非小细胞肺癌 EG FR 基因突变检测与临床意义

采用荧光PCR法对199例晚期非小细胞肺癌（NSCLC ）组织进行表皮生长因子受体（EGFR ）基因突变检测,分析EGFR基因突变的分布特征及其与临床病理特征的相关性。结果显示56例（28．1％）存在EGFR基因突变,其中27例（13．6％）为外显子19突变,25例（12．6％）为外显子21突变,2例为外显子18突变,1例外显子20突变,1例外显子18和20的共突变。另外,除广东及安徽省铜陵市外,辽宁地区NSCLC患者EGFR基因突变率及主要突变类型与其他地区相符,常见于外显子19、21突变,其中腺癌、不吸烟患者突变率更高,更适宜EGFR-TKI靶向治疗。     

Effects of protein malnutrition and the administration of cortisol on the reflexologic development in rats.

The use of neurological tests in various states of undernutrition has confirmed the presence of delays in reflex ontogeny. Glucocorticoid administration in conditions of normal nutrition produces diminished growth and alterations in brain development similar to those observed in malnutrition, but there is not enough evidence about its effect on reflex development. In addition, some facts lead us to think that the use of permissive doses of these hormones during gestation could alleviate some of the effects of protein malnutrition on the development of pups. In the present study the ages at which certain reflexes appeared in the offspring of Wistar rats (Rattus norvegicus) fed a 20% (N) or 10% (M) protein diet from a week before conception to the end of lactation were observed. Each dietary group was subdivided into two: mothers receiving a daily injection during gestation either of a 0.9% NaCl (S) solution or of a 0.5 mg/100 g weight hydrocortisone acetate (C) solution. Results showed that the NS group of pups generally presented earlier ages of appearance of the variables under study than the remaining groups. Pups of the NC group presented delays in the age of appearance of reflexes. Finally, protein malnutrition delayed the appearance of reflexes and this effect seemed to be attenuated by treatment with hydrocortisone. Thus, hydrocortisone administration in protein malnutrition conditions seems to be beneficial although the results are harmful when administered under normal nutritional conditions.     

糖尿病的免疫抑制治疗

淡化糖尿病的分型为我们提供了一个全新的思维空间.即传统的1型和至少部分2型糖尿病可能都是一种自身免疫性疾病,而目前流行的炎症学说可能是对认可免疫损伤是糖尿病发病理论的一个过渡,我们应该重新审视糖尿病的早期治疗和研究其慢性并发症的发病机理.我们则采用小剂量、长时间的治疗理念,早期接受这种免疫治疗的患者出现低血糖的症状,遂减少胰岛素的剂量;再次出现低血糖,我们就继续减少胰岛素的荆量.结果,有部分患者完全摆脱了胰岛素.我们对糖尿病的再认识是建立在对多脏器活检的基础之上.我们的活检结果表明,糖尿病肾病存在着免疫损伤.糖尿病眼底病变是使患者致盲的主要病因,糖尿病患者的眼底病变是一种自身免疫损伤的结果.我们尝试用小剂量的免疫抑制剂环孢茵素A(25 mg bid)治疗糖尿病眼底出血,取得了不错的疗效,也证实糖屎病眼底病变是一种血管炎,与自身免疫痛变有关.其他的器官还包括垂体、大脑的血管、糖尿痛足、冠心痛、皮肤的病变和肌肉活检的免疫组化也均有证据表明,免疫损伤是导致多种慢性并发症的罪魁祸首,是一种多器官免疫损伤的结果无论是1型糖尿痛,还是2型糖尿病,肌细胞表面或多或少均有免疫复合物沉积.这些免疫复合物的存在势必会影响胰岛素与肌肉细胞表面的胰岛素受体结合,即胰岛素抵抗的存在.为此,我们在临床上广泛采用了免疫抑制治疗的理念治疗糖尿病.应用小剂量胰岛素和小剂量环孢素A治疗早期发现的糖尿病取得了不错的疗效.唯一担心的副作用发生在肝脏,即部分糖尿病患者会出现总胆红索升高,而也有一部分患者总胆红素不升高.     

