药名诗源流、批评及药名入诗论梳评

药名诗诞生于风骚传统,并受医学著作诗化的影响,是中国古代乐舞诗治疗功能延伸增殖的结果。它的发展、功用展示出中国古典文学创作强大的生命力和兼容力,伴随着人们对中医和文学关系认识的增进,药名诗作为雅正传统之一脉,应受到古代文学研究者的更多关注。对药名诗的理论批评和争论,是对古代诗歌理论和批评的有益启示和补充。药名、医理进入到诗论中,使诗论呈现出一定的医理化特征。

Assessment and impact of diastolic function by echocardiography in elderly patients

Doppler echocardiography is the gold standard for assessment of diastolic dysfunction, which is increasingly recognised as a cause of heart failure, especially in the elderly. Using a combination of Doppler echocardiography techniques, it is possible to identify grades of dia- stolic dysftmction, estimate left ventricular filling pressures and establish the chronicity of diastolic dysfunction. These physiologi- cally-derived measures have been widely validated against invasive measurements of left heart pressures and have been shown to be prog- nostically valuable in a wide range of clinical settings. This review explores the mechanisms, and approaches to the assessment of diastolic dysfunction in the elderly. The challenge for clinicians is to identify pathophysiological changes from those associated with normal ageing. When used in combination, and taking age into account, Doppler echocardiographic parameters are helpful in the assessment of dyspnoea in older patients and provide prognostic insights.

The study of the situation of critical thinking emotional tendency of nursing teachers

Critical thinking （CT） is an important content of nursing education. It is also the important symbol of the improvementof overall quality of nursing teachers. In recent years, educational circles pay more and more attention to the cultivationof students’ CT ability, take CT and solve the problem as two basic skills of thinking. In the early 1980s, critical societytheory was led into the nursing field. After years of development, CT has become one of research hotspots in today’sinternational nursing. Numerous studies had confirmed that the CT played a significant role in nursing education, clinicalpractice and nursing scientific research. The paper studied the whole status and characteristics of CT emotional tendencyof college nursing teachers, and analyzed potential cause and discussed deeply on the corresponding factors of how toimprove college nursing teachers’ teaching ability and scientific ability. This research adopted random sampling method,in which questionnaires were distributed among some nursing teachers in six universities and 97 nursing teachers. Thestatistical results indicated that nursing teachers had a positive performance towards CT emotional tendency, but notstrong positive, and there were statistical significance among nursing teachers with different age, different length ofservice and reading habit （all P〈0.05）. In a conclusion, the managers of universities should lay stress on the importanceof critical thinking, and provide the development space to enhance the nursing teachers’ CT ability and offer betterservices for nursing student.

Opportunities and challenges for the development of traditional Chinese medicinenursing under the new healthcare reform

Based on the “Opinions on Deepening the Reform of Medicine and Health”, “Strategic planning outline of thedevelopment of Traditional Chinese Medicine （2016-2030）” and the other relevant polices announced by StateAdministration of Traditional Chinese Medicine of the People’s Republic of China, this paper analyzes and summarizesthe opportunities and challenges for the development of Traditional Chinese Medicine nursing （TCM nursing） under thenew healthcare reform, in order to provide reference and thinking for the professional development of TCM nursing.

Correlation Analysis between TCM Syndromes and Physicochemical Parameters

Traditionally, differentiation of syndromes of Traditional Chinese Medicine (TCM) mainly depends on the information obtained from four diagnosis methods. Now many physicochemical parameters are available in clinic. There exists great correlation between TCM syndromes and physicochemical parameters. The objective of the paper is to analyze the correlation between TCM syndromes and physicochemical parameters quantitatively. Correlation analysis has been widely studied and many analysis methods have been developed. Mutual information based on entropy can measure arbitrary dependence between variables. It has been applied to many kinds of fields, especially to pattern recognition. But most works are restricted to discrete variables and little work has been done to study the relation between discrete and continuous variables. A novel algorithm is proposed to calculate the mutual information between discrete and continuous variables. It is used to analyze the correlation between TCM syndromes and physicochemical parameters.

