中、西医治疗慢性乙型肝炎现状的分析与思考

分析了中、西医肝病临床治疗慢性乙型肝炎的现状,着重探讨了中医药在防治乙肝中的优势和不足.指出多数医生存在对乙肝发病机制认识模糊、不能提供合理的治疗方案和研究方法欠科学等三个误区.倡导用循征医学方法对中医药防治乙肝的疗效进行评价.     

农村中医药人才的培养机制探讨

目前农村中医药人员的人员状况和从业素质令人担忧,主要存在人数减少、人员学识低下、临床能力不足等问题。发展中医药事业,重点是加强中医药人才的教育,培养出一批农村中医药人才骨干队伍,从而满足农村基层对中医药卫生医疗保健的需要。     

中药在心血管疾病中应用现状与反思

具有悠久历史的中医药在现代医学中有鲜明的时代特点。心血管疾病是现代社会严重威胁生命及健康的病患。本文总结分析了古老中药在现代心血管疾病中应用的现状,并深入分析其影响因素,从而提出扬长避短的未来心血管疾病应用中药的思路。     

重建医学哲学学科的“公共性”

作为医学科学技术类硕士生的一门公共课,医学哲学学科有其独特的“公共性”。医学哲学学科当前面临的一个大的问题就是整个知识系统“公共性”的丧失和它原有的“公共性”的失效。医学哲学学科必须在新语境下重建“公共性”,才能寻回自身的合理性。医学哲学学科的“公共性”需要从开放性、批判性、学术性、介入性、当下性和人文性等几个方面来进行重建。     

为医学"会诊”-当代医学的主要缺憾

现代医学发展迅速,方兴未艾,由于技术主义抬头,认识局限与医学发展水平的制约。出现某些缺憾性倾向。主要有：破足的医学、分裂的医学。被动的医学、治标的医学、人性淡漠的医学、不公正的医学等。在对上述进行分析与评论的基础上,对医疗服务变革真挚进行了预测与展望。     

民间医药的内涵实质及研究意义

民间医药是指某一地区或人群中长期用于预防和治疗疾病,有临床实践经验积累,但未形成系统的传统医药学理论,未被典籍所录载,具有独特疗效的草药、处方和医疗技术,它是传统医学中三大组成部分之一。加强民间医药的研究对于促进现代中医药发展、保护我国非物质文化遗产和民间知识产权、造福人类具有积极的作用和意义。     

The Socio-political Situation of Avicenna’s Time and His Spiritual Messages: On the Occasion of 1031st Birth Anniversary of Avicenna (23 August 980)

In the fourth century A.H. (tenth century AD) many thinkers, philosophers, jurisprudents, poets, and authors were present in different scientific, literary and health fields in ancient Iran and Islamic world that by their hard attempts the sciences and literature were safe from incidents and resulted in growth, development and innovation of Islamic sciences. Meanwhile, Avicenna was superior to all others and the most famous scientist. He was a great human that by attempting hard, perseverance, stability, patience, and believing in God could complete supreme scientific ranks and compiled encyclopedia of Canon of Medicine and besides gathering many written important issues that most of them were confiscated at libraries of kings. He added medical experiences of ancient Iran and especially Jondishapour University and also his personal experiences and finally Canon of Medicine by benefiting from monotheistic style and science based on faith was written. He has written a book that is regarded as root and basics of modern medicine and by completing it some infrastructure health viewpoints and common medicine were created. It is a kind of book that in spite of scientific advances and production of modern research tools many of its contents are replaced with modern methods of medicine and health, but still many of its health basic messages, research orientation and monotheism with great dynamic mode is considerable at world’s medical references. The aim of this study is evaluate the political situation of Avicenna’s time and a review of his Godly writings. This is a library study by using electronic version of Canon of Medicine and other related resources. Findings, include writing style of monotheistic literature, and freeing from nihilism and affiliating diseases to Satan, jinn and such issues. It is necessary that our students within course of Iranian and Islamic culture and civilization to be more familiar with monotheistic thoughts and activities of scientists like Avicenna.     

