Depressed people who display "risky behaviour", agitation and impulsivity are at least 50% more likely to attempt suicide, a study has found.

Research by the European College of Neuropsychopharmacology (ECNP) concluded that the behaviour patterns "precede many suicide attempts".

The study said effective prevention measures were "urgently needed".

The World Health Organisation estimates that there were more than 800,000 suicides worldwide in 2012.

The ECNP study evaluated 2,811 patients suffering from depression, of whom 628 had previously attempted suicide.

Researchers "looked especially at the characteristics and behaviours of those who had attempted suicide", and found that "certain patterns recur" before attempts.

They said the risk of an attempt was "at least 50% higher" if a depressed patient displayed:

• risky behaviour" such as reckless driving or promiscuous behaviour
• psychomotor agitation" such as pacing around rooms or wringing their hands
• impulsivity - defined by the researchers as acting with "little or no forethought, reflection, or consideration of the consequences"

Dr Dina Popovic, one of the report's authors, added: "We found that 'depressive mixed states' often preceded suicide attempts.

"A depressive mixed state is where a patient is depressed, but also has symptoms of 'excitation', or mania."
 
Michael Mansfield QC, whose daughter Anna took her own life earlier this year, said her death came "out of the blue".

He said she had two children and a successful career, and no one suspected she was at risk of suicide.

Speaking about the new research, he said: "We want to know more. We want somebody to correlate all this and make sense of what seems like a senseless situation.

"So I would welcome anybody who's spent the time and bothered to assemble the pattern of behaviour because in Anna's case there was a pattern of behaviour and I for one didn't really spot it."

'Indicators'

Paul Farmer, of mental health charity Mind, said 6,000 UK people a year take their own lives - and "we don't know enough about why that happens".

He said the ENCP research had an "important message" about the "indicators that people should look out for" if they are worried about someone.

Factors already established included people being very withdrawn or very anxious, he said.

The study's findings are being presented at the ENCP conference in Amsterdam on Sunday.
 
中文翻译：
本文地址：http://www.wjbb.com/know/1219
原文出处：http://www.bbc.com/news/health-34101608 收起阅读 »

荷兰的研究表明，晚上酗酒后扫荡一空你的冰箱或喝数杯水不会改善第二天的头痛。

相反，一项研究得出结论，防止宿醉唯一的办法是少喝酒。

超过800名学生被询问是如何试图缓解宿醉症状，食物和水都未发现有任何积极的作用。

这项调查结果在阿姆斯特丹的一个会议上被汇报。

来自荷兰和加拿大的国际研究团队调查了学生的饮酒习惯，以找出宿醉是否可以被缓解或是否有人能不受影响。

826荷兰学生中， 54%饮酒后会吃东西，包括含脂肪的食物和大份的早餐，希望能避免宿醉。

出自同样的目的，超过三分之二的学生会在喝酒的同时喝水，而超过一半的同学会在睡觉前的喝水。

虽然与没喝水的学生相比，喝了水的学生表现出轻微的改善，但他们的宿醉的严重程度并没有实质性的区别。

以前的研究发现，大约25%的人宣称自己从来没有宿醉。

因此研究人员询问789名加拿大学生前一个月的饮酒以及宿醉情况，发现没有宿醉的首位原因是“消耗酒精的量不足以引起宿醉”。

那些酗酒，血液酒精浓度估计超过0.2%的学生中，几乎没有人能幸免于宿醉。

据来自乌特列支大学的第一作者Dr Joris维斯特认为，关系很简单。

“你喝的越多，你就越有可能宿醉。

“饮水可能有助于防止口干舌燥，但它不会带走痛苦，头痛和恶心。”

“无药可治。”

维斯特博士说，问题的一部分是科学家们仍然不知道是什么原因引起的宿醉。

“研究得出的结论是，这不是一个简单的脱水，我们知道免疫系统是参与的，但在我们知道引起它的原因之前，不大可能找到一种有效的治疗方法。”

