Having a life versus being alive.

In an attempt to provide some clarification in the abortion issue it has recently been proposed that since 'brain death' is used to define the end of life, 'brain life' would be a logical demarcation for life's beginning. This paper argues in support of this position, not on empirical grounds, but because of what it reflects of what is valuable about the term 'life'. It is pointed out that 'life' is an ambiguous concept as it is used in English, obscuring the differences between being alive and having a life, a crucial distinction for bioethical questions. The implications of this distinction for the moral debate about abortion are discussed.     

3R理论对生命科学研究的影响

本文介绍了在医学科学研究中进行动物实验研究时涉及的3R理论,回顾了3R理论的形成、发展,概括了各国在医学实验研究中实验动物的替代、减少和动物实验的优化,简单分析了3R理论对我国医学科学研究产生的影响.     

Surgical service centralisation in Australia versus choice and quality of life for rural patients

High patient volume for both hospitals and surgeons is an important determinant of operative mortality and outcome for complex and infrequently performed operations. The 13% of Australia's population who live in rural and remote areas often choose to have surgery close to home and support networks despite the potentially higher operative mortality and morbidity. Rural patients should be able to make an informed choice about having their surgery locally. Rural and metropolitan surgeons should discuss and reach mutual agreement on where each patient is best treated. A balance must be struck between quality of services that can be provided locally and geographic convenience.     

科学话语权与科学多元论

读《读书》2 0 0 1年第 9期田松先生“科学话语权的争夺及策略”一文 ,令笔者感到强烈的震撼。首先是“中国古代有无科学”的问题足以令像笔者这样的《读书》杂志的芸芸读者惊骇莫名 :五千年的文明古国 ,有无科学 ,居然在千禧交替的今天成为“问题” !然而组织者之权威和会议的“级别非常之高” ,又不能不令人肃然起敬。不过文中展现的“有”“无”双方的尖锐对立及剖析问题之深刻透彻 ,确令笔者有“胜读十年书”的痛快又夹杂几分铭心的沉痛。笔者赞同“反方的立论”———“从定义入手”。“ＳＣＩＥＮＣＥ ,在西方语境中的意义应该是 :源…     

"Allow natural death" versus "do not resuscitate": three words that can change a life

Physician-written "do not resuscitate" DNR orders elicit negative reactions from stakeholders that may decrease appropriate end-of-life care. The semantic significance of the phrase has led to a proposed replacement of DNR with "allow natural death" (AND). Prior to this investigation, no scientific papers address the impact of such a change. Our results support this proposition due to increased likelihood of endorsement with the term AND.     

奥氮平和奋乃静治疗精神分裂症的对照研究

目的：探讨奥氮平对精神分裂症患者疗效及生活质量的影响。方法：将符合入组标准的精神分裂症患者80例随机分为奥氮平组和奋乃静组,共治疗8周,采用阳性与阴性症状量表（PANSS）、不良反应量表（TESS）及生活质量综合评定问卷（GQOLI）分别评定疗效、不良反应及生活质量变化。结果：奥氮平组治疗前后PANSS及阴性症状减分率显著高于奋乃静组（P〈0．05）,而两组阳性症状减分率差异无显著性,奥氮平组不良反应轻微,常见的有口干、困倦、便秘和体重增加。奥氮平组躯体功能维度、心理功能维度、社会功能维度及总体生活质量评分治疗后均显著高于奋乃静组（P〈0．01）。结论：奥氮平治疗精神分裂症疗效好,安全性高,能明显改善患者的生活质量。     

