药价“虚高”:成因、结果分析与对策探讨

药品价格“虚高”已成为近年来药品市场中的一个突出问题。通过考量药价“虚高”的成因,并从实证的角度分析药价“虚高”的结果———“有效需求人数”和“消费者剩余”的减少,提出一些建议。     

Are psychodynamic and psychoanalytic therapies effective?: A review of empirical data

There is a need for empirical outcome research in psychodynamic and psychoanalytic therapy. However, both the approach of empirically supported therapies (EST) and the procedures of evidence‐based medicine (EBM) have severe limitations making randomised controlled trials (RCTs) an absolute standard. After a critical discussion of this approach, the author reviews the empirical evidence for the efficacy of psychodynamic psychotherapy in specific psychiatric disorders. The review aims to identify for which psychiatric disorders RCTs of specific models of psychodynamic psychotherapy are available and for which they are lacking, thus providing a basis for planning further research. In addition, results of process research of psychodynamic psychotherapy are presented. As the methodology of RCTs is not appropriate for psychoanalytic therapy, effectiveness studies of psychoanalytic therapy are reviewed as well. Studies of psychodynamic psychotherapy published between 1960 and 2004 were identifed by a computerised search using Medline, PsycINFO and Current Contents. In addition, textbooks and journal articles were used. Twenty‐two RCTs were identifed of which 64% had not been included in the 1998 report by Chambless and Hollon. According to the results, for the following psychiatric disorders at least one RCT providing evidence for the efficacy of psychodynamic psychotherapy was identifed: depressive disorders (4 RCTs), anxiety disorders (1 RCT), post‐traumatic stress disorder (1 RCT), somatoform disorder (4 RCTs), bulimia nervosa (3 RCTs), anorexia nervosa (2 RCTs), borderline personality disorder (2 RCTs), Cluster C personality disorder (1 RCT), and substance‐related disorders (4 RCTs). According to results of process research, outcome in psychodynamic psychotherapy is related to the competent delivery of therapeutic techniques and to the development of a therapeutic alliance. With regard to psychoanalytic therapy, controlled quasi‐experimental effectiveness studies provide evidence that psychoanalytic therapy is (1) more effective than no treatment or treatment as usual, and (2) more effective than shorter forms of psychodynamic therapy. Conclusions are drawn for future research.     

肢体延长与美容增高的启示

美容医学持续升温,“美容增高”即“肢体延长术”被越来越多的爱美男女所尝试。纵观其发展经历了许多挫折与失败,并发症多且严重,应慎重认识其实际效果。如不加选择地运用美容医学,是对医学核心价值体系的扭曲和嘲弄。只有坚持运用正确的哲学思维进行引导,肢体延长术才会健康发展。     

人文社会医学教育应纳为继续医学教育的重要内容

从人文社会医学的概念、现状及加强人文社会医学继续教育的重要性,阐述了应将人文社会医学教育纳为继续医学教育的重要内容的现点.指出加强人文社会医学继续教育应统一认识,加强领导;强化培训,纳入正规;注重实践,回归社会.     

仿生医学--一个新的医学理论体系的创立

医学发展呼唤原始性创新.大自然是人类创新的不竭源泉,国际上仿生学研究如火如荼.为了强化将仿生方法、仿生技术贯穿到科研创新的全过程,引导医学科技人员巧妙寻找源头创新,率先提出创立仿生医学体系,并初步建立起仿生医学的学科框架,以便更好地把握学科前沿和判断发展趋势,为我国在仿生医学学科领域的领先作用奠定重要基础.     

创新促进烧伤医学的发展

勇于探索和创新,则事业有成;因循守旧,则停滞不前.持续50余年的烧伤治疗创新大潮极大地推进了中国与欧美等国的烧伤医学向前发展.     

从量变到质变--浅谈经验医学到循证医学的转变

循证医学是近十年来国际医学界倡导的一种新的医学模式,强调用科学的方法寻求最佳研究证据以指导临床决策.经验医学到循证医学的转变,是从量变到质变的过程,体现了事物发展的一般规律.     

国内循证医学人才资源分布研究

目的了解国内循证医学人才资源分布情况.方法采用描述性统计分析方法,对循证医学文献进行调查,统计分析区域分布、著者单位分布、著者分布.结果循证医学文献区域分布遍布全国26个省市,分布极不均衡,其中四川省著者最多,几乎占了1/3;四川大学循证医学文献产出最多,接近总产出的1/3;高产著者中多数著者均为四川大学华西医院著者.结论国内循证医学人才资源分布严重失衡,不利于国内循证医学研究的全面开展和循证医学水平的普遍提高.     

现代医学科学和人文精神的统一与临床医生综合素质的培养

运用医学哲学的原理,分析了现代医学模式存在的弊端,阐述了现代医学精神是科学和人文精神的统一,结合临床医生综合素质的培养,指出了现代医学科学和人文精神统一的重要性.     

心、脑科学与医学人道主义价值观

当今,心、脑科学的研究进展及成果极大支持了科学的医学人道主价值观应当以正确认识、把握、运用脑模式科学假说为基础的观点.试从意识的本质、医学人道价值观的机制、与价值相关的医者心灵的自我控制和意志自由等三个方面探讨心、脑科学同医学实践中的医学人道价值观的关系.