他说，下一步是对宿醉进行更多的对照试验。

伦敦大学学院的Michael Bloomfielf博士说，酒精滥用的经济成本每年达到数百亿欧元。

"因此，回答简单的问题很重要，如‘你如何避免后遗症？’”

“虽然还需要进一步的研究，这项新的研究告诉我们，答案很简单——少喝酒。”

 本文在欧洲神经精神药理学学院的会议上被发布。

中文翻译：米小胖
本文地址：http://www.wjbb.com/know/1218
原文出处：http://www.bbc.com/news/health-34072712 收起阅读 »

Story highlights

• A regular 6-foot-tall man living with his child gained an average of 4.4 pounds, after being a father for the first time, the study says
• For "nonresident" dads, who lived in a different house than their child, the average weight gain was 3.3 pounds
• Change in BMI for nonfathers was attributed solely to age, says the study

 
(CNN)When John Kinnear's wife became pregnant, her boss warned the soon-to-be father that he gained 10 pounds for every child he'd had."I shook it off at the time, and now here I am two kids and 25 pounds later," Kinnear said. It's a good thing we're done having kids!"

Kinnear, who writes the "Ask Your Dad" blog, may have been personally surprised by his path to extra pounds, but a study shows he's not the only dad with such an experience.

A new study released in the American Journal of Men's Health analyzed the BMI of more than 10,000 men from adolescence into their mid-30s through data collected from the National Longitudinal Study of Adolescent Health. By comparing three groups -- nonfathers, resident fathers (who live with their children) and nonresident fathers — researchers from Northwestern Medicine discovered the dad groups showed an increase in BMI between adolescence and fatherhood.

In fact, a regular 6-foot-tall man living with his child gained an average of 4.4 pounds after becoming a dad for the first time, according to the study. There was only a slight difference for the nonresident dads. Those fathers gained, on average, 3.3 pounds.

Meanwhile, nonfathers lost 1.4 pounds over the same period.

The results were surprising to the study's lead author, Dr. Craig F. Garfield, especially given his earlier research that fatherhood motivated men to improve their health habits.

"Regardless of what kind of father you were," Garfield said, "Your weight actually increased. So all fathers ended up increasing their weight as they go through fatherhood." Garfield serves as associate professor of pediatrics and of medical social sciences at Northwestern University Feinberg School of Medicine and attending pediatrician at Ann & Robert H. Lurie Children's Hospital of Chicago.
 
The study accounted for factors such as race, education, income and screen time as well as marriage status, which has been shown to affect weight. Though all the young men's BMI showed an increase over time due to age, additional weight gain was shown to be contingent on fatherhood status, according to the study.
 
The study only speculates why fatherhood leads to extra pounds. But Garfield's noted his weakness for finishing his kids' leftover frozen pizza.

Kinnear was not surprised by the study. "I have so many more priorities as a father than I did before I had kids," said Kinnear. "I love to cook and eat healthy, but when it comes to compromises on time I will trade a healthy meal for more time with my kids every time."

While Kinnear admitted it's a common struggle among his friends, it's about accepting a "new normal," for Adrian Kulp, author of the "Dad or Alive" blog. Kulp is a stay-at-home dad to Ava, age 5, Charlie, 4, and Mason, 18 months.

"When you have your first child," Kulp said, "they are your priority. You put everything else on hold, which sometimes means working out and staying active."

He's gained a little "sympathy weight" he added, but Kulp said it's more about a lifestyle change than any extra snacking. Sometimes it's hard to wake up for a 5:30 a.m. run, he said, if the kids get to bed late.

But there's very little literature on how fatherhood influences male health, according to Kermyt G. Anderson, who co-wrote the 2012 book "Fatherhood: Evolution and Human Paternal Behavior," with Peter B. Gray.

Anderson said the new study might be a bit skewed given its narrow age range, which doesn't account for changes past early fatherhood, but overall, the research is interesting because it really pinpoints fatherhood as a contributor to weight gain, isolated from other factors.

