阿卡波糖、二甲双胍联合胰岛素类似物治疗肥胖糖尿病短期疗效

观察阿卡波糖、二甲双胍联合胰岛素类似物治疗肥胖2型糖尿病的短期疗效。将60例符合标准患者随机分为观察组和对照组各30例,均给予重组甘精胰岛素联合赖脯胰岛素强化治疗控制血糖,观察组同时给予阿卡波糖及二甲双胍口服,出院时进行疗效评价。观察组血糖达标时间、胰岛素用量少于对照组,餐时胰岛素停用比例大于对照组,差异有统计学意义（P＜0．05）;两组患者出院时体重较入院时均有所下降,观察组较对照组体重变化更明显（P＜0．01）。阿卡波糖、二甲双胍联合胰岛素类似物治疗方案,可作为初诊肥胖2型糖尿病治疗的理想方法之一。     

甘精胰岛素注射时段对2型糖尿病患者空腹血糖的影响

比较甘精胰岛素在不同时段注射对2型糖尿病患者空腹血糖的影响。最终选择89例2型糖尿病患者随机分为两组接受甘精胰岛素早餐前（A组,n=46）和夜间睡前（B组,n=43）注射治疗,观察两组患者空腹血糖的变化。结果显示,所有患者使用甘精胰岛素治疗以后,空腹血糖水平较治疗前均有明显下降,具有统计学差异（P均〈0.001）。但B...     

甘精胰岛素注射时段对2型糖尿病患者空腹血糖的影响

比较甘精胰岛素在不同时段注射对2型糖尿痛患者空腹血糖的影响.最终选择89例2型糖尿病患者随机分为两组接受甘精胰岛素早餐前(A组,n=46)和夜间睡前(B组,n=43)注射治疗,观察两组患者空腹血糖的变化.结果显示,所有患者使用甘精胰岛素治疗以后,空腹血糖水平较治疗前均有明显下降,具有统计学差异(P均<0.001).但B组的空腹血糖水平下降幅度更为明显,两者相比具有统计学差异(P<0.001).故在相同剂量的情况下,夜间睡前注射甘精胰岛素较晨间注射具有更强的降糖幅度,效果更好.     

维格列汀在心力衰竭合并2型糖尿病患者中的安全性研究

为探索维格列汀在心力衰竭合并2型糖尿病患者中应用的安全性,连续入组心力衰竭合并2型糖尿病患者,随机分为维格列汀治疗组(n=64例)和对照组(n=63例)。对照组采用心衰优化治疗+二甲双胍单药降糖治疗,维格列汀治疗组在对照组用药的基础上加用维格列汀。观察指标包括左室射血分数(LVEF)、左室舒张末期容积(LVEDV)及收缩末期容积(LVESV)、6分钟步行试验及不良事件。12个月随访时,糖化血红蛋白整体降低均数为2.52%,较基线明显降低(P0.001)。LVEF、LVEDV、LVESV及6分钟步行试验整体及两组均较基线无明显变化(P均0.05)。组间不良事件比较无差异(P均0.05)。因此,维格列汀未导致心力衰竭合并2型糖尿病患者左室功能的恶化及不良事件的发生。     

门诊糖尿病患者对相关知识了解程度的调查

调查二级甲等医院门诊2型糖尿病患者知识水平并探讨不同治疗方法患者的知识水平情况.根据"不平衡指数最小的原则",选取唐山市某二级甲等医院门诊就诊的糖尿病患者,并按治疗方式分为应用胰岛素组和单纯口服降糖药物组,每组90 例.采用统一调查量表进行调查.应用胰岛素组在低血糖处理、足部护理、慢性并发症的认识方面优于口服降糖药物组(P<0.05).口服降糖药物组在糖化血红蛋白作用、体育锻炼认识上好于应用胰岛素组(P<0.05).二级甲等医院门诊糖尿病患者糖尿病知识水平较差,不同治疗方式患者知识水平不同.因此,今后应对不同治疗方式的门诊糖尿病患者进行有针对性的干预,加强糖尿病知识健康教育,提高患者的自我管理知识水平,延缓和控制并发症的发生.     

强化控制2型糖尿病患者血糖、血压、血脂可降低尿白蛋白/肌酐比率

探讨2型糖尿病(T2DM)患者尿白蛋白/肌酐比率(UACR)的主要影响因素.89例T2DM患者实施血糖、血脂、血压强化控制,随诊1年并检测相关指标变化,统计学分析显示强化治疗后UACR降低,糖化血红蛋白和收缩压的变化值是影响UACR变化的主要因素.强化控制血糖、血脂、血压,尤其是严格控制糖化血红蛋白及收缩压,能减低糖尿病肾病发生的风险.     