机器人辅助与胸骨正中切开二尖瓣置换术的生活质量及远期疗效比较

目的 总结并对比分析机器人二尖瓣置换和常规开胸二尖瓣置换相关手术指标和术后的生活质量、伤口满意度及术后恢复时长。方法 回顾性收集 2007 年 1 月~ 2015 年 12 月我院47例接受 da Vinci 机器人二尖瓣置换术的患者的资料,并以此47例患者作为机器人组。2002 年3 月~2014 年6 月正中开胸二尖瓣置换手术患者共286 例,依据7 个指标从正中开胸患者中抽取 47 例作为开胸组进行1∶1配对。通过收集围术期相关资料,随访患者出院后临床资料,使用生活质量调查量表（SF-12）调查术30 d、半年的生活质量,同时对比两组患者术后恢复工作时间和对手术切口的满意度。结果 机器人组和开胸组的患者均成功完成二尖瓣置换手术,术中未见患者死亡。机器人组术后并发症仅有 1 例为胸腔积液。开胸组患者中1 例因术后引流过多接受二次开胸止血,1 例患者术后死于感染性休克。在手术输血量、术后引流量、术后监护时间、呼吸机时间及术后住院时间上,机器人组均优于正中开胸组,差异有统计学意义（P<0.05）。两组患者术后并发症的发生率无明显区别。术后30 d生活质量调查（SF-12）显示机器人组有明显的优势,但在半年后两组趋于一致。术后患者对于切口的满意程度,机器人组明显优于开胸组（P<0.001）。术后半年随访患者工作生活恢复情况,机器人组明显快于开胸组。结论 机器人二尖瓣置换手术效果可靠,机器人组对比开胸组手术创伤更小,术后恢复更快,对于生活质量及伤口恢复更满意,是可供选择的良好微创手术方式。     

敬畏生命还是关爱生命、护卫生命——史怀泽敬畏生命理论在医学伦理学中应用辨析

史怀泽敬畏生命的理论对于协调人与其他生物的关系具有重要的意义。但由于这一理论本身的不足和局限,其并不能作为医学伦理学的生命观。但可借鉴、吸取其尊重生命的成份,丰富和完善医学伦理学关爱生命、护卫生命的生命观。     

Embryonic life and human life.

A new human life comes into being not when there is mere cellular life in a human embryo, but when the newly developing body organs and systems begin to function as a whole, the author argues. This is symmetrical with the dealth of an existing human life, which occurs when its organs and systems have permanently ceased to function as a whole. Thus a new human life cannot begin until the development of a functioning brain which has begun to co-ordinate and organise the activities of the body as a whole.     

北京大学医学部2009级514名学生对大学生活期望的调查分析

高校作为人才培养的基地,始终要把"培养什么人"和"如何培养人"的问题摆在首要位置.只有了解培养对象的特点和需求,才能够为"如何培养人"提供参考依据.本文以北京大学医学部为例,通过对2009级学生对大学生活期望的问卷调查,了解当今学生的特点、进入大学后所关心的问题和对大学生活的期望,为学生教育工作的改进提供建议,从而探索一种适应新形势需求的医学教育育人模式.     

北京大学医学部2009级514名学生对大学生活期望的调查分析

高校作为人才培养的基地,始终要把"培养什么人"和"如何培养人"的问题摆在首要位置.只有了解培养对象的特点和需求,才能够为"如何培养人"提供参考依据.本文以北京大学医学部为例,通过对2009级学生对大学生活期望的问卷调查,了解当今学生的特点、进入大学后所关心的问题和对大学生活的期望,为学生教育工作的改进提供建议,从而探索一种适应新形势需求的医学教育育人模式.

Abstract：

University education which offers basic training for students to become able men, need to put crucial issues of "What kind of person will the students trained to be?" and "How to bring up them?" on the first places. Only if we acquaint with characteristics and of our training object, would we get evidences to decide "How to bring up them?". Therefore this article takes Peking University Health Science Center as an example, bases on questionnaires of first-year medical students' expectation of college life which let we realize the characteristics of temporal students, know what they have concern for after entering the university and be aware of their expectation of college life, offers suggestion for improving the university education of students on campus, in order to explore a new education pattern adapted to the new current of the times.     

电凝与钛夹钳夹在胸交感神经阻断术治疗手汗症中的应用研究：代偿性多汗和生存质量的比较

目的 通过对电凝、钛夹钳夹两种术式患者代偿性多汗和生存质量的比较,评估何种术式在胸交感神经阻断术治疗手汗症中更为优越。方法 选取2007年10月至2010年8月我院收治的120例原发性手汗症患者,术前随机分为电凝组和钛夹组,每组各60例。两组患者均全麻双腔气管插管下行胸腔镜下胸4交感神经链阻断术。比较两组患者手术后代偿性多汗程度及手术前后生存质量的变化。结果 所有患者均治愈。电凝组3例患者,钛夹组1例患者术后单侧少量胸腔积气,均自行吸收。两组手术均顺利,无心律失常、Horner’s 综合症等严重并发症发生或围手术期死亡。电凝组代偿性多汗的发生较钛夹组更为常见（p = 0.001）。中度、重度代偿性多汗两组均较少发生,组间比较无统计学差异(p = 0.193)。大部分患者均自觉术后生存质量显著改善,但是组间比较无统计学差异（p = 0.588）。结论 电凝和钛夹钳夹胸4交感神经链阻断术治疗手汗症均微创、安全、有效。两种术式对生存质量改善程度相似,钛夹钳夹术代偿性多汗发生程度较轻,在治疗手汗症中更值得推广应用。     

