咳嗽与咳嗽治疗

咳嗽是临床上常见的症状之一,其对人们健康的影响是辩证的,咳嗽治疗也是辩证的.有需要止咳的,有需要治疗但不是止咳治疗的,有不需要治疗的,还有要鼓励患者咳嗽的.临床上遇到咳嗽患者时,要用辩证的观点进行治疗,辨证施治,用哲学观来看待问题,最终才能解决问题.     

不同地塞米松给药方法对芬太尼咳嗽反射的研究

探讨不同地塞米松给药方法对芬太尼咳嗽反射抑制的效果。选择200例全麻患者分为四组,按不同方法静脉注射地塞米松。诱导时芬太尼用量为5Mg·kg。观察各组患者出现咳嗽的例数和强度变化以及心率（HR）、平均动脉血压（MAP）、脉搏氧饱和度（SpO2）、脑电双频谱指数（BIS）的变化。结果显示,提前15min静注地塞米松组（Ⅰ组）咳嗽发生率为8％,与其他组有显著性差异。静注芬太尼2min时段Ⅰ组的HR、MAP和BIS与其他组相比有显著性差异。组内发生咳嗽反射患者HR、MAP明显升高,BIS值也有所回升。认为预先15min静脉注射地塞米松更有效降低麻醉诱导期间芬太尼所致咳嗽反射的发生。     

感染后咳嗽患儿血微量元素分析与黄芪注射液联合甘草合剂治疗研究

分析儿童感染后咳嗽的临床特点以及与外周血微量元素的关系,观察黄芪注射液联合甘草合剂治疗儿童感染后咳嗽的疗效.对自2006年1月至2008年6月在德州市妇幼保健院儿科门诊治疗的75例感染后咳嗽患儿行外周血微量元素测定,与40例健康小儿微量元素时比,并将75例患儿随机分为两个治疗组进行临床观察:实验组39例,口服黄芪注射液和甘草合剂联合治疗;对照组36例,口服阿奇霉素治疗;对比两组疗效,并在治疗前后行肝肾功检查,观察有无肝肾损害.75例患儿外周血铁、锌、镁均有不同程度的降低.实验组疗效优于对照组,治愈率分别为92.31%和75%,统计学处理χ2=4.17,P<0.05.治疗前后两组均未出现肝肾功损害.感染后咳嗽发病可能与患儿血中微量元素铁、锌、镁降低有关,黄芪注射液联合甘草合剂治疗儿童感染后咳嗽安全有效.     

感染后咳嗽患儿血微量元素分析与黄芪注射液联合甘草合剂治疗研究

分析儿童感染后咳嗽的临床特点以及与外周血微量元素的关系,观察黄芪注射液联合甘草合剂治疗儿童感染后咳嗽的疗效。对自2006年1月至2008年6月在德州市妇幼保健院儿科门诊治疗的75例感染后咳嗽患儿行外周血微量元素测定,与40例健康小儿微量元素对比,并将75例患儿随机分为两个治疗组进行临床观察：实验组39例,口服黄芪注射液...     

急性胰腺炎临床决策中的辩证思维观

急性胰腺炎（AP）是临床常见危重症。近年来AP诊断和治疗取得了令人瞩目的进展,及早诊断和恰当、合理的生命支持治疗极大改善了AP患者的预后。临床上AP患者病情往往复杂多变,要求在极短时间内做出正确的临床决策,科学理性的临床决策思维对AP患者的合理诊治起着非常重要的指导作用。临床医师应努力学习和充分灵活地运用辩证思维,为对AP进行科学的临床诊疗决策提供合理的思路。     

骨科疾病诊治中的辩证观

骨科医生在复杂的临床工作中,需要掌握科学的方法论。特别是掌握科学的辩证思维方法,建立局部与整体的观念,善于抓住主要矛盾。培养起辩证逻辑思维的能力。有助于正确分析和理解骨科疾病的诊断和治疗中的各种复杂问题,提高认识水平和实践能力。     

辩证思维在重症急性胰腺炎治疗中的运用

重症急性胰腺炎的治疗水平在近几十年已有了很大的发展,但是SAP的死亡率依然居高不下,严重威胁患者生命。这类患者的病情复杂,需要运用多种治疗方法进行综合救治。从多种治疗方法中选择合适的方法并进行合理的治疗很难准确把握,需要我们用哲学的思维来看待胰腺炎的诊治,辩证地对其进行有针对性的治疗,从而提高重症急性胰腺炎的治疗水平。     

骨科疾病诊治中的辩证观

骨科医生在复杂的临床工作中,需要掌握科学的方法论.特别是掌握科学的辩证思维方法,建立局部与整体的观念,善于抓住主要矛盾.培养起辩证逻辑思维的能力.有助于正确分析和理解骨科疾病的诊断和治疗中的各种复杂问题,提高认识水平和实践能力.     

从肝脏移植手术治疗原发性肝癌的辩证思考

肝癌的手术治疗中肝切除和肝移植在适应证的选择、手术方式、围手术期的管理上有很大的不同,但在治疗目的、手术和解剖技术上又有共同之处。这种对立统一的关系对指导临床工作有重要意义。结合我国实际,用辩证的方法和发展的观点选择恰当的方法是手术治疗肝癌的关键。     

从肝脏移植手术治疗原发性肝癌的辩证思考

肝癌的手术治疗中肝切除和肝移植在适应证的选择、手术方式、围手术期的管理上有很大的不同,但在治疗目的、手术和解剖技术上又有共同之处.这种对立统一的关系对指导临床工作有重要意义.结合我国实际,用辩证的方法和发展的观点选择恰当的方法是手术治疗肝癌的关键.     

