当下高等医学人文教育的困境与出路

医学人文教育是医学教育不可或缺的重要组成部分,医学科学精神与医学人文精神的融合是医学学科发展的目标和方向.当下医学人文教育的困境在于:医学人文教育与政治教育混谈,人文教育目标不明;医学人文教学与社会现实脱节,人文教学效果不佳.破解医学人文教育的困境,必须从顶层设计,跳出医学人文教育看教育,实施医学人文教育发展战略,实现医学教育的全面、协调、可持续发展.     

医学、医学教育的本质与医学人文精神的培养

医学的本质属性是社会性和人文性.医学的终极价值是医学人文价值,医学教育的本质要求必须做好医学生人文精神的培养.医学教育改革的重点是如何加强和改进医学人文教育.医学人才培养的重点是增强医学人文精神的培育与养成.从新的视角加强医学人文教育是当代医学教育工作者的历史使命和重要责任.     

医学人文教育功能简论

医学人文教育功能是医学人文教育这一特殊的社会现象和社会活动能够引起个体或其他社会系统发生变化的作用或能力,是医学人文教育自身固有的根本属性和重要特征的外在表现,主要用来回答“医学人文教育为什么能够存在和它对外界能产生何种影响”的问题。发展、认识、文化、享用、激励等诸多功能都是医学人文教育功能的现实表现,因此,医学人文教育功能是医学人文教育得以存在和发展的本体依据和坚实基础,必须从多重维度出发去促成医学人文教育功能的充分发挥和完全实现。     

以医学人文教育为载体加强人文医学执业技能培养

人文医学执业技能的培养必须以医学人文精神为核心;以医学人文教育为载体.要结合医学人文教育的目标和内容;建立理论与实践相结合的人文医学执业技能教育模块;结合医学人文教育的方法和途径;加强人文医学执业技能培养的连续性和终身性;结合医学人文教育的具体要求完善服务基层卫生保健的人文医学执业技能培养体系.     

中外医学人文教育的比较及启示

国外医学人文教育有明确的目标、切实可行的措施、鲜明的教育特色和强有力的师资保障,相比较而言,我国的医学人文教育暴露出很多问题,医学人文教育改革步履维艰.通过抓住医学人文教育目标、学习主体、教学体系、内容、方式等几个医学人文教育的中心环节,探索了我国医学人文教育改革的新途径.     

美国的医学人文教育:历史与理论

大体上考察了美国医学人文教育的发展情况.首先,对医学人文研究加入到美国医学教育计划中的原因与方式进行考察.其次,对美国医学人文运动的历史进行考察,决定医学人文的诞生的原因,并讨论医学人文领域中的学者是如何定义"医学人文"的.最后,从理论视角对医学人文的目的与教育方法进行分析.     

医学人文教育困境之根源研究

医学人文教育必须奠基于人文教育的基础之上,通过对人文教育和医学人文教育根本要义的解析提出造成我国医学人文教育今天的困境原因有三:文化断层使得我国大学教育丧失人文教育之根;实利原则严重侵蚀我国教育制度,医学院校难以独善其身;文理分科和医学教育专业化使我国医学人文教育难有立足之居.     

军医大学人文教育需求的实证研究

军医大学人文教育需求的实证研究,以第三军医大学2005级7个不同专业的学生为主要对象进行医学人文教育需求问卷调查,初步探讨军医大学学生对开设医学人文课程的心理需求和知识需求.调研中还发现,学生对医学人文科学抱有浓厚兴趣,认为具备良好的医学人文素质是未来医生的核心竞争力.     

医学人文素质教育与小班化教学

中国医学人文教育正处于起步、探索阶段,课堂教学是主要渠道和途径,而目前各校的医学人文教育采取的大班课教学方式影响了教学效果。从医学人文教育的理念和教育规律出发,并借鉴他国的经验,小班化教学应是落实人文教育的实效性一个中心环节。     

台湾中山医学大学医学人文教育特色与反思

台湾中山医学大学教育的宗旨是以医学暨人文发展为导向,致力建构一个崇尚人文价值与尊重生命、医学人文兼容并蓄的医学大学,强调“先学做人,再学当医师”.开设的医学人文课程非常有医学针对性,按核心能力要求整合医学人文核心课程,分为文化与社会、人际关系与沟通、医学伦理/法律三个主轴,贯穿于1年级～6年级的学习中,而且与专业课程学习紧密相联,教学方式多元、务实和潜移默化.其教育模式无疑为我国的医学人文教育改革带来全新的视野.     

