一种全面的、细化的治疗皮肤病思路的探索

传统的疾病治疗思路或模式显得相对单一和笼统.全面的、细化的疾病治疗应包括病因治疗、病机治疗、症状治疗、体征治疗和指标治疗五个方面.以湿疹和寻常型银屑病的治疗为例介绍全面的、细化的治疗皮肤病思路,期望这一思路能得到他人的认可和推广.     

早期复发性流产的系统论思考

早期复发性流产是妊娠期妇女较常见的疾病.根据系统论方法主要基本原则,分析其在早期复发性流产诊断治疗中的指导性作用.揭示在医学科学研究中自觉、主动地运用辩证思维方法和系统论科学方法,可以拓展我们的研究思路,为疾病的诊断治疗提供最佳方案.     

早期复发性流产的系统论思考

早期复发性流产是妊娠期妇女较常见的疾病。根据系统论方法主要基本原则,分析其在早期复发性流产诊断治疗中的指导性作用。揭示在医学科学研究中自觉、主动地运用辩证思维方法和系统论科学方法,可以拓展我们的研究思路,为疾病的诊断治疗提供最佳方案。     

儿童缺血性脑病的诊治策略

结合国内外文献资料,从儿童缺血性脑病的病因、临床表现、影像学特点、治疗方式及疗效等方面着手,进行分析和比较,加深医患对儿童缺血性脑病的了解,同时为该类疾病的临床诊断与治疗思路提供借鉴。     

儿童缺血性脑病的诊治策略

结合国内外文献资料,从儿童缺血性脑病的病因、临床表现、影像学特点、治疗方式及疗效等方面着手,进行分析和比较,加深医患对儿童缺血性脑病的了解,同时为该类疾病的临床诊断与治疗思路提供借鉴.     

药物治疗决策的临床思维

为形成正确的药物治疗决策,需要从诊断、病情、患者和药学四个角度进行思维。首先,正确全面的诊断不仅要对每个疾病做出完整的诊断,还要对该患者所患的所有疾病做出诊断;其次,充分的病情评估,包括易患因素和危险因素、疾病特点、病情进展及疾病预后转归等;第三,具体患者评估,包括患者的生物学特征、社会人文背景等;第四,对治疗本身进行评估,包括治疗计划中总体安排的评估、药物治疗具体方案的评估、治疗计划执行的评估、治疗反应的评估。     

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。     

从整合医学视角看心血管学科未来发展

心血管疾病已经成为威胁国人健康的首位疾病.现代医学的发展使药物、介入和外科手术成为治疗心血管疾病的三大基石,但专科的进一步细化也带来相当多的弊端.因此,需要以患者为核心,摒弃学科的分野,将各种医学知识和防治手段有机融合,构建一个新的整合医学体系去培养年轻医师,切实控制心血管疾病.     

论疾病诊治中的顾此失彼

"顾此失彼"指在疾病的诊治中发现、意识或处理了事物的一个方面或一个事物,而遗漏、忽视了事物的另一个方面或另一个事物。首先,表现在没有全面地收集和分析相关的临床资料。其次,表现为疾病诊断的不全面。再次,表现为疾病治疗的总体安排、治疗方案或药学监护等方面的顾此失彼。与疾病诊断和治疗有关的"彼"是必须被发现和意识的。但在处理时,则根据"彼"与诊断或治疗关系的程度分别对待。为减少或减轻疾病诊治中"顾此失彼"的不良后果,需要采取一系列相应对策,如实施毕业后规范化培养、学习诊治指南和临床路径、重视疾病诊治的程序、提高临床技能、积累临床经验、丰富相关知识、培养临床思维、提高职业素养等。     

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.     

Nonepileptic seizures: an overview

Since before the time of Charcot, nonepileptic seizures (NES) have intrigued and perplexed physicians. With the advent of the electroencephalogram, particularly with the addition of continuous video monitoring, the diagnosis of NES has received increasing evaluation. Characteristic historical features and clinical signs of NES, coupled with new diagnostic techniques, have progressively refined our understanding of the disorder. The treatment of patients who have NES has received much less attention and the prognosis of these patients illustrates the need for a more comprehensive, systematic, and validated intervention. These issues are discussed with an emphasis on the need for future research.     

Construct validation of scales derived from the Rorschach method: a review of issues and introduction to the Rorschach rating scale

I suggest the main goal of Rorschach validation should be a refined understanding of what each score means. Toward this end, I review general issues in construct validity, hurdles unique to the Rorschach, and general limitations with validation criteria. I then recommend two approaches for improving criteria so they can begin approximating the gold standards that are necessary for a refined understanding of what scores actually measure. The first is a method for improving expert clinical judgment, and the second is a method for aggregating data across diverse judges. Finally, the Rorschach Rating Scale (RRS) is presented as a criterion tool to be used with either of these approaches to validation. The RRS is a fairly comprehensive summary of the constructs thought to be measured by various Rorschach scoring systems. The utility of the RRS for research and training are discussed, as are other practical, theoretical, and psychometric issues in its application.     

