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广东省深圳额头除皱多少钱深圳罗湖绣眉多少钱深圳市伊斯佑整形医院祛疤手术多少钱 Woman Marries Herself After Six Years OfBeing Single. Here#39;s Why...经过6年的单身生活,英女子决定嫁给自己It#39;s not your typical wedding scenario,marrying yourself.这不会是你心目中典型的婚礼场景,因为新娘将自己嫁给了自己。However it#39;s not unheard of either, asproven by Grace Gelder who is now happily married to...Grace Gelder.不过这种情况也不是前所未有,GraceGelder就幸福地将自己嫁给了自己。The reason? After a long spell of beingsingle, Grace decided that enough was enough.她为何要这么做呢?在长期单身之后,Grace确定自己已经受够了这样的日子。She#39;d built up a ;brilliant relationship; with herself and was y to commit toan ;adventurous period of self discovery; while also looking forwardto a new phase in her life.她同自己建立了“绝妙的关系”并准备投入“自我发现的冒险阶段”,同时也期望人生开启新篇章。The obvious answer following thisreflection was, of course, marriage.经过认真的思考,不言自明,当然,她需要步入婚姻殿堂。So, Grace paid a visit to Parliament Hillin London lastNovember and proposed to herself on a park bench.于是,Grace于去年11月份去了伦敦的国会山,她在一个公园的长椅上向自己求婚。After announcing her news, Grace wasslightly anxious that people would see it as a bit self-absorbed.在公布了消息之后,Grace有点担心人们会认为她有点自恋。She told The Guardian: ;Obviously, if you#39;ve just announcedyou#39;re marrying yourself, it is plainly a statement of self-love, and I wasunder no illusion how self-indulgent that might appear.;她对《卫报》说:“如果你公布要同自己结婚的话,那显然就是自恋的表现,”;But I was completely comfortable withmy motivations.;“但是我完全没有因自己的动机感到不自在”。The day itself was a humble affair, with 50guests in an ;idyllic farmhouse in rural Devon.;婚礼当天一切都很低调,50名宾客来到了位于“德文郡田园诗般的乡下农家”。The dress was vintage (snapped up a coupleof days before the ceremony) .婚纱是老式的(在举办婚礼的前几天抢购的)。Since the wedding, Grace has been told byher female friends that she#39;s an example to women. Her response?自从举办了婚礼之后,Grace的女性朋友们都说她是女性的榜样。那她对此作何反应呢?;Why not an example to men too? I reallydon#39;t see it as any kind of feminist statement, but creating a wedding of thiskind on my own terms felt incredibly empowering.;“为什么不会也是男性的榜样呢?我的确没把这看作是任何女权主义的宣言,但按照我自己的意愿举办一场这样的婚礼让我感到自己的不可思议”。Although it#39;s an unusual event, Grace isnot the first woman to marry herself.虽然这样的事情非同寻常,但Grace并不是第一个与自己结婚的女性。In 2012, Huffington Post reported that Nadine Schweigert from North Dakota had marriedherself following a painful divorce.据《赫芬顿邮报》报道,2012年,美国北达科他州的Nadine Schweigert在经历痛苦的离婚之后,自己独自举办了婚礼。Nadine told Inforum: ;I was waitingfor someone to come along and make me happy. At some point, a friend said, ;Why do you need someone to marry you to be happy? Marry yourself.;Nadine对Inforum 说:“我等待那个能让我幸福的人出现。某日一个朋友提到,;为何要嫁给别人以获得幸福?何不嫁给自己;。Additionally, 30-year-old Taiwanese woman,Chen Wei-yih married herself back in 2010.此外,30岁的台湾女子Chen Wei-yih于2010年嫁给了自己。 /201410/334629深圳市中医院做隆胸手术多少钱

深圳自体脂肪丰胸价格福田区脂肪丰胸价格 Cindy Wachenheim was someone people didn#39;t think they had to worry about. She was a levelheaded lawyer working for the State Supreme Court, a favorite aunt who got down on the floor to play with her nieces and nephews, and, finally, in her 40s, the mother she had long dreamed of becoming.辛迪·瓦肯海姆(Cindy Wachenheim)是一个人们觉得不用为她操心的人。她是个头脑冷静的律师,在州最高法院工作;也是个受欢迎的长辈,能和甥侄辈的孩子玩个不亦乐乎;在40多岁时,她终于实现了长期以来的梦想,成为一个母亲。But when her baby was a few months old, she became obsessed with the idea that she had caused him irrevocable brain damage. Nothing could shake her from that certainty, not even repeated assurances from doctors that he was normal.然而,在宝宝几个月大的时候,辛迪开始固执地认为,自己给孩子的大脑造成了不可挽回的损伤。任何事情,哪怕多位医生反复保她儿子一切正常,都无法动摇她对那一点的确信。;I love him so much, but it#39;s obviously a terrible kind of love,; she agonized in a 13-page handwritten note. ;It#39;s a love where I can#39;t bear knowing he is going to suffer physically and mentally/emotionally for much of his life.;“我很爱他,但这显然是一种可怕的爱,”她在手写的一封13页长的信中痛苦地写到,“这种爱,让我无法忍受知道他一生中的很多时候,都要饱受身体和精神/情感上的煎熬。”On March 13, 2013, Ms. Wachenheim, 44, strapped her 10-month-old son to her chest in a baby carrier and leapt to her death from the eighth-floor window of her Harlem apartment. ;I became so low,; she wrote in the 13-page outpouring shortly before she jumped, ;thinking that if I had unknowingly caused brain damage to my beautiful, precious baby, I didn#39;t want to live.;2013年3月13日,44岁的瓦肯海姆用背带把10个月大的儿子绑在胸前,从哈林区八楼的公寓窗户跳楼身亡。