乳腺癌术式的演变及其最佳选择

乳腺癌作为女性常见的恶性肿瘤之一,一直是肿瘤学界研究的热点和焦点。手术作为其基本的治疗手段,术式几经改变。通过对乳腺癌术式演变的历史回顾,认为正是由于对乳腺癌生物学行为研究的不断深入,使得乳腺癌手术切除范围更趋于规范和科学。而由生物医学模式向生物—心理—社会医学模式的转变,以及循证医学(EBM)研究的开展,更促进了乳腺癌术式的不断改进,以最大程度减少并发症,获得更为满意的疗效。     

生命意义感获取的心理机制及其影响因素

生命意义感体验对个体身心健康有重要的影响,其相关研究也已开始受到心理学各个领域的广泛关注。生命意义感获得与维持的理论研究主要是包括意义感层次模型、意义感构建模型及意义感维持与流动模型。大五人格、心理模拟、积极/消极情绪和亲社会行为是影响个体生命意义感体验的主要因素。未来研究要进一步探讨生命意义感产生的影响因素,完善相关的理论模型,并要从时间序列的角度探讨意义感的产生过程,并对生命意义感获得及维持的跨文化差异进行探讨。     

Shame,Guilt, and Suicide Ideation among Bondage and Discipline,Dominance and Submission,and Sadomasochism Practitioners: Examining the Role of the Interpersonal Theory of Suicide

To date, no study has examined rates of suicide ideation or theory‐based risk factors for suicide ideation among bondage and discipline, dominance and submission, and sadomasochism (BDSM) practitioners. Participants were 321 adults that endorsed BDSM involvement. Thirty‐seven percent of the sample indicated a nonzero level of suicide ideation. Thwarted belongingness and perceived burdensomeness (PB) were positively associated with suicide ideation and their interactive effect predicted additional variance in suicide ideation after adjusting for depressive symptoms. Overall, shame and guilt were positively associated with suicide ideation and these relations were mediated by thwarted belongingness and PB in parallel adjusting for depressive symptoms; however, there were some differences between demographic subgroups. Among BDSM practitioners, stigma‐related internalized feelings (i.e., shame and guilt) may be associated with increased thwarted belongingness and PB, which are associated with suicide ideation.     

重症免疫性血小板减少性紫癜紧急救治方案的探讨

为了探讨重症免疫性血小板减少性紫癜(ITP)的治疗方案,回顾性分析118例接受激素(92例)或丙种球蛋白(16例)或rhTPO(10例)治疗患者的临床资料,分析疗效及不良反应.结果显示:(1)激素组,丙种球蛋白组和rhTPO组总有效率分别为76.1%、81.3%和70%,组间差异无统计学意义.复发组有效率(67.3%)明显低于初治组(83.3%,P<0.05),PAIgG伴PAIgM升高组有效率明显低于不伴PAIgM升高组(P<0.05);(2)血小板达峰时间:激素组为(5.70±3.68)d,丙种球蛋白组为(4.31±0.75)d,rhTPO组为(5.00±1.63)d,激素组与丙种球蛋白组间差异有统计学意义(P<0.05);(3)不良反应:激素组均出现类库欣综合征表现,丙种球蛋白组未见不良反应,1例(10%)rhTPO组患者出现轻度转氨酶增高.总之,丙种球蛋白和rhTPO治疗成人重症ITP疗效好,不良反应轻微.     

项安世卦变说新探

卦变说是理解项安世易说的关键,其卦变说接续了李挺之的相关识见,分反对卦与不反对八卦。反对卦皆自消息卦来,不反对卦皆自坎离来。以坎离作为主变之卦,既是对汉代易学重视坎离传统的接续,又融合了丹道思想,更是对当时理学家体用思想的认同与接纳,这使得项氏卦变说既具有深厚的传统积淀又有鲜明的时代认同。项氏卦变说的理论动机是从易象本身开显易道之变易,以弥补程颐仅从义理一面揭示易道变易之不足。     

医疗人工智能的“图灵测试”：路在何方

通过对医疗人工智能发展应关注的医学人文相关伦理问题进行总结,探索并思考医疗人工智能长远发展应关注的伦理要求,包括对医师专业精神的要求、精准服务患者的个性需求、医疗人工智能服务公平可及以及医患之间的情感互动等问题,并对以类人智能为终极目标的人工智能技术在医疗应用提出深层的哲学问题,即如何对医学人工智能技术在医学人文伦理方面进行测试。进而提出医疗人工智能的"图灵测试"之问,以期在交叉领域及时就医疗人工智能发展的伦理框架进行深度哲学探讨,从而产生有针对性的可执行的测试方法和标准,促进医疗人工智能的健康长远发展。     

论马一浮"六艺之学"视野中的易学研究

作为现代新儒家早期思想的代表人物,马一浮先生提出了以儒家"六艺之学"统摄天下诸学的主张.这是马先生的一个创举,体现着他对传统儒学有意识地改造和发扬.作为"六艺之学"的一个分支,易学研究在马一浮先生的学术研究中无疑具有着"本体论"地位和作用,它所体现的"心之本体",不仅是"六艺"所自出的本原,也是"六艺之学"共同的目的和归宿.     

Are People Polite to Computers? Responses to Computer-Based Interviewing Systems1

The present studies were designed to test whether people are “polite” to computers. Among people, an interviewer who directly asks about him- or herself will receive more positive and less varied responses than if the same question is posed by a third party. Two studies were designed to determine if the same phenomenon occurs in human–computer interaction. In the first study (N= 30), participants performed a task with a text-based computer and were then interviewed about the performance of that computer on 1 of 3 loci: (a) the same computer, (b) a paper-and-pencil questionnaire, or (c) a different (but identical) text-based computer. Consistent with the politeness prediction, same-computer participants evaluated the computer more positively and more homogeneously than did either paper-and-pencil or different-computer participants. Study 2 (N= 30) replicated the results with voice-based computers. Implications for computer-based interviewing are discussed.     

对现行医疗损害鉴定方式进行改革的探讨

医惠纠纷要顺畅解决必须成立一个独立于卫生行政机关,能独立承担法律责任、能高速运转,医患双方均能认可、中立并且权威的医疗损害鉴定机构,用单一的医疗损害鉴定来取代现行的医疗事故技术鉴定和医疗过错司法鉴定.采用仲裁构架模式设立医疗损害鉴定委员会和成立中国医疗损害鉴定协会对医疗损害进行鉴定是一种可行的方法.