心肌保护基因治疗进展及展望

心肌保护基因治疗的研究目前仍停留在动物实验阶段。本文从哲学的角度论述了心肌保护基因治疗研究的进展与优点,以及存在的安全性、局限性与伦理学方面的问题,并就目前其它领域基因治疗的进展对其作了进一步的展望。     

肿瘤基因治疗模式与中医辨证论治思维

肿瘤基因治疗模式与中医辨证论治思维第一军医大学南方医院消化中心（广州５１０５１５）肖冰,张万岱,周殿元近年来,基因治疗主要在肿瘤疾病方面被广泛而深入地研究,是目前至为方兴未艾的研究领域,并在传统的基因治疗基础上,于方法及模式上发展了许多令人振奋的项目...     

心肌缺血预处理研究中的哲理与伦理

心肌缺血预处理研究中的哲理与伦理湖南医科大学附属湘雅医院心胸外科博士生（４１０００８）鲁尔雄导师袁明道在较长时程心肌缺血之前,给予一个或多个短时的缺血过程中造成的损伤,反而能够增强心肌保护作用,这一机制被称为缺血预处理保护作用,是目前最强有力的心肌保...     

肿瘤基因治疗中的宏观决策

基因治疗是９０年代医学生物学领域的生大进展，给肿瘤治疗这一医学难题带来了新的机遇和挑战。在经历了基因治疗的初步实践后，对其治疗策略进行客观的回顾与反思，必将带来对其认识上的深化与飞跃，从而引导人们寻求更合理，更完备的基因治疗途径 。     

体细胞基因治疗中的伦理学问题

体细胞基因治疗中的伦理学问题北京医科大学医学史研究中心（１０００８３）张大庆基因治疗一般分为四类：体细胞基因治疗、生殖系基因治疗、增强基因工程和优生基因工程。目前医学界对基因治疗持审慎态度,且主要限于体细胞基因治疗方法。自基因治疗诞生之际,就引起广泛...     

基因治疗面临的挑战

基因治疗无疑将是２１世纪疾病治疗史上的重大突破。但由于目前一些基础性、关键性问题尚未解决,致使外源基因不能稳定地、持续地、高效地表达,限制了其在临床的应用,基因治疗正面临严峻的挑战。本文针对目前基因治疗过热现象,尤其是匆忙向临床过渡的现象,力图阐明基因治疗在基础领域的一些关键性、未解决的问题,呼吁人们重新回到基础研究,努力解决这些问题,从而使基因治疗真正走向临床。     

血管紧张素转换酶抑制剂与心肌缺血再灌注的细胞凋亡

随着心脏外科手术和介入治疗技术的进展以及心肌缺血患者的增加,心肌缺血再灌注损伤成为临床工作一种常见的病理生理过程。如何采用有效的治疗手段进行心肌保护,防治或降低缺血再灌注所造成的损伤,一直是心脏科学探索的一个重要课题。血管紧张素转化酶抑制剂对很多心脏疾病的治疗特别是拟行心脏手术患者的治疗都取得了良好的效果。随着对其研究的进展,其预处理可为临床预防治疗心肌缺血再灌注损伤提供思路与方法。     

心肌保护技术研究中的历史及启示

心肌保护技术研究中的历史及启示第四军医大学９７级研究生（西安７１００３２）李宏导师易定华心肌保护是心脏手术的基础：只有心肌组织在手术期间得到了良好的保护,手术矫治心脏疾病才有意义,术后良好的心功能才有保障,病人才能得以顺利康复。而回顾心肌保护技术的发...     

血管紧张素转换酶抑制剂与心肌缺血再灌注的细胞凋亡

随着心脏外科手术和介入治疗技术的进展以及心肌缺血患者的增加,心肌缺血再灌注损伤成为临床工作一种常见的病理生理过程.如何采用有效的治疗手段进行心肌保护,防治或降低缺血再灌注所造成的损伤,一直是心脏科学探索的一个重要课题.血管紧张素转化酶抑制剂对很多心脏疾病的治疗特别是拟行心脏手术患者的治疗都取得了良好的效果.随着对其研究的进展,其预处理可为临床预防治疗心肌缺血再灌注损伤提供思路与方法.     

Akt与心肌保护的研究进展及临床启示

心肌保护是心脏疾病治疗的研究热点之一。多种生长因子对心脏有保护作用,使其免受局部缺血及其他损伤带来的损害。虽然这些心肌保护因子下游的转导通路很复杂,但在很多情况下,Akt的激活是一个共同的特征。它在调节各种生长因子和其他胞外刺激诱导的心肌细胞存活、生长、增殖、保持功能和营养物质代谢上发挥了重要作用。通过追踪最近的研究进展以更好地理解Akt在心肌保护中发挥的作用,讨论这些研究的临床启示。关键词:Akt,心肌保护,信号转导通路     

血液肿瘤的基因治疗及伦理学问题

基因治疗是一种新的有希望的抗肿瘤治疗方法。本文首先简述基因治疗发展史,然后介绍目前尝试性用于血液系统肿瘤的反义核酸疗法、抑癌基因疗法、自杀基因疗法以及过继性免疫疗法等基因治疗方法,进一步阐述基因治疗在血液系统肿瘤患者中应用存在的伦理学问题。     

生殖系基因治疗的技术和伦理问题

生殖系基因治疗是通过对生殖系细胞的基因修饰,给该细胞发育而来的整个有机体及其后代带来永久性的遗传纠正。本文着重对生殖系治疗的现有技术条件,存在技术问题及各种观点作一归纳,主要试图反映生殖系基因治疗的科学背景及当代人的思考,希望有助于人们的思考。     

