版權所㈲ 翻㊞必究 All rights reserved. No part of the publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying or otherwise, without the prior consent of the publisher. 《 澳 門 科 技 大 ㈻ ㈻ 報 》 (季 刊 ) 第 ㈩ ㈦ 卷 第 ㆔ 期 JOURNAL OF MACAU UNIVERSITY OF SCIENCE AND TECHNOLOGY VOL.17 NO.3 主 辦 方：澳門科技大學 Distributor：Macau University of Science and Technology 主 席：李行偉 Chairman：Lee, Joseph Hun Wei 編 輯 方：澳門科技大學學報編輯部 Editorial ： Editorial department, Macau University of Science and Technology 編 輯：曾幸麒 Editor：Chang, Henry Hang Kei 出 版 者：澳門科技大學 Publisher：Macau University of Science and Technology 地 址：澳門氹仔偉龍馬路 Address：Avienda Wai Long, Taipa, Macau 出版年月：2023年 9月 30日 Issued date：September, 2023 鳴 謝：澳門基金會資助出版 Acknowledgement：Publication sponsored by the Macau Foundation 聯絡電話(Phone)：(853) 8897-3932 電 郵(Email)：publication@must.edu.mo 印 刷(Print run)：200本 規 格(Size)：21cmｘ14cm 定 價(Price)：葡 幣 4 0元 期 刊 號(ISSN)：1994-4926 期刊網址(Website)：https://www.mustjournal.com/CN/home
澳門科技大學學報編輯委員會 主編 Chief Editor 李行偉 澳門科技大學校長 LEE, JOSEPH HUN WEI President, Macau University of Science and Technology 英國皇家工程院院士 Fellow of the Royal Academy of Engineering 執行編輯 Executive Editor 龐 川 澳門科技大學副校長兼研究生院院長 PANG, CHUAN Vice-President and Dean of School of Graduate Studies, Macau University of Science and Technology 編輯委員 Editorial Board Members 李行偉 澳門科技大學校長 LEE, JOSEPH HUN WEI President, Macau University of Science and Technology 英國皇家工程院院士 Fellow of the Royal Academy of Engineering 譚廣亨 澳門科技大學副校長 TAM, PAUL KWONG HANG Vice-President, Macau University of Science and Technology 香港科學院院士 Member of the Hong Kong Academy of Sciences 姜志宏 澳門科技大學副校長兼中藥質量研究國家重點實驗室主任 JIANG, ZHIHONG Vice-President and Director of State Key Laboratory of Quality Research in Chinese Medicines, Macau University of Science and Technology 龐 川 澳門科技大學副校長兼研究生院院長 PANG, CHUAN Vice-President and Dean of School of Graduate Studies, Macau University of Science and Technology 林志軍 澳門科技大學校長高級顧問(QA) LIN, ZHIJUN Senior Advisor to President (QA), Macau University of Science and Technology 蘇育洲 澳門科技大學校長高級顧問(AACSB) SO, JACKY YUK CHOW Senior Advisor to President (AACSB), Macau University of Science and Technology 方 泉 澳門科技大學法學院院長 FANG, QUAN Dean, Faculty of Law, Macau University of Science and Technology 吳國民 澳門科技大學酒店與旅遊管理學院院長 GOH, KOK BENG Dean, Faculty Hospitality and Tourism Management, Macau University of Science and Technology
The Editorial Board List for Journal of Macau University of Science and Technology 張志慶 澳門科技大學人文藝術學院院長 ZHANG, ZHIQING Dean, Faculty Humanities and Arts, Macau University of Science and Technology 張洪明 澳門科技大學國際學院院長 ZHANG, HONGMING Dean, University International College, Macau University of Science and Technology 林廣志 澳門科技大學社會和文化研究所所長 LIN, GUANGZHI Director, Institute for Social and Cultural Research, Macau University of Science and Technology 劉成昆 澳門科技大學可持續發展研究所所長 LIU, CHENGKUN Director, Institute for Sustainable Development, Macau University of Science and Technology 陳東燊 澳門科技大學商學院副院長 CHAN, TUNG SUN Vice-Dean, School of Business, Macau University of Science and Technology 錢 濤 澳門科技大學數學研究中心主任 QIAN, TAO Director, Macao Centre for Mathematical Sciences, Macau University of Science and Technology 湯開建 澳門科技大學社會和文化研究所講座教授 TANG, KAIJIAN Chair Professor, Institute for Social and Cultural Research, Macau University of Science and Technology 錢乘旦 澳門科技大學社會和文化研究所特聘教授 QIAN, CHENGDAN Distinguished Professor, Institute for Social and Cultural Research, Macau University of Science and Technology 英國皇家歷史學會通訊院士 Fellow of the Royal Historical Society 吳漢東 澳門科技大學法學院特聘教授 WU, HANDONG Distinguished Professor, Faculty of Law of Macau University of Science and Technology 張 楊 澳門科技大學酒店與旅遊管理學院課程主任 ZHANG, YANG Program Director, Faculty of Hospitality and Tourism Management, Macau University of Science and Technology
!""#" " " Contents ㈵約稿專區—「㊩㈻探索」 中國肥胖代謝外科的歷史、現狀和未來 History, Current Status, and Future of Metabolic and Bariatric Surgery in China 袁開盛、吳 冰、胡瑞翔、董志勇、王存川 1 Yuan, Kaisheng ; Wu, Bing ; Hu, Ruixiang ; Dong, Zhiyong ; Wang, Cunchuan 法㈻論文 中國突發事件應對中的刑事政策 Chinese Criminal Policy in Emergency Responses 陳 芹 Chen, Qin 19 旅遊與酒店管理㈻論文 後疫情時期澳門居民對遊客的情感團結以及對澳門旅遊業發展的態度 Residents’ Emotional Solidarity and Tourism Impact Attitude during the COVID-19 Pandemic: A Case Study of Macau 王藝璇、唐 娟 41 Wang,Yixuan; Tang, Juan
㆟文藝術㈻論文 基於羅蘭·巴特圖像分層裡論之澳門文化遺產的電影化表達 —以《大辮子的誘惑》為例 The Cinematographic Expression of Macao’s Cultural Heritage Based on Roland Barthes’ Image Rhetoric Theory: The Bewitching Braids as an Example: 李亞青 Li, Yaqing 61 ㆗㊩藥㈻論文 蘆薈水提物與吉非替尼聯合用藥 對H1975細胞生長和遷移的抑制作用及其機制研究 The Combination of Aloe vera and Gefitinib Effectively Suppresses Growth and Migration of Gefitinib-resistant H1975 Lung Cancer Cells and Inhibits Wnt/β-catenin Signaling 余 典、尹田鵬、李 剛、王彩雲、白麗萍、朱國元、張 偉 79 Yu, Dian; Yin, Tianpeng; Li, Gang; Wang, Caiyun; Bai, Li-Ping; Zhu, Guoyuan; Zhang, Wei 世漢㈻會國際㆗文教育研究專欄 (由教育部㆗外語言合作交流㆗心㈾助設立) 在高等院校項目的考核中建立質量保障體系 —以西交利物浦大學的中文項目為例 Establishment of a Quality Assurance System in the Assessment in Higher Education Programmes: A Case from the Chinese language programme at Xi’an Jiaotong-Liverpool University 周思佳、蘇珩驊 111 Zhou, Sijia; Su, Henghua
第三語言習得視角下的語言遷移探索 —基於泰國學習者漢語作為第三語言語序習得及相關遷移現象的調查 The Exploration of Language Transfer in the Perspective of Third Language Acquisition: An Investigation of Chinese Word Order Acquisition as a Third Language and Related Transfer Phenomena among Thai Learners 段 然、魏慧萍 129 Duan, Ran; Wei, Hui Ping 「與科大卓越同行—前沿㈻術發展動態專欄」 The Frontline Academic Status of Macau University of Science and Technology 《澳門科技大學學報》編輯部 163 Editorial Department of M.U.S.T. Journal
袁開盛、吳冰、胡瑞翔、董志勇、王存川 2 History, Current Status, and Future of Metabolic and Bariatric Surgery in China Yuan, Kaisheng 1; Wu, Bing 1; Hu, Ruixiang 1; Dong, Zhiyong 1; Wang, Cunchuan 1 1. Department of Metabolic and Bariatric Surgery, the First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, 510000 Guangdong, China) Abstract: The global obesity issue is progressively worsening, becoming a significant public health challenge. According to statistics, the global obesity population continues to increase, surpassing 30% of the total population, with China's obesity figures also rapidly escalating, exceeding 50% of adults being diagnosed as overweight or obese. Obesity not only affects individual health but also closely associates with various chronic diseases such as cardiovascular disorders, diabetes, imposing a substantial burden on society and economy. Currently, there exists a variety of methods to address obesity, including dietary control, physical activity, pharmaceutical interventions, and surgical treatments. However, among these approaches, bariatric metabolic surgery (BMS) has been proven to be one of the most effective methods, particularly for patients with obesity-related comorbidities, showcasing more significant results. This trend has given rise to the development of metabolic surgery in the context of obesity. China, being one of the nations most severely affected by the obesity issue, has witnessed over two decades of development in the field of metabolic and bariatric surgery. At present, this field is experiencing a phase of rapid expansion. This paper provides an overview of the background and concept of metabolic and bariatric surgery in China, reviews the historical progression and development of this field, including various surgical techniques and technological breakthroughs. Furthermore, it delves into the challenges and opportunities faced by metabolic and bariatric surgery in China and presents recommendations for its future advancement. Keywords: Metabolic and Bariatric Surgery; Obesity; Bariatric Metabolic Surgery; Review
中國肥胖代謝外科的歷史、現狀和未來 3 一、引言 ⽇益嚴重的肥胖流⾏病正在成為⼀個主要的公共衛⽣問題，相關的成本給社會帶來了相當⼤的負擔。嚴重肥胖最常⾒的併發症包括⾼⾎壓、⾎脂異常、2 型糖尿病、⼼⾎管疾病和各種癌症。⽬前全球已有 26 億⼈⼜（佔世界總⼈⼜的 38%）超重或肥胖。1根據中國⼈⼜的標準，在最近的全國調查中，超過⼀半的中國成年⼈超重或肥胖。2019年，超重和肥胖佔非傳染性疾病相關死亡⼈數的 11.1%，⾼於1990年的 5.7%。2肥胖被定義為可能損害健康的不正常或過多的體內脂肪積累。3身體質量指數（BMI，Kg/m2）被廣泛應⽤於臨床中，作為身體脂肪測量之代理指標。4WHO將成⼈超重定義為 BMI在 25.0 - 29.9 kg/m²之間，肥胖定義為體重指數為 30.0 kg/m²或更⾼。5⽽在中國⼀般則使⽤ 24 和 28 的 BMI 分界點。6按照中國的標準，現如今中國已經成為世界上肥胖⼈數最多的國家。 在臨床實踐中，針對肥胖病⼈治療⽅式主要包括：⼀、⽣活⽅式⼲預︔⼆藥物治療︔三、減重⼿術治療。其中，減重⼿術是唯⼀⼀種在嚴重肥胖⼈群中達到持續短期和長期體重減輕、改善合併症和死亡率以及提⾼⽣活質量之⼲預措施。7脂肪組織是⼀種內分泌器官，它表達和釋放⼤量對整體能量代謝有影響的激素。8超重和肥胖是主要非傳染性疾病（包括⼼⾎管疾病、2 型糖尿病和癌症）的確定危險因 1 Perdomo CM, Cohen RV, Sumithran P, Clément K, Frühbeck G, “Contemporary Medical, Device, and Surgical Therapies for Obesity in Adults,” Lancet (2023): 1116-1130. 2 Pan XF, Wang L, Pan A, “Epidemiology and Determinants of Obesity in China,” Lancet Diabetes Endocrinol 9.6 (2021): 373-392. 3 Organization WH, “Obesity: Preventing and Managing the Global Epidemic Report of a WHO Consultation, ” World Health Organ Tech Rep Ser 894 (2000): i-xii, 1-253. 4 Deurenberg P, Yap M, van Staveren WA, “Body Mass Index and Percent Body Fat: A Meta Analysis among Different Ethnic Groups,” Int J Obes Relat Metab Disord 22.12 (1998): 1164-1171. 5 Caballero, B, “Caballero B. Humans Against Obesity: Who Will Win?” Adv Nutr 10.1 (2019): S4-S9. 6 Wang Y, Sun M, Yang Y, China Blue Paper on Obesity Prevention and Control, (Beijing: Peking University Medical Publisher, 2019). 7 Doumouras AG, Hong D, Lee Y, Tarride JE, Paterson JM, Anvari M, “Association Between Bariatric Surgery and All-Cause Mortality: A Population-Based Matched Cohort Study in a Universal Health Care System,” Ann Intern Med 173.9 (2020): 694-703. 8 Unamuno X, Gómez-Ambrosi J, Rodríguez A, Becerril S, Frühbeck G, Catalán V, “Adipokine Dysregulation and Adipose Tissue Inflammation in Human Obesity,” Eur J Clin Invest 48.9 (2018): e12997.
袁開盛、吳冰、胡瑞翔、董志勇、王存川 4 素。早在⼆⼗世紀八⼗年代，來⾃美國的 Pories等⼈通過對 608名⾏ Roux-en-Y胃旁路術（Roux-en-Y gastric bypass，RYGB）的肥胖患者進⾏ 14 年的長期隨訪，發現T2DM的治癒率可達 83%，同時還糾正或減輕了肥胖的許多其他合併症，包括⾼⾎壓、睡眠呼吸暫停、⼼肺衰竭、關節炎和不孕症等。9因此，肥胖患者管理的主要⽬標不再局限於體重減輕，還包括解決合併症和改善整體健康情況。減重⼿術越來越多地被推薦給嚴重肥胖或有相關合併症的肥胖患者。專業學科名稱也由原來的「減肥外科」、「減重外科」、「肥胖外科」等更名為「肥胖代謝外科」。 在過去幾⼗年，中國肥胖代謝外科經歷快速發展。越來越多醫療機構開始設⽴肥胖代謝外科中⼼，專⾨為肥胖症患者提供⼿術治療和綜合管理。同時，國內外學者也對肥胖代謝外科進⾏⼤量臨床研究和學術交流，不斷提⾼⼿術技術和治療效果。⽬前，中國肥胖代謝外科已經形成⼀套完整的治療體系。除了傳統的袖狀胃切除術（sleeve gastrectomy，SG）、胃旁路術（Roux-en-Y gastric bypass，RYGB）、可調節胃束帶術（adjustable gastric band，AGB），還發展出單吻合⼜胃旁路（one anastomosis gastric bypass，OAGB） ⼿ 術 、 膽 胰 轉 流 並 ⼗ ⼆ 指 腸 轉 位 術（biliopancreatic diversion with duodenal switch，BPD-DS）等多種治療⽅法，以滿⾜不同患者需求。此外，肥胖代謝外科還與內分泌學、營養學等多個學科相結合，形成多學科綜合治療模式。未來，中國肥胖代謝外科還有很⼤發展潛⼒。隨著肥胖⼈群不斷增加，對於肥胖治療需求也會越來越⼤。同時，隨著科技進步和醫療技術不斷創新，肥胖代謝外科⼿術⽅法和治療效果也將不斷提⾼。此外，對於肥胖病因研究和預防⼯作也將成為未來研究重點，以減少肥胖病例發⽣。 總體⽽⾔，中國肥胖代謝外科在歷史上取得顯著進展，並且在現狀下得到廣泛應⽤。未來，隨著科技和醫療⽔平的不斷發展，肥胖代謝外科將繼續在中國的醫學領域中發揮重要作⽤，併為肥胖症患者提供更好的治療⽅案。 9 Pories WJ, Swanson MS, MacDonald KG, Long SB, Morris PG, Brown BM, et al, “Who Would Have Thought It? An Operation Proves to be the Most Effective Therapy for Adult-onset Diabetes Mellitus,” Ann Surg 222.3 (1995): 339-350; discussion 350-332.
袁開盛、吳冰、胡瑞翔、董志勇、王存川 6 T2DM 的理念不僅為中國外科醫⽣所接受，也逐漸得到內分泌專家的認可。在經歷近⼗年蟄伏後，近年出現顯著性增長。2012 年，中國醫師協會外科醫師分會肥胖和糖尿病外科醫師委員會（Chinese Society for Metabolic & Bariatric Surgery，CSMBS）的成⽴標誌著我國肥胖代謝外科進入快速發展階段。國內第⼀部減重代謝⼿術指南《中國肥胖和 2型糖尿病外科治療指南 2014》於 2014年發佈，隨後於2015年在王存川教授的帶領下，《中華肥胖和代謝病電⼦雜誌》創刊︔2017年中華醫學會外科學分會甲狀腺及代謝外科學組成⽴以及 2019 年《中國肥胖及 2 型糖尿病外科治療指南（2019）》的發佈更是對我國肥胖代謝外科的發展有推波助瀾之作⽤。減重術式研究及⽂獻在長時間之沉澱後開展，⼀些減重⼿術共識、肥胖個案管理師共識以及減重術後圍術期管理書籍也應運⽽⽣。所有國內專家及教授都在將肥胖代謝外科從⼀個不被接受的學科，轉變為今天⽇益增長和受⼈尊敬之外科實踐⽅⾯有關鍵作⽤。 三、我國肥胖代謝外科的現狀 按照絕對⼈⼜數來計算，我國已有 6億⼈超重和肥胖達致全球第⼀。 其中成年⼈肥胖和超重比例⾼達 50.7%，6-17歲青少年為 19%，⼩於 6歲的兒童為 10.4%。16中國肥胖形勢嚴峻，且疾病負擔⼤。隨著肥胖問題在中國⽇益嚴重，越來越多的患者開始尋求外科⼿術的治療⽅式。近年來，中國肥胖代謝外科得到快速發展。中國肥胖代謝外科醫⽣和專家積極研究和推廣各種外科⼿術⽅法，並不斷提⾼⼿術技術和治療效果。⽬前，中國肥胖代謝外科的主要⼿術⽅法包括 LRYGB和 LSG等。這些⼿術通過改變胃部的結構和功能，限制食物的攝入量和吸收，從⽽達到減肥和改善代謝狀況⽬的。中國肥胖代謝外科的現狀還包括不斷進步之醫療技術和深入開展臨床研究。許多醫療機構和學術團體在該領域開展⼤量研究和臨床實踐，積累豐富經驗和數據。同時，⼀些新技術和治療⽅法也在不斷湧現，為患者提供更多選擇。然⽽，中國肥胖代謝外科現狀也存在⼀些問題和挑戰。⾸先，該領域的專家和醫療 16 Pan XF, Wang L, Pan A, “Epidemiology and determinants of obesity in China,” Lancet Diabetes 9.6 (2021): 373-392.
