基于社会资本理论的社区慢性病防治管理策略浅析

慢性非传染性疾病对居民健康的威胁与日俱增。预防和控制慢性病的蔓延是卫生工作者和公共卫生系统面临的挑战, 也关系到国家社会经济能否持续健康的发展。在社会资本理论这一全新视角下, 分析如何构建社区慢性病防治体系, 整合社会资源, 改善人际网络关系。社区慢性病防治体系的建立将为社会资本的重组和再生形成助推器, 并有助于实现二者的相互促进, 同时, 对提高医疗资源的使用效率, 减轻患者及其家属的经济负担, 建立互信互利的社区慢性病防治平台具有重要的现实指导意义。     

广西扶绥肝癌防治引发的环境与健康关系的哲学思考

从分析文献资料入手,对环境与健康的关系进行哲学思考。广西扶绥以玉米为主食的人群,因摄入过量黄曲霉素及饮用污染塘水,导致肝癌高发和高死亡率;而减少黄曲霉素摄入量、改饮清洁水,肝癌发生率和死亡率随之降低。因此,环境与健康相互影响,高温高湿环境诱发玉米产生黄曲霉素,污染塘水存在大量腐殖酸,食之饮之严重危害人的健康;健康意识觉醒,主粮由玉米改为水稻,饮用深井水,健康状况得以改善。在尊重环境与健康相互影响客观性基础上,追求客观性与主观性、人文性的统一。     

疾病的本质:本体多样性的呈现

从哲学上看,疾病是生命本体运动呈现出的异常变化,是生命存在的异常状态。其范畴随着社会发展和科学知识积累而不断变化,呈现出稳定性与变异性的统一,患病不仅是内外因相互作用的结果,同时也构成人类进化过程中的苦难,疾病是人类获取某种益处所付出的一种代价。判定疾病的标准表明,疾病本质上是一个实践的、带有价值判断的观念。     

Cognitive and attentional functioning in adolescents and young adults with Tetralogy of Fallot and d-transposition of the great arteries

The objective of this study is to investigate cognitive and attentional function in adolescents and young adults with operated congenital heart disease. Previous research has indicated that children with congenital heart disease have deficits in broad areas of cognitive function. However, less attention has been given to survivors as they grow into adolescence and early adulthood. The participants were 18 non-syndromic adolescents and young adults with tetralogy of Fallot and d-transposition of the great arteries that required cardiac surgery before the age of 5 years, and 18 healthy, unaffected siblings (11–22 years of age for both groups). Cases with congenital heart disease and their siblings were administered Wechsler Intelligence scales and reported attention problems using the Achenbach System of Empirically Based Assessments. Cases were compared to both healthy siblings and established norms. Cases performed significantly lower than siblings on full scale IQ and processing speed, and significantly lower than norms on perceptual reasoning. Cases also reported more attention problems compared to both siblings and norms. Effect sizes varied with medium-to-large effects for processing speed, perceptual reasoning, working memory, and attention problems. Findings suggest that neurocognitive function may continue to be affected for congenital heart disease survivors in adolescence and young adulthood, and that comparisons to established norms may underestimate neurocognitive vulnerabilities.     

近三十年小儿肾小球疾病治疗的回顾

总结了28年共2453篇有关小儿肾小球疾病治疗的文献,发现其发展规律符合科学的发展观药物的选择趋向于疗效肯定而且毒副作用小的药物,新方法新技术不断涌现,药物疗效的评价日趋合理,药物作用机制从系统、器官水平深入到细胞、分子及基因水平,各学科间的合作与联系增加。     

An evolutionary system for neural logic networks using genetic programming and indirect encoding

Nowadays, intelligent connectionist systems such as artificial neural networks have been proved very powerful in a wide area of applications. Consequently, the ability to interpret their structure was always a desirable feature for experts. In this field, the neural logic networks (NLN) by their definition are able to represent complex human logic and provide knowledge discovery. However, under contemporary methodologies, the training of these networks may often result in non-comprehensible or poorly designed structures. In this work, we propose an evolutionary system that uses current advances in genetic programming that overcome these drawbacks and produces neural logic networks that can be arbitrarily connected and are easily interpretable into expert rules. To accomplish this task, we guide the genetic programming process using a context-free grammar and we encode indirectly the neural logic networks into the genetic programming individuals. We test the proposed system in two problems of medical diagnosis. Our results are examined both in terms of the solution interpretability that can lead in knowledge discovery, and in terms of the achieved accuracy. We draw conclusions about the effectiveness of the system and we propose further research directions.     

Impaired awareness of movement disorders in Parkinson’s disease

Background

This study analyzed the presence of awareness of movement disorders (dyskinesias and hypokinesias) in 25 patients with Parkinson’s disease (PD) and motor fluctuations (dyskinesias, wearing off, on–off fluctuations). Of the few studies that have dealt with this topic, none have analyzed the differences in the awareness of motor deficits by comparing the on and off states using motor scales and an extensive battery of tests to assess cognitive and behavioral functioning.

Methods

PD patients were compared on three different scales that we have devised to measure awareness of movement disorders: Global Awareness of Movement (GAM) Disorders, dyskinesia/hypo-bradykinesia rating scales.

Results

Data showed that PD patients had greater awareness and psychological suffering in the off state than in the on state. In particular, they were troubled by motor disabilities related to hypokinesias and had mood-related symptoms and a perception of disability in activities of daily living. Interestingly, patients only showed a selective reduction of awareness of movement disorders associated with executive functions and related to dyskinesias in the on state, compared to a preserved awareness of hypokinesias in the off state. On the contrary, no association with executive functions was found in the off state.

Conclusion

Our findings suggest that the dopaminergic overstimulation of mesocorticolimbic pathways may cause a dysfunction of prefrontal–subcortical connections related to the impaired insight.     

重症手足口病的早期识别与处理

手足口病(hand-foot-mouth disease,HFMD)是由肠道病毒[以柯萨奇A组16型(Coxsackievirus A16,CoxA16)、肠道病毒71型(Enterovirus 71,EV71)多见]引起的急性传染病,而重症多由EV71感染引起。由于EV71的高度嗜神经性,重症者可合并中枢神经系统(central nervous system,CNS)损害、急性肺水肿/出血等。现就重症手足口病的早期识别与处理进行简要综述。     

Preserved metamemorial ability in patients with mild Alzheimer's disease: shifting response bias

Patients with mild Alzheimer's disease (AD) display a greater tendency to endorse unstudied items as "old" on memory tests than healthy older adults. This liberal response bias may result in mistaken beliefs about the completion of common tasks. This research attempted to determine whether it was possible to shift the response bias of mild AD patients to be more conservative on a recognition memory test through behavioral intervention. Patients with mild AD and matched controls were evaluated with two almost identical paradigms, separated by about one week. For each session, 30 words were studied and 60 words (half studied, half novel) were shown at test. During one session participants were told that 30% of words were old, and at the other session that 70% were old. We found that both groups were able to shift their response bias between the two conditions. That patients with mild AD were able to successfully shift their response bias demonstrates that--despite their overall liberal response bias and poor memory relative to controls--one component of metamemorial ability is preserved in patients with mild AD.