肾移植性别失衡的现状、影响因素及思考

肾移植的性别失衡问题在全球已经很普遍。本文回顾国内外相关文献,着重综述肾移植中存在的性别失衡现状及相关因素,并对肾移植中的性别失衡所产生的临床后果和社会问题进行思考,提出相应的建议和意见,以期改善肾移植中性别不一致现状,优化肾移植治疗效果。     

活体器官移植中的矛与盾

随着临床医学的发展和免疫隔离技术的开发利用,器官移植目前已经被公认为是治疗终末期疾病的一个临床选择,本文综述器官移植中供体短缺与活体器官移植的优势与风险、活体器官移植后抗排斥与防治感染的问题以及哲学思想在器官移植诊疗过程中的指导作用。     

瑶医学“心肾相交论”内涵及临床指导意义

“心肾相交论”是瑶医药理论的脏腑生命观,心主要的功能是主宰其他脏腑的生理机能,对人的心理活动也进行调节;肾是气血化生之根源.如果心功能受损,那么其调节作用减弱,瑶医的整体观内涵得不到体现,人体作为一个整体的属性就不复存在,人体就会进入病理状态,甚至危及生命.对于肾,瑶医学认为人的出生、生长、发育和成熟直至衰老死亡的过程,是肾“气化”功能由盛到衰的自然过程.“心肾相交论”强调心肾功能的正常是人保存生命最基本的前提.通过探讨“心肾相交论”的学术思想,用以指导临床医疗实践,提高对瑶医药理论的认识.     

小儿肾脏替代疗法发展方向的思考

慢性肾功能衰竭目前主要依靠透析或肾移植替代疗法来延长生命,但二者并未彻底解决问题并且代价昂贵.体外干细胞研究的兴起,为解决慢性肾功能衰竭的治疗带来了一丝曙光,但获得成功恐怕还需要一个相当长的时间.只有契合了整体辩证统一原则的再生医学,通过在肾脏原位重建生理环境,激发机体本身潜能,使肾脏修复到自然的完美状态,才能实现与人体生命一体化的有机结合,才是小儿肾脏替代疗法中有光明前景的发展方向.     

Impact of Transplant-Related Stressors and Feelings of Indebtedness on Psychosocial Adjustment Following Kidney Transplantation

Forty-seven patients answered a questionnaire about stress, feelings of indebtedness toward the donor, and psychosocial adjustment following kidney transplantation. The combination of age, general life stress, and transplant-related stress explained 47% of the variance in psychosocial adjustment. Areas of adjustment most influenced by this combination of predictors included attitudes toward health care, domestic, vocational, social adjustment, and psychological distress. Younger patients endorsed higher levels of transplant-related stress and higher levels of psychological distress. Moderate to intense feelings of indebtedness toward the donor were common but were unrelated to psychosocial adjustment posttransplant.     

The experience of receiving a kidney transplant from a deceased donor: Implications for renal services

Objective: The study aimed to explore the psychological experiences of receiving a kidney transplant from a deceased donor and to examine resulting implications for renal services.

Design: A qualitative design was utilised within an interpretative phenomenological analysis (IPA) framework.

Main outcome measures: Semi-structured interviews were conducted with six adults (male = 5, mean age = 45 yrs) on their experiences of receiving a kidney transplant from a deceased donor. All participants had their transplant within the preceding 21 months. Data were analysed using IPA.

Results: The four elicited themes incorporate recipients’ positive feelings about receiving a transplant, mainly arising from the newfound freedom that this entails, in addition to strong feelings of gratitude towards their donors. They also capture challenges, such as the uncertainty of living with a transplanted kidney, and highlight the increased dependence on others throughout the transplant process.

Conclusion: The findings indicate a range of psychological, social and occupational experiences for participants. It is concluded that optimal care in renal services would incorporate a holistic approach to pre and post-transplant care; identifying and supporting the needs of transplant recipients. A biopsychosocial model of care may enhance service user well-being. Potential areas of future research are explored.     

Social entrepreneurship: understanding consumer motives for buying The Big Issue

This paper examines consumer response to a particular social entrepreneurship initiative, The Big Issue. Focusing on consumer motivation, the research explores the utilitarian value of the product as compared to the desire to help the homeless as the primary motivation for purchase. The research found that, although the utilitarian value partly motivated purchase, consumers widely perceived there to be a helping dimension to the exchange. Consumers valued the empowerment goals espoused by The Big Issue and found it rewarding to play a part in the empowerment process. The appearance and manner of The Big Issue vendors influenced consumer reactions to the initiative, indicating a need for careful management of ‘beneficiary portrayal’ in this context.     

谈中医认知方式及中医理论体系的构建

提出开箱式思维和闭箱式思维的概念,并以此为基础对中医认知方式和中医理论体系的构建进行初步的探讨.整体上,中医认知方式是一种宏观性闭箱式思维,中医学是一种闭箱式理论体系.     

论器官资源的开拓与公平分配

器官移植在我国正处于快速发展阶段,目前除技术层面的问题外,供体数量严重不足和分配不公的问题也十分突出。本文对我国器官资源短缺原因、器官移植立法的迫切性、器官移植市场的规范化引导等问题做了全面论述,尤其对如何建立可靠的供体库和器官分配公平性的实现等问题做了较为深入细致的探讨。     

伦理学视域下活体肾移植供者身份认同

将活体肾移植供者的身份问题置于伦理学视域下,梳理活体肾移植整个医疗过程中供者身份的产生背景,分析供者身份出现与转变过程及其产生的伦理问题,进一步探讨其身份认同困境产生的实质是供者自身对其主体性的忽视以及过分依赖“他者”肯定。因此,解决这一问题的方法在于从供者自身和“他者”两方面帮助其建构自身身份完整性,协助其达成对自身的身份认同。供者建构其身份的完整性在于其自身实体性到主体性的转变,“他者”对供者适度关怀与尊重是对其主体性的成就。