“我变得很低沉,”她在那封跳楼前不久一口气写成的长信中写道。“想到如果自己在无意中给我漂亮、珍爱的儿子造成了大脑损伤,我就不想活了。”Ms. Wachenheim#39;s story provides a wrenching case study of one woman#39;s experience with maternal mental illness in its most extreme and rare form. It also illuminates some of the surprising research findings that are redefining the scientific understanding of such disorders: that they often develop later than expected and include symptoms not just of depression, but of psychiatric illnesses.瓦肯海姆的故事是一个令人心痛的案例,以最极端、最罕见的形式呈现了一名女性患上产后精神疾病的经历。这个故事也阐明了一些出人意料的研究结果,这些研究结果正在重新定义对这类疾病的科学理解:它们的发展通常会比预期晚,不仅包括抑郁的症状,还包括精神疾病的症状。Now these mood disorders, long hidden in shame and fear, are coming out of the shadows. Many women have been afraid to admit to terrifying visions or deadened emotions, believing they should be flush with maternal joy or fearing their babies would be taken from them.如今,长期以来一直隐藏在羞耻和恐惧中的这些情绪紊乱,正在从阴影中走出来。很多女性一直害怕承认自己有可怕的念头,或是低落的情绪,认为自己应该陶醉在当母亲的喜悦中,或是害怕孩子会被夺走。But now, advocacy groups on maternal mental illness are springing up, and some mothers are blogging about their experiences with remarkable candor. A dozen states have passed laws encouraging screening, education and treatment. And celebrities, including Brooke Shields, Gwyneth Paltrow and Courteney Cox, have disclosed their postpartum depression.但现在,关注产妇精神疾病的倡导团体正在涌现,有些母亲十分坦率地在客中记述自己的经历。已经有12个州通过了鼓励筛查、教导和治疗的法律。波姬小丝(Brooke Shields)、格温妮丝·帕特洛(Gwyneth Paltrow)以及柯特尼·考克斯(Courteney Cox)等多位名人都透露自己曾患过产后抑郁症。Ms. Wachenheim#39;s sister, Deb, is among those breaking the silence.瓦肯海姆的黛布(Deb)便是打破沉默的人之一。;We did try to help her, but perhaps if we had been more knowledgeable about postpartum mood disorders, including the fact that postpartum depression is just one of an array of such mood disorders, we could have done something differently that would have maybe saved her life,; she wrote in an email.“我们的确尝试过帮她,但如果当时对产后情绪障碍有更多了解,比如产后抑郁症实际上只是诸多情绪障碍中的一种,我们或许就能以不同的方式做些事情,兴许就能挽救她的生命了,”她在电子邮件中写道。Cindy Wachenheim#39;s experience defied the long-held belief among doctors and experts that symptoms emerge within a few weeks after birth. She seemed fine until her son was about 4 months old, said family and friends. And as a healthy, active woman, Cindy had no risk factors that would signal a mother likely to become delusional and suicidal.医生和专家们长期以来认为,症状会在产后几星期内出现,但辛迪·瓦肯海姆的经历与这种观念相左。据辛迪的家人和朋友说,在儿子大约四个月之前,她看上去很正常。而且辛迪作为一个健康积极的女性,根本没有表现出这个母亲可能会产生妄想,甚至自杀的风险因素。;She loved life, she loved family, she was social,; said her sister-in-law, Karen Wachenheim.“她热爱生活,热爱家庭,也爱和人交往,”她的嫂子卡伦·瓦肯海姆(Karen Wachenheim)说。In fact, Cindy, long interested in women#39;s issues and social justice, had, years earlier, identified postpartum depression in Karen. ;Cindy would call at least once a day to check on me,; Karen recalled. ;She said, #39;Maybe you have postpartum; I think it#39;s past the baby blues.#39; ; At Cindy#39;s urging, Karen got therapy and medication, recovering quickly.实际上,一直关注女性问题和社会公正的辛迪,多年前在卡伦身上发现了产后抑郁症。“辛迪每天至少会打一次电话,确认我没事,”卡伦回忆说。“她说,#39;你可能是患上了产后抑郁症,我觉得不只是生宝宝后情绪不好。#39; ”在辛迪的督促下,卡伦接受了治疗并了药,很快便康复了。A Son Who Was #39;My Heart#39;“心肝宝贝”儿子Cindy grew up in Colonie, N.Y., outside Albany, where she was her high school#39;s valedictorian. She attended the State University of New York at Buffalo and Columbia Law School. She valued public service and took a job doing research and writing for judges on the State Supreme Court in Manhattan.辛迪在纽约州奥尔巴尼郊区的科隆尼长大,曾因成绩优异在高中时作为毕业生代表发言,并在纽约州立大学布法罗分校(State University of New York at Buffalo)和哥伦比亚大学法学院(Columbia Law School)就读。她重视公共务,曾在位于曼哈顿的州最高法院工作,为法官做研究并撰写文件。When her mother became ill with leukemia, and later her father with lung cancer, Cindy would travel upstate to go to their medical appointments with them. When her siblings or their children had medical checkups, Cindy jotted the dates in notebooks, and called the night before to remind them to fill her in.当母亲患上白血病,后来父亲又患上肺癌时,辛迪会去纽约州的北部,陪同父母就诊。当兄弟或是他们的孩子体检时,辛迪会在笔记本上记下日期,并在前一天晚上打电话,提醒他们要把最新情况告诉她。;I think she even kept all those books too, in a shoe box,; said her brother, Ron. ;People collect stamps; she collected that stuff.;“我想她甚至保存着所有这些本子,放在一个鞋盒里的,”哥哥罗恩(Ron)说。