循证医学与临床诊断学教育改革

探讨在临床诊断学教育中,导入循证医学的理念和方法,改变传统的经验医学教育模式,实现教学相长。以期提高医学生的理论知识水平和临床技能,提高临床实践能力,培养具有临床循证思维和创新思维的新一代医学人才。     

胸腔镜肺切除术治疗肺部恶性肿瘤的合理性

通过回顾近年电视胸腔镜手术(VATS)在治疗非小细胞肺癌的进展,得出以下结论:在有经验的胸外科医师手中,VATS肺叶切除术是一种安全有效、死亡率和并发症发生率很低的术式。VATS肺叶切除是一种完全的肺部肿瘤切除手术,在有选择的早期病例可以达到与开胸手术一样的生存率。但这种术式并不适用于全部肺部恶性肿瘤和所有胸外科医师。     

Religion and Forgiveness from a Hong Kong Chinese Perspective

This study investigated the relationship between religion and forgiveness in a sample of Hong Kong Chinese teachers (n=230) and students (n=714). Findings indicated some influence from Chinese cultural values in the conceptualization of forgiveness. Religious affiliation was the strongest predictor of concepts of forgiveness, whereas religious practice predicted attitudes toward “forgivingness” and the practice of forgiveness. No significant difference in forgiveness between believers and non-believers in real life situations was reported. Implications for future research on forgiveness are discussed.We wish to acknowledge the University of Hong Kong Committee on Research and Conference Grants for funding our research. Portions of this paper were presented at the 3rd Annual Mid-Year Research Conference on Religion and Spirituality sponsored by Division 36 of the American Psychological Association and the Department of Pastoral Counseling at Loyola College in Maryland April 1–2, 2005.     

Insurance Coverage and Mental Health Service Use by Adolescents with Serious Emotional Disturbance

This paper examines the relationships between insurance coverage, need, and mental health services in a community-based sample of 1,015 youths who were 9, 11, and 13 years old at the beginning of the study. They were followed over a two-year period. A strong measure of need based on a standardized diagnostic interview was available and repeated over three annual waves. Data on service use was collected quarterly across two years. Major findings included: (a) high need (serious emotional disturbance [SED]) was strongly related to use of any mental health services; (b) services use was much more likely to occur with public (Medicaid) insurance coverage than either private or no insurance; (c) considerable unmet need was observed even for youths with SED; (d) school-based mental health services potentially substituted for professional mental health services; and (e) there was little unnecessary use of mental health services in the low need group. The major policy implication of these findings is that the regulation of insurance benefits should be based on level of need, rather than on arbitrary limits which are likely to either reduce the probability of or appropriate amount of care for youths who most need mental health services.     

Warriors versus worriers: the role of COMT gene variants

Behavioral phenotypes are generally complex, reflecting the action of multiple different genes. Nevertheless, there is growing evidence that key gene variants can alter activity within specific neuronal circuits and, therefore, influence particular cognitive-affective phenomena. One example is the catechol-O-methyltransferase (COMT) gene, which has a common variant at codon 158. Those with valine (Val158) alleles have increased greater COMT activity and lower prefrontal extracellular dopamine compared with those with the methionine (Met158) substitution. Val158 alleles may be associated with an advantage in the processing of aversive stimuli (warrior strategy), while Met158 alleles may be associated with an advantage in memory and attention tasks (worrier strategy). Under conditions of increased dopamine release (eg, stress), individuals with Val158 alleles may have improved dopaminergic transmission and better performance, while individuals with Met158 alleles may have less efficient neurotransmission and worse performance. Some evidence suggests that Val158 alleles are associated with schizophrenia, while Met158 alleles are associated with anxiety.     

胸腔镜肺切除术治疗肺部恶性肿瘤的合理性

通过回顾近年电视胸腔镜手术(VATS)在治疗非小细胞肺癌的进展,得出以下结论:在有经验的胸外科医师手中,VATS肺叶切除术是一种安全有效、死亡率和并发症发生率很低的术式.VATS肺叶切除是一种完全的肺部肿瘤切除手术,在有选择的早期病例可以达到与开胸手术一样的生存率.但这种术式并不适用于全部肺部恶性肿瘤和所有胸外科医师.     

Individual Differences in Brain Structure and Resting Brain Function Underlie Representation-Connection in Scientific Problem Solving

Evidence from a range of fields shows that representation-connection (RC) is the key step towards the solution of a real-world insight problem. However, no study has focused on the inter-individual variability in RC, and little is known about whether structural and resting-state functional signals can account for inter-individual differences in RC. Combining structural (regional grey matter density, rGMD) and functional (fractional amplitude of low-frequency fluctuations (fALFF) and resting-state functional connectivity (RSFC)) analysis approaches was used to examine the neural substrates of RC. The results showed that the RC score was positively correlated with rGMD and fALFF values in the bilateral lingual gyrus (LG), which might be related to relevant visual imagery during the correct matching of a specific prototype with an unsolved technical problem and the retrieval and application of key information from prototypes. In addition, the RC score was negatively correlated with the rGMD in the left dorsolateral prefrontal cortex (DLPFC), and functional connectivity analysis revealed that a higher RC score was inversely correlated with the strength of the RSFC between the right LG and the left inferior parietal lobule (IPL), which indicated that RC might be supported by decreased response inhibition and the automatic association of semantics.     

Are the psychophysical laws fine-tuned?

International Journal for Philosophy of Religion - Neil Sinhababu (Am Philos Q 54(1):89–98, 2017) has recently argued against the fine-tuning argument for God. They claim that the question of...     

决策的加工过程及个体差异:模糊痕迹理论视角

模糊痕迹理论是行为决策领域的重要解释理论,它认为个体在加工信息时存在字面加工和要义加工两种方式,在决策时个体更倾向于使用要义加工,而且这两种加工存在个体差异。决策的加工模型依据模糊痕迹理论提出,以框架效应和风险知觉为例对该模型进行解释。模糊痕迹理论通过分析加工方式的个体差异来解释决策的个体差异。未来研究应进一步比较模糊痕迹理论与其他理论,完善根据模糊痕迹理论提出的决策加工模型,并深入探索决策的个体差异。