中风肢痛辨治浅探

通过中医文献关于中风病因病机学说的研讨 ,结合中风肢痛的临床特点 ,认为风寒湿邪痹阻经络是中风肢痛的基本病机。祛风除湿、散寒化瘀是中风肢痛的基本治法     

脾胃学说与儿科临证

通过中医古代文献对脾胃在人体生命活动中作用的论述 ,结合小儿的生理病理特点 ,总结归纳脾胃学说与儿科临床的重要意义 ,并指导儿科疾病的预防及治疗     

《内经》针刺禁忌理论的人文观与自然观探讨

用人文与自然的观点，对《内经》关于针刺禁忌的理论进行分析，用中医的整体观念，将针刺禁忌理论，从具体的部位、具体的疾病升华到人神与自然的高度。论述了精神对气血的导引作用以及体内阴阳之气的运动规律，同时阐明了逆时逆势而刺后患无穷，反为针害的重要道理，并强调了针灸治疗要关注人的精神，关注自然环境的绿色医学思想。     

Can Young People with Autism Refer to Knowledge States? Evidence from Their Understanding of "Know" and "Guess"

A number of studies have reported that most individuals with autism have difficulty in attributing mental states. The primary aim of the present study was to compare the ability of children with autism to refer to knowledge states with that of mainstream school children and children with Down's syndrome. The second aim was to investigate the role of verbal mental age in referring to knowledge states. The third aim was to compare the ease with which the children referred to their own mental state and to that of others. The results suggest that some individuals with autism are able to attribute knowledge to themselves and others but that they need to have higher verbal skills than is necessary in normal individuals. The level of language skill predicted the performance of the individuals with autism, but not that of the children in the other groups. There was no good evidence that referring to one's own mental states was easier than referring to another person's, a finding which supports representational theory rather than the simulationist position.     

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。