论医学人文精神的重塑

重塑医学人文精神是一个无法回避而又必须作出回答的紧迫问题。把现代医学技术放到人文哲学的大视野中去体认,从人学本体论意义上现代医学技术的价值理性,进一步澄清人们对医学技术无限崇拜的工具理性的错误认识;阐述了现代医学人文精神的内涵,认为以人为本,确立科学理性对医学技术的指导地位,适时约束医学技术行为应该成为现代医学人文精神的核心理念;提出了重塑现代医学人文精神的基本原则,即：坚持医学技术进步与人的全面发展相一致的原则,坚持医学技术进步与医学工作者道德健全相一致的原则,坚持医学进步与卫生事业持续、协调、健康发展相一致的原则。     

The body in the analytic session: focusing on the body-mind link

The author focuses on the importance of the body in the analysis of patients with a defect of thinking. In many cases this defect is not fully evident until concrete and bodily aspects begin to emerge in sessions. In the absence of awareness of the body, the patient's personality is deprived of the main source of emotional stimulus, and mental growth is consequently paralysed. Hence the body is considered the starting point of mental processes and a progressive source of experience requiring the exercise of responsibility and thought. To indicate the theoretical background to this essentially clinical paper, some hypotheses about the body-mind link are very briefly considered. Specific emphasis is given to the development of Freud-Klein-Bionian theories about this subject and to some of Ferrari 's recent proposals. The author discusses four clinical cases, emphasizing the encounter with the body in analysis and its integration in emotional and thinking processes. The analyst's function in such cases is conceived mainly as that of midwife for a dialogue between the analysand 's body and mind.     

Hemispheric asymmetries for temporal information processing: transient detection versus sustained monitoring

This study investigated functional differences in the processing of visual temporal information between the left and right hemispheres (LH and RH). Participants indicated whether or not a checkerboard pattern contained a temporal gap lasting between 10 and 40 ms. When the stimulus contained a temporal signal (i.e. a gap), responses were more accurate for the right visual field-left hemisphere (RVF-LH) than for the left visual field-right hemisphere (LVF-RH). This RVF-LH advantage was larger for the shorter gap durations (Experiments 1 and 2), suggesting that the LH has finer temporal resolution than the RH, and is efficient for transient detection. In contrast, for noise trials (i.e. trial without temporal signals), there was a LVF-RH advantage. This LVF-RH advantage was observed when the entire stimulus duration was long (240 ms, Experiment 1), but was eliminated when the duration was short (120 ms, Experiment 2). In Experiment 3, where the gap was placed toward the end of the stimulus presentation, a LVF-RH advantage was found for noise trials whereas the RVF-LH advantage was eliminated for signal trials. It is likely that participants needed to monitor the stimulus for a longer period of time when the gap was absent (i.e. noise trials) or was placed toward the end of the presentation. The RH may therefore be more efficient in the sustained monitoring of visual temporal information whereas the LH is more efficient for transient detection.     

视觉运动追踪的加工过程

视觉运动追踪是运动知觉研究的一个重要领域。通过构建视觉运动追踪的过程模型和分析每个阶段的认知加工任务, 可以帮助人们认识运动物体识别的本质。视觉运动追踪包括目标获取和运动追踪两个加工过程：目标获取阶段的主要任务是将目标与背景分离, 集中注意力加工追踪目标; 运动追踪阶段的主要任务是启动平滑追踪眼动和追赶性眼跳, 并发挥行为水平、眼动水平和神经活动水平的预测机制。目标获取同时受背景和目标的运动特征和身份特征影响; 运动追踪系统发挥预测机制的基础是客体表征连续性, 而客体表征连续性的建立同时依赖于目标时空属性和身份特征的编码加工。因此, 视觉运动追踪是视觉系统对客体运动信息和身份语义信息整合的结果。其中, 客体运动信息的加工特性已经获得了比较广泛的研究, 而语义信息加工机制还有待进一步加强。     

在发展中求善：动脉粥样硬化影像诊断技术不断演进的思索

动脉粥样硬化疾病是严重危害人类健康的一大类疾病,涉及人体全身各个部位,影响多个器官。动脉粥样硬化的影像诊断经历了从有创到无创、从局部到全身、从单一技术到整体化优势一系列过程,充分体现了影像技术在动脉粥样硬化诊断中的动态发展观、整体原则及个体化原则。     

PiCCO与Swan—Ganz导管监测的比较与思考

在工程技术的推动下,Swan-Ganz导管监测和PiCCO先后产生并应用于有创血流动力学监测。通过对比两者的操作性能、监测指标、并发症及费用等方面,展示PiCCO的优越性及安全性,思考现代医疗活动中的社会价值和人文体现,从科技发展方向和医学价值回归的角度分析临床决策,为广大临床工作者提供借鉴。     

幽门螺杆菌感染治疗新进展

在中国幽门螺杆茵(Helicobacter pybri,Hp)有非常高的感染率,国人感染率约55%,所以Hp感染处理中的临床问题是目前Hp研究领域中的重点课题,Hp感染治疗中的重要问题主要包括以下几方面:(1)哪些病人应该治疗?(治疗适应证问题);(2)如何治疗?(治疗方案问题);(3)如何避免或克服Hp对抗生素的耐药性问题?Hp对抗生素的耐药是Hp根除失败的主要原因,所以本文还要重点讨论Hp对抗生素的耐药牲,Hp根除失败的补救治疗及其治疗研究进展.     

口腔修复体制作技术发展的辩证思考

口腔修复体制作技术发展经历了从手工操作到计算机辅助制作、从“去材成形”到“增材制造”、从间接制造到直接制造发展阶段。回顾和分析口腔修复学技术发展中存在的基本矛盾以及矛盾对立统一运动的基本规律,有助于口腔医生自觉地培养和建立自然辩证观念,提高辩证思维能力,更好地把握口腔修复学发展趋势和规律。     

Elements of analytic style: Bion's clinical seminars

The author finds that the idea of analytic style better describes significant aspects of the way he practices psychoanalysis than does the notion of analytic technique. The latter is comprised to a large extent of principles of practice developed by previous generations of analysts. By contrast, the concept of analytic style, though it presupposes the analyst's thorough knowledge of analytic theory and technique, emphasizes (1) the analyst's use of his unique personality as reflected in his individual ways of thinking, listening, and speaking, his own particular use of metaphor, humor, irony, and so on; (2) the analyst's drawing on his personal experience, for example, as an analyst, an analysand, a parent, a child, a spouse, a teacher, and a student; (3) the analyst's capacity to think in a way that draws on, but is independent of, the ideas of his colleagues, his teachers, his analyst, and his analytic ancestors; and (4) the responsibility of the analyst to invent psychoanalysis freshly for each patient. Close readings of three of Bion's 'Clinical seminars' are presented in order to articulate some of the elements of Bion's analytic style. Bion's style is not presented as a model for others to emulate or, worse yet, imitate; rather, it is described in an effort to help the reader consider from a different vantage point (provided by the concept of analytic style) the way in which he, the reader, practices psychoanalysis.