中國肥胖代謝外科的歷史、現狀和未來 7 資源仍然不夠充⾜，導致患者等待時間較長。其次，部分患者對外科⼿術的治療效果和安全性存在疑慮，需要更多宣傳和教育⼯作。此外，⼿術後長期隨訪和管理也需要進⼀步加強，以確保⼿術的長期效果和患者安全。 （㆒）、 我國肥胖㈹謝外科手術的主要術式與效果 隨著肥胖代謝外科新興學科在我國之興起，肥胖代謝外科⼿術量也⽇益增長。⽬前所有常⽤⼿術絕⼤部分通過腹腔鏡完成，住院時間短，每種⼿術技術都有其⾃身的風險和併發症。由暨南⼤學附屬第⼀醫院成⽴之中國肥胖代謝資料庫於 2020年之年度數據統計，全國共 138 家醫院及減重中⼼參與登記，減重⼿術的總⼿術量達 12837例。17據⼤中華減重與代謝⼿術資料庫記載，來⾃ 19個省（⾃治區、直轄市）49家中⼼在 2022年度共登記有效病例 7376例。18隨著中國肥胖代謝外科的快速發展，⼿術器械和設備已基本達到世界其他地區的先進⽔準。 ⼤型肥胖代謝外科中⼼的疾病和療效也開始與國際接軌。 2019年發佈《中國肥胖及 2型糖尿病外科治療指南》強調，除減肥外還需要改善代謝。強烈建議 BMI 為 37.5 kg/m²或更⾼的患者進⾏減重⼿術，並建議 BMI 為32.5 -37.5 kg/m²進⾏減重⼿術。對於 BMI為 27.5 - 32.5 kg/m²患者，當⽣活⽅式⼲預和藥物控制不能控制體重時，並伴有代謝綜合征或其他合併症的至少兩個組成部分時也被推薦進⾏⼿術。在多學科團隊（MDT）之額外評估基礎上，亦建議腹部肥胖患者（男性腰圍≥ 90 cm或女性腰圍≥ 85 cm）進⾏減重⼿術。19 有綜述表明，在 2001年至 2015年間，中國發表科學⽂獻共記載 7779例減重⼿術，其中 89.2%來⾃ 2011-2015年期間的出版物。在 2011-2015年間，中國肥胖代謝外科最常⾒的⼿術類型為 RYGB（70.7%（4906/6937）），其次為 LAGB（12.9%（896/6937））和 SG（12.7%（879/6937）），其中 99.5%（6279/6937）為腹腔鏡⼿術。20 17 楊華、陳緣、董志勇、程中、戴曉江、胡揚喜等，〈中國肥胖代謝外科資料庫：2020 年度報告〉，《中華肥胖與代謝病電子雜誌》第 7卷第 1期（2021），1-7. 18 李夢伊、劉雁軍、于衛華、劉少壯、王冰、李瀅旭等，〈大中華減重與代謝手術資料庫 2022 年度報告〉，《中國實用外科雜誌》，第 43卷第 5期（2023），540-551. 19 王勇、王存川、朱曬紅、張頻、梁輝、〈中國肥胖及 2型糖尿病外科治療指南（2019版）〉，《中國實用外科雜誌》，第 39卷第 4期（2019），301-306。 20 Du X, Dai R, Zhou HX, Su ML, Lu C, Zhou ZG, et al, “Bariatric Surgery in China: How Is This New
袁開盛、吳冰、胡瑞翔、董志勇、王存川 8 但是，IFSO 和亞太代謝與減肥外科學會（The Asia-Pacific Metabolic and Bariatric Surgery Society，APMBSS）分別在 2016年和 2017年進⾏兩項包括中國在內之國際調查，中國在 2016年登記 6240例減重⼿術，其中 RYGB為 1830例，SG為 4201例︔212017年登記 8850例⼿術，其中 SG佔比 61.3%，RYGB佔比 20.8%。22 Tianshu Zeng等⼈在 2016年對 23項研究的系統回顧和薈萃分析中，報告 1316中國成年⼈肥胖患者在減重⼿術後 2年內平均 BMI下降 10.8 kg/m²，並顯著改善脂質分佈。雖然在體重減輕⽅⾯沒有顯著差異，但在改善糖尿病指標和脂質⽅⾯，RYGB通常優於 SG。23與 RYGB相比，SG的優勢在於操作簡單，嚴重併發症風險低，但是對於合併 2型糖尿病、⾼脂⾎症等代謝疾病時，RYGB是更優選擇。24LSG相關的體重減輕被認為是繼發於縮⼩胃儲存庫限制食物攝入和空腹胃饑餓素⽔平顯著降低。25⽽ RYGB相關的體重減輕被認為是限制吸收的同時改變消化道的激素分泌。 （㆓）、肥胖㈹謝外科手術在我國的推廣價值 超重和肥胖已成為國民健康的重⼤挑戰，特別是在 COVID-19 ⼤流⾏之後，其患病率持續上升。嚴重超重被公認為是糖尿病和⾼⾎壓等疾病的危險因素，可能會增加致殘甚至致死風險。26肥胖與多種慢性疾病的患病率的上升同時發⽣，並且已 Concept Going?” Obes Surg 26.12 (2016): 2906-2912. 21 Angrisani L, Santonicola A, Iovino P, Vitiello A, Higa K, Himpens J, et al, “IFSO Worldwide Survey 2016: Primary, Endoluminal, and Revisional Procedures,” Obes Surg 28.12 (2018): 3783-3794. 22 Ohta M, Seki Y, Wong SK, Wang C, Huang CK, Aly A, et al, “Bariatric/Metabolic Surgery in the Asia-Pacific Region: APMBSS 2018 Survey,” Obes Surg 29.2 (2019): 534-541. 23 Zeng T, Cai Y, Chen L, “The Effectiveness of Bariatric Surgery for Chinese Obesity in 2 Years: A Meta-Analysis and Systematic Review,” J Invest Surg 30.5 (2017): 332-341. 24 Wilkinson KH, Helm M, Lak K, Higgins RM, Gould JC, Kindel TL, “The Risk of Post-operative Complications in Super-Super Obesity Compared to Super Obesity in Accredited Bariatric Surgery Centers,” Obes Surg 29.9 (2019): 2964-2971. 25 Gill RS, Birch DW, Shi X, Sharma AM, Karmali S, “Sleeve Gastrectomy and Type 2 Diabetes Mellitus: A Systematic Rreview,” Surg Obes Relat Dis 6.6 (2010): 707-713. 26 Flegal KM, Kit BK, Orpana H, Graubard BI, “Association of All-cause Mortality with Overweight and Obesity Using Standard Body Mass Index Categories: A Systematic Review and Meta-analysis,” Jama 309.1 (2013): 71-82.
中國肥胖代謝外科的歷史、現狀和未來 9 經建⽴病理⽣理學聯繫，這解釋肥胖在促進⼀些慢性疾病危險因素及其進展。瞭解所涉及的機制並採取措施來遏制超重及其後果，減重⼿術已成為⼀種有⽤且有效的⽅法，可以補充或替代其他⽅法，例如：⽣活⽅式的改變和/或藥物治療。也可以説明肥胖病⼈減少肥胖相關疾病的風險，提⾼⽣活品質，降低死亡風險。例如：瑞典肥胖受試者研究組在 2007 年納入 4047 名肥胖患者，其中 2010 ⼈接受減重⼿術（⼿術組），2037 ⼈接受常規治療（匹配對照組），平均 10.9 年隨訪期間的總死亡率。在⼿術組的 2010名受試者中，376⼈接受 LAGB，1369⼈接受 SG，265⼈接受 RYGB。 研究最後發現對照組 129⼈死亡，⼿術組 101⼈死亡。⼿術組在 1-2年後觀察到最⼤的體重減輕分別為：RYGB，32%; SG，25%; LAGB，20%。 10年後，與基線相比體重下降分別穩定在 25%、16%和 14%。這些結果表明嚴重肥胖症之減重⼿術與長期體重減輕和總體死亡率降低相關。27 同樣在 2020年瑞典肥胖受試者研究組將 2007和 2040例患者分別納入⼿術組和對照組。其中⼿術組和對照組患者死亡率的中位隨訪時間分別為 24年和 22年。⼿術組 457例患者（22.8%）和對照組 539例患者（26.4%）死亡。⼼⾎管疾病死亡和癌症死亡的相應風險比分別為 0.70和 0.77。⼿術組的校正中位預期壽命比對照組長3 年。28我們可以得知在肥胖患者中，與常規肥胖治療相比，減重⼿術能延長患者的預期壽命以及降低癌症等併發症風險。我國梁輝教授等⼈進⾏了單中⼼⼤樣本回顧性分析，⼀共收集 4255例⾏減重⼿術的患者，最終發現⾏減重⼿術後 30天內嚴重併發症患者 22 例（0.52%），常⾒嚴重併發症為漏（12 例，0.28%）、出⾎（6 例，0.14%）及梗阻（2例，0.05%）。29 儘管肥胖病⼈在我國普遍存在，但每年進⾏減重⼿術數量非常少。2016 年，中國⼤陸僅進⾏ 6240 例減重⼿術（不包括腔內⼿術和修正⼿術）。30減重⼿術的低 27 Sjöström L, Narbro K, Sjöström CD, Karason K, Larsson B, Wedel H, et al, “Effects of Bariatric Surgery on Mortality in Swedish Obese Subjects,” N Engl J Med 357.8 (2007): 741-752. 28 Carlsson LMS, Sjöholm K, Jacobson P, Andersson-Assarsson JC, Svensson PA, Taube M, et al, “Life Expectancy after Bariatric Surgery in the Swedish Obese Subjects Study,” N Engl J Med 383.16 (2020): 1535-1543. 29 梁輝、林士波、管蔚、李聰、沈佳佳，〈單中心 4255 例減重代謝手術後早期嚴重併發症及其危險因素分析〉，《中華胃腸外科雜誌 》，第 10期（2022），899-905。 30 Angrisani L, Santonicola A, Iovino P, Vitiello A, Higa K, Himpens J, et al, “IFSO Worldwide Survey 2016: Primary, Endoluminal, and Revisional Procedures,” 3783-3794.
袁開盛、吳冰、胡瑞翔、董志勇、王存川 10 接受度可能是由於對其健康益處的認識不⾜和證據基礎的進步。減重⼿術的⾼成本也可能是另⼀個相關因素。不過對於長遠收益來看，減重⼿術卻能使肥胖帶來的經濟負擔降低。Bin Wan等⼈對中國肥胖 2 型糖尿病患者減重⼿術與藥物治療的成本效益進⾏比較發現，在 40 年的時間範圍內，每位⼿術治療患者的平均成本為 86366.55 元⼈民幣，每位藥物治療患者的平均成本為 113235.94 元⼈民幣。⼿術治療和藥物治療患者的⽣命質量調整年（quality-adjusted life-years，QALYs）分別為 13.46 和 10.95。與藥物治療相比，減重⼿術平均為每位患者節省 26869.39 元的醫療費⽤，額外增加 2.51個 QALY。31⽬前，由於實施減重⼿術的外科醫⽣專業化程度相對較差，術前規範化培訓程度相對不⾜，導致肥胖和糖尿病⼈群對減重⼿術的認識不⾜，通過推動我國醫學界對肥胖代謝外科⼿術的研究和應⽤，可以不斷改進⼿術技術和圍⼿術期的管理，提⾼減重⼿術效果以及安全性。這將有助於積累更多的臨床經驗，提升中國在肥胖代謝外科領域的國際聲譽。 （㆔）、肥胖㈹謝外科在我國肥胖治療㆗的不足之處 然⽽，肥胖代謝外科在我國也⾯臨著⼀些不⾜之處。⾸先，中國現有的與肥胖相關的政策是分散的，⼀個協調和⽀援性的政策體系對於創造⼀個促進制度變⾰以應對肥胖流⾏病的監管環境至關重要。有國內現有研究表明，⼤多數消費者在購買食品時很少或從不使⽤營養標籤。32⾼收入國家的實證研究表明，針對兒童的食品和飲料⾏銷⼀直是導致兒童肥胖流⾏的原因之⼀。33其次，⼈們對肥胖代謝外科⼿術的適應症、風險瞭解不⾜，甚至國內有很多⼈不知道肥胖代謝外科的存在。最後，由於我國減重⼿術發展的歷史較短，在中國進⾏減重⼿術的外科醫⽣在⼿術技術、圍⼿術期治療選擇等⽅⾯的⽔準存在較⼤差異。 肥胖代謝外科的資源分配不均，主要分佈在我國⼀⼆線城市的⼤型三甲醫院，導致患者認知不⾜。減重⼿術的⾼成 31 Wan B, Fang N, Guan W, Ding H, Wang Y, Ge X, et al, “Cost-Effectiveness of Bariatric Surgery Versus Medication Therapy for Obese Patients with Type 2 Diabetes in China: A Markov Analysis,”J Diabetes Res (2019): 1341963. 32 Zhang J, Zhai L, Osewe M, Liu A, “Analysis of Factors Influencing Food Nutritional Labels Use in Nanjing China,” Foods 9.12 (2020). 33 Cairns G, Angus K, Hastings G, Caraher M, “Systematic Reviews of the Evidence on the Nature, Extent and Effects of Food Marketing to Children: A Retrospective Summary,” Appetite 62 (2013): 209-215.
中國肥胖代謝外科的歷史、現狀和未來 11 本也可能是我國肥胖患者拒絕進⾏⼿術的原因之⼀，在中國，減重⼿術的平均成本⾼達 7000美元，相當於 2019年⼈均可⽀配收入的近 1.5倍。34因此需要加⼤對肥胖代謝外科的投入、對相應醫⽣的培訓以及降低減重⼿術的成本，提⾼⼿術可及性，更好的造福我國龐⼤的肥胖⼈群。 四、我國肥胖代謝外科的未來 （㆒）、肥胖㈹謝外科在我國肥胖治療㆗的前景 ⾃上世紀九⼗年代以來，中國經歷許多劇烈的社會和經濟變化，⼈們⽣活⽅式也發⽣變化，肥胖流⾏病已成為中國的突發公共衛⽣事件，該學科在中國的發展前景也備受關注。中國之肥胖相關政策取得實質進展，促進從社會⽣態和⾏為層⾯到下游衛⽣服務和醫療⼲預等多層次的系統性變化。減重代謝⼿術成為⼀種有效的治療⼿段，對於解決中國肥胖問題具有重要意義。 腹腔鏡微創外科的探索，開啟腹腔鏡技術應⽤於肥胖代謝外科的新領域。更重要的是，在全國多個⼤型減重代謝培訓中⼼學術帶頭⼈的推動和帶動，⼀批致⼒於腹腔鏡減重代謝⼿術發展的青年學者逐漸湧現並⾛向成熟，為肥胖代謝外科發展增添新動⼒。隨著醫療技術不斷進步，肥胖代謝外科⼿術之安全性和效果得到⼤幅提升。新⼿術技術和設備引入使⼿術更加精準、微創，減少術後併發症和恢復時間，提⾼了⼿術的成功率。肥胖代謝外科在中國的發展也宣導多學科綜合治療的模式。內分泌醫⽣、營養師、⼼理學家和其他相關專家之間合作變得更加緊密，以提供全⾯肥胖治療⽅案。 這種模式強調術前評估、術後管理和長期隨訪，對患者在⼿術後保持健康的體重和⽣活⽅式有重要影響。 （㆓）、肥胖㈹謝外科在我國的未來發展建議 在中國減重⼿術候選⼈中，由於肥胖代謝外科相關知識宣傳⼒度不夠，⼤部分 34 Tang S, Yu S, Wang C, Yang J, Gao L, Chen X, et al, “Factors Influence the Acceptance of Surgical Treatment in Chinese Bariatric Surgery Candidates,” Obes Surg 28.9 (2018): 2767-2773.
袁開盛、吳冰、胡瑞翔、董志勇、王存川 12 ⼈並未意識到肥胖對健康的危害以及減重⼿術指徵，甚至不認為肥胖是⼀個疾病，故此為患者提供適當的醫療保健教育和⽀援非常重要。重點關注肥胖相關的健康風險和⼿術治療的選擇，以提⾼他們對減重⼿術接受度。35許多其他科室的醫⽣對減重⼿術的接受度也很低，他們對減重⼿術認識不夠。當他們看到因為其他原因就診的肥胖病⼈時，他們並未推薦減重⼿術。不僅應加⼤公眾宣傳的⼒度，還應在醫院進⾏專業的講座培訓，讓更多的⼈瞭解肥胖代謝外科，消除對⼿術的不必要恐懼和誤解。對於肥胖代謝外科醫⽣來說，建⽴多學科會診（Multi-Disciplinary Treatment，MDT）有助於患者術後康復，制定更全⾯和個性化的治療⽅案，也有助於減重⼿術的推廣。36 ⽬前減重⼿術被⼀部分肥胖患者拒絕的另外⼀個主要原因是中國⼤陸⼤部分城市的基本醫療保險未包括減重⼿術，⼀些城市甚至將減重⼿術歸類為整形⼿術，這給患者帶來巨⼤的經濟負擔。因為所有費⽤都由患者承擔，所以對於中低收入家庭來說，這無疑是⼀筆巨⼤的經濟負擔。建議政府以及保險機構增加對肥胖代謝外科的醫保覆蓋，減輕患者經濟壓⼒，讓更多肥胖患者能選擇減重⼿術。在我國，2010年至 2014年間，學齡兒童超重和肥胖的綜合患病率從 17.1%上升到 22.5%，37現在「西⽅飲食」取代中國傳統飲食、各階段活動⼤幅減少和久坐活動增加被認為是超重和肥胖迅速增加的主要原因，建議政府相關部⾨應對餐飲⾏業實施強制性營養標籤制度，限制⾼能量密度、飽和脂肪、反式脂肪酸和添加糖或鹽的預包裝食品的⽣產、銷售和廣告並增加相關稅收，增加對體育產業的投入，減少健身場所和體育相關產品稅收，這可能減少我國肥胖⼈群增長速度。同時應該增加對青少年肥胖問題研究。現在我國關於減重⼿術患者的資料庫比較主流的是由暨南⼤學附屬第⼀醫院成⽴的中國肥胖代謝資料庫和⾸都醫科⼤學附屬北京友誼醫院成⽴的⼤中華減重與代謝⼿術資料庫，但是對於⽬前數據的採集、存儲、處理以及共⽤在技術層⾯上沒 35 Tang S, Yu S, Wang C, Yang J, Gao L, Chen X, et al, “Factors Influence the Acceptance of Surgical Treatment in Chinese Bariatric Surgery Candidates,” 2767-2773. 36 Blanchet MC, Frering V, Gignoux B, Matussière Y, Oudar P, Noël R, et al, “Four-Year Evolution of a Thrombophylaxis Protocol in an Enhanced Recovery After Surgery (ERAS) Program: Recent Results in 485 Patients,” Obes Surg 28.7 (2018): 2140-2144. 37 Dong Y, Ma Y, Dong B, Zou Z, Hu P, Wang Z, et al, “Geographical Variation and Urban-rural Disparity of Overweight and Obesity in Chinese School-aged Children between 2010 and 2014: Two Successive National Cross-sectional Surveys,” BMJ Open 9.4 (2019): e025559.
