乙肝防治决策的基本点

我国现有乙肝现症感染者1亿多人,乙肝防治决策需要整个社会的参与,决策是否可以取得成效取决于以下几个基本点:决策的权威性;决策的科学性;决策的可行性。决策的前提是:预防为主,治疗为辅。     

慢性乙型肝炎患者外周血中睾酮的变化及其意义

测定65例慢性乙型肝炎患者和35例健康者血清睾酮水平,并分别检测血清丙氨酸氨基转移酶（alanine aminotransferase,ALT）、谷氨酸氨基转移酶（aspartate aminotransferase,AST）、γ-谷氨酰基转肽酶（gamma-glutamyl transpeptidase,GOT）、血清总胆红素（total bilirubin,TBIL）、碱性磷酸酶（alkaline phosphatase,ALP）、免疫球蛋白IgG、IgM、IgA,荧光定量PCR检测外周血HBV DNA水平。慢性乙型肝炎患者血清睾酮水平显著高于正常对照组,HBeAg阳性患者较HBeAg阴性患者升高明显,但差别无显著意义。慢性乙型肝炎患者肝功血清学指标ALT、AST、TBIL、GGT、ALP及IgG水平显著高于正常人,但乙肝患者睾酮水平与ALT等生化指标及HBV DNA水平无明显相关性,与免疫球蛋白IgG呈中等负相关。因而可以看出慢性乙型肝炎患者血清睾酮水平显著高于正常人,睾酮水平升高可作为慢性乙型肝炎的易感因素之一。     

干扰素治疗慢性乙型肝炎临床评价

干扰素治疗慢性乙型肝炎已有20多年历史,由于其抑制病毒复制和强大的免疫调节作用,以及具有疗程确定,不引起病毒变异耐药,显效后疗效持久的特点,是慢性乙型肝炎抗病毒治疗的首选药物之一。多项试验证明聚乙二醇化干扰素治疗慢性乙型肝炎的疗效优于普通干扰素和核苷类似物。本文就有关干扰素单用、联合核苷类似物和序贯疗法治疗慢性乙型肝炎的临床研究和HBV基因型对干扰素疗效的影响做简要综述。     

慢性乙肝治疗路线图和HBV DNA、HBeAg、HBsAg定量的监测意义

慢性乙型肝炎病毒感染呈世界分布并且引起不良结局,是极为严重的健康问题。慢性乙型肝炎治疗最重要的目标是长期抑制病毒以改善预后,防止出现肝硬化、肝衰竭和肝癌。目前,抗病毒药物主要有干扰素和口服核苷（酸）类似物,核苷（酸）类似物的缺点主要在于长期治疗中出现耐药。路线图概念被用于监测耐药预测疗效。HBV DNA定量水平被作为路线图较好的监测指标。由于血清转换率及清除率过低,HBeAg、HBsAg定量检测不适合用于路线图监测,但对于使用聚乙二醇干扰素的慢性乙肝患者,可作为预测治疗应答的指标。     

我国病毒性肝炎住院费用灰色关联分析

基于2004年～2008年<中国卫生统计年鉴>和第三次国家卫生服务调查有关数据,计算病毒性肝炎现惠指标,并运用灰色关联法对住院费用进行定量分析.结果显示,我国病毒性肝炎发病率为108.44/10万,病死率为0.09/10万;平均住院天数呈逐渐递减趋势;药品费用是影响住院费用的主要因素.因此,控制住院费用的增长应重点控制药品费用.     

L’indemnisation par la solidarité nationale des dommages imputables à des contaminations d’origine transfusionnelle

Until 2009, the national effort to prevent transfusion contamination was aimed exclusively at the human immunodeficiency virus. Article 67 of the law of 17th December, 2008 instituted a new procedure for the out of court settlement of litigation arising from the contamination of blood transfusions by hepatitis C virus. The application of these successive legislative regulations is bound to raise questions. With the special systems adopted in the matter of transfusion contamination, damages attributable to mandatory vaccinations, biomedical research, serious health threats or treatment with extractive human growth hormone, the legislator has sized up the usefulness of extending the protection given by the health insurance system to a larger area of national concern, that of the health risk.     

Fitting Attitude Analyses of Value and the Partiality Challenge

According to ‘Fitting Attitude’ (FA) analyses of value, for an object to be valuable is for that object to have properties—other than its being valuable—that make it a fitting object of certain responses. In short, if an object is positively valuable it is fitting to favour it; if an object is negatively valuable it is fitting to disfavour it. There are several variants of FA analyses. Some hold that for an object to be valuable is for it to be such that it ought to be favoured; others hold that value is analyzable in terms of reasons or requirements to favour. All these variants of the FA analysis are subject to a partiality challenge: there are circumstances in which some agents have reasons to favour or disfavour some object—due to the personal relations in which they stand to the object—without this having any bearing on the value of the object. A. C. Ewing was one of the first philosophers to draw attention to the partiality challenge for FA analyses. In this paper I explain the challenge and consider Ewing's responses, one of which is preferable to the other, but none of which is entirely satisfactory. I go on to develop an alternative Brentano-inspired response that Ewing could have offered and that may well be preferable to the responses Ewing actually did offer.

乙肝病毒感染儿童面临的社会伦理学问题

我国是乙型病毒性肝炎高发区,母婴传播感染是一条极其重要且不易阻断的感染途径,由母婴传播导致的儿童乙肝病毒感染问题,不仅仅是现阶段我国严重的公共卫生问题,同时也是严重的社会伦理问题。HBV感染儿童在成长过程中所面临的社会歧视和自身权利保障是每一个患儿家庭迫切关心的,也是社会伦理学工作者的研究范畴。     

Weighing evils: the C. S. Lewis approach

It is often argued that the great quantity of evil in our world makes God’s existence less likely than a lesser quantity would, and this, presumably, because the probability that some evils are gratuitous increases as the overall quantity of evil increases. Often, an additive approach to quantifying evil is employed in such arguments. In this paper, we examine C. S. Lewis’ objection to the additive approach, arguing that although he is correct to reject this approach, there is a sense in which he underestimates the quantity of pain. However, the quantity of pain in that sense does not significantly increase the probability that some pain is gratuitous. Therefore, the quantitative argument likely fails.     

Inching towards wholeness: C.G. Jung and his relationship to Judaism

The evolution of Jung's relationship with Judaism is interpreted as reflecting aspects of the individuation journey over the course of a long life. The progress and limitations of his public positions and personal relationships are explored through his published work and correspondence. Perspectives from relational psychoanalysis and Jewish philosophy are used to amplify Jung's understanding of Jewish, and specifically Kabbalistic, text and image. Dimensions of the author's own journey toward greater acceptance of his own Jewish soul is also considered, along with the wider contemporary relevance of these themes.