古埃及疾病医治理念透析

疾病医治理念是古埃及文明的重要组成部分。古埃及人针对不同类别疾病有着相应的医治理念：药物、魔法与意志是内科疾病的医治理念;河渠原理是医治外科疾病的理念;对于治疗心理疾病主要是寻求神灵的拯救;预防疾病的理念是保持圣洁。挖掘、梳理这些医治理念,可以加强医学史的学科建设,对某些疾病的治疗有参考价值。     

Issues Involving Informed Consent for Research Participants with Alzheimer’s Disease

Alzheimer’s disease is the most common form of dementia which is estimated to impact 350,000 people over 65 years of age in Canada. The lack of effective treatment and the growing number of people who are expected to be diagnosed with Alzheimer’s disease in the near future are compelling reasons why continued research is in this area is necessary. With additional research, there needs to be greater recognition of the complexity of seeking ongoing informed consent from those with Alzheimer’s disease. This complexity is because the impairment of memory and cognitive ability does not diminish in a linear manner, but rather fluctuates between periods of impairment and relatively normal cognitive lucidness. There is limited discussion in the guidelines of those progressing from early stages of Alzheimer’s disease who have intermittent cognitive function. Guidelines to research and Research Ethics Boards require further development to facilitate researcher including those with Alzheimer’s disease while protecting this growing pool of potential participants.     

Impulsivity as a predictor of newly-diagnosed peptic ulcer disease: A prospective cohort study

We examined the role of impulsivity in the development of peptic ulcer disease (PUD). The subjects were initially healthy 4636 hospital employees aged 19–62 who responded to a questionnaire on personality, health habits, mental health, and PUD in 1998 and 2000. We used multivariate logistic analyses to determine the relationship between impulsivity and newly-diagnosed PUD among those employees who did not have PUD at baseline. Impulsivity was assessed with the Karolinska Scale of Personality. High level of impulsivity was associated with increased 2-year incidence of doctor-diagnosed PUD after adjustment of age, gender, education and shift work (odds ratio = 2.42, 95% confidence interval = 1.21–4.82). Additional adjustment for the effects of smoking, alcohol consumption, BMI, physical activity, minor psychiatric morbidity and diagnosed depression and other psychiatric disease had little effect on this relationship. The present study suggests that impulsivity may be a risk factor for the development of PUD.     

呼吸危重症临床决策中的若干问题

在临床实践中,呼吸危重症的诊断和治疗存在着一些不同的观点。就其中某些热点问题,如慢性阻塞性肺疾病合并哮喘的诊断和机械通气的指征、肺栓塞的诊断、急性呼吸窘迫综合征的治疗、呼吸重症监护病房的建设和呼吸危重症的伦理学问题进行阐述,以期提高对呼吸危重症的认识。     

骨科疾病诊治中的临床思维

医学哲学是对医学科学成就总的概括,并以此为基础探讨生命活动和病程的一般规律,研究医学科学的思维方式,直至疾病预防、诊断治疗。同时研究辩证规律和范畴在医学科学中的表现,从而指导骨科医师解决在骨科疾病诊治中遇到的诸多问题,并有助于形成正确的临床思维。结合临床工作体会,探讨医学哲学在骨科疾病诊治临床思维中的应用。     

从能量观疾病

能量在机体的各种离子、分子、细胞、器官、组织、系统间协调分布,共同维持着健康状态。某一病因作用于人体后,“协调分布”会被不同程度地打破,当超过一定的阈值,就会产生疾病。对于人体,各种能量的直接表现形式和能量的携带者——各种营养物质,都与疾病之间有着千丝万缕的联系。从“能量”角度,我们既可进一步探讨尚未阐述清楚的疾病发生机制,又可以设计更为完美的治疗方案与医学仪器。     

非传统理念指导下的传统技术导致应用医学重大课题的突破--关于2005年诺贝尔生理学或医学奖

发现幽门螺杆菌(Helicobacter pylori,以下简称Hp)导致慢性胃炎和消化性溃疡,是沃伦和马歇尔获得2005年诺贝尔医学奖的原因.他们在1982年得出的这一假说,违反了关于这一类慢性病传统的发病机制理念.可能因为这一理念的反传统性,其假说被世界同行基本接受大概经历了20年时间.值得强调的是,对HP的观察、分离、培养、鉴定和人体试验,以及它与疾病相关的诊断、治疗、临床流行病学等研究,应用的都是传统的医学技术.从而表明,即使到了20世纪80年代,传统技术仍能导致诺贝尔奖级科研成果的出现.     

《神农本草经》的道家养生思想与汉画像石中的羽人仙药图

以<神农本草经>中的道家养生思想,结合汉画像石中的羽人仙药图,说明秦汉时期道家养生思想对<神农本草经>的渗透与影响,以及<神农本草经>道家养生思想对后世本草方剂学的重要影响.     

Depression in Women with Heart Disease: The Importance of Social Role Performance and Spirituality

Compared with men, women are more likely to experience depression, and depression increases risk of morbidity and mortality in individuals with heart disease. Psychosocial interventions have been developed for depressed patients with heart disease; however, women's experience of chronic disease differs from men's and women may benefit from interventions tailored to address their difficulties. Spirituality and social roles have been related to depressive symptoms in other populations. To identify the relationship between depression and spirituality and social role performance (i.e., role concerns, role rewards and confidence in ability to fulfill roles) in women with heart disease, we assessed depressive symptoms, spirituality, social role functioning and medical history in 125 women with heart disease. After controlling for age and severity of medical conditions, spirituality, role confidence and role concerns were significantly associated with depressive symptoms. Consideration of spirituality and aspects of social role performance may be important when developing psychosocial interventions for depressed women with heart disease.     

Flanker compatibility effects in patients with Parkinson's disease: impact of target onset delay and trial-by-trial stimulus variation

Parkinson’s disease (PD) patients and healthy controls were administered a flanker task that consisted of the presentation of colored targets and distractors. Participants were required to attend to the center target and identify its color. The stimulus displays were either congruent (i.e., the target and flankers were the same color) or incongruent. The time between the onset of the flanker and the target color (the target onset delay) was either short or long. Results indicated that PD patients and controls did not differ in the magnitude of the flanker effect within individual trials in that both groups demonstrated a typical flanker effect at the short target onset delay and neither group demonstrated a flanker effect at the longer delay. However, when performance was examined on a trial-by-trial basis, PD patients demonstrated a slowing of reaction time relative to controls when having to make the same response across consecutive trials at longer inter-trial intervals when the flankers were incongruent across consecutive trials and the display on the second of two trials was incongruent. These results indicate that PD patients are impaired in inhibiting the distractors over an extended delay and that this deficit may impact motor responding in these patients, suggesting that the basal ganglia contribute to the interface of attention and action.