中西医结合治疗儿童过敏性紫癜和预防相关肾损害的临床研究

过敏性紫癜是儿童常见的免疫系统疾病。西医治疗过敏性紫癜已形成常规模式,并有一定疗效,但也有一定局限性。本病易反复,易损伤肾脏,严重时可导致紫癜性肾炎。本文拟研究中西医结合方法治疗过敏性紫癜及预防肾脏损伤的临床效果。研究表明,中西医结合治疗该病存在一定优势,能有效治疗过敏性紫癜,并降低肾脏损害及紫癜性肾炎的发生率。但应看到本研究结论主要是通过临床经验取得,样本量小,未进行远期随访,缺乏系统深层次实验室论证,还有待进一步研究。     

论转化医学发展的机制与平台

转化医学被人们认为是穿越死亡峡谷的重要途径,但需要有相应的机制和平台支撑,在机制方面主要需建立转化医学的教育体系、转化医学的管理体系、转化医学发展的科研业绩评价体系和转化医学的协同创新文化体系,并有转化医学中心、临床研究机构、医学伦理委员会、生物样本库、社区中心、成果转化服务平台等条件的支撑.     

医学人文教育的关怀哲学基点探究

医学人文教育固然以提倡患者的自主存在性突破了医学技术主义形态,但若对患者自主地位的过度强调则会使其陷入二律背反的困境,于此之上的关怀哲学探究则把患者视为处于具体情境中的特殊他人,如此便能建立并维持医学人文情境中的医患和谐.透过耕犁“以患者自主为核心的医学教育限度”、“以关怀为始点的医学哲学诠解”与“关怀哲学在医学人文中的教育张力”三重意涵来突显关怀哲学在医学人文教育中的本位复归,期使医学教育能够透过关怀哲学的融汇从而在医疗临床过程中达成其效力显现的人文基点.     

Cognitive organization of disease concepts in Singapore

Abstract

This research investigates illness cognition and its relationship to the use of different types of medicine in three ethnic groups in Singapore. Four hundred and twenty-nine Chinese, Malay, and Indian Singaporeans rated 24 diseases as to their similarity. Multidimensional scaling (MDS) indicated three dimensions. Regression of these dimensions against 17 disease attributes suggested that these dimensions represented spiritual/psychological causation, disease severity, and viral causation. When the dimensions were related to the use of, preference for and perceived effectiveness of different types of medicine it was found that Indian medicine tended to be used, preferred and perceived to be most effective for diseases low in severity whereas Chinese medicine was viewed most favourably for diseases perceived to be low in spiritual/psychological causation as well as those not seen as virally caused. Malay medicine tended to used, preferred and perceived as most effective for conditions believed to be non-serious and not caused by a virus. Western medicine was most likely to be used, preferred, and seen as most effective for diseases viewed as serious as well as those believed to be virally caused.     

Follow-up results of a cognitive-behavioural treatment for chronic pain in a primary care setting

Abstract

An outpatient cognitive-behavioural treatment programme for pain control was administered to chronic pain patients in three primary care practices with a medical psychologist as a group therapist. The patients suffered from headaches, migraines, cervical pain, shoulder-arm pain, and low back pain. A matched sample of patients with the same disorders served as a waiting-list control group. The programme consisted of training in progressive muscle relaxation, several attention related techniques, and cognitive restructuring as well as reinforcing non-pain behaviour, and aimed at an improvement of self-control strategies. At the six month follow-up, the treated subjects showed improvements in their average scores of anxiety, depression and bodily symptoms compared with the untreated controls. Pain intensity was reduced by 34% in those subjects (9 out of 25) who were most adherent to the treatment regimen. Our results indicate a long-term improvement in well-being as a consequence of the treatment. This was confirmed by the ratings of the physicians and by the reduced number of patient-physician contacts three months post treatment as compared to the controls. Treatment adherence seems to be a most important agent in maintaining long-term reductions of pain intensity.     

The beneficial effect of Tai Chi on self‐concept in adolescents

Previous research has documented the beneficial effect of Tai Chi, but most of the studies focused on elders and patients with specific health conditions. The aim of the study was to test whether Tai Chi can help to improve self‐concept in adolescents with a longitudinal study. The sample comprised 160 students from a Chinese middle school; half of students formed the experimental group and the rest formed the control group. A 1‐year Tai Chi intervention was delivered in 60‐minute sessions, five times a week. Both groups were instructed to complete the measure of self‐concept at the beginning and end of the intervention. Statistical analysis shows the significant reduction of good behaviour, intellectual and school status, popularity and anxiety in the experimental group compared with the control group. The results suggest that the Tai Chi intervention could improve self‐concept in adolescents.     

以急诊医学为依托的全科医学培养模式探讨

全科医生是一类重要的复合型医学人才。但目前在我国,合格的全科医生十分匮乏,其中一个重要的原因是我国尚未建立起科学有效的全科医师培养模式。因此,探索适合我国国情且行之有效的全科医生培养模式迫在眉睫。由于全科医学与急诊医学学科特点上有诸多相似性,以急诊医学为依托进行全科医生培养是全科医学发展初始阶段的有益探索,以实现由急诊医生培养全科医生逐步过渡到全科医生培养全科医生。以急诊医学为依托的全科医学培养模式符合全科医学的内在要求,为探索符合我国现阶段实际的全科医学模式提供了新的思路。     

临床医学中人性化医疗的非显性误区辨析

随着现代医疗技术的迅猛发展,人们在享受高新技术提供服务的同时,却对临床医学存在的非人性化趋势提出越来越多的质疑,因此,需要对医学目的和价值进行重新审视。本文阐述了人性化医疗中存在的某些非显性误区,这是医学人文削减的主要内在原因,面对技术与人文之间的矛盾关系,出路在于医疗技术的人性化方向,赋予非人性化手段以人性化关怀,在探索人性化的医疗手段中实现医疗的人性化复兴。     

从医学人文角度看微创医疗中的危险因素

微创医疗是现代医学的一项新技术和新兴理念,由于具有创伤小、恢复快等特点而风靡全球,人们迷恋于微创技术的绝对化作用,关注的焦点也更多地是在微创技术自身的创新与改进,而对微创技术带给患者及麻醉的附加伤害和危险却很少问津,当今微创医疗技术发展的基础在于直面问题和解决问题,用技术自身发展解决技术缺陷问题,用人文理念改善和解决医学的人性问题。成功的微创技术是多学科协助的结果,务必认清医学的仁学特性,坚持微创发展的人性化方向,科学规避微创中的危险因素,为微创技术的可持续发展奠定基础。     

人文医学与医学人文之概念比较和价值探析

近年来,伴随着医学人文学科的发展,学界对医学人文和人文医学的研究也不断深入。医学人文和人文医学的内涵与定义也为学界广为关注和研究。将这两个关注度较高、且存在争议的词进行概念比较、分析差别,以明辨研究内容,建立医学和人文学科交叉研究的研究基础。在争辩医学人文与人文医学概念的过程中,更应当注意的是医学和人文的关系,并以之建立关于医学的人文价值评判,以医学人文为基础,探析医学和人文学科的交互融合,通过价值评判推进人文对医学的影响,实现人文真正的走进医学,走进临床。