从治疗法学到预防法学:法律硕士教育改革的新思维

介绍了预防法学的概念,认为在我国的法学教育中引入预防法学思维不仅有助于提升法律硕士教育的质量,而且对于法治建设和社会发展也有积极指导意义。提出引入预防法学思维需要改革现有的法学教学方法和教育模式,采取"解释论"和"风险评估与预防论"的教学方法,开展法商融合教育,发展虚拟法律实践平台,全面深化案例教学,强化系统思维,引入实战型考评机制。

治疗法学理论与民法典成年监护制度改革

我国《民法总则》第34及35条虽于正反两面确定了被监护人的最佳利益原则,但现有成年监护制度仍难以缓和我国老龄化社会图景下出现的诸多矛盾。监护制度涉及社会伦理甚深且巨,交叉学科的研究范式将为政策改革提供更多维之选项。本文以治疗法学为研究视角,结合法学及社会心理学分析,以老年人福祉的实现作为制度改革的核心,对传统监护制度进行反思,并以自益性监护制度的构建作为未来老年人监护制度改革的方向,以期为我国未来民法典亲属编中的监护制度改革提供另外一种思路。

《内经》“神客在门”新解及其中医治疗方法学探讨

所谓神者,人之正气也;所谓客者,邪所也,邪气之所感,有时如客之往来。通过对《内经》"神客在门"的阐释,即神气、邪气都由"门"(眼耳鼻舌身意六根)出入身体,结合基本病因病机,从新的角度总结中医的病因分类。并根据《辅行诀脏腑用药法要》体现的五行生克制化规律,结合内经五行应象关系,探索新的中医治疗方法。

程序正义的社会心理学及在纠纷解决中的运用

法律权威需要寻找一些方法,以解决冲突并增进和协调人际和群体之间的关系。在这种考察中,社会心理学领域中围绕"程序正义(procedural Justice)"以实验方法展开的研究成果显示:程序和程序正义在解决纠纷方面存在巨大的潜能。无论从理论还是实证角度,程序正义的社会心理学及其在美国社会的冲突衡量与评价、冲突转型的治疗分析以及冲突解决策略的可行性认识等方面,均提供了丰富的理论资源,也有助于我们分析美国替代性纠纷解决方法 (ADR)适用的各种情境。

Expression of HMGB1 Protein in Human Cervical Squamous Epithelium Carcinoma

OBJECTIVE To investigate the expression of the high mobility group boxl（HMGB1） in human cervical squamous epithelial carcinoma （CSEC） and to explore the relationship of HMGB1 expression to the differentiation degree, size, invasion and metastasis of CSEC. METHODS Immunohistochemical staining of tissue microarrays and Western blot analysis were conducted to detect the expression of HMGB1 in the following tissue samples： 30 carcinoma in situ, 90 invasive CSEC without metastasis, 30 invasive CSEC with metastasis, 30 cases of normal cervical squamous epithelia. RESULTS The positive-expression rate of HMGB1 was 58.7% （88/150） in CSEC, showing a significant difference compared to normal cervical squamous epithelia. The expression of HMGB1 was correlated with tumor size, invasion and metastasis of CSEC （respectively, P〈0.01）, but had no relationship with the degree of differentiation （P〉0.05）. CONCLUSION The over-expression of HMGB1 in CSEC might be a useful parameter as an indication of tumor invasion, metastasis, prognosis and overall biological behavior of human CSEC, as well as a noval target site for gene therapy.

中医治疗方法学对完善中医学理论体系的作用研究

中医治法是中医学基础理论体系和中医临床理法方药辨治体系的重要内容,确定治法也是临床辨证论治的核心内容之一。然而,中医治法理论一直未被系统总结,没有一本专门针对中医治法方面的教材或专著。千余种治法被广泛运用于中药学、方剂学、中医内科学、中医外科学等基础以及临床学科中,由于治法的定义、适用病证以及使用方法这3个核心问题都没有在中医学理论体系中得以系统回答,导致了各个治法基础概念的混淆不清以及临床使用上的不规范、不合理。直到2022年4月,高等中医药院校“十四五”创新教材《中医治疗方法学》正式出版,成为我国第一本全面、系统地介绍中医治疗方法学的专业教材,也标志着中医治疗方法学理论体系初步形成。中医治疗方法学对填补中医基础理论体系中治法内容的空白、完善理法方药辨治体系中治法的内容、强化治法在中医基础理论向临床实践跨越的“桥梁”作用、促进中医基础学科与临床学科的发展具有十分重要的意义。

