Clinical Efficacy of TCM Multi-channel Intervention Plus Antagonist Regimen on Ovarian Function，TCM Syndromes and Natural Conception in Poor Ovarian Responders Undergoing IVF-ET / 中国实验方剂学杂志

ObjectiveTo objectively analyze the effects of traditional Chinese Medicine （TCM） multi-channel intervention on the ovarian function，TCM syndromes and natural conception of poor ovarian responders（kidney-Yin deficiency，liver depression and blood stasis pattern） who planned to receive another in vitro fertilization embryo transfer（IVF-ET）antagonist regimen. MethodThe 128 low-prognosis patients （kidney Yin deficiency，liver depression and blood stasis pattern） who attended the West China Second University Hospital， Sichuan University and the Hospital of Chengdu University of Traditional Chinese Medicine from August 2020 to February 2023 and met the inclusion criteria were selected，and then divided into the treatment group and the control group according to the random number table，with 64 patients in each group. The control group was treated with oral dehydroepiandrosterone（DHEA），while the treatment group was treated with multi-channel TCM（oral TCM decoction + auricular point sticking + Bushen Huoxue prescription through retention enema）. After 3 menstrual cycles，the relevant indicators for ovarian function evaluation，TCM syndrome scores and natural conception were collected from both groups. ResultCompared with the situation before treatment，the basal follicle stimulating hormone（bFSH），bFSH/basal luteinizing hormone（bLH），basal estradiol（bE2），antral follicle count（AFC），the number of oocytes obtained，the number of normal fertilization，the number of superior embryos and TCM syndrome scores in the treatment group were improved after treatment（P<0.05，P<0.01）. For the control group， the bFSH/bLH and TCM syndrome scores were increased after treatment（P<0.05）， while the bFSH，bFSH/bLH，bE2，AFC，the number of oocytes obtained，the number of normal fertilization，and the number of superior embryos showed no significant difference after treatment. Compared with the control group after treatment，bFSH，bFSH/bLH，bE2，AFC，the number of normal fertilization，the number of superior embryos and TCM syndrome scores in the treatment group were better （P<0.05，P<0.01），while there was no significant difference in the number of oocytes obtained. After treatment，there were 3 cases of natural conception in the treatment group，while there were no natural conception in the control group. ConclusionFor patients with poor ovarian response and kidney Yin deficiency，liver depression and blood stasis pattern，multi-channel intervention of TCM plus the antagonist regimen can reduce bFSH，bFSH/bLH values，improve the levels of bE2，increase AFC，the number of oocytes obtained，the number of normal fertilization and the number of superior embryos，improve ovarian function，menstruation and TCM syndromes，improve their quality of life，and even enable some patients to get pregnant naturally before re-progression and improve their pregnancy outcome.

Chinese mainland′s first case report of Munchausen syndrome by proxy in children / 中华实用儿科临床杂志

Clinical data of a case of Munchausen syndrome by proxy (MSBP) admitted to the Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology in November 2020 were retrospectively analyzed.The 4 years and 4 months old female patient presented with retrosternal and abdominal pain for 1 month, and aggravated with multi-organ pain for 20 days.She complained about the retrosternal pain with acid reflux, pain in the teeth, esophagus, and abdomen, etc.During the hospitalization, she frequently complained of multi-organ pain.Her mother repeatedly declared her painful hip joint and she often cried for pain at night, and even could not walk.However, the clinical examination showed no obvious abnormalities.Combining characteristics of the patient and her caregiver, the patient was confirmed as MSBP.It is suggested that MSBP in children should be concerned in cases with complicated severe chief complaints, frequent medical visits, and a strong willing to see a doctor or be hospitalized by their caregivers, but normal physical and auxiliary examination findings.

Desconstruindo o conceito de função paterna: um paradigma interpelado / Deconstructing the concept of paternal function: a questioned paradigm

A autora desenvolve um trabalho de desconstrução da noção de função paterna enquanto proposta como um elemento essencial para separar o filho de sua mãe e assegurar sua inserção em um universo simbólico. Percorrem-se algum marcos que derivam da noção de patriarcado e as suas ligações com a conceituação de função paterna. Isso tem forte influência em algumas postulações da psicanálise. A necessidade de uma análise genealógica e de historizar esta função é reforçada. Enfatiza-se que há na mãe suficientes reservas simbólicas para exercer essa função, sem recorrer à explicação – de caráter tautológico – de que o Pai dita a Lei e introduz essa função na mãe, para que esta possa exercê-la. Pelo contrário, é uma legalidade que está além de uma figura, mesmo no seu aspecto metafórico, proposta por uma determinada organização sociocultural e discursiva. Esta proposta permite desarticular a frequente validação mãe/natureza versus pai/cultura/logos separador e descentralizar essa dicotomia. Defende-se que o papel do pai é uma operação simbólica que deveria denominar-se, com propriedade, função terceira, independentemente de quem a exerça e além de dicotomias empobrecedoras. Geralmente é exercida pelo pai, mas pode ser exercida pela mãe ou outros, através de suas próprias reservas simbólicas e desejos. Torna-se, portanto, mais complexa a rede que permite o exercício de terceiridade nos processos de subjetivação. Considerar que essa função terceira, simbólica, também pode ser exercida pela mãe enriquece a compreensão da constituição do sujeito em uma trama de laços sociais.

