盆腔炎性疾病的预防

盆腔炎性疾病（pelvic inflammatory disease,PID）是影响妇女健康的常见病,针对其发病的诱因,预防PID可以从以下几个方面进行：（1）加强性教育,减少性传播疾病;（2）积极做好妇女的卫生保健指导工作;（3）重视筛查、早期诊断及一次性根治下生殖道感染;（4）提高医务人员的理论水平和技术,避免医源性感染;（5）持续正确选择避孕措施;（6）避免阴道冲洗。此外,长期放置宫内节育器不会增加PID的风险;口服避孕药对PID无明显预防作用,而仅仅与减轻其严重症状有关。     

从现代系统科学角度看冠状动脉支架置入术后再狭窄

随着介入治疗技术在临床的广泛应用,目前已成为治疗冠心病（CAD）的主要方法之一。目前国内外指南一致推荐对于CAD的大多数de novo病变常规置入支架,可有效减少单纯球囊扩张的并发症和再狭窄的发生率,但支架内再狭窄的形成又日益突出,成为严重影响介入治疗远期疗效的主要问题。对再狭窄发生机制的研究近十年来取得诸多新进展,对其发生机制的研究和探索为解决这个世纪难题提供了理论基础和依据。本文应用现代系统科学的自组织理论,从哲学角度深入认识和理解这一病理过程。     

干细胞移植治疗冠心病的现状与未来

冠心病仍然是全球的主要死亡原因。其所造成的心肌梗死及慢性心力衰竭对生活质量的影响和由此造成的高额医疗费用促使我们不断寻求新的医疗措施。近几年有关干细胞用于心肌梗死后心肌再生、心肌内新生血管形成,可能还会改善梗死后的心功能的研究成为心脏病学研究的最热门领域。尽管干细胞治疗有可能使心力衰竭的治疗得到彻底的革命,但仍有部分问题需要澄清。已发表的各个研究结果设计不尽相同,致使对该项治疗的效果较难得出一致的结论。但这些研究都强调干细胞治疗在未来心血管疾病的治疗中可能会发挥较大的作用。干细胞治疗与药学、外科及介入治疗的结合会显著改善冠心病患者的预后。     

风湿性心脏病瓣膜置换术后抗凝治疗中“度”的把握

风湿性心脏瓣膜病在世界范围内发病率极高,瓣膜置换术是目前治疗该病的主要方法,根据不同的病情及需要可置换机械瓣或生物瓣,我国患者更常选择机械瓣置换,术后生物瓣置换需抗凝3个月～6个月,而机械辩置换者需终身抗凝,故抗凝治疗非常关键。本文从辨证思维的角度分析如何在瓣膜置换术后把握好抗凝治疗。     

亲子关系与问题行为的动态相互作用模型：对儿童早期的追踪研究

通过对81名幼儿的父母历时两年的三次追踪测查,考察了父子、母子关系与儿童问题行为的动态相互作用模型。结构方程模型的分析结果表明：一方面,相邻两次测查的母子、父子关系、各种问题行为之间的路径系数都非常显著;另一方面,母子关系与退缩、攻击问题的双向作用,父子关系与攻击、违纪问题的双向作用都得到了支持,焦虑问题对父子、母子关系的作用,违纪问题对父子关系的作用也都得到了支持     

Motivational Interviewing in Primary Care

Healthcare systems are in the process of reforming themselves to better meet the needs of people with, or at risk of developing, chronic diseases and long term conditions. One goal of these efforts is the coproduction of activated, informed, engaged and motivated patients and citizens. The clinical, public health and financial benefits of achieving such a goal may be dramatic. Motivational Interviewing (MI) is a proven and practical front-line approach which can help deliver this goal whilst also helping to deliver such policy objectives and intermediate outcomes as increased levels of patient centered care, participatory or shared decision making, evidence-based healthcare and improved clinician-patient relationships. Until now, MI has been passively diffusing through the system as a result of the innovation and early uptake by insightful individuals and organizations. If healthcare systems want to breakthrough to higher levels of performance, investment in the conscious and deliberate implementation of MI into front-line settings may prove helpful.     

The Effectiveness of Cognitive and Behavioural Treatment of Chronic Pain in the Elderly: A Quantitative Review

This study provides a meta-analytic review of cognitive and behavioural interventions for chronic pain in the elderly, focusing on treatment effectiveness. Included in the analysis are studies in which a comparison was made either to a control condition or to pre-treatment. A total of 12 outcome studies published or reported between January 1975 and March 2008, were identified involving participants 60 years and above and providing 16 separate treatment interventions. The analysis indicated that cognitive and behavioural interventions were effective on self-reported pain experience, yielding an overall effect size of 0.47. However, there were no significant effects of cognitive and behavioural treatment on symptoms of depression, physical functioning and medication use. Methodological issues concerning design, outcome measures and treatment are discussed and recommendations for future studies are outlined.     

INTRODUCTION: RETHINKING PHILOSOPHICAL PRESUMPTIONS IN LIGHT OF COGNITIVE DISABILITY

Abstract: This Introduction to the collection of essays surveys the philosophical literature to date with respect to five central questions: justice, care, agency, metaphilosophical issues regarding the language and representation of cognitive disability, and personhood. These themes are discussed in relation to three specific conditions: intellectual and developmental disabilities, Alzheimer's disease, and autism, though the issues raised are relevant to a broad range of cognitive disabilities. The Introduction offers a brief historical overview of the treatment cognitive disability has received from philosophers, and explains the specific challenges that cognitive disability poses to philosophy. In briefly summarizing the essays in the collection, it highlights the distinctive contributions the collection makes to ethics, political philosophy, bioethics, and the philosophy of disability. We hope that the richness of the topics explored by these essays will be a spur to further investigation.     

Aggression in Tilapia affects immunocompetent leucocytes

Social interactions are typical behavioral patterns serving to regulate life in a group. These interactions may develop into aggression, which causes stress in the defeated animal. We used Tilapia, a commercially important fish which is aggressive, to examine how this behavior affects them and whether it induces alterations in leucocytes. Compared to dominant fish, subordinate ones had elevated glucose levels and hemolytic blood sera. In addition, cells from blood and pronephros of subordinates, when compared to dominant fish, showed qualitative changes characterized by granulocytosis and lymphopenia. Furthermore, leucocytes revealed cytoplasmic and karyoplasmic vacuolation, indicating cellular disintegration. These morphological alterations were also accompanied by impaired leukocyte function and thus may increase susceptibility to diseases and neoplasia.     

Regression I. Experimental approaches to regression

The concept of regression is considered with an emphasis on the differences between the positions of Freud and Jung regarding its significance. The paper discusses the results of experimental analyses of individual experience dynamics (from gene expression changes and impulse neuronal activity in animals to prosocial behaviour in healthy humans at different ages, and humans in chronic pain) in those situations where regression occurs: stress, disease, learning, highly emotional states and alcohol intoxication. Common mechanisms of regression in all these situations are proposed. The mechanisms of regression can be described as reversible dedifferentiation, which is understood as a relative increase of the representation of low-differentiated (older) systems in the actualized experience. In all of the cases of dedifferentiation mentioned above, the complexity of the systemic organization of behaviour significantly decreases.