高血压患者长期应用阿司匹林应注意的问题

我国高血压患者人数已高达1．6亿。高血压的严重后果是心脑血管血栓性事件（心绞痛、心肌梗死、脑梗死等）发生率的显著增高。大量的证据显示,每天100mg阿司匹林可以有效预防血栓性事件,使心肌梗死的发生率下降1／3,脑梗死发生率下降1／4,心血管疾病病死率下降1／6,国内外指南均明确规定有适应证的高血压患者需终身服用阿可匹林。本文就长期应用阿司匹林应注意的问题做一综述。     

中国古代对出生缺陷的认知及态度

婴儿死亡率是反映一个国家卫生发展和社会经济发展状况的重要指标之一。出生缺陷(birth defect)是一种婴儿在母亲的子宫内便发生了的发育异常[1],即出生时就存在的结构、功能和代谢方面的异常,包括先天畸形、智力障碍、代谢性疾病等。当今,出生缺陷已成为婴儿死亡的主要原因之一,而出生缺陷的发生直接影响着婴儿死亡率。我国的出生缺陷发生率也逐年增加、日益突出,1996年~2004年,我国医院出生缺陷发生率呈上升趋势,2004年出生缺陷总发生率为128.38/万[2]。出生缺陷所带来的健康损失和疾病负担引起了全社会的重视,已经成为影响民族素质的公共…     

大学生抑郁状况及相关因素调查

目的：了解当代大学生的抑郁状况及其相关因素,分析研究与发生抑郁相关的心理社会因素,为大学生的心理健康教育及心理疾病防治提供理论支持。方法：采用抑郁自评量表（SDS）和青少年生活事件量表（ASLEC）对分层整群随机抽取的某综合性大学1000名在校本科生进行调查。全部数据运用SPSS10．0软件包进行统计处理。结果：被调查的大学生的抑郁发生率为38．53％。女生的抑郁发生率高于男生;一年级学生的抑郁发生率高于其他年级;农村生源学生的抑郁发生率高于城市生源;高负性生活事件刺激量学生的抑郁发生率明显高于低者;文理科学生的抑郁发生率相近。结论：大学生的抑郁状况值得高度关注,其抑郁情绪与性别、年级、生源地、生活事件经历等因素密切相关,应从加强社会-学校-家庭联系与支持,加强心理健康教育等方面解决相关问题。促进大学生心身健康,使其人格得到逐步完善。     

基督徒妇女如何面对家庭暴力

家庭暴力是一个全球性的社会问题,行为人以殴打、捆绑、残害、强行限制人身自由或者其他手段,给其家庭成员的身体、精神等方面造成一定伤害后果的行为,都属于家庭暴力。持续性、经常性的家庭暴力,构成虐待罪。据有关部门的权威调查,我国家庭暴力的发生率在29.7%到35.7%之间,其中90%以上的受害人是女性。家庭暴力的特征家庭暴力发生在家庭共同生活关系中,     

胰岛素增敏剂使用增加心梗、骨折发生率所引发的思考

在ADOPT研究公布之时,研究者同时发现罗格列酮（一种胰岛素增敏剂）可增加更年期女性骨折发生率,美国心脏病专家Nisson也通过荟萃分析发现罗格列酮可能增加患者的心梗发生率。从而引起了人们对胰岛素增敏剂安全性的顾虑。本文将从免疫损伤修复机制方面探讨骨质疏松、血管钙化及心梗发生之间的关系,并提出胰岛素增敏剂之所以可能会增加骨质疏松和心梗发生,可能与其减轻机体慢性炎症反应、促进炎症修复有关的假设。     

从“扁鹊自责”谈我国糖尿病防治现状及对策

全球糖尿病发病率日益增多。我国糖尿病诊断率及治疗达标率低,并发症发生率高、进展快,治疗现状令人担忧。减轻体重干预糖耐量受损,是决定疾病转归的关键环节、生活方式及药物干预均可降低糖尿病发生率。只有重视普及糖尿病相关知识,提高专业队伍素质,针对高危人群重点筛查及干预,早期发现糖尿病及综合治疗,才有可能减少糖尿病发病率及致残、致死率。     

下肢深静脉血栓患者预防性置入下腔静脉滤器的临床决策

下肢深静脉血栓的患者,预防性置入下腔静脉滤器,可有效预防致命性肺栓塞。但致命性肺栓塞的发生率低,滤器置入是侵入性手术,术后需长期抗凝。下肢深静脉血栓患者是否常规置入滤器,临床上仍存在争议。本文对目前我国下腔静脉滤器置入现状进行分析,提出除一些特殊情况外,滤器置入不应作为一种常规,为临床决策提供参考。     

日本医疗纠纷防范处理措施研究

日本的人文以及社会文化背景与我国相近,而日本医院精细化的管理,医师协会创立的医疗责任保险以及有效的医疗纠纷处理机制,使得日本的医疗纠纷发生率一直较低.通过分析日本在防范医疗纠纷中以上几方面的成功经验,提出对我国医疗纠纷防范的启示,为我国当前医疗纠纷的防范和处理提供有益的参考.     

从"扁鹊自责"谈我国糖尿病防治现状及对策

全球糖尿病发病率日益增多.我国糖尿病诊断率及治疗达标率低,并发症发生率高、进展快,治疗现状令人担忧.减轻体重干预糖耐量受损,是决定疾病转归的关键环节、生活方式及药物干预均可降低糖尿病发生率.只有重视普及糖尿病相关知识,提高专业队伍素质,针对高危人群重点筛查及干预,早期发现糖尿病及综合治疗,才有可能减少糖尿病发病率及致残、致死率.     

