妊娠期高血压疾病的系统论思考

妊娠期高血压疾病是妊娠期常见而又严重危害母儿健康的疾病.从胎盘浅着床,血管内皮受损,遗传因素,免疫机制探讨了妊娠期高血压疾病的发病机制.随着研究的深入,免疫机制在妊娠期高血压疾病的发病中的作用越来越受到重视.介绍了APS最新的治疗进展,为今后的APS发病机制研究及临床治疗带来更多的启示.     

妊娠期高血压疾病高凝状态的研究

有关研究表明高凝状态在妊娠期高血压疾病的发病中起重要作用,运用哲学观点辩证地研究妊娠期高血压疾病的高凝状态,是我们研究妊娠期高血压疾病切实可行的出路,并且已在长期的研究中得到了体现.     

睡眠呼吸暂停综合征与肺高血压

肺高血压是一类以肺血管阻力进行性升高为主要特征,并最终导致右心衰竭甚至死亡的恶性心血管疾病.多种疾病可导致肺高血压,其中第三大类肺高血压与肺部疾病及缺氧有关.已有许多研究得出结论睡眠呼吸暂停综合征是肺高血压的高危因素,但具体发病机制不详.本文目的是结合国外文献阐述睡眠呼吸暂停综合征致肺高血压的发病机制及干预睡眠呼吸暂停综合征对肺动脉高压的影响.     

肝肾移植患者红细胞免疫功能的研究进展与设想

许多疾病(如自身免疫性疾病、病毒性肝炎、肿瘤、肾脏疾病等)免疫发病机制中,红细胞天然免疫缺陷占有很重要的地位.此外,红细胞免疫功能也是判断病情进展、治疗效果及预后的一项灵敏的指标.本文希望通过总结红细胞免疫功能介导肝、肾疾病发生发展的物质基础、机制,探讨红细胞免疫功能对肝、肾移植移植的意义.     

个体化降压的临床意义

高血压是由多种病因和发病机制引起的一种慢性疾病,可以导致多种靶器官功能损害,并最终导致严重的心、脑血管并发症,危及人类的健康和生命。如何做到有效的预防和治疗是目前面,临的问题。本文分析了高血压控制的现状,以矛盾的特殊性原理为指导,从高血压的病因和发病机制、临床特点以及药物对个体的敏感性等诸多方面出发,阐述了高血压患者个体差异性。高血压患者个体差异性决定每一个个体综合控制策略的不同,运用“具体问题具体分析”的方法,为每一个个体制定个体化的血压控制方案,以期达到理想的高血压整体控制水平。     

个体化降压的临床意义

高血压是由多种病因和发病机制引起的一种慢性疾病,可以导致多种靶器官功能损害,并最终导致严重的心、脑血管并发症,危及人类的健康和生命.如何做到有效的预防和治疗是目前面临的问题.本文分析了高血压控制的现状,以矛盾的特殊性原理为指导,从高血压的病因和发病机制、临床特点以及药物对个体的敏感性等诸多方面出发,阐述了高血压患者个体差异性.高血压患者个体差异性决定每一个个体综合控制策略的不同,运用"具体问题具体分析"的方法,为每一个个体制定个体化的血压控制方案,以期达到理想的高血压整体控制水平.     

心身疾病——精神疾病还是躯体疾病

心身疾病涉及了全身各个系统，几乎所有的躯体疾病都有心理因素的影响，而这些精神心理因素决定了其发病、临床表现、持续时间以及对治疗的易感性。心理因素作用于人脑后，通过一定的生理中介机制如自主神经系统、内分泌系统、免疫与应激及心理神经免疫作用于靶器官发生生理改变，最终导致躯体症状或疾病的发生。     

多角度认识妊娠期肝内胆汁淤积症

妊娠期肝内胆汁淤积症是妊娠晚期特发性疾病,以皮肤瘙痒、胆汁酸增高及肝功能损害为特征.对孕产妇危害较小,对围产儿产生严重后果,使围产儿患病率、死亡率增加.其发病机制尚不明确,许多研究表明它是一种多因素疾病.任何事物都是辨证统一的,在临床中运用辨证的眼光看待疾病,可以促进对疾病的认识.     

心身疾病——精神疾病还是躯体疾病

心身疾病涉及了全身各个系统,几乎所有的躯体痰病都有心理因素的影响,而这些精神心理因素决定了其发病、临床表现、持续时间以及对治疗的易感性.心理因素作用于人脑后,通过一定的生理中介机制如自主神经系统、内分泌系统、免疫与应激及心理神经免疫作用于靶器官发生生理改变,最终导致躯体症状或疾病的发生.     

骨髓造血干细胞移植治疗自身免疫性疾病的进展

自身免疫疾病发病机制复杂,目前尚缺少有效的治疗方法。近年来发现造血干细胞移植可以通过免疫重建显著缓解甚至治愈自身免疫病。笔者对近年来造血干细胞移植治疗自身免疫病进行了介绍和综述,就其在1型糖尿病这一领域的研究进展进行了述评,探讨造血干细胞移植用于治疗自身免疫病的前景和待解决的问题。     

骨科学的新进展及其在治疗中的应用

现代各学科的交叉和融汇已经使骨科的临床诊疗技术有了革命性的进展,医学各学科之间以及医学与其它学科之间的交叉引用、促进发展体现了哲学体系中"综合"的概念.通过对近年来骨科发展的一些新思路的浅见来窥探综合理念在本领域应用的前景,试图阐明从学科交叉寻找合理且有前景的增长点也是未来骨科发展的必由之路.     

