Neural mechanism of proposer's decision-making in the ultimatum and dictator games

Previous studies have demonstrated that reactions to unfair offers in the ultimatum game are correlated with negative emotion. However, little is known about the difference in neural activity between a proposer''s decision-making in the ultimatum game compared with the dictator game. The present functional magnetic resonance imaging study revealed that proposing fair offers in the dictator game elicited greater activation in the right supramarginal gyrus, right medial frontal gyrus and left anterior cingulate cortex compared with proposing fair offers in the ultimatum game in 23 Chinese undergraduate and graduate students from Beijing Normal University in China. However, greater activation was found in the right superior temporal gyrus and left cingulate gyrus for the reverse contrast. The results indicate that proposing fair offers in the dictator game is more strongly associated with cognitive control and conflicting information processing compared with proposing fair offers in the ultimatum game.     

Priority Preferences: “End of Life” Does Not Matter,But Total Life Does

There is increasing evidence that the social value of an incremental health gain depends on patient characteristics, such as their age and their prognosis. This article presents an analytical framework to illustrate how a disease splits our life expectancy into 1) past health (age), 2) prognosis untreated, 3) gain from treatment, and 4) incurable loss. A Norwegian population sample was asked to make pairwise choices and prioritize hypothetical patients who differed in terms of age (30, 50, and 70 years old), remaining lifetime without treatment (1, 3, and 10 years), and increase in remaining lifetime with treatment (1 month, 3 months, 1 year, and 3 years). Their preferences reveal strong support for the “fair innings” argument that total lifetime inequalities should be reduced. Differences in patients’ remaining lifetime without treatment did not matter, implying little support for the “end-of-life” argument that a short life expectancy makes patients entitled to preferential treatment.     

Cloning of human melanoma antigen MAGE-A9 and its expression in hepatocellular carcinomas

Objective：To express the melanoma associated gene MAGE-A9 recombinant protein, obtain the anti-MAGE-A9 monoclonal antibody and to examine the expression of MAGE-A9 in hapatocellular carcinoma specimens. Methods：MAGE-A9 cDNA was cloned from human hepatocellular carcinoma tissue by using RT-PCR, and then subcloned into the plasmid pMD18-T. After sequencing, the MAGE-A9 was cloned into the prokaryotic expression vector pBAD/gⅢ to construct the recombinant expression vector pBAD/gⅢ - MAGE-A9, and was transformed into E. coli TOP10. The recombinant MAGE-A9 protein was expressed under induction of L-Arabinose, and was purified through Hitrap column. The anti-MAGE-A9 monoclonal antibody was generated. The expression of MAGE-A9 in hepatocellular carcinoma specimens was examined through ABC assay. Results：The cDNA sequence of the cloned MAGE-A9 gene was consistent with the reported sequence. By affinity column and SDS-PAGE, the purified MAGE-A9 fusion protein displayed a band of Mr 35,000, and subsequently the anti-MAGE-A9 monoclonal antibody was obtained. We found that MAGE-A9 expressed in the cytoplast of positive cells and MAGE-A9 antigen was detected in 8 cases out of 39 （21%） hepatocellular carcinoma specimens. Conclusion：MAGE-A9 antigen was expressed in a fair proportion of hepatocellular carcinoma specimens, these patients might be suitable candidates for immune involving antigen, encoded by the MAGE-A9 gene.     

重视维护医疗机构的诉讼公平权

为更好地保护患者权益,我国对医疗损害赔偿诉讼规定了一些特殊的诉讼规则,如患者有多种诉求选择、举证责任的倒置等,这些特殊诉讼规则可以更好地保护患者的权益。但我们在努力保护患者权益的同时,也要注意维护医疗机构的诉讼公平权。而现在,医疗机构的诉讼公平权已在一定程度上受到了损害。     

处理医患纠纷中存在的鉴定“二元化”问题初探

《医疗事故处理条例》是解决医患纠纷的专门性规范,医学鉴定是我国目前认定医疗行为是否有过失以及过失与损害结果是否存在因果关系的权威鉴定。司法鉴定中的法医类鉴定有其专门的适用领域,将法医类鉴定用于处理医患纠纷,出现"二元化"甚至"多元化"鉴定,很难客观、公正地解决医患纠纷。因此,树立医学技术鉴定的权威性,维护医患双方的合法权益,更有利于促进医学科学的发展。     

薪酬公平视角下县级公立医院医护人员职业评价调查及建议

目的：通过县级公立医院医护人员职业评价调查,探讨公立医院医护人员薪酬满意度及薪酬公平感知,为公立医院薪酬制度设计提出建议参考。方法采用文献分析法、问卷调查法、数据分析法。结果(1)医护人员职业评价水平一般,对职业风险和薪酬收入的满意度最低。(2)个体因素差异对职业评价影响显著,如年龄、工龄、年收入;(3)医护人员薪酬待遇公平性评价一般,科室薪酬公平感的评价差异不显著。结论公立医院薪酬制度要遵循公平原则,既保证医务人员薪酬收入水平与社会、行业平均收入水平保持均衡关系,又保证医务人员薪酬水平与其技能、风险、责任相匹配。     

我国卫生改革与发展应坚持的价值观和伦理原则

卫生经济问题无一不具有道德成分，无一能离开伦理政策得以解决。我国卫生改革一开始就缺乏伦理基准，医疗服务过度市场化倾向、政府责任不到位和伦理缺席已将卫生改革引向功利主义的死胡同，使得卫生改革背离了公正目标。我们要正确认识市场的目标、价值和规律，正确理解和发挥政府和市场的调节作用，促进卫生改革的健康发展。在对我国卫生改革的伦理学展望中，我们提倡一种“公平优先，兼顾效率”的价值观。