骨科疾病诊治中的临床思维

医学哲学是对医学科学成就总的概括,并以此为基础探讨生命活动和病程的一般规律,研究医学科学的思维方式,直至疾病预防、诊断治疗。同时研究辩证规律和范畴在医学科学中的表现,从而指导骨科医师解决在骨科疾病诊治中遇到的诸多问题,并有助于形成正确的临床思维。结合临床工作体会,探讨医学哲学在骨科疾病诊治临床思维中的应用。     

从能量观疾病

能量在机体的各种离子、分子、细胞、器官、组织、系统间协调分布,共同维持着健康状态。某一病因作用于人体后,“协调分布”会被不同程度地打破,当超过一定的阈值,就会产生疾病。对于人体,各种能量的直接表现形式和能量的携带者——各种营养物质,都与疾病之间有着千丝万缕的联系。从“能量”角度,我们既可进一步探讨尚未阐述清楚的疾病发生机制,又可以设计更为完美的治疗方案与医学仪器。     

非传统理念指导下的传统技术导致应用医学重大课题的突破--关于2005年诺贝尔生理学或医学奖

发现幽门螺杆菌(Helicobacter pylori,以下简称Hp)导致慢性胃炎和消化性溃疡,是沃伦和马歇尔获得2005年诺贝尔医学奖的原因.他们在1982年得出的这一假说,违反了关于这一类慢性病传统的发病机制理念.可能因为这一理念的反传统性,其假说被世界同行基本接受大概经历了20年时间.值得强调的是,对HP的观察、分离、培养、鉴定和人体试验,以及它与疾病相关的诊断、治疗、临床流行病学等研究,应用的都是传统的医学技术.从而表明,即使到了20世纪80年代,传统技术仍能导致诺贝尔奖级科研成果的出现.     

中医诸“优势”辨析

通过对“中医是我国优秀传统文化的组成部分”、“中医博大精深,属于‘超科学’”和“中医是系统医学”三种较为流行的中医“优势”的说法的辨析,不难发现,这些优势说法具有自我标榜的性质,并没有确实的依据。固守这些没有科学依据的“优势”,容易导致医学守旧,不利于我国医学科学的进步。     

《神农本草经》的道家养生思想与汉画像石中的羽人仙药图

以<神农本草经>中的道家养生思想,结合汉画像石中的羽人仙药图,说明秦汉时期道家养生思想对<神农本草经>的渗透与影响,以及<神农本草经>道家养生思想对后世本草方剂学的重要影响.     

《周易》阴阳论的层级结构性质

传统中国哲学中的阴阳论一直是学界所关注的一个焦点,但对于该体系所具备确切内涵的各方面、以及由其所结成的整个架构的整体理论性质,却很少有人能深入体察。本文通过对《周易》阴阳论的细致分析,提出该理论作为一种形而上学宇宙论,实则是一个内在含括生命论、差异论与秩序论等三个主要方面,并以其中生命论为根基也是最终目的的层级结构。     

Depression in Women with Heart Disease: The Importance of Social Role Performance and Spirituality

Compared with men, women are more likely to experience depression, and depression increases risk of morbidity and mortality in individuals with heart disease. Psychosocial interventions have been developed for depressed patients with heart disease; however, women's experience of chronic disease differs from men's and women may benefit from interventions tailored to address their difficulties. Spirituality and social roles have been related to depressive symptoms in other populations. To identify the relationship between depression and spirituality and social role performance (i.e., role concerns, role rewards and confidence in ability to fulfill roles) in women with heart disease, we assessed depressive symptoms, spirituality, social role functioning and medical history in 125 women with heart disease. After controlling for age and severity of medical conditions, spirituality, role confidence and role concerns were significantly associated with depressive symptoms. Consideration of spirituality and aspects of social role performance may be important when developing psychosocial interventions for depressed women with heart disease.     

How does crime pay? The differentiation of criminal specialisms by fundamental incentive

Most attempts to determine offence specialisms have not benefited from any formal psychological framework of behavioural differentiation. Bandura's framework (Social foundations of thought and action, 1986) of the fundamental incentives to human action offers an interesting perspective on what might underlie differential patterns of offending. The framework draws attention to the distinction between Material, Power/Status, and Sensory incentives, leading to the hypotheses that crimes which share any one of these incentives will be more likely to be committed by the same person, as revealed through high inter‐correlations, but be less highly correlated with crimes with different fundamental incentives. To test these hypotheses the correlations between 42 offending behaviours as self‐reported by 185 convicted young offenders were examined. A Multidimensional Scaling analysis of the inter‐correlations revealed three distinct styles of offending that could be related to Bandura's Material (Cronbach's α = 0.94), Power/Status (α = 0.90) and Sensory (α = 0.76) incentives. The identification of this psychological basis for the differentiation of criminal styles provides a model for considering offenders' patterns of specialisation which is of value both in clarifying the aetiology of different types of crime and in considering which crimes may be behaviourally equivalent when trying to link them to a common offender or infer offender characteristics from crime scene information. Copyright © 2006 John Wiley & Sons, Ltd.     

Flanker compatibility effects in patients with Parkinson's disease: impact of target onset delay and trial-by-trial stimulus variation

Parkinson’s disease (PD) patients and healthy controls were administered a flanker task that consisted of the presentation of colored targets and distractors. Participants were required to attend to the center target and identify its color. The stimulus displays were either congruent (i.e., the target and flankers were the same color) or incongruent. The time between the onset of the flanker and the target color (the target onset delay) was either short or long. Results indicated that PD patients and controls did not differ in the magnitude of the flanker effect within individual trials in that both groups demonstrated a typical flanker effect at the short target onset delay and neither group demonstrated a flanker effect at the longer delay. However, when performance was examined on a trial-by-trial basis, PD patients demonstrated a slowing of reaction time relative to controls when having to make the same response across consecutive trials at longer inter-trial intervals when the flankers were incongruent across consecutive trials and the display on the second of two trials was incongruent. These results indicate that PD patients are impaired in inhibiting the distractors over an extended delay and that this deficit may impact motor responding in these patients, suggesting that the basal ganglia contribute to the interface of attention and action.     

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.