中医医案方剂多维相似度算法设计与探索＊

中医医案方剂具有多维度的特性，单独采用一种相似度算法难以展现方剂数据在各维度的相似情况，具有一定的局限性。本研究基于中医医案方剂的多维数据特点，结合中医临床遣方用药的思维过程，设计了中医医案方剂的多维相似度算法，并以七则国医大师医案为示例，详细展示了该算法的计算过程，同时将多维相似度算法计算结果与传统算法计算结果进行了对比分析。通过对比可以看出本算法能够相对全面地反映不同方剂间的相似度，且结果更为合理也更贴合中医临床实际。     

类比思维在医学文献检索教学中的应用

针对文献检索部分教学内容抽象、枯燥、容易混淆,难以理解和掌握等问题,在分析类比含义的基础上,将类比思维应用于文献检索教学中,并结合实际教学举例阐述了类比联想在文献级别等概念中的应用和类比推理在CBM和Pub Med数据库讲解中的应用,教学实践证明类比法对重点、难点知识的讲解能够达到由浅入深、化难为易的教学效果,对提高学生分析问题、解决问题的能力和创新思维的培养具有较好效果。     

The process of reflection: A principle‐based concept analysis

The purpose of this paper is to evaluate the concept reflection as a process using a principle‐based method of analysis that acknowledges the philosophical premises of formal cognitive operations (experiencing, understanding, judging, and deciding) espoused by Bernard Lonergan. The aim is to understand how we think and process cognitively in reflection while developing consciousness in knowing. Using Lonergan's formal cognitive operations adds a philosophical perspective and structure to the concept. Fostering the enactment of reflection is a complex process, but it is vital for nursing science and disciplinary advancement.     

广州市某高校医学生批判性思维能力现状及其影响因素

目的 了解广州市高校医学生批判性思维能力现状及其影响因素,为改善医学生批判性思维能力提供依据.方法 采用中文版批判性思维测量表,分层整群抽取广州医科大学医学生335名进行问卷调查.结果 医学生总体具有正性批判性思维(285.75±33.74分),多因素logistic回归结果显示:参加科研学习(OR =0.651,95％ CI:0.441～0.960)、了解批判性思维(OR =0.460,95％ CI:0.277～0.765)、热爱本专业(OR=0.559,95％ CI:0.330～0.946)、参加过医院临床实习(OR=3.327,95％CI:2.053～5.392)是医学生批判性思维能力的主要影响因素.结论 广州市高校医学生批判性思维平均得分低于欧美国家,注重培养医学生的科研能力、开展批判性思维能力相关知识的教育、增强专业的热爱感以及合理的医院临床实习教学是高等医学教育提高医学生批判性思维能力的有效途径.     

一场"新冠肺炎疫情的阻击战"引发对微生物学与免疫学教学的思考

微生物学与免疫学是药学和中药学专业本科生的一门不断更新和发展的基础课程。2020年席扫全球的新型冠状病毒(2019-nCoV)为我们微生物学与免疫学教学打开了新篇章,同时也引发我对该门课程的教学思考：疫情与课程知识的关联,针对疫情调整优化教学内容线上线下混合式金课的打造以及课程思政。在一学期的教学实践中取得了良好的教学效果,更好地促进学生的专业发展与提升。     

The effect of desire thinking on facilitating beliefs in alcohol use disorder: An experimental investigation

Permissive beliefs relate to the acceptability of engaging in alcohol use in spite of obvious potential negative consequences. They are considered the most proximal and precipitating cognitive factor in the decision to use alcohol and/or the activation of strategies to obtain it. Recent research suggested that ‘desire thinking’ may be involved in the escalation of craving and addictive behaviours and can play a role in strengthening permissive beliefs. The current study tested whether the induction of desire thinking would have a stronger effect on rate of conviction in permissive beliefs compared to a control cognitive response in the form of neutral thinking and whether this effect would be specific for patients with alcohol use disorder (AUD). Thirty AUD patients and 30 social drinkers (SD) were randomly allocated to two thinking manipulation tasks (desire thinking and neutral thinking). Current permissive beliefs were measured before and after manipulation and after a resting phase. Findings showed that desire thinking increased the level of current permissive beliefs after manipulation relative to the neutral thinking condition for the AUD group but not for the SD group. This effect was not purely dependent on the concurrent level of perceived craving. This study supports a causal relationship between the induction of desire thinking and rate of conviction in permissive beliefs and highlights the relevance of targeting desire thinking in the treatment for AUD patients.     

Quantitative evaluation of the diagnostic thinking process in medical students

OBJECTIVE: To explore the diagnostic thinking process of medical students. SUBJECTS AND METHODS: Two hundred twenty-four medical students were presented with 3 clinical scenarios corresponding to high, low, and intermediate pre-test probability of coronary artery disease. Estimates of test characteristics of the exercise stress test, and pre-test and post-test probability for each scenario were elicited from the students (intuitive estimates) and from the literature (reference estimates). Post-test probabilities were calculated using Bayes' theorem based upon the intuitive estimates (Bayesian estimates of post-test probability) and upon the reference estimates (reference estimates of post-test probability). The differences between the reference estimates and the intuitive estimates, and between Bayesian estimates and the intuitive estimates were used for assessing knowledge of test characteristics, and ability of estimating pre-test and post-test probability of disease. RESULTS: Medical students could not rule out disease in low or intermediate pre-test probability settings, mainly because of poor pre-test estimates of disease probability. They were also easily confused by test results that differed from their anticipated results, probably because of their inaptitude in applying Bayes' theorem to real clinical situations. These diagnostic thinking patterns account for medical students or novice physicians repeating unnecessary examinations. CONCLUSIONS: Medical students' diagnostic ability may be enhanced by the following educational strategies: 1) emphasizing the importance of ruling out disease in clinical practice, 2) training in the estimation of pre-test disease probability based upon history and physical examination, and 3) incorporation of the Bayesian probabilistic thinking and its application to real clinical situations.     

《伤寒论》太阳篇辩证思维内涵探讨

本文结合思维方法学对《伤寒论》太阳篇进行分析,认为太阳证是一个太阳证的抽象与具体概念及其对应治法组成的综合体系.“太阳篇”首先据太阳证的基本病机选择提纲证,形成其抽象概念,然后以此为逻辑起点,依据太阳证自身及其与伤寒病其他五证、类似病证、患者机体、宿疾、误治的内在联系,以太阳证的演变过程为逻辑顺序,从不同角度阐述太阳证的本质及其表现形式、治法方法、转归预后等,展现出一个具体的太阳证概念.太阳证概念体系中蕴含着从抽象上升到具体的辩证思维方法,把握这一特点并加以运用,有助于掌握仲景伤寒、杂病辩治体系.