法制医学--我们必须面对的一种新型医学形态

面临医学发展中的困惑,作者提出法制医学观念。法制医学是随法律、法规变化而不断自我调整的一种新的医学形态。其主要目的是规范医疗行为,合法行医,和谐医患关系和防止医学科学技术的异化造成伦理和社会危机。作者解析法制医学模式出现的社会背景、法律背景和科学背景,并分析法制医学与人文医学的关系,最后提出该医学模式对医务人员、社会和患方的要求。     

谈中药知识产权保护的现状与对策

中国加入WTO之后,中国民族医药产业将面临着机遇和挑战,加强中药知识产权的保护工作意义尤其重大。作者在详尽分析了我国中药知识产权方面的现状之后,进一步提出了我国在中药知识产权保护方面的对策。     

论中医学的网络性思维

任继愈认为,中医哲学的科学价值主要表现在两个方面:一是以自然哲学和科学哲学丰富了中国哲学的内涵;二是通过其基本概念和范畴、特有的思维方式和表达方式,为全面把握中国哲学提供了新的视角。刘长林探讨了中医哲学的“元”创性问题,认为中医哲学的认识论从主客相融一体出发,所把握的是事物自然整体层面的规律。运用这些规律可以避免西方科学技术的缺失,并有望实现人与自然、人与社会的和谐发展。张其成将中医学的生命模型概括为“气—阴阳—五行”模型,认为这一关系性思维模式有助于揭示生命的整体性、动态性、开放性、自相似性、自组织性的本质。萧汉明指出,中医学的思维是一种网络型思维,这一具有普遍意义的思维原理,可以解决在宏观调节与总体把握复杂矛盾系统时遭遇到的困扰,进而有助于促进当代哲学的发展。     

Development of the Emergency Department Senior Abuse Identification (ED Senior AID) tool

Emergency departments (EDs) are an important health care setting for the identification of elder abuse (EA). Our objective was to develop an ED-based tool to identify EA. The initial tool included a brief cognitive assessment, questions to detect multiple domains of EA, and a physical examination. Refinement of the tool was based on input from clinical experts and nurse and patient feedback. The revised tool, which included 15 questions about EA, was then tested in an academic ED. We calculated the inter-rater reliability, sensitivity, and specificity of individual EA questions. Among ED patients age≥65 (N = 259), 17 (7%) screened positive for suspicion of EA. We identified a combination of six questions that cover the included domains of EA, demonstrated good or excellent inter-rater reliability, and had a sensitivity and specificity of 94% (95% confidence interval (CI) 71–100%) and 90% (95% CI 85–93%), respectively. These results inform a proposed screening tool for multisite validation testing.     

论人口老龄化进程与全科医学的互动关系

全科医学是 2 0世纪 6 0年代在北美兴起的一门综合性临床医学学科 ,它是以人为中心 ,以维护和促进健康为目标 ,向个人、家庭与社区提供连续、综合、便捷的基本卫生服务的新型医学学科。人口老龄化进程对全科医学形成和发展有重要影响。全科医学的发展对我国人口老龄化进程也有重大影响 ,有助于社区卫生工作的完善与发展、加快社区养老社会化服务的进程 ,有助于实现健康老龄化。     

以服务基层为导向的全科医学人才培养模式的探索

当前,我国基层卫生技术人员队伍建设相对滞后,已经成为制约基层卫生机构发展的瓶颈。医学院校充分发挥人才培养职能,积极探索符合基层医疗服务特点的全科医生培养模式,对推动我国基层医疗卫生服务质量的提高,促进我国医药卫生体制改革的深化具有重要作用。本文对现阶段我国全科医学人才培养中存在的问题进行了分析,介绍了开展全科医学教育的重要意义,并结合辽宁医学院的工作实践,提出了以服务基层为导向的全科医学人才培养的建议和措施。     

培养医学生阅读风格促进中华医药传统文化教育

阅读从来就是培养文化和传承文化的重要途径,阅读风格的培养是涵养医学人文品格的重要内容。重构大学生阅读兴趣,提升医学生阅读层次,通过漫阅读、深阅读、精阅读、动阅读等多元形式,引导大学生在书籍的海洋里涵养身心,以提高医学生全面素质,培养医学人文精神,传承中华医药传统文化。     

An intuitive risk factors search algorithm: usage of the Bayesian network technique in personalized medicine

The article focuses on the application of the Bayesian networks (BN) technique to problems of personalized medicine. The simple (intuitive) algorithm of BN optimization with respect to the number of nodes using naive network topology is developed. This algorithm allows to increase the BN prediction quality and to identify the most important variables of the network. The parallel program implementing the algorithm has demonstrated good scalability with an increase in the computational cores number, and it can be applied to the large patients database containing thousands of variables. This program is applied for the prediction for the unfavorable outcome of coronary artery disease (CAD) for patients who survived the acute coronary syndrome (ACS). As a result, the quality of the predictions of the investigated networks was significantly improved and the most important risk factors were detected. The significance of the tumor necrosis factor-alpha gene polymorphism for the prediction of the unfavorable outcome of CAD for patients survived after ACS was revealed for the first time.     

Medicare and Amyloid PET Imaging: The Battle Over Evidence

We examine a recent dispute regarding the Centers for Medicare and Medicaid Services’ (CMS) refusal to unconditionally pay for amyloid positron emission tomography (PET) imaging for Medicare beneficiaries being assessed for Alzheimer’s disease. CMS will only pay for amyloid PET imaging when patients are enrolled in clinical trials that meet certain criteria. The dispute reflects CMS’s willingness in certain circumstances to require effectiveness evidence that differs from the Food and Drug Administration’s standard for pre-market approval of a medical intervention and reveals how stakeholders with differing perspectives about evidentiary standards have played a role in attempting to shape the Medicare program’s coverage policies.     

川南苗族丧葬仪式中的史诗唱述及音乐样态研究

近年来,苗族史诗及苗族仪式音乐的研究成果很多,但大多侧重对仪式中史诗唱诵的文本译介或价值分析,缺少对音乐的描写及调查研究.我们注意到,苗族史诗的唱述是与其民族的民俗生活环境密切相关.为此,本文结合田野调查资料,聚焦于川南苗族丧葬仪式上苗族史诗的唱述音乐之民俗环境、音乐形态、史诗语言韵律等方面进行分析.研究显示,苗族史诗的唱述音乐作为较特殊类别的仪式音乐,由多种乐器声响和人的声音相交融,是其民族的音乐、语言和信仰观念的综合表达.把握其唱述与传承的相关关系,对拓展民族音乐学的视野具有学术的意义.