"It's common sense in a way," said Anderson, who is an associate professor at the University of Oklahoma's department of anthropology and not affiliated with the study. The study doesn't track lifestyle changes such as decreased physical activity and eating, he said, but those behaviors would affect fathers living with children slightly more, which may account for the difference in weight gain between resident and nonresident dads.
 
"It's not the biology of fathering a child," Anderson said. "It's after you have a baby. Are you living with that kid? Are you getting up in the middle of the night? Are you spending time with the kid instead of going to the gym?"

"It certainly echoes my own experience," Anderson added, and said there was much less time for eating healthy once he became a dad. He himself has had to work off the 30 pounds he gained since fatherhood.

That connection — and the fact that obesity is on the rise -- calls for a greater conversation around young men's health, according to Garfield, who said this group tends not to regularly see a primary care physician.

As a result, pediatricians are in a good position to counsel dads about taking care of their health, according to Garfield.

"The transition of fatherhood is a magical moment," said Garfield. "We need to find a way to engage men for their improved health," he added, including having doctors and the health care system be there in such a transitional period of their lives.

"It's a two for one," according to Garfield, who explained the importance of fathers setting the precedents for healthy behaviors. "By helping a father take care of himself, he ends up role-modeling for his children."
 
中文翻译：
本文地址：http://www.wjbb.com/know/1217
原文出处：http://edition.cnn.com/2015/07/21/health/fatherhood-makes-you-fat/index.html
文献下载：http://jmh.sagepub.com/content/early/2015/07/21/1557988315596224.full
  收起阅读 »

红肉、白肉是研究人员为了分析不同颜色的肉类对健康的影响而分的。关于红、白肉如何区分有三种不同的方法。第一种方法是按照肉做熟后的颜色区分，红色即为红肉，白色即为白肉；第二种方法按是否为哺乳动物来分，是哺乳动物则为红肉，不是则为白肉；第三种则按肉类中肌红蛋白的含量来分，多就是红肉，少就是白肉。

其实，第一种按照肉做熟后的颜色这种方法并不十分完善，例如三文鱼的肉做熟前就是红色的，但它属于白肉。做熟前的猪肉是红色的，但做熟后会变成白色，但猪肉还是属于红肉；虾、蟹加热后会变成红色，但还是属于白肉。所以大家了解一下大体的分法就行了，不必去钻牛角尖。

人类的血液是红色的，这主要和血液中的红细胞有关，而红细胞的红色是因为含有血红蛋白，血红蛋白的组成成分之一就是铁，血红蛋白把氧运送到身体的各个部分。同样的道理，红肉的颜色主要是由于哺乳动物肉中含有肌红蛋白。肌红蛋白是一种蛋白质，它的组成成分之一也包括铁，肌红蛋白能够将氧传送至动物的肌肉中去。

有关吃红肉、白肉对健康影响的研究发现，吃红肉多的人群患结肠癌、乳腺癌等疾病的危险性会增高；研究还发现，男性吃太多红肉还会导致得前列腺各种疾病的几率加大。需要注意的是，这里说的是“吃红肉多的”，并不意味着吃点红肉就增加得病的危险。

分析吃红肉多的人得某些疾病的危险性高，这主要是因为，和白肉相比，红肉中含的脂肪多，并且其中的饱和脂肪酸多。动物脂肪主要是提供能量。能量摄入过多会增加肥胖和心血管疾病的危险，饱和脂肪酸摄入过高是导致血中胆固醇和低密度脂蛋白胆固醇升高的最强因素。

需要了解的是，不管红肉，还是白肉：
1、都含有脂肪，只是含的多还是少的问题；
2、都含有饱和脂肪酸、不饱和脂肪酸，含量也是相对的。
 
同样重量的肉中，猪肉的脂肪含量最高，羊肉次之，牛肉最低。即使在红肉的瘦肉中，脂肪的含量也不少。鸡、鸭肉中的脂肪含量也较低，不饱和脂肪酸含量较高。鱼类中的脂肪含量一般较低，并且含有较多的多不饱和脂肪酸，深海鱼类中富含EPA和DHA，对预防血脂异常和心脑血管病有一定作用。