“别人集邮,她收集的却是这些东西。”She married at 40, and she and her husband underwent fertility treatment. She miscarried twice. But family and friends said that while mourning those losses and dealing with fertility hormones, she remained hopeful, noting that doctors said it was a good sign she had been able to become pregnant.辛迪结婚时40岁,夫妇俩都接受过生育治疗。她小产过两次,但家人和朋友表示,尽管经历了流产之痛,还要调节生育激素,但她仍很乐观,还说医生表示,她还能怀就是个好兆头。;She just thought that she#39;s going to keep trying and take each step as it came,; said a longtime friend, Julie Knapp.“她只是觉得要不断尝试,每次机会到来时都要抓住,”多年好友朱莉·纳普(Julie Knapp)说。Experts say little evidence links fertility treatment to postpartum mental illness; indeed, becoming pregnant may bring more joy than stress. Still, Wendy N. Davis, the executive director of Postpartum Support International, said some women experience cumulative stress from ;fertility treatments, many losses, and the very, very high expectation she will enjoy this new baby.;专家称,鲜有据表明产后精神疾病与生育治疗有关;的确,怀可能会带来更多的喜悦,而非压力。然而,产后持国际组织(Postpartum Support International)的执行董事温迪·N·戴维斯(Wendy N. Davis)表示,某些女性会因“生育治疗、多次流产,以及十分十分期望自己会喜欢新生的宝宝”而导致压力累积。Eventually, Cindy was able to conceive and have an uneventful pregnancy, her only out-of-the-ordinary response being a tendency to be hyperaware of whether the fetus was kicking.终于,辛迪成功怀了,而且怀期间一切平安。唯一不寻常的反应似乎是,她常常极其在意胎儿有没有在踢她。Cindy gave birth normally and adored her son, often calling him ;my heart.;辛迪顺利生产,并且非常喜欢自己的儿子,常常称他为“我的心肝宝贝”。;Not unlike a lot of high-achieving women, she was somewhat of a perfectionist, and she also wanted to be the perfect mother,; Deb said. Still, she was pretty easygoing in the first months of her son#39;s life, even when she had to introduce formula early because she produced too little breast milk, Deb said.黛布说,“和很多优秀女性一样,她有些完美主义,而且想当一个完美的母亲。”但黛布表示,在生下儿子的最初几个月里,她还是很放松的,即便在因为母乳不足,而不得不早早地给孩子喝配方奶粉时也一样。But when her son was 4 months old, Cindy emailed Deb that he was making ;strange/jerky movements w/his right arm,; almost ;flapping like a wing.;但在儿子四个月大时,辛迪给黛布发电子邮件说儿子正在“用右手做些抽筋似的奇怪动作”,就像“在扇翅膀”。The pediatrician said it was nothing to worry about, but Cindy scoured the Internet for diagnoses. She fixated on an instance a few weeks earlier, in August when, while washing clothes, she briefly left the baby on a play mat on the floor. He fell while pushing up, hitting his head.儿科医生说完全不用担心,但辛迪却在网上四处搜寻资料自行诊断。她对数周前发生的一件事耿耿于怀。那是在8月,在洗衣时,她暂时把孩子放在了游戏垫上。宝宝在往起爬时跌倒了,碰到了头。She believed this minor episode had caused him severe neurological problems: seizures, autism, concussion. She blamed herself for leaving the room, for placing the play mat on the hardwood floor. Other incidents alarmed her, and she decided he was more irritable, smiling less.她认为这次小小的意外给他的神经系统造成了严重的问题:癫痫、自闭症和脑震荡。她怪自己离开了房间,怪自己把游戏垫放在了硬木地板上。其它一些事情也使她感到不安。她确信孩子变得更烦燥了,也笑得少了。She visited two pediatric neurologists. Then she saw an expert in cerebral palsy because her son did not always exhibit the Landau reflex, a Superman-like pose babies make when held aloft, stomach-down.辛迪去见了两位儿童神经科医生,后来还去看了一位大脑性麻痹领域的专家,因为儿子并不总是能做出兰多反射(Landau Reflex)——被腹部朝下抱起时,婴儿通常会做出这个像超人一样的姿势。In October 2012, when her son was 5 months old, she emailed a doctor she had seen that day: ;When you said babies can#39;t injure their brains from even several floor-level head hits on a wooden floor, did that include hits even if they are turning and hit back or side of head on the floor?;2012年10月,儿子5个月大,她给当天见过的一名医生发电子邮件询问:“你说,宝宝哪怕是头在木地板上磕了好几下也不会伤到大脑,这种情况包括他们在转身时后脑勺或脑袋两侧撞到地板上吗?”The doctor replied: ;That#39;s right. Little bumps on the head at floor level that a baby may cause themselves in the course of normal spontaneous movements would not cause any injury. Babies are really very hardy (thank goodness)!;医生回复:“是的。宝宝在地板上自发进行正常活动时,可能会导致头部受到轻微碰撞,但这不会造成任何损伤。宝宝真的很结实(谢天谢地)!”Cindy sent the doctor a of her son, noting that ;he almost always moves the right hand when holding a toy, reaching to grab something, etc.;辛迪又把儿子的一段视频发给了那名医生,称“他在拿玩具、伸手抓东西或做其他事情时,几乎总是用右手”。The doctor responded: ;All of his movements look like normal, age-appropriate movements to me.;医生回复:“在我看来,你儿子的所有举动都很正常,都和他的年龄相符。”