Dualism and its Importance for Medicine

Cartesian dualism has been viewed by medical theorists to be oneof the chief causes of a reductionist/mechanistic treatment ofthe patient. Although I aver that Cartesian dualism is one culprit for the misapprehension of the genuine treatment of patients in termsof both mind and body, I argue that interactive dualism whichstresses the interaction of mind and body is essential to treatpatients with dignity and compassion. Thus, adequate medical carethat is humanistic in nature is difficult (if not impossible)to achieve without physicians adhering to a dualistic frameworkin which the body and person is treated during illness.     

老年甲状腺结节的诊治经验

介绍笔者及科室老年甲状腺结节的诊治经验,对2003年1月至2009年12月期间共收治的144例年龄大于60岁的老年甲状腺结节患者进行分析和总结。老年甲状腺结节以多发为主;压迫症状、异物和不适感、继发性甲状腺功能亢进是老年甲状腺结节患者主要的手术指证;术中发现喉返神经和甲状旁腺有脂肪沉着;病理方面良性结节的钙化率较高;患者术后切口水肿比较明显;暂时性低钙血症的发生率较高;虽然术前麻醉ASA评分较低,但术后心肺并发症的发生率并未上升。老年甲状腺结节患者以全麻为宜,最好采用双甲近全切除术,这不仅可避免术后复发和再次手术率,更可减少甲状腺素制剂的用量,减少药物副作用。     

Overconfidence and underconfidence: When and why people underestimate (and overestimate) the competition

It is commonly held that people believe themselves to be better than others, especially for outcomes under their control. However, such overconfidence is not universal. This paper presents evidence showing that people believe that they are below average on skill-based tasks that are difficult. A simple Bayesian explanation can account for these effects and for their robustness: On skill-based tasks, people generally have better information about themselves than about others, so their beliefs about others’ performances tend to be more regressive (thus less extreme) than their beliefs about their own performances. This explanation is tested in two experiments that examine these effects’ robustness to experience, feedback, and market forces. The discussion explores the implications for strategic planning in general and entrepreneurial entry in particular.     

妇产科学临床诊疗中的思维

从辩证思维方式在妇产科学临床诊疗中的运用入手,通过多个临床诊疗的实例,说明哲学与医学的共通性。哲学辨证思维的开阔思维方式,可以使妇产科学的临床诊疗活动更加全面和完善,使临床诊断更加精准,制定的治疗方案更加合理,从而尽可能地减少医疗纠纷。     

胎儿产前超声诊断中的人文关怀

随着医学的进步,医学模式的转变,越来越提倡医学对人们心理和社会因素的关怀。同时随着产前诊断技术和超声诊断技术的迅速发展和日臻完善,以及社会、经济的发展和变革,也越来越重视对孕妇及家属的人文关怀。胎儿产前超声诊断中的人文关怀不仅是对人的关怀,也是对技术、对心理健康、对生命的关怀。     

Comorbidity between and within childhood externalizing and internalizing disorders: reflections and directions

The term and concept of lcomorbidity has been mired in controversy, although there is little question that the existence of covariation among psychiatric diagnoses poses significant challenges to current models of psychiatric classification and diagnosis. The papers in this Special Section underscore a number of important issues relevant to the comorbidity between and within childhood externalizing and internalizing disorders, and illustrate both methodological and substantive reasons for such comorbidity. Weiss, Susser, and Catron's distinction among common, broad-band specific, and narrow-band specific features provides a helpful framework for understanding the comorbidity of childhood externalizing and internalizing disorders (B, Weiss, K. Susser, & T. Catron, 1998). Hierarchical models of psychopathology help to dissolve the distinction between splitters and lumpers and point to variables that may elucidate the etiology of externalizing and internalizing disorders.     

Stress and Coping: A Comparison of Self-Report Measures of Functioning in Families of Young Children with Cerebral Palsy or No Medical Diagnosis

We analyzed data from 87 mothers of children ages 15 to 44 months with cerebral palsy (CP) or no diagnosis, who completed the Dyadic Adjustment Scale, Parenting Stress Index, Support Functions Scale, and Inventory of Social Support. Principal components analysis of the 15 subscales from the 5 measures revealed few cross-measure loadings. Mothers of children with CP (severe or mild) reported higher levels of parenting stress than did mothers of controls. However, cluster analysis of self-report measures yielded a 5-cluster solution, with no diagnostic group differences across clusters. That is, there were no overall differences in self-reported family functioning according to presence or severity of the child's disability. The results are discussed in terms of the organization of family systems and their relationship to child diagnosis. Clinical implications for assessing and working with families are noted.     

帕金森病诊断标记物系统回顾与展望

本篇综述总结了帕金森病的诊断、鉴别诊断和病程监测的各领域的生物学标记物的研究进展。其中重点介绍了神经影像学和生物化学领域的生物学标记物,也是当前研究较为成熟的两大领域。神经影像学标记物以多巴胺能影像及非多巴胺能影像为代表,生物化学标记物为包括a一突触核蛋白在内的多种蛋白和激素,两者的结合能够有效提高疾病诊断的特异性和灵敏性。同时文章还介绍了当前研究的热点——帕金森病的前驱诊断手段,即在疾病典型的运动症状和非运动症状出现前便可预测帕金森病的诊断手段。     

试论“肝病传脾”的诊断及治疗思路

《金匮要略》中“肝病传脾”的思想,广泛应用于临床诊断与治疗,本文以脏腑经络辨证论治思想为依据,探讨中医诊断肝痛的思路：根据症状判断病位深浅,肝病见四肢疲乏为病轻、肝病见食不消化甚至不思饮食为病重。由此判断病情轻重,为临床提供治疗依据。     

解读2009年GINA——5岁及5岁以下儿童哮喘诊断与管理

2009年5月,全球哮喘防治创议组织（GINA）发布了“Global Strategy for the Diagnosis and Management of Asthma in Children 5 Years and Younger（5岁及5岁以下儿童哮喘诊断和管理的全球策略”。这是由GINA执行委员会所组织的儿科专家组,根据当前所能得到的循证医学证据为基础,并且考虑到5岁及5岁以下儿童哮喘管理所面临的特殊挑战（包括诊断困难、药物和药物输出装置的有效性和安全性、缺乏在该年龄段新疗法的数据等）,专门针对这个年龄组的儿童,所提出的哮喘诊断和管理方面的报告。