精子捐赠与伦理

引起男性不育的一个重要原因是无精症、死精症.精子捐赠的出现为这些患者带来了福音,使其享受天伦之乐成为可能,但同时也带来了一系列伦理学、社会学上的问题,包括子代的知情权问题、近亲结婚问题、家庭内部矛盾问题等等.因此要准确认识、运用和完善新的医学技术,并对其进行伦理和法律的规范,防止滥用.     

男性不育症诊疗中的伦理学思考

男性不育症是影响男性身心健康的重要疾患。生殖医学,特别是辅助生殖技术突飞猛进的发展,给男性不育症患者带来了福音,同时也给社会带来了许多伦理学问题。在工作中,医生应将伦理学原则与诊疗规范相结合,思考遇到的伦理学问题,自觉遵守医学伦理学规范。唯有这样,才能使生殖医学健康发展,才能保证患者最大程度受益。     

男性不育症诊疗中的伦理学思考

男性不育症是影响男性身心健康的重要疾患.生殖医学,特别是辅助生殖技术突飞猛进的发展,给男性不育症患者带来了福音,同时也给社会带来了许多伦理学问题.在工作中,医生应将伦理学原则与诊疗规范相结合,思考遇到的伦理学问题,自觉遵守医学伦理学规范.唯有这样,才能使生殖医学健康发展,才能保证患者最大程度受益.     

囤积症的行为心理特征及相关因素

囤积症是指过度获取和不能丢弃那些没有用处或失去价值的物品。这种行为通常会给患者本人及其家庭成员带来感情、躯体、财务、社会甚至法律方面的负面影响。对于囤积症的行为特征、心理特征及相关因素,学界已有大量的研究。近期,囤积症已被纳入DSM-5,这将有助于确定有持续性丢弃困难的个体,并对其予以帮助与干预。     

膀胱过度活动症诊治的思考

随着老年人口的增多,膀胱过度活动症的发病率也会逐年升高,但其确切病因不清楚,临床症状不典型,很多患者对这种疾病认识不够,严重影响着患者的生活质量,给患者带来了极大的生理和心理上的困扰。因此,临床工作中应注意发现膀胱过度活动症相关的临床症状,结合完整全面的病史,进行体格检查和相关的辅助检查,及早诊断并给予合理的治疗,提高患者的生活质量。     

电影《消失的爱人》中“艾米”角色心理分析

好莱坞著名导演大卫·芬奇于201 4午带来又一悬疑类型力作《消失的爱人》.片中的女主角艾米,其行为模式充满了令人惊恐的色彩.深入分析其心理根源可以发现:艾米是一位自我认知障碍症患者及角色扮演的痴迷者.尼克与艾米的婚姻,从开始到破裂,再到复合,始终都围绕着角色扮演的问题.能不能继续表演,是这场婚姻的内在逻辑,至于感情、责任,这些通俗视野下的婚姻要素,对他们而言,只是包装的道具.     

消化内镜诊疗技术创新的哲学思考

科学技术的发展离不开技术创新,技术创新给人类带来了高回报,同时也给人类带来了高投入和高风险。在医学领域,技术创新有其特殊性,新技术再给患者带来了利益,同时也伴随而生着负效应,如医疗费用的增加、过度医疗、伦理问题、并发症等等,甚至可以阻碍技术创新。那么,如何处理好技术创新的利与弊,如何使技术创新真正发挥其应有的作用。本文从哲学角度对消化内镜诊疗技术创新的本质及特征、过度手术、伦理问题、并发症等方面进行了探讨。     

恐音症的临床心理特征及其神经机制

恐音症是一种特殊的情绪性心理障碍,会导致患者对某些日常声音产生负面情绪、生理唤醒和异常行为,并严重影响其身心发展和社会适应。恐音症与强迫症等心身疾病存在症状上的重叠,但其在脑岛、眶额皮层、运动皮层上却表现出神经特征的独特性。进一步的脑成像显示,恐音症在视听皮层、边缘系统、自主神经系统、脑岛、运动皮层间存在异常功能连接。强烈世界理论和过度镜像模型为恐音症在注意系统、感知系统、情绪系统、感知-动作联结系统等异常方面提供了其临床心理及神经机制的解释。在此基础上,通过区分单通道干预和跨通道干预方案,从修正认知、重塑神经活跃程度、改善脑区间功能连接等角度,为完善和建构恐音症治疗方案提供新思路。     

