Alzheimer型痴呆病因学的研究现状,困惑与出路

Ａｌｚｈｅｉｍｅｒ型痴呆病因学的研究现状、困惑与出路解放军总医院老年医学研究所博士生（北京１００８５３）黄福南导师李文彬Ａｌｚｈｅｉｍｅｒ型痴呆（又称早老性痴呆）被认定是独立的疾病将近一百年了。早期它被认为是一个少见病,不被重视。［１］随着时间的推移...     

对老年性痴呆治疗研究的反思

随着世界人口逐年老化,老年性痴呆已成为全球性的社会一医学问题。神经科学及相关学科领域的内的工作者正积极地投入到对Ａｌｚｈｅｉｍｅｒ病各方面的深入研究,在预防和治疗方面的探索已取得一些阶段性的成果。然而,由于相关基础研究尚无关键性突破,临床治疗始终缺乏有效手段。     

中医现代化的哲学思考

中医现代化是一种不可抗拒的历史趋势,一方面现代化的社会需要现代化的中医,另一方面,传统中医本身也需要现代化,以便在现代社会中继续扮演重要角色。基于对天、人、疾病的细致观察与深刻反省,中医学本来是紧跟时代的,但今天的中医学却失去了这一长处,原因之一就是...     

阿尔茨海默病缘何成为当今医学领域多学科的焦点

在医学史上,某种疾病成为研究的热点、众多学科之论坛的例子不胜枚举,这种独特的现象有着深刻的哲学根源。从汇集当今医学领域多学科的阿尔茨海默病(Ａｌｚｈｅｉｍｅｒ’ｓＤｉｓｅａｓｅ,ＡＤ),可窥其一斑。1　人口老龄化和发病率上升是ＡＤ成为热点的前提虽然在20世纪初已经发现了ＡＤ,但当时该病的发病率并不高,这显然与人口的年龄结构以及该病主要发病于老年人有关。近一个世纪以来,随着人口老龄化的发展,老年性疾患已经成为一个明显影响人类健康的突出问题。据国外报道,老年痴呆的患病率占老年人口的4.6%,其中半数为ＡＤ[1]。我国的人…     

哮喘病的病因学及哲学思考

1　外因对支气管哮喘 (简称哮喘 )形成及发展的影响1 1　外界变应原 :外界变应原是引起哮喘发生和发展的重要因素 ,其中主要是吸入性变应原如花粉、霉菌、室内尘土、尘螨 ,蟑螂、动物毛皮等。外界变应原作用于机体后 ,使之致敏 ,并产生ＩｇＥ ,当机体再次接触该变应原时 ,体内肥大细胞上的ＩｇＥ与变应原结合 ,激活肥大细胞 ,使之释放组胺等介质 ,引起哮喘发作 ,属Ⅰ型变态反应[1,2 ] 。此外 ,奶、鱼、肉、蛋等食物性过敏原及阿司匹林类、青霉素类等药物过敏原亦可诱发哮喘。1 2　感染 :呼吸道感染尤其是病毒感染是小儿哮喘的主要原因。盛锦…     

血液循环发现史研究的哲学思考

血液循环发现史研究的哲学思考贵阳中医学院（５５０００２）许红,吴元黔一、古代自然哲学时期对血液循环现象的认识自然哲学时期一般指自然科学还未从哲学中独立出来的古希腊时期,在中国正是春秋战国时期。那时候的科学家都是一些自然哲学家,东西方大都相类似,他们常...     

慢性腰痛的哲学思考

慢性腰痛是临床最常见的病症之一,其临床表现错综复杂,真正病因扑朔迷离,诊断和治疗均非常困难,只有对其进行不断反思,才能进一步提高慢性腰痛的诊断水平和治疗效果.     

关于银屑病动物模型的哲学思考

１银屑病动物模型银屑病是一种慢性炎症性增生性皮肤病。其临床特点［１］是不同部位皮肤反复发生红斑、丘疹、斑丘疹,具同形反应、Ａｕｓｐｉｔｚ征、薄膜现象。人们试图建立一个理想的动物模型,可以模拟银屑病的特征,以便揭示银屑病的病因、发病机理、预防治疗机理...     

脓毒症研究进展及启示

脓毒症(sepsis)是是当前外科ICU所面临的棘手难题。对感染和脓毒症的研究已成为外科学十分活跃的领域之一,所取得的进展已使人们从本质上更深刻、更准确地了解感染与脓毒症,从而为解决这一棘手问题开辟新的途径。脓毒症的研究揭示了人类科学发现和科学认识的普遍规律。     

阿尔茨海默病的治疗进展

阿尔茨海默病(AD)的病因学和发病机制尚不清楚,目前存在胆碱能假说、β-淀粉样肽假说、基因假说、营养因子假说、有害网络假说等,但尚无一种假说能较完整地解释AD的发病机制,所以AD的临床治疗仍然是一个亟待解决的难题.     

