早孕期诊断及其相关问题分析

早孕期诊断是早期诊断的一部分.将新方法应用于早孕期诊断时,应考虑其成本效益问题.早孕期咨询应注意孕妇的年龄特征、个体化诊断和社会伦理学问题,正确诠释诊断结果,让孕妇及其配偶共同参与诊断.     

初级照料中高血压诊断选择的成本效益

高血压的诊断历来是在诊所测量血压的基础上作出的,但家庭和日间测量与心血管结果应更好地关联,动态监测是在诊所和家庭监控中较准确诊断高血压的手段。我们的目的是比较不同的诊断方式对高血压决策的成本效益分析。     

免疫分析中抗体干扰相关问题的探讨

免疫分析是一项应用广泛的技术,抗体是免疫分析的关键问题.循环中内源性抗体对免疫分析的干扰与该技术本身一样古老,由于抗体干扰造成的可疑或错误的结果一直与其并存.但对于其机制、类型和对策并未廓清.有鉴于此,有必要对抗体干扰免疫分析的诸多问题进行更深入的基础与临床研究,以提高临床诊断水平.     

免疫分析中抗体干扰相关问题的探讨

免疫分析是一项应用广泛的技术,抗体是免疫分析的关键问题。循环中内源性抗体对免疫分析的干扰与该技术本身一样古老,由于抗体干扰造成的可疑或错误的结果一直与其并存。但对于其机制、类型扣对策并未廓清。有鉴于此,有必要对抗体干扰免疫分析的诸多问题进行更深入的基础与临床研究,以提高临床诊断水平。     

对医疗纠纷问题的探讨--62例医疗纠纷临床分析

通过62例医疗纠纷的分析,证明医生的诊断和治疗是引发医疗纠纷的重要原因.经营医院的观念,对医疗纠纷的产生起到了一定的催化作用.为此,医疗纠纷的防范不仅要加强和完善制度的落实,更要加强医护人员的业务学习,提高医护人员的敬业精神,使之与社会的发展、人民的需求相适应,更要处理好政府、医院、患者之间的关系.     

对医疗纠纷问题的探讨——62例医疗纠纷临床分析

通过62例医疗纠纷的分析,证明医生的诊断和治疗是引发医疗纠纷的重要原因。经营医院的观念,对医疗纠纷的产生起到了一定的催化作用。为此,医疗纠纷的防范不仅要加强和完善制度的落实,更要加强医护人员的业务学习,提高医护人员的敬业精神,使之与社会的发展、人民的需求相适应,更要处理好政府、医院、患者之间的关系。     

我国产后抑郁评估与诊断方法应用现状分析

早期评估与诊断是产后抑郁预防干预的第一步,通过分析国内产后抑郁评估与诊断方法的应用现状.为提高评估与诊断结果的科学性提供依据.发现爱丁堡产后抑郁量表为筛查首选量表,分析显示采用同一种量表和不同量表进行评估的检出率均有较大差异.因此,应根据研究特点选择适宜的筛查量表以提高不同研究结果的可比性,同时,需加强量表分界值本土化的研究.     

我国产后抑郁评估与诊断方法应用现状分析

早期评估与诊断是产后抑郁预防干预的第一步,通过分析国内产后抑郁评估与诊断方法的应用现状,为提高评估与诊断结果的科学性提供依据。发现爱丁堡产后抑郁量表为筛查首选量表,分析显示采用同一种量表和不同量表进行评估的检出率均有较大差异。因此,应根据研究特点选择适宜的筛查量表以提高不同研究结果的可比性,同时,需加强量表分界值本土化的研究。     

探索性因子分析及其在应用中存在的主要问题

探索性因子分析的发展非常迅速,已成为教育与社会心理学领域中最常用的统计方法之一。本文全面介绍了探索性因子分析的基本原理,阐述了其发生的机制及基本过程,对其在教育、心理领域应用中存在的问题进行了总结,并针对应用中样本容量和观测变量数目不够、因子求解方法的误用、因子数目的确定标准及因子旋转中存在的问题、因子值缺乏重复验证性、研究结果呈现形式不规范、过于依赖SPSS、缺乏主动性等问题提出了一些相应的建议。     

工读学校学生心理健康问题分析及其教育对策研究

工读学校学生目前在心理健康方面,主要存在学习动机低下、学业成绩差、人际交往不良、情绪不稳定、人格偏差、性心理不健康等问题,结合现存的问题,根据我国有关心理健康教育的政策法规,需要建立工读学生心理健康教育的和谐氛围,这就要妥善处理好学习与心理健康、自我与同伴以及自我与社会等的关系,作者提出了工读学校在开展心理健康教育中需要注意的问题,为有关部门开展该方面工作提供参考.     

Sequential Down Syndrome Screening: The Importance of First and Second Trimester Test Correlations when Calculating Risk

Down syndrome screening can be particularly effective when both first and second trimester tests are performed. However, the counseling of women who have received sequential first and second trimester screening can be problematic. We evaluated an approximation where the post-test risk from the first trimester screening is used as the new a priori risk for the second trimester screening. The approximation disregards between-trimester test correlations. The Down syndrome detection rate based on the approximation (90.2%) would be close to that obtained when all correlations were considered (90.8%) but the false positive rate would be 26% higher (3.9% versus 3.1%, respectively). For any particular woman, the use of the approximation could result in highly inaccurate risks. We conclude that the correlations that exist between first and second trimester screening tests preclude the use of second trimester risks derived from the direct product of separate first and second trimester screening. Counseling issues in the delivery of sequential screening are discussed.     

