A successful trial utilizing the Leuzinger-Bohleber methodology for evaluation of psychoanalytic treatment: Preliminary report

Utilizing audio-recorded psychoanalytic interviews of both patients and their analysts, group discussions of these interviews, and the application of questionnaires commonly used in psychotherapy research, the authors investigate the potential use of the Leuzinger-Bohleber methodology as an objective evaluative instrument to assess the quality of psychoanalytic treatment. Preliminary study results were obtained through interviews conducted with seven analysts and their respective patients, three of whom were treated with psychoanalysis (three or more sessions per week, for a duration of no less than one year) and four with psychotherapy (one or two sessions per week, for a duration of no less than one year). Patients were found to be eager to participate, and no adverse experiences were reported by analysts, patients or the research team. In addition to the interviews, further data were obtained through review of mailed-in questionnaires completed by 21 patients. The authors present both preliminary observations regarding the methodology as a whole, as well as the detailed results of one specifi c case subject treated with psychotherapy. Review of study fi ndings supports the utilization of this methodology as an evaluative instrument which may ultimately advance current knowledge of the process and outcome of psychoanalytic treatment.     

医院管理公司"两权分离"的实践与思考

上海仁济医疗管理有限公司作为一家专业化的医院管理公司,以医院的委托经营管理为主要模式,在我国公立医院"两权分离"理论的实践和公立医院的职业化管理方面,逐步形成一套具有系统与特色的管理体系.通过介绍其运作模式和主要内容,初步评价其实施效果.     

加强我国卫生领域科研诚信建设的重要性

近几年来,我国的科研不端案例呈不断上升趋势.科技部、教育部、中国科学院,国家自然科学基金委员会、中国科学技术协会等部门或机构已发布了关于科研不端行为的处理规定,然而在我国卫生领域科研不端行为的处理和科研诚信建设方面尚未出台相关政策或指导意见.加强我国卫生领域的科研诚信建设具有重要意义.     

当前实施麻醉过程中遇到的困惑及解决办法

当前麻醉应用过程中存在困惑,表现为:麻醉知情告知与患者接受存在矛盾;麻醉应用费用支出与患者经济节约构成冲突;麻醉风险意外出现与患者期待绝对安全冲突;麻醉要求与外科医生要求冲突.当前麻醉应用困惑的解决在于将告知沟通贯穿治疗全程,体现人文关怀;提高麻醉质量,提高麻醉安全系数;加强麻醉医生与外科医生沟通配合,共同提高手术效果;细化优化现有法律规定,平衡医患法律关系.     

美国住院医师培训制度对完善上海市住院医师培训制度的启示

美国住院医师培训制度经过100多年的发展,目前已经形成了一套系统化、规范化和科学化的制度。上海市的住院医师培训制度起步晚,亟待规范、完善和发展。本文对美国住院医师培训制度的现状及特点进行深入分析,为上海市住院医师培训制度的进一步完善提供经验和做法。     

中药及其提取物防治血管内皮细胞损伤的研究概况

血管内皮细胞衬覆于血管内膜表面,不仅是血液与血管壁之间的屏障,更是重要的内分泌和效应器官,内皮细胞损伤和功能障碍是动脉粥样硬化发生的启动步骤。近年来的研究表明,中药及其提取物对血管内皮细胞具有保护作用,因此对防治动脉粥样硬化相关疾病有重要的意义。     

Message Derogation and Self‐Distancing Denial: Situational and Dispositional Influences on the Use of Denial to Protect Against a Threatening Message1

Five types of denial to protect against the implications of a personal health threat message (cardiovascular disease or CVD) were examined. Undergraduates (N = 150) were randomly assigned to levels of threat and difficulty, read the message, and completed measures of objective risk for CVD, optimistic denial threat orientation, measures of 1 type of message‐oriented denial (message derogation) and 4 types of self‐oriented denial, and intentions to engage in protective action. High threat and difficulty both provoked message derogation, but low threat led to more self‐oriented denial. Individual differences were evident: Those higher in optimistic denial used more self‐oriented denial and had lower intention to engage in protective actions. Self‐oriented denial mediated the relationship between optimistic denial and behavioral intentions.     

负性情绪干扰行为抑制控制:一项事件相关电位研究

以往研究提示,行为抑制控制与视觉情绪加工的神经活动存在交互作用,而视觉材料诱发的正、负情绪如何影响行为控制加工过程尚不清楚。采用双选择情绪oddball范式与事件相关电位(ERP)技术,本研究假设视觉情绪刺激的呈现对个体的行为控制能力具有显著影响。实验要求被试对标准刺激与偏差刺激(85%vs.15%)分别做不同的按键反应。偏差刺激由正、负、中三种来自中国情绪图片系统的情绪图片组成。行为结果发现,负性条件下的反应时间显著长于中性与正性条件,而三类偏差刺激的反应时均显著长于标准刺激的反应时。ERP结果显示,不论效价,在240～300ms与350～550ms两个时间窗口,偏差刺激与标准刺激诱发的平均波幅差异显著,表明本研究条件下行为抑制控制效应显著。在代表行为控制加工的偏差-标准差异波中,在上述两窗口内分别出现显著的N2与P3成分。负性条件下N2及P3潜伏期显著长于中性条件;而负性条件下N2波幅显著大于而P3波幅显著小于中性条件。相反,正性条件下N2波幅显著小于而P3波幅显著大于中性条件。因此,本研究从行为与脑电两个层面揭示了情绪对行为控制过程的影响:负性情绪减弱个体的行为控制能力,从而导致个体对反应冲突的觉察变慢及对优势反应的抑制过程更长。相反,正性情绪对行为控制过程可能具有促进作用。     

腹主动脉瘤的外科治疗决策

腹主动脉瘤破裂是最常见、最凶险的疾病之一。提高对其治疗的临床决策水平至关重要。比较传统开腹修复治疗和血管腔内修复治疗的优缺点,以最佳证据为指导,选出最佳方案应用于临床实践。以人为本,做出科学决策,从而降低医疗费用及提高疗效及患者生活质量。     

干细胞技术与肝硬化:共性与个性的新实践

干细胞横向分化(transdifferentiation)的能力,在肝脏再生过程中发挥作用,随着对干细胞的深入研究,干细胞技术为终末期肝病的治疗提供了新思路.本文对干细胞加以分类并综述了各种干细胞研究进展,对干细胞在肝脏疾病细胞治疗上的应用及前景作了总结和展望.