此基础之上,归结出一条约束现象概念与其指称之间关系的硬信念原则(hard belief principle,HBP)。最后,简略探讨了围绕现象概念的争论对于我们理解物理概念及其相关问题可能带来的一些影响。     

Heart-beat perception, panic/somatic symptoms and anxiety sensitivity in children

There is considerable evidence implicating heart-beat perception (HBP) accuracy and anxiety sensitivity (AS) in the development of panic in adults. However, to date there have been no studies exploring the association between HBP, AS and childhood panic/somatic symptoms. Seventy-nine children aged 8 to 11 years completed a mental tracking paradigm (Psychophysiology 18 (1981) 483) to assess HBP, the Children's Anxiety Sensitivity Index (J Clin Chil Psychol 20 (1991) 162) and the Screen for Childhood Anxiety Related Emotional Disorders (J Am Acad Child Adoles Psych 38 (1999) 1230). Those with good HBP (n = 7, 9%) had significantly higher panic/somatic symptoms (t = -1.71, P < 0.05), and AS (t = -2.16, P < 0.02) than those with poor HBP. There were no effects of age, sex or BMI on HBP. Those with high levels of panic/somatic symptoms were seven times more likely to have good HBP and had AS scores 1 S.D. higher than the remainder of the sample. Multivariate analyses revealed that these two phenotypes had independent associations with high panic/somatic symptoms. These results extend the literature on HBP and panic and suggest that in children, as in adults, increased panic/somatic symptoms are associated with enhanced ability to perceive internal physiological cues, and fear of such sensations.     

Justice for Irregular Migrants,Refugees and Temporary Workers: Some Issues for Carens

The Ethics of Immigration is a wonderfully comprehensive and insightful journey through all the major contemporary ethical issues concerning immigration. Through this outstandingly well‐crafted work, Carens builds a compelling case for many important positions on how we should treat migrants. Nevertheless, I believe there are some tensions in his arguments that could do with more analysis. I present some of these issues in this article. These include some important problems with arguments for the right to education for children of irregular migrants and those concerning admission, his general position on refugees, and his views about what is required in order to treat temporary workers fairly.     

Heartbeat perception in panic disorder: a reanalysis

This article describes a reanalysis of seven studies on heart beat perception (HBP) in panic disorder. The pooled sample had 709 participants from eight diagnostic categories. Accurate HBP was uncommon, but more prevalent among panic disorder patients than among healthy controls, depressed patients, patients with palpitations and individuals with infrequent panic attacks. No differences were found between panic disorder patients and patients with other anxiety disorders. Accurate perceivers had higher anxiety sensitivity scores than inaccurate perceivers. The data remain inconclusive as to whether perceived heart rate is correlated with anxiety in inaccurate perceivers. Physical exercise, distraction, variations in instructions and treatment each influenced HBP. However, the influence was different than previously thought. Finally, it is suggested that HBP may be understood in terms of schema-guided information processing.     

JUMPING FROM THE COUCH

This paper addresses two questions: first, how do phantasies work? Second, how do these mental activities affect a person's overall emotional life? The first question tends to be overlooked since those who accept, for example, projective identification as a basic mental activity tend also to treat it as an explanatory primitive. On this view, there is no further question to ask about how projective identification itself works; rather, other psychological and emotional phenomena are explained in terms of it. By contrast, this paper asks, how does projective identification itself work? The aim is not to provide a reductive explanation but to ask how it is that phantasies have the efficacy they have. To that end, one moment in the analysis of the Rat Man is re‐examined. There is then an attempt to show the difficulties involved in weaving an account of phantasy into the broader‐scale interpretation of emotional life.     