袁開盛、吳冰、胡瑞翔、董志勇、王存川 14 徵引書目 [1] Perdomo CM, Cohen RV, Sumithran P, Clément K, Frühbeck G, “Contemporary Medical, Device, and Surgical Therapies for Obesity in Adults.” Lancet 401.10382 (2023): 1116-1130. [2] Pan XF, Wang L, Pan A, “Epidemiology and Determinants of Obesity in China.” Lancet Diabetes Endocrinol 9.6 (2021): 373-392. [3] Organization WH, “Obesity: Preventing and Managing the Global Epidemic. Report of a WHO Consultation.” World Health Organ Tech Rep Ser 894 (2000): i-xii, 1-253. [4] Deurenberg P, Yap M, van Staveren WA, “Body Mass Index and Percent Body Fat: A Meta Analysis among Different Ethnic Groups.” Int J Obes Relat Metab Disord 22.12 (1998): 1164-1171. [5] Caballero B, “Caballero B. Humans against Obesity: Who Will Win?” Adv Nutr 10.1 (2019): S4-S9. [6] Wang Y, Sun M, Yang Y. China Blue Paper on Obesity Prevention and Control. Beijing: Peking University Medical Publisher, 2019. [7] Doumouras AG, Hong D, Lee Y, Tarride JE, Paterson JM, Anvari M, “Association between Bariatric Surgery and All-Cause Mortality: A Population-Based Matched Cohort Study in a Universal Health Care System.” Ann Intern Med 173.9 (2020): 694-703. [8] Unamuno X, Gómez-Ambrosi J, Rodríguez A, Becerril S, Frühbeck G, Catalán V, “Adipokine Dysregulation and Adipose Tissue Inflammation in Human Obesity.” Eur J Clin Invest 48.9 (2018): e12997. [9] Pories WJ, Swanson MS, MacDonald KG, Long SB, Morris PG, Brown BM, et al, “Who Would Have Thought It? An Operation Proves to be the Most Effective Therapy for Adult-onset Diabetes Mellitus.” Ann Surg 222.3 (1995): 339-350; discussion 350-332. [10] 楊忠魁、趙曉宇、楊洪⽊、董國光，〈Payne改良法治療肥胖病⼀例〉，《中華外
中國肥胖代謝外科的歷史、現狀和未來 15 科雜誌》，第22卷第3期（1984），143。 [11] 鄭成⽵、柯重偉、印慨、李際輝、吳⽉鳳、胡明根等，〈腹腔鏡垂直捆綁胃成形術治療病態肥胖（附25例報告）〉，《中國實⽤外科雜誌》，第10期（2002），17-19+68。 [12] 王存川、陳鋆、胡友主、徐以浩，〈腹腔鏡胃間隔捆紮術治療重度肥胖症三例〉，《中華普通外科雜誌》，第7期（2002），53。 [13] 鄭成⽵、胡明根、柯重偉、印慨、李際輝、胡兵等，〈腹腔鏡可調節捆紮帶胃減容術治療單純重度肥胖症的臨床應⽤〉，《中華胃腸外科雜誌》， 第7卷第5期（2004），368-371。 [14] 王存川、陳均⾦、胡友主、許朋、徐以浩，〈腹腔鏡Roux-en-y分流胃旁路減肥術1例報告〉，《中國內鏡雜誌》，第12期（2004），118-119。 [15] 劉⾦鋼、⽥忠、楊福全、孟相真、劉源、喬麟等，〈腹腔鏡袖狀胃切除術治療單純性肥胖症1例報告〉，《中國實⽤外科雜誌》，第6期（2007），481-482。 [16] 楊華、陳緣、董志勇、程中、戴曉江、胡揚喜等，〈中國肥胖代謝外科資料庫：2020年度報告〉，《中華肥胖與代謝病電⼦雜誌》，第7卷第1期（1001），1-7。 [17] 李夢伊、劉雁軍、于衛華、劉少壯、王冰、李瀅旭等，〈⼤中華減重與代謝⼿術資料庫2022年度報告〉，《中國實⽤外科雜誌》，第43卷第5期（2023），540-551。 [18] 王勇、王存川、朱曬紅、張頻、梁輝，〈中國肥胖及2型糖尿病外科治療指南（2019版）〉，《中國實⽤外科雜誌》，第39卷第4期（2019），301-306。 [19] Du X, Dai R, Zhou HX, Su ML, Lu C, Zhou ZG, et al, “Bariatric Surgery in China: How Is This New Concept Going? ” Obes Surg 26.12 (2016): 2906-2912. [20] Angrisani L, Santonicola A, Iovino P, Vitiello A, Higa K, Himpens J, et al, “IFSO Worldwide Survey 2016: Primary, Endoluminal, and Revisional Procedures.” Obes Surg 28.12 (2018): 3783-3794. [21] Ohta M, Seki Y, Wong SK, Wang C, Huang CK, Aly A, et al, “Bariatric/Metabolic Surgery in the Asia-Pacific Region: APMBSS 2018 Survey.” Obes Surg 29.2 (2019):
袁開盛、吳冰、胡瑞翔、董志勇、王存川 16 534-541. [22] Zeng T, Cai Y, Chen L, “The Effectiveness of Bariatric Surgery for Chinese Obesity in 2 Years: A Meta-Analysis and Systematic Review.” J Invest Surg 30.5 (2017): 332-341. [23] Wilkinson KH, Helm M, Lak K, Higgins RM, Gould JC, Kindel TL, “The Risk of Post-operative Complications in Super-Super Obesity Compared to Super Obesity in Accredited Bariatric Surgery Centers.” Obes Surg 29.9 (2019): 2964-2971. [24] Gill RS, Birch DW, Shi X, Sharma AM, Karmali S, “Sleeve Gastrectomy and Type 2 Diabetes Mellitus: A Systematic Review.” Surg Obes Relat Dis 6.6 (2010): 707-713. [25] Flegal KM, Kit BK, Orpana H, Graubard BI, “Association of All-cause Mortality with Overweight and Obesity Using Standard Body Mass Index Categories: A Systematic Review and Meta-analysis.” Jama 309.1 (2013): 71-82. [26] Sjöström L, Narbro K, Sjöström CD, Karason K, Larsson B, Wedel H, et al, “Effects of Bariatric Surgery on Mortality in Swedish Obese Subjects.” N Engl J Med 357.8 (2007): 741-752. [27] Carlsson LMS, Sjöholm K, Jacobson P, Andersson-Assarsson JC, Svensson PA, Taube M, et al, “Life Expectancy after Bariatric Surgery in the Swedish Obese Subjects Study.” N Engl J Med 383.16 (2020): 1535-1543. [28] 梁輝、林⼠波、管蔚、李聰、沈佳佳，〈單中⼼4255例減重代謝⼿術後早期嚴重併發症及其危險因素分析〉，《中華胃腸外科雜誌》，第10期（2022），899-905。 [29] Wan B, Fang N, Guan W, Ding H, Wang Y, Ge X, et al, “Cost-Effectiveness of Bariatric Surgery versus Medication Therapy for Obese Patients with Type 2 Diabetes in China: A Markov Analysis.” J Diabetes Res 2019: 1341963. [30] Zhang J, Zhai L, Osewe M, Liu A, “Analysis of Factors Influencing Food Nutritional Labels Use in Nanjing, China.” Foods 9.12 (2020). [31] Cairns G, Angus K, Hastings G, Caraher M, “Systematic Reviews of the Evidence on the Nature, Extent and Effects of Food Marketing to Children: A Retrospective
中國肥胖代謝外科的歷史、現狀和未來 17 Summary.” Appetite 62 (2013): 209-215. [32] Tang S, Yu S, Wang C, Yang J, Gao L, Chen X, et al, “Factors Influence the Acceptance of Surgical Treatment in Chinese Bariatric Surgery Candidates.” Obes Surg 28.9 (2018): 2767-2773. [33] Blanchet MC, Frering V, Gignoux B, Matussière Y, Oudar P, Noël R, et al. Four-Year “Evolution of a Thrombophylaxis Protocol in an Enhanced Recovery After Surgery (ERAS) Program: Recent Results in 485 Patients.” Obes Surg 28.7 (2018): 2140-2144. [34] Dong Y, Ma Y, Dong B, Zou Z, Hu P, Wang Z, et al, “Geographical Variation and Urban-Rural Disparity of Overweight and Obesity in Chinese School-aged Children between 2010 and 2014: Two Successive National Cross-sectional Surveys.” BMJ Open 9.4 (2019): e025559. 第㆒作者簡介 袁開盛，暨南大學外科學在讀博士生，研究領域減重代謝外科方向 通訊地址 ： 中國廣東省廣州市天河區黃埔大道西 613號 廣州華僑醫院 通訊電郵 ： yuan_kaisheng@163.com 第㆓作者簡介 吳冰，暨南大學外科學在讀博士生，研究領域減重代謝外科方向 通訊地址 ： 中國廣東省廣州市天河區黃埔大道西 613號 廣州華僑醫院 通訊電郵 ： 13016087370@163.com 第㆔作者簡介 胡瑞翔，暨南大學附屬第一醫院胃腸外科住院醫師，曾於美國哈佛大學留
陳芹 20 Chinese Criminal Policy in Emergency Responses Chen, Qin （Assistant Professor, School of Law, Macao University of Science and Technology） Abstract: Chinese criminal policy in dealing with the “COVID-19” Pandemic is effective, which emphasizes “rule of law”, rather than the traditional formulation of “strict” or “lenient”. It provides new thinking mode and analyzing sample to the exploration of emergency mechanism. Criminal policy can only affect the implementation of criminal law. Temporary criminal policy is a “variable” of criminal law, which can make timely response in emergencies. While the long-term criminal policy is a “constant”, which requires the application of criminal law keep consistent with it. During the epidemic, the distinction between the crime of impairing the prevention and treatment of the infectious diseases and the crime of endangering public security by dangerous means fully embodies this principle. Keywords: “COVID-19” Pandemic; Emergency response; Criminal policy; Criminal law doctrine
陳芹 34 (㆓)、因突發事件而得以重新啟動的長時性刑事政策 如前所述，兩罪的法定刑輕重差別較⼤，不存在重疊部分，表明⼆者的不法內涵完全不同，但⼆者的結果難以區分，其不法內涵的差異只能體現在⾏為上。2020年〈意⾒〉對於兩罪的區分正是建⽴在⾏為區分的基礎上，可將之稱為⾏為中⼼論。⾏為中⼼論的正確性源於它與該兩罪的⽴法政策相吻合。 1、以危險方法危害安全罪的政策蘊含 以危險⽅法危害公共安全罪的⽴法政策包括兩個⽅⾯：刑罰前置化與刑罰限縮化，前者擴⼤刑罰範圍，後者則防⽌刑罰過度擴⼤。 ⾸先，危害公共安全是抽象危險犯，其⽴法是基於刑罰前置化的政策考量。 具體⽽⾔，我國刑法第⼆章的危害公共安全罪最終侵害的法益都是個⼈法益（⽣命、健康），當最終的實害結果發⽣時，完全可以按照侵害個⼈法益（⽣命、健康）的實害犯來處罰，如法益侵害具有「公共性」，則可數罪並罰。⽴法者為什麼要單獨設⽴危害公共安全罪呢？其⽴法意義不在於法益的「公共性」，⽽在於將這些「公共性」法益的保護前置化，或說刑罰前置化（相當於未遂犯既遂化），它使得刑罰介入的時點由實害結果發⽣的 B 點，提前至尚未發⽣實害結果、但產⽣了相應危險的 A 點。這是因為此類⾏為本身所蘊含的⾼度危險性，⽴法者特別在 A 點確⽴標準的⾏為模式，17只要違背該⾏為模式，即使以 B 點的「公共性」實害結果未發⽣，也予以處罰，從⽽有效避免 B 點的公共侵害的發⽣。這才使得危害公共安全罪有了獨⽴於實害犯的意義，基於此，危害公共安全罪只能是抽象危險犯，這也是其獨特的政策蘊含。它表明，抽象危險犯的核⼼不在於結果，⽽在於⾏為。 然⽽，我國傳統理論認為，刑法 115條是實害犯（以重傷、死亡為要件），114條是輕結果犯或具體危險犯（以「尚未發⽣嚴重結果」為要件），並明確反對將兩條均認定為抽象危險犯。18這種觀點忽視了危險犯的獨⽴意義，難以⾃洽。詳⾔之，危害公共安全罪（如放⽕罪）與個⼈法益犯罪（如殺⼈罪）的區別不在於結果的 17 黃榮堅，《基礎刑法學（下）》，（北京：中國人民大學出版社，2009），382。 18 張明楷，〈高空拋物案的刑法學分析〉，《法學評論》，第 3期（湖北：2020.06），12-26。
中國突發事件應對中的刑事政策 35 「公共性」，⽽在於，後者的法益是處於 B 點的「個⼈法益本身」，⽽前者的法益是更早的 A 點的「個⼈法益之安全」，當「安全」成為法益，「危險」⾃然就是對「安全」的法益侵害。因此，危害公共安全罪必然是危險犯。這也是國外刑法理論的共識。德⽇刑法均將「公共危險罪」視為危險犯（危殆犯）。19例如，放⽕罪是危害公共安全罪的典型，在⽇本刑法理論中也被視為抽象危險犯，20獨⽴燃燒（A點）既為既遂，⽽無需等到發⽣傷亡結果（B點）才既遂。 根據理論通說，抽象危險犯就是⾏為犯，其構成要件只有⾏為要素，沒有結果要素，這是⾏為中⼼論的理論基礎。 其次，危害公共安全罪作為抽象危險犯，沒有構成要件結果，但在⽴法往往在其罪狀中設置了「描述性結果」，其作⽤在於限縮刑罰處罰的範圍。為什麼要對刑罰進⾏限縮呢？這是因為，作為危險犯的法益侵害是「危險」，⽽「危險」是無形的，是對未來是否發⽣結果的⼀種預測，預測就會有失誤的可能，這就使得刑罰早期化存在恣意的風險，因⽽，對這種風險進⾏限制就成為抽象危險犯的第⼆個政策蘊含。對此，我國刑法的作法是：將非構成要件的、未來的實害結果在罪狀中予以描述，以描述性結果作為限制處罰的技術措施，呈現出「危險犯構成要件+描述性結果」的⽴法模式。 在危險犯罪狀中的描述性結果，是危險犯實⾏⾏為的輔助判斷標準，表明實⾏⾏為有可能造成該描述性結果。例如，刑法第 114 條的結果描述屬於「輕結果」，它是表明：本罪的實⾏⾏為是⼀種低危險⾏為，它通常不會導致嚴重後果︔第 115條的規定為「重傷、死亡」，表明：本罪的實⾏⾏為是⼀種⾼危險⾏為，通常能導致「重傷、死亡」。若未發這⼀結果，實⾏⾏為的危險性未獲得證實，根據「存疑利益歸於被告」的原則，應當否定犯罪成⽴。 2、妨害傳染病防治罪的政策蘊含 妨害傳染病防治罪的⽴法政策也包括兩個⽅⾯：⼀是擴⼤刑罰範圍，⼆是防⽌刑罰過度擴⼤。 19 大塚仁，馮軍譯，《刑法概說（各論）》，（北京：中國人民大學出版社，2003），346。 20 大塚仁，馮軍譯，《刑法概說（各論）》，（北京：中國人民大學出版社，2003），120。
王藝璇、唐娟 42 Residents’ Emotional Solidarity and Tourism Impact Attitude during the COVID-19 Pandemic: A Case Study of Macau Wang,Yixuan1; Tang, Juan （1. Doctoral student, Faculty of Hospitality and Tourism Management, Macau University of Science and Technology） Abstract: Residents’ attitude towards tourism is a key factor affecting the sustainable development of a destination. In recent years, the rapid development of Macau tourism industry has led to insufficient tourism carrying capacity, which has brought pressure and inconvenience to the lives of local residents. And the contradiction between host and guest has become increasingly prominent. However, with the outbreak of COVID-19, the emotional attitudes of both residents and tourists have changed. This study aims to explore how the emotional solidarity of Macau residents towards tourists influences their tourism impact attitude in the post-COVID-19 pandemic. Through quantitative method, SPSS24 and SmartPLS3.0 were used to analyze the data from 422 questionnaires from Macau residents. The results showed that different dimensions of emotional solidarity between Macau residents and tourists after the epidemic had different degrees of positive influence on their tourism impact attitude. This study re-examined the emotional solidarity between residents and tourists and the changes in the relationship of emotional solidarity in the post-pandemic era. The conclusion provided practical significance for Macau destination management organization. Keywords: Overtourism; Post-COVID-19 pandemic; Residents’ emotional solidarity; Tourism impact attitude
後疫情時期澳門居民對遊客的情感團結以及對澳門旅遊業發展的態度 43 一、引言 過去的幾⼗年裡，快速發展的旅遊業在成為⼀些地區的經濟⽀柱產業的同時，帶來的過度旅遊對旅遊⽬的地造成極⼤的破壞，從⽽給居民的⽣活帶來巨⼤的壓⼒。過度旅遊導致的旅遊承載⼒嚴重不⾜的問題影響了居民對旅遊業發展的態度，使居民對遊客的情感態度產⽣變化。居民對旅遊業發展的態度研究在近幾⼗年來⼀直被持續關注。 1Andriotis 指出，社區旅遊發展要以居民的需求和願望為基礎，才能更好地實現旅遊可持續發展。2研究表明，旅遊⽬的地居民是受到旅遊發展影響最⼤和最直接的群體，3同時他們也是遊客旅遊體驗的重要組成部分。4因此，居民與遊客之間的關係成為了社區旅遊業可持續發展的關鍵。5Woosnam, Norman和 Ying將情感團結概念引入旅遊領域，來解釋居民與遊客之間的情感關係。6同時，有學者提出居民態度⽂獻應該將居民對遊客的情感態度如何影響他們對旅遊業發展的看法考慮在內，因此，Woosnam研究了居民與遊客的情感團結程度如何影響這些居民對旅遊和旅遊發展的態度。7隨後，Lai 和 Hitchcock 與 Lai 和 Pintassilgo 以澳⾨為例探究了居民對遊客的情感團結與他們對旅遊發展態度之間的關係。8 1 Kyle M. Woosnam, “Using Emotional Solidarity to Explain Residents’ Attitudes about Tourism and Tourism Development,” Journal of Travel Research 51.3 (SAGE: 2012): 315-327; Kathleen L. Andereck and Gyan P. Nyaupane, “Exploring the Nature of Tourism and Quality of Life Perceptions among Residents,” Journal of Travel research 50.3 (SAGE: 2011): 248-260; Hio Kuan Lai, Patrícia Pinto and Pedro Pintassilgo, “Quality of Life and Emotional Solidarity in Residents’ Attitudes toward Tourists: The Case of Macau,” Journal of Travel Research 60.5 (SAGE: 2021): 1123-1139. 2 Konstantinos Andriotis, “Community Groups’ Perceptions of and Preferences for Tourism Development: Evidence from Crete,” Journal of Hospitality & Tourism Research 29.1 (SAGE: 2005): 67-90. 3 Xiangping Li and Yim King Penny Wan, “Residents’ Support for Festivals: Integration of Emotional Solidarity,” Journal of Sustainable Tourism 25.4 (Taylor & Francis: 2017): 517-535. 4 Gayle Jennings and Norma Nickerson, eds. Quality Tourism Experiences. (Routledge, 2006). 5 María Francisca Blasco López, Nuria Recuero Virto, Joaquín Aldas Manzano and Jesús García-Madariaga Miranda, “Residents’ Attitude as Determinant of Tourism Sustainability: The Case of Trujillo,” Journal of Hospitality and Tourism Management 35 (Elsevier: 2018): 36–45. 6 Kyle M. Woosnam, William C. Norman and Tianyu Ying, “Exploring the Theoretical Framework of Emotional Solidarity between Residents and Tourists,” Journal of Travel Research 48.2 (SAGE: 2009): 245-258. 7 Kyle M. Woosnam, “Using Emotional Solidarity to Explain Residents’ Attitudes about Tourism and Tourism Development,” 315-327. 8 Hio Kuan Lai, Patrícia Pinto and Pedro Pintassilgo, “Quality of Life and Emotional Solidarity in Residents’ Attitudes toward Tourists: The Case of Macau,” 1123-1139; Ivan Ka Wai Lai and Michael Hitchcock, “Local Reactions to Mass Tourism and Community Tourism Development in Macau,” Journal of Sustainable Tourism 25.4 (Taylor & Francis: 2017): 451-470.
