用现代医学模式看心血管疾病合并抑郁症的诊疗

随着社会进步,生活节奏日益加快,抑郁症及抑郁情绪已经悄无声息地蔓延开来,心血管疾病已成为城乡居民的第一位死因,分别为心理、生理疾病,从传统医学模式的角度看两者互不相干,但从生理-心理-社会的现代医学模式理解以及各种研究表明它们其实有着密切的联系.     

医学模式的转变与对腰痛患者实施认知行为治疗

随着医学模式从生物医学模式向生物-心理-社会医学模式的转变,心理社会因素对腰痛患者疼痛的影响亦日益引起社会的普遍关注.从心理社会因素对腰痛患者疼痛的影响探讨医学模式转变的必要性以及给腰痛患者实施认知行为治疗的可行性.     

试论"生理-心理-伦理-社会"相结合的大学生心理健康教育模式

提出了"生理-心理-伦理-社会"相结合的大学生心理健康教育模式,指出这种模式是建立在健康新概念的指导下,全面考虑了影响心理健康的各种因素,以当代大学生心理健康的现状与原因为基础和依据的具有中国特色的大学生心理健康教育模式.     

急性心肌梗死早期康复治疗的探讨

遵循生物-心理-社会医学模式,结合传统康复治疗从生物功能、心理功能、社会功能三方面去探讨急性心肌梗死的早期康复治疗是切实可行的,而且明显优于传统的康复治疗,实行早期康复治疗时应从生物功能、心理功能、社会功能三个方面综合考虑,不宜偏废任何一方.     

脑卒中的康复治疗

讨论和研究了遵循生物-心理-社会医学模式,从生物功能、心理功能、社会功能三个纬度综述脑卒中的康复治疗理论.一个以躯体生物功能损害为突出表现的脑卒中患者,要综合考虑他的受损的躯体功能、心理状态和社会功能,三者不宜偏废.     

互联网医学的伦理问题探讨

归纳总结了互联网医学面临的医疗安全、信息安全、医疗公平性、隐私保护、各参与方责任界定和医患关系重构六个问题,围绕互联网医学与伦理的关系,基于伦理基本原则,发现当中存在的伦理问题,并运用获益-风险评估的金钥匙,从生理获益-生理风险、心理获益-心理风险、社会获益-社会风险、经济获益-经济风险四个方面对互联网诊疗和远程医疗服务活动的优势和劣势进行讨论和分析,最终基于我国最新的互联网诊疗和远程医疗服务管理办法的相关要求进行分析并提出建议。     

糖尿病防治的几点认识

根据世界卫生组织的健康定义,健康是人的生理、心理和社会的协调一致,反之产生疾病.糖尿病在影响人们生理、心理健康的同时,影响着人们的生活方式、社会关系、收入和社会期望度.因此糖尿病的诊断和治疗必须考虑到患者的心理社会因素.临床医生应学会使用现代的生物心理社会模式,倡导正确的行为生活方式、落实连续性医疗服务、提高卫生服务整体效能、提供多方位社会支持、选择个体化的糖尿病治疗方案,针对性地进行糖尿病的防治.     

糖尿病防治的几点认识

根据世界卫生组织的健康定义,健康是人的生理、心理和社会的协调一致,反之产生疾病。糖尿病在影响人们生理、心理健康的同时,影响着人们的生活方式、社会关系、收入和社会期望度。因此糖尿病的诊断和治疗必须考虑到患者的心理社会因素。临床医生应学会使用现代的生物心理社会模式,倡导正确的行为生活方式、落实连续性医疗服务、提高卫生服务整体效能、提供多方位社会支持、选择个体化的糖尿病治疗方案,针对性地进行糖尿病的防治。     

血液系统恶性肿瘤患者相关疲劳的生物-心理-社会模式探讨

普遍的疲劳感是引起血液系统恶性肿瘤患者治疗及康复过程中生活质量显著降低的主要因素之一.因此如何减少肿瘤相关疲劳逐渐引起了血液病医生的关注.在医学从传统的"生物"模式向新的"生物-心理-社会"模式转变的背景下,本文就如何利用生物心理社会模式分析血液系统恶性肿瘤相关疲劳的病因、机制、评估、干预进行探讨.     

