功能性便秘

功能性便秘是常见的慢性便秘，罗马III提出了新的诊断标准。功能性便秘的一般治疗包括定期排便、增加活动、增加纤维素摄取，改变生活方式和调整情绪。慢传输型便秘的药物选择膨胀性泻药、渗透性泻剂、促动力剂、氯通道激活剂等。功能性排便障碍型患者可选择生物反馈治疗。治疗成功后应调节剂量，维持疗效。外科治疗应有严格的适应证。进一步研究结肠动力与排便生理，以提高对疾病的认识和提出有效的治疗。     

生物反馈在功能性结直肠病中的应用及体会

生物反馈作为一种新兴的行为疗法,在治疗功能性结直肠病中发挥着越来越重要的作用,主要用于治疗功能性大便失禁和功能性便秘。根据目前的研究,依从性和心理状况是影响生物反馈疗效的主要因素。本文就生物反馈在功能性结直肠病中的应用及体会做一综述。     

功能性内窥镜鼻窦外科应用的情况及问题

20世纪70年代,以慢性鼻窦炎/鼻息肉为主要治疗对象的功能性内窥镜鼻窦外科的创立和发展,开辟了鼻窦外科的新领域。功能性内窥镜鼻窦外科技术把鼻窦外科推向了新的阶段,使鼻窦炎临床治愈率提高到80%~90%,已成为国内外鼻窦炎外科治疗的主要方式。回顾功能性内窥镜鼻窦外科的发展历史,分析了鼻腔-鼻窦病变中应用的情况,并提出了应用中应处理好的两个问题,对准确把握功能性内窥镜鼻窦外科发展的趋势和特点具有重要的作用。     

功能性胃肠病的病因和发病机制研究进展

功能性胃肠病（FGIDs）是一组常见的消化科疾病,其病因和发病机制复杂繁多,与遗传和心理社会因素具有一定的关系,胃肠动力、内脏感觉、脑肠肽等在FGIDs发病中的作用已得到肯定,近年来关于炎症和肠道茵群在FGIDs中作用的研究较多,对FGIDs病因机制的阐明将使其诊断和治疗提高到一个新的水平。     

功能性内窥镜鼻窦外科应用的情况及问题

20世纪70年代,以慢性鼻窦炎/鼻息肉为主要治疗对象的功能性内窥镜鼻窦外科的创立和发展,开辟了鼻窦外科的新领域.功能性内窥镜鼻窦外科技术把鼻窦外科推向了新的阶段,使鼻窦炎临床治愈率提高到80%～90%,已成为国内外鼻窦炎外科治疗的主要方式.回顾功能性内窥镜鼻窦外科的发展历史,分析了鼻腔-鼻窦病变中应用的情况,并提出了应用中应处理好的两个问题,对准确把握功能性内窥镜鼻窦外科发展的趋势和特点具有重要的作用.     

中国林县帕金森病患者非运动症状调查

调查中国林县PD患者非运动症状发生状况.对中国林县PD患者和对照人群进行痴呆诊断、运动功能损害评估及其他非运动症状,包括便秘、抑郁、焦虑、睡眠评估.PD患者MMSE平均分为19 (15.00～22.50)分,正常对照人群MMSE平均分21(17.25～24.00)分.两组人群时间定向和MMSE总分两组比较P＜0.05,差异有统计学意义.PD患者抑郁自评分数平均为(39.43士7.95)分,正常对照人群平均分数为(33.34±9.36)分,两组之间有显著差异(P＜0.05).PD患者焦虑患病率(43.3％),与对照人群间差异不显著.38.81％PD患者便秘,与对照组之间差异不显著.PD患者常见非运动症状,以认知功能损害、抑郁、焦虑、便秘为主要表现.     

超声药物透入靶向性治疗胸腰椎骨折后腹胀的疗效研究

观察胸腰椎骨折后,应用超声药物透入治疗腹胀的临床效果.60例胸腰椎骨折后腹胀的患者,随机分为治疗组和对照组,每组30例.治疗组:应用胃肠宁凝胶贴片超声药物透入;对照组:应用复方大承气汤口服治疗.记录两组患者肛门排气、排便及腹胀缓解时间,按照相应标准进行疗效评价.结果两组患者肛门初次排气、排便时间及总有效率比较,差异具有统计学意义(P＜0.05).超声药物透入治疗可促进脊柱骨折患者排气、排便,加快胃肠功能恢复,显著改善腹胀症状.     

