整合理念在医学影像学教学中的应用

伴随着信息科技的发展,医学影像学的发展已进入"大影像"时代。该学科由原先单一的放射诊断学发展成为一门综合性的学科,是现代医学领域发展最快、涉及范围最广的学科之一。随着该学科的发展,现代高校对医学影像学教学的要求也进一步提高。如何完善医学影像学教学,使之与临床科目更好地整合一起,是目前教学实践中迫切需要解决的问题。无论是教学内容、手段、形式还是教学评估的改革,都必须始终贯彻"整合"这个思想理念,从而完善医学影像学教学,使之与临床科目更好地整合一起,适应时代发展的需求。     

“三位一体”模式下的全科医学人才培养

全科医学是一个服务于社区与家庭,整合临床医学、预防医学、康复医学以及人文社会学科等多专业内容于一体的综合性医学专业学科[1],它既包含了其他学科在医学专业知识和技能上的共性,更具有自身学科专业体系和服务模式的特性。因此,在着眼于全科医学的学科发展,特别是学科发展的核心——全科医学人才的培养时,应当注意兼顾学科的两大特性。     

边缘学科拓出新天地“十一五”以来我军疗养康复医学学科新进展(之一)

目的研究探讨"十一五"以来我国疗养康复医学学科的新进展。方法收集检索我国我军疗养康复医学学科建立发展的历史沿革相关资料,并进行归纳整理和分析总结。结果疗养康复医学是疗养医学与康复医学交叉、渗透、整合而成的一门新型的边缘学科。在我国政府和军队医疗卫生部门的正确决策下,疗养康复医学创办了自己的学术机构,创新了自己的学科模式,创立了自己的学科技术和方法,在预防、保健、治疗、康复领域中对健康、亚健康、慢性疾病、伤残人员的身心健康起到了很好的促进作用,在各种突发性事件的医学应对中体现了贡献社会的核心价值。结论疗养康复医学这一边缘学科开拓出了新的天地。     

加强对睡眠呼吸障碍的诊疗促进我国睡眠医学的发展

在国际上,经过30多年的发展,以睡眠疾病诊疗为主的一门新兴边缘交叉学科——睡眠医学已经形成并逐渐发展壮大。本文重点从国际睡眠医学发展特点、国内睡眠医学发展、睡眠呼吸医学发展及人才培养等几个方面进行了全面的论述。其中,对睡眠呼吸障碍的认识是催生睡眠医学这一新兴边缘交叉学科的学术引擎,而提高睡眠呼吸障碍的诊疗和研究水平将是促进学科建设的持久驱动力。     

TBL教学模式下推动睡眠呼吸障碍疾病多学科交叉精细化培养的探索与实践

探讨以团队协作为基础的(TBL)教学模式下推动睡眠呼吸障碍疾病多学科交叉精细化培养的原则、方法、内容和课程教学的体会,以睡眠医学为核心进行教学知识的多元化整合,通过TBL教学方法探索和实践我校研究生教学多学科交叉培养模式,一方面在教学中强化多学科教师团队的协作意识,改善教学方法和教学理念,突出睡眠呼吸障碍疾病的分类及其与全身其他脏器疾病的相关性,另一方面培养学生自主学习的能力,将学生整合成一个学习小组后,通过查阅文献,共同协作,解决老师所提出的问题,使之能够发挥出各自专业的优势,在多学科临床实习中巩固并强化基础知识,成为知识结构专业深度、知识广度和知识交叉等特点的综合性复合型人才。     

全科医学还是社区医学

通过对全科医学由来、产生的背景和其学科特点的阐述，以及对全科医学和家庭医学两个概念的分析比较，认为全科医学概念中的“全科”二字易给人造成误解，不能很好地表现全科医学的特点，应该改作社区医学才比较能体现该学科的特点。     

医学伦理学(8)——生命医学科学研究中的伦理道德

生命科学技术是当今最活跃、发展最迅速和对社会影响最广泛的学科之一,而其发展带动了医学、农业、食品业和制药业等的深刻变化。生物医学研究的目的是为人类控制和预防疾病、维护和增进健康、拯救和延长生命、改善和提高生活质量服务的,是生命科学技术的主体,其人体试验具有不可替代的特点。生物医学的迅速发展,既对人类带来了莫大福祉,同时也带来许多新的伦理问题。生命科学的发展需要伦理规范一、生命科学的发展,呼唤伦理规范自1952年Watson和Crick发现DNA双螺旋结构以来,分子生物学、分子遗传学得以迅速发展,其带动了生物学、医学和农…     

