移植排斥反应中若干问题的思考

随着器官移植术和免疫抑制药物的发展,器官移植已成为挽救各类终末期器官功能衰竭患者的最有效手段。然而,移植排斥反应依然是困扰移植学界的难题。移植排斥反应的发生机制和治疗过程中体现了矛盾的普遍性和特殊性,用辩证思考的方法可以有效地指导移植排斥反应机制研究和临床治疗。     

稳定型冠心病治疗方案的临床抉择

由于医疗技术水平的发展,稳定型冠心痛的治疗方案在不断地更新与变化。以往,经皮冠状动脉介入术被广泛应用到稳定型冠心痛的治疗上。但最近的COURAGE试验（the clinical outcomes utilizing revascularization and aggressive drug evaluation trial）使得这一治疗手段的合理性和必要性被质疑。我们必须重新考虑稳定型冠心病治疗方案的临床抉择。     

我们需要一场医疗观念的革命——关于文化医学与物种医学的思考

现代文明的本质特征是用文化秩序取代自然秩序,用文化选择取代自然选择。现代文明的生活方式同人的生命原理的冲突,是现代许多疾病产生的文化根源。因而我们需要一种对现代疾病的“文化治疗”。传统医学只是关注个体生命的“个体医学”。由于个体健康同物种健康之间的内在冲突,我们需要一种防止物种衰退的“物种医学”。     

人工腰椎间盘置换预示了腰椎融合的终结？

腰椎间盘退变性疾患的治疗方法主要是病变椎间盘的单纯切除和腰椎融合。而人工腰椎间盘置换的出现预示了脊柱外科一个新的时代的到来。简要介绍SB charité人工腰椎间盘置换技术,并分析了其早期的临床效果及可能出现的一些并发症,总结了目前人工腰椎间盘的应用所遇到的一些问题。客观的评价人工腰椎间置换技术,为临床实践和进一步研究提供依据。     

The effectiveness of UK student counselling services: an analysis using the CORE System

Despite concern surrounding the mental health of students, brought about by the government's policy of widening participation and increasing demands upon students, the effectiveness of student counselling has been a neglected research area. This study examines data from seven UK student counselling services using the CORE System in the routine evaluation of their services. Results indicate that counselling is effective, with 70% (service range 67% to 83%) of clients with outcome measures available showing reliable improvement on the CORE-OM from pre- to post-therapy. However, students who complete a course of counselling show significantly greater improvement, according to practitioner pre- and post-therapy severity ratings of depression and anxiety, than those clients who drop out or have an unplanned therapy ending (effect size 1.03, 0.85, respectively). The stage at which students drop out of therapy is important, with those students dropping out of therapy before the third session being the most vulnerable. The implications of these findings are discussed.     

Choosing an Endorser for a Women’s Sporting Event: The Interaction of Attractiveness and Expertise

An experimental study was conducted to determine the impact of expertise and attractiveness on perceived appropriateness of the endorser with a women’s tennis event and, subsequently, attitudes towards the event and intentions to purchase tickets. The sample was comprised of 184 undergraduate students at three U.S. universities. Hypotheses were tested through observed path analysis and results indicated both attractiveness and expertise were significantly related to the endorser’s appropriateness and explained 24% of the variance. However, there was a significant interaction; in the lower expertise condition, the more attractive athlete was rated as a more appropriate endorser. Further, endorser appropriateness led to more positive attitudes and intentions to purchase tickets, and the model explained 13 and 48% of the variance in these variables respectively.     

The Medical Offset Effect: Patterns in Outpatient Services Reduction for High Utilizers of Health Care

Psychosocial intervention has been found to be related to subsequent reductions in health care use. Studies generally measure this “offset effect” by combining medical use categories into one outcome variable, such as outpatient doctor visits. However, using a general outcome variable may obscure more specific patterns of reduction. In an effort to identify potential “targets” for mental health intervention, outpatient care for health screening, illness visits, laboratory/X-ray, and urgent care were considered. Health care use reductions were most prominent for high utilizers and were found across a number of different types of outpatient care. With high utilizers, those who participated in MFT showed significant reductions of 68% for health screening visits, 38% for illness visits, 56% for laboratory/X-ray visits, and 78% for urgent care visits.     

中国组织情境下公仆型领导有效性的追踪研究

公仆型领导以服务员工为导向, 在本质上超越了以往任何一种以组织利益为先的领导方式。然而, 国内该主题的研究还很不系统。本研究首先在中国组织情境下, 采用质化研究与量化研究相结合的方式, 探讨公仆型领导的结构维度, 建构公仆型领导的测量量表; 然后以团队及其成员为研究对象, 采用追踪研究设计, 收集“管理者-员工”配对数据, 运用结构方程模型、多元回归分析以及多层线性模型技术进行统计分析, 从而探讨公仆型领导的有效性。具体包括三个研究：(1)公仆型领导的结构与测量研究; (2)公仆型领导有效性的追踪研究—— 基于领导行为比较的视角(是否有效); (3)公仆型领导有效性的追踪研究—— 基于作用机制的视角(如何有效)。研究结果有助于澄清公仆型领导的内涵与维度结构, 识别和测量公仆型领导行为, 证实公仆型领导的有效性, 比较公仆型领导与家长式领导、变革型领导的影响效果, 揭开公仆型领导对个体绩效和团队绩效的作用机制。     

抑郁症计算机化治疗的效果及其影响因素：基于RCT的元分析与元回归分析

运用元分析和元回归分析的方法考察抑郁症计算机化治疗的效果及其影响因素。来源于50篇文献,42项RCT研究的67个样本满足了元分析标准（N=7920）。结果发现：（1）整体效果量为0.53,三个月追踪效果量为0.14;6个月追踪效果量为0.16;（2）在年龄段、抑郁严重程度、支持方式和测量量表四个亚组分析中,其效果量存在显著差异。干预方式、干预取向和分析方法对效果量的影响不显著;（3）出版年份显著影响治疗效果量,脱落率和干预单元数对整体效果量的影响不显著。结果表明：抑郁症的计算机化治疗具有中等的效果量;年龄段、抑郁严重程度、支持方式、测量量表和出版年份对其整体效果量有调节作用。将来抑郁症计算机化治疗的研究应重视上述调节变量对治疗效果的影响。     

关注儿童艾滋病和艾滋孤儿

目前,我国艾滋病处于快速增长期,儿童艾滋病患者增长较快,艾滋孤儿亦逐渐增多.儿童艾滋病以母婴传播为主要途径,所以切断母婴垂直传播是遏制艾滋病向儿童传播的有效方法,应采取药物治疗、产科干预和人工喂养等综合措施.同时高度重视艾滋孤儿问题,采取措施预防出现下一代的艾滋孤儿,整个社会包括政府要加大对这些儿童的支持和关爱.