既然是这样的情况，是不是红肉就完全不能吃了？我们反复强调过，每类、每种食物都有它的营养含量特点，没有一种天然的食物中含的营养物质能满足身体所有的营养需要。红肉的脂肪偏多，但是红肉中富含矿物质尤其是铁、锌，并且容易被人体所吸收、利用，还有丰富的蛋白质、维生素（B1、B2、A、D）等。过量吃不利于健康，建议适量吃。中国营养学会推荐成年人每天吃动物性食物的量：鱼虾类50～100克（1-2两），畜禽肉类50～75克。

对于那些吃肉偏多的居民，特别吃猪肉过多的，应注意调整，尽量多吃鸡、鸭、鱼肉。还有一些人平常吃动物性食物的量还不够，应适当增加。
 

本文作者：马冠生
本文地址：http://www.wjbb.com/know/1216
原文出处：http://weibo.com/p/2304185d5947690102wsza 收起阅读 »

Sharing childcare makes for happier couples with better sex lives, US research suggests.

In a study of 487 families, parents who split childcare duties evenly reported greater satisfaction, both sexually and emotionally.

But in couples where the woman did most of the childcare, both men and women reported being less content.

The researchers said men doing a greater share of childcare did not have the same impact.

The conclusions have been drawn from a study called the 2006 Marital and Relationship Study, which was a survey into marriage and relationships among heterosexual couples.

Who does the childcare?

The data, being presented at a meeting of the American Sociological Association, shows that couples where the women performed more than 60% of childcare - specifically in terms of rule-making, praising and playing - fared the worst on scores of relationship satisfaction and conflict, as well as being less happy about the quality of their sex life.

The study leader, Dr Daniel Carlson, an assistant professor of sociology at Georgia State University, said: "One of the most important findings is that the only childcare arrangement that appears really problematic for the quality of both a couple's relationship and sex life is when the woman does most or all of the childcare."

The team found that fathers could in fact take on most or all of the childcare responsibilities without negatively affecting the quality of the couple's relationship.

The study did not look at who performed tasks such as feeding and bathing the children.

The academics are planning more research into why those couples with more equal childcare responsibilities seem to have better relationships.

"We are trying to understand what is it about sharing that couples view so positively," Dr Carlson added.

The 'new man'

Prof Sir Cary Cooper, an expert in organisational psychology and health at Manchester Business School, said the findings made sense, but they might reveal more about the kind of couples who shared their responsibilities.

"If you have a 'new' man who is happy to share childcare, he probably invests more in the relationship anyway," he said.

He added that it was becoming increasingly acceptable for men to opt for more flexible working and to take on more of the responsibility for family and domestic life.

"Increasingly there's a lot of pressure on men who wouldn't normally do that - the question is would that make a difference in the relationship. I think it could do."

The 487 couples in the study were selected at random and included low-to-moderate income couples who had children living with them and where the woman was under 45 years.

A total of 605 couples were interviewed, but the researchers only included in this study those where both partners had completed the full survey.
 
中文翻译：
本文地址：
原文出处：http://www.bbc.com/news/health-34017916 收起阅读 »

多年来，张琳达和丈夫一直想要一个孩子，但是她却一直怀不上，这让他俩都很伤心。她试着联系中国的非法代孕市场，但是因为可能面临巨大风险，最终她搁置了这一想法。

“此后我从朋友那里得知，美国的代孕法律更健全、医疗程序更正规，所以我想到美国去找代孕妈妈。”她说。

14个月后，张女士和丈夫带着刚出生的儿子回到了上海。

张女士的故事只是一个缩影。近年来，越来越多的中国家庭在美国寻找代孕妈妈，代孕妈妈俨然已经成了一个横跨两大洲的高利润产业。

“我从没有看到过像中国人这样疯狂的客户。”来自波士顿的一家代孕机构的约翰·维尔特曼说，“注册代孕的中国客人爆炸式地增长。”