关注心房颤动的临床治疗决策

心房颤动发生率很高,我国为0．77％,估计有1000万患者。房颤分类为初发房颤、阵发性房颤、持续性房颤和永久性房颤。房颤病因众多,包括高血压病、心肌病、心衰、甲亢及冠心病等。房颤危害严重,房颤引发卒中高出5倍,房颤促进或加重心衰,房颤增加痴呆2倍。房颤增加病死率,严重降低患者生命质量。房颤治疗决策主要恢复正常窦性心律,并预防其复发和控制心室率与抗凝治疗预防血栓事件。     

知道感（FOK）和不知道感（FOnK）的实验分离

新近的脑成像研究结果提示：“知道感”（FOK）与“不知道感”（FOnK）可能是由两种不同的认知与脑机制所实现的。尽管这一设想质疑了以往的知道感研究中对此二者不加区分的处理方法,但脑成像研究在本质上是一种相关研究,因而并不能提供因果性的推论。这项行为实验将加工深度对FOK和FOnK的影响分开来加以考察,结果发现：深度加工只能使FOK的预测准确性增加,但却不但不能使FOnK的预测准确性增加,反而会使之降低。上述结果在（1）被试内设计,（2）被试间设计,（3）排除熟悉性所导致的不确定的再认等三种情况下都成立。上述结果为知道感的“双过程假设”提供了来自行为研究的证据。     

Le médecin expert confronté aux confidences de la personne expertisée

During an expertise, if the expert “discovers” or is entrusted with information concerning an offence, should he report it to the authorities? Could the expert be sanctioned in the absence of denunciation of a tort or criminal act? The answer will be nuanced on a case-by-case basis. The expert confronted with the revelation of a crime or misdemeanor must decide in good conscience what he reveals in his report, or even report it to the prosecution.     

Exploring the Non-objectified Character of Dao in the Laozi: A Modem Articulation

This article focuses on the interpretation of heng dao 恆 道 (sometimes translated as "the constant dao") and its fundamental character in the Laozi.It argues against the prevailing interpretation of dao as an unchanging metaphysical substance or reality,and maintains that the fundamental feature of heng dao is both dynamic and eternal.Heng dao is beyond language because of its dynamic character,but the Laozi nevertheless strives to express it in three aspects:1) its flexibility and adaptability as represented in the metaphor of water;2) its movement of reversal and return;3) and in its existential significance as a guide for life.Heng dao can be called the non-objectified dao,which produces law,principle,rule,method,and so on.Looked at in this way,the dynamic character of heng dao can be called non-objective.     

Causalité juridique et imputabilité médicale : l’incidence de l’approche juridique du lien de causalité sur la pratique expertale en droit de la réparation du dommage corporel

Traditionally, a “direct and certain” causal link was required between fault and harm in order to engage an individual's compensatory liability. However, upon reading case law, it is possible to note that causality no longer necessarily has to be either direct or certain. Indeed, although the presence of a previous condition long enabled the exclusion of a direct link between a harmful event and its aftereffects, the French Court of Appeal (Cour de Cassation) now considers that pathological predispositions must no longer be taken into account (in respect of an exclusion or a reduction in the right to compensation) if these were latent, and only revealed by the harmful event. Similarly, on occasion the plaintiffs support their claims with bundles of evidence and arguments that can but force magistrates to set aside the absence of absolute certainty on a scientific level. Presumptions of accountability have even been put forward in some areas of personal injury compensation (traffic accidents and workplace accidents). The conduct and content of forensic expertises are then disrupted, both for the expert and for the victim's lawyer.     

Missing piece of the puzzle in the science of consciousness: Resting state and endogenous correlates of consciousness

Consciousness still stands as one of the most interesting and the most elusive problems of neuroscience. Finding its correlates is the first step toward its satisfactory explanation. Several theories have proposed its correlates but none of them seem to be generally accepted even though most of them share some very similar elements. These elements are the activity of the thalamus, which is considered by some as the central region for consciousness, and gamma synchronization, which should be the general principal for the emergence of conscious experience. However, all of these proposed theories share one characteristic and that is that they do not take into consideration the recently discovered endogenous activity of the brain, which is generally associated with the default mode network. Although the activity of this large scale brain network is in correlation with various levels of consciousness it is still missing in discussions of consciousness. This review recognizes the importance of endogenous activity and points out the important discoveries of endogenous activity that could be an important step toward a satisfactory explanation of consciousness.     

Civil law regulation and criminal enforcement of mandatory vaccination policies: A comparative aspect

One of the most important tasks of any state is to provide everyone, including the child, with the opportunity for a healthy and fulfilling life. Processes of immunisation through vaccination are considered most appropriate for the prevention of infectious diseases. The purpose of this study is to understand the legal regulation of immunisation of the population and to give it a legal assessment, to review the legal acts on vaccination in different countries of the world and to identify the legal tendencies of resolving conflicts in the field of vaccination on the basis of court decisions. As a result of the research the prospective directions of work of civil and criminal regulation of vaccination of children, regulation of the right to education for children who have not been vaccinated, the lawsuits, petitions and court decisions regarding the population response to vaccinations were analysed. The authors of the study conclude on the methods of introducing mandatory vaccination of children, the development of new criminal legislation to protect rights and freedoms.