血液系统恶性肿瘤患者相关疲劳的生物-心理-社会模式探讨

普遍的疲劳感是引起血液系统恶性肿瘤患者治疗及康复过程中生活质量显著降低的主要因素之一。因此如何减少肿瘤相关疲劳逐渐引起了血液病医生的关注。在医学从传统的"生物"模式向新的"生物-心理-社会"模式转变的背景下,本文就如何利用生物心理社会模式分析血液系统恶性肿瘤相关疲劳的病因、机制、评估、干预进行探讨。     

认识脑死亡

脑死亡是指脑功能永久性不可逆的完全丧失,而不考虑呼吸心跳是否停止。目前脑死亡临床诊断标准已具有高度准确性。脑死亡的确立对树立新的道德观念、节约社会资源、促进器官移植发展意义重大,但要在中国立法可能还需要一个漫长的过程。     

Go no-go performance under psychosocial stress: beneficial effects of implementation intentions

Acute stress has been found to have negative and implementation intentions (IIs) to have positive effects on cognitive performance. This study was the first to examine the effects of IIs on executive action control under acute psychosocial stress. Forty-two male subjects aged 21-39 years were randomly assigned to the Trier Social Stress Test (TSST) versus a rest condition. In addition, the instruction to the executive task (a go no-go task) was manipulated (IIs versus standard instruction). After the stress test, a dual-task procedure including a go no-go task was conducted. The TSST resulted in increases in cortisol response, heart rate and state anxiety compared to the rest condition. Acute stress significantly impaired go no-go performance, but only in the group without IIs. We conclude that under acute stress conditions executive functioning is reduced, but the use of IIs can be an effective strategy to overcome this negative effect.     

Task difficulty, cardiovascular response, and the magnitude of goal valence

Sixty-four young women expected to perform an easy, moderately difficult, or extremely difficult memory task with the opportunity to earn a small incentive for good performance. Cardiovascular (heart rate, systolic and diastolic blood pressure) and subjective measures were taken immediately prior to task performance. Both systolic blood pressure (SBP) responses and ratings of goal attractiveness were nonmonotonically related to expected task difficulty, with the most pronounced SBP elevations and highest goal attractiveness in the moderately difficult task condition. Product-moment correlations among cardiovascular response measures revealed a strong positive association between systolic and diastolic pressure (but not heart rate) change in the easy condition, positive relationships among all measures in the moderately difficult condition, and no significant correlations in the extremely difficult condition. Subjective measures of arousal were not affected by the task difficulty manipulation. Principal findings are discussed in terms of a theoretical model proposed by Brehm (1979) that states that motivation varies as a nonmonotonic function of the difficulty of goal attainment. Intercorrelations among cardiovascular response variables are considered in terms of their possible indication of the mechanisms underlying blood pressure changes associated with variations in motivation.     

Impulsive Responses In Children with Conduct Disorder and Borderline Intellectual Functioning

The study is designed to investigate response inhibition in children with conduct disorder and borderline intellectual functioning. To this end, children are compared to a normal peer control group using the Alertness test. The test has two conditions. In one condition, children are instructed to push a response button after a visual “go” signal is presented on the screen. In a second condition the “go” signal is preceded by an auditory signal, telling the child that a target stimulus will occur soon. Compared to the control group, the group carrying the dual diagnosis made many preliminary responses (responses before the presentation of the “go” signal), especially in the condition with an auditory signal. This impulsive response style was controlled for attention deficit/hyperactivity disorder characteristics of the children.     

Impulsive responses in children with conduct disorder and borderline intellectual functioning.

