禽类实验动物在感染实验中安乐死的伦理问题

实验动物病原学感染实验在兽医科学和生物制品研究等方面发挥越来越大的作用。我们对从2009年至今正式发表在NCBI上的以禽类实验动物进行感染试验的科研报告进行了文献调查，重点关注涉及的动物福利，特别是关于安乐死的问题。通过对247项研究调查，虽然几乎所有报告都声称经过了动物实验和福利委员会的审核，但采用的安乐死方法并不相同。CO2吸入和注射麻醉剂是最常用的方法，但缺乏剂量上的标准。此外，对于临终终点或人道终点的判断标准也表现出很大的主观性。     

基础医学实验教学中关于实验动物福利教育的探讨

动物实验在生命科学发展、医学教学等方面有着十分重要的作用.但在基础医学实验教学中,实验动物福利教育缺失,导致学生对实验动物福利的法律法规认知不足,实验动物福利意识淡薄,不能正确使用动物福利的方式进行医学实验,给动物身体和心理造成伤痛.因此,医学院校应通过设置实验动物福利课程、遵循3R原则进行动物实验、考核实验动物福利课...     

实验动物的环境与福利

实验动物在生物科学研究领域中的应用不断发展,其饲养环境和福利保障的问题已越来越被国际所关注.实验动物的环境与福利不仅是对动物本身的保护,更重要的是对动物试验结果的保证.本文详细论述了大环境(温度、湿度、气流等方面)及小环境( 笼具、饲养密度、垫料)对实验动物福利的影响,通过总结国内外的研究概况,旨为我国改善和提高实验动物的福利提出一些思路.     

基于对生命的尊重：略谈实验动物纪念日与纪念碑

实验动物作为生命科学、医学、药学等领域研究的基础载体和关键条件,对现代科学的发展发挥了极其重要的作用。动物福利伦理建立于人类文明道德基础之上,是社会、经济发展到一定阶段的产物。从科学角度看,善待动物既是人道主义的需要,也是科学实验的需要。本文从实验动物福利伦理的发展历程及法规政策内容、是否需要设立及如何设立实验动物纪念日和纪念碑等几个方面阐述实验动物福利的作用和意义,呼吁实验人员遵循“3R”原则并增强责任感和规范意识。     

医学实验动物福利伦理问题分析

实验动物是生命科学研究和发展重要的基础和支撑条件,对医学发展和人类健康具有十分重要的意义。但是如何正确对待实验动物生命,如何维护实验动物福利伦理,如何使动物实验符合生命伦理学规范等一系问题引起了人们的深思。文中对动物实验与动物福利伦理的关系、动物福利伦理的起源和发展、3R理论的提出、国内外实验动物福利伦理立法状况、影响实验动物福利伦理的因素等进行了分析,对如何加强并改善我国实验动物福利伦理工作提出了措施和建议。     

实验动物福利操作技术规范培训

正实验动物福利要求在兼顾科学探索和在可能的基础上最大限度的满足实验动物维持生命、维持健康和提高舒适程度。是实验动物科学技术发展的核心问题之一。根据其需求给予动物应享有的权益,是人类文明进步的表现。为了推动我国实验动物福利发展,中国实验动物学会计划在2014年6月25日在重庆召开"实验动物福利操作技术规范培训班"。主要内容是实验动物福利操作技术(啮齿类),实验动物优化技术(犬、猪、猴)、中     

实验动物伦理新原则的框架分析与我国相关立法发展方向

实验动物研究的3R原则发布数十年来,得到了世界范围内的普遍承认与适用,但其本身存在着一定缺陷,不能系统地保护实验动物福利,节约社会成本,创造社会效益。2020年,动物伦理研究的6项新原则被提出,通过“社会效益”三大原则与“动物福利”三大原则的构成,对3R原则进行了批判继承,在提高动物实验科学性要求的基础上,融入了丰富的道德考量。基于实验动物伦理新原则的框架分析,结合我国实验动物立法的现状,能够探索在新原则视角下未来我国实验动物立法的发展方向。     