後疫情時期澳門居民對遊客的情感團結以及對澳門旅遊業發展的態度 45 化，研究結果為澳⾨政府以及其他利益相關者提供可參考的⾒解，進⼀步改善澳⾨旅遊環境，促進澳⾨旅遊可持續發展，具有實踐意義。本研究從引言、文獻綜述、研究方法、數據分析及結果、結論五個部分進行探討。 二、文獻綜述 (㆒)、居民對遊客的情感團結 居民與遊客的關係⼀直以來都被旅遊界關注，傳統的旅遊研究將居民與遊客的關係常視作分離狀態，多⽤「⾃⼰和他⼈」這種⼆分法的形式來定義。⽽情感團結理論則揭⽰了主客之間有存在親密關係的可能性。情感團結的概念最初來⾃於古典社會學，由 Durkheim在 The Elementary Forms of Religious Life⼀書中提出，指出⼈們通過從事神聖的信仰和儀式⾏為來建⽴情感紐帶。11隨後 Hammarstrom 將其定義為⼈與⼈之間所體驗到的情感聯結，特徵在於感知到的情感親密度和接觸度。12情感團結的另⼀個常⽤定義是Wallace和Wolf提出的，團結被認為是⼀個⼈對另⼀個⼈的認同感，這種認同感旨在加強⼈與⼈之間的聯繫。13 Woosnam⾸次將該理論引入旅遊學科，來解釋旅遊⽬的地的居民與遊客在互動時如何建⽴和諧的關係。14情感團結被看作是預測⼈們對旅遊相關的看法或⾏為的重要指標，Woosnam和 Norman通過擴展 Durkheim的理論，開發和驗證了⼀個量表來衡量居民對遊客的情感團結。15情感團結量表（簡稱 ESS）包含了三個因素：「對遊客的歡迎」、「對遊客情感上的親近」和「對遊客的共情式理解」。許多研究證實了該量表的穩健性。Woosnam進⼀步將居民對遊客情感團結的這三個維度與Wang和 11 Emile Durkheim, The Elementary Forms of the Religious Life, 1st ed, (New York: Free Press, 1915/1995). 12 Gunhild Hammarström, “The Construct of Intergenerational Solidarity in a Lineage Perspective: A Discussion on Underlying Theoretical Assumptions” Journal of Aging Studies 19.1 (Elsevier: 2005): 33-51. 13 Ruth A. Wallace and Alison Wolf, Contemporary Sociological Theory: Expanding the Classica Tradition, 5th ed, (Upper Saddle River: Prentice Hall, 2005). 14 Kyle M. Woosnam, “Using Emotional Solidarity to Explain Residents’ Attitudes about Tourism and Tourism Development,” 315-327. 15 Kyle M. Woosnam and William C. Norman, “Measuring Residents’ Emotional Solidarity with Tourists: Scale Development of Durkheim’s Theoretical Constructs,” Journal of Travel Research 49.3 (SAGE: 2010): 365-380.
王藝璇、唐娟 46 Pfister 的旅遊影響態度量表（簡稱 TIAS）的兩個維度（「對旅遊業發展的⽀持」和「旅遊業對社區的貢獻」）相結合，以解釋在美國德克薩斯州加爾維斯頓縣（Galveston County, Texas）遭遇颶風後，居民對遊客的情感團結以及對旅遊業發展的態度。16此外，通過後續研究，ESS也被證明⽤於衡量遊客對居民的情感態度以及遊客之間的情感聯繫。17 (㆓)、居民對旅遊業發展的態度 研究表明，居民對遊客以及對⽬的地旅遊發展的態度受多種因素的影響，如經濟、⽂化、環境、個⼈特質等。根據居民對旅遊的態度的不同，居民被分為了熱愛者、憎恨者、謹慎的⽀持者、中⽴者、理性愛好者等不同類型。18社會交換理論、旅遊地⽣命週期理論、旅遊發展階段理論等也經常⽤來評估居民態度。旅遊發展階段和旅遊地⽣命週期理論表⽰，居民態度隨著旅遊業發展處於不同階段⽽產⽣從⽀持到反對的變化︔⽽社會交換理論表明，當旅遊給居民帶來的收益⾼於成本時，居民對旅遊發展的態度持積極態度，⼀旦成本⾼於收益時，例如社區遊客過多⽽導致的擁擠讓居民受到旅遊業的不利影響，此時居民對旅遊發展則持消極態度。19較新的研究證明，居民態度不僅取決於旅遊業的成本和收益，主客之間的情感關係也會影響到居民對旅遊業發展的態度，因此提出了情感團結理論，並證實居民對遊客的情感團結程度會影響居民對旅遊業發展的態度，繼⽽影響旅遊⽬的地的可持續發展。Woosnam 對居民情感團結與居民對旅遊影響的態度的研究中指出遭遇颶風後的社 16 Kyle M. Woosnam, “Using Emotional Solidarity to Explain Residents’ Attitudes about Tourism and Tourism Development,” 315-327; Yasong (Alex) Wang and Robert E. Pfister, “Residents’ Attitudes toward Tourism and Perceived Personal Benefits in a Rural Community,” Journal of Travel Research 47.1 (SAGE: 2008): 84–93. 17 Kayode D. Aleshinloye, Xiaoxiao Fu, Manuel Alector Ribeiro, Kyle M. Woosnam and Asli D.A. Tasci, “The Influence of Place Attachment on Social Distance: Examining Mediating Effects of Emotional Solidarity and the Moderating Role of Interaction,” Journal of Travel Research 59.5 (SAGE: 2020): 828-849; Dongoh Joo and Kyle M. Woosnam, “Measuring Tourists’ Emotional Solidarity with One Another: A Modification of the Emotional Solidarity Scale,” Journal of Travel Research 59.7 (SAGE: 2020): 1186-1203; Kyle M. Woosnam and Kayode Dare Aleshinloye, “Can Tourists Experience Emotional Solidarity with Residents? Testing Durkheim’s Model from a New Perspective,” Journal of Travel Research 52.4 (SAGE: 2012): 494-505. 18 Duane Davis, Jeff Allen and Robert M. Cosenza, “Segmenting Local Residents By Their Attitudes, Interests, and Opinions Toward Tourism,” Journal of Travel Research 27.2 (SAGE: 1988): 2-8. 19 John Ap, “Residents’ Perceptions on Tourism Impacts,” Annals of Tourism Research 19.4 (Elsevier: 1992): 665-690.
後疫情時期澳門居民對遊客的情感團結以及對澳門旅遊業發展的態度 47 區居民非常歡迎遊客的到訪，從旅遊業中受益的狀態激發了居民對社區旅遊發展更⾼⽔準的⽀持。20 居民對旅遊的態度在相關研究中越來越受歡迎。21旅遊影響態度量表（TIAS）最早由 Lankford 和 Howard 開發，⽤於測量居民的態度。22這是在過去幾⼗年的研究中被廣泛使⽤的最早的量表之⼀。23隨後，Wang和 Pfister在此基礎上開發了雙因素結構，包括「對旅遊發展的⽀持」和「旅遊對社區的貢獻」來衡量居民的態度，Woosnam在隨後的研究中使⽤驗證性因素分析進⼀步確認了 TIAS的因素結構。 (㆔)、澳門居民對遊客的情感團結和對旅遊業發展的態度的關係 澳⾨作為世界旅遊休閒中⼼，訪澳遊客量年創新⾼，但過多的遊客給居民⽣活帶來了不便。澳⾨社交媒體上曾有相關討論揭⽰了居民對遊客的態度差異，有居民因遊客到訪可以帶來豐厚的經濟效益⽽歡迎他們訪澳旅遊，多多益善︔但也有居民反映過多遊客導致通關、出⾏、住宿等難題產⽣，給他們的⽣活造成影響，因⽽希望減少遊客數量。24這說明居民因遊客帶來的經濟效益⽀持旅遊業發展，也會因旅遊承載⼒不⾜⽽產⽣的⽣活壓⼒反對旅遊業發展。 Lai和Hitchcock通過情感團結理論探究了澳⾨居民對⼤眾旅遊的看法以及對旅遊發展的態度，研究結果證明情感團結三個維度（「對遊客的歡迎」、「對遊客情感上的親近」、「對遊客共情式的理解」）對旅遊影響態度兩個維度（「對旅遊業發展的⽀持」和「旅遊業對社區的貢獻」）產⽣了部分積極影響。25 儘管已有研究探究了澳⾨居民的情感團結與他們的對旅遊發展態度之間的關係， 20 Yasong (Alex) Wang and Robert E. Pfister, “Residents’ Attitudes toward Tourism and Perceived Personal Benefits in a Rural Community,” 84-93. 21 Dongoh Joo, Wenjie Xu, Juhee Lee, Choong-Ki Lee and Kyle M. Woosnam, “Residents’ Perceived Risk, Emotional Solidarity, and Support for Tourism Amidst the COVID-19 Pandemic,” Journal of Destination Marketing & Management 19 (Elsevier: 2021). 22 Samuel V. Lankford and Dennis R. Howard, “Developing a Tourism Impact Attitude Scale,” Annals of tourism research 21.1 (Elsevier: 1994): 121-139. 23 Samuel V. Lankford, John S.Y. Chen and Wellin Chen, “Tourism’s Impacts in the Penghu National Scenic Area, Taiwan,” Tourism Management 15.3 (Elsevier: 1994): 222-227; Rick Rollins, “Validation of the TIAS as a Tourism Tool,” Annals of tourism research 24.3 (1997): 740-742. 24 「 你 對 遊 客 的 態 度 到 了 哪 個 階 段 」， 澳 門 流 動 社 區 CyberCTM.com ，https://forum.cyberctm.com/forum.php?mod=viewthread&tid=11079228，瀏覽日期為：2022 年 8 月 24 日。 25 Ivan Ka Wai Lai and Michael Hitchcock, “Local Reactions to Mass Tourism and Community Tourism development in Macau,” 451-470.
王藝璇、唐娟 54 本研究結果顯⽰「對遊客的歡迎」對旅遊影響態度產⽣積極影響，⽽「對遊客情感上的親近」與旅遊影響態度直接沒有顯著影響，這與 Lai 和 Hitchcock 研究結果⼀致。Li和Wan在澳⾨旅遊背景下的相關研究也⽀持了該觀點。27但在「對遊客共情式的理解」與旅遊影響態度的關係的假設中，本研究發現「對遊客共情式的理解」僅對「旅遊業對社區的貢獻」產⽣積極影響，⽽對「對旅遊業發展的⽀持」沒有顯著影響，這意味著澳⾨居民對遊客的共情式理解並不影響他們對旅遊發展的⽀持態度。儘管這於Woosnam與 Lai和 Hitchcock的假設結果不同，但 Li和Wan與 Hasani, Moghavvemi和 Hamzah⽀持本研究的觀點。28同樣在澳⾨旅遊背景下，造成本研究結果與 Lai和Hitchcock在疫情前的假設結果不同的原因可能部分歸結於疫情背景。疫情期間訪澳遊客數量減少，且出於安全考慮，居民會減少與遊客的接觸，主客間缺少互動，這些都可能會導致居民無法與遊客建⽴良好的⼈際關係。本研究運⽤情感團結理論探索了澳⾨的主客關係現狀，進⼀步延伸和驗證了情感團結理論的使⽤背景。更為重要的是，本研究在疫情特殊時期探索了情感團結各個維度與旅遊影響態度的關係⽅向和⼒度變化，從⽽進⼀步細化和補充了疫情背景下對情感團結理論的理解。 數據分析結果表明，居民對遊客的熱情歡迎對居民對旅遊影響的態度的兩個維度均產⽣了積極影響。正如假設 1和假設 4預測的那樣，在後疫情時代，居民更加歡迎遊客的到來，因為他們清楚的知道旅遊業復甦可以使他們有更多機會在經濟上受益。因此，特區政府需要抓住機會，通過多種渠道，宣傳旅遊業為澳⾨帶來的效益，尤其在後疫情時期，突出旅遊業發展為澳⾨經濟復蘇所做出的貢獻，讓居民更加深刻地意識到旅遊發展的重要性，幫助居民更好地瞭解旅遊業如何為他們的⽣活帶來改善，從旅遊業造成⽣活不便的單⼀視角，擴展到更全⾯綜合的視角，從⽽加強居民發⾃內⼼的對遊客到來的歡迎態度︔同時也要更加重視旅遊教育的發展，培養更多優質的旅遊⼈才，全⾯提升旅遊管理⽔準，為將來⼤灣區旅遊升級做好⼒量儲備，以便更好的服務於遊客與居民。 根據研究結果顯⽰，居民對遊客情感上的親近對他們對旅遊影響的態度的兩個 27 Xiangping Li and Yim King Penny Wan, “Residents’ support for festivals: Integration of emotional solidarity,” 517-535. 28 Ali Hasani, Sedigheh Moghavvemi and Amran Hamzah, “The Impact of Emotional Solidarity on Residents’ Attitude and Tourism Development,” PloS one 11.6 (PLOS: 2016).
