元认知能力在医学生临床实习中的培养

元认知能力在医学生临床实习过程中起着非常重要的作用。培养医学生的元认知能力 ,必须丰富医学生的元认知知识 ,强化医学生的元认知体验 ,促进医学生加强元认知监控 ,从而使他们成为独立自主、有创造力的学习者。     

高等医药院校大学生健康人格培养模式研究

健康人格是个体身心顺利发展的重要保证，是大学生适应社会、充分发挥自己能力的心理基础。而目前许多高等医药院校在大学生健康人格培养方面，普遍重视不够。本文从学校、教师、失学生自身三个角度，试探索出一套适合高等医药院校大学生健康人格建立和发展的培养模式，以期为对以后的心理健康教育工作有一定的启发和指导作用。     

明天的医学向何处去——平衡医学方法论略谈

《明天的医学向何处去》一文是王佑三同志应中国中医研究院、中西医结合研究会1990～2010年中医药研究的重大进展与突破预测研究课题组和中国人体科学学会之约所撰。本报征得作者同意稍加删节后发表,期望引起对“明天的医学”的关注。     

On the Importance of Age-Adjustment Methods in Ecological Studies of Social Determinants of Mortality

Objective. To illustrate the potential sensitivity of ecological associations between mortality and certain socioeconomic factors to different methods of age-adjustment.
Data Sources. Secondary analysis employing state-level data from several publicly available sources. Crude and age-adjusted mortality rates for 1990 are obtained from the U.S. Centers for Disease Control. The Gini coefficient for family income and percent of persons below the federal poverty line are from the U.S. Bureau of Labor Statistics. Putnam's (2000) Social Capital Index was downloaded from http://www.bowlingalone.com ; the Social Mistrust Index was calculated from responses to the General Social Survey, following the method described in Kawachi et al. (1997) . All other covariates are obtained from the U.S. Census Bureau.
Study Design. We use least squares regression to estimate the effect of several state-level socioeconomic factors on mortality rates. We examine whether these statistical associations are sensitive to the use of alternative methods of accounting for the different age composition of state populations. Following several previous studies, we present results for the case when only mortality rates are age-adjusted. We contrast these results with those obtained from regressions of crude mortality on age variables.
Principal Findings. Different age-adjustment methods can cause a change in the sign or statistical significance of the association between mortality and various socioeconomic factors. When age variables are included as regressors, we find no significant association between mortality and either income inequality, minority racial concentration, or social capital.
Conclusions. Ecological associations between certain socioeconomic factors and mortality may be extremely sensitive to different age-adjustment methods.     

Early dissemination of Borrelia burgdorferi without generalized symptoms in patients with erythema migrans

The diagnosis of erythema migrans (EM) is not always easy, and reports of culture- or PCR-confirmed diagnosis as well as reports of EM with simultaneous disseminated disease are few. Characteristics and incidence of EM in addition to frequency of early dissemination of B. burgdorferi were studied in the archipelago of South-Western Finland prospectively using questionnaires, skin biopsies and blood samples. Clinical EM was recognized in 82 patients (incidence 148/100,000 inhabitants/year). Of skin biopsy samples, 35.5% were positive by PCR (the majority B. garinii), and 21.5% by cultivation (all B. garinii). Of blood samples, 3.8% were positive by PCR, and 7.7% by cultivation. Of the patients, 30.9% were seropositive at the first visit, and 52.9% 3 weeks later. Of the patients with laboratory confirmed diagnosis, the EM lesion was ring-like in 31.8% and homogeneous in 65.9%. Dissemination of B. burgdorferi, based on culture or PCR positivity of blood samples, was detected in 11.0% of the patients. The frequency of generalized symptoms was nearly the same in patients with as in those without dissemination (22.2% vs 27.4%). Only 21.4% of the patients with culture-positive EM recalled a previous tick bite at the site of the EM lesion. We conclude that EM lesions are more often homogeneous than ring-like. B. burgdorferi may disseminate early without generalized symptoms.     

A Cross-Country Network Analysis of Adolescent Resilience

PurposeIn situations of adversity, young people draw on individual, relational, and contextual (community and cultural) resources to foster their resilience. Recent literature defines resilience as a capacity that is underpinned by a network of interrelated resources. Although empirical studies show evidence of the value of a network approach, little is known regarding how different country contexts influence which resources are most critical within a resource network and how resources interact for adolescent resilience.MethodsNetwork analysis was conducted with data from studies that had used the Child and Youth Resilience Measure. Regularized partial correlation networks of 17 resources were estimated for 14 countries (Botswana, Canada, China, Colombia, Equatorial Guinea, India, Indonesia, Italy, Jordan, New Zealand, the Philippines, Romania, South Africa, and Syrian refugees living in Jordan). The sample size was 18,914 (mean age = 15.70 years, 48.8% female).ResultsWe observed mostly positive associations between the resources of interest. The salience and strength of associations between resources varied by country. The most central resource across countries was having supportive caregivers during stressful times because this resource had the most and strongest positive associations with other resources.ConclusionsThis study gives first empirical evidence from multiple countries that an interplay of social–ecological resources (such as individual skills, peer, caregiver and community support, and educational aspirations and opportunities) matter for adolescent resilience. Across countries, caregiver support appears to be most central for adolescent resilience. Future resilience interventions might apply this network approach to identify important, contextually relevant resources that likely foster additional resources.     

河北省燕山及太行山山脉黄芩生态适宜性区划研究

目的:研究黄芩在河北省燕山及太行山山脉生态适宜性区划。方法:通过第四次全国中药资源普查等方式获取黄芩分布位点信息,利用地理信息系统技术和最大信息熵模型分析其分布区的主导生态因子、数值和权重,得出黄芩药材在河北省的生态适宜生长区。结果:研究表明,海拔、坡度、最暖季降水量、最湿月降水量、年均温、土壤类型、植被类型7项环境因子是影响黄芩分布的主要生态因子;黄芩在河北省的生态适宜生长区主要分布在承德、张家口、保定等地的燕山及太行山山脉区域。结论:可在太行山山脉的承德市、张家口市、保定市,燕山山脉的秦皇岛市引种栽培黄芩。     

医学伦理学教学模式探讨

医学伦理学是医学科学和伦理学科学交叉的边缘科学 ,是医学道德的科学 ,是一般伦理学原理在医学实践中的具体运用。培养合格医学生 ,不仅要注重医学知识的教育 ,而且要重视医学伦理道德的引导和培养。本文从教育的目的、原则、内容及教学方法等方面探讨医学伦理学的教学模式 ,旨在从理论到实践提高医学生的医德修养     

由复方中单一组分微小效应引发的对中西医结合理论的思考

“霰弹理论”认为中药作用机制和途径表现为多向性、多层面、多靶点的药理学特点 ,这些特点决定了中药复方中任何一种单一组分均可具有微小的生物学效应。在药物组分之间的相互作用中 ,除了少数已证明具有受体效应的组分外 ,多数组分是微效组分 ,即 :中药药效 =A B C …N个微小效应的累加作用。对某一组分不能忽略其生物学的微小效应 ,也不能采用简单的检测手段和数学统计方法分析微小效应。采用细胞培养的方法结合数学概率论将组分的微小生物学效应合并成机体的整体的生物学效应 ,可以解决实验医学与中医结合中遇到的理论与实际相脱节、实验研究结果与临床效果相背离等问题。