《史记·扁鹊仓公列传》的治疗学思想

《史记·扁鹊仓公列传》是记述扁鹊和仓公医事活动的专篇.目前,中医界大多集中在对其原文的医古文语言学分析、扁鹊和仓公医事活动年代的考证、所载病案的病因病机与诊法的探讨等方面,而专篇探讨扁鹊和仓公治疗学思想的研究尚缺,本文就此加以论述,并与《内经》简单地对照.     

诺贝尔生理学或医学奖美国获得者学术条件背景分析

在诺贝尔生理学或医学奖105年的历史中,美国分别占了颁奖年度的52.08%,获奖成果的44.87%,获奖人数的48.91%.形成这些科学家学术优势积累和美国国家科技竞争优势的学术条件背景是:适宜的宏观政策,充足的经费投入,成功的人才政策,根本的教育改革和创新的科技管理.     

成人气管、支气管异物误诊原因之辩证分析

气管、支气管异物是耳鼻喉科常见疾病,但成人气管、支气管异物较少见,因异物吸入史不明确、临床表现不典型,常易误诊。利用哲学原理辩证分析其误诊的主客观原因,以提高对成人气管、支气管异物认识,减少误诊,防止误治。哲学对于当前临床医学是十分重要的。     

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。     

整形外科的临床治疗决策分析

在生物心理社会医学模式下,以循证医学为基础的共享型临床决策成为主导。整形外科疾病有着诊断容易、治疗方法多样、效果不一、患者年龄小、心理脆弱、大众认知有一定误区等特点,更需要在情感和实践上体现对患者的理解和尊重,真正实现医生患者共同参与的共享型临床决策。     

森田疗法与认知行为疗法的比较分析

规律是客观的,而规则具有主观性,虽然两者本质上不同,但他们又是相关的。从口腔临床医学规则的制定过程来看,我们不难得出结论:口腔临床医学规则的制定要遵循临床医学的一般规律,突出口腔临床医学的特点,并受到我国经济、文化、政治等因素的影响,且随着这些因素的改变而改变,以适应新的环境条件。     

Continuity in adolescent career preparation and its effects on adjustment

Career preparation represents a major developmental task of adolescence, which has not received sufficient attention in empirical research on career development. Thus, this study was designed to examine the structure, continuity, and change in adolescent career preparation and its relationships with adjustment. The data were collected from a diverse sample of 389 adolescents on four occasions beginning in Grade 11 in high school and ending 6 months after high school graduation. Using Structural Equations modeling, a four-wave, developmental model of adolescent career preparation indicated by career decidedness, planning, and confidence was shown to fit the empirical data very well. Career preparation was characterized by continuity and a consistent pattern of positive concurrent and prospective associations with various indicators of adjustment. The results of the study provide empirical support for the theoretical propositions about the adaptive role of adolescent career preparation, particularly in terms of its contribution to psychological well-being and social integration.     

Cognitive-behaviour therapy for chronic fatigue syndrome: comparison of outcomes within and outside the confines of a randomised controlled trial

Outcomes for cognitive-behaviour therapy (CBT) in randomised controlled trials (RCTs) have rarely been compared to those in routine clinical practice. Taking the case of CBT for chronic fatigue syndrome (CFS), we evaluated the results of a successful RCT against those of the same treatment given in the same setting as part of routine practice. Fatigue and social adjustment scores were compared for patients who received CBT for CFS as part of a RCT (N=30) and patients who received CBT as part of everyday clinical practice (N=384). The results in the RCT were superior to those in routine clinical practice. Between pre-treatment and 6-month follow-up, the RCT showed a larger reduction in fatigue and greater improvement in social adjustment than those in routine treatment. The changes in fatigue scores were similar for both groups during treatment but were greater in the RCT between post-treatment and follow-up. Potential reasons for the superior results of the RCT include patient selection, therapist factors and the use of a manualised treatment protocol. Practitioners need to pay particular attention to relapse prevention and ensuring adequate follow-up in addition to encouraging patients to continue with cognitive-behavioural strategies once treatment has ended.     

Infant observation: A range of questions and challenges for contemporary psychoanalysis1

The author attempts to integrate several perspectives within the field of infant observation that reflect the analyst's personal experience as a clinician, as a professor at the analytic institute and as a researcher in the field of psychoanalysis. Can infant observation contribute to analytic technique, theory and training? If so, what would be the nature of such contribution? To answer these questions, the author reviews the literature on infant observation from Freud to the present, highlighting Latin American contributions to this subject. She makes reference to the role of technological innovations, which have allowed videotaping, repeated observations, temporal segmentation and computerized programs, thus giving rise to microanalytic research. This discussion prompts the question about the contributions made by systematic research to clinical practice. To tackle this question, the author presents both a clinical vignette taken from her personal experience, and the current debate on this subject as it appears in the work of Daniel Stern and André Green. Finally, she presents some conclusions that are part of an ongoing debate in the psychoanalytic field.     

协和育才模式与创造性人格

创造性人格是个体创造力的主体部分。协和医科大学的教育模式有助于培养医学生积极的人生态度、高度的自我肯定评价、强烈的内在动机、自主的认知风格以及丰富的情感。在我国高等医学教育改革进程中,普通医学院校应将协和模式与本校实际相结合,加强对医学生创造性人格的培养,增强其创造力,更好地适应国际医学发展的需求。