借美国人腹生子让中国人有效地规避了中国严苛的生育政策。在中国，代孕是不合法的。尽管近年来中国的生育政策有所松动，但是一个家庭如果存在超生现象，依然要面临处罚。

另一个重要的推动因素：在美国出生的孩子天然地拥有美国国籍，当孩子长到21岁时，他可以成为父母的担保人，帮父母获得美国绿卡。

当前美国社会对于出生公民权存在争论，代孕机构则表示他们在进行代孕之前会对申请人进行严格的审核，并要求申请夫妻阐述寻求代孕的医疗原因。

代孕的好消息在中国传开

在美国，张琳达选择了Extraordinary Conceptions进行代孕。Extraordinary Conceptions是一家帮助客户寻找医生、咨询律师以及代孕妈妈的代孕机构。维尔特曼表示，有的夫妻能够用自己的精子和卵子完成代孕，而有的夫妻则需要寻找配子捐献者，中国的夫妻更倾向于寻找华裔或者是有着其他亚裔人种背景的捐献者。

整个代孕流程一般需要持续15个月，期间需要夫妻双方前往美国数次。代孕手术总共花了张琳达13万美元，这一价格与其他代孕机构基本持平。加上其他的花费，完成一次代孕的费用可能高达15万美元。

Extraordinary Conceptions已经完成了数百例中国夫妇的代孕计划，同时几乎每个月都能接到10个来自中国的代孕咨询。该机构40%的客户是中国人，集团甚至已经招聘了5个中国人来应对中国人高涨的代孕热情。

“正如其他的事情一样，一旦有人发现了什么好东西，消息就不胫而走。中国人意识到他们还有别的选择。”Extraordinary Conceptions主管马里奥·卡巴雷若说。

加州梦

中国夫妇手持旅游签证来到美国，旅游签证同样能够覆盖美国的医疗服务。很多夫妇选择在加州进行代孕，因为加州的法律对于非亲生父母的权利更友好。

孩子一出生，夫妻双方可以把自己的名字——而不是代孕妈妈的名字——写在孩子的出生证上。在其他州，这一流程要复杂得多。

“孩子的所有官方证明都显示我们就是父母——只要我们不说，没有人会知道我们进行了代孕。”张女士说，“不过，我们的家人和朋友都知道，他们也很为我们高兴。”

张琳达和丈夫也开始经营起了一家自己的代孕中介。他们帮助中国夫妇在美国联系代孕机构，翻译官方文件以及申请签证，一次要价1万5000美元。

一些来美国寻找代孕的夫妇在此前从未踏出过国门。

“人们选择代孕有各种各样的医疗原因。”已经为数百对中国夫妇进行了代孕手术的大卫·斯姆特里克医生表示，有些是因为女方的身体条件不允许，怀孕具有高风险性；有些是同性恋家庭来寻找代孕。此外，环境污染也导致了中国家庭的不孕不育率越来越高。

东方遭遇西方

雇佣美国代孕妈妈势必会产生语言和其他文化问题。

比如，有的夫妇想要把中医或者是一些传统的观念强加到代孕妈妈身上，而美国人是绝对不会这么做的。

江托尼和妻子通过代孕已经有了三个孩子。当时，他对美国女人在怀孕时的生活方式十分吃惊。中国的准妈妈在怀孕时会被要求好好休息，吃特制的传统饮食进行调理。而在通常情况下，美国妈妈会继续工作、出行甚至进行锻炼。

江先生现在也是一家代孕中介的老板。作为日常工作的一部分，他甚至要告诉中国夫妇传统的“八字”在孩子身上并不适用。“八字”要求知道孩子出生的时间和地点，而美国比中国时间晚了至少12个小时，天上的星宿位置也不尽然相同。