Her siblings assured her that their children had made similar movements, but she was implacable. Without telling her sister, Deb called the pediatrician, who said she was also concerned about Cindy. Deb said Cindy#39;s husband worried too, although ;part of him said: #39;Maybe she#39;s right. She is smart and was with the baby all the time.#39; ;辛迪的兄弟安慰她说,他们的孩子也曾有过类似的动作,但这还是无法缓解辛迪的忧虑。黛布瞒着,偷偷给那名儿科医生打了电话。医生表示她也对辛迪有所担心。黛布说,夫也有忧虑,不过“他同时认为:#39;或许她是对的。她很聪明,而且时刻都和孩子在一起。#39;”Still, both Cindy#39;s husband and siblings urged her to seek therapy.但辛迪的丈夫和兄弟还是敦促她接受治疗。;I just really want you to see someone,; Deb emailed Cindy. ;You cannot continue like this, for your sake and for his sake.;“我真的想让你去看看医生,”黛布给辛迪发邮件。“为了你自己,也为了你儿子,不能再这样下去了。”Cindy agreed, but insisted that she had no postpartum mental illness. She told her family she was simply depressed because of the harm she had done to the baby.辛迪同意了,但坚称自己没患产后精神疾病。她告诉家人,只是因为给宝宝造成了伤害而觉得郁闷。;You can hardly imagine how it feels to strongly believe he has brain damage and that I caused it,; she emailed Deb. ;It must be one of the top one or two nightmares for any parent. iloveyou, cindy.;“你几乎想象不到这种感觉是什么样子,我强烈地觉得他有大脑损伤,而且是我造成的,”她给黛布发邮件说。“对任何父母来说,这肯定都是数一数二的恶梦。爱你的辛迪。”Consumed With Worry忧心忡忡Experts say such breaks from reality are likely symptoms of postpartum psychosis, which affects only one or two in 1,000 mothers. About 4 percent of those hurt their children; about 5 percent kill themselves. Flagrant cases usually emerge soon after birth; women may hear voices or feel compelled to inflict harm, like Andrea Yates, who drowned her five children in a bathtub in 2001, or Dena Schlosser, who in 2004 cut off her infant#39;s arms. Both women were ultimately found not guilty by reason of insanity.专家表示,这类与现实的脱节,很可能是产后精神病的症状。产后精神病的发病率只有千分之一到千分之二。在那些患病的母亲中,约有4%的人会伤害自己的孩子;大约5%的人会自杀。骇人听闻的案例通常出现在母亲生下孩子后不久;产妇可能会出现幻听,或者有去制造伤害的冲动,比如2001年将自己的五个孩子淹死在浴缸里的安德烈娅·耶茨(Andrea Yates),以及2004年砍掉婴儿双臂的德娜·施洛瑟(Dena Schlosser)。这两位母亲最终都因精神失常被判无罪。;More subtle forms of psychosis are going to be picked up later,; said Dr. Katherine Wisner, a professor of psychiatry and obstetrics at Northwestern University. These women ;tend to have prolonged delusional thinking: #39;there#39;s something really wrong with my baby.#39; ;西北大学(Northwestern University)的精神病学和产科学教授凯瑟琳·威斯纳(Katherine Wisner)说:“不那么典型的产后精神病会较晚出现症状。”这些女性“往往会出现长期错觉:#39;我的孩子真的有问题#39;”。Most other maternal mood disorders do not involve such unshakably unrealistic convictions; most women know something is wrong, and although they fear they will harm their children, they rarely do.大部分其他产后情绪障碍都不会出现这类不切实际到不可动摇的坚定想法;大部分女性知道出了问题,而且尽管害怕自己会伤害到孩子,但她们很少真的那么做。At Thanksgiving in 2012, Cindy#39;s family gathered at her brother Ron#39;s home outside Albany, and Cindy, normally outgoing, seemed consumed with her son#39;s supposed problems. She told Deb she had thought about suicide, saying ;How can you go on knowing that you#39;ve ruined your baby#39;s life and it was your fault?; Deb was stunned. She and Cindy#39;s husband discussed the situation, hopeful that therapy would help.2012年的感恩节,辛迪的家人在哥哥罗恩(Ron)位于奥尔巴尼郊区的家中聚会。通常颇为外向的辛迪,似乎一心想着她所谓的儿子的问题。她告诉黛布她想过自杀,说“知道因为自己的错误而亲手毁了孩子的一生,你还能活下去吗?”黛布大吃一惊。她和辛迪的丈夫讨论了这一情况,希望治疗会有所帮助。Later that visit, the baby rolled off a low bed. It was one of several times that Cindy panicked and took him to the emergency room, where doctors pronounced him fine.那次聚会后,宝宝从一张矮床上滚了下来。辛迪惊慌失措地把孩子送到急诊室,但医生却说宝宝一切安好。这样的情况发生过好几次。The next month, Cindy began seeing a psychiatrist, who prescribed Zoloft, an antidepressant. She briefly visited other counselors for talk therapy. Friends offered support and company.接下来的那个月里,辛迪开始看精神科医生。那名医师给她开了左洛复(Zoloft),一种抗忧郁的药物。她还短暂地去其他几名咨询师那里接受过谈话治疗。朋友给了她持与陪伴。One January weekend at Ron#39;s house, she seemed more engaged, smiling more. When Deb asked, she acknowledged still having thoughts of suicide, but said her psychiatrist had told her it was not too worrisome ;as long as they#39;re not getting more frequent,; Deb recalled.1月的一个周末,在哥哥罗恩家,辛迪似乎精神更集中了,笑容也多了。黛布回忆,当她问起时,辛迪坦言依然会有自杀的想法,但她说,精神科医生告诉她不用太担心,“只要这些想法没有变得更频繁。”Family and friends wonder now if she was feigning feeling better. ;Now I think maybe she was backing off so everyone wouldn#39;t think she was crazy,; Karen said.