Prognostic factors in patients with advanced cholangiocarcinoma: Role of surgery, chemotherapy and body mass index

AIM： To study the factors that may affect survival of cholangiocarcinoma in Lebanon. METHODS： A retrospective review of the medical records of 55 patients diagnosed with cholangio- carcinoma at the American University of Beirut between 1990 and 2005 was conducted. Univariate and multivariate analyses were performed to determine the impact of surgery, chemotherapy, body mass index, bilirubin level and other factors on survival. RJ^SULTS： The median survival of all patients was 8.57 mo （0.03-105.2）. Univariate analysis showed that low bilirubin level （〈 10 mg/dL）, radical surgery and chemotherapy administration were significantly associated with better survival （P = 0.012, 0.038 and 0.038, respectively）, in subgroup analysis on patients who had no surgery, chemotherapy administration prolonged median survival significantly （17.0 mo vs 3.5 mo, P = 0.001）. Multivariate analysis identified only low bilirubin level 〈 10 mg/dL and chemotherapy administration as independent predictors associated with better survival （P 〈 0.05）. CONCLUSION： Our data show that palliative and postoperative chemotherapy as well as a bilirubin level 〈 10 mg/dL are independent predictors of a significant increase in survival in patients with cholangiocarcinoma.

Risk factors for alcohol-related liver injury in the island population of China: A population-based case-control study

AIM:To investigate the association of alcohol dose, duration of drinking and obesity with abnormal alcohol-related liver injury indicators, the prevalence of alcohol-related liver injury in the island population of China.METHODS:Randomized multistage stratified cluster sampling from the island population of China was used in the population-based case-control study. Then interview, physical examination, laboratory assessments and ultrasonography were done. RESULTS:Daily alcohol intake ≥ 20 g, duration of drinking ≥ 5 years and obesity were closely related to alcohol-related liver injury (P < 0.05). The odds-ratio (OR) (95% CI) was 1.965 (1.122-3.442), 3.412 (1.789-6.507) and 1.887 (1.261-2.824), respectively. The prevalence rate of alcohol-related liver injury in ≥ 20 g daily alcohol intake group and < 20 g daily alcohol intake group was 37.14% and 12.06%, respectively. The prevalence rate of alcohol-related liver injury in ≥ 5 years drinking group and < 5 years drinking group was 34.44% and 8.53%, respectively. No significant dose-response relation was found between daily alcohol intake and abnormal alcohol-related liver injury indicators as well as between duration of drinking and abnormal alcohol-related liver injury indicators. There was no significant difference in the prevalence of alcohol-related liver injury between beer drinking group and yellow rice wine drinking group, hard liquor drinking group, multiple drinking group.CONCLUSION:The risk threshold of daily alcohol intake is 20 g and duration of drinking inducing alcohol-related liver injury 5 years in the island population of China. Liver injury induced by obesity should be concerned.

Is it relevant that intra-arterial chemotherapy may be effective for advanced pancreatic cancer?

Unresectable pancreatic cancers have an extremely dismal prognosis and chemoresistant nature. The treatment of pancreatic cancer is still problematic. Gemcitabine is a promising new agent that has been studied recently for palliation of advanced pancreatic cancer. However,the response rates have been highly variable,and are often irreproducible. To improve this low response rate,various treatments are needed because no standard treatment exists. Intra-arterial chemotherapy is considered to take advantage of the first pass effect of the drug,generating higher local drug concentrations in tumor cells with lower toxicity. Regional intra-arterial chemotherapy may provide high levels of cytostatic concentrations within the tumor and,simultaneously,a low rate of systemic side effects compared with systemic administration of anti-neoplastic drugs. Intra-arterial chemotherapy has been introduced as an alternative treatment for advanced pancreatic cancer. Further clinical trials of this method should be subjected to a prospective randomized controlled study for advanced pancreatic cancer.