实验动物福利立法的必要性和可行性

1　实验动物福利立法的社会背景目前 ,世界上已有 10 0多个国家和国际组织设立了动物福利法 ,其中 ,有的已经有近 2 0 0年的历史。而在中国 ,为实验动物福利立法 ,还是一件新事物。用于科学研究的实验动物理应得到尊重和爱护 ,但仍存在不人道地对待实验动物的种种行为。这为我国在与国际间进行科技交流设置了无形障碍 ,引起实验动物科学界有识之士的共鸣和评议。他们提出 ,动物福利立法应先从实验动物福利立法开始。自 2 0 0 2年以来 ,在中国先后召开了 4次以动物福利及其立法为主题的国际会议。目前 ,已有越来越多的各界人士呼吁在我国应该…     

关于实验动物福利伦理实践中主体责任的思考

在实验动物福利伦理实践中,3R原则是其核心内容。作为这一实践活动主体的实验动物工作者在其中发挥主导作用,应承担起相应的主体责任。本文从主体责任的提出、贯彻福利原则的需要、福利伦理技术方法的需要、开发福利新产品的需要、福利伦理相关政策执行的需要以及设立实验动物纪念日和纪念碑以体现主体责任等几个方面阐述了主体责任在实验动物福利伦理实践中的作用、实现途径和意义。     

做好医院实验动物福利保障工作的初步探讨

在医学研究中,实验动物常被用作研究对象,而动物福利和良好的科研结果有着千丝万缕的联系。在医院环境下,培养科研人员树立保护动物福利的观念具有重要意义。笔者尝试结合南京大学医学院附属鼓楼医院近年来在实验动物福利与伦理审查工作的实际,对医院动物实验的重要性、维护实验动物福利的意义、如何开展福利伦理审查工作等进行初步的探讨,旨在为医院科研人员做好实验动物福利工作提供参考。     

Attitudes of Finnish doctors towards euthanasia in 1993 and 2003

Questionnaire studies on the attitudes of Finnish doctors towards euthanasia were conducted in 1993 and 2003, and the results show that they have not become more positive.The attitudes of doctors towards active euthanasia are, in general, more negative than the attitudes of the general public. The interpretations of surveys are, however, highly dependent on the formulation of the questions and, although the questions posed to these groups are similar, it is probable that the interpretations of doctors differ from those of the general public.According to most studies, most doctors, except those from The Netherlands, are against legalisation on active euthanasia. Considerable variation exists in the percentage of doctors opposing the practice. The variation is, of course, partly because of the variation in opinion, but several methodological issues also explain it. Some studies have asked direct questions about the legalisation of euthanasia—for example, in others, the questions have been about the ethical acceptance of the practice. Some studies have used case vignettes, whereas others have used general questionnaires. The knowledge and availability of palliative care may also affect the answers.¹The definition of euthanasia is of particular importance in the studies. The distinction between passive euthanasia (ie, withholding or withdrawing life‐saving treatment) and active euthanasia (ie, deliberately terminating the life of the patient with a lethal drug, for example,) has not always been clear.Although numerous studies with different methods have focused on the attitudes of doctors towards euthanasia and other practices at the end of life, we lack knowledge on possible changes in these attitudes. Legal changes in The Netherlands and Belgium, and open public discussion on these issues, most recently in the Council of Europe (http://assembly.coe.int/Documents/WorkingDocs/Doc03/EDOC9898.htm), may lead us to think that the attitudes of doctors have also become more positive. This study determined whether such a change had taken place in Finland.     