家人和朋友现在揣测,她当时是不是假装感觉好些了?“我现在觉得,她那时候是退了一步,这样大家就不会觉得她疯了,”卡伦说。Experts said postpartum psychosis symptoms can fluctuate. Sometimes women are ;lucid and not delusional,; said Dr. Davis of Postpartum Support International. ;Then they slip back into delusions more easily than with other types of psychosis.;专家表示,产后精神病的症状可能会出现波动。国际产后持组织的戴维斯士说,病人有时候“头脑清晰,不会产生错觉。然后,她们会比患其他精神病的人更容易陷入错觉中去”。The mixed signals from Cindy continued into March. She discussed returning to work and finding day care. On a visit to her mother-in-law on Long Island, she called Deb while strolling by the ocean and sounded good. But the next day, Sunday, the baby fell while pulling up on a chair in his grandmother#39;s kitchen. Cindy considered it another disastrous ;head hit.;辛迪表现出来的复杂情况持续到了3月。她说起回去工作,并找家日间托儿所。去长岛探望婆婆期间,她一边在海边散步,一边给黛布打电话,当时听上去挺好的。但第二天是星期日,在奶奶的厨房里,孩子碰到椅子上摔倒了。辛迪把这看作是另一场灾难性的“撞头事件”。On Tuesday, Cindy uncharacteristically canceled her psychiatrist#39;s appointment, citing rain. On Wednesday, as she sometimes did, Cindy asked her husband to come home from work. When he arrived, she said their son#39;s morning had been rough, but that she was feeling better. After a few hours, he returned to work.接下来的周二,辛迪以下雨为由,反常地取消了和精神科医生的预约。周三,与之前偶尔出现的情况一样,辛迪把丈夫从公司叫回了家。丈夫到家后,她说儿子一上午都过得不顺,不过她感觉正在好转。几个小时后,丈夫回去上班了。That afternoon, with her baby snug to her chest, she jumped.当天下午,辛迪把孩子捆在自己胸前,跳下了楼。;I am so unbearably sorry, which I know does nothing to undo the evil I have done,; her farewell note began. ;I wanted to be a mother so badly and I hoped to be a wonderful one, and instead I have become the worst of the worst.;“我特别特别愧疚,我知道这无法弥补我犯下的恶行,”辛迪在遗书开头写道。“我非常想当母亲,想成为一位优秀的母亲,然而,我却成了差到不能再差的一个母亲。”Searching for anything to blame herself for, she described minor, harmless moments: tucking a light blanket over his face for warmth, letting him suck a leaf, briefly putting a dime in his mouth and immediately removing it. ;These things I did were horrible,; she wrote.在找一切理由责怪自己时,她说到了一些没造成什么伤害的小事:为了保暖把薄毯子盖到了宝宝脸上、任由他吮吸一片树叶、短暂地把十分钱硬币放到宝宝嘴里又马上拿走。“我做的这一切太可怕了,”她在信里写道。She was sure her son would never walk, and said she believed his most recent fall caused a concussion. ;I#39;m so so sorry, but I can#39;t bear for him to suffer more and more.;她确信儿子永远都不会走路,还说她认为最近那次摔倒造成了脑震荡。“真的非常非常对不起,但我无法忍受他越来越遭罪。”She said she knew others would see her suicide as a result of ;postpartum depression/psychosis.; But, she said: ;I know I am right that I mistakenly harmed him. I#39;m not claiming a voice told me to do this.;她还说自己知道,其他人会把她的自杀归咎于“产后抑郁症/精神病”,但她说:“我无意中伤害到了儿子,我知道自己是有理由这么想的。并不是说有个声音让我这么做。”She even chastised herself for crumbling emotionally, saying she made her son a less happy baby.她甚至苛责自己情绪不稳定,说她让儿子没那么快乐。;I don#39;t know if there is a hell,; she wrote, ;but I hope so.;“我不知道是否有地狱,”她写道,“但我希望有。”Cindy Wachenheim would never know that in her last act, her body cushioned the fall for her son and saved his life. Weeks later, the healthy little boy took his first steps.辛迪·瓦肯海姆永远不会知道,她生命的最后一刻,自己的身体为儿子从高处摔下来时提供了缓冲,救了他一命。几个星期后,这个健康的小男孩迈出了人生的第一步。 /201411/339901深圳哪家医院治疗脱发

宝安区面部除皱纹费用 More than a decade ago, a 43-year-old woman went to a surgeon for a hysterectomy. She was put under, and everything seemed to be going according to plan, until, for a horrible interval, her anesthesia stopped working. She couldn#39;t open her eyes or move her fingers. She tried to breathe, but even that most basic reflex didn#39;t seem to work; a tube was lodged in her throat. She was awake and aware on the operating table, but frozen and unable to tell anyone what was happening.十多年前的一天,外科医生们正在对一名43岁的女性进行子宫切除术。患者在麻醉下失去了意识,所有的一切似乎都按部就班有条不紊——直到她身上的麻醉突然失效了一段时间,她无法睁开眼睛,无法动一动手指。她试图呼吸,可即使是这样最基本的反射也不能正常进行;一根管子卡在她的喉咙里。她的神智清醒着,知道自己正在手术台上,只是一动也不能动,不能向任何人诉说发生了多么可怕的事情。