羊水性状及脐动脉S/D与新生儿Apgar评分关系的探讨

目的分析羊水指数、脐动脉S/D和新生儿Apgar评分资料,探讨其相互关系。方法37周以上、在分娩前3d内接受了超声检查的孕妇263例为研究对象。年龄（30.37±3.27）岁,孕龄（39.24±1.25）周;排除胎儿畸形、中度以上妊娠高血压综合征、严重孕妇疾病等异常情况。四象限法测量羊水指数,根据内部回声情况对羊水性状进行评价;频谱多普勒超声测量脐带动脉SV、DV和S/D;胎儿出生后进行Apgar 1min评分。统计学相关分析。结果羊水指数和羊水性状与胎儿脐带动脉S/D显示了一致的变化;以胎儿脐带动脉S/D≥3.0,Apgar 1 min评分≤7有22例,二者呈显著相关（R=0.667,P=0.000）;羊水指数和羊水性状与新生儿Apgar 1 min评分也显示了良好的相关性（R分别为0.667,0.513和0.765,P=0.000）。结论羊水指数和羊水性状与胎儿脐带动脉S/D对评价新生儿缺氧有相同的意义。     

Psychobiological personality dimensions in two environmental-illness patient groups

The aim of the present study was to investigate the psychobiological personality dimensions in two subgroups of patients with environmental illness (EI). Fifty-nine patients, 34 women and 25 men (aged 32–69 years), were referred for symptoms allegedly caused by abnormal sensitivity to either dental fillings (DF; n=26) or electromagnetic fields (EMF; n=33). For the evaluation of personality, the Swedish 238-item version of the Temperament and Character Inventory (TCI) was used. Compared with a control group, the EMF group scored higher on the temperament dimension Persistence. The DF group scored higher on the TCI subscales Harm Avoidance (fatigability and asthenia) and Self-Directedness (self-acceptance). Women scored higher than men did on the Novelty Seeking and Reward Dependence (RD) dimensions in the DF group and on RD in the control group, indicating an inherited gender difference. No differences were found between men and women in the EMF group. Our results indicate that the high level of persistence found in the EMF group and the high level of fatigability and asthenia in combination with high self-acceptance found in the DF group represent vulnerable personalities. No significant differences were found between the two patient groups, indicating that these groups are quite similar regarding personality. This vulnerability can be expressed as various mental and somatic symptoms, which can be interpreted as EI symptoms by the affected individual.     

品格教育:向右摆动的"钟摆"?--美国品格教育发展与面临问题的探究

如果把美国20世纪50年代个人主义兴起,品格教育成为"一抹斜阳",视为道德教育的钟摆开始向左摆动的话,那么,20世纪70年代,以相对主义和浪漫自然主义为指导的"价值澄清"、"认知发展"等,则是道德教育钟摆回到了"顶点".而新保守主义思潮浸润下20世纪90年代品格教育运动的风起云涌,表明美国道德教育的钟摆开始向右摆动.现代社会越来越彰显出曼德斯所揭示的"去道德化的教育"现象.美国道德教育钟摆的摆动轨迹,无疑是一面镜子,对我国新一轮课程改革中的道德教育"钟摆"的摆动,具有借鉴意义.     

老年性消化性溃疡的特征与治疗

目的探讨老年性消化性溃疡的临床特点。方法回顾性分析60例老年性消化性溃疡的临床资料。结果老年性消化性溃疡诱发因素中，不良生活习惯占33．3％，服用非甾体类抗炎药物占30％；发病部位胃溃疡占45％，十二指肠球部溃疡占38．3％；并发症上消化道出血占43．3％。结论除幽门螺杆菌感染外，不良生活习惯和服用非甾体类抗炎药物是老年性消化性溃疡的常见诱发因素；老年人胃溃疡的患病率较高，临床表现不典型，并发症以出血多见，合并症多且严重，死亡率较高。     

青少年精神分裂症患者个性特征与家庭环境的相关性

目的探讨青少年精神分裂症的个性特点、家庭环境模式,及其家庭环境因素对青少年个性的影响。方法以16~19岁首发精神分裂症60例为研究组,同年龄段在校就读学生60例为正常对照组;以艾森克个性(成人)问卷(EPQ),家庭环境量表中文版(FES-CV),为测评工具,测验结果全部输入心理测验软件系统,用SPSS11.0统计软件进行均数、2、t检验及相关性检验。结果青少年精神分裂症性格多为内向不稳定型(19例)、高精神质[(7.12±3.22)分]、高神经质[(14.38±5.85)分];其家庭环境亲密度[(5.55±2.19)分]、成功性[(5.22±2.18)分]、知识性[(4.08±1.82)分]、娱乐性[(4.37±2.16)分]、组织性[(5.13±2.23)分]、道德性[(5.23±1.79)分]得分显著低于对照组,而家庭环境中亲密度和组织性与个性有高度相关性(P<0.01)。结论家庭环境对青少年的个性有重要的影响,特别是家庭环境中的亲密度和组织性。     

