金代医家张子和医学地位变迁与攻邪论学术史研究

金代医家张子和,精通汗、吐、下三法,开创攻邪派。在中国医学史上,张子和与刘完素、李东垣、朱丹溪并称为中医“金元四大家”。实际上,在历代有关中医“四大家”的历史书写演变历程中,张子和的医家地位并非一成不变,而是经历医学地位变迁的三个不同阶段。其医家地位变化脉络可概括为：医名盛于金元,淡于明清,名归于近代。在中医学术发展史上,自明代以及降,攻邪论逐渐淡出中医主流学术范畴,其学术传承脉络出现明显的断层现象。到了近现代,尽管张子和的医家地位重新回归中医“金元四大家”之列,但是攻邪论实际影响力仍旧式微。

     

世界医学会《国际医学伦理准则》的诞生与发展：一项历史的回顾

《国际医学伦理准则》是世界医学会代表性伦理规范之一。世界医学会成立于第二次世界大战结束之际,是国际重要的医学专业组织,致力于制定体系化的伦理规范对个体医生提供道德指导,也对世界各国医学会、政府和国际组织提供帮助。《国际医学伦理准则》于1949年诞生,70余年来历经4次修订不断完善,2022年最新修订版做出了重要调整,中国参与了最近一次修订工作。历史性地分析《国际医学伦理准则》,有助于进一步理解当代医学职业精神的特征,深入认识世界医学会的伦理治理体系,也对推进中国医学伦理学规范建设有借鉴性意义。     

医学人文应用能力的培养和评价——基于医师资格考试医学人文模块考试结果的反馈

为促进医学人文课程教学和评价,回顾分析临床类别医师资格考试医学人文模块不同年度和不同学科的平均掌握率。分析发现医学人文模块平均难度适当(63.3%,SD=25.2%),整体的平均掌握率均高于合格标准(D=3.3%,P=0.04),各年度平均掌握率比较稳定;医学伦理学掌握率显著高于医学心理学(D=11.7%,P=0.04)和卫生法规(D=9.7%,P=0.01),医学伦理学案例型试题平均掌握率显著好于非案例型试题(D=21.6%,P=0.00),为考试提供了效度证据。建议要不断完善医师资格考试医学人文模块的设计与评价,医学人文教育应更重视应用能力的培养,要以岗位胜任力为导向完善医学人文能力的评价。     

中医典籍中文化负载词的识别及翻译策略刍议

中医深植于中国传统文化中,英译过程存在大量文化对应空缺现象,因而中医典籍中文化负载词的翻译成为中医典籍外译的关键步骤和难点。提出了中医文化负载词的识别步骤和选词标准,进而提出中医典籍文化负载词的翻译策略。在中医文化负载词的识别步骤基础上,对中医典籍文化负载词的翻译策略进行了总结:中医药基本名词术语的文化负载词采用直译法;中国物质文化独有词语的负载词采用音译或音译加注;古汉语独有的文化负载词采用省译或意译。目的是通过中医典籍文化负载词的界定和提出的翻译策略推动中医典籍对外传播。     

EFFECTS OF REINFORCER QUALITY ON BEHAVIORAL MOMENTUM: COORDINATED APPLIED AND BASIC RESEARCH

The high-probability (high-p) instructional sequence has been an effective treatment for noncompliance. However, treatment failures have also been reported. We hypothesized that the efficacy of the high-p treatment may be improved by using higher quality reinforcers for compliance to high-p instructions. The resistance of compliance to change was tested by varying reinforcer quality in two applied studies and a basic laboratory experiment. Experiment 1 tested the hypothesis that an increase in reinforcer quality for high-p compliance will increase the effectiveness of the high-p treatment when it fails to increase compliance. Experiment 2 assessed the effects of reinforcer quality on resistance of compliance to change by presenting successive low-p requests following the high-p treatment. A basic laboratory study (Experiment 3) was conducted to further isolate the relation between reinforcer quality and behavioral momentum. Two different liquid reinforcers (sucrose and citric acid solutions) were presented in a two-component multiple variable-interval variable-interval schedule followed by a single extinction test session. Results of all three experiments showed a generally consistent relationship between reinforcer quality and behavioral momentum.     

Factor comparison of two Minnesota Multiphasic Personality Inventory short forms

A sample of 315 valid Minnesota Multiphasic Personality Inventory (MMPI) protocols were selected from inpatient files and scored for both the MMPI-168 and Faschingbauer Abbreviated MMPI short forms. Each short form was then factor-analyzed by a principal axis strategy with varimax rotation. The six factors extracted from each short form were then compared as to their similarity by use of the s index. This procedure showed five of the six factors in each short form as having a significant relationship of the pattern of salient variables they had in common with the complimentary factors of the other form. These data suggest that both short forms, though based on different construction methodologies, share the same underlying personality attributes. Future research is suggested to replicate these results and extend them to the full MMPI.     

THE EFFECTS OF A CHILD'S SELF-EVALUATION PROGRAM ON COMPLIANCE WITH PARENTAL INSTRUCTIONS IN THE HOME

A self-evaluation program was implemented with a kindergarten-aged boy in the home to increase compliance with parent instructions and decrease inappropriate verbal behavior. The self-evaluation package included the child's assessing the appropriateness of his behavior in 5-min intervals, receiving chips for positive self-evaluations, and exchanging chips for a reward following experimental sessions. In a reversal design, analyses were conducted of the effectiveness of the self-evaluation program, the requisite conditions for effective child behavior change with a self-evaluation approach, and the parent's efficiency in using the self-evaluation package. The self-evaluation procedures typically resulted in increased compliant behavior and decreased inappropriate behavior, although the effects generally weakened with time. Behavioral gains were greater and better maintained when the self-evaluation procedures were preceded by a phase of external evaluation via the mother than by baseline, suggesting that self-evaluation procedures may serve more to maintain the effects of external evaluation rather than to induce their own changes. The parent generally was efficient in implementing the procedures. Research and clinical implications for using self-evaluation procedures in a home setting are discussed.     

Central auditory processing : II. Effects of anterior temporal lobectomy

Ear dominance for the pitch of dichotically presented tonal stimuli was measured in nine patients before and after a unilateral anterior temporal lobectomy. Four subjects had a left and five had a right lobectomy. Every patient exhibited a change of ear dominance consistent with the hypothesis that a unilateral lobectomy decreases the perceptual salience of the tone presented to the ear contralateral to the lesion. Depending on the direction and magnitude of the subject's preoperative ear dominance and the side of the lobectomy, the postoperative results either increased or decreased the strength of ear dominance in a predictable fashion. The results support the idea that within each temporal lobe lie physiological mechanisms which can enhance the perceptual salience of the acoustic signal emitted by one sound source when other, concurrent, spatially separated sound sources are present. It is also argued that the same mechanism operates on speech, melodic, and tonal signals.