王藝璇、唐娟 56 徵引書目 ㆗文著作 [1] 趙偉兵，〈澳門旅遊休閒產業：現狀、特徵與趨勢〉，錄入林廣志編，《澳門旅遊休閒發展報告（2018～2019）》（北京：社會科學文獻出版社，2019），76。 西文著作 [1] Aleshinloye, Kayode D., Xiaoxiao Fu, Manuel Alector Ribeiro, Kyle M. Woosnam and Asli D.A. Tasci, “The Influence of Place Attachment on Social Distance: Examining Mediating Effects of Emotional Solidarity and the Moderating Role of Interaction,” Journal of Travel Research 59.5 (SAGE: 2020): 828-849. [2] Andereck, Kathleen L. and Gyan P. Nyaupane, “Exploring the Nature of Tourism and Quality of Life Perceptions among Residents,” Journal of Travel research 50.3 (SAGE: 2011): 248-260. [3] Andriotis, Konstantinos, “Community Groups’ Perceptions of and Preferences for Tourism Development: Evidence from Crete,” Journal of Hospitality & Tourism Research 29.1 (SAGE: 2005): 67-90. [4] Ap, John, “Residents’ Perceptions on Tourism Impacts,” Annals of Tourism Research 19.4 (Elsevier: 1992): 665-690. [5] Bagozzi, Richard P. and Youjae Yi, “Specification, Evaluation, and Interpretation of Structural Equation Models,” Journal of the Academy of Marketing Science 40 (SAGE: 2012): 8-34. [6] Davis, Duane, Jeff Allen and Robert M. Cosenza, “Segmenting Local Residents By Their Attitudes, Interests, and Opinions Toward Tourism,” Journal of Travel Research 27.2 (SAGE: 1988): 2-8. [7] Durkheim, Emile, The Elementary Forms of the Religious Life, 1st ed. (New York: Free Press, 1915/1995). [8 ] Hammarström, Gunhild, “The Construct of Intergenerational Solidarity in a Lineage Perspective: A Discussion on Underlying Theoretical Assumptions,” Journal of Aging
後疫情時期澳門居民對遊客的情感團結以及對澳門旅遊業發展的態度 57 Studies 19.1 (Elsevier: 2005): 33-51. [9 ] Hasani, Ali, Sedigheh Moghavvemi and Amran Hamzah, “The Impact of Emotional Solidarity on Residents’ Attitude and Tourism development,” PloS one 11.6 (PLOS: 2016). [10] Jennings, Gayle and Norma Nickerson, eds. Quality Tourism Experiences. (Routledge, 2006). [11] Joo, Dongoh, Wenjie Xu, Juhee Lee, Choong-Ki Lee and Kyle M. Woosnam, “Residents’ Perceived Risk, Emotional Solidarity, and Support for Tourism Amidst the COVID-19 Pandemic,” Journal of Destination Marketing & Management 19 (Elsevier: 2021). [12] Joo, Dongoh and Kyle M. Woosnam, “Measuring Tourists’ Emotional Solidarity with One Another: A Modification of the Emotional Solidarity Scale,” Journal of Travel Research 59.7 (SAGE: 2020): 1186-1203. [13] Lai, Hio Kuan, Patrícia Pinto and Pedro Pintassilgo, “Quality of Life and Emotional Solidarity in Residents’ Attitudes toward Tourists: The Case of Macau,” Journal of Travel Research 60.5 (SAGE: 2021): 1123-1139. [14] Lai, Ivan Ka Wai and Michael Hitchcock, “Local Reactions to Mass Tourism and Community Tourism Development in Macau,” Journal of Sustainable Tourism 25.4 (Taylor & Francis: 2017): 451-470. [15] Lankford, Samuel V. and Dennis R. Howard, “Developing a tourism impact attitude scale,” Annals of tourism research 21.1 (Elsevier: 1994): 121-139. [16] Lankford, Samuel V., John S.Y. Chen and Wellin Chen, “Tourism’s Impacts in the Penghu National Scenic area, Taiwan,” Tourism Management 15.3 (Elsevier: 1994): 222-227. [17] Li, Xiangping and Yim King Penny Wan, “Residents’ Support for Festivals: Integration of Emotional Solidarity,” Journal of Sustainable Tourism 25.4 (Taylor & Francis: 2017): 517-535. [18] López, María Francisca Blasco, Nuria Recuero Virto, Joaquín Aldas Manzano and Jesús García-Madariaga Miranda, “Residents’ Attitude as Determinant of Tourism Sustainability: The Case of Trujillo,” Journal of Hospitality and Tourism Management 35 (Elsevier: 2018): 36–45. [19] Rollins, Rick, “Validation of the TIAS as a Tourism Tool,” Annals of Tourism Research 24.3 (1997): 740-742.
王藝璇、唐娟 58 [20] Wallace, Ruth A. and Alison Wolf, Contemporary Sociological Theory: Expanding the Classica Tradition, 5th ed. (Upper Saddle River: Prentice Hall, 2005). [21] Wang, Yasong (Alex) and Robert E. Pfister, “Residents’ Attitudes toward Tourism and Perceived Personal Benefits in a Rural Community,” Journal of Travel Research 47.1 (SAGE: 2008): 84–93. [22] Woosnam, Kyle M. and Kayode Dare Aleshinloye, “Can Tourists Experience Emotional Solidarity with Residents? Testing Durkheim’s Model from a New Perspective,” Journal of Travel Research 52.4 (SAGE: 2012): 494-505. [23] Woosnam, Kyle M., William C. Norman and Tianyu Ying, “Exploring the Theoretical Framework of Emotional Solidarity between Residents and Tourists,” Journal of Travel Research 48.2 (SAGE: 2009): 245-258. [24] Woosnam, Kyle M., “Using Emotional Solidarity to Explain Residents’ Attitudes about Tourism and Tourism Development,” Journal of Travel Research 51.3 (SAGE: 2012): 315-327. [25] Woosnam, Kyle M. and William C. Norman, “Measuring Residents’ Emotional Solidarity with Tourists: Scale Development of Durkheim’s Theoretical Constructs,” Journal of Travel Research 49.3 (SAGE: 2010): 365-380. 電子書或網絡㈾源 [1] 澳門統計暨普查局，「旅遊、會展及博彩」，澳門特區政府統計暨普查局數據庫，https://www.dsec.gov.mo/zh-MO/Statistic?id=4，瀏覽日期為：2022年8月24日。 [2] 「你對遊客的態度到了哪個階段」，澳門流動社區 CyberCTM.com，https://forum.cyberctm.com/forum.php?mod=viewthread&tid=11079228，瀏覽日期為：2022年8月24日。
李亞青 62 The Cinematographic Expression of Macao’s Cultural Heritage Based on Roland Barthes’ Image Rhetoric Theory: The Bewitching Braids as an Example Li, Yaqing （Lecturer, University International College, Macao University of Science and Technology） Abstract: Film is a medium for spreading cultural heritage and a carrier for its living preservation, which helps to maintain the vitality of cultural legacy. The first local film in Macao, The Bewitching Braids, not only presents Macao’s World Cultural Heritage--the Historic Centre of Macao, but also reflects Macao’s intangible cultural heritage such as religious beliefs, festive rituals and local dialects, making it an important visual archive for the study of Macao’s history and culture. Taking The Bewitching Braids as the research text, based on Roland Barthes’ theory of image rhetoric, this paper analyzes the embodiment of Macao’s tangible and intangible cultural heritage elements and symbols in the film’s linguistic message layer and the denoted image layer, as well as their connoted roles in shaping the characters, promoting the plot, and expressing the theme of the film, so as to explore how to tell the cultural heritage stories through film. Keywords: External embodiment; Internal expression; Cinematic expression
基於羅蘭·巴特圖像分層理論之澳門文化遺產的電影化表達—以《大辮子的誘惑》為例 63 一、引言 ⽂化遺產作為城市的重要組成部分，不可避免地與電影發⽣聯繫。物質⽂化遺產可以是電影故事發⽣的場所和背景，非物質⽂化遺產可以是電影故事的主要內容和素材。電影既可以塑造城市形象，傳播城市⽂化，也是保護城市⽂化遺產的天然媒介之⼀。物質⽂化遺產通過電影得到呈現和展⽰，非物質⽂化遺產通過電影得到傳播和保護。九⼗年代中期，澳⾨本⼟電影製作初⾒端倪，⾸部反映澳⾨本⼟⽂化的長篇電影—《⼤辮⼦的誘惑》誕⽣。該電影由澳⾨蔡氏兄弟影業公司和珠江電影製⽚公司聯合出品，1995 年發⾏，曾獲得第 19 屆⼤眾電影百花獎最佳合拍故事⽚獎、第 25屆費格拉達福茲國際電影節特別⼤獎等獎項。電影根據澳⾨⼟⽣葡⼈作家⾶利奇（Henrique de Senna Fernandes）的同名⼩說《⼤辮⼦的誘惑》改編⽽來，講述葡萄牙貴族青年阿托欣多與中國挑⽔女孩阿玲之間的愛情故事。不同種族，不同⽂化，不同語⾔、出身和教育背景的男女主角歷經波折，相互碰撞，最終克服萬難⽽結合，是⼀部獨具澳⾨歷史⽂化特⾊的影⽚。《⼤辮⼦的誘惑》不僅⼤量呈現了澳⾨的物質⽂化遺產—澳⾨歷史城區，⽽且反映了澳⾨的宗教信仰、節慶儀式以及地⽅⽅⾔等非物質⽂化遺產，是研究澳⾨歷史與⽂化的重要「電影⽂化遺產」。1本⽂根據法國符號學家羅蘭•巴特（Roland Barthes）提出的圖像分層理論，從語⾔學訊息層和外延圖像層分析澳⾨物質⽂化遺產和非物質⽂化遺產在電影《⼤辮⼦的誘惑》中的體現，進⽽探討這些澳⾨⽂化遺產符號在影⽚中的含蓄意指功能。 二、圖像分層理論與電影視覺符號的關係 1957 年《神話學》（Mythologies）、1964 年《圖像的修辭》（Rhetoric of the 1 張經武，《電影的「城市性」》，（北京：中國社會科學出版社，2019），260。其所說的「電影文化遺產」分為電影物質文化遺產和電影非物質文化遺產。電影物質文化遺產包括「具有歷史、藝術、科學、檔案、學術或文化再利用價值的電影文化物質實體，主要包括電影建築（電影廠、電影院、電影名人故居、電影城等）、電影設備、電影拷貝、電影道具、電影服裝、電影劇本、電影海報、電影書刊、電影明星遺物、後電影產品等」。電影非物質文化遺產是指「各種以非物質形態存在電影拍攝、表演、製作、傳播、修復等方面的特殊技藝、儀式、風俗、節慶等精神文化形式」。
李亞青 64 Image）和 1965年《符號學原理》（Elements of Semiology）這三部理論著作，奠定了羅蘭•巴特在結構主義符號學領域的先驅地位。在索緒爾（Ferdinand de Saussure）語⾔符號學的基礎上，巴特將符號學理論應⽤於視覺傳播領域，對攝影、電影、廣告等視覺符號進⾏研究並提出了著名的「圖像分層」理論。索緒爾認為語⾔符號具有能指和所指功能，能指（signifier）是事物的外在表現形式，所指（signified）是與事物相關的概念，兩者相互交織從⽽產⽣意指作⽤。2巴特認為視覺符號和語⾔符號⼀樣具有能指和所指功能，能指是視覺符號的表達⾯，所指是其內容⾯︔3能指符號與所指符號共同作⽤，實現含蓄意指或內涵表達的功能，內涵表達過程充滿⽂化象徵意義和意識形態性。在《圖像的修辭》⼀⽂中，巴特通過對 Panzani廣告圖像的分析提出「圖像分層」理論，即⼀個圖像包含三個層次的訊息：語⾔學訊息層（the linguistic message）、外延圖像層（the denoted image）和內涵圖像層（the connoted image）。 「語⾔學訊息層」指的是圖像附帶的⽂字，包括標題、附加新聞稿、漫畫對話框、解說詞、電影台詞和旁⽩等⽂字語⾔信息。巴特認為「所有圖像都是多義的，在圖像的能指背後，有⼀個浮動鏈的所指，觀眾可以選擇⼀些⽽忽略其他（所指）」。4因此，圖像的能指和所指關係並不穩定，要避免圖像所指的多義性就需要語⾔學訊息層的介入，對圖像進⾏「錨定（Anchorage）」和「轉介（Relay）」。錨定是語⾔學訊息層針對圖像的多義性發揮其固定所指內容和明確概念的功能，通過對圖像進⾏解釋和引導，從⽽限制內涵意義的過度擴散。轉介是語⾔學訊息層對圖像訊息的補充說明，如漫畫中⼈物的對話框。圖像層訊息可以分為兩類，第⼀類是未編碼圖像信息（non-coded iconic image），也稱為「直接意指」或「外延圖像」。外延圖像以圖像的初始狀態呈現出來，是未經編碼且連續⾃然的訊息，是外在物體在圖像中的複製，也是承載內涵信息的載體。外延圖像的能指和所指關係不是任意的，解讀這層訊息需要觀眾的常識性知識和基本知覺能⼒。圖像層訊息的第⼆類是 2 弗迪南•德•索緒爾（Ferdinand de Saussure）著，高名凱譯，《普通語言學教程》，（北京：外語教學與研究出版社，2001），100-102。 3 羅蘭•巴特（Roland Barthes）著，李幼蒸譯，《符號學原理（羅蘭•巴特文集）》，（北京：中國人民大學出版社，2008），28-33。 4 Roland Barthes, Rhetoric of the Image, Sel. and Trans. Stephen Heath (New York: Hill and Wang, 1977), 152-163.
李亞青 66 刻不離⼿的刻⼑、線繩繫住且掛在脖⼦上的⽼花鏡，以及頭上的⽩髮、臉上的皺紋、⼿上的⽼繭等這些外延圖像層訊息無不在刻畫著⽊雕匠⼈的⼯匠精神與澳⾨城市的精神⽂化。 電影中包含的⼈物性格、隱喻象徵、歷史⽂化、意識形態層⾯的信息都屬於內涵圖像層範疇，並通過語⾔學訊息層和外延圖像層得以體現。7電影的內涵圖像層訊息具有意識形態功能且呈現社會歷史和⽂化，電影內涵所指的表達有賴於語⾔、圖像、聲⾳、⾏動等內涵能指符號的協作。正是通過語⾔學訊息層和外延圖像層的配合，電影《又⾒蓮花》對於澳⾨神像⽊雕這項非遺⽂化的刻畫才能由表及裡，⽣動形象，表達出澳⾨⼈对梦想和初衷的堅持、對傳統⽂化的繼承與發展、對家鄉澳⾨的熱愛以及兩岸⼈民⾎濃於⽔的深厚感情等深層主題。 三、澳門文化遺產在《大辮子的誘惑》中語言學訊息層的體現 電影《⼤辮⼦的誘惑》中，澳⾨華洋社群在語⾔習慣、⽣活環境、宗教信仰、節慶儀式等⽅⾯的不同，通過⼈物對⽩、旁⽩敘述、他⼈轉述等語⾔訊息層內容得到體現。語⾔的錨定與轉介功能使得電影劇情得以推進和⼈物形象得到塑造。 （㆒）錨定 澳⾨⽂化多元的⼀個重要表現是語⾔的多樣，幾百年華洋共處的社會形成了澳⾨今⽇三⽂四語的語⾔格局。「三⽂」指的是中⽂、葡⽂和英⽂，「四語」則是粵語、葡語、普通話和英語。為了展現這種語⾔格局，電影《⼤辮⼦的誘惑》在台詞環節就做了錨定安排：雀仔園街區的⼈說漢語，葡⼈社區的⼈說葡語︔男主阿托欣多精通葡語，英語流利，漢語不俗，整部影⽚在葡漢兩種語⾔之間切換︔澳⾨非物質⽂化遺產符號之⼀的澳⾨⼟⽣葡語在影⽚的語⾔學訊息層也有所體現。⼟⽣葡語是定居澳⾨的⼟⽣葡⼈在澳⾨四百多年間形成的⼀個獨特的語⾔體系，現在幾乎絕 7 Feyrouz Bouzida, “The Semiology Analysis in Media Studies: Roland Barthes Approach,” Paper presented at 2014 International Conference on Social Sciences and Humanities, Istanbul, Turkey, 1001-1007.
蘆薈水提物與吉非替尼聯合用藥對 H1975細胞生長和遷移的抑制作用及其機制研究 81 The Combination of Aloe vera and Gefitinib Effectively Suppresses Growth and Migration of Gefitinib-resistant H1975 Lung Cancer Cells and Inhibits Wnt/β-catenin Signaling Yu, Dian1, Yin, Tianpeng1, Li, Gang2, Wang, Caiyun1, Bai, Li-Ping1, Zhu, Guoyuan1, Zhang, Wei1 1 State Key Laboratory of Quality Research in Chinese Medicines, Guangdong-Hong Kong-Macao Joint Laboratory of Respiratory Infectious Disease, Macau Institute for Applied Research in Medicine and Health, Macau University of Science and Technology 2 Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University Abstract: Lung cancer treatment has been revolutionized by the discovery of somatic mutations in epidermal growth factor receptors (EGFRs) and the development of EGFR tyrosine kinase inhibitors (TKIs). However, in most cases, non-small cell lung cancer (NSCLC) patients who are treated with gefitinib eventually develop resistance. The purpose of this study was to investigate the effect of Aloe vera (L.) Burm. f. (A. vera) extract combined with gefitinib on gefitinib-resistant NSCLC cell lines. The cytotoxicity assay showed that there was a minimal inhibitory effect of A. vera on cell proliferation in A549, PC-9, and H1975 cells, while the combined use of A. vera and gefitinib resulted in a significant inhibitory effect on cell growth in a concentration-dependent manner. Importantly, compared to other cell lines, H1975 proliferation was inhibited by the combined treatment more effectively. The IC50 values at 24 h decreased from 37.92 ± 1.19 to 20.09 ± 1.03 μM for H1975 cells. As a result of the combined treatment of A. vera and gefitinib, the migration ability of H1975 cells was decreased compared with that of the gefitinib group. Moreover, A. vera significantly increased the gefitinib-induced apoptosis in H1975 cells and the combination treatment induced G2/M phase arrest in H1975 cells. Furthermore, the Wnt/β-catenin pathway was inhibited in H1975 cells of the high-concentration combination group, suggesting that A. vera is a potential anticancer therapeutic adjuvant for gefitinib-resistant NSCLC with the EGFR-T790M mutation. Keywords: Aloe vera; gefitinib; gefitinib-resistant; EGFR T790M; β-catenin
余典、尹田鵬、李剛、王彩雲、白麗萍、朱國元、張偉 82 1. Introduction Globally, lung cancer remains the leading cause of cancer-related death with high mortality and a poor prognosis.1 It remains unsatisfactory to treat lung cancer using conventional chemotherapy.2 Epidermal growth factor receptor (EGFR) mutations and EGFR tyrosine kinase inhibitors (TKIs) have revolutionized lung cancer therapy. It is the first-line treatment for non-small cell lung cancer (NSCLC) patients with EGFR mutations, which greatly improves their outcomes. However, due to continuous tumor drug selection pressure, in most cases, EGFR-TKIs will develop acquired resistance, resulting in a limited treatment effect.3 There are two types of resistance observed in clinical trials: primary and acquired. Patients with primary resistance typically had mutations downstream of the EGFR signaling pathway, such as KRAS mutations.4 The acquired resistance mainly occurs as a result of acquiring a single recurrent missense mutation within exon 20, the T790M mutation. Gefitinib and kinase domains can be blocked by this mutation, potentially triggering resistance, which has been identified as the major mechanism of resistance to gefitinib and erlotinib.5 H1975 cells possess the L858R mutation along with a secondary mutation at T790M, leading to complete resistance to first-generation EGFR-TKIs. Afatinib, a second-generation EGFR TKI, was initially promising against T790M-mutant cells, but ultimately showed no additional 1 Rebecca L Siegel, Kimberly D Miller, et al, “Cancer statistics, 2020,” A Cancer Journal for Clinicians 70.1 (CA: 2020): 7-30. 2 Mark A Socinski, Tracey Evans, et al, “Hensing et al Treatment of Stage IV Non-small Cell Lung Cancer Diagnosis and Management of Lung Cancer, 3rd ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines,” The Journal of Circulation, Respiration and Related Systems (Chest: 2013). 3 Susumu Kobayashi, Titus J Boggon, et al, “EGFR Mutation and Resistance of Non-Small-Cell Lung Cancer to Gefitinib,” The New England Journal of Medicine 24, 352.8 (2005): 786-92. 4 Lihua Huang, Liwu Fu, “Mechanisms of Resistance to EGFR Tyrosine Kinase Inhibitors,” Acta Pharmaceutica Sinica B 5 (2015): 390-401. 5 Kang-Yi Su, Hsuan-Yu Chen, et al, “Pretreatment Epidermal Growth Factor Receptor (EGFR) T790M Mutation Predicts Shorter EGFR Tyrosine Kinase Inhibitor Response Duration in Patients with Non-small-cell Lung Cancer,” Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology (2012).