公立医院改革与发展的伦理选择

我国公立医院的牌子是公立，资产属于国家，而经营行为。明显地走上了营利性道路。在公立医院改革与发展路径的选择上，既要反对由政府包办的纯公益路径，也要反对完全市场化的路径，要在坚持公益性的前提下进行有限的市场化。将公共机制与市场机制有机结合。     

志贺菌群的特征研究

目的 探讨志贺菌不同群的特征,为临床正确诊断及合理用药提供依据.方法 通过志贺菌及沙门菌(SS)大便培养,将志贺菌经生化及血清学进一步鉴定到种、群,并用纸片扩散法测定了13种抗菌药物的敏感性,探讨不同菌群的特征.结果 10年分离的福氏志贺菌群和宋内志贺菌群共1554株,分别1015(65.3%)株、539(34.7%)株,宋内志贺菌逐渐增加;宋内志贺菌感染以14岁以下儿童为主,而福氏志菌以31-50岁的中青年为主:二者的临床表现有差别;福氏志贺菌对青霉素类、喹诺酮类、氯霉素、复方磺胺甲噁唑耐药率高于宋内志贺菌;而对第三代头孢菌素的耐药率明显低于宋内志贺菌.结论 福氏志贺菌和宋内志贺菌特征差异多,耐药性不同,临床诊治应区别对待.     

传统中国医疗伦理对当代美德医疗伦理学可作的贡献

晚近20年,英语世界道德哲学的最重大发展是美德伦理学的复兴。除了新亚里士多德学派,还有休谟学派、尼采学派及基督教学派等。同样的复兴也在医疗伦理学中发生。影响世界的Beauchamp与Childress的《生命医疗伦理学原则》,也在最新版本（第6版,2009年）中不再批评美德伦理学,而且承认其优点。从此书的第三版开始分析,看书的作者如何在以后三次修订版中,修改自己对美德伦理学的立场。与现代西方不同,古代中国医疗伦理的著述,是规则导向与关德导向并重,这肯定受了儒家文化的影响。儒家伦理学一直是美德导向,今天西方美德伦理学也要向孔孟取经。礼失求诸野,今天西方的医疗伦理学都强调美德的重要性,中国的医疗伦理学难道还只停留在讨论四个道德原则的运用吗？再者,我们要提出切合这个时代需要的修养工夫,这样不单是对当代中国医疗伦理的建设,也是对世界性美德医疗伦理学的贡献。     

青光眼患者心理因素及性格倾向对疾病的影响及对策

目的:探讨有效的处理对策对青光眼患者相关心理因素的影响及意义。方法:分析了青光眼患者的心理因素及性格倾向,并针对这些心理因素采取有效的对策进行处理。结果:有效的处理对策,可以帮助患者调整心态,稳定情绪,树立战胜疾病的信心,使疗效得到提高。结论:通过对378例青光眼患者心理因素和性格特点的总结分析和采取相应的处理对策,稳定了患者视力,降低了眼压,确保了手术质量,有效的控制了病情,减少了疾病导致的病残率,使患者的生活质量得以提高。     

Serotonin receptor HTR1A and HTR2C variants and personality traits in suicide attempters and controls

Introduction

Serotonin has been extensively studied in relation to both personality features and suicidal behaviours.

Objective

In this study, we considered the association between the serotonin receptor 1A (HTR1A) and 2C (HTR2C) SNPs and personality traits, as measured by the Temperament and Character Inventory (TCI), in a sample of suicide patients and healthy volunteers.

Methods

The SNPs considered were, for HTR1A rs1423691, rs878567 and rs6295, and for HTR2C rs547536, rs2192372, rs6318, rs2428707, rs4272555 and rs1801412. The sample was composed of three groups: two German samples, consisting of a healthy control group of 289 subjects (42.6% males, mean age: 45.2 ± 14.9) and a psychiatric patient group of 111 suicide attempters (38.7% males, mean age: 39.2 ± 13.6), and an Italian sample, composed of 64 mood disorder patients (35.9% males, mean age: 43.0 ± 14.8). In the German samples all the SNPs were investigated, while in the Italian sample only the HTR1A rs6295 and the HTR2C rs6318 SNPs were considered.

Results

Controlling for sex, age and educational level, single markers and haplotypes were not or only marginally associated with personality dimensions.

Conclusions

Our study does not support the role of HTR1A and HTR2C gene variants on personality traits in both healthy volunteers and mood disorder patients.