肾移植受者 BK 病毒感染的诊治进展

BK病毒（BK V ）是人类多瘤病毒的一个亚群,有很高的隐性感染率,研究显示全球超过80％的人口BK V血清学阳性。随着移植后强效免疫抑制剂的使用,BK V感染正成为移植肾失活的重要原因。据统计,约1％～10％的肾移植受者在免疫抑制状态下,可因BKV激活而引起BKV肾病（BKVN）,而BKVN可引起约45％的远期移植肾失活。由于目前缺乏明确有效的抗病毒药物,早期监测病毒载量、减少免疫抑制剂对控制BKVN、保留移植肾功能至关重要。本文就肾移植相关的BKV感染概况及BKVN的诊断、治疗进展进行综述。     

Caring for the Suffering: Meeting the Ebola Crisis Responsibly

The current Ebola virus epidemic in Western Africa appears to be spiraling out of control. The worst-case projections suggested that the unchecked spread could result in almost 1.4 million cases by the end of January 2015 with a case fatality rate of at least 50%. The United States and European nations have begun to respond in earnest with promises of supplies, isolation beds, and trained health care personnel in an effort to contain the epidemic and care for the sick. However, there is neither a vaccine nor specific treatment for Ebola infection, and therapy is ideally centered on supportive care. I have previously argued that the provision of palliative care is obligatory during an overwhelming health catastrophe, notably pandemic influenza. Since affected Ebola patients have best outcomes with technologically advanced intensive care—resources in scarce supply in the area—I suggest that the only acceptable approach to large numbers of very sick, dying, and suffering Ebola patients who overwhelm the resources available to successfully manage them is effective palliative care. However, this could hasten death in this vulnerable population and hence, while ethically and medically justifiable, is not without social risk.     

通过打破抗原特异性T细胞免疫耐受控制慢性HBV感染

乙型肝炎病毒(HBV)感染诱导机体抗病毒免疫应答,若不能对病毒有效清除,体内抗原特异的CTL降低,出现抗原特异性T细胞免疫耐受,造成慢性肝脏炎症。分析HBV感染时抗原特异性T细胞免疫耐受机制,并通过打破免疫耐受预防HBV感染。     

OUR COMMON ENEMY: COMBATTING THE WORLD'S DEADLIEST VIRUSES TO ENSURE EQUITY HEALTH CARE IN DEVELOPING NATIONS

In a previous issue of Zygon (Carvalho 2007), I explored the role of scientists—especially those engaging the science-religion dialogue—within the arena of global equity health, world poverty, and human rights. I contended that experimental biologists, who might have reduced agency because of their professional workload or lack of individual resources, can still unite into collective forces with other scientists as well as human rights organizations, medical doctors, and political and civic leaders to foster progressive change in our world. In this article, I present some recent findings from research on three emerging viruses—HIV, dengue, and rotavirus—to explore the factors that lead to the geographical expansion of these viruses and the increase in frequency of the infectious diseases they cause. I show how these viruses are generating problems for geopolitical stability, human rights, and equity health care for developing nations that are already experiencing a growing poverty crisis. I suggest some avenues of future research for the scientific community for the movement toward resolution of these problems and indicate where the science-religion field can be of additional aid.     

Phenomenology and Theology—Reflections on the Study of Religion

The academic study of religious belief and practice is frequently taken to debunk the content of religion. This attitude impedes the science-theology dialogue and causes believers to react defensively toward studies of religion. I argue that a large, although not unrestricted, domain exists in which phenomenology of religion is neutral with respect to content, that is, compatible with either belief or unbelief. Theology can constructively interact with secular studies of religion, in some cases even explicitly hostile ones. Three themes emerge that elaborate on this interaction: (1) the claim that a scientific study of religion is capable of refuting belief is a logical mistake; (2) religious practice, and to some extent belief, can benefit from secular scrutiny; (3) the entirety of religious expressions is richer than the content that can be captured by analytical study of the phenomenon.     

慢性乙型肝炎抗病毒治疗的进展

针对目前乙型肝炎的抗病毒治疗现状以及临床用药中存在的问题进行分析,就如何选择合理治疗方法提出医疗原则,认为对于慢性乙型肝炎的抗病毒治疗,应坚持联合治疗和个体化治疗,长期用药和间断反复用药结合,把病毒抑制到最低水平,以使发生原发性肝癌的可能性减至最小。     

全世界最早的病毒研究机构——弗里德里希·勒夫勒研究院

弗里德里希·勒夫勒研究院(Friedrich-Loeffler-Institut,FLI)由弗里德里希·勒夫勒于1910年创建,是全世界最早开展病毒研究的机构.FLI的使命是关注家畜卫生,研究人畜共患疾病.其主要职能除了研制口蹄疫病、经典猪瘟等动物疾病的一些疫苗外,还为传染性疾病做诊断.FLI在德国6个地方设有10个分支机构,总部设在Riems岛,岛上设有4个研究所;Jena设有2个研究所;Brunswick有1个研究所;Mariensee有1个研究所;Celle有1个研究所;Wuster hausen有1个研究所.FLI的标志人物是弗里德里希·勒夫勒,他是德国著名的微生物学家、卫生学家、病毒学建立者之一,开辟了免疫学,尤其是白喉的治疗等.     

Using Participatory System Dynamics Modeling to Examine the Local HIV Test and Treatment Care Continuum in Order to Reduce Community Viral Load

Achieving community‐level goals to eliminate the HIV epidemic requires coordinated efforts through community consortia with a common purpose to examine and critique their own HIV testing and treatment (T&T) care system and build effective tools to guide their efforts to improve it. Participatory system dynamics (SD) modeling offers conceptual, methodological, and analytical tools to engage diverse stakeholders in systems conceptualization and visual mapping of dynamics that undermine community‐level health outcomes and identify those that can be leveraged for systems improvement. We recruited and engaged a 25‐member multi‐stakeholder Task Force, whose members provide or utilize HIV‐related services, to participate in SD modeling to examine and address problems of their local HIV T&T service system. Findings from the iterative model building sessions indicated Task Force members’ increasingly complex understanding of the local HIV care system and demonstrated their improved capacity to visualize and critique multiple models of the HIV T&T service system and identify areas of potential leverage. Findings also showed members’ enhanced communication and consensus in seeking deeper systems understanding and options for solutions. We discuss implications of using these visual SD models for subsequent simulation modeling of the T&T system and for other community applications to improve system effectiveness.     

客观地看待慢性乙型肝炎抗病毒治疗

乙肝病毒(HBV)感染是我国肝硬化和肝癌的主要致病因子,因此抗HBV治疗十分重要.但是,由于对抗HBV的治疗现状不够了解,不少人在盲目追求彻底清除体内的HBV,以至于弄巧成拙,所以,有必要客观地看待慢性乙型肝炎的抗病毒治疗,以求得到最佳的治疗效果.     

1918年流感世界大流行病毒株溯源

发生于1918年的第一次世界流感大流行夺走至少两千万人的生命,这场灾难赋予了科学家探求其来源的巨大责任感.病毒学家发挥了严谨而又富有创造性的科研精神,使流感病毒的真实面目得以逐步揭开.这些研究成果加深了我们对流感病毒本身的认识,更为重要的是,为下一次流感世界大流行的防治提供了若干有价值的信息.