扩散张量成像在弱视中应用的探讨

弱视是儿童常见眼科疾病,发病机制目前尚不完全清楚。扩散张量成像（diffusion tensor imaging,DTI）是MRI技术的一个新应用,将DTI引入弱视发病机制的研究使人们能更加直观地研究弱视患者视路相关结构有否解剖改变。正确运用哲学观点、充分发挥创新能力并灵活选用适宜技术与高新技术以期达到弱视诊断的最优化。     

Location coding by the human visual system: multiple topological adaptations in a case of strabismic amblyopia

Amblyopia, a major cause of vision loss, is a developmental disorder of visual perception commonly associated with strabismus (squint). Although defined by a reduction in visual acuity, severe distortions of perceived visual location are common in strabismic amblyopia. These distortions can help us understand the cortical coding of visual location and its development in normal vision, as well as in amblyopia. The history of retinotopic mapping in the visual cortex highlights the potential impact of amblyopia. Theories of amblyopia include topological disarray of receptors in primary visual cortex, undersampling from the amblyopic eye compared with normal eyes, and the presence of anomalous retinal correspondence or multiple cortical representations of the strabismic fovea. We examined the distortions in a strabismic amblyope, using a pop-out localization task, in which normal observers made errors dependent on the visual context of the stimulus. The localization errors of the strabismic amblyope were abnormal. We found that none of the available theories could fully explain this one patient's localization performance. Instead, the observed behavior suggests that multiple adaptations of the underlying cortical topology are possible simultaneously in different parts of the visual field.     

语义认知的习得、发展和老化及其神经机制

作为语言系统的重要组成部分, 探究语义认知发展机制及其神经机理对揭示人类语言发展、认知机制有着重要意义。以语义认知能力的习得、发展、老化认知机制为主线, 在系统阐释词汇-语义系统的习得、语义认知能力和策略发展的基础上, 进一步探讨了语义认知老化的认知机制及其神经机理。最后, 围绕儿童和成人的语义认知差异、句法和语义认知老化的差异、语义认知老化的影响因素等问题上进行了思考和展望。     

神经元活动的时相同步与脑功能整合

从大脑整合的角度分析心理的神经机制。神经元之间的交互和动态联结而构成神经集合被认为是每一个认知活动的基础。然而这一交互作用的具体性质,即脑整合的机制尚未明确。通过对有关实验结果的分析,认为神经元活动的时相同步可能是脑整合的机制。     

刻板印象的认知神经机制

刻板印象是大脑对社会信息的一种自动的类别化加工过程。近期脑成像的研究表明, 刻板印象的注意编码、语义表征以及抑制控制等认知成分可以分别通过相应的ERP成分表现出来; 而基于ERP源定位以及fMRI的研究表明, 杏仁核、前扣带回、大脑前额皮层以及外侧顶叶皮层附近的颞顶联结区可能参与到了它们的认知加工。最后结合已有的研究, 提出了刻板印象可能的认知通道, 并简要分析了当前研究的不足与今后的发展方向。     

Egocentric Distance Perception Disorder in Amblyopia

Egocentric distance perception is a psychological process in which observers use various depth cues to estimate the distance between a target and themselves. The impairment of basic visual function and treatment of amblyopia have been well documented. However, the disorder of egocentric distance perception of amblyopes is poorly understood. In this review, we describe the cognitive mechanism of egocentric distance perception, and then, we focus on empirical evidence for disorders in egocentric distance perception for amblyopes in the whole visual space. In the personal space (within 2 m), it is difficult for amblyopes to show normal hand-eye coordination; in the action space (within 2 m~30 m), amblyopes cannot accurately judge the distance of a target suspended in the air. Few studies have focused on the performance of amblyopes in the vista space (more than 30 m). Finally, five critical topics for future research are discussed: 1) it is necessary to systematically explore the mechanism of egocentric distance perception in all three spaces; 2) the laws of egocentric distance perception in moving objects for amblyopes should be explored; and 3) the comparison of three subtypes of amblyopia is still insufficient; 4) study the perception of distance under another theoretical framework; 5) explore the mechanisms of amblyopia by Virtual Reality.     