Treatment of upper gastrointestinal fistula and leakage with personal stage nutrition support

AIM： To investigate the feasibility of treatment for upper gastrointestinal fistula and leakage with personal stage nutrition support. METHODS： Forty-three patients with upper gastrointestinal fistula and leakage were randomly divided into two groups. Patients in group A were treated with personal stage nutrition support and patients in group B were treated with total parental nutrition （TPN） in combination with operation. Nutritional states of the candidates were evaluated by detecting albumin （AIb） and pre-AIb. The balance between nutrition and hepatic function was evaluated by measurement of aspartate aminotransferase （AST）, alanine aminotransferase （ALT） and total bilirubin （Tbill） before and after operation. At the same time their complications and hospitalized time were surveyed. RESULTS： Personal stage nutrition support improved upper gastrointestinal fistula and leakage. The nutrition state and hepatic function were better in patients who received personal stage nutrition support than in those who did not receive TPN. There was no significant difference in the complication and hospitalized time in the two groups of patients. CONCLUSION： Upper gastrointestinal fistula and leakage can be treated with personal stage nutrition support which is more beneficial for the post-operation recovery and more economic than surgical operation.

Repeated morphine treatment influences operant and spatial learning differentially

Objective To investigate whether repeated morphine exposure or prolonged withdrawal could influence operant and spatial learning differentially. Methods Animals were chronically treated with morphine or subjected to morphine withdrawal. Then, they were subjected to two kinds of learning: operant conditioning and spatial learning. Results The acquisition of both simple appetitive and cued operant learning was impaired after repeated morphine treatment. Withdrawal for 5 weeks alleviated the impairments. Single morphine exposure disrupted the retrieval of operant memory but had no effect on rats after 5-week withdrawal. Contrarily, neither chronic morphine exposure nor 5-week withdrawal influenced spatial learning task of the Morris water maze. Nevertheless, the retrieval of spatial memory was impaired by repeated morphine exposure but not by 5-week withdrawal. Conclusion These observations suggest that repeated morphine exposure can influence different types of learning at different aspects, implicating that the formation of opiate addiction may usurp memory mechanisms differentially.

Metastatic colorectal cancer-past,progress and future

The clinical management of metastatic （stage IV） colorectal cancer （CRC） is a common challenge faced by surgeons and physicians. The last decade has seen exciting developments in the management of CRC, with significant improvements in prognosis for patients diagnosed with stage IV disease. Treatment options have expanded from 5-fluorouracil alone to a range of pharmaceutical and interventional therapies, improving survival, and providing a cure in selected cases. Enhanced understanding of the biologic pathways most important in colorectal carcinogenesis has led to a new generation of drugs showing promise in advanced disease. It is hoped that in the near future the treatment paradigm of metastatic CRC will be analogous to that of a chronic illness, rather than a rapidly terminal condition. This overview discusses the epidemiology of advanced CRC and currently available therapeutic options including medical, surgical, ablative and novel modalities in the management of metastatic colorectal cancer.

Role of sex steroid receptors in pathobiology of hepatocellular carcinoma

The striking gender disparity observed in the incidence of hepatocellutar carcinoma （HCC） suggests an important role of sex hormones in HCC pathogenesis. Though the studies began as early as in 1980s, the precise role of sex hormones and the significance of their receptors in HCC still remain poorly understood and perhaps contribute to current controversies about the potential use of hormonal therapy in HCC. A comprehensive review of the existing literature revealed several shortcomings associated with the studies on estrogen receptor （ER） and androgen receptor （AR） in normal liver and HCC. These shortcomings include the use of less sensitive receptor ligand binding assays and immunohistochemistry studies for ERα alone until 1996 when ERβ isoform was identified. The animal models of HCC utilized for studies were primarily based on chemical-induced hepatocarcinogenesis with less similarity to virus-induced HCC pathogenesis. However, recent in vitro studies in hepatoma cells provide newer insights for hormonal regulation of key cellular processes including interaction of ER and AR with viral proteins. In light of the above facts, there is an urgent need for a detailed investigation of sex hormones and their receptors in normal liver and HCC. In this review, we systematically present the information currently available on androgens, estrogens and their receptors in normal liver and HCC obtained from in vitro, in vivo experimental models and clinical studies. This information will direct future basic and clinical research to bridge the gap in knowledge to explore the therapeutic potential of hormonal therapy in HCC.

