“象”模型：易医会通的交点——兼论中医学的本质及其未来发展

易学与中医学的会通问题历来是一个有争议的问题,本文从一个特定的层面即思维方式的层面探讨了这一问题,提出“象”思维是医易学共同的思维方式,是医易会通的交点。“象”思维包括“象”思维方法和“象”思维模型,本文认为“象”思维方法是一种模型思维方法,“象”思维模型有卦爻模型、阴阳模型、易数模型,五行模型、干支模型等多级同源、同质、同构的子模型。文章进而探讨了“象”思维具有整体性、全息性、功能性、关系性、超形态性、时序性以及重直觉、体悟、程式、循环的特征,指出这一特征正是中医学理论的本质。中医学与西医学的本质差别就是“模型论”与“原型论”的差别,两者各有优劣。文章还从“象”模型角度提出了“修补”中医思维方式、促进中医学术发展的中医未来观。     

现代医学的有限与无奈

在充分肯定现代医学在取得巨大进步的同时,分别从疾病病因、发病机制、早期诊断、疗效和预后等8个方向阐述了现代医学在防治人类疾病中的局限性,并简要分析了产生这种局限性的原因。     

试论可持续消费的伦理观

可持续消费作为一种消费观念,是在西方国家工业化经济迅速增长,出现世界性的环境恶化、人口膨胀等一系列危机之后,人们进行探索和反思而产生的。人类通过对古代节俭消费观念的重新审视,对传统工业文明消费观的全面批判,于20世纪90年代初步形成了一种新型消费观———可持续消费观。可持续消费观的确立不仅仅是一场消费方式的变革,在更深层次上是人类思维方式、价值观念和发展观念的根本革命。     

When views about alternative medicine,nature and god come in the way of people's vaccination intentions

In spite of the safety and efficiency of the COVID-19 vaccines and the many promotion efforts of political and expert authorities, a fair portion of the population remained hesitant if not opposed to vaccination. Public debate and the available literature point to the possible role of people's attitudes towards medical institutions as well as their preference for complementary and alternative medicine (CAM) on their motivations and intentions to be vaccinated. Other potential ideological factors are beliefs about environmental laissez-faire and divine providence insofar as they encourage people to let the pandemic unfold without human interference. In three cross-sectional samples (total N = 8214), collected at successive moments during the Belgian vaccination campaign, the present research examines the distal role of these psychological and ideological factors on vaccination intentions via motivational processes. Study 1 gauges the relation between trust in medical institutions and preference for CAM on intentions to get vaccinated via motivations. Study 2 examined the role of beliefs in the desirability of letting nature take its course (‘environmental laissez-faire beliefs’) on vaccination intention via motivations. Study 3 tests whether people's adherence to environmental laissez-faire and beliefs about divine providence are linked to their motivations for vaccination via trust in the medical institutions and CAM. Results show that adherence to CAM has a deleterious effect on vaccination intentions, whereas trust in medical institutions has a positive effect. Both ideological factors pertaining to external control are only moderately related, with environmental laissez-faire beliefs having stronger effects on CAM, medical trust and vaccination motivations. We discuss the importance of this set of results in light of the growing interest in CAM and the increasing presence of messages appealing to the environment.     

当今医学科技的发展趋势及我国的发展战略

作为生命科学最重要组成部分的医学科学走向科技发展的新时代。在下个世纪,科研重点将向生命科学和生命医学转移。充分认识医学科学技术的地位和作用,及当代医学科技发展的主要趋势和特点,制定我国医学科学的发展战略,加强医学高技术的发展,对我国的医学科技发展将具有十分重要的意义。     

浅谈分子生物学与临床医学研究的结合

随着分子生物学理论和技术从基础研究渗透到临床各个学科,对临床诊断和治疗水平的提高起到了积极的推动作用。但在实际工作中还存在着发展不平衡以及认识与理解上的误区。就分子生物学与临床医学研究的相结合的现状、存在问题及相应对策,以及今后我国临床医学分子生物学研究的发展前景进行了较广泛深入的讨论。     

医学与宗教

通过展示医学与宗教部分客观存在的联系,经此努力发现并力图提示宗教与医学之间的某些关系及其影响,认为医学与宗教有着共同的研究目的、生命与死亡。两者殊途同归。     

REDUCING NONCOMPLIANCE TO FOLLOW-UP APPOINTMENT KEEPING AT A FAMILY PRACTICE CENTER

In this study, we evaluated follow-up appointment keeping at a family practice center. To determine if noncompliance could be reduced, four treatments were implemented: no-treatment control, modified appointment card, free follow-up, and a reduced rate follow-up. Thereafter, the reduced rate follow-up was implemented again to determine the extent noncompliance could be reduced for all eligible patients. Incentives significantly increased follow-up appointment keeping, whereas the modified appointment card was ineffective. A cost analysis suggested that the no-treatment control and modified appointment card conditions were the least expensive, but also the least effective. The incentive conditions were more expensive, but the reduced rate condition generated the most net revenue. Questionnaire data suggested that the incentive conditions had an effect on noncompliance and may be considered for use in other medical settings.     

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.