重症加强监护医学与临床思维

重症加强监护医学的发展史,也是其临床思维的发展史,一个由个体性呼吸衰竭救治观念转化为集群性救治启动了重症加强监护学的建立,它们的发展带动亦受益于其临床思维、动态思维的发展。重症加强监护的实施,引发了医学伦理学新的思考与选择,而新的生物技术革命,必将导致重症加强监护医学及其临床思维的巨大变革。     

医疗过失的法律责任

引起医疗纠纷的事实可分为应由医方承担责任的事实和不应由医方承担责任的事实,只有医方符合法律责任的构成要件－即医疗行为的主体是医疗单位、主体有过失或违反义务的行为、有损害后果、而且主体的行为与损害后果之间有因果关系,才需承担法律责任,以消除只有损害后果医方就要承担法律责任和只有鉴定为医疗事故的才承担法律责任等方面的误区。     

Using a new analysis of the best interests standard to address cultural disputes: Whose data,which values?

Clinicians sometimes disagree about how much to honor surrogates’ deeply held cultural values or traditions when they differ from those of the host country. Such a controversy arose when parents requested a cultural accommodation to let their infant die by withdrawing life saving care. While both the parents and clinicians claimed to be using the Best Interests Standard to decide what to do, they were at an impasse. This standard is analyzed into three necessary and jointly sufficient conditions and used to resolve the question of how much to accommodate cultural preferences and how to treat this infant. The extreme versions of absolutism and relativism are rejected. Properly understood, the Best Interests Standard can serve as a powerful tool in settling disputes about how to make good decisions for those who cannot decide for themselves.     

ICU患者外出检查风险分析与对策

为了探讨ICU危重患者外出检查风险的原因,从而降低ICU危重患者外出检查风险,本文通过对312例ICU患者外出检查风险因素进行讨论分析,研究降低风险的对策,即在规范ICU患者外出检查流程、做好检查前准备和注意途中安全及返回后的护理,结果提示285例患者无意外发生,安全返回病房,其余27例患者存在一定风险,但在相应处理措施下均安全返回病房。     

Replacement—A Sheffer Stroke for Belief Change

By replacement is meant an operation that replaces one sentence by another in a belief set. Replacement can be used as a kind of Sheffer stroke for belief change, since contraction, revision, and expansion can all be defined in terms of it. Replacement can also be defined either in terms of contraction or in terms of revision. Close connections are shown to hold between axioms for replacement and axioms for contraction and revision. Partial meet replacement is axiomatically characterized. It is shown that this operation can have outcomes that are not obtainable through either partial meet contraction or partial meet revision.     

汉语口语词汇产生的音韵编码单元：内隐启动范式的ERP研究

本研究中选择英语水平低的汉语母语者, 排除作为二语的英语音韵编码单元(音素)可能对汉语口语词汇产生过程的影响后, 运用事件相关电位技术, 考察了汉语口语产生过程中音节和音素效应的时间进程。实验采用内隐启动范式, 要求被试看到提示词之后说出对应的目标词。事件相关电位分析结果发现, 音节效应出现在线索词呈现后的100~400 ms之间, 音素效应出现在500~600 ms之间, 波形表现为相关条件比无关条件的波形更正。这表明在词汇选择之后的音韵编码阶段讲话者首先提取的单元是音节, 而音素效应出现的时间窗口可能是音韵编码阶段后期或者是语音编码阶段, 结果验证了合适编码单元假说的观点。     

汉字词错觉结合的层次和影响因素

采用数字再认与词汇再认双作业范式,从笔画、部件、整字层次,考察汉字错觉结合的层次和影响因素。结果发现：（1）在汉字词识别中,两个相邻字（词）之间存在笔画、部件或字的互换错误,说明在笔画、部件和字的层次上存在错觉结合。（2）字的错觉结合率最高,其次是部件,笔画最低。（3）汉字词的错觉结合受刺激对的呈现方式、汉字结构和词性影响。     

建立“社区卒中单元”的必要性

"社区卒中单元"是以社区医疗机构为支撑,以患者家庭为中心,以此二者双向互动为轴线,以提高卒中患者的生活质量为目的。"社区卒中单元"与通常意义上的"医院卒中单元"不同。在这一模式中,患者及其家属的康复自助的积极性、主动性具有决定意义。