细菌感染性疾病中的对立统一规律与Quorum Sensing系统

引起人类细菌性感染的病原菌可以分为条件致病菌和非条件致病菌,不同性质的细菌引起的感染决定了感染矛盾的特殊性,对于不同质的矛盾,只有用不同质的方法才能解决。抗生素的发明和使用为人类控制感染性疾病的同时,这种单纯的“对抗”的解决方法也引出了一些新的矛盾。因此,细菌感染矛盾的特殊性决定我们不能采用千篇一律的“对抗斗争”形式,而必须寻求一种特殊的解决方式。对QS系统的研究发现在细菌表现致病性过程中发挥重要作用,通过QS系统减弱细菌的致病性而不杀死细菌的“抗致病性药物”来治疗感染成为一种新的抗感染思路,这种“抗致病性”概念使我们抗感染的态度从与细菌“对抗”转变为“共生”,因而QS系统可以为这种特殊矛盾提供一个合理的解决方式。     

营养支持疗法在严重烧伤治疗中的作用

烧伤救治是一个复杂的系统工程,涉及急救、复苏、感染、创面、营养、康复及心理等.营养支持已成为中度以上烧伤患者的重要治疗措施之一:积极正确的营养支持,可促进合成、增强免疫和加速创面愈合,对烧伤救治疗效有明显的改善作用.相反,营养不良可使创面愈合延缓、降低身体抵抗力、易并发感染等并发症,严重影响预后.给予合理的营养支持治疗来维持烧伤患者的营养是严重烧伤治疗中重要措施之一.因此,重视营养支持,相关治疗措施才会发挥应有疗效,烧伤的整体治疗水平才可能提高.     

CXCR4／CXCL12在胃癌及结直肠癌中的研究进展

消化道肿瘤是一种常见的恶性肿瘤,远处转移是其预后不良的主要原因。近年来消化道肿瘤的发病率逐年上升,其相应的研究得到了广泛的重视。趋化因子对肿瘤的侵袭和转移作用也备受关注。 CXCR4及 CXCL12在肿瘤研究中已逐渐成为热点;最近研究表明,其与胃癌、结直肠癌等的转移密切相关,将为消化道肿瘤转移的防治提供新的思路。此文对CXCR4／CXCL12在胃癌及结直肠癌中的研究进展做一简要综述,CXCR4／CXCL12轴的深入研究将有望使其成为消化道肿瘤靶向治疗的特异靶点。     

W. R. D. FAIRBAIRN AND THE PROBLEM OF HOMOSEXUALITY: A STUDY IN PSYCHOANALYTIC PREJUDICE

W. R. D. Fairbairn believed that the psychoanalyst's motivations and theories must ultimately be rooted in a need to resolve personal conflicts. His self‐analytic and other records, now publicly available, indicate how his struggles with unacceptable sexual feelings and their symptomatic manifestations affected not only his theorizing, especially about sexuality, but also his clinical practice, as well as his personal and family life. Fairbairn's case affords a unique opportunity to document the effects of homophobia in a major psychoanalyst.     

Mental health of Chinese primary care patients with lower urinary tract symptoms

The aim of this study was to evaluate the mental health of Chinese primary care patients with lower urinary tract symptoms (LUTS). This was a cross-sectional observational study. Five hundred and nineteen subjects with LUTS completed a structured questionnaire containing the Depression, Anxiety, and Stress Scale-Short Form, the International Prostate Symptom Score, the adapted International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form and questions about socio-demographics. Overall, 17.7% of subjects reported depressive symptoms, 24.3% anxiety symptoms and 9.6% stress symptoms. In males, demographic factors associated with poorer mental health included being not married; clinical factors included higher LUTS severity, weak stream, straining and mixed urinary incontinence. In females, demographic factors associated with poorer mental health included being younger, not married and lower household income; clinical factors included higher LUTS severity, incomplete bladder emptying, urgency and weak stream. Chinese primary care patients with LUTS appear to be an at-risk group for poorer mental health with increased prevalence of anxiety and depressive symptoms and may require routine screening to identify those who may require more tailored interventions to address both their urinary symptoms and psychological distress.     

影响肝移植术后患者长期生存的关键因素及术后健康管理策略

肝移植患者术后健康管理具有“战略”高度的地位.患者术后良好康复的关键因素有定期随访、按时服用免疫抑制剂和良好日常生活管理.影响患者术后长期生存的主要因素有感染、排异反应、移植肝功能异常、肿瘤复发、胆道问题以及经济压力.对肝移植术后并发症的深入研究和及时有效管控、良好的医患互动、患者良好的依从性和健康的生活方式是保障患者术后长期生存的最重要措施.肝移植术后患者随访就近原则、加大肝移植内科建设和投入,可有效改变我国肝移植术后健康管理水平较低的现况.     

Exploring risk and protective mechanisms associated with HIV infection among adolescents in South Africa

This study explored South African adolescents’ perceived risk and protection for HIV infection. Adolescents (N=28) with a mean age of 14.6 years receiving mental health care participated in Focus Group Discussions (FGDs) to engage in an in-depth exploration of their perceived risk and protective mechanisms for HIV prevention. The data were analysed using thematic content analysis. Themes that emerged from the FGDs associated with risk for HIV infection were: Alcohol and illicit drug use; Non-condom use; Prostitution and risky sexual activity with multiple partners; and Non-disclosure of HIV status. Themes that emerged as protective mechanisms included: HIV knowledge and appropriate HIV risk reducing behaviour; and Proactive parental attitudes and behaviour. These findings highlight the importance of ascertaining the perceptions of adolescents about risk and protection from HIV infection in order to inform future programs for HIV prevention among adolescents.     

The role of fear in predicting sexually transmitted infection screening

Objective: This study assessed the extent to which social-cognitive factors (attitude, subjective norm and perceived control) and the fear of a positive test result predict sexually transmitted infection (STI) screening intentions and subsequent behaviour.

Design: Study 1 (N = 85) used a longitudinal design to assess the factors that predict STI screening intention and future screening behaviour measured one month later at Time 2. Study 2 (N = 102) used an experimental design to determine whether the relationship between fear and screening varied depending on whether STI or HIV screening was being assessed both before and after controlling for social-cognitive factors.

Main Outcome Measures: Across the studies the outcome measures were sexual health screening.

Results: In both studies, the fear of having an STI positively predicted STI screening intention. In Study 1, fear, but not the social-cognitive factors, also predicted subsequent STI screening behaviour. In Study 2, the fear of having HIV did not predict HIV screening intention, but attitude negatively and response efficacy positively predicted screening intention.

Conclusion: This study highlights the importance of considering the nature of the health condition when assessing the role of fear on health promotion.     

外科疾病的发热

发热是临床上的一种常见症状,引起发热的原因很多,只有找到发热的原因才能做出正确的处理。启动临床思维必须掌握充分的临床资料,然后进行周密的鉴别诊断思维程序,首先排除引起发热的其他科疾病,再考虑外科原因。感染是外科发热最主要的原因,如果是手术病人,特别应该想到和手术有关的各种感染问题。思维惯性、思维顺性和思维惰性的误导是误诊的思维原因。