蘆薈水提物與吉非替尼聯合用藥對 H1975細胞生長和遷移的抑制作用及其機制研究 83 benefits over first-generation drugs.6 The third-generation EGFR inhibitor AZD9291 is more effective at preventing tumor growth by circumventing drug resistance.7 However, the high cost of the drug and its limited availability in a few countries constitute a major hurdle in clinical practice. Hence, exploring effective and feasible treatment strategies to prevent or delay the development of resistance to first generation EGFR-TKIs is still of significance for improving the prognosis of patients with NSCLC.8 More recent studies have concentrated on the combinatory usage of EGFR-TKIs for EGFR-mutant NSCLC treatment, which can improve the efficacy of EGFR‐TKIs in EGFR‐positive patients, delaying the occurrence of drug resistance.9 Accordingly, several clinical trials have attempted to investigate the effects of gefitinib doublet regimens by combining chemotherapeutic agents with TKIs. Nevertheless, most of these trials are limited by negative results.10 Clinical studies have shown that gefitinib in combination with paclitaxel and carboplatin can improve the OS (overall survival), and the combination with pemetrexed and carboplatin chemotherapy can promote survival in patients.11 However, the simultaneous drug toxicity and high cost often compromise the 6 Yi-Long Wu, Caicun Zhou, et al, “Afatinib Versus Cisplatin Plus Gemcitabine for First-line Treatment of Asian Patients with Advanced Non-small-cell Lung Cancer Harbouring EGFR Mutations (LUX-Lung 6): An Open-Label, Randomised Phase 3 Trial,” The Lancet Oncology 15 (2014): 213-222; Youngwook Kim, Jeonghun Ko, et al, “The EGFR T790M Mutation in Acquired Resistance to an Irreversible Second-Generation EGFR Inhibitor,” Journal of Thoracic Oncology 5 (2010): S421-S421. 7 Chee-Seng Tan, David Gilligan, et al, “Treatment Approaches for EGFR-inhibitor-resistant Patients with Non-small-cell Lung Cancer,” The Lancet Oncology 16 (2015): e447-459; Darren A E Cross, Susan E Ashton, et al, “AZD9291, An Irreversible EGFR TKI, Overcomes T790M-Mediated Resistance to EGFR Inhibitors in Lung Cancer,” Cancer Discovery 4 (2014): 1046-1061. 8 Geoffrey R Oxnard, Maria E Arcila, et al, “New Strategies in Overcoming Acquired Resistance to Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors in Lung Cancer,” Clinical Cancer Research 17 (2011): 5530-5537. 9 Curtis R Chong, Pasi A Janne, “The Quest to Overcome Resistance to EGFR-targeted Therapies in Cancer,” Nature Medicine 19 (2013): 1389-1400. 10 Mariona Riudavets, Marie Naigeon, et al, “Gefitinib Plus Tremelimumab Combination in Refractory Non-small-cell Lung Cancer Patients Harbouring EGFR Mutations: the GEFTREM Phase I Trial,” Lung Cancer 166 (2022): 255-264. 11 Herbst R S, Giaccone G, et al, “Gefitinib in Combination with Paclitaxel and Carboplatin in Advanced Non-small-cell Lung Cancer: A Phase III Trial-INTACT 2,” Journal of Clinical Oncology 22 (2004): 785-794; Hosomi Y, Morita S, et al, “Gefitinib Alone Versus Gefitinib Plus Chemotherapy for Non-Small-Cell
余典、尹田鵬、李剛、王彩雲、白麗萍、朱國元、張偉 84 benefits of combination therapies.12 Thus, it is a major clinical challenge to combine safe and cost-effective therapeutic modalities. During the last decade, various types of cancer have been frequently treated with naturally occurring compounds due to their anticancer efficacy and safety. Several preclinical studies have shown that a combination of natural compounds and conventional chemotherapy may be beneficial, which can enhance the anticancer therapeutic efficacy and reduce the toxicity, including curcumin, ursolic acid, and capilliposide from Lysimachia capillipes.13 Therefore, researching natural products with minimal side effects might be a promising alternative strategy to prevent TKIs resistance or improve the prognosis of resistant patients. Aloe vera (L.) Burm. f. is a species of medicinal plant belonging to the genus Aloe, which is widely used in the pharmaceutical, cosmetic, and food industries.14 As a laxative, it is included in the Chinese Pharmacopeia for the treatment of constipation. In addition to its antitumor, antioxidant and anti-inflammatory properties, this species serves as a therapeutic agent in health management.15 Furthermore, it provides a complementary Lung Cancer With Mutated Epidermal Growth Factor Receptor: NEJ009 Study,” Journal of Clinical Oncology 38 (2020): 115-+. 12 Noronha V, Patil V M, et al, “Gefitinib Versus Gefitinib Plus Pemetrexed and Carboplatin Chemotherapy in EGFR-Mutated Lung Cancer,” Journal of Clinical Oncology 38 (2020): 124; Cheng Y, Murakami H, et al, “Randomized Phase II Trial of Gefitinib With and Without Pemetrexed as First-Line Therapy in Patients With Advanced Nonsquamous Non-Small-Cell Lung Cancer With Activating Epidermal Growth Factor Receptor Mutations,” Journal of Clinical Oncology 34 (2016): 3258. 13 Chen P, Huang H P, et al, “Curcumin Overcome Primary Gefitinib Resistance in Non-small-cell Lung Cancer Cells through inducing Autophagy-related Cell Death,” Journal of Experimental & Clinical Cancer Research 38 (2019); Yang K Y, Chen Y, et al, “Ursolic Acid Promotes Apoptosis and Mediates Transcriptional Suppression of CT45A2 Gene Expression in Non-small-cell Lung Carcinoma Harbouring EGFR T790M Mutations,” British Journal of Pharmacology 176 (2019): 4609-4624; Zhang S R, Xu Y S, et al, “Capilliposide from Lysimachia Capillipes Inhibits AKT Activation and Rrestores Gefitinib Sensitivity in Human Non-small Cell Lung Cancer Cells with Acquired Gefitinib Resistance,” Acta Pharmacologica Sinica 38 (2017): 100-109. 14 Sonawane S K, Gokhale J S, et al, “A Comprehensive Overview of Functional and Rheological Properties of Aloe Vera and its Application in Foods,” Journal of Food Science and Technology-Mysore 58 (2021): 1217-1226. 15 Yin T P, Yu Y, et al, “13C-NMR-based MixONat Strategy Coupled with 2D NMR for Rapid Dereplication and Identification of New Secondary Metabolites from Aloe Vera,” Journal of Food Composition and Analysis 115 (2023); Nalimu F, Oloro J, et al, “ Review on the Phytochemistry and Toxicological Profiles
蘆薈水提物與吉非替尼聯合用藥對 H1975細胞生長和遷移的抑制作用及其機制研究 85 alternative way to prevent and treat a variety of diseases. Additionally, A. vera selectively induces apoptosis in human cancer cells, with no significant effect on normal cells, reflecting its antitumor and cytotoxic potential.16 Thus, with its numerous health benefits, A. vera makes it an excellent adjuvant for drug combination therapy. A clinical trial has shown that the combination of A. vera and chemotherapy drugs can enhance the anticancer therapeutic efficacy in terms of both tumor regression rate and survival time in metastatic cancer patients.17 Experimental studies have also revealed that A. vera can reduce cell viability of human breast cancer and cervical cancer cells through apoptosis induction.18 However, the efficacy of A. vera on TKI-resistant lung cancer cells and its molecular mechanisms of action remain elusive. Consequently, we hypothesized that the combination of A. vera and gefitinib could restrict the growth of primary TKI- resistant NSCLC cells. To address these issues, this study investigated the efficacy of the combination of A. vera and gefitinib, a first-generation EGFR-TKI, on H1975 cells, and the potential molecular mechanisms. 2. Materials and methods 2.1. A. vera preparation A. vera was purchased from Yifang Pharmaceutical Co., Ltd. (Guangzhou, China), which were dried exudate of A. vera. Then, it was extracted ultrasonically in water at 80°C for 30 min before the extract was filtered. After that, the extraction solution was stored at -20°C until further use. In this study, an LC-MS/MS assay was used in the quality control of A. vera extract. of Aloe Vera and Aloe Ferox,” Future Journal of Pharmaceutical Sciences 7 (2021). 16 Radha M H, Laxmipriya N P, “Evaluation of Biological Properties and Clinical Effectiveness of Aloevera: Asystematic Review,” Journal of Traditional & Complementary Medicine 5 (2015): 21-26. 17 Lissoni P, Rovelli F, et al, “A Randomized Study of Chemotherapy Versus Biochemotherapy with Chemotherapy Plus Aloe Arborescens in Patients with Metastatic Cancer,” Vivo 23 (2009): 171-175. 18 Sanchez M, Gonzalez-Burgos E, et al, “Pharmacological Update Properties of Aloe Vera and its Major Active Constituents,” Molecules 25 (2020).
余典、尹田鵬、李剛、王彩雲、白麗萍、朱國元、張偉 86 By comparing the reference compounds, Aloin A, Aloin B, Aloesin, and Aloesin were identified according to their retention time and fragmentation pattern. Aloin A, Aloin B, Aloenin, and Aloesin were further quantified in Aloe as marker substances. The contents of Aloin A, Aloin B, Aloenin, and Aloesin were 1249.0, 1080.0, 23.8, and 4.3 µg/g, respectively. The data are detailed in the supplemental material (Supplemental Material, Supplemental Figure 1). 2.2. Cell lines and cell culture A549 (wild-type EGFR gene), PC-9 (EGFR exon 19 deletion), H1975 (EGFR exon 21 L858R and exon 20 T790M), and BEAS-2B (normal bronchial epithelial cell line) cells were purchased from ATCC (American Type Culture Collection, Manassas, VA, USA). BEAS-2B cells were maintained in Dulbecco’s modified Eagle’s medium (DMEM), and A549, PC-9, and H1975 cells were routinely cultured in complete RPMI-1640 medium supplemented with 10% fetal bovine serum (FBS). Cells were maintained in a 37 °C humidified incubator with a 5% CO2 atmosphere. 2.3. Sulforhodamine B assay for cytotoxicity screening Cytotoxicity assays were performed according to the previously described sulforhodamine B (SRB) assay.19 A total of 5 × 103 cells per well were seeded in a 96-well plate for 24 h and separately treated with various concentrations of A. vera and gefitinib for 24 h or 48 h. For the combination treatment, cells were incubated with A. vera extract at the indicated concentrations for 24 h and then washed with PBS before gefitinib was added for another 24 h or 48 h. Within 24 h of polysulfide exposure, HBSS was replaced by complete cell growth medium, and SRB assays were performed. Before fixation, the cells were rinsed with HBSS. A solution of 10% ice-cold trichloroacetic acid 19 Balko J M, Jones B R, et al, “Combined MEK and EGFR Inhibition Demonstrates Synergistic Activity in EGFR-dependent NSCLC,” Cancer Biology & Therapy 8 (2009): 522-530.
蘆薈水提物與吉非替尼聯合用藥對 H1975細胞生長和遷移的抑制作用及其機制研究 87 was added to each well, and then the cells were incubated for an hour at 4°C. Each well was incubated for 15 minutes at room temperature with 50 microliters of SRB stain (0.4% in 1% acetic acid). For each well, 1% acetic acid was rinsing four times and 10 mM Tris base solution (pH 10.5) was added, and then plates were shaken for 5 min to solubilize the protein-bound dye. An absorbance measurement of 570 nm was conducted on a plate reader (BioTek). A paired t-test was performed using Prism 8 software (GraphPad). 2.4. Scratch wound healing assay H1975 cells were plated into 6-well plates at a density of 3×105 cells per well and incubated overnight. The confluent monolayer was scratched with the tip of a 200 μL sterile pipette when the cells were approximately 70% confluent. The detached cells were gently washed off twice, and the medium was replaced with 1% FBS complete medium. Cell monolayers were photographed under an inverted microscope after the exfoliated cells were washed away with PBS. The gap distance was quantitatively evaluated using ImageJ software. 2.5. Apoptosis assay Cells were treated with the indicated concentrations of gefitinib, A. vera, or both for 24 h and centrifuged and collected after trypsin digestion. Apoptotic cells were identified using the FITC Annexin V Apoptosis Kit (BD Biosciences). Cells were gently resuspended in 200 μL binding buffer. Then, 5 μL Annexin V‐FITC and 5 μL PI stains were added and incubated for 15 minutes in the dark. Apoptotic cells were detected using flow cytometry (BD Biosciences, CA, USA). Cell apoptosis rate was calculated with follows: cell apoptosis rate (%) = (early apoptotic cells + advanced apoptotic cells)/total cell number × 100%.
余典、尹田鵬、李剛、王彩雲、白麗萍、朱國元、張偉 88 2.6. Cell cycle analysis Cell cycle analysis was performed as previously described. In brief, cells were seeded at 3×105 cells/well in 6-well culture plates in duplicate and incubated with the indicated concentrations of gefitinib, A. vera or combination for 24 h. After harvesting and centrifuging the cells, they were suspended in PBS and fixed with 70% (v/v) cold ethanol solution overnight at 4°C. Cells were collected by centrifugation, resuspended in PBS, and incubated with 10 mg/mL RNase A (Sigma‒Aldrich) and 5 mg/mL propidium iodide (Sigma‒Aldrich) for 30 min in the dark at room temperature. Then, cells were analyzed on a BD LSRII flow cytometer (BD Biosciences). Finally, the percentages of cells in different phases (G0/G1, S and G2/M) were calculated using Modfit software (Verity Software House, USA). 2.7. Western blot analysis Cells were plated in 6-well plates and treated as mentioned in the above section. Then, each sample was lysed with RIPA buffer and quantified with Bradford reagent (Bio-Rad Laboratory, Hercules, CA, USA). Cell lysates were mixed with 5×SDS loading buffer and denatured at 100°C for 10 min. Protein lysates (30 μg) were subjected to 10% SDS‒PAGE and blotted onto nitrocellulose. Blots were blocked using 5% BSA and incubated overnight with primary antibodies at 4°C, followed by incubation with HRP conjugated secondary antibodies for 1 h. Blots were visualized on Amersham hyperfilm ECL or by AI800 Amersham Imager chemiluminescence. Bands were analyzed by densitometry using ImageJ software. 2.8. Statistical analysis All the data were obtained from at least three independent experiments in a parallel manner and are presented as the mean ± standard deviation (SD). ANOVA was used to
蘆薈水提物與吉非替尼聯合用藥對 H1975細胞生長和遷移的抑制作用及其機制研究 89 analyze the statistical significance of any difference among different groups, while Student’s t-test was used to evaluate the comparison between two groups. The level of significance is defined as 95% (p < 0.05) while p < 0.01 means very significant. 3. Results 3.1. Combination treatment with A. vera and gefitinib inhibits NSCLC cell growth First, to evaluate the inhibitory efficacy of gefitinib or A. vera, cell proliferation was assessed in three human NSCLC cell lines. Among these cell lines, A549 cells have wild-type EGFR, PC-9 cells express the EGFR exon 19 deletion (19Del), and H1975 cells harbor the EGFR L858R/T790M mutation. Cells were treated with different concentrations of gefitinib (0-50.0 µM) for 24 h. The results showed that the 50% inhibitory concentration (IC50) values of A549 and H1975 cell lines ranged from near 17 to 27 μM, suggesting that these cells are relatively resistant to gefitinib treatment (Table 1). In addition, after treating cells with different concentrations of A. vera (0-300.0 µg/mL) for 24 h, the results showed that A. vera ≤ 200.0 µg/mL had no obvious cytotoxic effect on human normal lung epithelial cells and NSCLC cells, and more than 90% of cells survived (Figure 1a). To assess the combination effects of A. vera and gefitinib, nontoxic doses of A. vera (200.0 µg/mL) were selected to combine with various doses of gefitinib. Compared to the gefitinib group, a significant loss of cell viability was observed after the combination treatment. A. vera increased the inhibitory efficacy of gefitinib with decreases in the IC50 values at 48 h from 8.45 ± 0.88 to 4.59 ± 0.96 μM for PC-9 cells, 17.52 ± 0.47 to 7.03 ± 0.53 μM for H1975 cells, and 26.25 ± 0.48 to 17.62 ± 0.65 μM for A549 cells (Table 1). Of note, the combined treatment inhibited H1975 cell proliferation more effectively than other cell lines, and the IC50 values at 24 h decreased from 37.92 ± 1.19 to 20.09 ± 1.03 μM for H1975 (Figure 1b and Table 1), confirming that A. vera could enhance the
余典、尹田鵬、李剛、王彩雲、白麗萍、朱國元、張偉 90 inhibitory efficacy of gefitinib in gefitinib-resistant NSCLC cells. Hence, to further explore the combination efficacy, H1975 cells were treated with indicated 10 and 20 μM gefitinib for 24 h in the following experiments, selected based on the IC50 concentration of gefitinib (Table 1). (a) (b) Figure 1. Cytotoxic effects of gefitinib and A. vera on NSCLC cells: (a) Cells were incubated with various doses of A. vera for 24 h and cell viability was analyzed using an SRB assay; (b) H1975 cells were treated with A. vera (200 µg/mL) combined with different doses of gefitinib for 24 h. Cell viability was examined by SRB assay and absorbance was read at 570 nm. The error bars represent the standard deviation of three independent measurements. Table 1. Characteristics of NSCLC cell lines used in the study Gefitinib A. vera + Gefitinib Cell lines EGFR IC50 IC50 (μM) (μM) 24 h 48 h 24 h 48 h A549 Wild type N/A 26.25±0.48 N/A 17.62±0.65* PC-9 19Del N/A 8.45±0.88 N/A 4.59±0.96* H1975 L858R/T790 M 37.92±1.19 17.52±0.47 20.09±1.03** 7.03±0.53** (∗ p < 0.05, ∗∗ p < 0.01, compared with the gefitinib group). 0 50 100 150 200 250 300020406080100120A. vera (µg/mL)cell viability（%）BEAS-2BA549PC-9H19750 10 20 30 40 500255075100125Gefitinib(µM)cell viability（%）GefitinibA. vera + Gefitinib
蘆薈水提物與吉非替尼聯合用藥對 H1975細胞生長和遷移的抑制作用及其機制研究 91 3.2. Combination treatment with A. vera and gefitinib decreases the migration ability of H1975 cells To examine the inhibitory effect of A. vera or gefitinib on the migration of H1975 cells, a scratch wound-healing assay was performed in vitro. Cells were treated with 200 μg/mL A. vera alone, 10 or 20 μM gefitinib alone, or a combination treatment for 24 h. Compared to the gefitinib group, exposure to the combination treatment induced a higher percentage of wound closure (Figure 2a and 2b), and the results were presented in a dose-dependent manner. It was indicated that A. vera could enhance the inhibitory efficacy of gefitinib on the migration of H1975 cells. (a)
余典、尹田鵬、李剛、王彩雲、白麗萍、朱國元、張偉 92 (b) Figure 2. A. vera and gefitinib inhibit cell migration in gefitinib-resistant H1975 cells for 24 h. (a) Scratch wound healing assay. (b) Changes in cell motility were assessed by scratch wound healing assay. Error bars indicate the standard deviation of three independent measurements. (∗ p < 0.05, ∗∗ p < 0.01, compared with the Gefitinib group). 3.3. A. vera enhances gefitinib-induced apoptosis in H1975 cells To clarify the mechanism of A. vera, cell apoptosis analysis was evaluated after treatment with 200 μg/mL A. vera, 10 or 20 μM gefitinib, or the combination. As shown in Figure 3a and 3b, a remarkable increase of total apoptosis was detected after treatment with the combination, compared to the gefitinib group (low-concentration group 8.21% vs. 13.42%, p < 0.01; high-concentration group 14.83% vs. 21.78%, p < 0.05). These results revealed that A. vera enhanced the apoptotic response to gefitinib treatment in H1975 cells.