AKRASIA

Aristotle's account of akrasia is unsatisfactory for a number of reasons. First, his account of the problem is coloured by a number of unattractive assumptions and preoccupations; second, his central claim, that akrasia involves a temporary displacement of knowledge, deals at best with only a small number of cases; third, he is wrong to suppose that the akrates is typically someone overwhelmed by passion. We need to follow Davidson in recognising that the central problem consists in a failure to convert intention into action. Any solution must involve a recognition that we are dealing with a range of very different kinds of case, which demand different kinds of treatment. For example sometimes agents are overtaken by passion; sometimes they coolly and calmly do the wrong thing; sometimes they are insincere; sometimes they are suffering from a weakness of will; sometimes they are guilty of some kind of self deception; and sometimes they may have difficulty in comparing the goods and evils available.     

温度与攻击的研究回顾与展望

从人类攻击的一般理论模型出发,着重介绍了与温度有关的注意不足模型、社会公平模型、负面情绪矫正模型,阐述了热假说的有关研究和成果。最后分析了该研究领域存在的主要问题：(1)研究结果常相互矛盾,有的支持高温增加攻击行为,有的支持高温减少攻击行为。(2)实验室中的攻击与现实生活中的攻击有很大区别。(3)现场研究的数据中热效应与冷效应缺少对称。(4)目前学者的解释和研究未全面考察影响攻击行为的因素,因此需要综合探讨各种影响因素及它们的交互作用,并采用多种方法进行研究。     

Writing about psychoanalysis: II. Analysts who write, patients who read

When we make a decision to lecture, or to write for publication, we have begun an activity that will affect every one of our patients. If they attend our lectures, or read our published works, they cannot help being influenced. Even if they do not, they will have some reaction to the focusing of our interest on particular phases of the analysis. This will be true whether or not we intend to present clinical material. These considerations inevitably affect the analyst himself, sometimes inhibiting his writing altogether, sometimes constricting its scope, or worst of all, degrading its quality. The analyst's writing is also almost certain to influence whether and with what success his patient may choose to write. Lest these considerations suggest that we avoid writing altogether, I emphasize that such a sacrifice is by no means desirable or necessary. Problems of discretion will arise, and may in some cases be virtually insoluble; but there are ways of writing that can overcome most such objections. The analyst's interest in writing should be recognized and its effects, if any, brought into the analysis; so long as the writing itself is done with due regard to the conduct of the analysis and the welfare of the patient, it need have no adverse effects on either.     

宁养的概论及实施

宁养为结合团队力量,在患者面临生命末期时,协助其可以面对身、心、灵、社会之整体性的痛苦,关心患者的心声、生命的意义、生活的维持、使患者被治疗、关怀、尊重、倾听、接受及了解,有尊严地面对死亡。照顾者依自己的需要关心、照顾自己,宁养团队成员需装备好自己,了解面对的病患问题,给予全人的照顾,使患者善终,家属善生。     

Examining punishment at different explanatory levels

Experimental studies on punishment have sometimes been over-interpreted not only for the reasons Guala lists, but also because of a frequent conflation of proximate and ultimate explanatory levels that Guala's review perpetuates. Moreover, for future analyses we may need a clearer classification of different kinds of punishment.     

Observations on the rejection of physician-assisted suicide: a Roman Catholic perspective.

Roman Catholic moral theology follows a centuries-old tradition of moral reflection. Contemporary Roman Catholic moral theory applies these traditional arguments to the realm of medical ethics, including the issues of active euthanasia and physician-assisted suicide. Unavoidable moral limits on licit medical intervention sometimes require that the moral duty to treat cede to the duty to cease treatment when measures become more harmful than beneficial to the patient. This does not reduce the need for the compassionate use of palliative care in response to suffering. However, it does mean that rather than being excessively committed to maintaining mere biological human life, or actively seeking death, that we learn a sober realism about the limits of human life. Catholic moral analysis examines an act objectively, both in its relation to the agent and as a material event in the world. This allows both the virtuous or vicious intentions of the agent and the effects of the action to be included in its moral evaluation. Thus, Catholic moral analysis is both quasi-deontological and quasi-consequentialist. Objectively, active euthanasia and physician-assisted suicide, as acts of deliberate killing, are seen as repugnant, in that they fail to incarnate a benign inner intention or to form an agent in virtue. Catholic moral theology is extremely skeptical that an act of intending death directly can be consonant with a sincere compassion for the dying, suffering person and views it as a direct negation of the precious gift of human life.     

What Are We Doing There? A Therapeutic Tale

In this paper I try to portray our interpsychic work as reflective of an infinite conversation: an intersubjective dreaming of one’s life, moving between multiple positions/self-states, those of the patient and our own; becoming involved while pondering the movement we are part of, sometimes in our hearts and minds, many times aloud and openly with our patient; recognizing her experience and enabling her to see us, and sometimes not reflecting at all—“the “moving talk.” The dilemma of the therapist’s positioning, internally and interpersonally, is further postulated, especially in regard to the posttraumatic patient who suffered severe childhood abuse.     

The ethical issue of competence in working with the suicidal patient

In this article, I discuss the ethical need for competence in the assessment and management of the suicidal patient, and further suggest that this specific competence be considered a routine element in professional psychological practice. I also argue that this particular competence necessitates adequate training in working with this high-risk population, as well as the need for every clinician to personally evaluate her or his own technical and personal competencies to work with suicidal patients before beginning independent practice activities in clinical situations wherein he or she may be called on to evaluate or treat a suicidal patient. This article concludes with a discussion of specific ethical dilemmas (e.g., the issue of confidentiality), and a list of suggestions for specific competencies in working with the suicidal patient is provided.