Incest: The four letter word. A theological approach to therapy

As those of us in the ministry reach out to counsel in the community, we sooner or later encounter the problem of incest. This article poses the question of possible clergy reluctance to treatment of the incest family. It then provides various theological issues present in incest and attempts to demonstrate the unique contribution brought to such therapy by the theological perspective.Mr. Smith is a pastoral counselor in private practice and may be addressed at 2301 Fifth Ave., Fort Worth, Texas 76110.     

系统生物学——中西医结合的平台

通过比较系统生物学与中医理论在整体观、系统观、预测性和预防性医疗以及个体化治疗等方面的相似之处,并分析中医和西医各自的优点和不足,提出中医和现代医学在系统生物学的基础上进行整合的必然性和可能性,系统生物学是中西医结合的平台。     

对纳米结合医学及中医药学的思考

就目前纳米与医学及中医药学结合的几个问题进行了回顾和探讨。首先分析了纳米中药、纳米医学以及纳米中医药学的定义,认为纳米与中医药学的结合将对中医药学的理论体系、临床实践以及中药行业的产业化产生深远的影响。客观地分析了目前对纳米医学及中医药学研究的现状,从学科建设的角度探索了纳米中医药学的研究思路与方法。     

巧用中西医结合,提高临床医学水平

通过对现代医学辨病的缺陷和临床与基础医学联系性、融合性不足的分析,阐述中医经典理论与现代医学基础理论结合,提高临床决策水平的重要意义。     

正确理解和应用循证医学的思维方法

循证医学(Evidence-based Medicine,EBM)是遵循证据的医学,经验医学的特点则是凭个人经验或上级高年资医生的指导、教科书与医学刊物上零星的研究报告为依据来处理病人.为提高临床疗效,必须克服经验医学中存在的问题,科学地应用循证医学的思维方法来指导医学实践.     

James Drane's More Humane Medicine: a new foundation for twenty-first century bioethics?

James Drane's More Humane Medicine: A Liberal Catholic Bioethics is an outstanding contribution to the study of bioethics in our day. Catholics and others who are interested in the issues discussed here will benefit from this masterful treatment. The author opens with a set of definitions, starting with what he means by a "more humane medicine." Drane contends that a more humane medicine has become necessary and desired, but not because the traditional medical ethic as "a self-declared and self-imposed ethic, outlining what noble service to others entails" is no longer valid. Rather he defines it as an advance on the traditional ethic; a "new foundation" based on a "lived set of obligations derived from a felt commitment to other persons ... an ethics based on the relationship between doctors and patients and essentially an ethics of virtue." Drane's work is a "liberal Catholic Bioethics" in which he challenges his own faith tradition, the Roman Catholic Church, on such topics as sexuality, birth control, abortion, cloning, stem cell research, aging and dying, and euthanasia and physician-assisted suicide. The present article is a critical essay that analyzes the author's statements and conclusions.     

Four Butterflies: End of Life Stories of Transition and Transformation

In this article, the author discusses her experiences as an Artist In Residence in the Department of Palliative Care and Rehabilitation Medicine at the University of Texas M. D. Anderson Cancer Center. Emphasis is placed on the ways in which end of life images and narratives often unfold in the fragile yet powerful space where conceptions of aesthetics and spirituality intersect with critical issues in the medical humanities. Drawing on four vivid case studies, the author examines the ways in which end of life narratives shed valuable light on conceptions of the subtlety of human embodiment; issues of violation, sorrow, and forgiveness; the mystical dimensions of traditional cultural beliefs; and the capacity for perceiving the natural world as a living symbol of grace. In so doing, she explores how the themes of transition and transformation become invested with meaningful existential and symbolic dimensions in artworks that give voice and presence to some of the most vulnerable, and often invisible, members of our society—people at the end of life.     

新型农村合作医疗定点医疗机构门诊用药分析

通过对新型农村合作医疗定点医疗机构门诊处方药品费用、药品种类、抗生素和激素的使用情况、给药方式等的分析,发现定点医疗机构存在不合理用药的问题,这将直接影响新型农村合作医疗的健康持续发展。对此,提出要加强健康教育和健康促进行动;加强医务人员专业知识和技能的培训;加强合理用药制度建设;加强定点医疗机构用药行为的监管。     

Relative Value Units: Using the New “Currency” for Measuring Clinical Productivity in a Productivity/Incentive Plan

This paper presents an overview of a productivity/incentive plan for faculty in an academic medicine center's department of behavioral medicine and psychiatry. The model utilizes the Resource-Based Relative Value Scale (RBRVS) for its measurement of clinical productivity. The paper provides an introduction to RBRVS terminology and how the RBRVS system was developed. The productivity/incentive plan developed for the Department of Behavioral Medicine and Psychiatry, West Virginia University School of Medicine, Morgantown, is described. The advantages and limitations of utilizing Relative Value Units (RVUs) in a productivity model are discussed. The paper may provide helpful insights to those charged with developing productivity/incentive plans at other academic health science centers.     

