白血病诱导分化治疗中的生态自然观

诱导分化是一种治疗白血病的新方法,它通过促使分化不完全的肿瘤细胞分化成熟,使恶性转为良性.临床应用全反式维甲酸(ATRA)和三氧化二砷(As2O3)诱导急性早幼粒细胞性白血病取得了较高的完全缓解率,毒副作用也较低.诱导分化治疗策略突破了将杀灭肿瘤细胞作为治疗肿瘤的惟一方法的思维局限,谋求在与白血病细胞的和谐中获得人类的健康,是生态自然观应用于医疗实践的成功范例.     

英国人类胚胎研究管理体制建立的背景及其现实功能分析--兼论日本生命科学技术的社会管理体制结构

随着生命科学技术的发展,出现了很多新的生命伦理学问题.英国的人类胚胎研究管理体制(HFEA)能够提供有益的借鉴.介绍了这一体制建立的背景并对其现实功能进行分析.得出结论:日本应该建立一个生命科学技术的社会管理体制.     

我国农村合作医疗的过去、现在和未来

回顾我国农村合作医疗的过去,分析其萎缩的原因,提出保证实施合作医疗的措施:政府重视合作医疗、加大财政投入、调整现行财政体制,合理配置农村医疗卫生资源等.     

分类的层次结构和基本水平研究的新进展

本文从层次结构的心理表征,基本水平优势的性质和分类差异的原因,场景、事件、情绪、对人分类等非客体领域的分类组织以及专业知识对分类的影响等方面,介绍了国外近年来在分类领域的研究进展情况。     

分心抑制与年龄关系的位置负启动效应实验研究

负启动效应是指当前一个刺激中的干扰项作为后一个刺激中的目标呈现时产生的抑制作用。本研究采用2×4混合实验设计,考察了4个年龄组被试(小学生、初中生、大学生和老年人)位置负启动效应的产生情况,探讨了位置负启动效应与年龄发展的关系。结果表明:(1)不同年龄组被试都能产生显著的位置负启动效应;(2)各年龄组被试位置负启动量差异不显著,说明位置抑制能力呈稳定的年龄发展趋势。     

Neuropsychological Measures that Predict Progression from Mild Cognitive Impairment to Alzheimer's type dementia in Older Adults: a Systematic Review and Meta-Analysis

This study aimed to determine the extent to which cognitive measures can predict progression from mild cognitive impairment (MCI) to Alzheimer’s type dementia (AD), assess the predictive accuracy of different cognitive domain categories, and determine whether accuracy varies as a function of age and length of follow-up. We systematically reviewed and meta-analyzed data from longitudinal studies reporting sensitivity and specificity values for neuropsychological tests to identify individuals with MCI who will develop AD. We searched articles in Medline, Cochrane, EMBASE, PsycINFO, and the Web of Science. Methodological quality was assessed using the STARDem and QUADAS standards. Twenty-eight studies met the eligibility criteria (2365 participants) and reported predictive values from 61 neuropsychological tests with a 31-month mean follow-up. Values were pooled to provide combined accuracy for 14 cognitive domains. Many domains showed very good predictive accuracy with high sensitivity and specificity values (≥ 0.7). Verbal memory measures and many language tests yielded very high predictive accuracy. Other domains (e.g., executive functions, visual memory) showed better specificity than sensitivity. Predictive accuracy was highest when combining memory measures with a small set of other domains or when relying on broad cognitive batteries. Cognitive tests are excellent at predicting MCI individuals who will progress to dementia and should be a critical component of any toolkit intended to identify AD at the pre-dementia stage. Some tasks are remarkable as early indicators, whereas others might be used to suggest imminent progression.     

Splenium development and early spoken language in human infants

The association between developmental trajectories of language‐related white matter fiber pathways from 6 to 24 months of age and individual differences in language production at 24 months of age was investigated. The splenium of the corpus callosum, a fiber pathway projecting through the posterior hub of the default mode network to occipital visual areas, was examined as well as pathways implicated in language function in the mature brain, including the arcuate fasciculi, uncinate fasciculi, and inferior longitudinal fasciculi. The hypothesis that the development of neural circuitry supporting domain‐general orienting skills would relate to later language performance was tested in a large sample of typically developing infants. The present study included 77 infants with diffusion weighted MRI scans at 6, 12 and 24 months and language assessment at 24 months. The rate of change in splenium development varied significantly as a function of language production, such that children with greater change in fractional anisotropy (FA) from 6 to 24 months produced more words at 24 months. Contrary to findings from older children and adults, significant associations between language production and FA in the arcuate, uncinate, or left inferior longitudinal fasciculi were not observed. The current study highlights the importance of tracing brain development trajectories from infancy to fully elucidate emerging brain–behavior associations while also emphasizing the role of the splenium as a key node in the structural network that supports the acquisition of spoken language.     

治疗决策十题

治疗决策是临床决策中的重要组成部分。为了提高治疗决策水平,临床医生可以从以下几个基本环节入手深究决策依据、明确治疗目标、坚持疗效优化、强调安全第一、注意条件约束、注重时效原则、突出救治重点、减损方案危害、分析失悔程度和了解敏感阈值。     

论医学哲学是什么和不是什么

弄清医学哲学是什么和不是什么,是医学哲学学科建设的基本问题。医学哲学理论构架的逻辑起点是生命健康,基本结构是医学哲学的本体论、认识论、方法论、价值论和发展观以及一系列医学范畴。“哲学理论 医学实例”不是医学哲学。医学哲学具备超验的思维方式、反思的学术精神、创新的学术风格、开放的学术视野,而临床经验总结、紧跟时局的宣传、时髦热闹的效果,从者众多的场面不是医学哲学。     

部分中文医药杂志伦理保护措施的报告情况

对2002年之前和之后(2000年7月~2001年12月和2003年1月~2004年6月)对6种中文医药杂志发表的临床研究类文章进行比较,并对文中报告知情同意和伦理委员会批准情况的比例给予评价。