蘆薈水提物與吉非替尼聯合用藥對 H1975細胞生長和遷移的抑制作用及其機制研究 93 (a) (b) Figure 3. A. vera and gefitinib induce the cell apoptosis in gefitinib-resistant H1975 cells for 24h. (a) Representative images of cell apoptosis analysis after the indicated treatment. (b) The graph indicated the average ratio (column) ± SD of cell apoptosis (∗ p < 0.05, ∗∗ p < 0.01, compared with Gefitinib group).
余典、尹田鵬、李剛、王彩雲、白麗萍、朱國元、張偉 94 3.4. Combination of A. vera and gefitinib induced G2/M phase arrest in H1975 cells To investigate the anticancer efficacy of gefitinib on H1975 cells, cell cycle was measured by flow cytometry with propidium iodide (PI) staining. Cells were treated with A. vera, gefitinib or the combination for 24 h. As shown in Figure 4a and 4b, compared to the gefitinib group, the combination group in H1975 cells resulted in a marked decrease in the G0/G1 phase (low-concentration group 68.24% vs. 56.16%, p < 0.05; high-concentration group 60.89% vs. 48.47%, p < 0.05), and a remarkable increase in the G2/M phase (low-concentration group 19.18% vs 27.48%, p < 0.05; high-concentration group 25.38% vs 33.38%, p < 0.05). The results showed that the combination of A. vera and gefitinib induced G2/M phase arrest in H1975 cells, suggesting that A. vera enhanced the effect of gefitinib-induced cell cycle arrest in H1975 cells. (a)
蘆薈水提物與吉非替尼聯合用藥對 H1975細胞生長和遷移的抑制作用及其機制研究 95 (b) Figure 4. A. vera and gefitinib induce the G2/M phase cell cycle arrest in gefitinib-resistant H1975 cells for 24 h. (a) Representative images of cell cycle analysis after the indicated treatment in H1975 cells. (b) The graph demonstrated the average ratio (column) ± SD at different phases. (∗ p < 0.05, compared with Gefitinib group). 3.5. Combination of A. vera and gefitinib inhibits the Wnt/β-catenin signaling in H1975 cells To further understand the mechanism of effect of the combination, the key genes of Wnt/β-catenin signaling were examined by Western blotting experiments. Cells were treated with 200 μg/mL A. vera, 10 or 20 μM gefitinib, or the combination. Figures 5a and 5b showed that the high-concentration (20 μM gefitinib) combination group effectively induced the downregulation of β-catenin signal, compared to gefitinib group (p < 0.01). Simultaneously, the expression level of phospho-EGFR protein was also downregulated after high-concentration combination treatment (p < 0.05). Furthermore, an increase in the level of phospho-GSK3β was observed in H1975 cells after exposure to the combination (p < 0.05). Cyclin D1 was detected, as an important downstream factor of the Wnt/β-catenin signaling, and an obvious decrease was observed in the high-concentration combination group (p < 0.01). It is worth noting that, compared to the low-concentration combination group (10 μM gefitinib), the high-concentration combination group (20 μM gefitinib) was significantly inhibited following exposure to the increasing concentrations of gefitinib. Taken together, these results demonstrated that the
余典、尹田鵬、李剛、王彩雲、白麗萍、朱國元、張偉 96 combination of A. vera and gefitinib could inhibit the Wnt/β-catenin signaling in H1975 cells. (a) (b)
蘆薈水提物與吉非替尼聯合用藥對 H1975細胞生長和遷移的抑制作用及其機制研究 97 Figure 5. Detection of the Wnt/β-catenin pathway in H1975 cells. (a) The levels of Wnt/β-catenin pathway proteins were assessed by Western blotting, and GAPDH was used as a loading control. (b) Relative expression levels of Wnt/β-catenin pathway proteins. (∗ p < 0.05, ∗∗ p < 0.01, compared with the Gefitinib group). 4. Discussion To date, the first-generation EGFR-TKI monotherapy is still the standard of first-line treatment for EGFR-mutated NSCLC, despite the third-generation TKIs being preferred. However, almost all patients who respond well to TKIs eventually develop acquired resistance to them, leading to the progression of their disease. It is imperative that combination therapies continue to be utilized in light of the emergence and presence of drug resistance. In this study, our data demonstrated that the combination of gefitinib and A. vera could enhance the sensibility to gefitinib in H1975 cells. In the presence of A. vera, a reduced IC50 for gefitinib was observed in NSCLC cells expressing both wild-type EGFR and various types of EGFR mutations, suggesting that A. vera might make a wide range of NSCLC cells sensitive to gefitinib treatment. Furthermore, the suppression of cell proliferation and migration confirmed that A. vera could enhance the anticancer effects of gefitinib. Interestingly, despite the same concentration as the combination group, single A. vera treatment showed approximately non-toxic effects to cells, indicating that gefitinib may be the main force while A. vera was the assistant in combination treatment. The molecular causes of first-generation EGFR-TKI resistance are only incompletely understood. EGFR activates several signal transduction pathways involved in cell survival and proliferation. EGFR-mutated cancers may become resistant to gefitinib or erlotinib if the activity of the downstream signaling pathways was maintained. Importantly, the major resistance mechanism is via the secondary mutation in EGFR at position 790 (T790M), which decreases the relative TKI binding to EGFR kinase domain,
余典、尹田鵬、李剛、王彩雲、白麗萍、朱國元、張偉 98 leading to TKI resistance.20 Therefore, developing inhibitors specific to EGFR-T790M or inhibitors of downstream targets of T790M may be a breakthrough point to study the resistance. β-catenin is a key component of Wnt/β-catenin signaling, and is involved in malignant tumors pathogenesis and progression including in lung cancer.21 It was found that NSCLC cell lines carrying EGFR mutations exhibited high levels of β-catenin expression in comparison with wild-type EGFR gene.22 A previous article has reported that a pharmacological inhibition of T790M mutations of EGFR can suppress tumor growth in patients with EGFR-L858R, and a genetic deletion of the β-catenin gene reduces lung tumor formation in transgenic mice with EGFR-L858R-T790M.23 These results suggest that β-catenin is closely related to the resistance induced by T790M mutation in NSCLC. Of note, several preclinical studies have shown that the inhibition of the β-catenin signal enhances the sensitivity to EGFR-TKIs in H1975 cells harboring the T790M mutation, which may influence curative effect of EGFR-TKI therapy through bypassing the EGFR stimulus or its downstream signaling. 24 Hence, there might be potential to prevent or overcome resistance to EGFR-TKIs by regulating β-catenin signaling. Furthermore, it has been mentioned that the combination of β-catenin inhibitors and EGFR-TKIs significantly decreases the phosphorylation of EGFR and inhibits the β- 20 Ariyasu R, Nishikawa S, et al, “High Ratio of T790M to EGFR Activating Mutations Correlate with the Osimertinib Response in Non-small-cell Lung Cancer,” Lung Cancer 117 (2018): 1-6. 21 Anastas J N, Moon R T, “WNT Signalling Pathways as Therapeutic Targets in Cancer,” Nature reviews Cancer (2013). 22 Nakayama S, Sng N, et al, “β-catenin Contributes to Lung Tumor Development induced by EGFR Mutations,” Cancer Research 74 (2014). 23 Togashi Y, Hayashi H, et al, “Inhibition of β-Catenin Enhances the Anticancer Efect of Irreversible EGFR-TKI in EGFR-mutated Non-small-cell Lung Cancer with a T790M Mutation,” Journal of Thoracic Oncology 10 (2015): 93-101. 24 Fang X, Gu P, et al, “β-Catenin Overexpression is Associated with Gefitinib Resistance in Non-small Cell Lung Cancer Cells,” Pulmonary Pharmacology & Therapeutics (2014), 28: 41-48; Casás-Selves M, Kim J, et al, “Tankyrase and the Canonical Wnt Pathway Protect Lung Cancer Cells from EGFR Inhibition,” Cancer Research 72 (2012): 4154-4164.
蘆薈水提物與吉非替尼聯合用藥對 H1975細胞生長和遷移的抑制作用及其機制研究 99 catenin signal in H1975 cells, compared with the use of EGFR-TKIs alone, suggesting that EGFR may interact with β-catenin signal.25 Previous research has demonstrated that A. vera can modulate Wnt/β-catenin pathway with wnt3a ligands in human embryonic kidney HEK293 cells and colorectal cancer cells.26 However, the impacts of A. vera on Wnt/β-catenin pathway in H1975 cells remain unclear. Thus, the efficacy of the combination with gefitinib and A. vera on β-catenin and EGFR protein levels was examined in this study, compared with the use of gefitinib or A. vera treatment alone. The results indicated that inhibition of either β-catenin or EGFR alone had a minimal influence, while the concurrent inhibition of both was obviously effective. It was also demonstrated that there might exist an interaction between EGFR and the β-catenin signal, which was consistent with the literature. In addition, our study detected the expression levels of the key proteins of Wnt/β-catenin signaling and found that the phospho-GSK3β expression and Cyclin D1 expression were also downregulated. Remarkably, a significant decrease in protein levels was observed only in the combination group with high concentrations of the drug, while the low-concentration group had minimal effect, suggesting that the inhibitory effect of A. vera on β-catenin signal was enhanced with increasing gefitinib concentration. It is necessary to increase the concentration or extend the time of administration in further studies. Hence, A. vera could be a potential therapeutic adjuvant for gefitinib-resistant NSCLC with the EGFR-T790M mutation. Recently, a growing number of studies have found that Chinese herbal medicine may 25 Togashi Y, Hayashi H, et al, “Inhibition of β-Catenin Enhances the Anticancer Effect of Irreversible EGFR-TKI in EGFR-mutated Non-small-cell Lung Cancer with a T790M Mutation,” Journal of Thoracic Oncology 10 (2015): 93-101. 26 Peng C, Zhang W J, et al. “Study of the Aqueous extract of Aloe vera and its Two Active Components on the Wnt/β-catenin and Notch Signaling Pathways in Colorectal Cancer Cells,” Journal of Ethnopharmacology 243 (2019): 112092; Chang PA, Wjz A, et al. “Post-transcriptional Regulation Activity through Alternative Splicing involved in the Effects of Aloe Vera on the Wnt/β-catenin and Notch Pathways in Colorectal Cancer cells-ScienceDirect,” Journal of Pharmacological Sciences 143 (2020): 148-155.
余典、尹田鵬、李剛、王彩雲、白麗萍、朱國元、張偉 100 be useful in cancer therapy for its effects on multidrug resistance.27 Herbal medicines are generally inexpensive, plentiful, and show little toxicity or side effects in clinical application.28 Traditional Chinese medicine therapy, as an adjunctive therapy, has been shown to significantly reduce adverse postradiation reactions and improve quality of life in NSCLC. 29 However, these results are based only on in vitro experiments in this research, and further studies are needed to clarify detailed regulatory mechanisms of NSCLC cells in relation to the therapeutic effects of combining a first-generation TKI with A. vera. 5. Conclusion In summary, these results suggested a potential clinical impact of the therapeutic strategy with aresistance. These data showed that A. vera enhanced the anticancer activity of gefitinib by modulating Wnt/β-catenin pathways in H1975 cells, which indicated that A. vera might be a potential anticancer therapeutic adjuvant for NSCLC patients receiving TKI treatment as a first-line therapy. 27 Qi F, Zhao L, et al, “The Advantages of Using Traditional Chinese Medicine as an Adjunctive Therapy in the Whole Course of Cancer Treatment Instead of Only Terminal Stage of Cancer,” Bioscience Trends 9 (2015): 16-34; Li F S, Weng J K, “Demystifying Traditional Herbal Medicine with Modern Approaches,” Nature Plants 3 (2017). 28 Hsiao W L, Liu L, “The Role of Traditional Chinese Herbal Medicines in Cancer Therapy-from TCM Theory to Mechanistic Insights,” Planta Medica 76 (2010): 1118-1131. 29 Zhang X Y, Qiu H, er al, “The Positive Rrole of Traditional Chinese Medicine as an Adjunctive Therapy for Cancer,” Bioscience Trends 15 (2021): 283-298.
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蘆薈水提物與吉非替尼聯合用藥對 H1975細胞生長和遷移的抑制作用及其機制研究 103 [20] Sonawane S K , Gokhale J S, et al, “A Comprehensive Overview of Functional and Rheological Properties of Aloe Vera and its Application in Foods,” Journal of Food Science and Technology-Mysore 58 (2021): 1217-1226. [21] Yin T P, Yu Y, et al, “13C-NMR-based MixONat Strategy Coupled with 2D NMR for Rapid Dereplication and Identification of New Secondary Metabolites from Aloe Vera,” Journal of Food Composition and Analysis 115 (2023). [22] Nalimu F, Oloro J, et al, “Review on the Phytochemistry and Toxicological Profiles of Aloe Vera and Aloe Ferox,” Future Journal of Pharmaceutical Sciences 7 (2021). [23] Radha M H, Laxmipriya N P, “Evaluation of Biological Properties and Clinical Effectiveness of Aloevera: Asystematic Review,” Journal of Traditional & Complementary Medicine 5 (2015): 21-26. [24] Lissoni P, Rovelli F, et al, “A Randomized Study of Chemotherapy Versus Biochemotherapy with Chemotherapy Plus Aloe Arborescens in Patients with Metastatic Cancer,” Vivo 23 (2009): 171-175. [25] Sanchez M, Gonzalez-Burgos E, et al, “Pharmacological Update Properties of Aloe Vera and its Major Active Constituents,” Molecules 25 (2020). [26] Balko J M, Jones B R, et al, “Combined MEK and EGFR Inhibition Demonstrates Synergistic Activity in EGFR-dependent NSCLC,” Cancer Biology & Therapy 8 (2009): 522-530. [27] Ariyasu R, Nishikawa S, et al, “High Ratio of T790M to EGFR Activating Mutations Correlate with the Osimertinib Response in Non-small-cell Lung Cancer,” Lung Cancer 117 (2018): 1-6. [28] Anastas J N, Moon R T, “WNT Signalling Pathways as Therapeutic Targets in Cancer,” Nature reviews Cancer (2013). [29] Nakayama S, Sng N, et al, “β-catenin Contributes to Lung Tumor Development Induced by EGFR Mutations,” Cancer Research 74 (2014). [30] Togashi Y, Hayashi H, et al, “Inhibition of β-Catenin enhances the anticancer effect of irreversible EGFR-TKI in EGFR-mutated Non-small-cell Lung Cancer with a T790M Mutation,” Journal of Thoracic Oncology 10 (2015): 93-101. [31] Fang X, Gu P, et al, “β-Catenin Overexpression is Associated with Gefitinib Resistance in Non-small Cell Lung Cancer Cells,” Pulmonary Pharmacology & Therapeutics 28 (2014): 41-48.
余典、尹田鵬、李剛、王彩雲、白麗萍、朱國元、張偉 104 [32] Casás-Selves M, Kim J, et al, “Tankyrase and the Canonical Wnt Pathway Protect Lung Cancer Cells from EGFR Inhibition,” Cancer Research 72 (2012): 4154-4164. [33] Peng C, Zhang W J, et al. “Study of the Aqueous Extract of Aloe Vera and its Two Active Components on the Wnt/β-catenin and Notch Signaling Pathways in Colorectal Cancer cells,” Journal of Ethnopharmacology 243 (2019): 112092. [34] Chang PA, Wjz A, et al. “Post-transcriptional Regulation Activity through Alternative Splicing involved in the Effects of Aloe Vera on the Wnt/β-catenin and Notch Pathways in Colorectal Cancer Cells-ScienceDirect,” Journal of Pharmacological Sciences 143 (2020): 148-155. [35] Qi F, Zhao L, et al, “The Advantages of Using Traditional Chinese Medicine as an Adjunctive Therapy in the Whole Course of Cancer Treatment Instead of Only Terminal Stage of Cancer,” Bioscience Trends 9 (2015): 16-34. [36] Li F S, Weng J K, “Demystifying Traditional Herbal Medicine with Modern Approaches,” Nature Plants 3 (2017). [37] Hsiao W L, Liu L, “The Role of Traditional Chinese Herbal Medicines in Cancer Therapy - from TCM Theory to Mechanistic Insights,” Planta Medica 76 (2010): 1118-1131. [38] Zhang X Y, Qiu H, er al, “The Positive Role of Traditional Chinese Medicine as an Adjunctive Therapy for Cancer,” Bioscience Trends 15 (2021): 283-298.
