社会正义是对健康的最好保障

健康是公民的一项基本权利,社会或政府有义务保障公民的这一权利。公民的健康除了由医疗卫生和生理因素决定外,还由诸多社会因素决定。这些健康的社会决定因素所反映的实际上是社会正义问题,因此要保障公民的健康权利,最根本的是要营造一个正义的社会环境,并建立一个正义的社会保障支持系统。     

脑梗塞的神经保护治疗

近年来缺血半暗带和再灌注损伤理论的提出,更新了急性脑梗塞的临床治疗观念:神经保护治疗和溶栓治疗。但神经保护治疗的临床试验失败迫使我们不得不从整体、综合、多元化的角度重新思考这一措施,提出要辩证认识其与溶栓治疗的关系,采取个体化治疗和“鸡尾酒疗法”。     

急性脑梗死早期OCSP分型的临床应用评价

为了研究急性脑梗死早期OCSP（Oxfordshire Community Stroke Projet）分型的应用价值,连续收集首次发病的脑梗死患者326例,按OCSP分型分为完全前循环梗死（TACI）、部分前循环梗死（PACI）、腔隙性脑梗死（LACI）、后循环梗死（PCI）,入组后各亚型比较急性期神经功能缺损评分和结构影像学特征,3个月的病死率和日常生活活动（ADL）能力评分。显示,TACI大面积脑梗死占74．4％,PACI中等面积脑梗死占64．5%。LACI腔隙灶脑梗死占90％,POCI大面积脑梗死占22．7％,中等面积脑梗死占40.9％,小梗死占36.4％。急性期神经功能缺损以TACI最严重,PACI和POCI次之,LACI最轻,TACI与其他各型之间,PACI和POCI与LACI之间的差异均有极显著性意义（P〈0．0005）,PACI和POCI之间差异无显著性意义（P〉0．05）。TACI的病死率为44．2％,PACI为10．2%,POCI为18．2%赫,LACI为2．6％,TACI病死率与各型比较有极显著性意义（P〈0．01）.TAC13个月的ADL为重度依赖,POCI为中度依赖,另2个亚型均为轻度依赖,有极显著性意义（P〈0．005）。由此得出结论,OCSP分型与影像学有良好对应关系。不同的OCSP分型可以反映脑梗死急性期神经功能缺损的严重程度,OCSP分型有利于脑梗死急性期个体化治疗选择。     

"伦理经营"诠释

伦理经营观念是企业经营哲学历史发展的逻辑结论,也是企业伦理学家们对市场经济条件下企业经营管理活动的伦理学总结。在我国,企业行为失范、坚持科学发展观和构建社会主义和谐社会、参与经济全球化进程、生态环境的恶化态势等因素决定了企业必须坚持伦理经营价值观。伦理经营既是一种守法经营,也是一种合德经营。经营法规、人性化管理、诚信交易、绿色营销、积极负责等,是伦理经营价值观体系的构成要素。     

Risk and protective factors for pre- and postnatal bonding

Since disturbances in the mother–child bond increase the risk of negative consequences for child development, it is important to identify risk and protective factors for bonding as well as longitudinal associations. Previous research has used different bonding instruments during pregnancy and the postnatal phase, leading to inconsistent results. In the current study, the same instrument was used during the various phases. In a large, community-based sample (N = 793), general information, feelings of pre- and postnatal bonding (Pre- and Postnatal Bonding Scale), depressive symptoms (Edinburgh Postnatal Depression Scale), and partner support (subscale Tilburg Pregnancy/Postnatal Distress Scale) were measured at both 32 weeks of pregnancy and 8 months postnatally. Partner support was found to be a protective factor for suboptimal pre- and postnatal bonding, as was the engagement with fetal movements for prenatal bonding. High maternal educational level was a risk factor for suboptimal prenatal bonding, as were depressive symptoms for suboptimal postnatal bonding. The associations between most prenatal determinants and postnatal bonding were mediated by prenatal bonding, which underlines the importance of promoting prenatal bonding. Professionals in clinical practice should be aware of partner support, engagement with fetal movements, and postnatal depressive symptoms: All these factors offer opportunities for improving the bonding processes.     

大鼠脑反复缺血致不可逆性学习记忆障碍的研究

大鼠全脑反复缺血后产生不可逆性学习记忆障碍的研究,采用４血管阻断的方法,脑反复缺血再灌流,然后长期饲养。作水迷宫试验和跳台试验,结果显示缺血后出现了显著的、不可逆的学习记忆障碍。同时用放射免疫方法测定了额叶、颞叶、纹状体、丘脑、海马、Ｍｅｙｎｅｒｔ氏核中胆碱递质和ＡＶＰ,发现ＡＣｈ、ＣｈＡＴ、ＡＶＰ含量显著下降。下降的时间、幅度一致,变化呈正相关。ＡＣｈ、ＣｈＡＴ、ＡＶＰ是与学习、记忆密切相关的神经递质和神经肽。因而推断脑缺血后出现不可逆性学习记忆障碍与多脑区内ＡＣｈ、ＣｈＡＴ、ＡＶＰ含量显著下降有关。这对探讨临床上血管性痴呆发病机理进而开发有效的防治药物有重要意义。     

Modern medicine and biotechnology: an ethical conflict of interest?

When confronting the issues related to developments in modern medicine and biotechnology, we must repeatedly ask ourselves anew what can and cannot be justified in an ethical sense. For radically new ethical questions seem to arise through innovative techniques such as stem cell research or preimplantation diagnosis — and with them new areas of conflicting interests. If one scrutinizes the previous positions related to this subject, it becomes conspicuous that a multitude of questions has quickly piled up — however, (as in the case of Germany) comprehensive and differentiated views have mostly been lacking. An earlier version of this paper was presented at an International Conference on “Conflict of Interest and its Significance in Science and Medicine” held in Warsaw, Poland on 5–6 April, 2002.     

Western scrub-jays (<Emphasis Type="Italic">Aphelocoma californica</Emphasis>) use cognitive strategies to protect their caches from thieving conspecifics

Food caching birds hide food and recover the caches when supplies are less abundant. There is, however, a risk to this strategy because the caches are susceptible to pilfering by others. Corvids use a number of different strategies to reduce possible cache theft. Scrub-jays with previous experience of pilfering other's caches cached worms in two visuospatially distinct caching trays either in private or in the presence of a conspecific. When these storers had cached in private, they subsequently observed both trays out of reach of a conspecific. When these storers had cached in the presence of a conspecific, they subsequently watched the observer pilfering from one of the trays while the other tray was placed in full view, but out of reach. The storers were then allowed to recover the remaining caches 3 h later. Jays cached more worms when they were observed during caching. At the time of recovery, they re-cached more than if they had cached in private, selectively re-caching outside of the trays in sites unbeknown to potential thieves. In addition, after a single pilfering trial, the jays switched their recovery strategy from predominantly checking their caches (i.e. returning to a cache site to see whether the food remained there) to predominantly eating them. Re-caching remained constant across the three trials. These results suggest that scrub-jays use flexible, cognitive caching and recovery strategies to aid in reducing potential future pilfering of caches by conspecifics.