美托洛尔常规治疗与基因导向治疗高血压病的比较

功能性胃肠病（FGIDs）是一组常见的消化科疾病，其病因和发病机制复杂繁多，与遗传和心理社会因素具有一定的关系，胃肠动力、内脏感觉、脑肠肽等在FGIDs发病中的作用已得到肯定，近年来关于炎症和肠道茵群在FGIDs中作用的研究较多，对FGIDs病因机制的阐明将使其诊断和治疗提高到一个新的水平。     

市场经济与社会发展动力机制

社会发展有其动力机制。它的一般特征是社会要素的联系性、社会体系的系统性、社会发展的双向性和利益性。在市场经济条件下,社会发展的动力机制有了崭新的内容和时代特色。其内容主要包括新的淘汰机制、投入产出机制、竞争机制、功能机制、活力机制和利益机制。市场经济对社会发展动力机制的功能性影响是:导向功能、催化功能、规范功能和制约功能。     

功能性胃肠病的发病机制

功能性胃肠病（functional gastrointestinal disorders,FGIDs）是一类常见的消化道疾病,近几年其发病率有明显增高的趋势。以往认为FGIDs主要是由胃肠道动力障碍所引起,但近几年随着人们对这类疾病认识的进一步深入,发现其与内脏感觉、炎症、肠神经系统（ENS）甚至中枢神经系统（CNS）调节功能等因素有关。因此,明确FGIDs的病因和发病机制成为对其进行针对性治疗的突破口。     

A four-part working bibliography of neuroethics: part 1: overview and reviews – defining and describing the field and its practices

Background

Neuroethics entails investigations of neurocognitive mechanisms of morality and ethics; and studies and address of the ethical issues spawned by the use of neuroscience and its technologies to investigate cognition, emotion and actions. These two principal emphases, or what have been called “traditions” of neuroethics both mirror traditional bioethical discussions (such as debates about the safety of technological and pharmaceutical advances and ethical implications of new scientific and technological discoveries), and engage discourse about neuroscientific investigations of (proto-moral and moral) cognition, emotions and behaviors, and what such findings may mean for human beliefs and conduct - from the individual to the political levels.Given the growth, range, and rapid maturation of the field of neuroethics we provide an iterative, four-part document that affords a repository of international papers, books, and chapters that address the field in overview, and present discussion(s) of more particular aspects and topics of neuroethics. This first installment lists reviews and overviews of the discipline, and broad summaries of basic developments and issues of the field.

Methods

To systematically survey the neuroethics literature, searches were performed by accessing 11 databases, 8 additional literature depositories, and 4 individual journal searches using indexing language for National Library of Medicine (NLM) Medical Subject Heading databases. Searches and assurance against overlapping coverage were conducted using the RefWorks citation management program.

Results

Overview, review and reflections upon the history and multicultural perspectives of neuroethics were obtained and relevant listings from international journals, books, and book chapters are provided. Part I will be followed by three installments that will address a): the neuroscience of morality and ethics, including discussions of free will, and personal autonomy; b) “second tradition neuroethics”, to include specific ethical issues in neuroscience; clinical neuroethics; and c) neuroethics education/training; neuroethics and society; neuroethics and law; neuroethics and policy; and international neuroethics.

     

Translating Neuroethics: Reflections from Muslim Ethics

Muslim ethics is cautiously engaging developments in neuroscience. In their encounters with developments in neuroscience such as brain death and functional magnetic resonance imaging procedures, Muslim ethicists might be on the cusp of spirited debates. Science and religion perform different kinds of work and ought not to be conflated. Cultural translation is central to negotiating the complex life worlds of religious communities, Muslims included. Cultural translation involves lived encounters with modernity and its byproduct, modern science. Serious ethical debate requires more than just a mere instrumental encounter with science. A robust Muslim approach to neuroethics might require an emulsion of religion and neuroscience, thought and body, and body and soul. Yet one must anticipate that Muslim debates in neuroethics will be inflected with Muslim values, symbols and the discrete faith perspectives of this tradition with meanings that are specific to people who share this worldview and their concerns.     

