重型肝炎治疗方案的理性选择

针对我国重型肝炎治疗现状,对重型肝炎常用的以及部分有争议的治疗药物和方法进行分析和讨论,就如何选择治疗方案提出医疗原则,认为应采取内科治疗-人工肝-肝移植的综合治疗模式,结合患者的治疗愿望及经济承受力,理性地选择治疗方案,以期达到合理、有效和经济的目的.     

有关治疗老年股骨颈骨折最优方案的思考

老年股骨颈骨折是常见的骨科病,但其治疗方案的选择并没有统一的标准.本文回顾了骨折治疗原则的发展历程和股骨颈骨折现有的治疗方法,旨在从系统论的最优化原则角度,初步讨论治疗老年股骨颈骨折的最优方案,认为应结合患者的生理年龄、预期寿命、骨的质量、骨折情况和经济条件等因素来选择治疗方案.     

康复队伍建设对实现残疾人康复服务的影响

老年股骨颈骨折是常见的骨科病,但其治疗方案的选择并没有统一的标准。本文回顾了骨折治疗原则的发展历程和股骨颈骨折现有的治疗方法,旨在从系统论的最优化原则角度,初步讨论治疗老年股骨颈骨折的最优方案,认为应结合患者的生理年龄、预期寿命、骨的质量、骨折情况和经济条件等因素来选择治疗方案。     

泌尿外科微创技术与临床决策

微创技术在泌尿外科中的应用越来越广泛,对临床决策也产生了深远的影响.临床决策应以最佳证据作指导,充分评价不同方案的风险和利益,选择出最优方案应用于临床实践.微创技术的应用要以人为本,要贯穿诊断和治疗的全过程,要因地制宜,充分考虑应用的物质条件和基础.微创技术的应用也必须考虑经济因素,应选择适宜技术进行适度治疗.     

晚期乳腺癌的非手术治疗进展

晚期乳腺癌患者的治疗一直存在争议。不同治疗方案优势人群的选择仍有待细化和确认,以便将“个体化治疗”的概念落到实处。新药的开发为我们带来更多的选择,但是经济条件的限制,带来的临床问题更需我们冷静思考。相信通过不断的尝试和努力,定会获得进一步的突破。     

泌尿外科微创技术与临床决策

微创技术在泌尿外科中的应用越来越广泛,对临床决策也产生了深远的影响。临床决策应以最佳证据作指导,充分评价不同方案的风险和利益,选择出最优方案应用于临床实践。微创技术的应用要以人为本,要贯穿诊断和治疗的全过程,要因地制宜,充分考虑应用的物质条件和基础。微创技术的应用也必须考虑经济因素,应选择适宜技术进行适度治疗。     

关注肝炎的"过度医疗"

肝炎诊疗领域存在的过度医疗现象是最具代表性的,集中体现为过度使用联合治疗、过度进行化验等辅助检查、过度使用新特药物、虚假广告泛滥等等,肝炎患者承担了额外风险,不但身心受损,而且经济支出严重超标,因病返贫、因病致贫的现象比比皆是.过度医疗是目前不规范的经济大环境的必然产物,救死扶伤、人道主义本应是医疗工作的准则,现在拜金主义、经济效应第一成为医疗活动的目的,过度诊疗在所难免.另外患者的无知和盲目,以及尚不规范的市场环境加剧了过度医疗现象.制定行业规范,建立社会监督机制,与国际肝炎诊疗指南接轨,是克服和纠正诊疗过度的有效方法.     

自由基与重度颅脑外伤并发SIRS的原因及治疗研究探讨

就重型颅脑外伤由于过氧化反应后自由基产生的原因、自由基对神经细胞的继发损伤、自由基在重型颅脑外伤状态下诱发或并发全身炎性反应综合征以及两种因素所引起的神经细胞凋亡进行综述。同时就目前学者们在手术抢救、监测血液粘度、持续腰大池置管脑脊液外引流术、亚低温治疗、药物治疗、高压氧与活性氧液治疗、恒定磁场治疗等方面治疗自由基和全身炎性反应综合征对神经细胞的继发损伤进行了讨论。重型颅脑外伤后应重视自由基和全身炎性反应综合征的治疗。     

自由基与重度颅脑外伤并发SIRS的原因及治疗研究探讨

就重型颅脑外伤由于过氧化反应后自由基产生的原因、自由基对神经细胞的继发损伤、自由基在重型颅脑外伤状态下诱发或并发全身炎性反应综合征以及两种因素所引起的神经细胞凋亡进行综述.同时就目前学者们在手术抢救、监测血液粘度、持续腰大池置管脑脊液外引流术、亚低温治疗、药物治疗、高压氧与活性氧液治疗、恒定磁场治疗等方面治疗自由基和全身炎性反应综合征对神经细胞的继发损伤进行了讨论.重型颅脑外伤后应重视自由基和全身炎性反应综合征的治疗.     

新世纪医学影像学发展方向和对策——兼论与生物医学工程学的联系

重新认识医学模式的转变 20世纪60年代以来,随我国社会经济和卫生事业的进展,各种疾病尤其传染病的防治成果,普遍认为医学模式由生物-医学向社会-心理-医学模式转变。SARS(2003年)和禽流感(2004年)等新型传染病和人畜共患疾病的袭击,回顾人类与重大传染病斗争的历史,面对近年肝炎、艾滋病、结核病(两者交叉)、梅毒等性病以及血吸虫病的复燃,引发人们的反思和启示。1996年Koch提出“保     

The Moral Significance of Birth

Does birth make a difference to the moral rights of the fetus /infant? Should it make a difference to its legal rights? Most contemporary philosophers believe that birth cannot make a difference to moral rights. If this is true, then it becomes difficult to justify either a moral or a legal distinction between late abortion and infanticide. I argue that the view that birth is irrelevant to moral rights rests upon two highly questionable assumptions about the theoretical foundations of moral rights. If we reject these assumptions, then we are free to take account of the contrasting biological and social relationships that make even relatively late abortion morally different from infanticide.     