强化控制2型糖尿病患者血糖、血压＼血脂可降低尿白蛋白／肌酐比率

探讨2型糖尿病（T2DM）患者尿白蛋白／肌酐比率（UACR）的主要影响因素。89例T2DM患者实施血糖、血脂、血压强化控制,随诊1年并检测相关指标变化,统计学分析显示强化治疗后UACR降低,糖化血红蛋白和收缩压的变化值是影响UACR变化的主要因素。强化控制血糖、血脂、血压,尤其是严格控制糖化血红蛋白及收缩压,能减低糖尿病肾病发生的风险。     

二甲双胍对糖尿病大鼠脂联素的影响

二甲双胍能够改善胰岛素抵抗,而脂联素与胰岛素抵抗密切相关,因此本研究通过建立糖尿病大鼠模型,并给予二甲双胍治疗,观察胰岛素抵抗和脂联素的变化,研究结果显示二甲双胍的治疗改善胰岛素抵抗的同时,也增加了血清和组织中脂联素的表达,提示二甲双胍改善胰岛素抵抗的机制之一可能是通过增加脂联素的表达而获益。     

妊娠期糖尿病患者体重对甘丙肽水平的影响

探讨妊娠期糖尿病(GDM)患者血浆甘丙肽(GAL)水平对体质量指数(BMI)和糖代谢的影响。选择我院产科2015年2月~2015年10月收治的妊娠期糖尿病患者30例作为GDM组,另纳入同期医院收治的正常孕妇30例作为对照组。统计两组受试者的BMI,糖化血红蛋白(HbA1c),空腹血糖(FBG),餐后2小时血糖(2hPPG)和GAL水平。GDM组BMI、HbA1c、FBG、2hPPG和GAL均分别高于对照组,差异有统计学意义(P0.05);校正混杂因素后,偏相关分析表明,GDM组的GAL水平与BMI、FBG呈显著正相关(P0.05),对照组中GAL与各指标均不存在相关性(P0.05);多元线性分析结果表明,GDM患者GAL与BMI呈正相关。GDM患者BMI增加与GAL升高有关,应注意体重控制。     

肝纤维化分期和谷氨酸脱羧酶抗体在肝源性糖尿病中的诊断价值

探讨肝纤维化程度分期和谷氨酸脱羧酶抗体在慢性乙型肝炎（慢乙肝）并发肝源性糖尿病中的诊断价值。对75例慢乙肝和肝硬化合并糖尿病患者分别进行空腹、服糖后2h血浆血糖、胰岛素、C肽和谷氨酸脱羧酶抗体（GADA）测定,对慢乙肝患者进行肝组织病理检查,按肝纤维化程度分期。结果乙肝肝硬化并发肝源性糖尿病患者的BMI值较乙肝肝硬化合并糖尿病患者的低。慢乙肝合并糖尿病S≥3组空腹、餐后2h血糖、胰岛素、C肽、GADA的阳性率以及糖尿病症状、空腹低血糖发生率与乙肝肝硬化并发肝源性糖尿病组比较差异无统计学意义（P〉0．05）;慢乙肝合并糖尿病S≥3组空腹、餐后2h胰岛素、c肽和与慢乙肝血糖正常S≥3组比较差异无统计学意义（P〉0．05）,而GADA的阳性率显著升高,两组之间的差异具有统计学意义（χ^2=4．713,P〈0．05）。结论肝纤维化程度S≥3和谷氨酸脱羧酶抗体阳性有助于慢乙肝并发肝源性糖尿病的诊断。     

Seeing and hearing and space and space and time

A previous experiment had shown spatial location to be judged in terms of the framework provided by the modality in which stimuli were presented. In the present study, digits were either auditorally or visually presented, and in either form the three digits appeared successivly to the left, in the center, and to the right of the S. The digit which occurred temporally in the middle of the sequence was never central from the spatial viewpoint. The S was asked to indicate which digit was the middle one. Ss were blind, deaf, or normal. The deaf and two control groups saw visual displays, and the blind and their controls heard auditory displays. The former groups predominantly chose the spatially middle digit and the latter groups the temporally middle. It was concluded that modality of presentation was the trigger which switched in the coding dimension of time or space.     