发表文献中小鼠安死术方法的分析研究(2015—2016)

目的了解国内小鼠处死方法使用的情况,为实验动物管理部门掌握"安死术"在国内执行情况、制定政策提供参考和依据。方法万方数据库中检索2015年至2016年间正文中含有检索词"小鼠"和"处死"的文献,对符合纳入条件的文章进行统计分析。结果 890篇文献符合纳入标准,其中明确提出小鼠处死方法的有351篇,仅占39.44%。处死方法涉及颈椎脱臼、断头、麻醉后放血取材、过量麻醉剂、腹主动脉放血和二氧化碳窒息六种,其中颈椎脱臼法使用率最高,占75.78%。结论目前小鼠"安死术"实施状况不容乐观,且小鼠处死方法在论文撰写中被忽视,且其描述存在不规范现象。促进"安死术"相关法规标准的切实执行,还需加强相关技术的研究和人员的培训。     

机能实验教学中存在的实验动物伦理问题及解决办法

目的 调查医学实验及实验教学中的实验动物伦理观及存在的问题,并制定应对措施,使动物伦理和动物福利在医学实验中得以真正地体现。方法 本研究针对实验动物伦理认知情况、动物实验是否道德和如何看待动物伦理与实验教学问题,以及虚拟仿真实验教学认知情况等3个方面,制定了含25条问题的“基础机能实验中心动物实验问卷调查表”。采用发放问卷调查表的方式对湖北医药学院2017级留学生（五年制）、2017级五年制本科生和2018级护理（四年制）学生及教师、科研人员及实验动物中心从业人员（均具有本科及以上学历）进行调查。调查结果以百分比表示。结果 本研究调查表回收率为98.04%（2 451/2 500）。其中实验动物中心从业人员、教师及科研人员实验动物伦理观清晰明了,但学生中普遍存在伦理观滞后现象。有16.24%（398/2 451）的学生未接受过动物实验伦理教育和培训,29.46%（722/2 451）的不清楚动物保护相关法律法规,7.14%（175/2 451）的认为动物实验不道德。对动物福利及伦理知识的认知情况模糊占比29.54%（724/2 451）。不熟悉操作步骤的占25.91%（635/2 451）。操作失误导致动物额外受伤中,无所谓的占9.38%（230/2 451）;动物大出血后如何处理中,选择放弃实验的占7.83%（192/2 451）,及时止血并输液后继续实验仅占5.43%（133/2 451）,而是否做与本次实验无关操作的占9.26%（227/2 451）。在实验结束后采用放血处死动物的占2.28%（56/2 451）、只有5.51%（135/2 451）的学生选择过量麻醉安乐死,且仍有1.96%（48/2 451）选择颈椎脱臼、暴力处死。对动物尸体时选择缅怀2 min的仅占15.79%（387/2 451）。仅有32.56%（798/2 451）的被调查者了解虚拟仿真实验,34.92%（856/2 451）的被调查者认为可以应用虚拟仿真实验或实验教学录像代替现有活体动物实验,77.56%（1 901/2 451）的被调查者认为应该加强虚拟仿真实验室建设。结论 加强学生实验动物伦理观教育势在必行,这有利于医学生建立正确的实验动物伦理观,使“3R”原则和动物福利得以真正落实于实验教学和科研实验中。     

在动物福利和“3R”原则的指导下建立贵州小型猪的实验方法

目的在动物福利及"3R"原则的指导下,建立贵州小型猪常用的实验方法。方法应用对动物刺激小、痛苦少的方法给贵州小型猪肌内注射、灌胃给药、采血、麻醉、静脉注射、处死给药等方法。结果建立了一套符合动物福利要求和"3R"原则的小型猪的实验方法。     

The Practice of Euthanasia and Physician-Assisted Suicide in the United States: Adherence to Proposed Safeguards and Effects on Physicians

Ezekiel J. Emanuel, MD, PhD; Elisabeth R. Daniels, BA; Diane L. Fairclough, DPH; Brian R. Clarridge, PhD

JAMA. 1998;280:507-513.

Context.— Despite intense debates about legalization, there are few data examining the details of actual euthanasia and physician-assisted suicide (PAS) cases in the United States.

