补肾活血通络针刺法联合中药熏洗疗法治疗肝肾亏虚型膝骨关节炎临床观察

目的 观察补肾活血通络针刺法联合中药熏洗疗法治疗老年性膝骨关节炎（knee osteoarthritis,KOA）的临床疗效。方法 将76例KOA患者按照随机数字表法分为对照组和观察组,每组38例;对照组采用西医常规治疗,观察组在对照组治疗基础上采用补肾活血通络针刺法联合中药熏洗疗法治疗;观察两组患者治疗前后视觉模拟量表（visual analogue scale,VAS）评分,西安大略和麦克马斯特大学骨关节炎指数（the Western Ontario and McMaster University osteoarthritis index,WOMAC）,Lequesne MG评分,关节液白细胞介素（interleukin,IL）-1β、IL-6、肿瘤坏死因子（tumor necrosis factor,TNF）-α水平,血清环氧化酶-2（cyclooxygenase-2,COX-2）、基质金属蛋白酶-3（matrix metalloproteinase-3,MMP-3）水平的变化情况及临床疗效。结果 两组患者治疗后VAS评分、WOMAC、Lequesne MG评分均较治疗前显著降低（P＜0.05）,且观察组降低程度较对照组更显著（P＜0.05）。两组患者治疗后关节液IL-1β、TNF-α、IL-6水平,血清COX-2、MMP-3水平均较治疗前显著降低（P＜0.05）,且观察组降低程度较对照组更显著（P＜0.05）。观察组疗效优于对照组（P＜0.05）。结论 补肾活血通络针刺法联合中药熏洗疗法可显著改善KOA患者临床症状,减轻疼痛,改善膝关节功能。     

Preventing relapse versus “stopping” domestic violence: Do we expect too much too soon from battering men?

Given the deeply entrenched habit patterns that characterize domestic violence, the author questions the enormous demands for change that are immediately placed on both abusive men and the clinicians treating them. Battering men are not only required to abruptly and permanently halt overt physical violence, but they are also expected to stop all expressions of dominance and intimidation, and to abandon all their exploitative attitudes and sex-role expectations as well. While it is feasible and necessary to insist upon the cessation of physical violence in order to protect the spouse and family, to what degree can the clinician also demand a total revolution in the abusive male's attitudes, social behavior, and values? To better demonstrate the excessivity of these demands, the author makes a comparison to the treatment of substance abusers, where the features of relapse and enduring cognitive distortions are expected and permitted as part of the normal extended course of recovery. Instead, the author proposes a more realistic and humanitarian set of therapeutic expectations for change, emphasizing relapse prevention and supportive maintenance.     

生脉注射液联合化疗治疗晚期非小细胞肺癌的临床研究

目的:观察生脉注射液联合泰素加卡铂方案治疗晚期非小细胞肺癌的临床效果及其减毒作用。方法:将38例晚期非小细胞肺癌患者随机分为治疗组和对照组各19例。对照组第1天予泰素135 mg/m2,3 h静滴,卡铂AUC 5静滴,21 d为1个周期;治疗组予同一化疗方案并于化疗结束后第2天用生脉注射液60 m l加入50 g/L葡萄糖注射液500 m l静滴,每天1次,连用15 d。两个周期后按照WHO实体瘤近期客观疗效评定标准进行评价。结果:治疗组和对照组近期有效率分别为52.6%和47.4%;治疗组Karnorfsky评分增加6例,对照组增加3例;治疗组体质量明显增加,骨髓抑制发生率明显较对照组低。结论:生脉注射液能提高泰素加卡铂方案化疗患者的生存质量,减轻化疗后骨髓抑制。     

Substance Abuse and Social Deviance:

The authors discuss adolescent substance abuse as a manifestation of social deviance. Theories of adolescent deviance are reviewed in light of their contributions to understanding troubled youth. A youth assessment framework is developed to provide a systematic means of linking theories to specific treatment strategies.     

