In the criminological system, passive euthanasia is an act that meets the constitutive elements. We should discard the traditional view of distinguishing between acts and omissions, but use genuine consent or presumpt...In the criminological system, passive euthanasia is an act that meets the constitutive elements. We should discard the traditional view of distinguishing between acts and omissions, but use genuine consent or presumptive consent under the patient’s right to self-determination as the basis for its justification. In general, the patient’s genuine consent takes precedence, but in case of the unavail-ability of the patient’s genuine consent, his or her presumptive consent should be applied as a substitute. The judgment of presumptive con-sent should follow the subsequence, with the living will of the patient applied first and then the substitute decision-making. If the patient’s personal will cannot be inferred after exhausting all available possi-bilities, the principle of prioritizing the interests of life should prevail, and the ongoing life-sustaining medical care should not be interrupted or terminated.展开更多
目的:探讨代谢危险因素对骨代谢血清标志物的影响及其关系。方法:收集2015年1月至2020年4月于华西医院胃肠外科行减重手术的病人,并抽血检测血糖、三酰甘油(triglycerides, TG)、高密度脂蛋白(high-density lipoprotein, HDL)、骨特异...目的:探讨代谢危险因素对骨代谢血清标志物的影响及其关系。方法:收集2015年1月至2020年4月于华西医院胃肠外科行减重手术的病人,并抽血检测血糖、三酰甘油(triglycerides, TG)、高密度脂蛋白(high-density lipoprotein, HDL)、骨特异碱性磷酸酶(bone specific alkaline phosphatase,B-ALP)及Ⅰ型胶原羧基末端肽(C-telopeptide of type 1 collagen, CTX)等。根据B-ALP及CTX中位数分为两组(B-ALP≤14.24μg/L,B-ALP>14.24μg/L;CTX≤0.36μg/L,CTX>0.36μg/L)。比较两组临床资料、代谢危险因素,以及这些因素与B-ALP和CTX的相关性。结果:本研究共纳入205例,男81例,女124例。B-ALP≤14.24μg/L组在收缩压、舒张压、TG、HDL及低HDL血症例数方面与BALP>14.24μg/L组比较差异有统计学意义(P<0.05)。CTX≤0.36μg/L组在性别、皮下脂肪面积及空腹血糖方面与CTX>0.36μg/L组比较差异有统计学意义(P<0.05)。B-ALP与年龄及HDL负相关,与收缩压、舒张压及TG正相关。CTX与年龄及空腹血糖负相关。Logistic回归分析显示,HDL高者发生B-ALP指标异常的风险明显增加(OR=2.931,95%CI:1.585~5.421,P=0.001)。皮下脂肪面积大者发生CTX指标异常的风险明显降低(OR=0.381,95%CI:0.194~0.748,P=0.005);HDL高者发生CTX指标异常的风险明显增加(OR=2.067,95%CI:1.118~3.824,P=0.021)。结论:HDL降低、空腹血糖升高、高血压代谢危险因素以及皮下脂肪面积对减重手术病人的骨代谢指标有一定影响。展开更多
基金the Beijing Social Science Foundation Project (Project Number 20221BS0009).
文摘In the criminological system, passive euthanasia is an act that meets the constitutive elements. We should discard the traditional view of distinguishing between acts and omissions, but use genuine consent or presumptive consent under the patient’s right to self-determination as the basis for its justification. In general, the patient’s genuine consent takes precedence, but in case of the unavail-ability of the patient’s genuine consent, his or her presumptive consent should be applied as a substitute. The judgment of presumptive con-sent should follow the subsequence, with the living will of the patient applied first and then the substitute decision-making. If the patient’s personal will cannot be inferred after exhausting all available possi-bilities, the principle of prioritizing the interests of life should prevail, and the ongoing life-sustaining medical care should not be interrupted or terminated.
文摘目的:探讨代谢危险因素对骨代谢血清标志物的影响及其关系。方法:收集2015年1月至2020年4月于华西医院胃肠外科行减重手术的病人,并抽血检测血糖、三酰甘油(triglycerides, TG)、高密度脂蛋白(high-density lipoprotein, HDL)、骨特异碱性磷酸酶(bone specific alkaline phosphatase,B-ALP)及Ⅰ型胶原羧基末端肽(C-telopeptide of type 1 collagen, CTX)等。根据B-ALP及CTX中位数分为两组(B-ALP≤14.24μg/L,B-ALP>14.24μg/L;CTX≤0.36μg/L,CTX>0.36μg/L)。比较两组临床资料、代谢危险因素,以及这些因素与B-ALP和CTX的相关性。结果:本研究共纳入205例,男81例,女124例。B-ALP≤14.24μg/L组在收缩压、舒张压、TG、HDL及低HDL血症例数方面与BALP>14.24μg/L组比较差异有统计学意义(P<0.05)。CTX≤0.36μg/L组在性别、皮下脂肪面积及空腹血糖方面与CTX>0.36μg/L组比较差异有统计学意义(P<0.05)。B-ALP与年龄及HDL负相关,与收缩压、舒张压及TG正相关。CTX与年龄及空腹血糖负相关。Logistic回归分析显示,HDL高者发生B-ALP指标异常的风险明显增加(OR=2.931,95%CI:1.585~5.421,P=0.001)。皮下脂肪面积大者发生CTX指标异常的风险明显降低(OR=0.381,95%CI:0.194~0.748,P=0.005);HDL高者发生CTX指标异常的风险明显增加(OR=2.067,95%CI:1.118~3.824,P=0.021)。结论:HDL降低、空腹血糖升高、高血压代谢危险因素以及皮下脂肪面积对减重手术病人的骨代谢指标有一定影响。