K-ras基因与结直肠腺癌关系研究进展

肿瘤的发生涉及癌基因的激活及抑癌基因的失活,K-ras基因是与肿瘤形成关系较为密切的一种癌基因,其功能异常能够影响细胞的生长、增殖、分化和凋亡等。研究已发现K-ras基因的突变激活是结直肠癌变过程中的重要事件之一。本文拟对K-ras基因的生物学特性、对细胞信号转导的影响及在结直肠腺癌形成与治疗中的作用作一综述。     

Prospects for prenatal gene therapy in disorders causing mental retardation

Advances in understanding the genetics and pathogenesis of disease and in prenatal diagnosis have lead to an exploration of ways to intervene earlier and earlier in the disease process. The possibility of prenatal gene therapy for severe genetic and developmental disorders has sparked new research and debate as to its feasibility, reliability, and ethics as a therapeutic option. Recent animal studies have demonstrated the feasibility of introducing a vector into the developing fetus. The optimal timing and best mode of delivery, however, have yet to be defined. Whether or not this research should be pursued also has been the subject of recent bioethical debates. There is additional concern with the possibility of in utero gene transfer inducing mutagenesis and subsequent tumor formation. This review will provide a summary of the current state of knowledge in the field of prenatal gene therapy and possible directions for the future research.     

Shaping Individuality: Human Inheritable Germ Line Gene Modification

In this paper I deal with ethical factors surrounding germline gene therapy. Such implications include intergenerational responsibility, human dignity, moral status of embryos and so on. I will explore the relevance of the above mentioned issues to discuss the ethical implication of human germline gene therapy (HGLT). We will see that most of arguments claimed by bioethicists do not provide valid reason to oppose HGLT. I will propose an alternative view, based on personal identity issues, to discuss the ethics of human inheritable gene modification. This revised version was published online in August 2006 with corrections to the Cover Date.     

Transference focused psychotherapy: overview and update

This paper describes a specific psychoanalytic psychotherapy for patients with severe personality disorders, its technical approach and specific research projects establishing empirical evidence supporting its efficacy. This treatment derives from the findings of the Menninger Foundation Psychotherapy Research project, and applies a model of contemporary psychoanalytic object relations theory as its theoretical foundation. The paper differentiates this treatment from alternative psychoanalytic approaches, including other types of psychoanalytic psychotherapy as well as standard psychoanalysis, and from three alternative non-analytical treatments prevalent in the treatment of borderline patients, namely, dialectic behavior therapy, supportive psychotherapy based on psychoanalytic theory, and schema focused therapy. It concludes with indications and contraindications to this particular therapeutic approach derived from the clinical experience that evolved in the course of the sequence of research projects leading to the empirical establishment of its efficacy.     

The Phenomenological Approach to Art Therapy

The present paper discusses the phenomenological approach to art-therapy and suggests an operational terminology for its main theoretical concepts. First we present the general assumptions that underline art therapy. Definitions, leading approaches, and the therapeutic effect of artwork are considered. Next we indicate the need for relevant and particular theories of art therapy. Phenomenological theory is examined as a case in point because of its popularity among art therapists. Despite its philosophical appeal, however, we find phenomenological theory lacking the operational terminology that is essential to form a coherent and distinct school of therapy. In the present paper, we extract from phenomenological theory operational principles, which can be followed and applied by art therapists. In this analysis, we take into consideration Betensky's pioneer attempt to create the bridge between phenomenological theory as applied in verbal psychotherapy and art therapy. We end by discussing the urgent need to operationalize other verbal psychotherapeutic theories so they are relevant for art-therapy practice and may help create greater similarities among art therapists of the same school of psychotherapy.     

Postmodernism versus psychotherapy

‘Postmodernism’has made a substantial impact on various schools of psychotherapy, including family therapy.‘Postmodern’therapists tend to focus on the productive capacities of language, developing narrative styles for their work.‘Postmodern’family therapy is differentiated from modernist approaches by its disavowal of truth claims and its encouragement of alternative‘voices’or narratives. In this paper, it is argued that this represents too narrow an approach to psychotherapy and to postmodernism. Postmodernism takes as a central concern the limits of symbolization, so a postmodernist therapy would deal primarily with failures of language. Language-based therapeutic procedures such as those to be found in family therapy are consequently not postmodernist. This state of affairs should be welcomed, as a truly‘postmodern’mode of therapy would probably celebrate irrationality.     

The Budapest meeting 2005 intensified networking on ethics of science

This paper reports on the meeting of the Sounding Board of the EU Reprogenetics Project that was held in Budapest, Hungary, 6-9 November 2005. The Reprogenetics Project runs from 2004 until 2007 and has a brief to study the ethical aspects of human reproductive cloning and germline gene therapy. Discussions during The Budapest Meeting are reported in depth in this paper as well as the initiatives to involve the participating groups and others in ongoing collaborations with the goal of forming an integrated network of European resources in the fields of ethics of science.     

胎儿基因治疗展望及其伦理学问题

许多遗传性疾病导致胎儿在出生前就受到不可逆的损害,还有一些遗传性疾病在症状表明显以前如果获得治疗则可以从治疗中获益。在这些情况下,子宫内基因治疗（胎儿基因治疗）可能将是一种有效的治疗方法。目前,实验动物中子宫内基因治疗的研究已取得了一定的成功,但是在进行子宫内基因治疗的临床试验以前还有许多问题需要得到解决,特别是还有一些伦理学问题亟需得到进一步回答。