代谢手术的近期与远期并发症

代谢手术改善代谢的机制可能与能量摄入限制、吸收不良、胃肠道激素及脂肪细胞因子等体内多种因素的改变有关,为病态肥胖及代谢性疾病的治疗带来了新的方法和希望。但是手术本身也会带来一系列近期和远期并发症,其中近期并发症包括吻合口瘘、肺栓塞、伤口感染、切口疝、深静脉血栓、横纹肌溶解症等,远期并发症包括蛋白质、维生素等营养代谢紊乱以及铁、锌、硒等微量营养素的缺乏。     

睾丸微石症和成年男性精子质量关系探究

探讨睾丸微石症及其不同类型（CTM／LTM）和成年男性精子质量之间的关系,分析其相关性,为临床诊疗提供参考。回顾性分析接受精液常规检查并发现精子的41例睾丸微石症患者,并分为经典型睾丸微石症（CTM）和限制型睾丸微石症（LTM）两组进行对比。结果显示,在精子总数、精子总活力、前向运动精子率和不活动精子率方面,两组比较差异有统计学意义（P〈0．05）。相比LTM,CTM对精子质量的影响更明显。不同类型睾丸微石症和成年男性精子质量之间有关联,呈现出负相关。     

宫颈癌普查与人文关怀

随着不育症患者的不断增多,不育症治疗技术的迅速发展及医学模式的转化,在不育症临床诊疗中应树立人文关怀的理念,强化人性化服务的意识。在工作中应遵循患者第一的原则并恪守心身统一原则、保密原则、最优化原则、知情同意等原则。在治疗过程对患者同情、鼓励以及进行心理治疗,体现人文关怀,构建和谐的诊疗气氛。     

Psychoneuroimmunology and male infertility: A possible link between stress,coping and male immunological infertility

Abstract

This current study investigated a link between stress and coping with some male infertility problems via psychoneuroimmunological theories. The study was carried out on 77 males who came to a fertility clinic for sperm diagnosis. Appraisal and coping with stress reaction to negative life events and to infertility were related to non-sperm cells within the seminal plasma. Those men who had felt strained from external events and from problems of infertility, and had used emotional escape coping strategies, were more prone to have an immunosuppressed reaction, indicated by bacteria within their plasma. Those using task focused control strategies were more prone to have an immunostimulatory reaction, indicated by white blood cells, including in some cases, sperm destroying phagocytes suggesting a possible auto-immunity reaction. When the analyses were done separately on patients with known male fertility problems in comparison with those with unexplained infertility, the two opposing psychoneuroimmunological processes became more pronounced.     

Racial and Ethnic Differences in the Utilization of Prayer and Clergy Counseling by Infertile US Women Desiring Pregnancy

Religion can have a significant influence on the experience of infertility. However, it is unclear how many US women turn to religion when facing infertility. Here, we examine the utilization of prayer and clergy counsel among a nationally representative sample of 1062 infertile US women. Prayer was used by 74.8% of the participants, and clergy counsel was the most common formal support system utilized. Both prayer and clergy counsel were significantly more common among black and Hispanic women. Healthcare providers should acknowledge the spiritual needs of their infertile patients and ally with clergy when possible to provide maximally effective care.     