Mechanisms underlying an ability to behave ethically

Cognitive neuroscientists have anticipated the union of neural and behavioral science with ethics (Gazzaniga 2005). The identification of an ethical rule--the dictum that we should treat others in the manner in which we would like to be treated--apparently widespread among human societies suggests a dependence on fundamental human brain mechanisms. Now, studies of neural and molecular mechanisms that underlie the feeling of fear suggest how this form of ethical behavior is produced. Counterintuitively, a new theory presented here states that it is actually a loss of social information that leads to sharing others' fears with our own, thus allowing us to treat others as we would like to be treated. Adding to that hypothetical mechanism is the well-studied predilection toward affiliative behaviors. Thus, even as Chomsky hypothesizes that humans are predisposed to utter grammatical sentences, we propose that humans are 'wired for reciprocity'. However, these two neural forces supporting ethical behavior do not explain individual or collective violence. At any given moment, the ability to produce behavior that obeys this ethical rule is proposed to depend on a balance between mechanisms for prosocial and antisocial behaviors. That balance results not only from genetic influences on temperament but also from environmental effects particularly during critical neonatal and pubertal periods.     

Quasi-Realism, Negation and the Frege-Geach Problem

Every expressivist theory of moral language requires a solution to the Frege-Geach problem, i.e., the problem of explaining how moral sentences retain their meaning in unasserted (e.g., conditional and disjunctive) contexts. An essential part of Blackburn's ' quasi -realist project', i.e., the project of showing how we can earn the right to treat moral sentences as if they have ordinary truth-conditions, is to provide a sophisticated solution. I show, however, that simple negated contexts provide a fundamental difficulty, since accepting the negation of a sentence is easily confused with merely refusing to accept that sentence. I argue that Blackburn's model-set semantics for his 'Hooray!' and 'Boo!' operators requires logical apparatus to which he is not entitled. I consider various modifications, but show that they do not succeed.
email : n.unwin@bolton.ac.uk     

The Turning of the Tide: Theology,Religion, and Economics1

Abstract : Although capitalist free market economics is in crisis, its assumptions continue to shape not only how we do business or politics but also how we think and feel, and even what we believe. For theologians and scholars of religion this means that we can no longer do our work without taking into consideration what is happening in the economy and how it affects us; before religion can become part of the solution we need to understand how it has become part of the problem. This article investigates how economics has shaped religion and theology and develops alternative perspectives.     

Sharing Values

In this paper, we consider one of the ways in which shared valuing is normatively significant. More specifically, we analyze the processes that can reliably provide normative grounding for the standing to rebuke others for their failures to treat something as valuable. Yet problems with grounding this normative standing quickly arise, as it is not immediately clear why shared valuing binds group members together in ways that can sustain the collective pursuit of shared ends. Responding to this difficulty is no easy task, since doing so requires demonstrating that the standing to call on one's fellow participants because of shared forms of valuing is not merely a side effect of members authority to call on their fellow participants to do their fair share in a collective endeavor. This is, to the best of our knowledge, a problem that the sparse literature on shared valuing has yet to consider. We argue that the best way to address this difficulty is to consider the real‐world complexity of how forms of valuing come to be shared within well‐structured collectives and how members internalize the evaluative tendencies that sustain shared valuing. To accomplish those ends, we examine two different ways that shared valuing is cultivated within well‐structured groups and the corresponding ways that members internalize forms of valuing; specifically, we examine differences between forms of valuing that are passed downward from the top of a group, as they are in the U.S. Military, and forms of valuing that bubble‐up through local patterns of interaction, as they do among the Zapatistas of Chiapas.     

人的全面发展学说与中国马克思主义

人的全面发展学说,对中国马克思主义理论来说,主要涉及三方面问题。首先,如何认识人道主义和马克思主义的关系,即两者是对立的还是相容的,不同的看法,意味着人的全面发展是否具有马克思主义基本原理的地位。其次,如何认识自我的社会本质和具体存在的关系,以往是注重社会本质而忽略具体存在,突出表现在把人的本质归结为阶级性,由此人的全面发展失去了理论的立足点。再次,如何认识个人发展和社会发展的关系,过去把集体主义和个人主义的对立绝对化,出现了类似空想社会主义的片面性,即只强调个人是服务于集体的工具,不能将个人发展和社会发展看作是互为目的和手段。中国近20多年来,两次讨论人的全面发展问题,对此前的失误有所克服。