对于张琳达和江托尼来说，把孩子带回中国并没有那么困难。一旦他们得到了出生证和美国护照，他们就可以回到上海。中国并不允许双重国籍。

中国政府不定期地会对非法地下代孕市场进行打击查抄，但是张女士和江先生的公司并没有受到影响。他们的孩子也没有面临法律问题，也没有被社会的孤立——尽管中国与他们的出生环境截然不同。

张女士认为原因在于“所有的代孕工作都是在美国完成的——没有一项流程是在中国做的。”

当她谈到再过几年要把孩子送到一所国际学校中去时，张女士显得很兴奋。

“现在，我们很开心。但是前些年我们吃的那些苦想是其他人难以理解的。”她说。

中文翻译：韩宏
本文地址：http://www.wjbb.com/know/1214
原文出处：http://www.jiemian.com/article/362589.html
原始出处：http://money.cnn.com/2015/08/23/news/china-us-surrogacy 收起阅读 »

Women who eat healthily before and during pregnancy may cut the risk of their baby developing a heart problem, researchers believe.

The link is suggested by a study of 19,000 women in the US who were asked about their diet in the year leading up to pregnancy.

A healthy diet was one with plenty of fresh fish, fruit, nuts and vegetables.

Pregnant women and women trying to conceive are already advised to take certain supplements.

Experts recommend folic acid to reduce the risk of other birth defects like spina bifida, and vitamin D for healthy bones and teeth.

In England, the government's Healthy Start scheme provides vouchers for pregnant women that can be used to buy milk and vegetables.
 
In the study, published in Archives of Diseases in Childhood Fetal & Neonatal Edition, half of the women had babies with heart problems while the other half did not.

When the researchers compared the diets of these two groups they found a healthier maternal diet was associated with a lower chance of congenital heart defects.

Pregnant women in the top 25% (quartile) of diet quality, had a lower risk of having a baby with certain heart defects - atrial septal defects and Tetralogy of Fallot - than those in the bottom 25%, even after accounting for other factors such as whether the mother took folic acid or was a smoker.

Congenital heart disease is one of the most common types of birth defect, affecting up to nine in every 1,000 babies born in the UK.

Mild defects, such as holes in the heart, often don't need to be treated, as they may improve on their own and may not cause any further problems. But others can be more serious and some, lethal.

In most cases, something has gone wrong in the early development of the foetus. Some heart conditions are due to faulty genes or chromosomes. But often it is unclear why the baby's heart has not developed normally, says the British Heart Foundation (BHF).

Victoria Taylor, senior dietitian at the BHF, said: "This is an interesting study which highlights the importance of diet right from the start of life.

"A healthy diet before, during and after pregnancy can have benefits for both mother and child and, as seen here, the whole diet should be taken into consideration, rather than solely focusing on individual nutrients.

"Eating well isn't a guaranteed way to avoid congenital heart defects, but this will be another factor that will motivate women planning a pregnancy to make healthy choices."
 
中文翻译：
本文地址：http://www.wjbb.com/know/1213
原文出处：http://www.bbc.com/news/health-34041375
文献下载：http://fn.bmj.com/content/early/2015/07/10/archdischild-2014-308013 收起阅读 »

处暑是二十四节气的第十四个节气，在每年阳历的八月二十三日前后。处暑的“处”是指“终止”，处暑的意义是“夏天暑热正式终止”。所以有俗语说：争秋夺暑，是指立秋和处暑之间的时间，虽然秋季在意义上已经来临，但夏天的暑气仍然未减。关于节气的变化，我们老祖宗早就进行了总结，《月令七十二候集解》写到“七月中，处，止也，暑气至此而止矣。”

处暑后，我国大部分地区雨季即将结束，将迎来秋高气爽的好天气。民间有“早立秋凉嗖嗖，晚立秋热死牛”的说法。我国素有“处暑寒来”的谚语，处暑节气处在由热转凉的转换时期，因此我们的饮食、起居也应该进行相应的调整。