Liver alveolar echinococcosis in China: Clinical aspect with relative basic research

This paper deals with all aspects of liver alveolar echinococcosis (AE) including epidemiology, pathology, clinical manifestations, imaging examinations, diagnosis and differential diagnosis, surgical treatment and chemotherapy.The review is not only based on personal clinical experiences but also in combination with relative basic research such as proliferation and growth of alveococcus, preclinical studies of a novel compound extracted from TCM for treatment of liver AE, and molecular immunology used for specific AE diagnosis, etc.

SEVEN CASES OF EPITHELIAL OVARIAN CARCINOMA WITH BRAIN METASTASIS

Objective To summarize the clinical characteristics, treatment, and prognosis of brain metastasis in patients with epithelial ovarian carcinoma. Metbods Retrospective analysis was conducted in 7 cases of brain metastases of epithelial ovarian carcinoma from January 1986 to March 2007 in Peking Union Medical College Hospital for summarizing therapy results and prognosisaffecting factors. Results Incidence of brain metastases of epithelial ovarian carcinoma was about 0. 66% （7/1 055 ）. Serous adenocarcinoma was the predominant pathological type in 4 cases and the subsequent was adenocarcinoma in 3 cases. All the patients were diagnosed at late stage, 6 cases with the International Federation of Gynecology and Obstetrics （HGO） stage Ⅲc and 1 with FIGO stage IV. The mean duration from diagnosis of ovarian carcinoma to brain metastasis was 32.7 ± 20. 0 months （range, 23-73 months）. Single metastasis focus occurred in 43% of cases and multiple metastases in 57% of cases. Fifty-seven percent of patients presented extracranial metastasis. Serum CA125 played a role in monitoring reoccur- rence and brain metastases. The average survival time was about 12 months. Better treatment with prolonged survival could be achieved by combination of operation and chemotherapy or combination of radiotherapy with chemotherapy. Concltusions As a rare condition, brain metastasis of epithelial ovarian carcinoma is rising in incidence with improved treatment of ovarian carcinoma and prolonged survival. However, brain metastasis indicates bad prognosis which can be improved by combined therapy.

A study of transarterial infusion chemotherapy of gemcitabine plus three dimensional conformal radiotherapy for local advanced pancreatic cancer

Objective: To evaluate the clinical effect of transarterial infusion chemotherapy of gemcitabine plus three dimen- sional conformal radiotherapy on patients with local advanced pancreatic cancer. Methods: Fifty-one patients with local ad- vanced pancreatic cancer from June 2002 to February 2004 were enrolled, twenty-four patients of combined group were treat- ed with transarterial infusion chemotherapy of gemcitabine plus three dimensional conformal radiotherapy, while twenty-seven patients of control group were treated only with transarterial infusion chemotherapy of gemcitabine. Results: There were significant statistical differences between two groups in clinical benefit response (91.7% versus 74.1%, P < 0.01) and overall remission rate (70.8% versus 33.3%, P < 0.01). The 6-month survival rate, 12-month survival rate and 24-month survival rate of combined group were 83.3%, 62.5% and 37.5% respectively, while that of control group were 55.6%, 33.3% and 11.1% respectively. This showed significant difference between the two groups. Conclusion: Transarterial infusion chemotherapy of gemcitabine plus three dimensional conformal radiotherapy may be better than single transarterial infusion chemotherapy of gemcitabine in improving survival rates and elongating survival time of patients with local advanced pancreatic cancer.