The Subtle Influence of Check and X Marks: How Symbolic Markings Influence Judgment

Symbols can exert an influence on how we think, feel, and even behave. Here we examine whether symbolic markings serve as primes and influence how people make judgments. We propose that making either a check or an X mark to indicate an opinion can lead people to process the same information differently, thereby influencing the judgment people make. Across four experiments, we find that the check and X marks carry different symbolic associations; people associate check with good and X with bad. We also find downstream consequences of these mental associations. People who make positively connoted check marks (as opposed to negatively connoted X marks) to indicate their judgments are more agreeable toward familiar, controversial social policies as well as market research survey items on values and life styles. Differential symbolic markings with check and X marks seem to shape how people think and make judgments.     

Comparisons and advertising: the route from comparisons to effective advertising

In this study, we investigate what conditions cause subjects to make comparisons and the comparison patterns that influence effective advertising. People make social or temporal-past or temporal-future comparisons, or may not make any comparisons when facing a choice of purchase situation. Unlike past research, we investigate four comparison patterns, and propose a general comparison model that leads to greater advertising effectiveness.     

Spontaneous Goal Inference (SGI)

When people learn about or observe the behaviors of others, they tend to make implicit inferences from these behaviors (e.g., Uleman, Saribay, & Gonzalez, 2008). Such inferences are an essential part of a person's ability to understand his/her environment and to prepare appropriate behavior within that environment. In the present paper, we review the conditions under which people are more likely to make implicit goal inferences versus implicit trait inferences. The distinction between these two ways of understanding the behavior we observe has important consequences for how we make predictions about future behavior, set expectations for our interaction partners, and how we choose to behave. It can determine when we stereotype. However, until now, the literature has focused on trait inference as the dominant way perceivers make sense of their environment, with little discussion of inferences concerning a person's goals.     

The <Emphasis Type="Italic">what</Emphasis> and the <Emphasis Type="Italic">how</Emphasis> of metaphorical imagining,Part One

We humans are remarkably interested in and skilled at games of make believe, games whose rules make what we are called on to imagine depend on what’s actually perceivably true about things and people that have what it takes to assume various fictional roles and that thereby function in the games as props. For the most part we play these games on an improvised pickup basis, working out the rules we play by in the very act of playing by them. Part of what makes this coordinative feat possible are signals to the effect that as the speaker sees things, the rules and available props are such that this or that role is assumed by this or that prop, or props of this or that kind. Metaphors are make believe signals put to ambitious prop-characterizing use outside the game they serve to initiate, sustain, or otherwise regulate. Metaphoric competence is one manifestation of make believe competence.     

The critique of pure phenomenology

The topic of this paper is phenomenology. How should we think of phenomenology – the discipline or activity of investigating experience itself – if phenomenology is to be a genuine source of knowledge? This is related to the question whether phenomenology can make a contribution to the empirical study of human or animal experience. My own view is that it can. But only if we make a fresh start in understanding what phenomenology is and can be.     

酒依赖与酒文化

在医疗过程中,无法取得患者的同意时,通常由他人代其做出同意。但是,代为同意人在代为做出同意时,必须以患者本人的最佳利益为原则。在判断患者的最佳利益时,可以借鉴英国《心智能力法2005》的规定,通过对诸因素的评估,来综合决定何谓患者的最佳利益。我国在制订和修改代为同意的相关规定时,应该考虑如何借鉴英国的规定,制订符合我国国情的代为同意制度。     

Witnessing: The Axis of Group

We enter the group and, to some degree make choices in what we observe and focus on, and how we participate and make our presence known. Unavoidably, and with limited control, we are thrust into a public position of witness and witnessed. Witnessing deals with the impact of embracing experience beyond observing and participating–the uncertain consequence of coming to know and becoming known. It is specifically the axis of personal growth and transformation around which a dynamically oriented group process rotates with our leadership. Discussion and two case examples illustrate its key features and the role members and therapist play in fostering this process.     

消化道肿瘤的过度治疗及其对策

尽管当前消化道肿瘤的临床治疗发展迅速,在取得突出成绩的同时,也存在着一些问题,比如过度治疗的现象普遍存在.从消化道肿瘤过度治疗的主要表现、危害入手,分析它的成因并制定相应对策.总之,只有以循证医学的原则为指导,树立正确的临床辩证思维模式,坚持肿瘤治疗的个体化,加强综合管理,才能避免过度治疗,消化道肿瘤治疗才能健康发展并取得更大突破.     

Object-based eye movements: The eyes prefer to stay within the same object

The present study addressed the question of whether we prefer to make eye movements within or between objects. More specifically, when fixating one end of an object, are we more likely to make the next saccade within that same object or to another object? Observers had to discriminate small letters placed on rectangles similar to those used by Egly, Driver, and Rafal (1994). Following an exogenous cue, observers made a saccade to one end of one of the rectangles. The small target letter, which could be discriminated only after it had been fixated, could appear either within the same or at a different object. Consistent with object-based attention, we show that observers prefer to make an eye movement to the other end of the fixated same object, rather than to the equidistant end of a different object. It is concluded that there is a preference to make eye shifts within the same object, rather than between objects.