Studies of anesthesia awareness are full of such horror stories, because administering anesthesia is a tightrope walk. Too much can kill. But too little can leave a patient aware of the procedure and unable to communicate that awareness. For every 1,000 people who undergo general anesthesia, there will be one or two who are not as unconscious as they seem — people who remember their doctors talking, and who are aware of the surgeon#39;s knife, even while their bodies remain catatonic and passive. For the unlucky 0.13 percent for whom anesthesia goes awry, there#39;s not really a good preventive. That#39;s because successful anesthetization requires complete unconsciousness, and consciousness isn#39;t something we can measure.在关于麻醉觉醒(anesthesia awareness)的研究里,充满了此类恐怖故事,这是由于给予麻醉的确是一项令麻醉医师如履薄冰的棘手任务。用药过量可以致人于死地。但药量不足却可能使患者在手术中醒来,而无法向其他人诉说自己的困境。每1000名接受全身麻醉的患者中,平均会有一或两人(0.13%)不幸并非如表面所见的那样不省人事——他们记得医生们的交谈,感觉得到外科医生的刀划过血肉,尽管此时他们的身体仍然毫无知觉,被动地任人摆弄。目前还没有什么真正有效的方法可以防止麻醉过程中出现这种岔子。因为,成功的麻醉需要实现完全无意识,而我们现有的技术还无法对意识加以衡量。There are tools that anesthesiologists use to get a pretty good idea of how well their drugs are working, but these systems are imperfect. For most patients receiving inhaled anesthesia, they#39;re no better at spotting awareness than dosing metrics developed half a century ago, says George Mashour, a professor of anesthesiology at the University of Michigan Medical School. There are two intertwined mysteries at work, Mashour told me: First, we don#39;t totally understand how anesthetics work, at least not on a neurological basis. Second, we really don#39;t understand consciousness — how the brain creates it, or even what, exactly, it is.现在已经有一些工具可以帮助麻醉医师较好地把握自己所用药物的效力,但这些系统还不够完善。密歇根大学医学院(University of Michigan Medical School)的麻醉学教授乔治·马舒尔(George Mashour)表示,对于大多数接受吸入麻醉的患者而言,尚无比半个世纪前研发的用药剂量指标效果更好的知觉观察方法。马舒尔还告诉我,在麻醉工作中存在着两个相互交织的未解谜团:首先,我们并不完全了解麻醉的工作机制,至少在神经学基础的层面上是如此。其次,我们对意识也没有实现真正的理解——大脑如何创造了意识,以及,“意识”的确切定义究竟是什么。Lacking a way to measure consciousness directly, anesthesiologists monitor for proxies of it — the presence of certain types of brain waves, physical responses and sensitivity to pain — and adjust the dosage if they arise. To improve on this method, neuroscientists are searching for what they call neural correlates of consciousness — changes in brain function as a person transitions from being apparently conscious to apparently unconscious. The more they know about these, the better they hope to understand what consciousness is.由于无法直接对意识加以测量,麻醉师们只好退而求其次,监测意识的替代物——特定类型的脑电波、生理反应和疼痛敏感度的存在情况,并在上述指标升高时增加麻醉剂量。此外,为了改善这一方法,神经科学家正试图寻找“意识的神经机制”(neural correlates of consciousness),即,人在从明显的意识知觉状态转变为明显无意识状态的过程中脑功能的改变。他们认为,对此了解得越深入,就越有希望解开意识之谜。Michael Alkire, associate professor of anesthesiology at the University of California, Irvine, was one of the first people involved in the search for neural correlates of consciousness, back in the 1990s. He#39;s particularly excited now about a study published in August by an international team of researchers based at the University of S?o Paulo and the University of Wisconsin, Madison. They compared the brain activity of patients from the full spectrum of consciousness — awake, asleep, drugged with anesthetics, in comas or suffering from ;locked-in syndrome,; in which the body appears trapped in a comalike state but the brain is active and aware. The researchers stimulated these subjects#39; brains with a magnetic field and used EEG to trace the pulse#39;s path. The brains we might think of as conscious and those we think of as unconscious reacted to the stimulus in distinct ways. ;If the patient is awake, the electrical ‘ping#39; can travel all around the brain,; Alkire said. ;But if they#39;re unconscious, the ‘ping#39;tends to stay localized and just fades away like a sonar blip.;关于意识的神经机制的研究兴起于20世纪90年代。美国加州大学欧文分校(University of California, Irvine)的麻醉学副教授迈克尔·阿尔基尔(Michael Alkire)是最早参与此类研究的科学家之一。八月份由圣保罗大学(University of S?o Paulo)和威斯康星大学麦迪逊分校(University of Wisconsin, Madison)的研究人员组成的国际研究团队发表了一项研究,令他格外兴奋。该研究比较了患者在整个意识谱系——醒觉、睡眠、接受麻醉剂后、昏迷或罹患“闭锁综合征”(此时,患者的躯体陷入类似昏迷的状态,但大脑仍在活动且醒觉)——的多种状态下大脑活动的异同。研究人员采用磁场来刺激受试者们的大脑,并使用脑电图(EEG)跟踪了脑电脉冲的路径。结果显示,在我们通常认定为有意识或无意识的大脑中,这些刺激引起的反应方式截然不同。“如果患者处于醒觉状态,电脉冲信号可以传遍整个大脑,”阿尔基尔说。“但是,如果他们失去了意识,脉冲信号往往只在局部短暂停留,然后便如昙花一现般消失无踪。”