美国全科医生培养模式对综合性医院全科医生培养的启迪

全科医学是一门面向社会与家庭,整合临床医学、预防医学、康复医学以及人文社会学科相关内容于一体的,以人为中心,以维护和促进健康为目的综合性医学专业学科。全科医学的范围涉及各种年龄、性别、各个器官系统以及各类疾病。20世纪60年代,由于国内医疗费用急剧持续增长以及医学模式的改变,美国首先提出并创建了家庭医学学科（即全科医学学科）,并逐步形成了一个比较完善的全科医学教学模式。20世纪80年代末,全科医学引入中国。     

危重病医学临床教学经验交流

危重病医学(critical care medicine)是研究任何损伤或疾病导致机体向死亡发展过程的特点和规律性,并根据这些特点和规律性对重症患者进行治疗的学科。重症医学所服务和研究的对象为危重症患者。所谓危     

重症医学临床教学中深静脉穿刺操作的教学体会

重症医学(又称危重病医学,critical care medicine)是研究任何损伤或疾病导致机体向死亡发展过程的特点和规律性,并根据这些特点和规律性对重症患者进行治疗的学科[1].重症医学所服务和研究的对象为危重症患者.所谓危重病(critical illness)指病情危重,直接威胁生命的疾病或疾病的严重阶段.     

Future perspectives of personalized medicine in traditional Chinese medicine: a systems biology approach

Deconstruction of molecular pathways and advances in enabling technology platforms have opened new horizons for disease management, exploring therapeutic solutions to each individual patient beyond the one-size fits all practice. Application of personalized medicine paradigms aims to achieve the right diagnosis and right treatment for the right patient at the right time at the right cost. With the potential to transform medical practice across global communities, personalized medicine is emerging as the flagship of modern medicine. In recent years, the health care paradigm has shifted from a focus on diseases to a major hot of personalized traditional Chinese medicine (TCM) with holistic approach. TCM focuses on health maintenance, emphasizes on enhancing the body's resistance to diseases and especially showes great advantages in early intervention, personalized and combination therapies, etc. Systems biology, a new science of the 21st century, becomes practically available and resembles TCM in many aspects such as study method and design, and is current key component technologies that serves as the major driving force for translation of the personalized medicine revolution of TCM principles into practice, will advance personalized therapy principles into healthcare management tools for individuals and populations. Such system approach concepts are transforming principles of TCM to modern therapeutic approaches, enable a predictive and preventive medicine and will lead to personalized medicine. To realise the full potential of personalized TCM, we describe the current status of principles and practice of TCM integrated with systems biology platform. Some characteristic examples are presented to highlight the application of this platform to personalized TCM research and development as well as some of the necessary milestones for moving TCM into mainstream health care.     

Developments and trends in traditional medicine and complementary and alternative medicine

With the rapid development of society, medical science and technology, although quality of life is enhanced and life expectancy is prolonged, aging, environmental changes and health problems are unavoidable. More and more people, therefore, are concerned about their health and place high demands on medical care. As modern medicine cannot meet all such demands, other medical care systems emerge. Trends in the seeking of medical care show that people are inclined towards natural approaches, so attention is being paid once again to traditional medicine, as well as complementary and alternative medicine. Under the patient-oriented concept, medical personnel have to recognize means of health care while thinking of the individualized and socioeconomic impacts. The purpose of this paper therefore is to provide medical personnel with information on the developments and trends in, knowledge and research with regard to traditional medicine as well as complementary and alternative medicine.     

Use of traditional medicine in Lao PDR

OBJECTIVES: Exploring the attitudes and knowledge of household members and health staff in Lao PDR regarding the use of traditional medicine. BACKGROUND: Along with modern medicine, traditional medicine utilisation is officially supported in Laos, being part of the cultural heritage and considered useful for this low-income country in relation to the problems with access to modern pharmaceuticals. METHODS: The study population comprised 600 households from one lowland (Pakse) and one mountainous (Paksong) district. In a stratified two-stage sampling procedure, household surveys were conducted and focus group discussions (FGD) were performed among health staff and villagers in the same districts. RESULTS: Seventy-seven per cent of the households stated the ever use of traditional medicine including herbal medicines, sauna, massage and acupuncture. The main reason given was perceived efficacy. Traditional medicine was used for both chronic and acute diseases. The FGD revealed the perceived need to have training courses for traditional medicine providers and to have a medicinal garden in the villages. Utilisation was similar in lowland and mountainous districts as well as in urban and rural areas. CONCLUSIONS: The study indicates that traditional medicine is widely used and perceived as effective by a fairly large proportion of Lao people. The findings may form a basis for health sector reforms that are congruent with perceived local needs, e.g. in establishing a strategic plan for the development of the traditional medicine sector in Lao PDR.     

Integration of traditional and complementary medicine into national health care systems

The growth of complementary and alternative medicine in the Far East is discussed. The role of traditional medicine in the development of health care in Asia is presented, and integration of traditional and modern methods of health care are described.     