随着天气转凉，很多人会有懒洋洋的疲劳感，早上不爱起，白天不爱动，这就是“春困秋乏”中所指的“秋乏”。因此要早睡早起，保证充足的睡眠时间，还要天天进行运动。处暑后的气候变得干燥，容易出现“秋燥”，在饮食上应以清淡为主，新鲜蔬菜和水果不可少，蔬果中含有大量的水分，每天吃点水果有利于防“秋燥”，梨、瓜类都是不错的选择；不宜食用辣椒等辛热食物，更不宜吃烧烤食物。

还可以通过喝粥补充水分，可以说一举多得。首先，粥大都是以米、面、杂粮为原料，符合《中国居民膳食指南》中“谷类为主，粗细搭配”的原则。其次，粥的包容性强，想来点“腥”，鸡鸭鱼肉蛋奶都可以加进去；想吃清淡的，可以加蔬菜、水果等；想“炫富”，可以加海参鲍鱼山珍海味；想“平民”，加地瓜山药土豆；还可以任意组合，很容易实现食物多样。其三，用来煮粥的杂粮，一般不需要研磨加工，谷类表层所含的维生素、矿物质等营养素和膳食纤维都会全部保留下来，避免了营养物质的流失。

处暑时节，我推荐大家煮点银耳百合莲子羹。银耳百合莲子羹的做法非常简单。把银耳用温水泡发撕成小片，莲子、百合和枸杞分别用温水泡发。将银耳煮至浓稠后，放入冰糖搅拌均匀、然后倒入莲子，盖上锅盖小火煮半小时，最后放入百合和枸杞再煮15分钟左右即可熄火。想喝凉爽的，将煮好的羹放入冰箱，口感超级赞哟！银耳、百合、莲子也可以单独和谷类食物放在一起煮成粥，不仅可以提供蛋白质、碳水化合物，还有维生素和矿物质，关键是通过喝粥补充了不少水分。
 
本文作者：马冠生
本文地址：http://www.wjbb.com/know/1212
原文出处：http://weibo.com/p/2304185d5947690102wsdx 收起阅读 »

在微信朋友圈里，大家经常会转发一些阅读量很大的“好文章”，近期就在朋友圈里看到一篇阅读量和转发量很大的文章，讲的是剖宫产后生二胎，孕4个月子宫破裂。

根据这个案例和“临床经验”，“专家”就建议：疤痕子宫再次怀孕时，如果孕囊种植在上次剖宫产切口疤痕处（切口妊娠），一旦发现就要终止妊娠。如果没有及时终止妊娠，胚胎越长越大，穿过疤痕，就会直接导致子宫破裂。到了孕晚期，胎盘深深扎进子宫，就是凶险型前置胎盘，常常要面对子宫切除，产妇死亡的结局。

“有图有真相”，有“专家”的经验，让子宫有疤痕的女性朋友心惊胆颤，让很多不明真相的一线医生群众也提高了警惕，看到剖宫产后怀孕孕囊种植在子宫下段切口就让人家终止妊娠。

其实，真正有经验的医生会知道，对于切口妊娠，终止妊娠也是很可怕的一件事情，处理不好的话，出血就像水龙头打开一样止不住。在终止妊娠前谈话时要告知切口妊娠刮宫的风险：大出血、子宫切除、生命危险。这些风险和凶险型前置胎盘终止妊娠之前的谈话一模一样：大出血、子宫切除、生命危险。

那么患者和家属可能要问了，既然切口妊娠早孕刮宫和继续妊娠凶险型前置胎盘终止妊娠的风险一样，我为什么要刮宫呢？我继续妊娠的话，足月终止妊娠我还可以晚10个月切子宫，还可以多活10个月，而且还会多一个孩子，为什么要劝我冒同样的风险在早孕刮宫呢？

