叙事求真———医学人文的视野与洞察

“叙事求真”旨在让病人叙说疾病故事,医生聆听病人故事;从病人“身心灵”“全人生”和“全环境”等全方位、多维度,洞察探析疾病发生发展过程,疾病对病人的身、心、灵和社会适应等方面造成的痛苦;以期为病人提供个性化诊疗和照顾方案。     

沟通合作———医学人文的表达与实现

医务工作环境复杂,医生接触的人群多样且难以预见。通过沟通合作将医学人文素养进行表达和实现,有助于医生临床工作决策和合作,对顺利有效处理医疗事务、提高医疗工作效率和改善患者就医体验非常关键。在此探讨了更加契合医生的沟通新定义,并根据医生沟通合作的对象不同分别进行了分析。医患沟通应着眼未来,携手并进。同行沟通要互相尊重,求同存异。社会沟通掌握界限,消除偏见。只有像这样在沟通合作中运用一定的技巧,才能良好表达和实现医学人文素养,为稳定我国医疗环境作出贡献。     

中医药院校毕业生质量调查与教学改革互动机制探索

本研究通过对中医药院校教学改革和质量管理进行理论上的分析,提出完善中医药教育质量管理、优化教育教学改革的必要性。同时,进一步阐述了中医药院校教学改革和质量管理的全面性、导向性、可操作性以及定性与定量原则。在此基础上,提出完善中医药院校毕业生质量与教学改革互动机制的对策并进行实践;对策内容包含建立有效的毕业生质量跟踪反馈机制、积极开展教学质量监控和评价以及构建中医药教育教学质量测量与评价体系。以此结合当前社会对中医药学人才培养的需求以及行业素质培养标准,对中医药人才进行针对性培养,推动中医药事业发展。     

New avian influenza virus (H5N1) in wild birds, Qinghai, China

Highly pathogenic avian influenza virus (H5N1) (QH09) was isolated from dead wild birds (3 species) in Qinghai, China, during May-June 2009. Phylogenetic and antigenic analyses showed that QH09 was clearly distinguishable from classical clade 2.2 viruses and belonged to clade 2.3.2.     

Transmission and Maintenance Cycle of Bartonella quintana among Rhesus Macaques,China

We detected Bartonella quintana in 48.6% of captive rhesus macaques from an animal facility in Beijing, China. Prevalence of infection increased over the period of observation. Our findings suggest that macaques may serve as reservoir hosts for B. quintana and that Pedicinus obtusus lice might act as efficient vectors.     

探索创新———医学人文的发展与突破

医学人文的核心,是关爱患者。多少医者,他们在床边诊治病人的同时,还要努力探索创新,力图攻克横亘在医患面前的难题与障碍。他们努力跟踪国际前沿,学习钻研,增进自身知识,提高临床技能;他们在临床工作中探索前行,或归纳共性,或辨识特性,为个性化诊治病人而努力;他们遵循转化医学,从事课题研究,使新颖理论可付之技术实践,促进医学人文关怀的发展与突破。     

The effects of qualitatively different acute physical activity interventions in real-world settings on executive functions in preadolescent children

There is growing evidence indicating a positive effect of acute physical activity on cognitive performance in children. Most of the evidence originates, however, from studies in highly controlled laboratory settings. The aim of the present study was to investigate whether the same effects can be found in more real-world settings. We examined the effects of qualitatively different acute physical activity interventions on the three core dimensions of executive functions (updating, inhibition, shifting). In an experimental between-subject design, 219 ten to twelve year-olds were assigned to one of four conditions which varied systematically in physical activation and cognitive engagement. Executive functions were measured before and immediately after the intervention. Contrary to the hypothesis, no effects of acute physical activity with and without cognitive engagement were found on executive functions in the overall sample. Only children with higher fitness and/or higher academic achievement benefitted from the interventions in terms of their updating performance. Thus, the results indicate that it may be more difficult to attain positive effects through acute physical activity in real-world settings than in laboratory settings and that physiological and cognitive requirements may have to be adjusted to individual capacity to make an intervention effective.     

遵循规范———医学人文的支撑与边界

对医生而言,遵循规范无疑是必要的,因为这样既可以提升诊疗质量,也可以在遇到医疗纠纷的时候保护自己。医生需要遵循的规范很多,如保护患者隐私权、知情权等基本权利,承担其他社会责任,合理合规保障自我权利。但是从另一个角度考虑,规则规范存在一定的局限性和滞后性,有时需要医生自由裁量;处理好规范与自由裁量之间的关系同样非常重要。     

Circulation of Reassortant Influenza A(H7N9) Viruses in Poultry and Humans,Guangdong Province,China, 2013

Influenza A(H7N9) virus emerged in eastern China in February 2013 and continues to circulate in this region, but its ecology is poorly understood. In April 2013, the Guangdong Provincial Center for Disease Control and Prevention (CDC) implemented environmental and human syndromic surveillance for the virus. Environmental samples from poultry markets in 21 city CDCs (n = 8,942) and respiratory samples from persons with influenza-like illness or pneumonia (n = 32,342) were tested; viruses isolated from 6 environmental samples and 16 patients were sequenced. Sequence analysis showed co-circulation of 4 influenza A(H7N9) virus strains that evolved by reassortment with avian influenza A(H9N2) viruses circulating in this region. In addition, an increase in human cases starting in late 2013 coincided with an increase in influenza A H7 virus isolates detected by environmental surveillance. Co-circulation of multiple avian influenza viruses that can infect humans highlights the need for increased surveillance of poultry and potential environmental sources.