This finding excites Alkire because it bolsters an existing theory of how consciousness works. Mashour, who also studies neural correlates of consciousness, has repeatedly found evidence that — contrary to conventional- wisdom — sensory networks in the brains of unconscious people remain locally functional, but intrabrain communication has broken down. The neighborhood#39;s lights are on, in other words, but the Internet and phone lines have all been cut.这些研究结果令阿尔基尔十分振奋,因为它很好地持了一个现有的意识运作理论。在马舒尔对意识的神经机制进行研究的过程中,与传统观点相背离的据一再出现,这些据表明,在无意识者的大脑中,感觉网络仍在局部地发挥作用,只是大脑内部的通信系统完全崩坏了。换句话说,邻近街区的灯照常亮着,可互联网和电话线都被切断了。The S?o Paulo-Madison study could be showing that unconsciousness is what happens when different parts of the brain can#39;t connect: The signal simply dies. This also suggests that anesthetics work best when they cut those lines of communication. What#39;s more, it provides insight into a vexing question: How can the entirety of human experience arise from tiny electrical impulses?这项圣保罗-麦迪逊研究显示,无意识是大脑的不同部位间失去联系的外在表现:只是信号无法传递而已。它还表明,当麻醉剂恰好切断那些通信线路时,麻醉效果最好。更重要的是,该研究为我们探讨一个深奥的问题提供了启示:人类的体验作为一个整体,是如何从微小的电脉冲中诞生的?Neuroscientists do know that consciousness does not reside in any one part of the brain — there is no region where all information is aggregated together — but they don#39;t know much more than that. Consciousness is difficult to study by its very nature, so it has been left mostly to philosophers for the last hundred years — and they don#39;t agree on much. For instance, the philosopher John Searle describes consciousness as a purely subjective experience — what you have when you wake up in the morning, and what disappears when you fall asleep at night (or die, depending on how bad your day was). The philosopher Daniel Dennett wrote a book called ;Consciousness Explained,; which plays down the subjective experience of consciousness so much that critics dubbed it ;consciousness explained away.;神经科学家已然确知,意识并不存在于大脑的任何一个特定部位——并没有一个脑区专司汇总所有的信息——但他们所知的也仅限于此。意识的本质使其难以进行直接研究,因此,在过去的一百年中这一领域的绝大部分都是哲学家们的舞台,可惜他们各执己见,没有达成多少一致意见。例如,哲学家约翰·塞尔(John Searle)将意识描述成了一种纯粹的主观体验——当你在早晨醒来时,你就获得了意识;等你在夜间入睡(或者死亡,这取决于你这一天过得怎么样)时它便消失了。而在哲学家丹尼尔·丹尼特(Daniel Dennett)撰写的名为《意识的解释》(Consciousness Explained)论著中,则大大贬低了意识的主观体验,以至有家戏称这本书“把意识给解释没了”。Scientists largely ignored these sorts of debates for most of the 20th century. But in 1994, an interdisciplinary conference at the University of Arizona brought them together for the first time. That conference led to ongoing research studying the links between anesthesia and consciousness. Stuart Hameroff, an anesthesiologist and the director of the school#39;s Center for Consciousness Studies, was an organizer of the conference. Anesthesia, he told me, is a great example of why scientists have to think about consciousness. It#39;s not enough, he said, just to assume your patient is unconscious because she doesn#39;t respond to pain.在20世纪的绝大部分时间里,科学家们在很大程度上一直对这些争论视若无睹。但是,1994年美国亚利桑那大学(University of Arizona)举行的一场跨学科会议第一次将科学家和哲学家们聚在了一起。这次会议引发人们就麻醉和意识之间的联系展开了持续的研究。该校意识研究中心(Center for Consciousness Studies)的主任斯图尔特·哈姆鲁夫(Stuart Hameroff)是这次会议的组织者。他告诉我,麻醉是可解释科学家们为何需要思考意识问题的绝佳例子。他说,单凭患者无法对疼痛作出反应并不足以判定他已经失去了意识。That#39;s because, while you need a brain to have consciousness, you might not need a brain to experience pain. In the 1990s, scientists ran tests on rats and goats, studying how the effects of anesthetics changed as different parts of the brain were intentionally damaged or removed. The amount of the drugs necessary to prevent the animals from moving in response to pain didn#39;t change as the cortex, the thalamus and the brain stem were destroyed. ;Turns out, they were measuring a spinal-cord reflex, which is a much more primitive thing and has nothing to do with consciousness,; Hameroff said. Outward signs of consciousness may or not may not have anything to do with actual awareness.这是因为,虽然保持意识需要大脑,但感受痛苦却未必需要大脑的参与。20世纪90年代,科学家们在大鼠和山羊身上进行试验,他们故意损伤或去除了不同的大脑部位,然后研究麻醉剂的作用发生了怎样的改变。当皮层、丘脑和脑干受损后,要防止动物因疼痛而挣扎所需的药物剂量并没有发生改变。“事实明,他们之前检测的只是脊髓反射,这是一种非常原始的反应,跟意识没有任何关系,”哈姆鲁夫说。意识的外在表现与真正的觉醒状态之间可能存在关联,也可能完全是两码事。In everyday life, it#39;s nearly impossible to ever know whether someone is conscious or not, Hameroff said, even if it seems glaringly obvious. Philosophers are fond of pointing out that, for all you know, you#39;re surrounded by people who appear to be fully conscious but who experience none of it subjectively. (They frequently trot out these beings for thought experiments and call them ;philosophical zombies.;) But for those under anesthesia and the knife, such sophistry offers little solace.