中医理论博大精深,这里只讨论阴阳理论在细胞光生物调节作用(photobiomodulation,PBM)中的应用。中医阴阳理论非常古老。可喜的是在有名的Cell、Science和nat Cell Biol等杂志上已经有学者应用阴阳概念讨论细胞。有人更将阴阳与氧化和抗氧化联系起来,认为阳代表氧化,阴代表抗氧化,阴阳平衡对应于氧化与抗氧化的平衡。遗憾的是中医阴阳研究的对象是人体或脏腑,而上述阴阳概念的现代应用对象则是在细胞水平。这中间需要一个过渡才能将中医的阴阳规律应用到细胞水平上。在充分开展中医理论与过程哲学比较研究的基础上,刘承宜等人引入过程发生难度(degree of difficulty,DD)定义了DD阴阳概念:对于两个相关的过程,DD较小的称为阳,DD较大的过程称为阴。对中医的研究对象,DD阴阳与中医阴阳一致。本文用DD阴阳重新表述了中医阴阳规律,并用于讨论细胞PBM。阴平阳秘的流行观点是阴阳平衡,只有祝世讷等人将其理解为中医研究对象的阴和阳都处于最佳状态。本文的研究支持祝世讷等人的观点,细胞的阴平阳秘对应于细胞的功能内稳态。PBM调节细胞阴阳的最终目的是使细胞处于阴平阳秘的状态,因此,PBM对处于功能内稳态的细胞无效。细胞的DD阴阳可以根据细胞信号转导通路或细胞功能来定义。低强度的单色光或激光(low intensity monochromatic light or low intensity laser irradiation,LIL)的DD阴阳依赖于LIL的剂量。研究表明,阴阳平行原理、阴阳拮抗、阴阳转换和阴阳互补等阴阳原理对细胞是成立的。细胞PBM的DD阴阳原理与PBM的生物信息模型(biological information model of PBM,BIMP)一致。BIMP陆续得到可见光(Duan et al 2001,Shefer et al 2001&2003,Gao et al 2006)、长波紫外(320-400nm)(Bode et al 2003)和短波红外(700-1000nm) (Schieke et al 2002)的实验的直接支持和细胞水平PBM实验的间接支持。
Objective: To examine the association between patterns of outof-school care o ver time and the initiation of sex among young adolescents living in low-income urban families. Design: A prospective cohort study (using a...
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Objective: To examine the association between patterns of outof-school care o ver time and the initiation of sex among young adolescents living in low-income urban families. Design: A prospective cohort study (using a 16-month follow-u p) examining the predictive value of changes in out-of-school-care arrangemen ts on early sex initiation. Setting and Participants: By using a multistage stra tified area probability sampling strategy, we selected 494 subjects aged 11 to 1 3 years living in low-income central city neighborhoods who did not report havi ng had sexual intercourse by time *** Outcome Measure: Adolescent report of having had sexual intercourse by time ***: Bivariate results suggested th at being at home with an adult during out-of-school hours was related to less sex initiation than self-care, care at another person’s home, and attendance a t an organized/supervised activity. Adjusting for demographic attributes, parent al monitoring, parental curfews, and family routines, remaining in out-of-home care or selfcare was associated with a 2.5 times (95%confidence interval, 1. 3-5.1 times) increase in the likelihood of initiating sexual intercourse when compared with being at home with an adult at both assessment times. Conclusion: Policies and programs that enable young adolescents to spend their out-of-scho ol hours at home with an adult may help reduce the risk of early sex initiation among youth in low-income urban areas.
Background and Purpose:There is evidence of unequal access to health care int erventions even where universal health systems operate. We investigated associat ions between patients’sociodemographic characteristics an...
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Background and Purpose:There is evidence of unequal access to health care int erventions even where universal health systems operate. We investigated associat ions between patients’sociodemographic characteristics and the provision of acu te and longer-term stroke care in a multiethnic urban ***:We us ed data from 1635 patients with first-ever stroke, collected by a population-b ased stroke register from 1995 to 2000. Using multivariable analyses, controlled for sociodemographic and clinical factors, we investigated access to 22 evidenc e-based components of care. Results:1392 patients(85.1%) were admitted to hos pital; of these, 354 (25.4%) were admitted or transferred to a stroke unit. Of those with clinical need, 607 (70.7%) received physical therapies; 477 (59.8%) received speech and language therapy. Older age was associated with lower odds of hospitalization (odds ratio [OR], 0.50; 95%CI, 0.32 to 0.77, P=0.02) and dia gnostic brain imaging (OR,0.15; 95%CI, 0.08 to 0.30, P ng physical therapy (OR, 4.24;95%CI, 1.22 to 14.73,P nicity was associated with higher odds of stroke unit admission (OR, 1.59; 95% CI, 1.01 to 2.49, P n between socioeconomic status and admission to hospital and stroke unit. Gender was associated only wit h treatment of hypertension before stroke. Conclusions:Provision of individual components of care over 1 year varied for specific sociodemographic categories, but there was no consistent pattern of in equality. Clinical decision-making pr ocesses are likely to influence these patterns. Further information about clinic ian and patient roles in decision making is required.
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