中国唇腭裂治疗的发展思路

作者从发展适合我国国情的治疗模式、科学对待不同国度的唇腭裂治疗模式、有效利用病例资源开展特色研究、加强国内同行间的学术交流、制定唇腭裂临床治疗指南、友善处理与慈善项目间的合作关系等方面,论述了唇腭裂临床治疗在我国的发展,希望通过对上述论题内容的相互讨论,形成同行间行动上的一致,在最短的时间内使我国唇腭裂临床研究水平有一个大的飞跃。     

浅析以新理念解决山谷型填埋场库区工程设计难点

以包头市东河生活垃圾卫生填埋场填埋库区分区隔堤系统工程为例,旨在说明现代垃圾填埋技术新理念在解决山谷型填埋场库区设计难点上的突破性作用.     

Natural conception after age 45 in Bedouin women, a uniquely fertile population

Purpose: Women conceiving naturally and delivering after age 45 are an exceptionally fertile population that may serve as a model to identify factors associated with delayed reproductive aging. This work studies this phenomenon in Bedouin women. Methods: The study is an observational retrospective analysis of all Bedouin women who conceived spontaneously and had their latest delivery after the age of 45 years, during the years 1995–2000 at the participating medical center. Complete histories of the outcomes of all pregnancies were collected. Results: 133 of 34,519 (0.38%) Bedouin women gave birth after the age of 45 years. The mean maternal age at last delivery was 46±1.4 years (range: 45–52), and the mean parity was 11.6±2.9 children (range: 3–18). 96% were grandmultiparous (≥6 deliveries). The mean spontaneous abortion rate (6.6%) was not affected by increased parity and was significantly lower than in the general population: 12.4% vs.17.7% at age 39, 5% vs. 33.8% (p < 0.001) at age 44 and 1.8% vs. 53.2% (p < 0.001) at age 45. Conclusions: This unique group of Bedouin women may have a genetic predisposition to delayed ovarian and oocyte aging.     

邓兴学副教授诊疗妇科血证经验举隅

文章所论之妇科血证,主要指月经血量过多、或经期延长、或崩漏之证。经血量过多的病因病机有气虚、肾虚、血热、血瘀等。经期延长的病因病机有气虚、脾肾阳虚、血热、血瘀等。而崩漏的病因病机则有肾虚、脾虚、血热、血瘀等。故上述3证,有共同的病机:肾虚、血热、血瘀。邓兴学副教授的治则是:酸甘化阴以止血、补肾固冲任以止血、宁血止血3法合用为主法,并观其脉证,随证加减。其他妇科血证均可参照此法,随证加减。此法有执简驭繁、标本兼治之功,缓急兼顾之妙,证之临床,确有效验。并附验案3则。     

从隐喻认知角度探究中医之“火”的概念内涵

从隐喻认知的角度探究中医学生理之"火"和病理之"火"的概念内涵。古代中医学家在说明人体火的生理、病理以及治疗方法时,大量地借鉴了身边可感知的自然之火的性状特征,因而,对"人体之火"的感悟是以"自然之火"的体验为认知本源的。本文从现代科学的角度,对中医之"火"的概念和内涵进行阐述和分析。     

Experience of the Hungarian Preconception Service between 1984 and 2010

The objective of this historical account is to summarize the concept, objectives, methods, results and general experience of the Hungarian Preconception Service, Budapest, based on 27 years (1984-2010) and 25,313 women and couples. The service includes counseling and care (examinations and medical interventions) based on three steps: (1) preconception screening for reproductive risk factors ("reproductive health check-up"), (2) a 3-month preparation for conception, because conception is when some major developmental events, such as the sex of the conceptus and the foundation of health and many diseases, are determined, and (3) achievement of optimal conception and better protection of the embryo in early pregnancy. With normal prenatal care, pregnant women visit clinics between the 7th and 12th gestational weeks, but the embryo has passed through his/her most vulnerable period before the 10th week, and thus prenatal care is too late to reduce the risk of congenital abnormalities. The new primary health care infrastructure for preconception care is performed by qualified and trained nurses and midwifes. Couples at risk are selected and are referred to specialists who can reject or confirm the supposed risks and treat the couples if necessary as part of their secondary health care. The most important results of the Hungarian preconception service were (i) a significant reduction in the rate of preterm births (5.0% vs. 9.2%) which has been linked mainly to preconception screening of sexually transmitted infections of female participants followed by appropriate treatment, (ii) a very significant reduction of congenital abnormalities (2.9% vs. 4.0%), particularly neural-tube defects and cardiovascular malformations, due to periconception multivitamin supplementation, (iii) reduction of smoking among female participants, (iv) involvement of male partners in the family planning health system, (v) much improved identification of couples at high risk and greater access to the secondary care of specialists. In conclusion, the Hungarian experience demonstrates the feasibility and usefulness of preconception care in the prevention of adverse birth outcomes including congenital abnormalities and preterm births.     

Gamete donors’ reasons for,and expectations and experiences of,registration with a voluntary donor linking register

This paper reports on a study of the views and experiences of 21 sperm donors and five egg donors registered with UK DonorLink (UKDL), a voluntary DNA-based contact register established to facilitate contact between adults who wish to identify and locate others to whom they are genetically related following donor conception. Specifically, the paper examines donors’ reasons for searching for, or making information about themselves available to donor-conceived offspring. Their expectations of registration with UKDL, experiences of being registered and finally, the experiences of those who had contacted donor-conceived offspring and other genetic relatives are investigated. While most respondents reported largely positive experiences of registration, the study found significant issues relating to concerns about donation, DNA testing, possible linking with offspring and expectations of any relationship that might be established with offspring that have implications for support, mediation and counselling. Research that puts the experiences, perceptions and interests of gamete donors as the central focus of study is a relatively recent phenomenon. This study contributes to this debate and highlights directions for future research in this area.