在日常生活中,想要确知某个人的意识状态几乎是不可能的,哈姆鲁夫说,尽管它似乎是如此显而易见。哲学家们很喜欢这样讲:你只知道你周围的人看起来都具有完整的意识,但没有一个人对此有任何主观体验。(他们经常在这些人面前炫耀所谓的“思想实验”,并称他们为“哲学僵尸”。)只是对于那些身在麻醉和手术刀下的患者而言,这样的诡辩起不到什么宽慰效果。Increasingly, research on what happens to the brain under anesthesia suggests that the synthesis and integration of information among many different parts of the brain is the best measure of consciousness. Some people, Mashour said, go so far as to say that this communication among regions is consciousness itself. Our subjective experience of the world might arise as a byproduct of the brain#39;s piecing together different sensory inputs.有越来越多关于麻醉状态下大脑功能的研究表明,对来自大脑多个不同部位的信息加以综合的能力是衡量意识的最佳指标。马舒尔指出,有些人甚至认为这种不同脑区之间的通讯交流就是意识本身。我们对世界的主观体验很可能是大脑试图拼凑不同的感觉输入信息时产生的副产物。It#39;s easy to see the connections between this idea and the ;ping; study. When the brain falls asleep, drifts into a coma or comes under the influence of anesthetic drugs, the ability to synthesize information disappears, though the brain doesn#39;t cease to function. Figuring out a method for measuring intrabrain communication will be crucial for preventing operating-table awareness.很容易看出,上述观点与脑电脉冲研究之间存在一定关联。当大脑陷入熟睡、昏迷或麻醉药物的影响之下时,虽然它并没有停止运作,但其综合信息的能力却消失了。找出一种可测定脑内通讯的方法对于防止患者在手术台上醒觉至关重要。In the June 2013 issue of the journal Anesthesiology, Mashour proposed just that: a monitor that focuses on the brain#39;s ability to communicate within itself. It#39;s similar to the ;ping; study but tracks a different signal. Activity in conscious brains has been shown to loop between sensory areas (the visual cortex in the rear of the brain, for example) and the higher-level parts of the brain associated with processing information (like the temporal lobe, just behind your ears). Mashour and others call this ;recurrent processing;: Signals travel from the sensory areas to the processing areas and back again. When somebody is unconscious, the recurrent proc-essing disappears. Mashour#39;s study showed that this pattern — or lack thereof — is present in the brains of people anesthetized with three different classes of drugs. It#39;s not just a side effect of one kind of medication. His work suggests that anesthesia monitors might be more effective if, rather than measuring the presence of electrical waves produced bythe brain, they monitor how electrical signals move around the brain.在2013年6月的《麻醉学》(Anesthesiology)杂志上,马舒尔建议:使用一台监测仪来专门监测大脑内部的通讯能力。这与脑电脉冲研究有点类似,但它们跟踪的是不同的信号。研究显示,在意识清醒的大脑中,感觉区(例如,大脑后部的视觉皮层)与信息加工相关的高级区域(比如位于耳后侧的颞叶)之间存在脑部活动环路。马舒尔等称其为“回返加工”:信号从感觉区进入加工区,然后再返回感觉区。在人失去意识后,这种“回返加工”也随之烟消云散。马舒尔的研究表明,在三种不同类别药物的麻醉下,人的大脑中都呈现了这种模式的存在和缺失。这并不是某一种药物的副作用。这项工作表明,如果麻醉监测器能够监测电信号如何在大脑之中传送,可能会比单纯测定大脑是否产生电波更为有效。Should such a device be developed, it would be good news not only for those 0.13 percent of patients but also for fans of Enlightenment philosophy. Mashour told me that the synthetic model of consciousness dates back to Immanuel Kant — his ;Critique of Pure Reason; might be vindicated by neuroscience. ;Kant said there has to be some process that takes individual processing and connects it together into a unified experience,; Mashour said. ;Over the years, we#39;ve teased out the parts of the brain necessary for appreciating vision, color, motion. They#39;re all mediated by different brain areas. But how does the brain put all that together into single perception?; For Kant, this was clear long before EEG monitors and anesthetics. ;Without this synthesis,; he wrote in 1781, ;the manifold would not be united in one consciousness.;如果能够开发这样的设备,对于那0.13%的不幸患者以及启蒙哲学的粉丝们都是大好消息。马舒尔告诉我,意识的综合模式最早可以追溯到伊曼纽尔·康德(Immanuel Kant)——他的《纯粹理性批判》(Critique of Pure Reason)或可因神经科学的发展而获得平反。“康德认为,必有一定的过程将单独的信息整理加工,使其彼此联系并结合为一体,即成为经验,”马舒尔说。“多年来,我们已经逐步确定景象、色和运动的评鉴由大脑的不同区域所介导。然而,大脑是如何将它们整合为统一的感知印象的?”康德所处的时代远在脑电监测仪及麻醉剂的发明和使用之前,1781年,他写道,很明显,“如果没有这种综合作用,多姿多而散乱的感觉信息将不可能在一个意识中实现统一。” /201410/336958深圳南山医院做红色胎记手术多少钱深圳市妇幼保健院整形美容中心



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