The author develops a deconstruction work of the paternal function notion when proposed as an essential element to separate the child from his mother and ensure his inclusion in a symbolic universe. Some milestones that has a strong influence on some psychoanalytic postulates, derived from the notion of patriarchy and its links to the concept of paternal function are covered. It is enhanced the need for a genealogical and historical analysis of this function. It emphasizes that the mother has enough symbolic reserves to perform this function, without having to resort to the explanation – of tautological character – that the Father dictates the Law and introduces this function in the mother, so that she can exercise it. On the contrary, it is a legality beyond a figure, even in its metaphorical aspect, proposed by a socio-cultural and discursive organization. This proposal allows us to disrupt the frequent homologation mother/nature versus father/culture/logos, which separates, and to decentralize this dichotomy. It postulates that the father’s role is a symbolic operation that should be called third function, regardless of who performs it and beyond impoverishing dichotomies. Usually, the father exercises it, but also the mother, or others, can do it, through their own symbolic reserves and desires. The network that allows the exercise of thirdness in subjective processes becomes, therefore, more complex. The consideration that the mother may also exercise this third function, symbolic, enriches the understanding of the constitution of the subject in a web of social ties.

La autora desarrolla un trabajo de deconstrucción de la noción de función paterna en tanto es propuesta como un elemento esencial para separar al hijo de la madre y asegurar su inserción en un universo simbólico. Se recorren algunos hitos que derivan de la noción de patriarcado y sus eslabonamientos con la conceptualización de función paterna. Esto tiene fuerte influencia en algunas postulaciones psicoanalíticas. Se remarca la necesidad de efectuar un análisis genealógico e historizar esta función. Se enfatiza que hay en la madre suficientes reservas simbólicas para ejercer esa función sin recurrir a la explicación – de carácter tautológico – de que el Padre dicta la Ley e introduce esa función en la madre para que así ésta la pueda ejercer. Por el contrario, se trata de una legalidad que está más allá de una figura, aún en su vertiente metafórica, propuesta por una determinada organización socio-cultural y discursiva. Esta propuesta permite desarticular la frecuente homologación madre/naturaleza versus padre/cultura/ logos separador, y descentrar esa dicotomía. Se postula que la función paterna es una operatoria simbólica que debería denominarse con propiedad función tercera, independientemente de quién la ejerza y más allá de dicotomías empobrecedoras. Habitualmente es ejercida por el padre, pero puede ser ejercida por la madre u otros, a través de sus propias reservas simbólicas y deseos. Se complejiza así la red que permite el ejercicio de la terceridad en los procesos de subjetivación. Considerar que esa función tercera, simbólica, puede también ser ejercida por la madre enriquece la comprensión sobre la constitución del sujeto en un entramado de lazos sociales.

Croire en soi, croire en l'autre / Believe in yourself, believe in the other

La croyance aux Dieux ou en un Dieu unique c'est-à-dire à l'incroyable est fort répandue et semble normale comme avoir confiance en soi et en l'autre. Mais croire en soi et en l'autre apparaît étonnant car ce serait se mettre sur le même rang que Dieu. Effectivement l'homme essaie de ressembler à Dieu. Mais à Dieu blessé, faillible, s'interrogeant constamment. Ce Dieu nouveau est un "sujet amoureux" amoureux de soi, de l'autre et de la vie. Il se conduit comme un "Dichter" assumant une responsabilité morale. Il est difficile, voire souvent impossible de se situer comme un "Dichter". C'est pourtant la tâche à laquelle l'homme contemporain est confronté.(AU)

The belief in gods or in one God at the incredible is prevalent and seems normal like having confidence in yourself and in each other. But believing in yourself and in others appear surprising because it would be put on the same level as God. Actually the man tries to resemble God. But God wounded, fallible, questioning constantly. This new God loves himself, loves the other and loves life. It behaves like a "Dichter", witha moral responsibility. It is difficult, often impossible to be like a "Dichter". This is the task facing the contemporary man.(AU)

O movimento do Fort-da na leitura de Jacques Lacan / The Fort-da movement in the work of Jacques Lacan / Le movement du Fort-da dans la lecture de Jacques Lacan

A autora reconstrói o lugar e os usos que Lacan confere, no “Discurso de Roma” e ao longo da década de 1950, à concepção freudiana de Fort-da. Para encaminhar de maneira adequada sua reflexão, retorna ao contexto de “Além do Princípio do Prazer” no qual Freud (1920) primeiramente propõe esse movimento como capaz de fazer frente aos ditames da pulsão de morte. Para identificar o que será decisivo na elaboração lacaniana a respeito do funcionamento linguageiro em questão, a autora acompanha Lacan na cunhagem do conceito de linguagem assim como em sua proposta de diferenciar o “discurso do outro” do movimento do Fort-da. Note-se: trata-se do discurso do outro, com “o” minúsculo e não do “discurso do Outro”. O primeiro se apresenta como um discurso que leva ao adoecimento, enquanto o segundo é sinônimo do muro da linguagem, referência necessária para qualquer um dos modos como o inconsciente se estrutura. Para concluir, a autora retoma a necessidade de, em uma análise, dar-se preferência ao movimento do Fort-da, em detrimento do discurso do outro