男性不育症临床工作的问题与思考

在临床工作中,不育越来越受到大家的重视,但仍然有许多问题困扰着我们的医疗工作者,多数医生能对男性不育症做出诊断,并给予治疗。但是由于生殖问题的复杂性和我们认识的局限性,不育症的治疗效果并不满意。在不育症诊断和治疗的思路、方法和方式中仍有许多值得探讨和改进之处。     

Psychological and relationship changes of couples undergoing an infertility investigation: Some implications for counsellors

The emotional and psychological aspects of the experience of infertility have been largely ignored by researchers. A study was accordingly undertaken of 43 infertile couples who were undergoing medical investigation of their fertility problems. Preliminary analysis of the data suggests that the infertility investigation was most stressful for the participants at the time of the initial medical interview, and that distress was greater for those who were themselves identified as having an organic fertility problem. A substantial number of the men and women involved indicated a need for the provision of psychological counselling services. The nature of the most appropriate forms of such help is explored.     

Infertility,epistemic risk,and disease definitions

I explore the role that values and interests, especially ideological interests, play in managing and balancing epistemic risks in medicine. I will focus in particular on how diseases are identified and operationalized. Before we can do biomedical research on a condition, it needs to be identified as a medical condition, and it needs to be operationalized in a way that lets us identify sufferers, measure progress, and so forth. I will argue that each time we do this, we engage in epistemic risk balancing that inevitably draws upon values and interests, often including social and ideological values. My main interest here is in the conceptualization of infertility as a disease. Infertility is a rich test case for exploring the interplay between interests and epistemic risk management. There is no uncontested or standardized definition of infertility. The various definitions of it are internally ambiguous and tension-ridden, and in spectacular contradiction with one another. Many interest groups who are invested in framing infertility as a pressing problem deserving of social and medical redress are quick to insist that it is a legitimate ‘disease,’ but they cannot agree on which disease it is, what its symptoms or diagnostic markers are, or even what its basic ontology is. I suggest that there are political explanations for this epistemic mess. Indeed, I contend that there are good scientific and ethical reasons to reduce away the category of ‘infertility,’ especially understood as a scientific or medical category; I argue that we should excise the concept from our research and clinical practices.

     

The Relationships of Primary Appraisals of Infertility and Other Gynecological Stressors to Coping

Women experiencing infertility, pregnancy, medical gynecological problems, or annual checkups were assessed for primary appraisal of their stressor and types of coping strategies used. Diagnostic category approximated the subjective appraisal of stressor for pregnant (challenge) and checkup (no stress) groups. Most participants in the medical gynecological problems group appraised their stress as a threat, but a few participants chose other appraisal categories. Infertility was associated with two categories of appraisal—loss and challenge. Participants appraising their stressor as a loss made greater use of the coping strategies of Action, Wishful Thinking, and Fatalism than did women appraising their stressor as a challenge, a threat, or not stressful. Women appraising infertility as challenge were less distressed than women in any other group. The bimodal perception of infertility has implications for treating women who seek psychological help.     

The psychological reactions to infertility: Sex roles and coping styles

The purpose of this study was to determine if sex roles would predict the extent to which people experience problems in coping with infertility. Based on questionnaire responses of 164 medical patients, it was found that patients scoring higher in masculinity or androgyny reported fewer problems in coping with infertility, as measured by self-esteem and body image. It was also found that groups of infertile, formerly infertile, and fertile patients were no different in levels of coping. It was suggested that physicians might be able to identify patients at risk for poorer coping with infertility by screening new referrals for self-esteem and historical-background variables.     

子宫内膜异位症导致不孕机理探讨

近年来的研究表明了EMT和不孕之间存在较强的相关性,但是两者之间的因果关系和发病机制目前仍存在争议。本文对子宫内膜异位症与不孕之间机理探讨是从分析和综合相结合的认识方法来达到掌握两者关系的本质及其规律性的目的。遵循这样科学的发展战略才能更有利于人类医学领域的繁荣发展。     

不孕症女性污名现象产生原因、影响及对策思考

不孕症女性患者的污名或歧视现象是一个值得关注的话题。在我国,不孕污名的产生具有传统文化背景。不孕污名影响患者的身心健康,造成患者社会隔离,提出相关对策对改善不孕症女性患者及其家属认知与态度、提高不孕女性心理保健水平是有积极意义的。