慢性乙型肝炎治疗路线图的评价——应答指导的临床治疗策略

慢性乙型肝炎治疗路线图是根据患者对抗病毒药物应答的不同、用病毒及其抗原水平在治疗的整个过程中对患者进行科学管理、制定治疗策略、确定治疗时间的一种优化治疗方案。本文将从它的可行性和意义、重要性、治疗策略的确定及在临床上应用的局限性等方面进行论述。     

高龄冠心病患者冠脉介入治疗策略的哲学思考

探讨高龄冠心病患者的具体临床特点;从医学实践出发选择高龄冠心病患者的介入治疗策略,并辩证地看待各种新技术、新器械.从而确定最有利于患者的治疗策略.     

脑转移瘤治疗方案的比较

脑转移瘤是成人最常见的颅内肿瘤之一,也是肿瘤患者致残与死亡的主要原因,然而目前还没有完全统一的治疗策略.本文利用比较治疗学相关原理和方法,从治疗方式、疗效、费用等方面对脑转移瘤的不同治疗方法进行比较和分析,为患者进行治疗上的选择提供帮助,同时指导和规范该类疾病治疗的临床决策,为临床治疗思路提供借鉴.     

老年非小细胞肺癌治疗策略

非小细胞肺癌被认为是老年疾病.迄今为止尚无专门针对治疗老年NsCLC的指导原则.作者就当今对老年NSCLC的治疗策略进行论述,并指出年龄不是影响NSCLC患者实施手术治疗、放射治疗以及化学治疗的单一因素.     

早期胃癌的外科治疗策略

胃癌根治术目前仍为绝大多数胃癌患者的主要治疗手段。在我国,大多数胃癌患者确诊时已处于进展期,进展期胃癌外科治疗目前已趋于规范。然而,早期胃癌的治疗策略及外科治疗方式的选择,以及实施过程中仍存在诸多问题。规范化治疗是影响胃癌患者预后的重要因素,临床医生应根据个体化治疗原则,为患者选择最佳的临床治疗策略。本文重点探讨早期胃癌的类型及生物学意义、内镜治疗策略、外科治疗策略、手术适应证把握、术后随访策略等相关问题。     

对低危前列腺癌治疗策略的再认识及思考

前列腺癌被认为是老年男性中最常见的恶性肿瘤.近年来,PSA筛查技术的广泛使用提高了前列腺癌的检出率.但许多低危的非致命性的前列腺癌患者却承受着过度治疗所带来的毒副反应风险.作者就当前用于减少低危前列腺癌过度治疗的新策略进行描述,如观察等待和主动监测策略,并指出癌症的过度治疗是很普遍的现象.未来需要发展更多的对恶性肿瘤进行最优治疗的策略.     

急诊死亡病例放弃治疗原因分析及临床实践

对本院急诊科2008年～2012年302例急诊死亡病例进行分析,通过比较分析放弃治疗死亡和非放弃治疗死亡2组患者的年龄、疾病分类、伴发病、费用类别等情况,探析放弃治疗原因及探讨在急诊临床工作中如何实施放弃治疗.本组放弃治疗的主要原因是患者为疾病无康复可能、终晚期的老人.在放弃治疗过程中医生要遵循一定的程序,反复评估病情,确定是否符合放弃治疗标准,并与家属充分沟通,尊重患者的各种权利,同时必须规范填写医疗文书.     

难治性抑郁症成因与优化治疗的思考

抑郁症是一种高患病率、高致残率及高自杀率的严重精神疾患.在过去10年中,抗抑郁药物研究取得了突飞猛进的进展,然而,在临床上仍约有30%～50%的抑郁症患者最终成为难治性抑郁症病例.目前针对难治性抑郁症尚无较好的治疗策略.本文运用系统论方法学分析生物、心理、社会各个要素在病因中所起作用,探讨最佳治疗策略.     

肿瘤姑息治疗的全程介入

恶性肿瘤严重威胁人类健康,肿瘤本身以及针对肿瘤的治疗不仅会对患者的生理和心理产生重要影响,同时也会对照顾患者的家人产生各种心理影响。现有医疗条件下短时间内难以提高治愈率,就应更加注重将姑息治疗贯穿于肿瘤治疗的始终,不仅要及早介入,甚至延伸至居丧期。在肿瘤治疗过程中不断对肿瘤患者进行评估和适时调整姑息治疗策略,可有效地提高患者生活质量同时降低医疗成本,最终患者能够在不同阶段和各种治疗手段中获得最大受益。     

ARDS患者的肠内、外营养治疗

急性呼吸窘迫综合征(ARDS)是各种病因引起的由多种促炎因子介导的失控性瀑布式肺部炎症反应,病死率高.及时、有效的营养干预是重要的治疗策略.随着临床营养学的发展,ARDS患者营养治疗的目标已由单纯的提供细胞机体代谢所需能量与底物,向以调理代谢紊乱、调节免疫、作为疾病治疗的“药物”目标转变.制定出既满足临床患者营养需求,同时又能抑制炎症反应,利于提高ARDS患者的氧合作用甚至降低病死率的营养策略值得关注.     