英国执行欧盟细胞指令的经验和启示简

英国为执行欧盟人体组织和细胞三个指令在立法和执法上所作的努力及其获得的成功,对于我国建立人体组织细胞法律制度,发展监管科学,有效治理“干细胞治疗”乱象,具有重要借鉴价值.在实证的基础上,分析、介绍英国人体组织法的基础、基本制度和运作方式,设想中国干细胞疗法监管科学的框架,应当包括监管的目标和长远战略、科学立法、制度文化、监管体制与执法机制、行业治理、患者维权的伦理—法律问题等.     

Chapter 5: Family Preservation in Foster Care:

Treatment foster care is described in repect to the permanency continuum, particularly the importance of family connectedness for children placed out of home. The placement of specialist foster care in the treatment continuum is identified along with the associated advantages and challenges to be met.     

个人生活规则的探索与修正——韦斯勒之认知评价疗法的当代解读

认知评价疗法的核心概念是"个人生活规则",它是指个体的一种认知结构,代表个体对心理和社会性事件的法则化的看法和道德伦理的规定性。个体所产生的各种情绪和对自我的看法、评价皆与个人生活规则相关。个体心理问题之所以出现,在于个体所持有的个人生活规则缺乏一定的适应性,故心理治疗就是要对个人生活规则加以调整和修正。认知评价疗法吸收了诸多人文主义的观点,体现了心理疗法间相互融合的趋势。     

A physical therapy environment design concept for children with cerebral palsy in accordance with patient behavior and therapy effectiveness

This research aims to study the effects of interior environmental features on the effectiveness of physical therapy among children with cerebral palsy. The research assumes that interior environment primarily determines the central attention of the patients, which further institutes the level of cooperation and thus the effectiveness of therapy. Distinctive interior settings in three state hospitals are utilized to test the effects of different environmental settings on child patients＇ level of attention. A ＇~structured observation＂ together with an ＂achievement rating＂, measured by the patients＇ cooperative level, are utilized to gauge the success of therapy conducted within the three different environmental settings. Statistical result reveals a pattern of correlative linkages among the interior features, the level of central attention and the effectiveness of therapy. Behavioral responses are found to be positively correlated with the level of patient cooperation. The analysis of behavioral response discloses three types of environmental stimuli--crowding in the treatment rooms, present of particular interior features such as windows, and activities outside the treatment rooms visible to the patients. Desirable response is also found to be increasing along with the number of interior stimulus features. A design guideline for treatment room is finally established. Two groups of interior environmental features could be manipulated to elevate the effectiveness of therapy--the physical environment which includes room size, and the spatial location of therapy activities within the interior environment.     

Parent–Child Interaction Therapy with Domestic Violence Populations

Domestic violence continues to be a significant social problem impacting our society. Battered women and their children experience a myriad of negative consequences as a result of domestic violence. Of the possible negative sequelae that mothers and children experience, the disrupted parent–child relationship has received relatively little attention in the literature. Though psychosocial interventions are available to treat women who experience violence and children who witness violence, few interventions focus on the parent–child relationship. This article describes parent–child interaction therapy (PCIT), a relationship-based intervention. Although not initially developed to treat domestic violence, PCIT has unique characteristics that make it a promising intervention with this population. A rationale for the use of PCIT with battered women and their children is presented.     

Effectiveness of Functional Family Therapy for Mandated Versus Non‐Mandated Youth

This study compares the outcomes for youth mandated to participate in Functional Family Therapy (FFT) to those whose participation was referred but voluntary. FFT is a short‐term intervention for delinquents and status offenders, along with their parents. The study sample consists of 120 cases: 70 youth and parents who were mandated by the Family Court to participate in FFT and 50 youth and their parents who were referred to FFT by other agencies. The sample is diverse in terms of gender, race and ethnicity. The outcome variables consist of a set of scales obtained from the Strengths and Needs Assessment (SNA). Changes in life domain functioning, child strengths, acculturation, caregivers' strengths, caregivers' needs, child behavioral emotional needs, and child risk behaviors are assessed. The analysis indicates that both groups improved across all domains. Overall, being mandated to participate in FFT does not predict greater improvements in outcomes. The findings suggest that status offenders and minor delinquents who participated in FFT could be processed less formally without foregoing the therapy outcomes.