Imaging or imagining? A neuroethics challenge informed by genetics

From a twenty-first century partnership between bioethics and neuroscience, the modern field of neuroethics is emerging, and technologies enabling functional neuroimaging with unprecedented sensitivity have brought new ethical, social and legal issues to the forefront. Some issues, akin to those surrounding modern genetics, raise critical questions regarding prediction of disease, privacy and identity. However, with new and still-evolving insights into our neurobiology and previously unquantifiable features of profoundly personal behaviors such as social attitude, value and moral agency, the difficulty of carefully and properly interpreting the relationship between brain findings and our own self-concept is unprecedented. Therefore, while the ethics of genetics provides a legitimate starting point--even a backbone--for tackling ethical issues in neuroimaging, they do not suffice. Drawing on recent neuroimaging findings and their plausible real-world applications, we argue that interpretation of neuroimaging data is a key epistemological and ethical challenge. This challenge is two-fold. First, at the scientific level, the sheer complexity of neuroscience research poses challenges for integration of knowledge and meaningful interpretation of data. Second, at the social and cultural level, we find that interpretations of imaging studies are bound by cultural and anthropological frameworks. In particular, the introduction of concepts of self and personhood in neuroimaging illustrates the interaction of interpretation levels and is a major reason why ethical reflection on genetics will only partially help settle neuroethical issues. Indeed, ethical interpretation of such findings will necessitate not only traditional bioethical input but also a wider perspective on the construction of scientific knowledge.     

Imaging or Imagining? A Neuroethics Challenge Informed by Genetics

From a twenty-first century partnership between bioethics and neuroscience, the modern field of neuroethics is emerging, and technologies enabling functional neuroimaging with unprecedented sensitivity have brought new ethical, social and legal issues to the forefront. Some issues, akin to those surrounding modern genetics, raise critical questions regarding prediction of disease, privacy and identity. However, with new and still-evolving insights into our neurobiology and previously unquantifiable features of profoundly personal behaviors such as social attitude, value and moral agency, the difficulty of carefully and properly interpreting the relationship between brain findings and our own self-concept is unprecedented. Therefore, while the ethics of genetics provides a legitimate starting point—even a backbone—for tackling ethical issues in neuroimaging, they do not suffice. Drawing on recent neuroimaging findings and their plausible real-world applications, we argue that interpretation of neuroimaging data is a key epistemological and ethical challenge. This challenge is two-fold. First, at the scientific level, the sheer complexity of neuroscience research poses challenges for integration of knowledge and meaningful interpretation of data. Second, at the social and cultural level, we find that interpretations of imaging studies are bound by cultural and anthropological frameworks. In particular, the introduction of concepts of self and personhood in neuroimaging illustrates the interaction of interpretation levels and is a major reason why ethical reflection on genetics will only partially help settle neuroethical issues. Indeed, ethical interpretation of such findings will necessitate not only traditional bioethical input but also a wider perspective on the construction of scientific knowledge.     

Neuroethics,confidentiality, and a cultural imperative in early onset Alzheimer disease: a case study with a First Nation population

The meaningful consideration of cultural practices, values and beliefs is a necessary component in the effective translation of advancements in neuroscience to clinical practice and public discourse. Society’s immense investment in biomedical science and technology, in conjunction with an increasingly diverse socio-cultural landscape, necessitates the study of how potential discoveries in neurodegenerative diseases such as Alzheimer disease are perceived and utilized across cultures. Building on the work of neuroscientists, ethicists and philosophers, we argue that the growing field of neuroethics provides a pragmatic and constructive pathway to guide advancements in neuroscience in a manner that is culturally nuanced and relevant. Here we review a case study of one issue in culturally oriented neuroscience research where it is evident that traditional research ethics must be broadened and the values and needs of diverse populations considered for meaningful and relevant research practices. A global approach to neuroethics has the potential to furnish critical engagement with cultural considerations of advancements in neuroscience.     

