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。     

Equity and extramarital sexuality

Equity theory has recently been found to be a useful framework for under-standing the effects of imbalances in intimate contractual relationships such as marriage. Equitable couples seem to be happier, more satisfied with their relationship, and more confident that it will last than are their more mismatched, i.e., inequitable, counterparts. Furthermore, inequitable couples predictably act to set things right in their marriage. They either restore actual equity to the relationship or psychologically set their relationship in balance. If neither works, they may leave the field. Extramarital sex may be viewed as an equity restoration mechanism in that (1) it may be used by the deprived partner to achieve actual equity, (2) it may indicate a partner's readiness to leave the relationship because he feels he can do better, or (3) it may represent a desire to achieve equity in an alternative relationship(s) when inequity pervades the primary one. The hypothesis that the inequitable/underbenefited group should be more likely than the equitable group or the inequitable/overbenefited group to have engaged in extramarital sex was tested using data from a large-scale Psychology Todayquestionnaire. The results indicated that men and women in inequitable/under-benefited relationships had more extramarital affairs and began their extramarital activities earlier than did men and women in equitable and inequitable/over-benefited relationships. Alternative explanations of this finding, sex-role demands and length of the relationship, are explored and discarded as untenable. Research supported in part by National Institute of Mental Health Grant MH 26681.     

试论乌梅丸以气味配伍组方

乌梅丸出自《伤寒论》厥阴病篇，其为历代医家推崇的关键在于紧扣病机，方证对应，组方合理，配伍精当。本文从酸辛苦甘，刚柔相济；清上温下，攻补兼施；辛开苦降，土木两调3个方面讨论了乌梅丸按照气味配伍组方的特点。     

中药药效方法学研究初探（I）

对目前中药药效的研究方法进行全面论述，找出存在问题，并对中药药效方法学进行初步探讨。提出中医学发展是中药药效方法学研究的基础和前提，尤其是藏象经络学说和中药的归经理论的现代研究的突破对中药药效方法学研究起着主导作用；中药药效方法学研究四维系统论，在药效作用物质基础和药物作用机制两维的基础上增加时间维和人体精神维。