拇外翻畸形的发生、发展与外科矫正

拇外翻的发生有内因和外因两个方面,其发病是外因通过内因作用于足的一个过程。遗传、足结构的异常和一些全身性疾病都是常见的内因。而足部负重和鞋的挤压等是常见的外部原因。随着畸形的发展,会引起拇趾一系列病理改变。认识这些病理变化对拇外翻治疗有着重要的意义。手术是治疗拇外翻的主要方法。治疗中既要重视恢复足的功能也要重视足的外观。手术方式的选择主要取决于病理改变,另外,术者还应熟悉每种手术的适应证,同时要考虑患者的年龄和要求以及术者的经验和条件,选择最适合患者的手术方法。     

中医理念在拇趾外翻临床中的运用

探讨运用中医治病求本、阴阳学说、筋束骨、小夹板纸压垫原理、辨证施治等中医理论,构筑的中西医结合微创技术治疗拇外翻畸形的诊疗体系.从拇外翻畸形的病因、病理、矫形手术、手法复位、生物固定、术后康复等几方面,阐述对拇外翻畸形的新的矫形理念.     

中医理念在拇趾外翻临床中的运用

探讨运用中医治病求本、阴阳学说、筋束骨、小夹板纸压垫原理、辨证施治等中医理论,构筑的中西医结合微创技术治疗拇外翻畸形的诊疗体系。从拇外翻畸形的病因、病理、矫形手术、手法复位、生物固定、术后康复等几方面,阐述对拇外翻畸形的新的矫形理念。     

影响药物治疗的疗效和不良反应的内因和外因

影响药物治疗反应(主要指疗效和不良反应)的因素包括内因(如患者的生理因素、体质因素、病理因素和人文因素等)和外因(如疾病的病因和诱因、药物治疗方案及其执行以及社会环境因素等)。内因是基础,外因是条件,外因通过内因而起作用。内因和外因是相对的,并非一成不变。在制定药物治疗方案时,治疗方向和目标既要针对外因,又不能忽视内因。在实施药物治疗方案时,既要重视医务人员的规范,又要关注患者的教育和指导;既要监测疾病的改善,也要观察患者抵抗力的变化。在分析和处理药学问题时,既要从外因如治疗方案的设计和实施上去找原因,也要重视内因的变化对治疗反应的影响。     

对脊柱结核诊疗策略的思考

脊柱结核是临床常见病,其诊疗策略主要包括正确的诊断思路、合适的治疗选择.尤其重视非典型性脊柱结核的诊断,治疗方面要重视药物治疗、营养支持、休息制动等手段.对于需要手术治疗的患者,需个体化选择最适合的术式,且应完整理解并客观评估新技术的应用.     

浅谈垂体腺瘤手术入路的个体化选择

垂体腺瘤的治疗中,外科手术治疗是最佳的选择.本文就各种垂体腺瘤显微手术的入路进行探讨,分析了各种入路的适应证和优缺点.笔者认为,为了提高肿瘤全切率,减少副损伤,改善患者预后,应当根据肿瘤的大小、部位、生长方向,与周围组织结构的关系以及术者的技术和经验,选择合理的个体化手术入路,注重实施个体化的手术治疗方案.     

对脊柱结核诊疗策略的思考

脊柱结核是临床常见病,其诊疗策略主要包括正确的诊断思路、合适的治疗选择。尤其重视非典型性脊柱结核的诊断,治疗方面要重视药物治疗、营养支持、休息制动等手段。对于需要手术治疗的患者,需个体化选择最适合的术式,且应完整理解并客观评估新技术的应用。     

马蹄足与马蹄内翻足的分类及外科治疗策略

马蹄足与马蹄内翻足畸形是下肢畸形中最常见的畸形,其成因复杂,治法众多.为规范治疗及疗效评价,因此有必要对畸形进行分类.以便更好地制定手术策略.秦泗河等国内外学者为此做了大量的工作.对马蹄足及马蹄内翻足进行分类并制定手术策略.根据其成因将畸形分为:先天性、麻痹性、创伤性及痉挛性等.分型的目的是为了更好的治疗,一个良好的手术方案的设计和实施应该达到:足部无疼痛;能用足底负重;步态及外形美观;能穿正常的鞋;足要有弹性;病人及家属满意.将各种畸形逐渐细化,制定手术策略.简要评价了Ilizarov技术在马蹄足畸形矫治方面的应用.     