Construct Validation of Scales Derived From the Rorschach Method: A Review of issues and Introduction to the Rorschach Rating Scale

I suggest the main goal of Rorschach validation should be a refined understanding of what each score means. Toward this end, I review general issues in construct validity, hurdles unique to the Rorschach, and general limitations with validation criteria. I then recommend two approaches for improving criteria so they can begin approximating the gold standards that are necessary for a refined understanding of what scores actually measure. The first is a method for improving expert clinical judgment, and the second is a method for aggregating data across diverse judges. Finally, the Rorschach Rating Scale (RRS) is presented as a criterion tool to be used with either of these approaches to validation. The RRS is a fairly comprehensive summary of the constructs thought to be measured by various Rorschach scoring systems. The utility of the RRS for research and training are discussed, as are other practical, theoretical, and psychometric issues in its application.     

Pioneer vs. traditional: Two distinct vocational patterns of college alumnae

The standard approach to women's occupational patterns (Career vs. Homemaking) was refined into a trichotomous approach by dividing the Career group into Pioneer and Traditional subgroups. Using college alumnae, evidence was gathered to support this refined treatment of the Career group as two very distinct subgroups in terms of desire to work and work values.     

Low-literates’ support needs for societal participation learning: Empirical grounding of theory- and model-based design

Specialized learning support software can address the low societal participation of low-literate Dutch citizens. We use the situated Cognitive Engineering method to iteratively create a design specification for the envisioned system VESSEL: a Virtual Environment to Support the Societal participation Education of Low-literates. An initial high-level specification for this system is refined by incorporating the societal participation experiences of low-literate citizens into the design. In two series of user studies, the participant workshop and cultural probe methods were used with 23 low-literate participants. The Grounded Theory method was used to process the rich user data from these studies into the Societal Participation Experience of Low-Literates (SPELL) model. Using this experience model, the existing VESSEL specification was refined: requirements were empirically situated in the daily practice of low-literate societal participation, and new claims were written to explicate the learning effectiveness of the proposed VESSEL system. In conclusion, this study provides a comprehensive, theoretically and empirically grounded set of requirements and claims for the proposed VESSEL system, as well as the underlying SPELL model, which captures the societal participation experiences of low-literates citizens. The research methods used in this study are shown to be effective for requirements engineering with low-literate users.     

A Pilot Study of a Functional Contextual Treatment for Bulimia Nervosa

This paper describes the initial development of a treatment for bulimia nervosa using a functional contextual treatment approach. Seven women (6 with a diagnosis of bulimia nervosa and 1 with a diagnosis of eating disorder not otherwise specified) completed 12 sessions of functional contextual treatment. Participants were assessed with the Eating Disorders Examination at baseline and following treatment. The intervention produced significant reductions in binge eating, purgative behavior, dietary restraint, and eating concerns. A functional contextual treatment holds promise for the treatment of bulimia nervosa. However, the treatment needs to be refined further and will need to be tested in controlled clinical trials with long-term follow-up.     

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。     

The contributions of multi‐criteria decision making to the development of decision support systems subspecialties: an empirical investigation

This study focuses on examining the structure of decision support systems (DSS) research, with a particular emphasis on assessing the contributions of multi‐criteria decision making (MCDM) to the development of each of the DSS subspecialty areas. This study traces how concepts and findings by researchers in the MCDM area have been picked up by DSS researchers to be applied, extended and refined in the development of DSS research subspecialties. In doing so, factor analysis is applied to an author cocitation frequency matrix derived from a large database file of comprehensive DSS literature. This study concludes that researchers in the MCDM area have made crucial contributions to the development of DSS research subspecialties. Copyright © 1999 John Wiley & Sons, Ltd.     

从耗散理论解读肿瘤的发病及治疗

肿瘤的综合治疗方案,即药物-社会-心理治疗已广泛地应用于临床,虽效果显著,但其机制尚缺乏确切的实验依据。笔者从耗散结构理论来解读这种综合疗法,认为药物、社会及心理治疗均是通过增加机体的负熵,使肿瘤患者的内环境处于有序平衡状态而改善其病情。从耗散理论出发可以将肿瘤的综合疗法更好地应用于临床。     

Introduction to the Special Issue: Mechanisms of Action in Cognitive-Behavior Therapy

Research into mechanisms of treatment outcome in cognitive-behavior therapy (CBT), as work evaluating potential mechanisms through mediator and moderator analyses, has been increasing. In recognition of this growth in more refined analyses of functional components of treatment, this special issue highlights a diverse range of research-evaluating mechanisms, as well as mediators and moderators, of outcome. It is anticipated that the research described in these articles will stimulate additional investigations as well as provide important insights for clinicians in refining treatment programs.