骨科学的新进展及其在治疗中的应用

现代各学科的交叉和融汇已经使骨科的临床诊疗技术有了革命性的进展,医学各学科之间以及医学与其它学科之间的交叉引用、促进发展体现了哲学体系中"综合"的概念.通过对近年来骨科发展的一些新思路的浅见来窥探综合理念在本领域应用的前景,试图阐明从学科交叉寻找合理且有前景的增长点也是未来骨科发展的必由之路.     

妊娠期高血压疾病的系统论思考

妊娠期高血压疾病是妊娠期常见而又严重危害母儿健康的疾病。从胎盘浅着床,血管内皮受损,遗传因素,免疫机制探讨了妊娠期高血压疾病的发病机制。随着研究的深入,免疫机制在妊娠期高血压疾病的发病中的作用越来越受到重视。介绍了APS最新的治疗进展,为今后的APS发病机制研究及临床治疗带来更多的启示。     

台湾人工生殖技术管制之回顾与前瞻

台湾地区人工生殖技术的管制先后经历了道德管制和行政管制两个阶段,目前正积极总结各阶段管制模式的成败得失,努力构造《人工生殖法》的原则和框架,以提高人工生殖技术管制的合法性和有效性。     

Posttraumatic Stress Disorder and Associated Functional Impairments During Pregnancy: Some Consequences of Violence Against Women

Despite the high prevalence of violence in the lives of women of reproductive age, and the adverse consequences posed to pregnant women suffering from PTSD, few studies have examined violence-related trauma and PTSD among pregnant women. A structured research interview was administered to a convenience sample of 85 prenatal care women to collect information regarding their experiences of violence victimization, PTSD symptoms related to violence-related traumatic events, and whether these symptoms impaired various aspects of the women's daily functioning. Results indicated that 69% of the women experienced a violent traumatic event, with the majority of events occurring before the current pregnancy and being perpetrated by the women's intimate partners. The traumatized women evidenced high levels of PTSD symptoms during pregnancy, with 58% of the women meeting criteria for a PTSD diagnosis. Moreover, many of the women with PTSD symptoms reported that the symptoms adversely affected aspects of their daily functioning.     

Association of Depression with Complications of Diabetic Pregnancy: A Retrospective Analysis

The goal of this study was to determine whether an association between histories of depression and adverse pregnancy outcome could be established using a retrospective analysis. Participants were a convenience sample of 152 pregnant diabetic women for whom prior pregnancy data were available. Prior pregnancy outcome, depression history, and other clinical characteristics were determined from chart review and medical history questionnaires. Logistic regression was used to determine which of the measured clinical factors, including history of depression, had a significant association with history of pregnancy complications. Thirty-nine patients (26%) had a past history of depression. Three pregnancy complications (preterm labor, pre-eclampsia, fetal prematurity) were more common in the group having a history of depression as was the proportion of participants requiring Caesarean section p( < .05 for each comparison). A history of depression was associated with prior pregnancy complications independent of the effects of parity, prepregnancy BMI, tobacco use history, diabetes type, and presence of diabetes complications (OR = 3.6; 95% CI = 1.5–9.0, p = .006). These retrospective data indicate that depression is linked to complications of diabetic pregnancy and support the need for prospective studies to clarify the effects of depression and its treatment on diabetic pregnancy.     

Teenage Childbearing,Reproductive Justice,and Infant Mental Health

Reproductive justice advocates emphasize the rights of women to choose to have children, to decide the conditions under which they give birth, and to parent their children with support, safety, and dignity. This article examines what a reproductive justice perspective contributes to infant mental health work with teenage mothers and their families. It explores the historical framing of teenage pregnancy in which young mothers are the cause of a variety of social problems and in which the primary policy and practice approach is pregnancy prevention. The article offers alternative framings of teenage childbearing, based on reproductive justice principles, which focus on social conditions surrounding teenage parenthood and the meaning of motherhood in the lives of young women. These alternative frames shift the practice agenda to eradicating unjust social conditions and providing supports for young women in their roles as parents. The article then describes ways in which two infant mental health programs have incorporated reproductive justice principles into their work with young families: Chicago's community doula model and Florida's Young Parents Project for court-involved teenage parents. Finally, the article extracts a set of principles deriving from a reproductive justice perspective that are relevant to infant mental health work with young families.     

Role of psychosocial risk factors in predicting maternal and paternal depressive symptomatology during pregnancy

The aim of the present study was to investigate the role of several psychosocial risk factors in predicting depressive symptomatology during pregnancy in mothers and fathers, respectively. A total of 146 primiparous mothers and 105 primiparous fathers reporting a psychosocial risk condition were recruited independently from maternity and child health services, during the second trimester of pregnancy. All parents were evaluated for depressive symptomatology, anxiety, and perceived social support. Two hierarchical multiple regression analyses were performed to determine the role of psychosocial factors in predicting depressive symptomatology during pregnancy, in mothers and fathers. Marital dissatisfaction, personal history of depression, and personal trait anxiety were identified as significant predictors of depressive symptomatology during pregnancy, both in mothers and in fathers. Family history of substance abuse, conflictual relationship with the parents in the past year, and bereavement in the past year were identified as significant factors contributing to elevated depressive symptoms during pregnancy in mothers, but not fathers. In this study, several psychosocial risk factors were consistently related to an increase in maternal and paternal depressive symptoms during pregnancy; some of these factors seem to be specifically related to maternal depressive mood.     

关于“代孕爸爸”事件的生命伦理与法律问题思考

全球首位“代孕爸爸”托马斯&#183;比提的高调出现,带来了一场激烈的关于生命伦理与法律的大讨论。变性人的婚姻、生育及代孕问题让我们不得不对变性手术、人工辅助生殖技术以及代孕技术这些新兴生命技术进行再思考。我们不仅要肯定新兴生命技术的合理性,也要防止其所产生的潜在负面影响。合理利用新兴生命技术,客观地分析该事件并制定相应的法规是避免出现伦理道德和社会混乱的有效途径。     

Hypoactive Sexual Desire in Heterosexual Women:

The problem of hypoactive sexual desire is the most common sexual problem that heterosexual couples and individuals present to sex therapists. Often it is a woman who reports that she has the problem, or her male partner brings her to therapy believing she has hypoactive desire. The treatment literature describes a variety of causes that contribute to the disorders of sexual desire. However, most of the literature looks primarily at the causes within an individual's history of within a couple's relationship. There does not seem to be adequate consideration given to the social and cultural limitations that have defined and prescribed a sexual role for women that is primarily oriented to the service of male needs rather than female sexual pleasure. This article will analyze some of the social and cultural forces that limit female sexual expression, and are a neglected factor when causes for low sexual desire in heterosexual women are given.