冠脉介入患者焦虑的原因及对策研究

焦虑是冠脉介入患者常见的应激反应,焦虑引起的各种病理和生理改变会影响患者手术的顺利实施及疗效.本文基于应激理论,从认知因素、人格特征、应对策略、社会支持等方面入手,试图全面系统地探讨冠脉介入患者焦虑的成因和降低患者焦虑的对策.以期对临床心理干预提供理论依据和具体方法.     

浅谈垂体腺瘤手术入路的个体化选择

垂体腺瘤的治疗中,外科手术治疗是最佳的选择。本文就各种垂体腺瘤显微手术的入路进行探讨,分析了各种入路的适应证和优缺点。笔者认为,为了提高肿瘤全切率,减少副损伤,改善患者预后,应当根据肿瘤的大小、部位、生长方向,与周围组织结构的关系以及术者的技术和经验,选择合理的个体化手术入路,注重实施个体化的手术治疗方案。     

Breast Cancer in Men: A Need for Psychological Intervention

Male breast cancer is a serious issue that needs to be addressed more fully by the medical and public community. However, due to a lack of awareness and limited research on the topic, there is a general absence of knowledge concerning the psychological implications of this disease in men as well as a need for greater understanding of the medical diagnosis and treatment of male breast carcinoma. Similarly, there still remains a considerable gender difference between the awareness of female breast cancer and male breast cancer Although breast cancer in men makes up only 1% of all breast cancers reported in the United States, it is increasing in incidence. There are approximately 2000 new cases and approximately 450 deaths due to male breast cancer each year. Breast cancer diagnosis and treatment in men is very similar to that described in women, however, it has been shown that men are being diagnosed at a later stage of the disease than women.     

Comments on Dan Brock and Terrence Reynolds

Responding to accompanying articles by Dan W. Brock and Terrence Reynolds that criticize specific conclusions in his book, The Theory of Morality, Donagan clarifies and defends his arguments concerning the morality of taking innocent human life. The greater part of his article is devoted to a rejoinder to Brock's contention that a "duty-based" theory of the conditions under which it is morally permissible to take human life must be inferior to a "rights-based" one because rights-based theories credit rational beings with more control over what will happen to them, and hence with more autonomy, and because the implications of duty-based theories can be made tolerable only by recourse to the false thesis that, while it is always wrong to kill the innocent, it is not always wrong to let the innocent die. His briefer response to Reynolds expands upon the analysis of a case involving the death of a fetus resulting from a hysterectomy performed on a woman with cancer.     

How Satisficers Get Away with Murder

Traditional Consequentialism is based on a demanding principle of impartial maximization. Michael Slote's 'Satisficing Consequentialism' aims to reduce the demands of Consequentialism, by no longer requiring us to bring about the best possible outcome. This paper presents a new objection to Satisficing Consequentialism. We begin with a simple thought experiment, in which an agent must choose whether to save the lives of ten innocent people by using a sand bag or by killing an innocent person. The main aim of the paper is to demonstrate that, if it is to avoid making unreasonable demands, Satisficing Consequentialism must allow such an agent to kill. It is argued that this result is much more counter-intuitive than the fact that Maximizing Consequentialism permits agents to kill in order to produce the best consequences. The conclusion is that Satisficing Consequentialism is not an acceptable moral theory.     

