重视肠黏膜屏障功能障碍的防治

肠黏膜屏障损伤是严重创伤、感染、手术、休克时常见的病理生理过程,可造成细菌及内毒素移位、肠源性感染,甚至导致全身炎症反应综合征（SIRS）及多器官功能不全（MODS）等。因此对肠黏膜屏障功能障碍的认识与防治尤为重要,积极纠正肠屏障功能障碍将有助于提高疗效、改善患者预后。     

谷氨酰胺在危重患者中的应用

谷氨酰胺(Glutamine,Gln)是体内最为丰富的条件必须氨基酸,危重症患者体内Gln严重缺乏,研究认为适当补充Gln可起到促进肠道黏膜屏障功能恢复、调节细胞免疫等作用,从而降低危重症患者感染性并发症、缩短住院时间及减少ICU费用等,本文就这些方面做一综述。     

幽门螺杆菌相关性胃炎的时空特征研究

研究幽门螺杆菌导致胃黏膜病理损伤表现的多样性与年龄的关系.进行胃镜检查的患者,排除其它脏器疾病,测定尿素酶表达程度.观察黏膜损伤情况并取病理.结果是不同程度尿素酶表达的幽门螺杆菌感染性胃炎表现不同的病理特征;年龄、幽门螺杆菌感染时间及生活事件是相互作用的原因.幽门螺杆菌特征性慢性感染过程及其致病方式使胃黏膜的病理变化有了多样性,高尿素酶表达的幽门螺杆菌引起的增生性病灶乃至隆起性病变的机会随年龄增加及胃黏膜的病理变化而增长.     

营养支持疗法在严重烧伤治疗中的作用

烧伤救治是一个复杂的系统工程,涉及急救、复苏、感染、创面、营养、康复及心理等.营养支持已成为中度以上烧伤患者的重要治疗措施之一:积极正确的营养支持,可促进合成、增强免疫和加速创面愈合,对烧伤救治疗效有明显的改善作用.相反,营养不良可使创面愈合延缓、降低身体抵抗力、易并发感染等并发症,严重影响预后.给予合理的营养支持治疗来维持烧伤患者的营养是严重烧伤治疗中重要措施之一.因此,重视营养支持,相关治疗措施才会发挥应有疗效,烧伤的整体治疗水平才可能提高.     

幽门螺杆菌感染的治疗策略分析

研究发现幽门螺杆菌(Hp)与胃黏膜炎症,胃、十二指肠溃疡,胃黏膜相关淋巴组织淋巴瘤及胃癌等关系密切.然而,Hp感染的治疗应根据细菌本身的致病能力及肠黏膜免疫保护能力确定,对于有致病毒力的Hp感染应及时有效地根除,而部分情况下胃黏膜内Hp感染参与了黏膜免疫防御作用.     

我国开展活体小肠移植的现实和前景

1　我国开展活体小肠移植的必要性1.1　小肠移植是指将异体的一段小肠通过血管吻合、肠道重建的方式移植给由于各种原因而切除或损毁了大部或全部小肠患者的一门外科技术。小肠移植的适应症为各种原因引起的短肠综合征或肠功能不全 ,因经济或医疗问题 (出现并发症或已没有可输液的静脉 )而不能进行肠外营养 (ＴＰＮ )的患者。目前在我国虽然尚无确切的统计资料说明有多少患者需要进行小肠移植 ,但是根据Ｓｔｅｐｈｅｎ[1] 1997年对英国的统计依据推算 :在英国 ,每年每百万人口中有 1至 2人需要进行长期的肠外营养来维持生命 ,其中有近 1/2的…     

幽门螺杆菌相关性胃炎的时空特征研究

研究幽门螺杆菌导致胃黏膜病理损伤表现的多样性与年龄的关系。进行胃镜检查的患者,排除其它脏器疾病,测定尿素酶表达程度,观察黏膜损伤情况并取病理。结果是不同程度尿素酶表达的幽门螺杆菌感染性胃炎表现不同的病理特征;年龄、幽门螺杆菌感染时间及生活事件是相互作用的原因。幽门螺杆菌特征性慢性感染过程及其致病方式使胃黏膜的病理变化有了多样性,高尿素酶表达的幽门螺杆菌引起的增生性病灶乃至隆起性病变的机会随年龄增加及胃黏膜的病理变化而增长。     

腹内压的变化对肠道氧合及功能的影响

以胃黏膜pH值及血浆D-乳酸为监测指标,观察腹高压患者的腹内压变化前后胃肠道氧合及功能的变化。本研究提示胃黏膜pH值可以反映胃肠道的缺血,且早于腹腔间隙综合征出现,可敏感反映腹高压时肠道氧舍情况;血浆D-乳酸可反映肠缺血再灌注时肠屏障功能状态。以上观察为临床提供简便易行的监测手段及治疗思路。     