The author reconstructs the place and uses that Lacan gives in the "Rome Discourse" and throughout the 1950s, to the Freudian concept of Fort-da. In order to properly forward his reflection, returns to the context of "Beyond the Pleasure Principle" in which Freud (1920) first proposed this movement as able to cope with the dictates of the death drive. To identify what will be decisive in the lacanian development about the language operation in question, the author follows Lacan in coining the concept of language as well as its proposal to differentiate the "discourse of the other"-the Fort-da movement. Note: This is the discourse of the other, with the small “o” and not the "discourse of the Other." The first presents itself as a discourse that leads to illness, while the latter is a synonym of the wall of language, reference required for any of the ways in which the unconscious is structured. To conclude, the author announces the need, in an analysis, to give preference to the movement of the Fort-da despite of the discourse of the other

L'auteur reconstruit la place et les utilisations que Lacan donne au ®discours de Rome¼ et tout au long des années 1950, le fort-da freudien. Pour transférer votre réflexion correctement, renvoi au contexte de ®Au-delà du principe de plaisir¼, dans lequel Freud (1920) a d'abord proposé ce mouvement comme étant en mesure de faire face aux exigences de la pulsion de mort. Pour identifier ce qui sera décisif dans le développement lacanienne sur l'opération langagière en question, l'auteur suit Lacan en inventant la notion de langue ainsi que sa proposition de différencier le ®discours de l'autre¼, et le mouvement du Fort da. Note: ". Discours de l'Autre" C'est le discours de l'autre, avec le a minuscule. Le premier se présente comme un discours qui conduit à la maladie, tandis que le second est un synonyme de la paroi de la langue, référence nécessaire pour l'une des façons dont l'inconscient est structuré. Pour conclure, l'auteur impose la nécessité, dans une analyse, de privilégier le mouvement du Fort-da au détriment du discours de l'autre

Devoração ou hospitalidade? / Devour or show hospitality? / Dévoration ou Hospitalité? / ¿Devoración u hospitalidad?

Nosso objetivo é elaborar uma relação entre a antropofagia de Oswald de Andrade e a questão da alteridade em Michel Foucault. Essas duas experiências salientam que a literatura possui uma relação secreta com aquilo que é absolutamente outro. Andrade sustenta que a antropofagia tem um sentido ambivalente na sua relação com o outro: rivalidade e identificação. Segundo Foucault, a experiência do dehors, experiência - limite da qual testemunha a literatura, é uma outra forma de encontrar um lugar de "hospedagem" para o outro, o que foi excluído pela razão ocidental.

Our goal is to establish a relationship between Oswald de Andrade's anthropophagy and Michel Foucault's otherness. These two experiences show that literature has a secret relationship with what is absolutely other. Andrade assumes that cannibalism has an ambivalent sense in its relationship with the other: rivalry and identification. According to Foucault, the experience of outside (dehors), limiting the experience that literature witnesses, is another way of finding a place for "hosting" the other, a trend that has been excluded by Western reasoning.

Notre objectif est d'élaborer le rapport entre l'anthropophagie d'Oswald de Andrade et l'altérité de Foucault. Ces deux expériences soulignent que la littérature entretient un rapport secret avec ce qui est absolument autre. Andrade soutient que l'anthropophagie possède un sens ambivalent dans son rapport à l'autre: rivalité et identification. Selon Foucault, l'expérience du dehors, expérience limite dont témoigne la littérature, est une façon différente de trouver un lieu ®d'hospitalité¼ pour l'autre, ce qui a été exclu par la raison occidentale.

Nuestro objetivo es elaborar una relación entre la antropofagia de Oswald de Andrade y la cuestión de la alteridad en Michel Foucault. Estas dos experiencias destacan que la literatura tiene una relación secreta con eso que es absolutamente otro. Andrade sostiene que el canibalismo tiene un sentido ambivalente en su relación con el otro: rivalidad e identificación. Según Foucault, la experiencia del afuera (dehors), es una experiencia limite de la cual la literatura es testimonia, es otra forma de encontrar un lugar de "hospitalidad" para el otro, el que fue excluido por la razón occidental.

Sujeito e psicose / Subject and psychosis

Este artigo pretende examinar as possibilidades de produção de sujeito na psicose com base na análise de um caso clínico. Valendo-se das formulações de Lacan a respeito da psicose, discute-se a relação do psicótico com o gozo e a possibilidade de alteração na sua posição em face ao Outro, pensando formas de viabilizar a emergência de sujeito por meio do trabalho clínico.

This article intends to examine the possibilities of the subject production in the psychosis from the analysis of a clinical case. On the basis of Lacan’s formularizations regarding the psychosis, it is argued the psychotic relation with the joy and the possibility of alteration in its position face to the Other, thinking forms to make possible the subject emergency through clinical work.