Multiple Vulnerabilities of the Elderly People in Indonesia： Ethical Considerations

A closer look to the state of affairs of the elderly in Indonesia has disclosed the fact that the Indonesian elderly facing what this paper is coined as ＂multiple vulnerabilities.＂ On the one hand, Indonesian demographic is showing that the Indonesian people are getting old. The fertility rate has significantly decreased since 1970 when the total fertility rate decreases from 5.0 to 2.1 in 2025. This alone gives rise to various problems of the elderly, among whom are the dependency ratio, aging index, potential support ratio, and the feminization of aging. These problems show the level of vulnerability of the Indonesian elderly. From the perspective of the dependency ratio, for example, the number of people under the age of 15 and above 65 who depend on the labor force （15-64 years） has increased since 1970, from 7.0 to 29.0 in 2050. Again, this shows the high level of vulnerability of Indonesian elderly given that the dependency ratio itself has influenced on health care, living arrangements and family support, and so on. Aside from that, the economic burden will be very visible in the workforce. On the other hand, the policies on the elderly are still far from maximum realization. Law on the Welfare of the Elderly （13/1998） has recommended that every hospital must have geriatrics and gerontology section, yet only 8 hospitals fulfill the requirement. The situation is worsened due to the lack of adequate medical staff at the health center, which can serve elderly patients in a professional and humane way. Again, this brings forth the other side of the state of the elderly in Indonesia, which indicates the high level of their vulnerability. In this paper I will analyze the state of vulnerability of the elderly people in Indonesia from the perspective of ethics of vulnerability and personalism. I consider these two approaches as representing all ethical discussion about the ethical treatment of the elderly due to their characters of valuing the elderly as persons with dignity. Thus, this paper will show that the elderly in Indonesia is in danger of not being treated humanely.

Conditions for autonomous choice： a qualitative study of older adults＇ experience of decision-making in TAVR

Background Patient autonomy is a leading principle in bioethics and a basis for shared decision making. This study explores conditions for an autonomous choice experienced by older adults who recently underwent trans-catheter aortic valve replacement （TAVR）. Methods Qualitative study entailing semi-structured interviews of a purposive sample often older （range 73-89, median 83.5 years） adults after TAVR （median 23 days）. The study setting was a cardiac department at a university hospital performing TAVR since 2010. Analysis was by systematic text condensation. Results Even when choice seemed hard or absent, TAVR-patients deliberately took the chance offered them by processing risk assessment, ambivalence and fate. They regarded declining the treatment to be worse than accepting the risk related to the procedure. The experience of being thoroughly advised by their physician formed the basis of an autonomous trust. The trust they felt for the physicians＇ recommendations mitigated ambivalence about the procedure and risks. TAVR patients expressed feelings consistent with self-empowerment and claimed that it had to be their decision. Even so, choosing the intervention as an obligation to their family or passively accepting it was also reported. Conclusions Older TAVR patients＇ experience of an autonomous decision may encompass frank tradeoff; deliberate physician dependency as well as a resilient self-view. Physicians should be especially aware of how older adults＇ subtle cognitive declines and inclinations to preserve their identities which can influence their medical decision making when obtaining in- formed consent. Cardiologists and other providers may also use these insights to develop new strategies that better respond to such inherent complexities.

The Effect of Signs Design of Wayfinding to Elders in Hospital： Take National Taiwan University College of Medicine for Example

Taiwan had officially entered aging society in 1993, and meantime the birthrate reaches its lowest point again and again. The constitution of population dramatically turns into an elder and low-birthrate society. Therefore, the ratio of elders living along is increasing yearly. When the elders need to deal the illness and go to hospital along, decays come from degeneration might have affect on their activity in accessible environment in hospital. Signs is a vital tool for delivering and communicating information in the road sign system. Whether the elders can identify the signs in hospital clearly becomes an important issue in the current research. To understand the affect of signs design in hospital to elders, the research reviewed and gained insight of degeneration in both physical and psychological of elders and the proper principal of signs design for elders. The research surveys in Taipei City, which has densest medical center, and mainly focus on National Taiwan University College of Medicine, which has hundred years of history （founded in 1895）. The research conducts field survey in both old and new buildings of National Taiwan University College of Medicine in August, 2015. The survey includes five types of signs design： Public Facilities, Prohibition, Safety, Warning, and Commercial Facilities. The result from article review indicates the most salient psychological degenerations includes the change in cognitive function, decay of memory, and deceleration of information processing; physical degenerations includes the decay of vision. As a result, the following properties should be taken into consideration when designing sings for elders： （1） The proper ratio of graphic and text. （2） Avoid using colors or matches difficult to identify by elders, like purple, blue, and green. （3） Take the visibility, legibility, identity, attention, and memory into consideration, there should be 70% differentiation in contrast between text of sign and background. （4） Avoid using multi-meaning graphic, keep the design simple. The result from the survey of National Yaiwan University College of Medicine indicates： （1） Using mainly on graphic and text as subsidiary, part of the sign design using both Chinese and English, and make sure the appropriateness of ratio between graphic and text. Use more of sans-serif font, which has better legibility. （2） Match the color mainly as yellow background with black graphic, blue background with white graphic, white background with black graphic, white background with blue graphic, a strong contrast between background and graphic on brightness and chroma matches the principle of visibility, legibility, and identity. （3） Simplify the signs design may safeguard its visibility. When elder need to handle illness comes from degeneration alone and go to large and complex hospitals frequently, the decay of their mental and physical might have a huge negative affect. Therefore, the signs design in hospital should understand their properties and design signs that match their requirement, to safeguard their live independency.