临床活体部分小肠移植过程中矛盾现象及处理

从1999年至今、在国内我们率先成功地施行两例临床活体部分小肠移植术,在整个处置过程中出现许多的矛盾现象。如术前为纠正患者严重的营养不良,必须给予肠外营养支持。但是,长期的肠外营养又引起患者肝功能损害,使患者无法耐受手术;对受体来讲,当然是移植的肠管越长越有利,但是在活体移植的情况下供体只能有限地提供肠管,且肠管过长受体也无法接受;手术后患者必须应用有效的免疫抑制剂来防治免疫排斥反应,而机体在免疫抑制下极易发生感染,应用强效而广的抗菌素虽然可防治细菌的感染,但是可引起菌群的失调导致真菌感染;为防止血管内血栓的形成,需应用有效的抗凝剂,但同时可导致出血倾向等等。我们体会：正确地处理这些矛盾现象是我们成功的关键。首先要抓重点,抓主要矛盾,同时应对可能出现的问题有所感知并给与预防,尽可能避免副反应的发生。     

幽门螺杆菌感染的治疗策略分析

研究发现幽门螺杆菌（Hp）与胃黏膜炎症,胃、十二指肠溃疡,胃黏膜相关淋巴组织淋巴瘤及胃癌等关系密切。然而,坳感染的治疗应根据细菌本身的致病能力及肠黏膜免疫保护能力确定,对于有致病毒力的坳感染应及时有效地根除,而部分情况下胃黏膜内坳感染参与了黏膜免疫防御作用。     

Wittgenstein and the Dualism of the Inner and the Outer

A dualism characteristic of modern philosophy is the conception of the inner and the outer as two independently intelligible domains. Wittgenstein’s attack on this dualism contains deep insights. The main insight (excavated from §304 and §293 of the Philosophical Investigations) is this: our sensory consciousness is deeply shaped by language and this shaping plays a fundamental role in the etiology of the dualism. I locate this role in the learning of a sensation-language (as described in §244), by showing that this learning is, under another aspect, the incision of language, namely the infliction of cuts upon certain natural-primitive unities between the inner and the outer. These cuts, driven by powerful forces, eventually harden into an entrenched division between the inner and the outer, thereby providing a constant soil for the dualism. That this dualism is rooted in the very learning of a language is cause for ambivalence about language.     

Peter McHugh and Analysis: The One and the Many, the Universal and the Particular, the Whole and the Part

This paper takes the passing of Peter McHugh as an occasion to examine the intellectual development of his work. The paper is mainly focused on the product of his collaboration with his colleague and friend, Alan Blum. As such, it addresses the tradition of social inquiry, Analysis, which they cofounded. It traces the influence of Harold Garfinkel’s Ethnomethodology on McHugh and on the beginning of Analysis. The collaboration with Blum is examined through a variety of coauthored works but most especially in the two books On the Beginning of Social Inquiry (1974) and Self Reflection in the Arts and Sciences (1984). It also examines the relation of his independent writing before 1974, and since 1984 to the expression of the tradition of inquiry as exemplified in those two texts. The paper builds on some interview material with Peter McHugh and reflects on the influence of Peter the teacher as well as the theorist McHugh. Most especially, through its engagement with this material, it seeks to exemplify the dialectic and living nature of the program called Analysis.     

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.     

经济全球化与东西方宗教

本文认为,由于科技的高度发展,信息网络技术的普及,经济全球化已成为不可逆转的发展趋势;而经济全球化必然带来东西方宗教的种种变化。作者从传统宗教的复兴、民族宗教的冲突、宗教与政治的结缘。宗教的普世化与本色化、新兴宗教的异军突起及东西方宗教的交流与融合等６个方面分析了当前东西方宗教的这种发展趋势。     

Glossolalia and the psychology of the self and narcissism

A survey of the religious and psychological literature on glossolalia (speaking in tongues) reviews the various ways that have been used to try to understand this fascinating practice. At the present time an impasse has been reached: glossolalists can no longer be viewed as suffering from psychopathological disorders or from sociological deprivation. Insights derived from the psychology of the self and narcissism, as presented in the works of Heinz Kohut and D.W. Winnicott, are used to suggest new approaches to understand glossolalia.     

Belief and the problem of Ulysses and the sirens

While self-contained, this paper is a sequel to my Belief and the Will (1984); see theBibliographical Note at the end of this paper for a survey of the relevant literature since then and supplementary references. I have meanwhile benefitted greatly from Brad Armendt's commentary and Richard Foley's How should future opinion affect current opinion?, both presented at a symposium at the APA Central Division, April 1993.     

Spontaneity and Self-Consciousness in the Groundwork and the B-Critique

ABSTRACT

According to some influential readings of the Groundwork of the Metaphysics of Morals, the view presented there of the kind of spontaneity we are conscious of through theoretical reason and the significance of such self-consciousness is irremediably at odds with the Critical theory, and thus roundly and rightly rejected in the second edition of the Critique of Pure Reason and the Critique of Practical Reason. This paper argues, on the contrary, that the Groundwork can be read as articulating for the first time the account of self-consciousness and spontaneity that Kant goes on to develop in the B-Critique, especially the B-Transcendental Deduction.