前哨淋巴结活检在乳腺癌治疗中的意义

前哨淋巴结活检能够避免淋巴结阴性的乳腺癌患者遭受过度治疗带来的创伤。本文就前哨淋巴结活检在治疗乳腺癌患者中的应用及存在问题,进行了探讨,提出对乳腺癌生物学行为的深入认识,以及对前哨淋巴结活检临床价值的辨证分析,将有利于前哨淋巴结活检正确、有效的开展。     

术后认知功能障碍和阿尔茨海默病相关的发病机制思考

术后认知功能障碍是手术麻醉后的并发症之一,阿尔茨海默病是一种常见的慢性进行性神经退行性疾病,在发病机制方面二者存在诸多的相似点,且目前在此方面对二者的研究都没有取得重大进展,有必要从发病机制角度对二者进行相关的辩证思考,以便更好地指导临床及基础研究。     

介入性超声与临床医学的辩证统一

介入性超声是近年来超声领域开拓的一项崭新技术,它的出现从根本上改变了超声诊断作为单纯辅助科室的陈旧观念,使诊断和治疗真正成为一个整体过程.变革了超声医生的知识结构及思维方式,促进了临床各学科之间的综合与发展.要在日益深入局部微观研究使临床各学科越来越分化的同时,更广泛地注意整体的辩证统一,充分体现了辩证唯物主义的自然观.     

《黄帝内经》的历史评价与读法

《黄帝内经》仅代表当时医学理论水平,它是以自然哲学的思维来解释自然科学问题的理论假说,虽然发现了许多客观的规律与结论,也有不少错误的猜测.因此,读《黄帝内经》要注意三点:一是书中概念多,但定义少,需要辩证体会;二是要以实践来验证其理论的真与伪;三是书中有些概念的含义与现代不同,要区别对待.     

Using the Linehan Risk Assessment and Management Protocol With a Chronically Suicidal Patient: A Case Report

The Linehan Risk Assessment and Management Protocol (LRAMP) is an empirically supported, comprehensive framework used to assess suicide risk and protective factors, and provide a guide for the therapist to consider reasonable options for intervening on suicidal behavior. This protocol includes a structured checklist for assessing, managing, and documenting suicide risk. It also structures the documentation to clearly describe the presentation, assessment, in-session interventions, decision-making process, and follow-up to other members of the treatment team. This paper describes a case in which the LRAMP was used to guide the assessment, intervention, and documentation of the suicidal behavior of a patient, “Ann,” being treated with outpatient Dialectical Behavioral Therapy in a community mental health clinic. Each section of the LRAMP is discussed as it was used with this complex patient, who had history of high utilization of acute psychiatric services. Application of the LRAMP included the assessment of risk and protective factors, and the use of an individualized crisis plan that engaged the patient, her family, the therapist, and the clinical team, to decrease acute risk, continue outpatient treatment, and avoid inpatient hospitalization. The considerations for documenting clinical decision-making with chronically suicidal patients are discussed.     

辩证思维在重症急性胰腺炎治疗中的运用

重症急性胰腺炎的治疗水平在近几十年已有了很大的发展,但是SAP的死亡率依然居高不下,严重威胁患者生命。这类患者的病情复杂,需要运用多种治疗方法进行综合救治。从多种治疗方法中选择合适的方法并进行合理的治疗很难准确把握,需要我们用哲学的思维来看待胰腺炎的诊治,辩证地对其进行有针对性的治疗,从而提高重症急性胰腺炎的治疗水平。     

Manifest Rationality Reconsidered: Reply to my Fellow Symposiasts

In this paper, I respond to papers on my Manifest Rationality (2000) by Leo Groarke, Hans Hansen, David Hitchcock, and Christopher Tindale presented at the meetings of the Ontario Philosophical Society, October 2000. From the many useful challenges they have directed at my position, I have chosen to focus on two. The dominant issue raised by their papers concerns my definition of argument, and particularly problems with the idea of a dialectical tier. I have selected that as the first strand. Second, several have raised questions that deal with the relationship between logic, rhetoric and dialectic. That is the second strand.