Law and Gospel,and Youth and Family Ministry

Abstract : If “faith comes through hearing” the word of God comprised in law and gospel, how do the imperatives that characterize ‘Youth and Family Ministry’ make such hearing possible? Here, literature delineating ‘Youth and Family Ministry’ is analyzed in light of its biblical foundations. The primary lens implemented in this analysis is the law/gospel hermeneutic advocated by Martin Luther and other reformers.     

Extremes of self-esteem and narcissism and the experience and expression of anger and aggression

This study examined the level of self-esteem and narcissism as personality variables involved in the disposition to experience and express anger. Three hundred thirty-eight subjects were sampled across two higher education centres and one student teaching programme in the United Kingdom. It was reasoned that individuals with both high self-esteem and narcissism would report especially high tendencies to experience and express anger and aggression and that those with high self-esteem and low narcissism would report the lowest. These predictions were influenced by theories that emphasise the role of threats to high self-esteem in the production of aggression and violence. Results indicate that groups defined by their extreme scores on self-esteem and narcissism scales produced levels of anger expression in the predicted direction. The importance of considering extreme levels of self-esteem and narcissism (in conjunction with other factors) in an analysis of anger is discussed with reference to currently influential theories in the field. Aggr. Behav. 24:421–438, 1998. © 1998 Wiley-Liss, Inc.     

Bob and Carol and Tess and Ali

Conflicting religious experiences in different traditions do not necessarily defeat the rationality of conflicting beliefs sustained by those experiences in those traditions. The circularity that protects religious beliefs from such mutual defeat is not vicious. Moreover, the lack of ‘epistemological humility’ exhibited by such believers poses no threat to world peace. In fact, a campaign for compulsory humility would itself constitute a much greater threat.     

Yin and Yang,and the Hot and the Cold

Yin and Yang are important concepts in ancient Chinese philosophy.Western scholars have become more familiar with these two concepts recently,but for a long time almost no one considered comparing them with their own tradition such as the ancient Greek philosophy,and especially with the ideas of the Hot and the Cold in Presocratic philosophy.In this paper,I make an attempt to do exactly that,and especially make a detailed comparison between the thoughts of two ancient thinkers:Laozi and Anaximander.I discuss the thought of Yin and Yang in Laozi-who was the earliest philosopher making use of the concepts Yin and Yang-to express his cosmological thought in ancient Chinese philosophy.Comparatively,I discuss the ideas of the Hot and the Cold in Anaximander,the earlier among Presocratic philosophers referring to the Hot and the Cold as fundamental concepts used to establish his cosmological system.Through this comparison,I indicate that the similarity between ancient Chinese and Western traditions is far more significant than what people are used to imagining.     

Perversion and infancy and adolescence

Abstract

Studying the works of Freud and Lacan, the authors carried out research on perversion in childhood. Their work covered the perverse polymorphism of infantile sexuality and the perception of the anatomic difference between the sexes that leads the child to create sexual theories and fantasies. The phallic mother and the fetish are viewed as imaginary solutions directly related to the Oedipus and castration complexes. In perversion, a particular position is taken in relation to the Oedipus complex: a serious flaw occurs in the symbolization of the law, and the mechanisms of denial and disavowal take form. Sexuality requires a second “logical time,” separated from infancy by the latency period, in order to confirm (in action) that a fixed position of jouissance (enjoyment) has actually been established. This can only happen in a period after adolescent enhancement. The distinction between perverse traces and a perverse structure is made, taking into account the fact that, in the case of child analysis, the analyst should free the child from the family fantasy and help him/her to build his/her own fantasy.

Campos Santoro V. et al. Perversion und Kindheit und Adoleszenz.

Im Studium der Arbeiten von Freud und Lacan haben die Autoren Forschung über Perversion in der Kindheit gemacht. Die Studien behandeln den perversen Polymorphismus der infantilen Sexualität und die Wahrnehmung des anatomischen Unterschiedes zwischen den Geschlechtern, welche das Kind dazu führt, Sexual-Theorien und Phatasien zu schaffen.

Die phallische Mutter und der Fetisch werden als imaginäre Lösungen angesehen, die sich direkt auf den Ödipus- und Kastrations-Komplex beziehen. Bei der Perversion wird eine besondere Position in Bezug auf den Ödipus angenommen; ein ernsthafter Mangel tritt bei der Symbolisierung des Rechts auf; die Mechanismen der Verneinung und der Verleugnung bilden sich. Sexualität erfordert eine zweite “logische Zeit”, von der Kindheit durch die Latenz Periode getrennt, um (in der Handlung) zu bestätigen, daß eine fixierte Position der jouissance (Vergnügung) sich tatsächlich etabliert hat. Das kann sich nur in einer Periode nach der adoleszenten Verstärkung ereignen.

