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。     

用现代医学模式看心血管疾病合并抑郁症的诊疗

随着社会进步,生活节奏日益加快,抑郁症及抑郁情绪已经悄无声息地蔓延开来,心血管疾病已成为城乡居民的第一位死因,分别为心理、生理疾病,从传统医学模式的角度看两者互不相干,但从生理-心理-社会的现代医学模式理解以及各种研究表明它们其实有着密切的联系。     

缺血性脑血管病的血管内治疗热点

缺血性脑血管疾病的血管内治疗目前已成为脑血管病治疗研究的热点之一,并以其微创的理念、较好的疗效得到广泛认可,本文重点介绍缺血性脑血管病中支架辅助狭窄扩张、动静脉介入溶栓以及静脉窦血栓形成的发展现状以及存在的问题,并对介入技术在缺血性脑血管病中应用的未来发展方向,作了简要回顾和展望。     

从进化观点看应激对健康的影响

从进化的观点解释了不同生物体应对应激的不同行为策略及其生理基础,和由此引起的对不同应激性疾病易感性的差异。行为策略和生理基础的差异使得一定环境条件下引发的应激反应对不同个体产生了不同的非稳态获益和代价（非稳态负荷)。非稳态的获益和代价影响了健康和疾病间的平衡：攻击性个体由于非稳态调质失调,更可能出现冲动控制障碍、高血压、自身免疫性疾病、慢性疲劳状态等;反之,非攻击性个体由于非稳调质过度释放,更易发生焦虑障碍、抑郁症、代谢综合症等     

Are General Practitioners Willing and Able to Provide Genetic Services for Common Diseases?

Primary care in the United Kingdom has been advocated as an optimal location for the provision of genetic services for common diseases. Little, however, is known about general practitioners' own views toward this suggestion or the possible demand for such services from patients. To assess general practitioners' attitudes to providing genetic services for common diseases, and to estimate the demand from patients for these services, we used a single-page postal questionnaire survey of all 359 general practitioners registered with the Oxfordshire Health Authority; 339 (94%) responded. These physicians reported that a mean 4.1 patients (95% CI, 3.3–4.9) out of every 1,000 consulting them were concerned about their own risk of a common disease associated with a diagnosis in a family member. Half of the general practitioners (95% CI, 45–56%) counseled about genetics in the last year. A majority of general practitioners accept the need to provide genetic services, but far fewer are competent to do so. Although 60% (95% CI, 55–65%) believed they should be involved with genetic screening for common diseases, only 29% (95% CI, 24–34%) felt sufficiently prepared to take family histories and draw pedigrees, and only 15% (95% CI, 11–19%) felt sufficiently prepared to counsel patients about their genetic test results. Given the necessary training and information, 63% (95% CI, 58–68%) and 64% (95% CI, 59–69%) were willing to provide these services. Even with training and information, not all would be willing to provide these services, and lack of time may be a major deterrent. Practice-enabling strategies, such as computerized aids in genetics, may be useful.     

Topic-relevant cognition and empathic accuracy in laboratory discussions of safer sex

Abstract

The present study sought to identify some of the mechanisms that make safer sex such a difficult topic to talk about. Fifty six dating couples participated in a laboratory study in which the opposite-sex members of two pairs of couples engaged in two discussions of safer sex (or a control topic), each time with a different opposite-sex partner (their own dating partner or an opposite-sex stranger). The results indicated that discussions of safer sex evoke in dating partners a high level of perceived goal-incompatibility, difficulty maintaining one's focus on the topic, and difficulty in reading the other partner's thoughts and feelings. These reactions did not occur in response to the control topic. This initial demonstration study is important with respect to the processes it implicates, but further clarification is needed regarding the specific real-life conditions in which these processes do, and do not, occur.     

成也萧何败也萧何——工业化语境下当代医学的困境与出路

工业化革命的动力打造了当代医学的昌明和繁盛,而工业化思维即成为当代医学向高层次发展的新羁绊。工业化思维的价值取向,使当代医学走向刻板和教化,耐日益失去应有的灵性和柔性,其僵硬的模式化治疗体系与高度个性化的代谢性新疾病群形成了巨大的反差。医学的技术语汇应匡正“恶”行,择“善”而为,追求和谐,这是当代医学走出工业化阴影的必然出路。     

论疾病诊治中的顾此失彼

"顾此失彼"指在疾病的诊治中发现、意识或处理了事物的一个方面或一个事物,而遗漏、忽视了事物的另一个方面或另一个事物。首先,表现在没有全面地收集和分析相关的临床资料。其次,表现为疾病诊断的不全面。再次,表现为疾病治疗的总体安排、治疗方案或药学监护等方面的顾此失彼。与疾病诊断和治疗有关的"彼"是必须被发现和意识的。但在处理时,则根据"彼"与诊断或治疗关系的程度分别对待。为减少或减轻疾病诊治中"顾此失彼"的不良后果,需要采取一系列相应对策,如实施毕业后规范化培养、学习诊治指南和临床路径、重视疾病诊治的程序、提高临床技能、积累临床经验、丰富相关知识、培养临床思维、提高职业素养等。     

Patience mediates the relationship between mindfulness and pain in patients with cardiovascular diseases

The aim of the present study was to investigate the mediating role of patience in the relationship between mindfulness and pain among patients with cardiovascular disease. A cross-sectional design was employed. One hundred and ten patients with cardiovascular diseases were conveniently sampled from the clinic of Imam Reza in the city of Shiraz in Iran. Participants completed self-report measures of mindfulness, patience, and pain. Structural equation modeling was performed with Amos 16.0. Results indicated that mindfulness and patience had a significant inverse relationship with pain. There was also a significant positive relationship between patience and mindfulness. Estimated indirect effects showed that patience partly mediated the relationship between mindfulness and pain. These results show that among cardiovascular patients, increases in mindfulness are associated with reductions in pain as a function of increased patience. Therefore, patience is plausibly a key mechanism for understanding the impact of mindfulness on pain reduction.     

Nasal diseases and psychological distress

A high rate of ENT doctors were murdered by nasal disordered patients in China recently. It is obviously important and urgent to find out whether there is any potential relationship between nasal diseases (ND) and psychological distress that might contribute to violent behavior. For this purpose, we carried out this literature review. There is a complex relationship between ND and psychiatric distress, which is mainly considered as a bidirectional causal relationship with other controversy opinions. However, most of the previous studies were found to be focused on allergic rhinitis and chronic rhinosinusitis, while reports about other ND were rare. Further study is still needed to uncover the secret aspects in this field, and more attentions need to be paid to other ND.