Radiation protection: Some philosophical and ethical issues

The ethical issue of justification has become an urgent issue in radiology. There has been a shift in emphasis in the discussion from what has been regarded as a rather paternalistic attitude of practitioners to one that stresses the rights of the individual patient. This article comments on this current move on the part of the profession by offering certain relevant philosophical considerations. Using a medical scenario as the context to comment on this shift, it discusses important and fundamental issues, such as the autonomy and the rights of the patient in addition to the question of consent on the patient's part.     

CT中的放射防护

在放射诊断学中,CT检查对患者是一项高剂量X线诊断程序.在世界范围内,1991-1996年统计CT检查年频率占整个放射诊断年检查频率的5%左右[1],但CT检查所贡献的患者年集体有效剂量占整个放射学检查年集体有效剂量的34%左右;而1997-2007年统计以上数值分别增长为8%和42%[2].     

家庭之间“交叉换肾”的伦理考虑

自2007年5月1日《人体器官移植条例》正式实施以来，湖南何一文、何志刚两家交叉换肾案例引起各方人士热议。在分析支持和反对家庭交叉换肾的不同意见后，讨论了家庭交叉换肾涉及的伦理问题，包括：是否应该允许采用家庭交叉换肾办法拯救病人生命？是否应该允许将交叉换肾扩展到多个家庭？二元和多元家庭交叉换肾遇到的“缺口”应该如何解决？家庭交叉换肾与现行条例之间的不一致应如何解决？     

JUPITER and satellites: Clinical implications of the JUPITER study and its secondary analyses

The justification for the use of statins in prevention: an intervention trial evaluating rosuvastatin(JUPITER) study was a real breakthrough in primary cardiovascular disease prevention with statins,since it was conducted in apparently healthy individuals with normal levels of low-density lipoprotein cholesterol(LDL-C <130 mg/dL)and increased inflammatory state,reflected by a high concentration of high-sensitivity C-reactive protein(hs-CRP≥2 mg/L).These individuals would not have qualified for statin treatment according to current treatment guidelines.In JUPITER,rosuvastatin was associated with significant reductions in cardiovascular outcomes as well as in overall mortality compared with placebo.In this paper the most important secondary analyses of the JUPITER trial are discussed,by focusing on their novel findings regarding the role of statins in primary prevention.Also,the characteristics of otherwise healthy normocholesterolemic subjects who are anticipated to benefit more from statin treatment in the clinical setting are discussed.Subjects at"intermediate"or"high"10-year risk according to the Framingham score,those who exhibit low post-treatment levels of both LDL-C(< 70 mg/dL)and hs-CRP(<1 mg/L),who are 70 years of age or older,as well as those with moderate chronic kidney disease(estimated glomerular filtration rate <60 mL/min every 1.73 m2)are anticipated to benefit more from statin treatment.Unlikely other statin primary prevention trials,JUPITER added to our knowledge that statins may be effective drugs in the primary prevention of cardiovascular disease in normocholesterolemic individuals at moderate-to-high risk.Also,statin treatment may reduce the risk of venous thromboembolism and preserve renal function.An increase in physician-reported diabetes represents a major safety concern associated with the use of the most potent statins.