建立鼻腔结构与功能自适应生物力学模型在鼻科疾病中的作用

鼻腔结构在与鼻腔物理力学环境发生交互关系时,能够根据周围环境调整自身结构和形状,即所谓鼻腔结构与功能自适应性.鼻腔结构与功能自适应生物力学模型模拟鼻腔结构异常产生功能障碍所继发的上呼吸道疾病发生发展过程,为鼻科某些常见病的发生发展过程进行量化分析,为鼻内窥镜手术在恢复重建鼻腔结构功能方面临床决策提供依据.     

胃肠道干细胞

胃肠道是人体内各系统细胞更新频率最高的器官,其干细胞的增生分化也很旺盛。尽管胃肠道干细胞本身未分化成熟,其细胞表型无法确认而不利于鉴别,但随着一些干细胞标志物的发现及对细胞信号传导通路的不断了解,我们对胃肠道干细胞的调控机制的认识正在不断加深。胃肠道干细胞的基本特征:(1)胃肠道干细胞的数量、定位和组织起源;(2)胃肠道干细胞的主要功能,包括分化转化成胃肠道各成熟的细胞系及维持组织的动态平衡和稳定;(3)从其他组织的干细胞获得胃肠组织细胞系用以胃肠道疾病的治疗;(4)胃肠道组织癌变的基因变化及形态学观察。     

重视干细胞研究中的伦理问题

黄禹锡的“卵子风波”反映了干细胞研究领域中伦理规范的缺位。分析了针对干细胞研究的种种伦理争论,并且指出,由于与人类的尊严和幸福密切相关,生物医学领域的研究不能回避伦理问题,相关的伦理研究必须与科学研究同步进行。     

生育获得脐血行干细胞移植治疗重大遗传性疾病的风险和对策

通过生育获得脐带血行干细胞移植是治疗重大疾病的一条可行之路,但在治疗遗传性疾病时,当事家庭、检测机构和医疗机构三方都存在着极大的风险,特别是当事家庭很有可能要承受精神和经济上的更大打击,而且客观上造成患病或者携带者人群的进一步扩大,成为一个不可忽视的社会问题。有必要进行充分的伦理思考后提出尽可能周全的办法,以降低各方面的风险。     

干细胞移植治疗视网膜疾病的启示

干细胞是指具有自我更新、高度增殖和多向分化潜能的细胞群体,通过胚胎干细胞及视网膜干细胞、骨髓间充质细胞等成体干细胞移植治疗眼底病是近年来研究的热点,并取得了重要进展,为视网膜疾病的治疗开辟了新的途径,但同时也面临着技术的探讨及哲学的思考。本文就干细胞移植治疗视网膜疾病这一问题进行相关哲学思考。     

Semiotic transformations in psychoanalysis with infants and adults

The author addresses issues that emerge when we compare psychoanalytic experiences with adults and with infants. Two analyses-one with a 35 year-old woman and one with a 2 week-old boy and his mother-illustrate that infant psychoanalytic experiences help us understand and handle adult transference. However, we cannot extrapolate infant experiences to adult work. Truly, witnessing the baby's communication widens our sensitivity to non-verbal layers of the adult's communication. Infant work also offers a direct encounter with the container and the contained personified by a mother with her baby. But we need to conceptualize carefully the links between clinical experiences with babies and adults. When we call an adult transference pattern 'infantile', we imply that primeval experience has been transformed into present behaviour. However, if we view the analytical situation as one in which infantile invariants have transformed into adult symptoms, we face the impossible task of indicating the roots of the present symptoms. The author rather suggests that what is transformed is not an invariant infantile essence but signs denoting the patient's inner reality. He proposes we define transformation as a semiotic process instead of building it on an essentialist grounding. If we view the analytic situation as a map of signs that we translate during our psychoanalytic work, we can proceed into defining containment as a semiotic process. This idea will be linked with a conceptualization of the mother-infant relation in semiotic terms.     

Using Adult Learning Theory Concepts to Address Barriers to Cancer Genetic Risk Assessment in the African American Community

Utilization of cancer genetic risk assessment can be profoundly influenced by an individuals’ knowledge of risk assessment, attitudes regarding illness and healthcare, and affective reactions derived from social norms. Race and ethnicity play a powerful role in the development of an individual's attitudes and should be considered when attempting to understand a person's openness to cancer genetic risk assessment (Lannin et al., 1998). Until recently, however, cancer screening and prevention programs have been primarily based on data from studies conducted with the Caucasian population, yielding data that are not fully applicable to the African American community. In the last several years, research findings regarding African American's knowledge, attitudes, and feelings about genetic counseling and testing have grown (Matthews et al., 2000; Singer et al., 2004; Thompson et al., 2003). However, to the authors’ knowledge, these data have yet to be presented in a manner that both summarizes the barriers that African Americans have reported regarding cancer genetic risk assessment, while at the same time suggesting methods individual genetic counselors can utilize during community presentations to help address these barriers. This article will first summarize previous empirical findings regarding African Americans’ knowledge, attitudes, and feelings about cancer genetic risk assessment. The article will then apply adult learning theory to those findings to provide genetic counselors with practical, theory based techniques to apply toward community based educational programs with African American groups.     

大学生成人依恋、社会支持与抑郁的关系

通过整群随机抽样的方法抽取了438名大学生, 对其施测关系问卷、亲密关系经历量表、社会支持评定量表和抑郁问卷, 以探讨成人依恋关系、社会支持与抑郁之间的相互关系。结果表明:(1)依恋回避、依恋焦虑、社会支持和抑郁在依恋类型上存在显著差异;(2)依恋回避与不同来源社会支持均存在显著负相关, 与抑郁存在显著正相关。依恋焦虑与主观社会支持存在显著负相关, 与抑郁存在显著正相关。不同来源社会支持与抑郁均存在显著负相关;(3)社会支持可以部分中介成人依恋对抑郁的影响。     

癌痛治疗指南解析

对多国成人癌痛指南进行检索、回顾,发现近年癌痛治疗领域新进展和各国普遍遵循的共同原则,为临床医生改进癌痛治疗提供参考。采用现有的互联网临床实践指南检索平台,对成人癌痛指南进行检索,分析各国指南的异同之处,重点对疼痛评估、WHO三阶梯药物治疗及辅助治疗进行比较、归纳。全面的癌痛评估是指痛治疗的必要前提,也是众多癌痛指南强调的重点;按疼痛程度选择三阶梯镇痛药物仍是药物止痛的基本原则;口服途径是止痛治疗的首选给药途径;第一阶梯药物中阿司匹林的应用逐渐淡化,NSAIDs的毒性反应受到关注;第二阶梯药物的选择更灵活。应根据疼痛性质、患者的具体情况合理选择复合制荆。吗啡仍是强阿片类药物中的首选,可用于中、重度疼痛的治疗。因此,我国成人癌痛治疗需要改进,应重点推广全面的疼痛评估,提倡根据患者的具体情况合理、灵活的选择三阶梯药物,个体化治疗是止痛治疗的关键。