腹腔镜与开腹手术治疗结肠癌的临床疗效和术后生活质量比较

目的 比较腹腔镜与开腹手术治疗结肠癌的临床疗效和术后生活质量况.方法 分析中山大学附属第三医院粤东医院2014年5月至2016年3月收治的60例结肠癌患者的临床资料,依据手术方式分为腹腔镜组30例和开腹组30例.观察两组结肠癌患者临床疗效、预后以及术前、术后的生活质量评分情况.结果 开腹组和腹腔镜组淋巴结清扫数目[(25.1±5.0)cm和(24.8±5.6)cm]、切除标本长度[(17.8±5.4)cm和(16.8±5.3)cm]、肿瘤远端长度[(3.1±1.5)cm和(2.8±1.4)cm]差异均无统计学意义(P>0.05),结肠癌患者术前疼痛[(66.8±10.8)分和(67.5±10.4)分]、饮食受限[(66.2±10.1)分和(67.1±10.3)]分、焦虑[(66.2±10.1)分和(67.6±10.3)]分、排便功能评分[(66.1±10.2)分和(67.1±10.3)分]差异均无统计学意义(P>0.05);腹腔镜组结肠癌患者局部复发率(6.7%)、远处转移率(6.7%)均低于开腹组的26.7%、26.7%,术后开腹组和腹腔镜组疼痛[(76.8±10.1)分和(87.9±10.5)分]、饮食受限[(76.6±10.2)分和(87.5±10.4)分]、焦虑[(76.3±10.5)分和(87.9±10.6)分]、排便功能评分[(76.6±10.4)分和(87.5±10.3)分]均高于术前,腹腔镜组术后结肠癌患者疼痛、饮食受限、焦虑、排便功能评分均高于开腹组,差异均有统计学意义(P<0.05).结论 腹腔镜与开腹手术治疗结肠癌均有较好的临床疗效,而腹腔镜手术预后和生活质量更好.     

Comparison of compensatory sweating and quality of life following thoracic sympathetic block for palmar hyperhidrosis: electrocautery hook versus titanium clip

Background  Video-assisted thoracic sympathetic block is an effective, safe, and minimally invasive method for treatment of primary hyperhidrosis. The purpose of this study was to decide which one of using electrocautery hook and titanium clip is the appropriate procedure for primary palmar hyperhidrosis by assessing the compensatory sweating (CS) and quality of life (QOL) of patients after sympathetic block.

Methods  Between October 2007 to August 2010, 120 patients with primary palmar hyperhidrosis were randomly divided into two groups, electrocautery hook group (60 patients) and titanium clip group (60 patients). All patients were treated by sympathetic block at T4 level. The CS was graded based on severity and location; the QOL was classified to 5 different levels based upon the summed total scores (range from 20 to 100) before and after surgery. The variables were compared.

Results  The postoperative follow-up period was 2 months. All patients were cured. Three patients in electrocautery hook group and 1 patient in titanium clip group had a unilateral pneumothorax on chest X-ray, but none of them was necessary to have chest drainage. Neither perioperative mortality nor serious complications such as cardiac arrhythmia or arrest were observed during the operation. No bradycardia or Horner’s syndrome occured. CS was not more common in patients in titanium clip group than in those in electrocautery hook group (P=0.001). Moderate and severe CS was few in all patients, and there was no significant difference between two groups (P=0.193). Most of the patients feel a notable improvement of the the QOL; nevertheless, there was no significant difference between the groups (P=0.588).

Conclusions  Both electrocautery hook and titanium clip used for sympathetic block at the T4 level are effective, safe, and minimally invasive for palmar hyperhidrosis. Because of the lower severity of CS and the similar improvements in the QOL after operation, we prefer to use of titanium clip for treating palmar hyperhidrosis.