论辨证论治

辨证论治是中医学理论体系的特色之一，也是中国传统科学特征在医学中的体现。1．辨证理路的形成与中国传统文化以辨证的思维方式，《周易》哲学的变易观念，传统科技重视时间因素以时间统摄空间，以及承袭针灸治疗的操作习惯等有关。2．辨证论治的特点，主要体现在思维方式、框架体系、辨析内容、论治原则和操作技巧诸方面。3．辨证论治是建立在理论模型化的证候与“辨”的思维推理基础之上，辨证论治的境界与医生的学养、经验和创造性有关。辨证论治要提高、要发展、要突破。     

针刺中药并用治疗贫血45例

目的:观察针刺配合中药治疗贫血的疗效.方法:随机抽取单纯中药组,张针刺中药并用组各45例,进行疗效分析.结果:针药并用组临床显效率37.8%,总有效率93.4%,单用中药组显效率22.2%,总有效率68.9%,针药并用组总有效率明显优于单纯中药组(P＜0.05).结论:针刺中药并用治疗贫血,优于单纯中药治疗.     

从系统性看肿瘤发生与治疗

系统论是当今人们认识事物的重要理论和方法。本文从系统论的基本观点入手，以“基因决定论”为论点，用系统思维、系统方法来分析肿瘤的发生与肿瘤的基因治疗及肿瘤综合治疗，以阐明肿瘤的发生发展是一个多因素、多步骤的过程，是机体各系统功能紊乱、失衡的结果，因此，对肿瘤的治疗必须从系统和整体考虑，以期达到最佳治疗效果。强调系统性思维及方法在医学工作中的重要性。     

Portfolio Theory and Cost-Effectiveness Analysis: A Further Discussion

OBJECTIVES: Portfolio theory has been suggested as a means to improve the risk-return characteristics of investments in health-care programs through diversification when costs and effects are uncertain. This approach is based on the assumption that the investment proportions are not subject to uncertainty and that the budget can be invested in toto in health-care programs. METHODS: In the present paper we develop an algorithm that accounts for the fact that investment proportions in health-care programs may be uncertain (due to the uncertainty associated with costs) and limited (due to the size of the programs). The initial budget allocation across programs may therefore be revised at the end of the investment period to cover the extra costs of some programs with the leftover budget of other programs in the portfolio. RESULTS: Once the total budget is equivalent to or exceeds the expected costs of the programs in the portfolio, the initial budget allocation policy does not impact the risk-return characteristics of the combined portfolio, i.e., there is no benefit from diversification anymore. CONCLUSION: The applicability of portfolio methods to improve the risk-return characteristics of investments in health care is limited to situations where the available budget is much smaller than the expected costs of the programs to be funded.     

Handoff strategies in settings with high consequences for failure: lessons for health care operations.

OBJECTIVE: To describe strategies employed during handoffs in four settings with high consequences for failure. DESIGN: ANALYSIS: of observational data for evidence of use of 21 handoff strategies. SETTING: NASA Johnson Space Center in Texas, nuclear power generation plants in Canada, a railroad dispatch center in the United States, and an ambulance dispatch center in Toronto. MAIN MEASURE: Evidence of 21 handoff strategies from observations and interviews. RESULTS: Nineteen of 21 strategies were used in at least one domain, on at least an 'as needed' basis. CONCLUSIONS: An understanding of how handoffs are conducted in settings with high consequences for failure can jumpstart endeavors to modify handoffs to improve patient safety.     

医疗体制改革的理论思考

近来有关中国医疗体制改革的讨论，逐渐涉及公共经济学、卫生经济学理论层面的一些基本理念和基础概念，解决中国医疗体制改革缺陷的不少主张，也因为对基本理论、概念的混淆和对医改问题的历史成因认识不清，而对医疗服务中政府与市场作用的边界，以及在公平与效率的关系上陷入形而上学的思维方式。因此，有必要从理论和历史的视角上正确理解医疗服务性质、合理定位医疗体制改革，避免出现将政府作用神化和市场作用神化两个极端，重新厘定政府与市场、公平与效率在医疗体制改革进程中的均衡。     

关于中医基础理论重点学科建设问题的讨论

基础理论学科的知识创新与重点学科的建设工作密切相关，知识创新的技术平台建设主要依赖于学科发展方向、学术带头人、学科人才梯队和运行管理机制的建设。关注学术发展动态。拟定高起点、高水平的学科发展方向；根据科学发展趋势，选拔开拓进取、勇于创新的学科带头人；瞄准科学前沿，建立多层次、结构优化的学科人才梯队；创新管理模式，实行科学化运行机制和管理体制是保障知识创新的前提和基础。     

Understanding Atypical Emotions Among Children with Autism

Children with autism are said to be poor mind readers: They have a limited understanding of the role that mental states play in determining emotions and behavior. In this research, 23 high-functioning children from the autistic spectrum (M age 9 years 3 months), 42 6-year-old controls, and 43 10-year-old controls were presented with six emotion-evoking stories and they were asked to explain protagonists' typical and atypical emotions. In the case of typical emotions, as expected on the basis of the mindblind hypothesis, children from the autistic spectrum gave few mental state explanations, referring to fewer than even the 6-year-old control group. However, in the case of atypical emotions, the autistic group performed as well as the 10-year-old controls. Their explanations for the atypical emotions demonstrate that children from the autistic spectrum indeed have the capacity to mind read (with respect to both desires and beliefs), although they do not always use this capacity in the same way as normally developing children. It is argued that the mind-reading capacity of high-functioning children from the autistic spectrum might be basically intact; unused in everyday circumstances but not necessarily defective.     

产业集群竞争力理论的演变

西方产业集群理论中对产业集群竞争力分析最为著名的有马歇尔的外部经济理论、克鲁格曼的新经济地理学理论和波特新竞争优势理论等。马歇尔是从新古典经济学的角度,通过研究工业组织这种生产要素,间接表明了企业为了追求外部规模经济而集聚。克鲁格曼的新经济地理学产业群模型从理论上证明了制造业(工业)活动倾向于空间集聚的一般性趋势,并阐明由于外在环境的限制,产业区集聚的空间格局可以是多样的,产业集聚空间格局的形成及锁定效应,是经济活动收益递增和运输成本相互作用的产物。迈克尔·波特从组织变革、价值链、经济效率和柔性方面所创造的竞争优势角度重新审视产业集群的形成机理和价值,并提出了国家竞争优势的“钻石模型”。产业集群竞争力理论随着产业集群的不断发展而相应地演变成系统的理论体系,并不断为全球化背景下的区域发展提供新的政策和管制思路。     

从滑坡现象和风险社会理论看安乐死

“安乐死”问题一直是一个极具争论的议题，赞成者和反对者各持一方，近年来，国内赞成安乐死的呼声越来越高，笔者从风险社会理论角度出发，对比分析荷兰安乐死立法的社会背景和实践中的滑坡现象。认为像我们这样有着深厚传统文化，卫生资源相对贫乏，医疗保障水平低，法制还不十分健全的国家，在目前社会条件下，对安乐死的问题应审慎。