Neuronal substrates of relapse to cocaine-seeking behavior: role of prefrontal cortex

The return to drug seeking, even after prolonged periods of abstinence, is a defining feature of cocaine addiction. The neural circuitry underlying relapse has been identified in neuropharmacological studies of experimental animals, typically rats, and supported in brain imaging studies of human addicts. Although the nucleus accumbens (NAcc), which has long been implicated in goal-directed behavior, plays a critical role in this circuit, the prefrontal cortex (PFC) appears to process the events that directly trigger relapse: exposure to acute stress, cues previously associated with the drug, and the drug itself. In this paper, we review animal models of relapse and what they have revealed about the mechanisms underlying the involvement of the NAcc and PFC in cocaine-seeking behavior. We also present electrophysiological data from PFC illustrating how the hedonic, motor, motivational, and reinforcing effects of cocaine can be analyzed at the neuronal level. Our preliminary findings suggest a role for PFC in processing information related to cocaine seeking but not the hedonic effects of the drug. Further use of this recording technology can help dissect the functions of PFC and other components of the neural circuitry underlying relapse.     

视觉正常的自闭症儿童双眼注视点间距的特点及其意义

视网膜上物象对应的外在注视点之间的距离, 即双眼注视点间距(distance of binoculars point of regard, DBPR)在自闭症谱系障碍(autism spectrum disorders, ASD)个体上存在异常的表现, 而ASD个体伴随较高的斜视发病率, 可能会对其双眼注视点间距产生影响。研究采用正弦曲线平滑追踪任务范式, 探索视觉正常的ASD儿童在动态刺激加工过程中DBPR的鉴别意义。结果发现, ASD儿童DBPR过大且具有跨任务类型的稳定性, 且与斜视无关。DBPR在大振幅、快速度的条件下具有优良的鉴别力, 并与自闭症行为量表总分以及感知觉维度显著正相关。结果表明, 双眼注视点间距具有良好的鉴别价值。     

成瘾相关记忆的表观遗传学机制 ——药物成瘾研究的新视角

成瘾相关记忆长期性的脑机制一直是药物成瘾研究领域的难点与热点,该文简要介绍了成瘾记忆长期性分子机制的研究脉络,提示表观遗传学修饰可能是研究药物成瘾的新视角。成瘾药物可以调节染色体不同亚型组蛋白乙酰化水平,不同基因DNA的甲基化程度从而改变染色体的空间结构,进而调节基因的表达导致成瘾,特别是DNA甲基化改变的相对的稳定性可能是成瘾记忆长期存在的分子基础。记忆再巩固过程中学习记忆相关脑区的记忆促进基因与记忆抑制基因的表观遗传学改变可能是未来研究的新趋势     

On the relation between conceptual priming, neural priming, and novelty assessment

A consistently reported finding in functional neuroimaging studies which compare processing of new information to processing of old information is a reduction in blood flow, and hence neural activity, associated with the old condition. This deactivation has been labeled neural priming. Some investigators have hypothesized that neural priming is the physiological mechanism underlying conceptual priming—a facilitation in the semantic processing of repeated information. Others, however, have hypothesized that neural priming reflects novelty assessment—a mechanism which minimizes the probability that redundant information will be stored in long‐term memory. In this paper, the conceptual priming and novelty assessment hypotheses are compared and contrasted in order to ask, and tentatively answer, the question: Are conceptual priming and novelty assessment cognitively and neurophysiologically distinct? Based on a review of the literature, it is suggested that whereas novelty assessment and conceptual priming are distinct cognitive entities, they cannot be presently separated neurophysiologically. That is, some novelty assessment deactivations may in fact reflect priming, and some priming deactivations may in fact reflect novelty assessment.