Clinical Observation on Physiological and Psychological Effects of Eight-Section Brocade on Type 2 Diabetic Patients

Objective： To observe the physiological and psychological changing of type 2 diabetic patients after practicing Eight-Section Brocade, to evaluate the clinical curative effect, and to provide a safe and effective self-regulating method for type 2 diabetic patients. Methods： This study is a random controlled trial, the 54 type 2 diabetic patients were randomly assigned into the intervention and the control group. The intervention group was given a 2-month period of Eight-Section Brocade practice, then a comparison between groups was made. The intervention group continued to do Eight-Section Brocade practice for 2 months, so it was 4 months＇ intervention all together for this group, and then a comparison within the intervention group was made. Results： There was significant difference 4 months later on HbAlc in the intervention group （P〈0.05）. There was significant difference between the intervention and control groups on obsessive-compulsive, depression, anxiety and hostility scores after 2 months＇ practice （P〈0.05）. There was significant difference between 2 and 4 months＇ practice on hostilities scores within the intervention group （P〈0.05）. Conclusions： As an important part of the traditional Chinese medicine, Eight-section Brocade has physiological and psycholozical effects on type 2 Diabetic Patients.

A case of long survival in poorly differentiated small cell carcinoma of the pancreas

Small cell carcinoma (SCC) of the pancreas is rare. It has similar histological features to pulmonary small cell carcinoma and is equally aggressive. Most patients with SCC in the pancreas reported in case studies died within 1 year after diagnosis. We present a case of unusually long-term survival after surgery and combined chemotherapy for SCC of the pancreas. A 62-year-old woman presented with epigastric pain and jaundice. Computed tomography revealed dilated common bile duct caused by external compression of the mass in the pancreatic head. Exploratory laparotomy and pancreaticoduodenectomy (PPPD) was performed with histopathological analysis confirming a primary small cell carcinoma of the pancreas. After an uneventful postoperative recovery, the patient was treated with 6 cycles of combined chemotherapy consisting of cisplantin and ectoposide. During the follow-up, there was no evidence of recurrence and the patient has remained in a good health condition for 36 mo since the diagnosis.

STAT3 as a target for inducing apoptosis in solid and hematological tumors

Studies in the past few years have provided compelling evidence for the critical role of aberrant Signal Transducer and Activator of Transcription 3 （STAT3） in malignant transformation and tumorigenesis. Thus, it is now generally accepted that STAT3 is one of the critical players in human cancer formation and represents a valid target for novel anticancer drug design. This review focuses on aberrant STAT3 and its role in promoting tumor cell survival and sup- porting the malignant phenotype. A brief evaluation of the current strategies targeting STAT3 for the development of novel anticancer agents against human tumors harboring constitutively active STAT3 will also be presented.

Analysis of Cardiotoxicity from rh-Endostatin Therapy Combined with Chemotherapy

OBJECTIVE To evaluate the cardotoxicity from recombinant human endostatin(rh-endostatin)combined with chemotherapy. METHODS A total of 12 cancer patients treated with rh- endostatin combined with chemotherapy were selected,and their clinical data collected.Their symptoms,including cardiopalmus, chest distress,dyspnea and changes in their electrocardiogram (ECG),myocardium enzymogram and left ventricular ejection fraction(LVEF),were observed during the drug treatment.These indicators were used for early diagnosis of cardiotoxicity. RESULTS Compared with a pre-therapeutic value,there was a significant increase in the CK-MB value at one week after starting the treatment as well as at the end of treatment(P<0.05).There was a significant change in the ECG at the end of treatment, compared to a pre-therapeutic condition(P<0.05),but there was no significant difference when comparing the pre-and post- therapeutic LVEF values. CONCLUSION It was recognized that mild cardiac adverse reactions exist in the regimen of recombinant human endostatin combined with chemotherapy.This therapy caused definite injury to the cardiac muscle,but cardiac functions were not obviously changed.CK-MB and ECG may be used as indicators for early monitoring cardiac toxicity.Vigilance against cardiac adverse reactions should be heightened during a course of rh-endostatin combined with chemotherapy.