慢性乙型肝炎抗病毒治疗的策略

抗病毒治疗是慢性乙型肝炎治疗的关键,有效的抗乙型肝炎病毒药物主要有干扰素和核苷（酸）类似物。单药抗病毒治疗可获得较好的疗效,便于监测、管理;联合抗病毒治疗增加抗病毒疗效尚难肯定,更无法避免耐药发生,并可导致多药耐药、增加药物副作用和治疗费用。因此,优选单药进行抗病毒治疗才是目前理想的方案。     

The Prospective and Retrospective Memory Questionnaire (PRMQ): factorial structure, relations to global subjective memory ratings, and Swedish norms

The factorial structure of the Prospective and Retrospective Memory Questionnaire (PRMQ; Smith et al., 2000) was examined in a Swedish population based sample (N= 540, age range; 35-90 years). Concurrent validity was assessed by relating PRMQ to global ratings of memory. Confirmatory factor analyses of the PRMQ items indicated a superior fit of a three-factor model, with prospective and retrospective memory as orthogonal factors and episodic memory as a common factor. Furthermore, the PRMQ scales correlated with the global ratings of memory, suggesting that each rating contributed with unique variance in predicting PRMQ scores. Given differences in levels of complaints as compared with prior research (Crawford et al., 2003) norms for the Swedish version are provided. In conclusion, the present findings extend earlier work by providing additional support for the construct and concurrent validity of the PRMQ scales.     

The experiences of counselling for persons with ME

A number of studies have evaluated counselling interventions for people with myalgic encephalitis, but few report client perceptions in any detail. This study seeks to explore client perceptions using a qualitative methodology. A sample of 25 individuals with myalgic encephalitis were interviewed about their experiences in counselling. The interviews were transcribed and subjected to thematic analysis using grounded theory principles. The analysis showed that people with myalgic encephalitis endure significant changes to their lives, often involving great loss and trauma. After seeking help through counselling, participants had experienced a wide variety of approaches and there were positive and negative perceptions of each. Other perceptions related to therapist characteristics and the way in which interventions were carried out. Recommendations for practitioners are given.     

Value Dissonance and Ethics Failure in Academia: A Causal Connection?

Ethics failure in academia is not new, yet its prevalence, causes, and methods to prevent it remain a matter of debate. The author’s premise is that value dissonance underlies most of the reasons ethics failure occurs. Vignettes are used to illustrate value dissonance at the individual and institutional levels. Suggestions are offered for ways academic institutions can assume greater responsibility as a moral agency to prevent the occurrence of ethics failure.

海马NMDA受体经SP-NK1受体通路参与慢性应激诱发的抑郁样行为

为探讨海马N-甲基-D-天冬氨酸(N-methyl-D-aspartic acid, NMDA)受体与P物质(Substance P, SP)及其神经激肽1 (neurokinin1, NK1)受体在慢性不可预见性温和应激(chronic unpredictable mild stress, CUMS) 中的作用及其关系, 通过建立CUMS动物模型, 大鼠海马微量注射给药, 测量大鼠体重, 并采用糖水偏爱测试、旷场实验和悬尾实验等方法对大鼠进行行为学检测, 运用高效液相色谱(HPLC)法分析大鼠海马组织中SP和谷氨酸(glutamate, Glu)的含量变化。结果显示, CUMS诱发大鼠表现出明显的抑郁样行为, 海马组织中SP和Glu水平显著增加; 海马注射NMDA, 大鼠表现出与CUMS/SAL组相似的抑郁样行为, 且海马组织中SP的含量比正常对照组显著增加; 微量注射NK1受体阻断剂CP-96345和/或NMDA受体阻断剂MK-801后, 大鼠抑郁样行为明显改善, 且MK-801使CUMS导致的大鼠海马P物质水平升高得到明显控制, 而CP-96345没有明显改变CUMS引起的海马Glu水平升高; CP-96345使NMDA引起的抑郁样行为得到极显著改善。以上结果表明, 慢性应激引起大鼠海马Glu过量释放, 通过激活NMDA受体, 促进P物质合成释放增加, 激活NK1受体, 是导致抑郁样行为发生的重要途径之一。     

一个有待探索的新概念:心性脑病

从共性与个性、整体与局部的哲学观点以及临床上探讨心性脑病的存在,为基础研究和临床治疗提供理论依据.     

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.     

The Effectiveness of Mindfulness Training on the Grieving Process and Emotional Well-Being of Chronic Pain Patients

Losses in relationships, work, and other areas of life often accompany the physical discomfort of chronic pain. Often the depth and intensity of the grief associated with chronic pain are overlooked or possibly misdiagnosed and treated as depression. We used an 8-week mindfulness meditation program to determine its effectiveness in addressing the grieving process among 39 patients diagnosed with chronic pain. Eighteen patients volunteered to be in a comparison group. The study was conducted in a regional hospital's pain clinic and patients completed the Response to Loss Scale (measuring grief), the Beck Depression Inventory, and the State Trait Anxiety Inventory. Results indicated that the treatment group advanced significantly more quickly through the initial stages of grieving than the comparison group. In addition, the treatment group demonstrated significant reductions in depression and state anxiety, but no significant differences emerged when comparing groups on the final stages of grieving or trait anxiety.     

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.     

Meaningful coping with chronic pain: Exploring the interplay between goal violation,meaningful coping strategies and life satisfaction in chronic pain patients

Trying to cope with chronic pain is a highly demanding and challenging task and pain patients often need to reformulate goals or aspirations due to their pain condition. This goal violation is often related with experienced distress and requires coping processes in order to decrease the distress and stimulate a healthy adaptation. Some scholars, however, argued that in so‐called unsolvable or irreparable stressors such as chronic pain, conventional coping strategies like problem‐focused coping might not be the most adaptive option. In these situations, meaningful coping strategies attempting to transform the meaning of the stressful experience would be more accurate. In this study, we aim to test if goal violation triggers meaningful coping strategies over time and whether engagement in these meaningful coping strategies result in improved life satisfaction, as an indicator of adaptation. A longitudinal three wave study in a sample of paint patients (n = 125) tests whether goal violation triggers positive reappraisal and downward comparison, two possible meaningful coping strategies. The study furthermore tests if engagement in these strategies results in a better adaptation to the pain condition, reflected in higher life satisfaction. Results partially supported our hypotheses by pointing to the benevolent role of downward comparison on life satisfaction via decreased goal violation of pain patients. Our findings however did also show that positive reappraisal predicted lower life satisfaction via increased levels of appraised goal violation which questions the role of positive reappraisal as a genuine meaningful coping strategy. Implications and limitations are discussed.