A four-part working bibliography of neuroethics: part 3 – “second tradition neuroethics” – ethical issues in neuroscience

Background

Neuroethics describes several interdisciplinary topics exploring the application and implications of engaging neuroscience in societal contexts. To explore this topic, we present Part 3 of a four-part bibliography of neuroethics’ literature focusing on the “ethics of neuroscience.”

Methods

To complete a systematic survey of the neuroethics literature, 19 databases and 4 individual open-access journals were employed. Searches were conducted using the indexing language of the U.S. National Library of Medicine (NLM). A Python code was used to eliminate duplications in the final bibliography.

Results

This bibliography consists of 1137 papers, 56 books, and 134 book chapters published from 2002 through 2014, covering ethical issues in neuroimaging, neurogenetics, neurobiomarkers, neuro-psychopharmacology, brain stimulation, neural stem cells, neural tissue transplants, pediatric-specific issues, dual-use, and general neuroscience research issues. These works contain explanations of recent research regarding neurotechnology, while exploring ethical issues in future discoveries and use.

     

Legal and ethical issues in neuroimaging research: human subjects protection,medical privacy,and the public communication of research results

Humans subjects research entails significant legal and ethical obligations. Neuroimaging researchers must be familiar with the requirements of human subjects protection, including evolving standards for the protection of privacy and the disclosure of risk in "non-therapeutic" research. Techniques for creating veridical surface renderings from volumetric anatomical imaging data raise new privacy concerns, particularly under the federal medical privacy regulation. Additionally, neuroimaging researchers must consider their obligation to communicate research results responsibly. The emerging field of neuroethics should strive to raise awareness of these issues and to involve neuroimaging researchers in the legal, ethical, and policy debates that currently surround human subjects research.     

The molecules of social recognition memory: implications for social cognition, extended mind, and neuroethics

Social cognition, cognitive neuroscience, and neuroethics have reached a synthesis of late, but some troubling features are present. The neuroscience that currently dominates the study of social cognition is exclusively cognitive neuroscience, as contrasted with the cellular and increasingly molecular emphasis that has gripped mainstream neuroscience over the past three decades. Furthermore, the recent field of molecular and cellular cognition has begun to unravel some molecular mechanisms involved in social cognition, especially pertaining to the consolidation of memories of particular conspecific organisms. Some new experimental techniques for positive interventions into these hypothesized mechanisms offer opportunities for establishing direct causal linkages between intra-neuronal molecular events and the behaviors used to measure social cognitive phenomena. Predicted results from an experiment described below also cast doubt on the application of the “extended mind” approach from recent cognitive science to ground the neuroscience of social cognition. Since neuroethics relies heavily on our best neuroscience of social cognition, that field may soon need to extend its attention beyond cognitive neuroscience, and into neuroscience’s cellular and molecular mainstream.     

A four-part working bibliography of neuroethics: Part 4 - Ethical issues in clinical and social applications of neuroscience

Background

As a discipline, neuroethics addresses a range of questions and issues generated by basic neuroscientific research (inclusive of studies of putative neurobiological processes involved in moral and ethical cognition and behavior), and its use and meanings in the clinical and social spheres. Here, we present Part 4 of a four-part bibliography of the neuroethics literature focusing on clinical and social applications of neuroscience, to include: the treatment-enhancement discourse; issues arising in neurology, psychiatry, and pain care; neuroethics education and training; neuroethics and the law; neuroethics and policy and political issues; international neuroethics; and discourses addressing "trans-" and "post-" humanity.

Methods

To complete a systematic survey of the literature, 19 databases and 4 individual open-access journals were employed. Searches were conducted using the indexing language of the U.S. National Library of Medicine (NLM). A Python code was used to eliminate duplications in the final bibliography.

Results

When taken with Parts 1-3, this bibliography aims to provide a listing of international peerreviewed papers, books, and book chapters published from 2002 through 2016. While seeking to be as comprehensive as possible, it may be that some works were inadvertently and unintentionally not included. We therefore invite commentary from the field to afford completeness and contribute to this bibliography as a participatory work-in-progress.