Objective.— To determine whether the practices of euthanasia and PAS are consistent with proposed safeguards and the effect on physicians of having performed euthanasia or PAS.

Design.— Structured in-depth telephone interviews.

Setting and Participants.— Randomly selected oncologists in the United States.

Outcome Measures.— Adherence to primary and secondary safeguards for the practice of euthanasia and PAS; regret, comfort, and fear of prosecution from performing euthanasia or PAS.

Results.— A total of 355 oncologists (72.6% response rate) were interviewed on euthanasia and PAS. On 2 screening questions, 56 oncologists (15.8%) reported participating in euthanasia or PAS; 53 oncologists (94.6% response rate) participated in in-depth interviews. Thirty-eight of 53 oncologists described clearly defined cases of euthanasia or PAS. Twenty-three patients (60.5%) both initiated and repeated their request for euthanasia or PAS, but 6 patients (15.8%) did not participate in the decision for euthanasia or PAS. Thirty-seven patients (97.4%) were experiencing unremitting pain or such poor physical functioning they could not perform self-care. Physicians sought consultation in 15 cases (39.5%). Overall, oncologists adhered to all 3 main safeguards in 13 cases (34.2%): (1) having the patient initiate and repeat the request for euthanasia or PAS, (2) ensuring the patient was experiencing extreme physical pain or suffering, and (3) consulting with a colleague. Those who adhered to the safeguards had known their patients longer and tended to be more religious. In 28 cases (73.7%), the family supported the decision. In all cases of pain, patients were receiving narcotic analgesia. Fifteen patients (39.5%) were enrolled in a hospice. While 19 oncologists (52.6%) received comfort from having helped a patient with euthanasia or PAS, 9 (23.7%) regretted having performed euthanasia or PAS, and 15 (39.5%) feared prosecution.

Conclusions.— Intractable pain or poor physical functioning seem to be nearly absolute requirements for physicians to perform euthanasia or PAS. Only one third of cases are performed consistently with proposed safeguards. For some patients, end-of-life care that includes opioid analgesia and hospice care does not obviate their desire for euthanasia or PAS. While the majority of physicians seem comforted by their actions, some experience adverse consequences from having performed euthanasia or PAS.

     

发热伴血小板减少综合征病毒动物感染及动物模型

发热伴血小板减少综合征病毒（severe fever with thrombocytopenia syndrome virus,SFTSV）是我国2009年发现的一种新型布尼亚病毒。蜱虫是其重要储存宿主及传播媒介,野生动物和家畜均存在自然感染。α/β干扰素受体基因敲除的免疫缺陷小鼠是理想的实验动物模型。本文综述了SFTSV的动物感染及动物模型的研究成果,为SFTSV自然流行的控制以及动物实验提供依据。     

PCR检测实验恒河猴和食蟹猴群体中幽门螺杆菌和“猕猴螺杆菌”的感染

目的调查国内实验恒河猴和食蟹猴中幽门螺杆菌和"猕猴螺杆菌"的感染情况。方法参考文献中的螺杆菌属16S rRNA和幽门螺杆菌16S rRNA的引物序列,和新设计的"猕猴螺杆菌"16S rRNA特异性引物,在人工养殖的45只成年恒河猴和90只成年食蟹猴粪便样本中,通过q PCR或常规PCR检测来初步调查这两种猕猴中两种螺杆菌的感染情况。结果在恒河猴中幽门螺杆菌和"猕猴螺杆菌"的感染率均为100%,在食蟹猴中幽门螺杆菌和"猕猴螺杆菌"的感染率分别为100%和97.8%。结论证实我国人工繁育饲养的恒河猴和食蟹猴普遍存在"猕猴螺杆菌"感染。幽门螺杆菌和"猕猴螺杆菌"几乎同时存在于所有人工繁育的实验猴个体中,可能会对这两种猕猴的健康以及相关动物实验结果的准确性存在不利影响。     

