老年疾病按病种付费研究

以沧州市7所医疗机构的290名住院患者的医疗费用为研究对象,利用统计学中的中位数和P25和P75两个百分位数测算出了医疗费用的平均水平、参考值范围,利用逐步回归分析探索住院费用的影响因素。应根据年龄、住院天数、入院时情况等是影响住院费用的关键因素开发DRGS付费系统;采取必要的措施降低住院天数和术前住院天数。     

The Difficulty of Making Psychology Research and Clinical Practice Relevant to Medicine: Experiences and Observations

Psychology and medicine research and practice have demonstrated substantial and unique bodies of knowledge designed to both improve patient care and respond to contemporary health care needs for use of evidence and cost consciousness. At their full potential they represent a significant paradigm shift in healthcare. Despite impressive successes, it is clear that we are just on the cusp of such a change. These findings have had limited impact and penetration into medical practice, particularly outside of academic medicine and large, organized systems of health care, and there are multiple examples of such limitations in various arenas of health care. There also appear to be common themes to such examples which provide us opportunities to consider how psychologists might move things ahead. They also suggest how our unique position in academic medicine can both limit our impact and provide ways of creating continued shifts in the healthcare paradigm. This paper is based in part on the author’s presentation at the Association of Psychologists in Academic Health Centers 3rd National Conference in Minneapolis, Minnesota, May 2007.     

Nodal structure and the partitioning of equivalence classes

By definition, all of the stimuli in an equivalence class have to be functionally interchangeable with each other. The present experiment, however, demonstrated that this was not the case when using post-class-formation dual-option response transfer tests. With college students, two 4-node 6-member equivalence classes with nodal structures of A-->B-->C-->D-->E-->F were produced by training AB, BC, CD, DE, and EF. Then, unique responses were trained to the C and D stimuli in each class. The responses trained to C generalized to B and A, while the responses trained to D generalized to E and F. Thus, each 4-node 6-member equivalence class was bifurcated into two 3-member functional classes: A-->B-->C and D-->E-->F, with class membership precisely predicted by nodal structure. A final emergent relations test documented the intactness of the underlying 4-node 6-member equivalence classes. The coexistence of the interchangeability of stimuli in an equivalence class and the bifurcation of such a class in terms of nodal structure was explained in the following manner. The conditional discriminations that are used to establish a class also imposes a nodal structure on the stimuli in the class. Thus, the stimuli in the class acquire two sets of relational properties. If the format of a test trial allows only one response option per class, responding on those trials will be in accordance with class membership and will not express the effects of nodal distance. If the format of a test trial allows more than one response option per class, responding on those trials will be determined by the nodal structure of the class. Thus, the relational properties expressed by the stimuli in an equivalence class are determined by the discriminative function served by the format of a test trial.     

浅谈医学科研思维的逻辑性

医学科研思维过程中最重要的就是医学假说的提出、验证,推理和遵守逻辑思维的过程。它以抽象的概念、判断、推理为思维形式,通过分析、综合、比较、分类等多种逻辑思维方法进行操作,以达到它的最终目的。逻辑思维能力对于医学科研工作者是至关重要的,医学科研工作者应该不断加强逻辑修养,不断提升科研思维水准。     

Earth, Dream, and Healing: The Integration of Materia and Psyche in the Ancient World

Influenced by the methods and practices of Hippocrates, the Asclepius cult used herbal formulae and medicinal applications intricately connected with Asclepius cult rituals and worship. An understanding of the types of herb and medical applications surrounding their use by the cult aids understanding of the inner world and symbolism of ancient dreams.Jeffrey B. Pettis teaches in the field of New Testament Studies at Fordham University, New York City. His focus is the interpretation and use of ancient dreams in early Christianity and the Greco-Roman world. He has lived and traveled in Greece, Egypt and Turkey, studying the design and culture of ancient temples and the sanctuaries of Asclepius, the deity of the ancient dream cult. He received his Ph.D. from Union Seminary in 2004.     

SPIRITUAL TRANSFORMATION,HEALING, AND ALTRUISM: INTRODUCTION TO THE SYMPOSIUM

This essay introduces the five articles that follow, whose aim is to show how altruism emerges out of spiritual transformation and is integral to healing process in four kinds of ritual healing systems—popular, folk, an indigenous religious healing tradition, and complementary and alternative medicine represented by consciousness transformation movements. In this introduction I situate these largely marginalized religious and spiritual practices within the context of the religion‐science discourse, which has focused for the most part on the relationship between the established, mainstream religions and the dominant biomedical system. Antecedents of two of these types of religious practices, Spiritism and consciousness transformation movements, were part of the development of the psychological sciences in the nineteenth century but lost ground in the twentieth. Despite discrimination and persistent negative attitudes on the part of the established religions and biomedicine, these healing traditions have not only survived through the twentieth century but appear to have gained both followers and interest in the twenty‐first. In future decades, at least for complementary and alternative medical practices and perhaps also for spirit healing centers, there may be a reversal in status through greater acceptance of their unique combination of scientific and religious perspectives.     

诺贝尔医学奖与幽门螺杆菌

瑞典皇家科学院宣布了今年的化学、物理和医学诺贝尔奖获得者。获得医学奖的是两位澳大利亚科学家。他们因发现幽门螺杆菌而获奖。就幽门螺杆菌的实验研究过程和临床应用作一简介。     

肢体严重毁损伤保留与否的循证思考

肢体严重毁损伤的修复是当今医学领域的一个研究热点。从循证医学角度对肢体严重毁损伤的保肢与截肢提出思考并加以阐述,同时结合当前我国医疗环境提出一些这方面的倡议。     

建立鼻腔结构与功能自适应生物力学模型在鼻科疾病中的作用

鼻腔结构在与鼻腔物理力学环境发生交互关系时,能够根据周围环境调整自身结构和形状,即所谓鼻腔结构与功能自适应性.鼻腔结构与功能自适应生物力学模型模拟鼻腔结构异常产生功能障碍所继发的上呼吸道疾病发生发展过程,为鼻科某些常见病的发生发展过程进行量化分析,为鼻内窥镜手术在恢复重建鼻腔结构功能方面临床决策提供依据.     

第六讲：肿瘤学研究中循证医学的应用

病人的治疗结果取决于医生治疗方案选择的好坏,然而,为获得最佳的治疗方案,医务工作者需要有可靠的研究证据支持。循证医学以及Cochrane协作网和其它多种循证资源,作为一种新的获得高质量医学证据的方法和途径,在肿瘤学研究中起到了重要作用。在循证肿瘤学领域有很多组织提供高质量的指南,然而,循证肿瘤学以及基于循证证据的指南仍可能是有暇疵的。