肝胆与脏腑气化关系探讨

肝胆在脏腑气化功能中起着重要作用。主要表现在五个方面;肝升肺降、治节有权,木敷心和、血运畅达,木疏土达、纳运如常,木和肾充、开合自如,木气疏调、三焦司职。     

新感与伏邪学说研究

新感与伏邪学说是温病发病学的主要内容。在系统回顾温病新感、伏邪学说学术渊源的基础止,深入分析其涵义与特点,并对历代有关伏邪学说的学术争鸣进行了归类、汇总,进而提出对新感伏邪学说的研讨应着重于临床实际,分析不同类型温病的病变机理,探讨其演变规律及防治方法。     

The acceptance of SARS-CoV-2 rapid antigen self-testing: A cross-sectional study in China

Compared with the nucleic acid amplification test (NATT), the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) rapid antigen self-testing (RAST) has advantages in speed and convenience. However, little is known about people's acceptance and influencing factors for SARS-CoV-2 RAST. A cross-sectional study was conducted from April 21 to 30, 2022 in China. The χ² test and multivariate logistic regressions were used to identify the influencing factors. The structural equation model was used to test the extended protective motivation theory (PMT) model hypotheses. Among the total of 5107 participants, 62.5% were willing to accept the SARS-CoV-2 RAST. There were significant differences in acceptance among different residences (p < 0.001), educational level (p < 0.001), occupation (p < 0.001), monthly income (p < 0.001), travel frequency (p < 0.05), and feelings about NATT (p < 0.001). Response efficacy (β = 0.05; p = 0.025) and self-efficacy (β = 0.84; p < 0.001) had a positive effect, while response cost showed a negative effect (β = −0.07; p < 0.001). The public's major concerns about SARS-CoV-2 RAST are its reliability, testing method, price, and authority. Overall, a moderate intention to use SARS-CoV-2 RAST was found among the Chinese population. The extended PMT can be used for the prediction of intention to accept the RAST. We need to take measures to increase people's acceptance of SARS-CoV-2 RAST.     

医学图像增强方法综述

医学图像增强的目的是通过图像增强的方法得到优化的医学图像,以帮助医生从图像中获得更多细节信息,进一步做出更加客观的诊断及制定更全面的治疗方案,在一定程度上可提高临床诊断的准确性。本文首先归纳总结当前应用较为广泛的医学图像增强处理技术,包括传统的图像增强方法、改进的图像增强方法、融合的图像增强方法以及深度学习方法,然后对这些方法的原理、优缺点加以分析和总结。最后指出无论是传统方法还是现代图像增强方法,都应在最大限度保留其优势的情况下进行融合,取长补短,注重简单化和时效性,使提高图像的视觉质量同时更具有实用性。     

Exploring the Meaning of 'Dissatisfaction' with Health Care: The Importance of 'Personal Identity Threat'

Researchers argue that a number of assumptions have been made about the concepts of patient satisfaction and dissatisfaction that have compromised their validity. The aim of this study was to explore the meaning of 'dissatisfaction' with health care. Forty-one people who had experienced problems in health care were identified from a household survey of health service users. They were interviewed in depth using an unstructured schedule. A grounded theory approach was used to construct a framework inductively from their accounts. The results suggest that 'dissatisfaction' could not accommodate the range of feelings, beliefs and values people express when they encounter problems in health care. However, another concept, that of 'personal identity threat', was identified which offered additional insights into the meaning of untoward experiences in health care. This concept delineates the grounds for disappointment or dissatisfaction, and helped to capture the complexity of the feelings and views expressed. Personal identity was perceived as being challenged through experiences which were felt to be disempowering, dehumanising and devaluing. Gender, class and race differences also emerged in respondents' perceptions of identity threat.     

Attitudes and Approaches of Influential Role Models in Clinical Education

The influence of a role model is a frequently cited factor in choosing a specialty choice among medical students, particularly primary care oriented students. While many studies have looked at role modeling from students' perspectives, very few have considered role modeling characteristics from the perspective of the role models. This study, using the principles of Bandura's social learning theory, determined and illuminated the characteristics and teaching methods associated with positive role modeling in clinical education from the perspective of the role model. A qualitative approach employing interviews and observations was used. Five themes emerged: the role models' approaches to teaching, their attitudes towards teaching and learning, their emphasis on clinical competence in their teaching, their roles external to their specific responsibilities, and their general affect. We found that role models were similar in their views of teaching and working with students. Also, their teaching characteristics were similar to the recommended approaches found in the literature and adhered to the principles of social learning theory. Role models were attentive to the needs of the students and tailored their teaching appropriately. They provided students with ample patient interaction so that students could apply their classroom knowledge. They also demonstrated how rewarding being an effective physician can be. This revised version was published online in June 2006 with corrections to the Cover Date.     

Towards an ethics of immediacy A defense of a noncontractual foundation of the care giver—patient relationship

In this article, I argue that the relationship between patients and their health care providers need not be construed as a contract between moral strangers. Contrary to the (American) legal presumption that health care providers are not obligated to assist others in need unless the latter are already contracted patients of record, I submit that the presence of a suffering human being constitutes an immediate moral commandment to try to relieve such suffering. This thesis is developed in reference to the French philosopher Levinas and the Dutch theologian Schillebeeckx. An expanded version of the biblical parable of the Good Samaritan serves as test case.This revised version was published online in October 2005 with corrections to the Cover Date.     

中医经络学说与现代经络研究

论述经络学说的形成和发展过程,回顾现代经络研究的概况。认为经络研究必须 发重视十二经脉的特殊循行路线及其在人体机能调节中的作用这一核心问题,加强对经功能整体性的研究。