肺癌早期综合诊疗思考

通过分析目前肺癌患者5年生存率徘徊在10%,这一现实问题,可以得到一些重要启示和思考。今后肺癌治疗发展方向将是完善个体化、多学科早期综合治疗模式;利用基因芯片技术开展肺癌早期诊断,对肺癌高危人群开展大规模普查;开展靶向性、高效低毒、抗耐药性的肺癌治疗药物研究,进行肺癌逆转的分子干预治疗和分子阻断治疗,要用早期综合地手段诊疗肺癌。     

加强青年医师素质培养进一步提高临床教学水平

探讨青年医师应具备的临床素质:优秀的道德品质、较高的文化素养、扎实的专业知识、较强的身心素质和不断的创新意识.分析目前存在的问题,高学历与实际能力不符、轻视临床思维分析、功利主义思想严重.指出如何强化青年医师的素质培养,规范化培训、注重学习和实践、制定合理政策.     

大学生知识价值观的实证研究

该研究从理论上界定了知识价值观及其基本成分(即知识价值目标、知识价值评价和知识价值手段)。运用设计的《大学生知识价值观调查表》,对2043名大学生进行了调查。结果显示,大学生在知识价值目标、知识价值评价和知识价值手段三方面都呈现出年级、性别和专业的差异。     

情绪启动研究的实验范式

情绪启动是探讨情绪和态度自动激活的有效方法,近期其研究范式有了较大的发展,相继产生了经典情绪启动实验、阈下情绪启动实验、向后情绪启动实验以及情绪启动与其他范式相结合的实验等较有影响的研究范式。文章分别梳理了这些范式及其研究结果,并在此基础上,总结研究所采用的范式并展望今后研究的发展趋势。     

Restrictions in means for suicide: an effective tool in preventing suicide: the Danish experience

Restriction of means for suicide is an important part of suicide preventive strategies in different countries. The effect on method-specific suicide rate and overall suicide rate of restrictions on availability of carbon monoxide, barbiturates, and dextropropoxyphene was examined. From 1970 to 2000, overall suicide mortality and method-specific suicide mortality in Denmark were compared with official information about availability of barbiturates and analgesics and carbon monoxide in vehicle exhaust and household gas. Restrictions on availability of household gas with carbon monoxide content and barbiturates was associated with a decline in the number of suicides and suicides by self-poisoning with these compounds after controlling for the effect of calender year. Restricted access occurred concomittantly with a 55 percent decrease in suicide rate.     

Dynamic self-organization and early lexical development in children

In this study we present a self-organizing connectionist model of early lexical development. We call this model DevLex-II, based on the earlier DevLex model. DevLex-II can simulate a variety of empirical patterns in children's acquisition of words. These include a clear vocabulary spurt, effects of word frequency and length on age of acquisition, and individual differences as a function of phonological short-term memory and associative capacity. Further results from lesioned models indicate developmental plasticity in the network's recovery from damage, in a non-monotonic fashion. We attribute the network's abilities in accounting for lexical development to interactive dynamics in the learning process. In particular, variations displayed by the model in the rate and size of early vocabulary development are modulated by (a) input characteristics, such as word frequency and word length, (b) consolidation of lexical-semantic representation, meaning-form association, and phonological short-term memory, and (c) delayed processes due to interactions among timing, severity, and recoverability of lesion. Together, DevLex and DevLex-II provide an accurate computational account of early lexical development.     

结核病直接督导短程化疗策略的伦理学视角

从伦理学角度探讨了结核病直接监督下短程化疗(DOTS)策略以及DOTS策略实施过程中若干问题。DOTS策略被认为是当今结核病诊治和管理的最有效方法,体现了医学伦理学的公益论;尊重病人的选择及隐私是有效控制结核的重要内容,标准化疗方案和个体化疗方案应视病情而定;医务人员应有良好的综合素质。     

哮喘控制稳定后如何减停糖皮质激素

糖皮质激素是最有效的抗气道炎症药物,吸入糖皮质激素(ICS)是首选哮喘控制药物.由于治疗后达到哮喘临床控制(症状、肺功能)需要一定时间,ICS达到一定剂量后量效曲线较平坦,而全身不良反应却逐渐增加.因此,达到临床控制后在长期监测下至少维持哮喘控制3个月以上,开始减少50%ICS剂量,直至ICS减至最低维持剂量.如为ICS加另一种控制药(长效β2受体激动剂、白三烯调节剂、缓释茶碱)联合治疗达到控制者,在ICS减至最低剂量时再停用另一种控制药.应用最低剂量ICS维持控制达1年方可考虑停药.     

21世纪医疗保障制度改革与发展趋势管窥

21世纪的医疗保障制度改革与发展主要表现为:在理论上,强调医疗保障是人权的基本内容;在保障的对象上强调全民性和公平性;在保障的内容上更加重视预防保健;在医疗保障的运行机制上,强调政府主导与市场机制相结合;在服务模式方面,积极构建多层次网络化的社区卫生服务体系,推行医疗适宜技术;在筹资模式上,更注意建立以政府投入为主导的多元化筹资机制.     

成人在错误信念任务上的表现

考察成人在错误信念(FB)任务上是否存在"知识偏差"效应。实验1重复Birch等的实验程序并未得到与之一致的结果,成人在FB任务上的表现不理想,且无"知识偏差"效应存在。实验2排除琴盒位置及颜色的突出性影响后,结果与实验1相似。成人在FB任务上的不佳表现与成人具有心理理论的事实相悖,说明把通过FB任务作为衡量心理理论的唯一评定标准有待商榷。