"Psychotherapy" versus "treatment"

Presents a comment on "Psychological treatments" by D. H. Barlow. Barlow proposed that we distinguish between the terms "treatment" and "psychotherapy." The author believes that not only is the distinction unnecessary, but that its implications could have negative consequences for the field of clinical psychology. It is the proposed distinguishing feature that treatments are "specifically tailored to the pathological process that is causing the impairment and distress" that is most problematic. Clinical psychology does not need a distinction that further exacerbates the split between researchers and practitioners.     

"Enmeshment" and "Fusion"

The paper examines two related concepts utilized by two different schools of family therapy. Any family seen to be "enmeshed" is also seen as "fused," and vice versa. The difference in the level of focus, on the "system containing the individuals" (structural) or the "individual in the system" (fusion), determines the difference in therapeutic approach of these two schools.     

“对的”与“好的”

什么是“对的”,和对它的证立,是道德哲学中具有争议性的核心问题,也是效用主义和道义论间的主要差异之所在。统合效用主义对于“好的就是对的”这个陈述有一套完整周延的说法。而道义论对这个问题的证立不够周延或没有足够的说服力。     

"本体论"与"伦理学"--形而上学的两个向度

形而上学有两个密切相关的内在向度,就是本体论向度与伦理学向度.在哲学史上,哲学家们之所以在"追求形而上学"的同时,又总是"反形而上学",并非是人们的形上本性出了问题,而是因为人们总是将形而上学视为单纯的"一维性",总是用一个向度来取代或遮蔽另一个向度.而所谓的"后形而上学思想",也并不是消解了形而上学,而是指形而上学从"本体论向度"转向了"伦理学向度".     

"石狮"、"风水"与"吉祥"

谁都知道,在古老的中国,不管是衙门、宫殿、庙宇的门前,还是豪宅、大户人家的门口,人们都能看到摆着一对石狮。据说,这对石狮子在许多中国人的心目中,它不但是一种气派的象征,而且还是一种被人认为是好的“吉祥物”。如今,旧时的衙门没有了,但遗留下来的宫殿、庙宇的门前,其中有些石狮仍有保存。然而,想像不到的是,这号称“吉祥物”的石狮今天却开始“走”进某些党政机关的大门口,它们(石狮)在那里时时都在保护着这些政府要员“平平安安”、“吉祥如意”。这不仅使我联想起一些极端的报道,有些政府官员为升迁,请算命先生定位,用风水术为政府…     

PREFERRING "HOUSEWIVES" TO "FEMINISTS"

Four studies are described outlining the favorability of attitudes toward women. In Study 1, participants indicated their attitudes toward women and men and their construal of the term "women". The results revealed that women were evaluated more favorably than men, but that male right-wing authoritarians (RWAs) who construed women as referring primarily to feminists were least favorable in their attitudes. In Study 2, participants indicated their attitudes toward both "housewives" and "feminists". The results revealed that feminists were evaluated less favorably than housewives, and that the most negative attitudes toward feminists were expressed by authoritarian men. Study 3 revealed that high-RWA males held more negative symbolic beliefs concerning feminists (i.e., beliefs that feminists failed to promote participants'values) and that these beliefs accounted for variation in attitudes among high RWAs and much of the RWA-attitude relation. Finally, Study 4 revealed that high RWAs perceived greater value dissimilarity between them-selves and feminists. The implications of the findings for future research are discussed.     

从"管制"到"平衡"--政府与公众理想关系模式的构建及其制度化

论文从行政民主的角度探讨政府与公众之间的理想关系模式及其制度化构建过程 ,将我国在改革之前的政府与公众模式概括为管制模式。论文指出 ,在制度变迁的过程中 ,这一模式日益受到挑战。而在新的制度环境下 ,我国政府与公众的关系模式应该是平衡模式。这一模式的制度化措施包括培育自主的市民社会 ,赋予公众以独立的活动空间 ;促进行政公开 ,建立一个开放负责的政府 ;推进行政法建设 ,抑制行政恣意     

"Us" and "Them":

Abstract: In the Aristotelian tradition, politics is a matter of public deliberation over questions of justice and injustice. The Bush administration's response to the terrorist attacks of September 11, 2001, has been uniformly hostile to this notion, and it has instead promoted a jingoistic politics of self‐assertion by an America largely identified with the executive branch of its government. This is doubly disturbing, as the executive branch has sought to free itself from international law, multinational commitments, and domestic judicial regulation, even as it has sought to validate itself by demonizing its enemies. This essay draws out the disturbing echoes here of Carl Schmitt's work of the 1920s, in particular of Schmitt's conception of the sovereign as the ungrounded ground of the law and the political as the site of mortal conflict between friend and enemy. The essay argues that Schmitt's position in the twenties, for all of its evident problems, is superior to that of Bush, Wolfowitz, and Ashcroft in at least two senses: Schmitt condemns the idea of waging war for profit and recognizes that such wars will often be disguised as moral crusades waged against the “inhuman”; and he acknowledges that claiming to fight a war for humanity denies one's enemies their humanity, leaving them open to torture and even extermination.