国内外器官移植的比较研究

随着外科技术的改进,免疫抑制剂的发展,世界器官移植取得了巨大的发展。近年来我国的器官移植已取得了较大的进展,但要完全与国际接轨,还存在许多急需解决的问题。综述了国内外器官移植发展状况及趋势,分析了器官移植中尚待解决的伦理问题,从社会、伦理、经济、文化、心理、医疗等问题探讨了器官移植的新进展。     

倏忽与浑沌和中医与西医

中医“科学化”和“现代化”是西方医学传入我国一百多年来几代中医人的夙愿和奋斗目标,但在以感染和传染性疾病为主要矛盾的生物医学模式阶段,却一直难以取得突破性的进展。随着各种慢性疾病发病率的逐年增加、医疗重点的转移和生物-心理-社会医学模式的确立,中医的现代化发展正在面临着前所未有的机遇和挑战。借助《庄子》“倏忽为浑沌开窍”的故事,重点就新的医学模式下的中医现代化发展进行了一些方法论的探讨。     

当代医生心理压力现状探讨

随着社会的进步,医学模式的转变,医疗服务行业面临着更多的压力,医生同样面临着各种各样的压力,他们来自于患方、医院、社会。一些医务人员在工作中,思想负担重,心理压力大,因此工作愉悦度低,有消极的工作情绪,甚至采取了选择离开医生工作岗位的行为。通过对某院的208名医生进行的简单问卷调查,寻找出问题的症结和医生心理压力的主要原因,从伦理学角度加以分析,为缓解医务人员压力,更好地服务患者寻求解决办法。     

从灾难医学的发展看生命的生态文化性——关于医学的“人学”本质的追问

围绕近年来备受瞩目的灾难医学的快速发展,从哲学、文化学的角度出发,就灾难医学的诞生与发展,以及其未来的发展趋势进行了概括和展望;在此基础上,就医学的本质给予理性的反思与论证,提出医学的本质乃“人学”的观点;并就“人学”的三个层次分别给予了阐释,得出医学中“人的知识”不仅是躯体的,而且是复杂的、文化的,医学应回归对生命的终极关怀的文化追求的结论。     

西医——中医挥之不去的他者

中西医的论证是医学哲学与医学史研究的热点问题。后现代哲学可以为理解两种医学之间的关系提供一个新的视角。本文运用后现代哲学中的“他者”观念回顾了中西医之间张力的演变,指出在整个过程中“中医”未能摆脱“西医”作为“他者”的注视。并从后现代医学的角度对这种张力的未来进行展望。     

论地域传统文化与西部民族地区艾滋病防控

地域传统文化与疾病防控的关系密切,地域传统文化不仅是一种重要的文化资源,对地方的疾病防控也有着极大的促进作用,但有时还会阻碍疾病防控的进一步实施。由于西部少数民族地区艾滋病已蔓延到了非常严峻的时期。预防和控制艾滋病传播迫在眉睫,眼下首先应学习先进文化,急待转变和更新观念,消除地域传统文化摩擦;其次,高度重视教育,提高其人口素质,消除传统文化摩擦。     

The Development and Validation of the Health Proneness Questionnaire

This series of studies describes the development, validation and potential use of the Health Proneness Questionnaire (HPQ). Recent health, wellness and illness studies focus upon the dynamic interaction between psychological and physical well-being. This newly developed scale allows practitioners to quickly screen psychological characteristics related to health and a patient's perception of their quality of life. Participants were patients in university research clinics for vision problems. Through exploratory factor analysis three factors evolved related to the hypothesized psychological characteristics involved in health related quality of life: adaptability, self-efficacy and subjective well-being. In a confirmatory factor analysis, the best fit model yielded a higher-order health-proneness factor with the original three categories as sub-factors. Further criterion-related validity comparisons and discriminant and convergent validity studies indicated a psychometrically sound short survey for examining psychological characteristics of patients with mild chronic health conditions.     

Three sources of wisdom of Chinese traditional virtue and a contemporary examination

There are three explanations of the sources of virtue in the history of Chinese traditional ethical thoughts. The first source is tian Dao (the Dao of Heaven) (natural), the second is xing Dao (the Dao of nature) (mind-nature), and the third is ren Dao (the Dao of human) (social). These explanations not only demonstrate the unique wisdom of ancient Chinese thinkers in constructing mortality, but also have special revelations for us to comprehend more accurately the Chinese traditional morality, to clear up the wrong ideas about morality that have formed since modern times, to make virtue ‘present’ instead of ‘latent’, and to construct a moral society. __________ Translated from Fujian Luntan 福建论坛 (Fujian Forum) (Humanities and Social Sciences Edition), 2005 (2) by Xi Liuqin & Peng Hua     

Medicine as a career: Choices and consequences

Medicine has traditionally been regarded as a rewarding career both financially and socially. How true, however, is that tradition in today's world of rising costs and decreasing revenues? The educational debt of the physician-in-training is steadily increasing, and currently does not affect specialty choice. As the cost of medical education continues to rise, the applicant pool begins to shrink, thereby possibly affecting the quality of future physicians. Once the physician has completed training however, the majority enjoy a positive return on investment. Their incomes generally fail to remain ahead of inflation, and therefore, have remained within a narrow band of $40,000 in 1970 dollars. Finally, the demand for physician services cannot be attributed solely to either the consumer (patient) or to the supplier (physician). Rather, the demand for medical services appears to be a unique combination of the two. In conclusion, medicine still is an attractive career path, but the choices and consequences are becoming much more demanding.     

INDUCTION AND MAINTENANCE OF SWALLOWING RESPONSES IN INFANTS WITH DYSPHAGIA

A treatment package was used to induce and maintain swallowing with three infants who did not swallow food or liquid. Prior to treatment, they received all nutrition and hydration via gastrostomy tube feedings. The treatment package consisted of least-to-most intrusive physical prompts, an eliciting stimulus, contingent social reinforcement, and repeated trials to induce and maintain swallowing. The design combined elements of reversal and changing criterion designs for all three infants. The package was applied across feeding devices (nipple, cup, spoon), situations (liquid, pureed foods), and persons (trainer, primary nurses, mothers). The number of swallows or ounces per feeding (from 0 to 8 ounces) and the number of feeding sessions per day (from one to five) were progressively increased. In each case, the infant received baseline conditions alternated with the treatment package. Follow-up probes were done at 15 months, 21 months, or 24 months, respectively, after the last phase for the three patients. The package was successful in that the gastrostomy tube was no longer needed for Patients 1 and 3. Patient 2 maintained functional swallowing responses but received supplemental gastrostomy feedings because of unrelated medical problems. Results are discussed in terms of the need to isolate components of the package. The package can be used in cases in which the preexisting treatments (reinforcement with preferred foods, force-feeding) are not feasible because of age, physical fragility, or the lack of a swallowing response following the presentation of food.