序贯疗法根除幽门螺杆菌

幽门螺旋杆菌（HP）感染是胃炎、消化性溃疡、胃癌和胃黏膜相关淋巴组织淋巴瘤的主要病因,根除HP具有重大的临床意义。随着抗生素耐药株HP逐年增加,HP根除率日益下降,因此出现了一种新的HP根除方案——10天或14天序贯疗法。此疗法指前5天或7天的诱导期中应用质子泵抑制剂（PPI）加一种抗生素的二联治疗,随后5天或7天应用PPI和两种抗生素的三联治疗。目前除少数研究外,绝大多数临床研究表明序贯疗法能够获得比传统的7天或10天三联疗法更高的HP根除率,其具体机制尚不明确。目前大部分相关的研究为单中心、样本量少,缺乏双盲对照,未能评估抗生素耐药性,尚待大样本、多中心、随机双盲对照的临床研究来进一步证实该疗法的有效性和安全性。     

冠脉介入治疗时期氯吡格雷抵抗的认识与思考——抓住本质，全面获益

急性冠脉综合征已步入药物洗脱支架进行血运重建的时期,双联抗血小板治疗是接受PCI治疗的常规手段。临床发现部分患者不能从氯吡格雷治疗中获益,存在氯吡格雷抵抗的现象。笔者就氯吡格雷抵抗的发生机制、临床意义及治疗对策进行描述,反映相关研究的趋势和方向,为未来更优化抗血小板治疗提出一种策略。     

胰岛素抵抗与2型糖尿病关系的新思考

胰岛素抵抗(IR)与2型糖尿病关系密切,对IR的认识,经历了几十年反复的过程,胰岛素抵抗综合征(IRS)的提出使2型糖尿病防治观念发生了根本的转变,提出了2型糖尿病防治新策略:从以降糖治疗为主到全面防治心血管疾病.对IR的认识和IR与2型糖尿病的关系,体现了辩证唯物主义认识论和系统论的观点.     

核苷类似物治疗慢性乙型肝炎中的耐药及治疗决策

尽管核苷类药物做为慢性乙型肝炎抗病毒治疗的一线用药广泛应用于临床多年,但随着用药时间的延长,治疗过程中出现了耐药这个极具挑战性的问题。核苷类药物的联合治疗或许能阻止或延缓耐药发生。     

Home-School Communication in the Treatment of Childhood Behavior Problems

There is a shortage of intervention strategies for children with behavior disorders which incorporate both home and school influences. To address this need, a service delivery model was evaluated for public school children (Pre-K through G2) who were at risk for educational failure on account of behavior problems, family dysfunction, and poverty and social disadvantage. Interventions based on eco-behavioral principles were delivered by home-visitors in consultation with clinical child psychologists. A primary goal of all treatment plans was to enhance parent-teacher communication. Children in the experimental group (N = 34) showed overall improvement (as judged by parents) and decreases in targeted problems (as reported by teachers and parents), relative to control students (N = 15). The program decreased the number of children placed in special education. There was indication that better communication between home and school related to academic improvement. The protocol provides a possible behavioral consultation model of early intervention for behavior disorders and demonstrates how clinical services can be integrated with systems-wide dropout prevention efforts.     

克服肿瘤干细胞耐药性的策略和思路

肿瘤干细胞（cancersterncells,CSCs）是肿瘤细胞的祖细胞。已有的研究表明,肿瘤干细胞对多种化疗药物具有耐药性,是导致肿瘤治疗后复发的根源。研究针对肿瘤干细胞的治疗方法,克服肿瘤干细胞耐药性,将给肿瘤治疗模式带来全新的改变,有望彻底改善肿瘤患者的预后。     

未雨绸缪：变革前非正式信息对员工变革抵制意愿的影响

组织变革前总会有小道消息等非正式信息传播, 这些信息是员工提前了解变革的重要来源。研究探索变革前非正式信息对员工变革前抵制意愿的影响, 以及员工变革抵制意愿随时间推移的变化。基于255位样本数据的结构方程模型及多层次线性增长模型分析表明：(1)变革前非正式信息的消极性及不完整性, 显著负向影响员工变革认知, 进而使员工变革抵制意愿上升; (2)随着时间推移, 员工变革抵制意愿显著衰减, 即从变革前到变革发生时抵制意愿显著降低。研究揭示了变革前非正式信息对员工有“热身准备”的作用, 能够帮助员工提前适应, 从而更好地应对变革。研究结果有助于变革的顺利实施。     

健康本源论模型介绍及启示

基于文献分析的方法,梳理健康本源论的发展历程,重点介绍健康本源论模型及模型中的主要概念,探讨健康本源论在实践中的应用及其对健康研究的启示。国外应用健康本源论指导医学实践的经验表明,对健康领域的研究重心从疾病预防转移到健康促进,对于提高个体和社会健康水平具有一定的指导意义。未来我国健康相关研究可从健康本源论视角出发,结合国情及文化,对健康本源论进行本土化调整和发展,为健康领域研究与实践提供借鉴和理论依据。

     

Small Acts of Living: Everyday Resistance to Violence and Other Forms of Oppression

The author describes an approach to therapy which is based on the observation that whenever persons are badly treated, they resist. Case illustrations are given in which individuals seeking therapy had been subjected to violence and oppression.     

A KANTIAN PERSPECTIVE ON POLITICAL VIOLENCE

Rejecting Kant's absolute opposition to revolution, I propose a modified Kantian perspective for reflecting on political violence, drawing from Kant's basic ideas but abandoning some dubious assumptions. Developing suggestions in earlier papers, the essay sketches a model for moral legislation that combines the core ideas of each of Kant's formulas of the Categorical Imperative. Though only a framework for deliberation, not a complete decision procedure, this excludes extremist positions, prohibitive and permissive, about political violence. Despite Kant's hopes, the values implicit in his fundamental principle fail to support easy, inflexible solutions; but they place strong presumptions against lawless coercion and killing, undermining social order, treating persons as dispensable, underestimating options, arrogant faith in one's own judgment, and reckless simplicity in political thinking.