哲学思想为医学生创新思维提供启思与导向

创新能力与哲学素养直接相关,创新思维是哲学素养的运用和拓展。目前,医学思维能力培养中存在极大限制医学生想象力和创造力的问题,一是受权威迷信的束缚,二是受传统思维框架的束缚。基于此现状,本研究探讨培养医学生创新思维能力应采取的对策与措施,体现了哲学思想对医学生创新思维的启思与导向作用。     

对心血管病临床强化治疗的质疑

强化治疗是最近几年反复提到的话题。很多临床试验研究各种强化治疗对心血管疾病预后的影响,但结果显示强化治疗并未能带来更多的益处,甚至有害。因此我们必须理性地看待这些所谓的强化治疗。更应该倾向于个体化治疗、综合治疗,包括控制各种危险因素,改善生活的方式。把治疗的眼光放到疾病发生的早期,早治疗,以求更多获益。     

医学实验设计的几点思考

通过分析医学实验设计中常见的问题,思考其原因,提出了解决这些问题的初浅体会:针对研究主题,全面考量研究环节;重视知识积累,合理预知"未知"的结果;对他人和自己的研究行不间断反思;在研究活动持有客观的态度。     

妊娠期急性脂肪肝诊治中的科学思维应用

现代科学思维方法中系统思维及模糊思维方法具有普遍适用意义。妊娠期急性脂肪肝临床上极为罕见,并发症多,病死率极高,1例并发腹部卒中的妊娠期急性脂肪肝患者通过科学诊疗转危为安,及时终止妊娠、对症处理、多学科协作联合治疗,积极预防并发症是确保救治成功的关键。本文尝试介绍科学思维方法在该病诊疗中的一些体会。     

对慢性阻塞性肺疾病防治的若干思考

结合我国目前COPD防治的现实情况,从建立COPD防治的教育和管理综合模式、社区及基层医院普及COPD防治的途径、吸入剂的终身服用及利弊的权衡等角度,探讨了COPD防治的一些见解及认识。     

The Special Science Dilemma and How Culture Solves It

I argue that there is a tension between the claim that at least some kinds in the special sciences are multiply realized and the claim that the reason why kinds are prized by science is that they enter into a variety of different empirical generalizations. Nevertheless, I show that this tension ceases in the case of ‘cultural homologues’—such as specific ideologies, religions, and folk wisdom. I argue that the instances of such special science kinds do have several projectable properties in common due to their shared history of reproduction, and that the social learning involved means that we should also expect these kinds to be multiply realized.     

Primary shame,mortal wound and tragic circularity: Some new reflections on shame and shame conflicts

Invited to contribute some thoughts on recent developments in psychoanalytic thinking about shame, the author starts off with Aristotle's prescient analysis of shame and then focuses on accumulating experiences in the psychoanalytic treatment of patients with severe neuroses, in particular the close relationship of severe traumatization and chronic states of shame, and how this is reflected in shelfdestructive repetitions. Reminiscent of what we know from tragedy and the tragic dimension of human existence, this repetition compulsion shows a built‐in circularity. These circular dynamics have at their core struggles with deep woundedness that can variably be conceived of as primary pain, primary shame and primary anxiety. Consequently, throughout the experiences with these patients goes the absoluteness both of their conscience and of their ideal, what we know as the “archaic superego:”     

Finding words for feelings: The relationship between personality disorders and alexithymia

This study examined whether personality disorders (PDs) are associated with alexithymic features at varying levels of comorbid psychopathology distress. 167 psychiatric outpatients completed the Toronto Alexithymia Scale (TAS) and the General Severity Index (GSI) of the SCL90-revised. Bootstrapping analyses were performed to test whether the PD/alexithymia relationship was moderated by psychopathology distress (GSI). The overall number of PD criteria was associated with cognitive aspects of alexithymia (i.e., Externally Oriented Thinking, EOT) only at low/moderate levels of distress. Borderline criteria predicted EOT only when distress was low, while avoidant and dependent criteria were independently related with EOT. No association was found between other PDs and alexithymia facets. Thus, within clinical samples the alexithymia/PD association is mainly explained by comorbid psychopathology; however, individuals with avoidant, dependent and borderline features might have a specific difficulty with focusing on internal reality, even when their current symptom distress is low.     

Marital Satisfaction,Negative Interaction,and Religiosity: A Comparison of Three Age Groups

This study compared marital satisfaction among three age groups and examined how negative interaction patterns and religiosity relate to marital satisfaction at each age using a sample of Protestants (N = 45,387) diverse in denominations, location, geography, and size. We performed a 1-way ANOVA to compare marital satisfaction among three age groups (younger than 40, 40–59, and 60 and older) and found a U-shape curve with marital satisfaction highest among the youngest group, lowest among middle-age couples, and high among older couples. ANCOVA analysis found negative interaction, age, religiosity, age*negative interaction, and age*religiosity to be predictors of marital satisfaction.