Alzheimer's Disease: The Death of the Disease

Alzheimer's disease, a form of dementia, affects middle-age and older adults. The disease is becoming more evident because of growing numbers of older people and better diagnosis and detection methods. The author describes the behavioral and physical symptoms of the disease as well as specific suggestions for care of patients with Alzheimer's disease. Counselors can use this article to provide family members and other persons dealing with Alzheimer's disease with information and practical advice about dealing with the changes occurring in the patient.     

Source monitoring in Alzheimer's Disease

Source monitoring is the process of making judgments about the origin of memories. There are three categories of source monitoring: reality monitoring (discrimination between self- versus other-generated sources), external monitoring (discrimination between several external sources), and internal monitoring (discrimination between two types of self-generated sources). We investigated whether Alzheimer's Disease (AD) patients, when compared with young and older adults, are impaired at the same level on the three source monitoring categories. We designed three tasks, one for each source monitoring category. In the first task, aimed at reality monitoring, participants had to remember whether objects were previously placed in a bag by themselves or by the experimenter. In the second task, assessing external monitoring, participants had to remember whether the experimenter had previously placed objects in the bag with a black or white gloved hand. In the third task, measuring internal monitoring, participants had to remember whether they had previously placed or imagined themselves placing objects in the bag. Participants showed worse performances in the external and internal monitoring tasks, when compared with reality monitoring. The external monitoring deficit was even more pronounced in AD patients. Regression analyses showed that variation in the external monitoring performances was reliably predicted by inhibition. Our results emphasize the role of inhibitory processes in AD patients' source monitoring decline. The close relation between source and inhibitory decline in AD is interpreted in terms of a common neural base for both concepts.     

酒精性肝损伤的防治思考

酒精性肝损伤已成为继病毒性肝炎后的主要肝损伤病因,因此酒精性肝病的防治已经成为重要的医疗课题。其病因、发病机制、病理改变及治疗等有其独特的特点,用哲学的方法对其进行科学、全面的分析,可有助于对该病的认识和研究,指导我们从总体考虑,更为合理、有效地防治酒精性肝损害。     

皮肤科知情告知中的人文哲学思考

在皮肤科的临床工作中应该树立辩证唯物主义的思想方法,重视用普遍联系的观点看待皮肤疾病,分清主要矛盾和次要矛盾.应对患者进行全面、真实,合理的病情知情告知,并在知情告知中充分体现人文关怀的精神.     

阿尔茨海默病的免疫学治疗研究进展

1　阿尔茨海默病 (Ａｌｚｈｅｉｍｅｒ’ｓｄｉｓｅａｓｅ ,ＡＤ)免疫学治疗的机制应用免疫学方法阻断老年斑 (ＳＰ)的形成、清除已形成的ＳＰ的机制可能是多方面的。首先 ,Ａβ抗体进入脑后与Ａβ - 4 2形成稳定的复合物 ,阻止Ａβ- 4 2之间相互粘附形成沉积[1] 。其次 ,Ａβ抗体与Ａβ - 4 2结合后 ,阻止Ａβ - 4 2由可溶的α螺旋结构向具有毒性的β片层结构转化 ,进而减少Ａβ - 4 2对神经细胞的毒害作用[1] 。其三 ,Ａβ - 4 2抗原抗体复合物可激活补体系统对生成Ａβ的神经胶质细胞进行杀伤 ,从而阻断Ａβ - 4 2的生成[1] 。其四 ,Ａβ…     

Olfaction in Persons with Alzheimer's Disease

The need for low cost, noninvasive procedures for aiding in the diagnosis and understanding of Alzheimer's Disease (AD) has led to theories and procedures examining the role of olfactory disorders because of the finding that the brains of AD patients invariably exhibit neuropathology hi the hippocampus and entorhinal cortex. This loss correlates with the increase in the number of plaques and tangles and with the severity of dementia. Considered together, these findings suggest that brain structures closely related to the olfactory system demonstrate significant histopathology in AD. A comprehensive review of the literature pertaining to olfaction in persons with AD revealed that the olfactory identification ability of patients with memory disorders is impaired relative to controls. Consistency is lacking, however, when olfactory detection thresholds are investigated. Also, there is inconsistency in regards to severity of illness and olfactory function. In addition to differentiating AD patients from normals, the olfactory paradigm has shown some limited usefulness in differentiating AD patients from some other demented patients.     

Clinical Decision Making in Alzheimer's Disease

In the treatment of Alzheimer's Disease the occupational therapy goal is to enable persons to function as optimally as possible. Maximizing the patient's functioning in daily life necessitates a framework for clinical reasoning. Clinical reasoning currently emphasizes what persons can do but may fail to recognize the complex factors involved in what a person actually will do. A framework to guide clinical decision making for persons with Alzheimer's disease based on the model of human occupation was developed. The use of this framework is illustrated through a case application.     

高龄冠心病患者冠脉介入治疗策略的哲学思考

探讨高龄冠心病患者的具体临床特点;从医学实践出发选择高龄冠心病患者的介入治疗策略,并辩证地看待各种新技术、新器械.从而确定最有利于患者的治疗策略.