循证医学及其在心血管疾病中的应用

循证医学作为一门新兴的学科,对医学的研究和实践将产生越来越大的影响。在循证医学的操作过程中,如何正确评价和应用所获得的证据极为重要。在短短的十几年间,循证医学给心血管疾病的临床实践带来了根本的变化。     

Evidence of Impaired Glucose Tolerance and Insulin Resistance in Patients With Alzheimer’s Disease

Alzheimer’s disease (AD) and diabetes rarely occur together, a finding that provides a possible clue as to the development of AD. Abnormal glucose metabolism is not limited to diabetes, but also can include impaired glucose tolerance, insulin resistance, and hyperinsulinemia. AD patients have significantly varying insulin levels after drinking sugared sodas and thus may be classified as insulin resistant. After reviewing the literature on impaired glucose tolerance and insulin production in AD, we present several hypotheses as possible explanations for the relationship between insulin resistance and AD. Finally, we suggest future studies, including studies on use of thiazolidinediones (currently used in the treatment of diabetes) in AD.     

浅谈恙虫病的几点认识

恙虫病是自然疫源性急性传染病。通过恙虫病医疗实践，谈几点个人认识：恙虫病流行与该疫源地区鼠类活动有关；恙虫病疫源地会因气候变化而变更；重视恙虫病准确而及时诊断，尽量减少病人疾苦；恙虫病立克次体对人单核-吞噬细胞系统有特别的亲嗜性与专性细胞内寄生，是其临床病理基础；用氯霉素联合双黄连治疗恙虫病可获满意效果。     

Resilience in siblings of children with sickle cell disease

This pilot study was conducted to identify factors responsible for promoting resilience in siblings of children with sickle cell disease. Twenty siblings (10–17 years of age) of children (5–13 years) with sickle cell disease were selected from the Pediatric Clinic of Howard University Center for Sickle Cell Disease. The siblings responded to questionnaires, and the data obtained was analyzed by chi-square for association. The results indicated that age, birth order, and gender had no effect on resilience in the siblings. However, family size, number of parents in the home, sibling's knowledge of the illness, degree of morbidity of the illness, socioeconomic status of the family, and parents' attitudes and childrearing practices were all found to affect resilience. These findings provide additional insight into the psychosocial aspects of, and genetic counseling for sickle cell disease, as well as for other chronic genetic disorders.     

The anthropological tradition in the philosophy of medicine

The tradition of anthropological medicine in philosophy of medicine is analyzed in relation to the earlier interest in epistemological issues in medicine around the turn of the century as well as to the current interest in medical ethics. It is argued that there is a continuity between epistemological, anthropological and ethical approaches in philosophy of medicine. Three basic ideas of anthropologically-oriented medicine are discussed: the rejection of Cartesian dualism, the notion of medicine as science of the human person, and the necessity of a comprehensive understanding of disease. Next, it is discussed why the anthropological movement has been superseded by the increasing interest in medical ethics. It is concluded that the present-day moral issues cannot be interpreted and resolved without clarification of the underlying anthropological images.     

AIDS and ‘dirt’: Reflections on the ethics of ritual cleanliness

AIDS and the responses and attitudes it evokes surpass the analytic abilities of standard bioethics. These responses and attitudes are explored in terms of literary and anthropological categories, such as dirt, disorder, pollution and ritual cleanliness. Implications for medical education are suggested.     

联合预防阿尔茨海默病与缺血性脑卒中的构想

阿尔茨海默病（AD）与缺血性脑卒中（IS）是中枢神经系统常见的两种高发病率和高致残率疾病。传统观点认为这两种疾病的病因、发病机制、病理生理以及临床表现均截然不同,长期以来它们的预防工作是分别展开的。随着 AD 研究的不断深化,AD 与 IS 之间的共性也不断增多,AD 可能与 IS 有着共同的血管相关发病机制以及相似的预防措施。为此,结合近年来 AD 血管机制领域的研究进展,提出 AD 与 IS 联合预防的新概念,并探讨了最佳的开始时间和预防策略。     

分子生物学视野下结构和功能的关系与临床疾病

分子生物学作为一门新兴学科,代表了生命科学研究领域的前沿,新理论、新技术、新成果层出不穷。生物大分子结构与功能关系的研究对分子生物学的发展起着极其重要的推动作用,是分子生物学科研和教学的主题,也为探索疾病的本质和规律提供了新思路。     

急危重症患者的诊治方略：技术与人文兼备

急危重症患者随时可能有生命危险,医务人员往往只关注于患者的生命体征、脏器功能以及诊疗方案。因此,很容易忽略了患者精神和心理层面的需求,会带来一系列新的临床问题及心理创伤。“早期的舒适化镇痛、最小化的镇静和最大的人文关怀”概念真正以急危重症患者为中心,站在了生物心理社会医学模式的制高点,提出了一个整体性框架,医护结合临床实际可以最大化丰富其内涵,让患者在接受高精尖医疗技术诊治的同时,获得更全面的照护。     

重大公共卫生事件下学术论文的科研诚信建设

基于撤稿观察数据库,以生物医药领域COVID-19相关的撤稿论文为研究对象,分析撤稿论文中的学术不端现象,并就重大公共卫生事件背景下的学术论文科研诚信问题提出了一些思考与建议：探讨了重大公共卫生事件下科研诚信与学术论文出版速度的辨证关系,通过对学术论文的出版后再评价常态化完善科研诚信监督机制,通过加强学术论文数据管理和共享建立并完善科研诚信应急管理机制,重视生物医药领域的利益冲突问题,充分发挥学术期刊的公信力和传播优势解释学术争鸣,以及进一步夯实我国学术论文科研诚信建设。