The pregnant therapist and the psychotic client: A phenomenological understanding of the impact of the therapist’s pregnancy on the therapeutic process

This original paper examines the underresearched area of therapist pregnancy. It explores the impact of psychosis as an additional complicating factor to the therapeutic process and the experience of one British counselling psychologist working in the National Health Service whilst pregnant. Five brief client summaries/clinical examples are presented to explore the common themes of anger, rejection, abandonment and envy that often emerge following the disclosure of a therapist’s pregnancy or the opposite reactions of over-protectiveness and an unwillingness to engage in therapy for fear of harming the therapist. Recommendations are made for further research within this neglected area and the need to incorporate the themes within training for therapists and training for supervisors.     

CD_4~+ CD_(25)~+调节性T细胞在妊娠与分娩中的作用

近代生殖免疫学研究认为,正常妊娠维持有赖于母胎免疫耐受的形成,耐受一旦失调,就可能妊娠失败,发生如流产,妊娠期高血压疾病,胎膜早破,分娩发动等。近几年来,国内外学者逐渐认识到CD4+CD25+调节性T细胞在妊娠中的重要作用并进行系列研究。本文就目前CD4+CD25+调节性T细胞在妊娠与分娩中的作用作一综述。     

妊娠期肝内胆汁淤积症研究中的认识论

妊娠期肝内胆汁淤积症是一种常见的妊娠晚期并发症,临床上以皮肤瘙痒和黄疸为特征,伴有胆汁酸、肝酶等生化指标的异常。其对母体影响较小,但可以引起早产、胎窘和不明原因的死胎,对围生儿的严重危害使其受到了产科医生的重视。因此,有必要通过回顾妊娠期肝内胆汁淤积症的认识过程来看医学认识发展中所体现的哲学观点。     

Borderline personality disorder symptoms as predictors of 4-year romantic relationship dysfunction in young women: addressing issues of specificity

The relationships between romantic relationship dysfunction and symptoms of borderline personality disorder (BPD), other personality disorders, and depression were examined prospectively in a community sample of 142 late adolescent women. Although BPD symptoms predicted 4-year romantic dysfunction (romantic chronic stress, conflicts, partner satisfaction, abuse, and unwanted pregnancy), the associations were not unique to BPD. Instead, relationship dysfunction was better predicted by a cumulative index of non-BPD Axis II pathology. Depression did not predict outcomes uniquely when Axis II symptoms were included, except in the case of unplanned pregnancy. The results suggest that although BPD is associated with relationship dysfunction, the effect is a more general phenomenon applying rather broadly to Axis II pathology. The results also highlight the importance of subclinical psychopathology in the construction of early intimate relationships.     

单纯胸椎骨折合并迟发性血胸的诊治及临床特点

为了探讨单纯胸椎骨折合并迟发性血胸的临床特点及诊治方法,回顾分析了11例单纯胸椎骨折合并迟发性血胸患者的诊疗情况并总结其临床特点。结果显示,所有病例均获得明确诊断,10例通过胸穿治疗获得治愈,1例行割胸探查术。提示单纯胸椎骨折合并迟发性血胸临床较少见,伤后体温逐渐升高、胸闷、氧分压下降或剧烈咳嗽、翻身拍背后突然出现呼吸困难、发绀、大汗常为其临床特点,大多可通过保守治疗获得痊愈。     

An exploration of possible pre- and postnatal correlates of autism: a pilot survey

Biological mothers of children, diagnosed with autism or pervasive developmental disorder, and biological mothers of children without developmental delays and matched on age and sex, were surveyed about a number of possible pre- and postnatal correlates of autism or pervasive developmental disorder. A regression analysis for boys showed the mother not vomiting in the first trimester, not having smell aversions, not craving sweets, the mother reporting fewer food aversions during the pregnancy, and having an infection while pregnant significantly predicted a later diagnosis of autism or pervasive developmental disorder. Not vomiting in the first trimester was the only significant predictor of a diagnosis of autism or a pervasive developmental disorder in girls.     

In utero infection and adult schizophrenia

We review emerging evidence indicating that in utero exposure to infection is a risk factor for schizophrenia. It is hypothesized that a prenatal infection increases the liability to schizophrenia in adulthood by adversely affecting the maturation of critical brain structural and functional components implicated in the pathogenesis and pathophysiology of the disorder. Early evidence for a role of in utero infection includes investigations linking schizophrenia with birth during the winter and in urban regions, and ecologic studies demonstrating associations between influenza epidemics and births of pre-schizophrenic patients. The findings of the latter studies are, however, equivocal. To more rigorously address this question, our group has used increasingly sophisticated research designs that incorporate more refined measures of exposure and outcome, and continuous follow-up of treated cases. This work has already yielded several intriguing findings, including associations between schizophrenia and two in utero infections--rubella and respiratory infection. We also describe our ongoing birth cohort investigations that are expected to advance this work further, including studies that utilize maternal serum samples drawn during pregnancy of offspring who were later diagnosed with schizophrenia.     

Parent ADHD and Evidence-Based Treatment for Their Children: Review and Directions for Future Research

One fourth to one half of parents of children with attention-deficit/hyperactivity disorder (ADHD) have ADHD themselves, complicating delivery of evidence-based child behavioral and pharmacological treatments. In this article, we review the literature examining the relation between parent ADHD and outcomes following behavioral and pharmacological treatments for children with ADHD. We also review research that has incorporated treatment of parent ADHD (either alone or in combination with child treatment) with the goal of improving parenting and child outcomes. Finally, we offer recommendations for future research on the relation between parent ADHD and evidence-based treatment outcomes for their children, with the purpose of advancing the science and informing clinical care of these families.     

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。