The gas discharge visualization(GDV)order parameter model based on the principle of mastering both permanence and change

Objective To investigate the human body’s complex system,and classify and characterize the human body’s health states with“a comprehensive integrated method from qualitative to quantitative”.Methods This paper introduces the concept of“order parameters”and proposes a method for establishing an order parameter model of gas discharge visualization(GDV)based on the principle of“mastering both permanence and change(MBPC)”.The method involved the fol-lowing three steps.First,average luminous intensity(I)and average area(S)of the GDV im-ages were calculated to construct the phase space,and the score of the health questionnaire was calculated as the health deviation index(H).Second,the k-means++clustering method was employed to identify subclasses with the same health characteristics based on the data samples,and to statistically determine the symptom-specific frequencies of the subclasses.Third,the distance(d)between each sample and the“ideal health state”,which determined in the phase space of each subclass,was calculated as an order parameter describing the health imbalance,and a linear mapping was established between the d and the H.Further,the health implications of GDV signals were explored by analyzing subclass symptom profiles.We also compare the mean square error(MSE)with classification methods based on age,gen-der,and body mass index(BMI)indices to verify that the phase space possesses the ability to portray the health status of the human body.Results This study preliminarily tested the reliability of the order parameter model on data samples provided by 20 participants.Based on the discovered linear law,the current model can use d calculated by measuring the GDV signal to predict H(R^(2)>0.77).Combined with the symptom profiles of the subclasses,we explain the classification basis of the phase space based on the pattern identification.Compared with common classification methods based on age,gender,BMI,etc.,the MSE of phase space-based classification was reduced by an order of magnitude.Conclusion In this study,the GDV order parameter model based on MBPC can identify sub-classes and characterize individual health levels,and explore the TCM health meanings of the GDV signals by using subjective-objective methods,which holds significance for establishing mathematical models from TCM diagnosis principles to interpret human body signals.

Correlation between Traditional Chinese Medicine symptom patterns and serum concentration of zinc,iron,copper and magnesium in patients with hepatitis B and associated liver cirrhosis

OBJECTIVE:To investigate the correlation between the patterns of Traditional Chinese Medicine(TCM)syndromes and the serum concentration of zinc,iron,copper and magnesium of patients with chronic hepatitis B(CHB) and hepatitis B virus(HBV)-induced liver cirrhosis.METHODS:A total of 86 patients were included in the study between March 1,2009 and January 1,2010.All were diagnosed with CHB or HBV-induced liver cirrhosis according to the diagnosis standard of the Chinese Medical Association.Fasting serum concentrations of zinc,iron,copper and magnesium were measured.Patients were classified into different patterns of TCM symptoms according to TCM theory and clinical experience.RESULTS:In the HBV-induced liver cirrhosis group,the mean zinc concentration in patients with the TCM pattern of stagnation of fluid-Dampness was lower than that in patients with obstruction of collaterals by Blood stasis(P < 0.034).In the CHB group,the mean magnesium concentration in patients with toxic Heat flourishing was significantly lower than that in those with Damp-Heat in the Liver and Gallbladder,and those with Liver depression and Spleen deficiency(P < 0.021).The concentrations of iron and copper showed little difference among the different TCM symptom patterns.CONCLUSION:The serum zinc and magnesium concentrations correlated with certain TCM patterns of symptoms in patients with HBV-induced liver cirrhosis and CHB.It may be helpful to interpret the pathogenic change in the TCM symptom patterns in liver cirrhosis and CHB,and also to conduct clinical treatment of the diseases based on identified TCM patterns.

Resource Allocation in Public Healthcare: A Team-DEA Model

This paper combines the theory of teams and data envelopment analysis（DEA） to design a mechanism to optimally allocate resources in public healthcare. A statutory authority and the public hospitals under its governance are interpreted as a team, the members of which seek to operate efficiently under the shared institutional constraint that public healthcare is a public good. The individual public hospital exploits DEA to maximize own-payoff, subject to the team-condition that the payoff of each other public hospital does not fall and thereby subtract from the external effects created by the public supply of healthcare. The resulting team-DEA solution, which is shown to be both an individuallyefficient and team-satisficing equilibrium and to be computable in terms of a convergent algorithm, can then be applied by the authority to determine the optimal allocation of resources in public healthcare.A case based on Chinese data is presented to illustrate the team-DEA model＇s ready operationalization and computation.