年老化对风险决策和模糊决策的影响：来自生理性和病理性老化的证据

随着“全球老龄化”时代的到来, 老年人认知功能的下降引起了研究人员的广泛关注, 其中年老化对决策的影响成为了近年来的一个新关注点。风险决策和模糊决策受生理性老化和病理性老化影响的研究显示, 正常老化个体模糊决策能力受损, 但其风险决策能力受老化影响较小; 而病理性老化个体, 以阿尔兹海默症患者为例, 在两类决策行为上均表现出损伤; 此外, 脑神经机制的研究发现在完成决策任务时正常年老化个体纹状体激活模式与年轻人存在显著差异, 病理性老化个体杏仁核与腹内侧前额叶的功能连接亦存在异常。未来的研究应同时考察并比较两类决策类型, 结合外周和中枢神经证据, 深入探讨老化对决策行为及神经环路造成影响的机制。     

Evaluation of the effect of Spiritual care on patients with generalized anxiety and depression: a randomized controlled study

The present study was conducted to assess the effect of spiritual care in patients with depression, anxiety or both in a randomized controlled design. The participants were randomized either to receive spiritual care or not and Hamilton anxiety rating scale-A (HAM-A), Hamilton depression rating scale-D (HAM-D), WHO-quality of life-Brief (WHOQOL-BREF) and Functional assessment of chronic illness therapy – Spiritual well-being (FACIT-Sp) were assessed before therapy and two follow-ups at 3 and 6 week. However, with regard to the spiritual care therapy group, statistically significant differences were observed in both HAM-A and HAM-D scales between the baseline and visit 2 (p < 0.001), thus significantly reducing symptoms of anxiety and depression, respectively. No statistically significant differences were observed for any of the scales during the follow-up periods for the control group of participants. When the scores were compared between the study groups, HAM-A, HAM-D and FACIT-Sp 12 scores were significantly lower in the interventional group as compared to the control group at both third and sixth weeks. This suggests a significant improvement in symptoms of anxiety and depression in the spiritual care therapy group than the control group; however, large randomized controlled trials with robust design are needed to confirm the same.     

Examining patience as a psycho-religious construct in Iranian patients with cardiovascular diseases: a pilot study

The current study aimed to compare patience and its components in cardiovascular patients (CVPs) with healthy individuals. Ninety-one patients with cardiovascular diseases (CVDs) referring to the clinic of Imam Reza in the city of Shiraz in Iran, and 91 healthy individuals were recruited by convenience sampling method. They completed demographics questionnaire and the Patience Scale. The data were analysed by sets of analysis of covariance. Results showed significant difference between CVPs and healthy participants on patience (M?=?85.92, SD?=?12.69 vs. M?=?90.45, SD?=?11.33); patients had less patience mean than their healthy peers (F?=?9.423, η²?=?.050, p?=?.002). The results also indicated that cardiac patients had significantly lower scores on patience components of transcendence, persistence, and delay than the healthy group (all p’s?p?>?.05). According to the results of the present study, it can be inferred that less patience may play a key role in vulnerability to physical illnesses such as CVDs.     

按病种支付医疗保险费用与病种成本核算研究

医疗服务具有垄断性、委托代理双重性和需求刚性.在利益机制驱动下,医疗项目的选择变成供方偏好,是医疗费用快速攀升的症结之一.变按项目支付为按病种支付,是控制医疗费用快速上涨、深化卫生改革的重要措施之一.最科学的方法是进行病种成本核算.     

论我国司法精神病鉴定制度之完善

随着法律制度的日渐发展和完善,司法精神病鉴定制度越来越多地受到人们的关注,存在的问题也不断暴露出来。鉴于司法精神病鉴定在社会生活中的重要作用,在对中外司法精神病鉴定的历史及现状的考察上,结合对我国司法精神病鉴定的相关制度的分析和研究,对我国司法精神病鉴定制度的改革提出了自己的观点。     

肥胖的成因、相关疾病及减肥

肥胖严重威胁人们的健康和生活质量,受多种因素的影响,与多种疾病有密切联系。辩证地分析和研究肥胖与其相关因素的关系,有助于肥胖的预防和治疗。     

Caregiver burden and family functioning in different neurological diseases

Aim of this study is to examine caregiver burden and family functioning in different neurological conditions. Forty-two primary caregivers of patients with Amyotrophic Lateral Sclerosis (ALS), Alzheimer’s Disease and other dementia (AD), Parkinson’s Disease (PD), Acquired Brain Injuries (ABI) and Multiple Sclerosis (MS) were administered scales for the evaluation of caregiver burden (CBI) and family functioning (FACES IV). Caregiver burden was overall high, with caregivers of patients with ALS and ABI having exceeded the CBI cut-off score for possible burn-out. The average scores of caregivers of patients with AD or other dementia and PD were close to the cut-off score, whereas those of caregivers of patients with MS were significantly lower than the others. Family cohesion, family satisfaction and the quality of family communication were associated with reduced levels of caregiver burden, whereas disengagement was associated with a higher burden. The data from the present study confirm that caregiver burden is a relevant issue in the context of neurological diseases, especially for those causing higher degrees of impairment. Significant correlations with family functioning emerged as well, highlighting the importance of studying and treating caregiver burden within the context of family relations.     

骨髓造血干细胞移植治疗自身免疫性疾病的进展

自身免疫疾病发病机制复杂,目前尚缺少有效的治疗方法。近年来发现造血干细胞移植可以通过免疫重建显著缓解甚至治愈自身免疫病。笔者对近年来造血干细胞移植治疗自身免疫病进行了介绍和综述,就其在1型糖尿病这一领域的研究进展进行了述评,探讨造血干细胞移植用于治疗自身免疫病的前景和待解决的问题。     

家族性高胆固醇血症基因治疗的思考

家族性高胆固醇血症是最典型的常染色体显性遗传性疾病,是早发冠心痛的主要病因。随着目前人类基因组学的研究进展,基因治疗有望解决患者遗传基因缺陷,从根本上治疗家族性高胆固醇血症。期待在不久的将来,当人类娴熟的应用基因治疗技术时可以从根本上治愈多种基因相关疾病。推动人类医疗事业的巨大发展。     

肠易激综合征：罗马III标准与我国共识意见解读

肠易激综合征在我国的发病率逐年升高,2003年我国制定的IBS的共识意见已不适用,因此2007年我国肠易激综合征共识意见进行了重新修订,称为长沙共识意见。长沙共识意见借鉴了国际公认的罗马III标准,在IBS的诊断所需的时间,IBS的亚型分型等方面做了较大的修订。并强调了随诊在IBS诊断中的重要性。长沙共识意见同时指出罗马III标准是基于西方国家的研究资料制定的,并不完全适用于我国。我国在IBS的诊断中应结合国人的发病特点进行诊断。长沙共识意见在IBS的治疗方面就我国现状提出了治疗流程。