糖尿病的免疫抑制治疗

淡化糖尿病的分型为我们提供了一个全新的思维空间。即传统的1型和至少部分2型糖尿病可能都是一种自身免疫性疾病,而目前流行的炎症学说可能是对认可免疫损伤是糖尿病发病理论的一个过渡,我们应该重新审视糖尿病的早期治疗和研究其慢性并发症的发病机理。我们则采用小别量、长时间的治疗理念,早期接受这种免疫治疗的患者出现低血糖的症状,遂减少胰岛素的剂量;再次出现低血糖,我们就继续减少胰岛素的剂量。结果,有部分患者完全摆脱了胰岛素。我们对糖尿病的再认识是建立在对多脏器活检的基础之上。我们的活检结果表明,糖尿病肾病存在着免疫损伤。糖尿病眼底病变是使患者致盲的主要病因,糖尿病患者的眼底病变是一种自身免疫损伤的结果。我们尝试用小剂量的免疫抑制剂环孢菌素A（25mgbid）治疗糖尿病眼底出血,取得了不错的疗效,也证实糖尿病眼底病变是一种血管炎,与自身免疫病变有关。其他的器官还包括垂体、大脑的血管、糖尿病足、冠心病、皮肤的病变和肌肉活检的免疫组化也均有证据表明,免疫损伤是导致多种慢性并发症的罪魁祸首,是一种多器官免疫损伤的结果无论是1型糖尿病,还是2型糖尿病,肌细胞表面或多或少均有免疫复合物沉积。这些免疫复合物的存在势必会影响胰岛素与肌肉细胞表面的胰岛素受体结合,即胰岛素抵抗的存在。为此,我们在临床上广泛采用了免疫抑制治疗的理念治疗糖尿病。应用小剂量胰岛素和小剂量环孢素A治疗早期发现的糖尿病取得了不错的疗效。唯一担心的副作用发生在肝脏,即部分糖尿病患者会出现总胆红素升高,而也有一部分患者总胆红素不升高。     

试论《周易》象思维对石涛山水画的影响

象思维是中华民族的传统思维.深深影响着中国文化.<周易>蕴含着丰富的象思维,可以分为观物取象、立象尽意、得意忘象三个层面.中国画作为中华传统文化的典型代表,深受中国哲学的影响.石涛是清初著名画家,以擅长山水画闻名于世.他的画论<苦瓜和尚画语录>和其题画诗清晰地展现了其山水画深受<周易>象思维的影响,认为"画者形天地万物"、"画者从于心者也"、"不似似之当下拜".石涛山水画创作的这个过程与<周易>象思维的三个层面是一致的.     

GEORGE TYRRELL AND KARL RAHNER: A DIALOGUE ON REVELATION

The reality of revelation was one of the fundamental questions that occupied 1 Tyrrell as a writer until he died on 15 July 1909. The centenary of his death is an opportune time to engage this English Modernist in a dialogue with Karl Rahner on the subject of revelation. Tyrrell insists on the primacy of the interior experience of revelation. An exaggerated emphasis on inner religious experience, however, led him inevitably to a separation of the interior dimension of revelation from its verbal expressions and doctrinal formulations.
Rahner also affirms the primacy of the originating inner experience of God but stresses at the same time the intrinsic unity between this transcendental revelation and its categorical, historical dimension. Revelation corresponds to the symbolic nature of the addressee. The Mystery of the Incarnation is the point of reference for understanding God's self-communication. The fullness of revelation has been realized in the indissoluble and irreversible unity of the Divine Logos with the Man Jesus.     

浅析神经外科中的诊疗思路和思维方式

应该注重培训年轻医生在临床中学会应用哲学思想和思维方式,真正认识事物的本质。这对于诊断、治疗、科研、创新有事半功倍的作用,可避免片面性、盲目性,减少医源性偏差与失误,提高治愈率和生活质量。一般通过三种思维方式即理论、工程及评价思维思考疾病,如蛛网膜下腔出血的病因、临床特点、检查方法、诊疗思路、预后和转归,最终达到预期的疗效。     

Promoting the Culturally Sensitive Diagnosis of Mexican Americans: Some Personal Insights

This article presents a series of personal guidelines for promoting the culturally sensitive psychiatric diagnosis of Mexican American/Chicano clients. These guidelines are primarily based on the authors' collective experiences in diagnosing and treating this population.     

Examining the Psychometric Properties of the Family Accommodation Scale-Parent-Report (FAS-PR)

Growing research has examined parental accommodation among the families of children with obsessive-compulsive disorder (OCD). However, these studies have utilized a parent-report (PR) version of a measure, the Family Accommodation Scale (FAS) that has never received proper psychometric validation. In turn, previously derived subscales have been developed via clinical rather than empirical evidence. This study aims to conduct a comprehensive psychometric analysis of the FAS-PR utilizing data collected from 96 youths with OCD. Exploratory factors analysis was conducted and revealed a 12-item scale yielding two separate, yet related subscales, Avoidance of Triggers (AT) and Involvement in Compulsions (IC). Subsequent analyses revealed good internal consistency and convergent and discriminant validity. These findings suggest that future research should seek to examine factors that may impact various facets to accommodation as well as the role these facets plays in predicting treatment outcome. Limitations are discussed.