多元论生命价值观与唐氏综合征患者的人文关怀

唐氏综合征是智力低下最常见的原因,目前无法治愈。在传统功利主义生命价值观影响下,患者被主流社会忽视和歧视,其生存环境不容乐观。本文从价值多元论的角度探讨了对唐氏综合征患者进行人文关怀方面的依据,并就如何对唐氏综合征患者进行人文关怀提出建议。     

从系统论分析肾病综合症的诊断治疗

分析系统论方法主要基本原则在肾病综合症诊治中的指导性作用.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,可以拓展研究的新思路,为疾病的诊治提供最佳方案,对促进和指导医学研究发展有极其重要的意义.     

New insights into the formation and duration of flashbulb memories: Evidence from medical diagnosis memories

Flashbulb memories are vivid and salient memories for the moment one hears about a surprising, emotional, and significant event. The current research examined flashbulb memories for a loved one's medical diagnosis, focusing on individual and situational factors associated with memory development and endurance over time. An online survey collected memory narratives and subjective ratings from 309 mothers who received a diagnosis of Down syndrome for their child. Time since diagnosis ranged from 1 month to 52 years. Using two independent measures, the Flashbulb Memory Checklist and the Autobiographical Memory Questionnaire, we found that a majority of diagnosis memories qualified as flashbulb memories, even 20 years or more after the event. Importantly, support from the medical staff at diagnosis emerged as a critical variable related to flashbulb memory development and the persistence of these flashbulb memories over time.     

Continuation of Pregnancy Following the Diagnosis of a Fetal Sex Chromosome Abnormality: A Study of Parents' Counseling Needs and Experiences

Parents who decide to continue a pregnancy diagnosed with a sex chromosome abnormality (SCA) experience a variety of emotions as they deal with complex medical and genetic information. To better understand these individuals' psychosocial, educational, and support needs, 26 parents who received prenatal diagnosis of an SCA after 1989 and who had decided to continue their pregnancy were interviewed by telephone. Twenty (77%) reported they initially had a poor understanding of the predicted syndrome. All parents later met with a genetics professional. Twenty-two (92%) parents considered sterility and underdevelopment of secondary sexual characteristics to be the most negative aspects of SCAs. Contact with other parents of children with SCAs and with support organizations were generally viewed as helpful experiences. Insight gained from this study should be useful for genetic counselors and other health care providers involved with patients who have received abnormal prenatal diagnosis results.     

脑卒中诊治观念转变的思考

脑卒中是一种常见病,伴有较高的病死率和致残率。近年来脑卒中诊治方面取得了不少进展,许多有关脑卒中的诊治的观念发生了巨大的转变,如卒中后血压的控制,高血压脑出血的止血治疗,急性脑梗死的溶栓治疗,卒中单元以及卒中的预防等方面。从这些转变中渗透着许多哲学观点,如否定之否定规律,科学假说与理论之间的关系,系统论的应用等。运用哲学的观点认识脑卒中的诊断治疗的转变,对日后的临床和科研有着一定的指导意义。     

非严重遗传病产前诊断及PGT的伦理思考

随着近年基因诊断技术的飞速发展,出现了要求通过产前诊断或胚胎植入前遗传学检测（preimplantation genetic testing,PGT）技术阻断某些非严重遗传病在家族中传递的新需求。从非严重遗传病定义,目前产前诊断及PGT技术发展现状、适应证及各自本身存在的伦理问题,遗传咨询原则等进行阐述,并以白化病和成人多囊肾为例,讨论遗传咨询医师应该如何根据国情、现行法律以及伦理原则对这类患者进行知情同意并实现医患共同决策。呼吁国家组织专家探讨共识,明确相关规定,遵循相关医学伦理学原则。     

Embodied Knowledge and Making Sense of Prenatal Diagnosis

Open-ended, qualitative interviews with women to whom amniocentesis was offered were analyzed to understand how women made sense of these tests. We found that women, whether tested or not, negotiated with biomedical information. They transformed it through identifiable processes, then wove it with their own instincts and beliefs and with their personal experiences, thereby creating embodied knowledge on which their decisions were based. Women who were and were not tested may have differed from each other when categorized on the basis of a final, binary choice, but they were more alike than unalike in reaching this point. The apparent importance of embodied knowledge suggests the critical role of the listening activities of the genetic counselor and of awareness of the validity and importance of women's complementary ways of knowing and doing in understanding the uses and meanings of prenatal genetic testing.     

从中医症、证、病的概念谈辨证与辨病的关系

中医学中的症、证、病是三个不同的概念,症是人体在疾病状态下发出的每一个信息;证是疾病在瞬间的症状总和,是信息群;而病是症状和证候的主体,是一种状态,也是一个过程.只有辨证是不够的,辨证的同时应追求辨病,将辨证与辨病结合起来,在明确疾病诊断的前提下,辨证才是比较准确的.