The study is designed to investigate response inhibition in children with conduct disorder and borderline intellectual functioning. To this end, children are compared to a normal peer control group using the Alertness test. The test has two conditions. In one condition, children are instructed to push a response button after a visual "go" signal is presented on the screen. In a second condition the "go" signal is preceded by an auditory signal, telling the child that a target stimulus will occur soon. Compared to the control group, the group carrying the dual diagnosis made many preliminary responses (responses before the presentation of the "go" signal), especially in the condition with an auditory signal. This impulsive response style was controlled for attention deficit/hyperactivity disorder characteristics of the children.     

Possibilities of objective assessment of the course of activation in ideomotor training

An active exploration of movement tasks is accompanied with central nervous activation. Its systematical examination needs a teamwork of scientists of various branches of knowledge (i.e. physiology, psychology, sport sciences). Mental training (motor imagination - MI) was chosen as a model for such examinations. In connection with the execution of MI there are characteristic chances of the mean alpha frequency of the EEG, heart rate, respiration rate and skin conductance. The time course of these parameters depends on the number, the duration and the sequence of MI. A graduated submaximal load on ergometer has no influence on the course of the examined parameters. Our investigation allows the conclusion that different activation processes go on within different subsystems during the execution of MI. From a physiological point of view it seems to be necessary that a concrete paradigm of MI must be examined concerning the course of the parameters and, thus, to guarantee the effort of MI.     

Constructions of emotion: Discrepancy,arousal, and mood

An interactive adventure-type computer game was used to explore the constructive components of emotional experience — sympathetic nervous system arousal and evaluative cognitions — postulated by discrepancy/evaluation theory. Manipulations of expectations produced significant and large heart rate changes for both positive and negative discrepancies. Autonomic response also reflected the degree of interruption/discrepancy produced by an event. Negatively toned (discrepant) events tended to produce significant intensity and higher overall autonomic arousal. In addition, subjects' intensity of experience was related to their autonomic response.The research and preparation of this report were supported by a grant from the Spencer Foundation. We are grateful to Carol Beards, Barbara Lagana, and Jeffrey McIntosh for assistance in data collection and data analysis. Special thanks go to Mark Wallen for programming Rogue and much of the data analysis.     

Motivation and the Heart in the Xing Zi Ming Chu

In both content and historical position, the “Xing Zi Ming Chu” is of obvious significance for understanding the development of classical Chinese philosophy, particularly Confucian moral psychology. This article aims to clarify one aspect of the text, namely, its account of human motivation. This account can be divided into two parts. The first describes human motivation primarily in passive terms of response to external forces, as emotions arise from our nature when stimulated by things in the world. The second comes from the role of the heart, which takes a more active role in shaping our responses to the world. This article focuses on the role of the heart. At stake is the status of human agency, in particular, the degree to which the heart, through the formation of a stable intention, allows us to go beyond being simply pulled along by external forces.     

临床方法依然是神经内科医师最重要的诊断法宝

通过7例疑难、危重患者的诊治过程说明临床方法的重要性,在神经科疾病研究中尤为突出。忽视细致的病史采集和体查,常导致了诊疗的失误;面对种目繁多的检查,更需要以临床方法选择之;临床逻辑思维能力非常重要,正确的临床思维出新知。在实验室检查方法越来越多的今天,临床方法是神经内科医师最重要、方便、快捷、有效的诊断法宝,具有不可替代性。     

应培养年轻医师的“逐本溯源”临床思维方式

近年来,疾病谱及其特点在悄然改变,伴随着无规可循、错综复杂的临床表现,甚至呈现为多系统综合征。这些变化对临床医师尤其是年轻医师而言,难以理清思路、把握重点,医生往往容易被直接呈现的各种表象所迷惑或满足于表象诊断,从而错过主要矛盾,在诊治过程中出现漏诊误诊情况,并可能增加患者就诊次数和成本,带来经济与精神上的压力。我们在临床实践中总结发现,“逐本溯源”临床思维方式对疾病诊治、避免漏诊误诊尤其是在病因诊断中具有较好的指导作用。