Es wird die Unterscheidung zwischen perversen Spuren und einer perversen Struktur gemacht, in Rechnung stellend, daß im Fall der Kinder-Analyse der Analytiker das Kind von der Familien-Phantasie befreien sollte und ihm/ihr helfen sollte, seine/ihre Phantasie auszubilden.

Campos Santoro V. Perversión e infancia y adolescencia.

Estudiando los trabajos de Freud y Lacan, los autores han investigado la perversión en la niñez. Los estudios cubren la sexualidad infantil perversa polimorfa y la percepción de la diferencia anatómica entre los sexos, que llevan al niño a crear teorías sexuales y fantasías.

La madre fálica y el fetiche son vistos como soluciones imaginarias relacionadas directamente con el complejo de Edipo y de castración. La perversión, toma una posición particular en relación al Edipo; un fallo importante tiene lugar en la simbolización de la ley; los mecanismos de negación y repudio toman forma. La sexualidad requiere un segundo “tiempo lógico” separado de la infancia por el periodo de latencia, para confirmar (en acto) que una posición fija de jouissance (goce) se ha establecido. Esto solo puede ocurrir en un periodo posterior a la intensificación adolescente.

La distinción entre las huellas perversas y la estructura perversa se ha hecho, teniendo en cuenta que, en el caso del análisis de niños, el analista debe librar al niño de la fantasía familiar y ayudar a el/ella a construir su propia fantasía.     

Human Dignity and the Ethics and Aesthetics of Pain and Suffering

Inasmuch as unmitigated pain and suffering areoften thought to rob human beings of theirdignity, physicians and other care providersincur a special duty to relieve pain andsuffering when they encounter it. When pain andsuffering cannot be controlled it is sometimesthought that human dignity is compromised.Death, it is sometimes argued, would bepreferred to a life without dignity.Reasoning such as this trades on certainpreconceptions of the nature of pain andsuffering, and of their relationships todignity. The purpose of this paper is to laybare these preconceptions. The duties torelieve pain and suffering are clearly mattersof moral obligation, as is the duty to respondappropriately to the dignity of other persons.However, it is argued that our understanding ofthe phenomena of pain and suffering and theirrelationships to human dignity will be expandedwhen we explore the aesthetic dimensions ofthese various concepts. On the view presentedhere the life worth living is both morally goodand aesthetically beautiful. Appropriate``suffering with' another can help to maintainand restore the dignity of the relationshipsinvolved, even as it preserves and enhances thedignity of patient and caregiver alike.     

自我刻板化及其影响因素与效果

自我刻板化是指个体自认为某群体的成员时,把伴随此种身份的刻板印象加诸于自己身上的过程。该文首先简要介绍了自我刻板化的理论基础——自我归类理论,然后从自我刻板化的行为效应、态度效应以及影响自我刻板化的因素等方面对以往的相关研究进行了回顾。最后,指出未来的研究还有必要加强对自我刻板化的应用研究等五方面问题的探讨     

微生物与行为和精神疾病

病原微生物能够影响宿主的大脑和行为, 甚至诱发精神疾患。肠道细菌可影响小鼠的神经系统发育和行为模式的发展。慢性胃肠病、慢性疲劳综合征等生理疾病中的行为改变与微生物有关; 肝性脑病、多发性硬化等中枢神经系统生理疾病也可能由微生态改变引起; 抑郁症、孤独症等精神疾病与肠道细菌状态和比例有关; 卫生假说支持上述观点。建立良好的共生微生物平衡有利于人类身心健康。可以预期, 共生微生物与身心健康的关系将是今后心理学研究的关注热点。     

Self-regulatory and narcissistic grandiosity and vulnerability: Common and discriminant relations

In three studies we examined the unique relations of narcissistic grandiosity and vulnerability with the self-regulatory factors of promotion, prevention, assessment, and locomotion. We found that grandiosity has unique positive relations with promotion, assessment, and locomotion but is unrelated to prevention (Study 1). We also found that vulnerability has a unique positive relation with assessment, a unique negative one with promotion, and is unrelated to locomotion and prevention (Study 2). Study 3 replicated these findings and demonstrated that they do not derive from the self-regulatory factors’ or grandiosity and vulnerability’s associations with self-esteem. The results indicate that grandiosity and vulnerability have self-regulatory underpinnings and provide evidence of their specific discriminant nature. Further, they indicate that the critical evaluations associated with strong assessment concerns are a significant vulnerability for both narcissism presentations.