The ethics and economics of high-technology medicine

The exceptional advances of modern medicine have restored to productive life many patients with previously fatal or disabling diseases, but these very successes have raised a host of troubling ethical and economic questions. Reconciling society's increasing demands on medicine with the realities of inflation, governmental regulations, changing social values, and an aging population poses knotty problems, the answers to which will not be found in pious platitudes. To expect every American to receive ultrasophisticated health care at bargain-basement prices is merely delusional. Several resolutions of the controversies have been proposed, but real cost-benefit will derive from research into disease prevention and greater personal responsibility for maintaining health. Its vocal critics notwithstanding, the American health system remains the best in the world. Our society must decide whether medicine is to remain a profession or is to operate by governmental edict, and we must be prepared to accept the consequences of our decision.     

Emergency medicine and the health of the public: the critical role of emergency departments in US public health

This issue of the Emergency Medicine Clinics of North America focuses on the spectrum of public health issues that significantly impact the practice of emergency medicine and which are faced by practicing emergency physicians on daily basis. Topics include public health research in the emergency department; respiratory threats; emerging infectious diseases; emergency department overcrowding; end-of-life care; racial and ethnic disparities; issues of health promotion and disease prevention encompassing substance abuse, alcohol, and injury and violence; and public health surveillance; and the problems of homeless and disadvantaged patients. This article gives a brief introduction to the important relationship between emergency medicine and public health.     

Integration of molecular pathology,epidemiology and social science for global precision medicine

The precision medicine concept and the unique disease principle imply that each patient has unique pathogenic processes resulting from heterogeneous cellular genetic and epigenetic alterations and interactions between cells (including immune cells) and exposures, including dietary, environmental, microbial and lifestyle factors. As a core method field in population health science and medicine, epidemiology is a growing scientific discipline that can analyze disease risk factors and develop statistical methodologies to maximize utilization of big data on populations and disease pathology. The evolving transdisciplinary field of molecular pathological epidemiology (MPE) can advance biomedical and health research by linking exposures to molecular pathologic signatures, enhancing causal inference and identifying potential biomarkers for clinical impact. The MPE approach can be applied to any diseases, although it has been most commonly used in neoplastic diseases (including breast, lung and colorectal cancers) because of availability of various molecular diagnostic tests. However, use of state-of-the-art genomic, epigenomic and other omic technologies and expensive drugs in modern healthcare systems increases racial, ethnic and socioeconomic disparities. To address this, we propose to integrate molecular pathology, epidemiology and social science. Social epidemiology integrates the latter two fields. The integrative social MPE model can embrace sociology, economics and precision medicine, address global health disparities and inequalities, and elucidate biological effects of social environments, behaviors and networks. We foresee advancements of molecular medicine, including molecular diagnostics, biomedical imaging and targeted therapeutics, which should benefit individuals in a global population, by means of an interdisciplinary approach of integrative MPE and social health science.     

中国睡眠呼吸知识的普及情况调查

睡眠医学与呼吸系统密切相关,睡眠呼吸暂停事件是常见的睡眠障碍相关疾病的表现之一。睡眠呼吸暂停事件与心、脑血管疾病、内分泌疾病等密切相关,严重影响人类的健康和生活质量。虽然随着睡眠呼吸医学教育的普及,睡眠呼吸暂停低通气综合征等相关疾病逐渐引起我们的重视,然而不同群体对呼吸睡眠的认知因专业背景、宣传普及范围和力度等存在不同的水平差异。本次拟开展不同群体的教育和认知情况调查研究,初步了解中国睡眠呼吸市场的普及情况。     

Team medicine for COPD

From the standpoint of holistic respiratory care for patients with COPD, team medicine by various kinds of occupations are required. Patient education and guidance are very important at the introduction of HOT and HMV. Moreover, for smooth and safe home respiratory care, local health care network is essential. We secure nursing visit and local physicians as much as possible in order to confirm adherence after starting home care and for early discovery of problems. Delicate care through a local health care network is important. However there is insufficiency regarding the establishment of local health care network, so it should be improved immediately.     

Foucault and modern medicine

Foucault and modern medicine
Modernity as a concept or ideal, resulting from the age of Enlightenment and the French Revolution gave hope of a better future and new possibilities. To be modern means an 'enlightened' individual and society, welcoming change and development. In this paper, I will discuss Foucault's analysis (1973) of problematics in medicine in eighteenth century France. Three themes prominent in the text are: 'the birth of the clinic', 'the clinical gaze' and the power-knowledge relationship. Three problematics identified in modern medicine by Foucault and which are particularly relevant to twentieth century medicine are: (i) the extension of the clinical gaze from the individual body to the wider population; (ii) the increasing medical intervention and use of technology in fundamental life processes; and (iii) the relationship between society and medicine. I will argue that Foucault's analysis is fraught with ambiguities. It is useful, however, for establishing an explanation for medicine today and for presenting a particular interpretation of modernity.