血虚证与补血药白芍辨证药物动力学关系研究

目的:通过对补血药白芍主要效应成分芍药苷在血虚证和健康小鼠体内血药浓度比较,探讨血虚证与补血药的辨证药物动力学关系。方法:建立血虚证动物模型,将实验动物分为空白对照组,对照组(健康小鼠),实验组(血虚证动物模型),对照组和实验组均给予白芍提取物灌胃。采用高效液相色谱技术,比较两组小鼠灌胃后不同时间点血浆中芍药苷浓度的差异。结果:实验组小鼠平均血药浓度在60 min、90 min时明显高于对照组,实验组小鼠血浆中芍药苷平均血药浓度为116．52±5．28 ng/μl,而对照组为41．49±2．86 ng/μl,二者比较有显著差异(p<0．001)。结论:血虚证小鼠血浆中芍药苷浓度较健康小鼠高,说明血虚证与补血药白芍存在辨证药物动力学关系。     

Nurses,formerly incarcerated adults,and Gadamer: phronesis and the Socratic dialectic

This paper describes the first phase of an ongoing education and research project guided by three main intentions: (1) to create opportunities for phronesis in the classroom; (2) to develop new understandings about phronesis as it relates to nursing care generally and to caring for specific groups, like formerly incarcerated adults; and (3) to provide an opportunity for formerly incarcerated adults and graduate nursing students to participate in a dialectical conversation about ethical knowing. Gadamer's writings on practical philosophy, phronesis, and the Socratic dialectic provide the philosophical foundation and framework for the project. The first phase in the project was a 4‐h class within a graduate‐level health promotion course during which 30 nursing students and three formerly incarcerated panelists engaged in a dialectic conversation about what it means to care for formerly incarcerated adults in a meaningful way. After the class, two focus groups were conducted, one with the students and one with the formerly incarcerated panelists. Findings articulated participants' prejudices and assumptions prior to the class, expanded sense of phronesis, and ability to consider nursing practice within a larger ethical framework. Panelists and students left the class with a deeper understanding of one another and expressed an openness towards continued dialectic conversations together. Use of the Socratic dialectic within nursing curricula reflects a current and critical trend in nursing education to bring non‐epistemologic forms of knowledge into the classroom.     

Stroke

In this paper I propose a theoretical framework for the treatment of patients with self-care problems. This framework takes as its starting point the frequent countertransference “pulls” encountered with such patients toward what might be called concerned action—the impulse to intervene actively in a protective or directive way in the hope of fostering better self-care. I suggest that, rather than simply acting on these impulses, on one hand, or viewing them as projectively or intersubjectively induced impulses simply to be processed internally by the analyst for purposes of interpretation, on the other, we view such impulses as the opening of a paradoxical or dialectical potential space in the transference–countertransference relationship. I argue that self-care problems result from the breakdown of a central dialectic in the parent–child relationship between concerned action and empathic recognition and that it is this dialectic that must be reestablished and reworked in the treatment relationship.     

The School Dropout

This paper provides a commentary on Philip Cushman's “A Burning World, an Absent God: Midrash, Hermeneutics, and Relational Psychoanalysis.” Cushman creatively uses the rabbinic midrash as a model hermeneutic and dialogic tradition for contemporary psychoanalysis as an alternative to fundamentalist interpretation. I agree with Cushman's goal, but I find that he places greater emphasis on absence over presence, narrative over law, transcendence over immanence, change over continuity, revolution over evolution, construction over discovery, and individual freedom and autonomy over community and tradition. I believe that it is just this leaning to one side that leaves him defensive about the collapse to relativism. Holding these poles in greater tension and valuing both sides of these polarities offers a dialectical model that serves contemporary psychoanalysis better as a hermeneutic, dialogical, contextual, and dialectical model for interpretation.     

四期辨证结合络病理论治疗急重症胰腺炎

目的：运用中医理论对急重症胰腺炎四期辨证治疗的可行性分析和总结。方法：在临床中根据其在不同发展过程中的不同阶段的症候表现,运用中医的辨证施治和络病理论结合现代检查手段如化验、B超、CT等将其分为四期进行辨证施治。结果：通过长期临床观察,对急重症胰腺炎分四期辨证治疗,症状缓解快,实验室检验、B超、CT等检查结果对比较单纯应用西医治疗恢复快,疗程明显缩短。结论：四期辨证治疗急重症胰腺炎,效果较好,疗效可靠。     

Staying in the here‐and‐now: A pilot study on the use of dialectical behaviour therapy group skills training for forensic clients with intellectual disability

Background Dialectic behaviour therapy (DBT) has been widely used with individuals diagnosed with borderline personality disorder who exhibit severe emotional and behavioural dysregulation. There is a paucity of research in assessing the effectiveness of DBT with forensic clients with intellectual disability (ID). Methods This pilot study aims to evaluate the effectiveness of the DBT group skills training programme adapted particularly for offenders with ID. Six participants completed the 13‐week adapted DBT group skills training programme. All participants exhibited challenging behaviours and have a history of prior charges or convictions for violent crimes. The study conducted pre‐ and post‐tests using instruments that measured dynamic risks, relative strengths, coping skills and global functioning. Results The study result showed improvement across all measures. A decrease in the level of risks, increase in relative strengths and general improvement in overall functioning were found significant. The results were promising particularly as a stand‐alone adapted DBT group skills training programme for this client group.     

Dialectic classification of syndrome diagnosis in traditional Chinese medicine used as new criterion for evaluating prognosis of patients with cervical cancer

Summary 254 patients with cervical cancer were treated by radiotherapy from Jan 1979 to Dec 1984. All the patients were followed up at least for more than 3 years, of them 180 for over 5 years. According to various symptoms, picture of the tongue and pulse condition, the disease was classified into 4 types, namely: 1) deficiency of liver-yin and kidney-yin, 2) deficiency of splenic qi, 3) internal retention of damp-heat, and 4) stagnation of qi and blood or stagnation of liver qi, The survival rate of the various types was quite different. The patients of type 4 had the worst prognosis. The prognosis of patients with type 1 was significantly better than that of patients with type 4. The difference was of statistical significance (P< 0.01).     

墨家的军事辩证法思想

墨家关于进攻和防御 ,消灭敌人和保存自己的军事辩证法思想 ,主要体现在“剑犹甲 ,死生也” :进攻和防御 ,消灭敌人和保存自己的辩证法 ;“守则固 ,诛则强” :积极防御的战略原则 ;“守城者以亟伤敌为上” :积极防御的战术原则等三个方面。墨家的军事辩证法思想 ,反映了战争的矛盾、本质和规律 ,是其积极防御的战略战术原则的哲学基础 ,对现代和未来的人民防御战争、反侵略战争颇具启迪意义     

中医辨证施护在老年性肺炎患者中的应用研究

目的 探讨中医辨证施护对老年性肺炎患者治疗结果的影响.方法 选择128例老年性肺炎患者,随机分为辨证施护组(观察组)和常规护理组(对照组)各64例.对照组给予常规护理,观察组除常规护理外给予中医辨证施护.结果 观察组总有效率为87.5%,对照组总有效率为75%,观察组与对照组比较差异有显著性(P＜0.05),具有统计学意义.结论 采用中医辨证分型施护,能提高老年性肺炎的治疗效果.