慢性乙型肝炎诊断和治疗方法学探讨

探讨慢性乙型肝炎诊断和治疗的方法学。仔细谨慎评价病毒载量等指标,客观准确地把握治疗时机,重视情绪障碍和营养不当,恰当选择抗病毒治疗方案。尽力形成慢性乙型肝炎诊断和治疗的完善方法系统。     

恩替卡韦治疗失代偿期乙肝肝硬化临床疗效观察

观察恩替卡韦对失代偿期乙肝肝硬化患者的治疗效果和安全性。20例乙肝肝硬化失代偿期患者予恩替卡韦0.5mg,每天1次口服,持续治疗48周。观察治疗后12周、24周、48周病毒学、生化指标、凝血酶原活动度及Child-Pugh积分等变化情况。患者治疗前血清HBV DNA对数值平均为7.45±0.38 log拷贝/ml,在接...     

系统论视角下重型急性胰腺炎的治疗

重症急性胰腺炎(severe acute pancreatitis,SAP)是临床上常见的急腹症之一,本文试从系统生物学角度出发,探讨其在SAP营养支持治疗、抗生素的选用以及外科手术治疗中的应用。强调应用整体的、综合的、发展的观点去研究SAP的治疗,从而找到最佳治疗方案。     

Analogical reasoning as a tool of epidemiological investigation

Few, if any, scientific inquiries are conducted against a background of complete knowledge, a background in which inquirers are in possession of the full facts that relate to a particular question or issue. More often than not, scientists are compelled to conduct their deliberations in contexts of epistemic uncertainty, in which partial knowledge or even a total absence of knowledge characterise inquiry. Nowhere is this epistemic uncertainty more evident, or indeed more successfully controlled, than in the branch of scientific inquiry called epidemiology. In this paper, I examine how epidemiologists overcome the unique challenges to inquiry that are posed by epistemic uncertainty. In specific terms, I contend that epidemiologists employ analogical reasoning strategies in an attempt to advance their inquiries in situations that are epistemically uncertain. The context for my claims will be the early inquiries that were conducted into the emergence of HIV/AIDS in the United States. I argue that early scientific work in relation to HIV/AIDS was directly premised upon epidemiological investigations in which analogical reasoning with hepatitis B had featured significantly. I conclude that epidemiological investigations of AIDS exemplify the capacity of analogical reasoning to advance inquiry under conditions of epistemic uncertainty. To this extent, analogical reasoning should be a concern both to those who address practical problems of uncertainty management and to those who pursue theoretical debates within argumentation studies and epistemology.     

Reinforcement magnitude and responding during treatment with differential reinforcement

Basic findings indicate that the amount or magnitude of reinforcement can influence free-operant responding prior to and during extinction. In this study, the relation between reinforcement magnitude and adaptive behavior was evaluated with 3 children as part of treatment with differential reinforcement. In the first experiment, a communicative response was shaped and maintained by the same reinforcer that was found to maintain problem behavior. Two reinforcement magnitudes (20-s or 60-s access to toys or escape from demands) were compared and found to be associated with similar levels of resistance to extinction. The relation between reinforcement magnitude and response maintenance was further evaluated in the second experiment by exposing the communicative response to 20-s or 300-s access to toys or escape. Results for 2 participants suggested that this factor may alter the duration of postreinforcement pauses.     

乙型肝炎防治中值得医患共同注意的几个问题

乙型肝炎在我国人群中广泛存在,到目前为止,还没有特效的治疗方法和药物。由于乙型肝炎易慢性化,直接威胁患者的健康,,对社会及个人造成的影响已引起各界关注。今就乙型肝炎的诊断。治疗以及自保健,如何正确对待等方面问题从医学伦理的角度进行分析以供医患参考。     

小儿重症肺炎的诊治策略

肺炎是儿童常见的呼吸道疾病,小儿重症肺炎及其导致的并发症特别全身炎症反应综合征和多脏器功能衰竭是严重威胁儿童健康和生命的重要原因。随着基础医学和临床医学的发展,人们的认识逐渐深入,防治水平也取得重要进展。但病原学的变迁,不恰当的临床监测和干预仍然影响着人们对该病的正确认识和处理。运用哲学的辩证思维来探讨小儿重症肺炎诊治中的若干问题,将为儿科临床工作提供新的指导。     

我国乙型肝炎病毒携带者健康权现状分析

乙型肝炎病毒携带者健康权包括医疗保障权、劳动权、受教育权以及包括婚姻、家庭、社会交往在内的其他生活平等权。本文分析了我国乙肝携带者健康权现状,对我国近年来的乙肝维权工作进行回顾,并从减轻医疗费用负担、规范医疗市场、完善法律法规、推动非政府组织的发展等方面对维护和保障乙肝携带者健康权提出建议。     

从临床试验结果谈替比夫定的慢性乙型肝炎治疗路线图

“路线图”的概念根据以替比夫定为代表的核苷类药物治疗过程中HBVDNA下降的幅度与出现耐药性病毒突变明显相关的现象提出的。其核心内容是治疗后12周～24周的病毒学效应,对于预测和评估疗效具有重要意义。本文通过对“路线图”的概念、替比夫定“路线图”的临床试验依据及意义的介绍,阐明替比夫定治疗后12～24周的病毒学效应,对于预测和评估疗效具有重要意义;“路线图”对慢性乙型肝炎患者应用替比夫定治疗过程中调整治疗策略的指导意义,以规范临床治疗行为,规避耐药发生。