------------------------ 真相分割线 ------------------------

“真相”太多了就没有了真相，“专家”太多了就会有太多的谬误。真正的“真相”是什么呢？

1.切口妊娠导致子宫自发破裂的案例是有，但是罕见，中国年分娩量超过1700万，其中大约一半的人做剖宫产。二胎怀孕的人有一半的人是疤痕子宫，出现几例的切口妊娠的自发性子宫破裂很正常。

2.孕囊种植在切口部位并不等于一定会发生植入（绝大多数不会植入），发生植入，绝大部分也不会导致自发性的子宫破裂。随着子宫的增大，大多数胎盘会逐渐长上去并离开切口的。
 
3.发现孕囊种植在切口，首先要问的问题是孕妇想不想要生这个孩子，想的话在告知风险和注意事项的前提下完全可以继续妊娠，要注意超声随访。如果是不要这个孩子，反而麻烦，反而可怕，反而要事先做好很多的准备才能刮宫。这种切口妊娠的刮宫要充分谈话告知风险，准备好输血静脉通路，备足充分的血制品，做好子宫切除的准备，甚至于要事先进行子宫动脉的插管和栓塞。

写完了，吃几根辣条压压惊……。
 
本文作者：段涛医生
本文地址：http://www.wjbb.com/know/1211
原文出处：http://weibo.com/p/1001603879283289623027 收起阅读 »

Cutting fat from your diet leads to more fat loss than reducing carbohydrates, a US health study shows.

Scientists intensely analysed people on controlled diets by inspecting every morsel of food, minute of exercise and breath taken.

Both diets, analysed by the National Institutes of Health, led to fat loss when calories were cut, but people lost more when they reduced fat intake.

Experts say the most effective diet is one people can stick to.

It has been argued that restricting carbs is the best way to get rid of a "spare tyre" as it alters the body's metabolism.

Chemical processes

The theory goes that fewer carbohydrates lead to lower levels of insulin, which in turn lead to fat being released from the body's stores.

"All of those things do happen with carb reduction and you do lose body fat, but not as much as when you cut out the fat," said lead researchers Dr Kevin Hall, from the US-based National Institute of Diabetes and Digestive and Kidney Diseases.
 
In the study, 19 obese people were initially given 2,700 calories a day.

Then, over a period of two weeks they tried diets which cut their calorie intake by a third, either by reducing carbohydrates or fat.

The team analysed the amount of oxygen and carbon dioxide being breathed out and the amount of nitrogen in participants' urine to calculate precisely the chemical processes taking place inside the body.

The results published in Cell Metabolism showed that after six days on each diet, those reducing fat intake lost an average 463g of body fat - 80% more than those cutting down on carbs, whose average loss was 245g.

Dr Hall said there was no "metabolic" reason to chose a low-carb diet.

However, studies suggest that in the real world, where diets are less strictly controlled, people may lose more weight by reducing carbohydrate intake.

Dr Hall told the BBC News website: "If it's easier to stick to one diet than another, and to ideally do it permanently, then you should choose that diet.

"But if a low-fat diet is better for you, then you are not going to be at a metabolic disadvantage."

He is now analysing brain scans of the participants to see how the diets affect how rewarding food is.

Diet claims 'debunked'

Doctors Susan Roberts and Sai Das, from Tufts University, said in a commentary that the debate around diets was a source of "intense controversy".

They said the study had "debunked" many of the claims that low-carbohydrate diets were better, but the long-term impact was still unclear.

They added: "The most important message for now is probably that some carbohydrates are all right, especially the healthy whole-grain low-glycaemic-index variety."

Prof Susan Jebb, from the University of Oxford, said: "The investigators rightly conclude that the best diet for weight loss is the diet you can stick to.

"All diets 'work' if you stick to an eating plan that cuts calories, whether from fat or carbohydrate, but sticking to a diet is easier said than done, especially given the prolonged time it takes to lose weight."
 
中文翻译：
本文地址：http://www.wjbb.com/know/1210
原文出处：http://www.bbc.com/news/health-33905745
文献下载：http://www.cell.com/cell-metabolism/abstract/S1550-4131(15)00350-2 收起阅读 »