睾丸Sertoli细胞构建人工免疫赦免区的研究启示

异源胰岛细胞移植中免疫排斥的问题一直是制约胰岛移植成功运用于临床的主要障碍。最近有研究表明,睾丸Sertoli细胞能够表达有效诱导免疫排斥细胞凋亡的Fas配体。因此,通过人工方式为异休移植细胞构建一个类似的局部免疫赦免微环境将成为可能。     

CAN I KILL MY YOUNGER SELF? TIME TRAVEL AND THE RETROSUICIDE PARADOX

If (backward) time travel is possible, presumably so is my shooting my younger self (YS); then apparently I can kill him – I can commit retrosuicide. But if I were to kill him I would not exist to shoot him, so how can I kill him? The standard solution to this paradox understands ability as compossibility with the relevant facts and points to an equivocation about which facts are relevant: my killing YS is compossible with his proximity but not with his survival, so I can kill him if facts like his survival are irrelevant but I cannot if they are relevant. I identify a lacuna in this solution, namely its reliance without argument on the hidden assumption that my killing YS is possible: if it is impossible, it is not compossible with anything. I argue that this lacuna is important, and I sketch a different solution to the paradox.     

Comparing single and serial homicide offenses

Serial homicide has attracted much attention, but little empirical scientific investigation. This exploratory study reports demographic information on a large sample of serial homicide offenders (157 offenders, 608 victims), and compares a subsample of serial homicide offenses with a control group of single homicide offenses. Results show that serial homicide offenders target more women than men, and kill more strangers than family or friends. Single homicide offenders kill men and women in equal frequency, but kill family and friends more often than strangers. Serial homicide offenders kill for apparent sexual motivation more often than for any other reason, while single homicide offenders kill most often out of anger.     

Permissible killing and the irrelevance of being human

This is a review essay of Jeff McMahan's recent book The Ethics of Killing: Problems at the Margins of Life (OUP: 2002). In the first part, I lay out the central features of McMahan's account of the wrongness of killing and its implications for when it is permissible to kill. In the second part of the essay, I argue that we ought not to accept McMahan's rejection of species membership as having any bearing on whether it is permissible to kill a particular individual, as there are ways of understanding its relevance that are more plausible than McMahan allows. A review essay of Jeff McMahan. The Ethics of Killing: Problems at the Margins of Life (Oxford: Oxford University Press, 2002).     

Adopted children who kill their adoptive parents

The killing of parents, frequently referred to as parricide, is a disturbing phenomenon that often generates widespread media coverage. Most of the scholarly literature on this topic has focused on biological offspring who kill mothers and fathers. Some analyses have examined juveniles and adults who kill their stepparents. To date, virtually no research exists on children who kill their adoptive parents because this type of victim–offender relationship has been absent from available homicide databases, thereby preventing such analyses. The present study is a content analysis of news reports of 46 cases of adopted children who killed their adoptive parents in several different countries. Data pertaining to offender and victim demographics, incident characteristics, and the processing of offenders from the initial charge through conviction and sentencing are examined. To the extent possible, media accounts are used to classify cases according to motives or circumstances leading to the killings. The article concludes with a comparison of profiles of children who kill adoptive parents in relation to those who kill biological parents, important observations that emerged from these news accounts, and discussion of possible explanations of parricide by adopted children, including adopted children syndrome, reactive attachment disorder, and biological risk factors. Limitations of this study and directions for future research are addressed.     

CXCR4和CXCR7在甲状腺癌中的表达及病理意义

研究甲状腺癌组织中趋化因子4受体（CXCR4）和趋化因子7受体（CXCR7）的表达情况及临床病理意义。应用免疫组织化学PV-6000法及Westernblot法检测CXCR4与CXCR7在甲状腺癌中的表达。二者在甲状腺癌与甲状腺良性疾病组织的差异均具有统计学意义（P〈0．05）,在甲状腺癌中表达仅与淋巴结转移有关（P〈0．05）,CXCR4与CXCR7之间呈正相关。Westernblot结果提示二者在甲状腺癌中的表达率高于癌旁及甲状腺腺瘤。CXCR4和CXCR7的表达水平与淋巴结转移相关,可作为甲状腺癌预后的判断指标。