Stress experienced by women doctoral students,need for support,and occupational sex typing: An interactional view

The present study was concerned with emotional stress experienced by women doctoral students as an interactive function of type of department and personal need for support. Subjects were women registered as doctoral students at a large state university in the fall semester of 1975. Of the total, 86 were from female minority departments, 177 from egalitarian departments, and 114 from female majority departments. Stress from time pressures, marital pressures, and overall stress were all found to be interactive functions of need for support and type of department. The female minority group showed the strongest relationship between need for support and each of the three significant stress variables. Implications of these findings for women in graduate school are discussed.This study was supported in part by a grant from Division 9 of the American Psychological Association and by the Measurement and Evaluation Center at the University of Texas at Austin. It was based on a dissertation, under the direction of H. Paul Kelley, submitted in partial fulfillment of the doctoral degree at the University of Texas at Austin. The author wishes to thank Lucia Gilbert and Charles Holahan for their helpful comments on an earlier draft of this article.     

也谈中药现代化

中药现代化是中药走向国际市场的必由之路。国内研究已取得较大成就,内容有中药材、中药饮片和剂型的现代化等多方面。但是,也存在一些问题,如对中药现代化的认识不够、基础研究薄弱等,有待解决。     

Book review

Abstract

Chronic Illness: From Experience to Policy, edited by S. Kay Toombs, David Barnard, and Ronald A. Carson. Bloomington, IN: Indiana University Press. 1995. 221 pp. ISBN 0-253-36011-0. $27.95 hardback. Reviewed by Lee Combrinck-Graham.

S. Kay Toombs is Assistant Professor of Philosophy at Baylor University and author of The Meaning of Illness.

David Barnard is Professor and Chairman of the Department of Humanities at Pennsylvania State University College of Medicine. He is coauthor of Nourishing the Humanistic in Medicine: Interactions with the Social Sciences.

Ronald A. Carson is Professor and Director of the Institute for the Medical Humanities at the University of Texas in Galveston. He is coeditor of Medical Humanities Reviews.

Lee Combrinck-Graham is a Child and Adolescent Psychiatrist, Behavioral Health Medical Director of Oxford Health Plans, and Editor of Children in Family Contexts and Children in Families at Risk. She is the author of Giant Steps: Therapeutic Innovations in Child Mental Health.     

Variations in gender-role equality among classes: A research note

A widely accepted view describes gender-role inequality as less prevalent among the middle class than the working class. Gender-role inequality within the intact nuclear family is asserted to be a syndrome characterized by unequal husband—wife authority, rigid division of household labor, and greater freedom in leisure pursuits for the husband. This view is generally unsupported by the findings of the present study, a secondary analysis of a sample survey conducted in Houston in 1969–1970. Two classes (working and middle) were compared, with ethnicity (Anglo, Black, Mexican-American) and sex controlled. Questionnaire items concerned leisure-time freedom for wives, gender differences in children's socialization, and sexual division of labor in the household. Differences between groups were generally small and inconsistent. In some cases, sexual and ethnic differences were greater than those of class. An intercorrelation matrix revealed few significant correlations between egalitarian responses to the various items, suggesting that egalitarianism or its opposite is not a syndrome.This paper utilized data collected on a project partially supported by NIMH Grant No. MH 15708. Computer services were provided by the Institute of Computer Sciences, Baylor College of Medicine, Houston, Texas, supported by NIH Grant No. RR 00259, and the Institute for Computer Services and Applications, Rice University, Houston, Texas. Secondary analysis of data was carried out in the Winter of 1975–1976. We wish to thank Dr. George Antunes of the University of Houston, Dr. Richard Hamilton of McGill University, and Judith Scott of Texas Research Institute of Mental Sciences for their critical reading of an earlier draft of this paper.