动物实验面临的伦理问题

动物实验对生物医学的发展起到重要作用。但是随着动物保护运动的兴起，动物实验受到来自动物权利论和动物福利法的挑战。动物权利论是生态伦理学的一个流派，主张动物和人类一样，也拥有天赋的生存权和自由权。医学工作者应以科学、认真、人道的态度来进行动物实验。     

Pasteurella Septica Infections in Humans

Five instances of infection by Pasteurella septica, an organism which closely resembles H. influenzae on methods of presumptive bacteriology, are reported from an acute treatment general hospital practice over a period of three months. This infection decidedly outnumbers those caused by other Pasteurella species in North America. The organism is apt to be identified as H. influenzae, Friedlander's bacillus or Mima polymorpha. Unlike these, it shows extreme sensitivity to penicillin, sometimes combined with resistance to antibiotics that inhibit or kill these other organisms.

While in the past Pasteurella septica infection was considered to be characterized by persistent local infection following domestic animal scratches or bites, it is clear that it is more often found in cases of respiratory tract infection and peripheral septic disease. In three of the five cases reported, exposure to animals was the source of infection.

Because mixed infection with confusingly similar organisms may occur, lack of awareness of extreme penicillin sensitivity of Pasteurella septica may account for persistent failure of antibiotic therapy.

     

Cytomegalovirus Pneumonia in Patients with Rheumatic Diseases After Immunosuppressive Therapy: A Single Center Study in China

Background:

Rheumatic diseases involve multiple organs that are affected by immunological mechanisms. Treatment with corticosteroids and immunosuppressive agents may also increase the frequency of infection. Cytomegalovirus (CMV) is a widespread herpes virus and a well-recognized pathogen, which causes an opportunistic and potentially fatal infection in immunocompromised patients. This retrospective study aimed to investigate the clinical and laboratory characteristics of CMV pneumonia in patients with rheumatic diseases after immunosuppressive therapy in a single center in Shanghai, China.

Methods:

Eight hundred and thirty-four patients with rheumatic diseases who had undergone CMV-DNA viral load tests were included, and the medical records of 142 patients who were positive for CMV-DNA in plasma samples were evaluated. GraphPad Prism version 5.013 (San Diego, CA, USA) was used to conduct statistical analysis. The correlation between CMV-DNA viral loads and lymphocyte counts was assessed using the Spearman rank correlation coefficient test. Significance between qualitative data was analyzed using Pearson''s Chi-squared test. The cut-off thresholds for CMV-DNA viral load and lymphocyte count were determined by receiver operating characteristic (ROC) curve analysis.

Results:

One hundred and forty-two patients had positive CMV viral load tests. Of these 142 patients, 73 patients with CMV pneumonia were regarded as symptomatic, and the other 69 were asymptomatic. The symptomatic group received higher doses of prednisolone (PSL) and more frequently immunosuppressants than the asymptomatic group (P < 0.01). The symptomatic group had lower lymphocyte counts, especially CD⁴⁺ T-cells, than the asymptomatic group (P < 0.01). By ROC curve analysis, when CD⁴⁺ T-cell count was <0.39 × 10⁹/L, patients with rheumatic diseases were at high risk for symptomatic CMV infection. The CMV-DNA load was significantly higher in the symptomatic patients than that in asymptomatic patients (P < 0.01; threshold viral loads: 1.75 × 10⁴ copies/ml). Seven patients had a fatal outcome, and they had lower peripheral lymphocyte counts (P < 0.01), including CD4⁺ and CD⁸⁺ T-cells (P < 0.01).

Conclusions:

When CD⁴⁺ T-cell count is <0.39 × 10⁹/L, patients are at high risk for pulmonary CMV infection. Patients are prone to be symptomatic with CMV-DNA load >1.75 × 10⁴ copies/ml. Lymphopenia (especially CD⁴⁺ T-cells), presence of symptoms, and other infections, especially fungal infection, are significant risk factors for poor outcome, and a higher PSL dosage combined with immunosuppressants may predict CMV pneumonia.