如何正确认识和处理新发与复燃传染病

近40年来,由于诸多因素的影响,新发传染病陆续出现,再发传染病在某些地区"死灰复燃",并且呈现出不同以往传染病的新特点,如病原体的变异、人兽共患性、传播速度快、流行范围广等,加之传媒的"双刃剑"作用,共同造成了新发与复燃传染病的种种不确定性。因此,正确认识和积极防治新发与复燃传染病已成为新世纪人类亟待解决的重大问题,是当前世界疾病预防控制工作中的重要内容。     

Psychologie de la santé et éducation thérapeutique : état des lieux et perspectives

The aim of Patient Education (PE) is to make patients with chronic diseases more autonomous by facilitating their adherence to treatments and improving their quality of life. It is a multidisciplinary and expanding device. This article's aim is to propose a state of play of PE and its perspective in relation to psychology, especially health psychology, as a discipline and a practice. First, the development of PE in its historical context is presented as well as its definition. Then, the place and contribution of health psychology and psychologists in PE is presented. The following points deal with the contributions of research to understand the efficacy of PE, the difficulties that the different professionals face and the place of relatives. Finally, a reflexion about the links between the training of psychologists and the training for PE is proposed.     

铁过度负荷与疾病

铁是机体微量元素中含量最多的一种,是血红蛋白、肌红蛋白、细胞色素系统、呼吸链的主要复合物、过氧物酶和过氧化氢酶等的重要组成部分,广泛参与机体生理功能和生化反应,缺铁可导致贫血等疾病。体内铁过多,称为铁过度负荷。随着医疗条件改善、生活水平提高,源于生理性因素、病理性因素和外源性铁剂应用(治疗性应用、预防性应用),铁过度负荷相关疾病日益增多。铁过度负荷可对内分泌代谢、心血管、神经系统、肾脏、肝脏等系统器官产生损害,导致多种疾病或使疾病加重。目前铁过度负荷相关疾病的治疗措施主要有放血疗法和药物治疗。放血疗法,只可作于短期治疗。去铁胺作为目前较为有效的去铁剂,由于价格昂贵,不能广泛应用于临床。铁过度负荷对人体的影响和相关疾病尚未外起医学界的重视。深入研究以铁过度负荷为主要和次要病因相关疾病,探索正确补铁措施,是预防铁过度负荷相关疾病、增进人体健康的重要措施,也是临床面临床的新课题。     

一个新的中医研究范式:从非线性动力学的角度解读中医

西方对中医的研究多是利用随机控制试验来检验其疗效。通过讨论,认为这类研究有其局限性。同时探讨一种新的研究范式,即非线性动力学理论。认为这一理论能够提供理论依据来设计适合中医特征的临床试验,并可望得出为西方医学界所接受的研究结果。     

Improving Service Evaluation in Clinical Genetics: Identifying Effects of Genetic Diseases on Individuals and Families

Outcome measurement in clinical genetics is challenging. Outcome attributes used currently have been developed by service providers or adapted from measures used in other areas of healthcare. Many of the ‘patients’ in clinical genetics are healthy but at risk of developing or transmitting a condition. Usually no pharmacological or surgical treatment is offered, although information-giving is an objective of most consultations. We argue that services should be evaluated on the basis of how well they alleviate the effects of disease, from a patient perspective. This paper describes a qualitative study using seven focus groups with health professionals, patients and patient representatives. Social and emotional effects of genetics diseases were identified. Some differences emerged between the effects identified by health professionals and those identified by patients. These findings will be used to inform the evaluation of existing outcome measures and develop robust measures of outcome for clinical genetics services.     

Loneliness in patients with rheumatic diseases: the significance of invalidation and lack of social support

Rheumatic diseases affect about 20% of the population, leading to common symptoms such as joint problems, pain, fatigue, and stiffness. Loneliness is prevalent in individuals with rheumatic diseases. This could be due to not receiving social support and being stigmatized and invalidated, which might be most common in fibromyalgia, a rheumatic disease that lacks medical evidence. The aim of this study was to compare loneliness in distinct rheumatic diseases and to examine the association of loneliness with social support and invalidation. Participants were 927 patients with ankylosing spondylitis (n = 152), fibromyalgia (n = 341), osteoarthritis (n = 150), rheumatoid arthritis (n = 171), or systemic diseases (n = 113). They completed online questionnaires including an 11-point Likert scale assessing loneliness, the Illness Invalidation Inventory (3*1; Kool et al., 2010), and the Social Support Survey (SSS; De Boer, Wijker, Speelman, & De Haes, 1996; Sherbourne & Stewart, 1991). Patients with fibromyalgia experienced significantly more loneliness than patients with ankylosing spondylitis and patients with rheumatoid arthritis. Besides being younger, having lower education, and not working, in multiple regression analyses both lack of social support and invalidation were independently correlated with loneliness. This suggests that to decrease loneliness, therapeutic attention should be given to both increasing social support as well as decreasing invalidation in patients with rheumatic diseases, especially in patients with fibromyalgia.     

试论张仲景辩病结合辩证的辨证论治方法的先进性

张仲景辩病结合辩证的辨证论治方法,与现代医学认识疾病的思想非常近似,通过比较现代医学认识疾病思想与张仲景疾病认识概念在疾病诊治过程中的相似性,为研究<金匮要略>古代疾病与西医现代病的对应性结合、提高病证结合论治在临床的效验,有很大意义.     

消化系统疾病与精神心理因素的辩证关系

消化系统疾病与精神心理因素相互影响,其相互作用呈现个体化差异,这与个体间的内环境以及外环境差别有关。主要病理生理学机制之一为\"脑-肠轴\"及\"脑肠互动\"学说。临床医生需要认识到二者之间辩证关系的普遍性和重要性,及时发现躯体症状背后潜藏的精神心理问题,综合运用各种心理干预和药物治疗手段。