蘆薈水提物與吉非替尼聯合用藥對 H1975細胞生長和遷移的抑制作用及其機制研究 105 Author Contributions Dian Yu Conceptualization, Methodology, Software, Writing, Writing - original draft. Tianpeng Yin Conceptualization, Methodology, Formal analysis, Writing, Writing - original draft. Gang Li, Caiyun Wang Visualization, Formal analysis. Dr. Li-Ping Bai, Dr. Guoyuan Zhu Methodology, Investigation. Dr. Wei Zhang Conceptualization, Methodology, Supervision, Writing - review & editing. All authors have read and agreed to the published version of the manuscript. Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Acknowledgements This work was supported by the Science and Technology Development Fund, Macau SAR (File Nos. 0040/2021/AGJ).
世漢學會國際中文教育研究專欄 The Column of the International Society for Chinese Language Teaching 此專欄係教育部中外語言交流合作中心、世界漢語教學學會與《澳門科技大學學報》編輯部合作設立，並由教育部中外語言交流合作中心資助，特此鳴謝。
教育部㆗外語言交流合作㆗心 簡 介 中外語言交流合作中心（簡稱「語合中心」，英文名稱 Center for Language Education and Cooperation，簡稱 CLEC）隸屬於中國教育部，是發展國際中文教育事業的專業公益教育機構，致力於為世界各國民眾學習中文、瞭解中國提供優質的服務，為中外語言交流合作、世界多元文化互學互鑒搭建友好協作的平臺。 語合中心的主要職能為發展國際中文教育與促進中外語言交流合作提供服務，統籌建設國際中文教育資源體系，參與制定國際中文教育相關標準並組織實施；支持國際中文教師、教材、學科等建設和學術研究；組織實施國際中文教師考試、外國人中文水準系列考試，開展相關評估認定；運行漢語橋、新漢學、獎學金等國際中文教育相關項目；開展中外語言交流合作等。
世界漢語教㈻㈻會 簡 介 世界漢語教學學會（簡稱「世漢學會」，英文名稱 The International Society for Chinese Language Teaching）成立於 1987年 8月 14日，是經中華人民共和國民政部登記註冊的國際社會組織和非營利性民間學術團體，主管單位為中華人民共和國教育部，秘書處設在教育部中外語言交流合作中心（北京市西城區德勝門外大街 129號 401）。2011年 10月與聯合國教科文組織建立合作關係，會員遍佈全球 79個國家和地區，主要由世界各地從事漢語教學、研究和推廣的人士及相關機構組成。 學會宗旨是遵守中華人民共和國憲法、法律、法規和國家政策，遵守社會道德風尚；促進國際漢語教學、研究和推廣；加強世界各地漢語教學與研究工作者之間、機構之間的聯繫。 學會理事會為議事決策機構。歷任會長為朱德熙、呂必松、陸儉明、許嘉璐等，現任會長於 2019年 12月當選，為天津師範大學校長鍾英華教授。第十一屆理事會由來自 31 個國家和地區的國際中文教育學術團體、各國高等院校及中文專業院系、著名漢學家、具有較高聲望的學術帶頭人、世漢學會創會會員、永久會員和普通會員等 65位理事（單位）組成。
周思佳、蘇珩驊 112 Establishment of a Quality Assurance System in the Assessment in Higher Education Programmes: A Case from the Chinese language programme at Xi’an Jiaotong-Liverpool University Zhou, Sijia, Su, Henghua1 (Senior Professor, School of Languages, Xi’an Jiaotong- Liverpool University) Abstract: With the development of higher education, the quality assurance system of university-level programs has received increasing attention in recent years. This article introduces the quality assurance system in the assessment of the Chinese language program at Xi’an Jiaotong-Liverpool University, an international joint venture university. It is proposed that establishing internal and external moderation systems for assessment, introducing assessment preparation, and module marking moderation reports will effectively improve the quality of assessment, thereby enhancing higher education institutions’ academic standards. The article concludes with suggestions for enhancing the quality of assessment in higher education institutions in China. Keywords: International joint venture university; Chinese language program; Quality assurance； Assessment
周思佳、蘇珩驊 126 徵引書目 [1] 李梅、趙璐，〈多元共治下中外合作辦學機構的質量保障體系—以西交利物浦⼤學為例〉,《⼤學教育科學》，第2期，2019，114-121。 [2] 史秋衡、陳蕾，《中國特⾊⾼等教育質量評估體系的範式研究》，北京：⾼等教育出版社，2011。 [3] 王章豹，《基於TQM的⾼校教學質量管理模式》，杭州：浙江⼯業⼤學出版社， 2012。 [4] 英國⼤學組織（Universities UK），「Quality and Standards in UK universities: A guide to how the system works」（英國⼤學的質量與標準：系統⼯作指南），https://dera.ioe.ac.uk/26289/1/QualityStandardsGuide.pdf， 瀏覽⽇期為2023年4⽉20⽇。 [5] 英國⾼等教育質量保障署 (QAA)，「Quality Assurance in UK Higher Education: A Guide for International Readers」（英國⾼等教育質量保證：國際讀者指南），2005，https://www.qu.edu.qa/static_file/qu/offices%20and%20departments/VPAA/Academics/accreditation/documents/UK_QA_in_higher_education.pdf ，瀏覽⽇期為2023年4⽉20⽇。 [6] 英國⾼等教育質量保障署 (QAA)，「對英國跨國⾼等教育的評估— 2012 中華⼈民共和國綜述」，2013年，https://www.qaa.ac.uk/docs/qaa/international/tne-china-overview-mandarin.pdf?sfvrsn=60f981_0，瀏覽⽇期為2023年4⽉20⽇。 [7] 西交利物浦⼤學，「Code of Practice on Assessment」（評估實踐準則），內部⽂件。 [8] 西交利物浦⼤學，「Moderation Workflow」（評估審閱流程），內部⽂件。 [9] 西交利物浦⼤學，「關於我們」，https://www.xjtlu.edu.cn/zh/about，瀏覽⽇期為2023年4⽉20⽇。 [10] 趙彥志、孟韜，《中外合作辦學質量保障體系研究》，⼤連：東北財經⼤學出版社， 2015。
段然、魏慧萍 130 The Exploration of Language Transfer in the Perspective of Third Language Acquisition: An Investigation of Chinese Word Order Acquisition as a Third Language and Related Transfer Phenomena among Thai Learners Duan, Ran1; Wei, Hui Ping （1. PhD Candidate, Faculty of University International College, Macau University of Science and Technology） Abstract: As globalization continues to develop, second language learning and multilingualism have become increasingly common. As a result, the study of third language acquisition has gained attention. This study explores the process of word order acquisition and language transfer among Thai L1, English L2, and Chinese L3 learners, using Chinese word order acquisition as a starting point. Based on theoretical findings from previous studies on third language acquisition, the study found that Thai learners made different transfer choices at different levels and in linguistic elements, based on their perception of language distance. These choices showed non-unitary sources and directions of transfer in terms of language order and vocabulary. The mechanism of their choices depended on reducing cognitive difficulties in third language acquisition and enhancing learning effectiveness. At the level of Chinese word order acquisition, L1 (Thai) transfer was dominant, and learners showed an overall resistance to L2 (English) transfer. However, L2 (English) did have an effect on the acquisition of L3 (Chinese), mainly at the lexical level. Additionally, learners' language learning experiences and methods accumulated in L2 (English) or L3 (Chinese) facilitated the development of their meta-linguistic awareness, which had a positive effect on the development of multilingual competence. Keywords: Chinese as a Third Language; Acquisition; Thai learners; Transfer
第三語言習得視角下的語言遷移探索—基於泰國學習者漢語作為第三語言語序習得及相關遷移現象的調查 131 一、引言 語⾔遷移⼀直是語⾔習得研究的重點內容。早在上世紀 50 年代，Lado 在對比分析假說中就提出，第⼆語⾔習得過程中存在遷移問題。1Odlin 將遷移定義為「⽬的語與之前任何已習得（或未完全習得）的語⾔之間的共性和差異所造成的影響。」2由此，母語與⽬的語之間的共性和差異⽽產⽣的正遷移或負遷移成為由此，母語與⽬的語之間的共性和差異⽽產⽣的正遷移或負遷移成為影響第⼆語⾔習得結果的主要解釋。伴隨著全球化社會發展，多語現象和多語教育逐漸普及，第三語⾔習得（third language acquisition）研究受到重視。學者們逐漸意識到，第三語⾔習得要比第⼆語⾔習得更為複雜。學界進⼀步將第三語⾔（L3）定義為學習者在第⼀種語⾔（L1）3和已經掌握的第⼆種語⾔（L2）之外，正在學習的⼀種或多種語⾔。4跨語⾔影響（crosslinguistic influence）成為三語習得重要的區別性特徵。5Leung在研究多語者的語⾔習得時，進⼀步補充中介語理論，將 L2系統視為 L3習得者中介語的⼀部分，三語習得者在第⼆語⾔中介語系統的基礎上構建第三語⾔的中介語系統，兩種外語在語⾔學習動態過程中相互交織，相互影響。6 1 劉珣，《對外漢語教育學引論》，（北京：北京語言大學出版社，2000），168。 2 Odlin Terence, Language transfer: Cross-linguistic influence in language learning, (Cambridge: Cambridge University Press, 1989), 27. 3 學習者習得的第一種語言即第一語言，一般指一個人出生以後首先接觸並獲得的語言，與之相關的概念是「母語」。大多數情況下，第一語言即母語。但在有些情況中，第一語言並不等於就是母語，例如在歐美地區生長的華裔青少年。對此我們不做過多探討，本文所涉及的文獻中以及研究對象的第一語言都即學習者的母語。 4 Jessner Ulrike, Linguistic Awareness in Multilinguals: English as a Third Language, (Edinburgh: Edinburgh University Press, 2006), 35; De Angelis Gessica, Third or Additional Language Acquisition, (Clevedon: Multilingual Matters Ltd, 2007), 30-39. 5 Cenoz Jasone, Hufeisen Britta, Jessner Ulrike, Cross-linguistic Influence in Third Language Acquisition: Psycholinguistic Perspectives, (Clevedon: Multilingual Matters, 2001), 29. 6 Leung Yan-kit Ingrid, “Failed Features vs. Full Transfer Full Access in the Acquisition of Third Language: Evidence from Tense and Agreement,” In Proceedings of the 6th Generative Approaches to Second Language Acquisition Conference GASLA 2002: L2 Links, eds. Juana M. Liceras, Helmut Zobl and Helen Goodluck. (Sommerville MA: Cascadilla Proceedings Project, 2003a), 199–207; Leung Yan-kit Ingrid, “Functional Categories in Second and Third Language Acquisition: A Cross-linguistic Study of the Acquisition of English and French by Chinese and Vietnamese Speakers,” Chapter One (PhD diss., McGill University, 2003b), 2-13, https://www.proquest.com/dissertations-theses/functional-categories-second-
段然、魏慧萍 132 顯然，在三語習得中，學習者的語⾔系統存在三個相互影響的⼦系統：L1、L2和 L3。語⾔間的相互影響可能包括：（1）L1與 L2之間（L1↔L2）︔（2）L1與L3之間（L1↔L3）︔（3）L2與 L3之間（L2↔L3）。7對此，⼤量研究已經證實，學習者在習得第⼆⾨語⾔之後的其他語⾔時，存在⼀種「⼆語地位（L2 status）」的影響，表現為 L2對⽬的語極⼤的遷移影響，有時甚至會超越母語。8⽽另⼀部分⽣成語法學家則從句法遷移入⼿，先後提出累積強化模式（Cumulative Enhancement Model），⼿術⼑模型（The Scalpel Model），語⾔臨近模型（The Linguistic Proximity Model）、語⾔類型優選模型（The Typological Primacy Model）等遷移模型，9基本上都證實了母語並非遷移的唯⼀來源，母語之後學習的其他語⾔在⽬的語習得中確實存在影響。10但其中，⼿術⼑模型和語⾔臨近模型認為，三語習得涉及的是語⾔逐個特徵的掌握，學習者從已習得語⾔中選擇與⽬的語相似的某⼀特性進⾏遷移。當三語輸入中的某⼀語⾔特徵與某⼀已習得語⾔的特徵相近時，就會發⽣遷移。⽽語⾔類型優選模型則認為，所有已習得的語⾔原則上都能進入三語習得的初始狀態，但是為了避免習得冗餘，降低認知成本，學習者內部的語⾔習得裝置會對語⾔間的結構相似性做出整體判斷，進⽽完全遷移距離更近的語⾔，⽽並不會 third-language/docview/305243865/se-2. 7 Puig-Mayenco Eloi, Alonso Jorge Gonzalez, Rothman Jason, “A Systematic Review of Transfer Studies in Third Language Acquisition,” Second language Research 1.36 (London EC: 2020.01): 31-35. 8 Hammarberg Bjom, “Roles of L1 and L2 in L3 Production and Acquisition,” in Cross-linguistic Influence in Third Language Acquisition: Psycholinguistic Perspectives, eds. Jasone Cenoz, Britta Hufeisen and Ulrike Jessner. (Clevedon: Multilingual Matters, 2001), 21-41; De Angelis Gessica, Selinker Larry, “Interlanguage Transfer and Competing Linguistic Systems in the Multilingual Mind,” in Cross-linguistic Influence in Third Language Acquisition: Psycholinguistic Perspectives, eds. Jasone Cenoz, Britta Hufeisen and Ulrike Jessner. (Clevedon: Multilingual Matters, 2001), 42–58; Bardel Camilla, Falk Ylva, “The Role of the Second Language in Third Language Acquisition: The Case of Germanic Syntax,” Second Language Research 4.23 (London EC: 2007.10): 459-484. 9 Rothman Jason, Amaro Jennifer Cabrelli, “What Variables Condition Syntactic Transfer? A Look at the L3 Initial State,” Second Language Research 2.26 (London EC: 2010.01): 189–218. 10 Flynn Suzanne, Foley Claire, Vinnitskaya Inna, “The Cumulative-Enhancement Model for Language Acquisition: Comparing Adults’ and Children’s Patterns of Development in First, Second and Third Language Acquisition of Relative Clauses,” International Journal of Multilingualism 1.1 (Oxon: 2004): 3–16; Slabakova Roumyana, “The scalpel model of third language acquisition,” International Journal of Bilingualism 6.21 (London EC: 2017.12): 651-665; Westergaard Marit, Mitrofanova Natalia, Mykhaylyk Roksolana, Rodina Yulia, “Crosslinguistic Influence in the Acquisition of a Third Language: the Linguistic Proximity Model,” International Journal of Bilingualism 6.21 (London EC: 2017.12): 666-682.
第三語言習得視角下的語言遷移探索—基於泰國學習者漢語作為第三語言語序習得及相關遷移現象的調查 133 對個別的語⾔特徵進⾏逐個的對比和遷移。但無論是整體的遷移還是逐個特徵的遷移，學習者都將受到⼼理語⾔距離，語⾔類型相似性，語⾔⽔平等因素的影響。11 近幾⼗年來，漢語作為外語習得研究成果頗豐，其視角基本是將漢語作為第⼆語⾔，以對比分析假說、遷移理論、中介語理論、普遍語法理論等為理論依據，考察可能存在的遷移影響和習得發展模式等。12但隨著漢語作為第⼆語⾔習得研究的深入，逐漸有學者意識到，在多語者普遍存在的社會現實中，國際中⽂教育所⾯對的多數學習者，尤其是來⾃亞洲的學習者，13在學習漢語之前都已接觸、學習甚至熟練掌握了另⼀⾨或者多⾨外語。於是，對 L2（⼤多數為英語）遷移影響的證實成為研究的熱點問題，但結果並不⼀致：如Na Ranong and Leung、王勝、於靜針對泰語為 L1，英語為 L2 的漢語學習者的研究認為，L1 仍在漢語習得中發揮重要作⽤，L2的影響較⼩，僅在初級階段對語⾳習得較為明顯。14⽽王曉婷、⾦利娜對韓國學習者的調查則發現，儘管漢、韓的語⾔距離更近，但學習者在習得時還是更多地表現出 L2（英語）的影響。15胡紅豔、魏思⽂針對烏克蘭和⽇本學習者的研究則認為，L2（英語）在漢語習得中的確存在影響，但並未達到「⼆語地位」的程度， 11 Kellerman Eric, “Now You See It Now, You don’t,” in Language Transfer in Language Learning, eds. Gass, Susan., Selinker, Larry. (Rowley: Newbury House, 1983), 112-134; De Angelis Gessica, “Interlanguage Transfer of Function Words,” Language Learning 3.55 (Mississauga, ON: 2005.09): 379-414; Jaensch Carol, “L3 Enhanced Feature Sensitivity as a Result of Higher Proficiency in the L2,” In Third Language Acquisition and Universal Grammar, eds. Yan-kit Ingrid Leung, (Bristol: Multilingual Matters, 2009), 115-143. 12 王金、梁磊，〈三語習得視角下單母音/u/的感知研究—以日、英、漢三語學習者為例〉，《國際中文教育(中英文)》，第 3期（北京：2022.09），90-91。 13 根據新冠疫情爆發前，中華人民共和國教育部對來華留學生人數的最新統計，來自亞洲的留學生占 總 數 的 59.95%， 其 中 以 韓 國 、 泰 國 為 主 。 網 址 為https://www.moe.gov.cn/jyb_xwfb/gzdt_gzdt/s5987/201904/t20190412_377692.html。 14 Na Ranong Sirirat, Leung Yan-kit Ingrid, “Null Objects in L1 Thai–L2 English–L3 Chinese: An Empiricist Take on a Theoretical Problem,” in Third Language Acquisition and Universal Grammar, eds. Yan-kit Ingrid Leung. (Bristol: Multilingual Matters, 2009), 162-191；王勝，〈基於三語習得理論的母語負遷移理論之反思—以泰國學生漢語語音習得偏誤為例〉，《雲南師範大學學報（對外漢語教學與研究版）》，第 2期（昆明：2012.03），7-9；於靜，《漢語為第三語言的狀語語序偏誤研究》，（太原：山西大學碩士論文，2021），52-53。 15 王曉婷，《二語對三語習得的影響研究》，（廣州：廣東外語外貿大學碩士論文，2018），48-49；金利娜，《韓國學習者韓語（L1）和英語（L2）對漢語（L3）介詞短語學習的遷移現象研究》，（上海：華東師範大學碩士論文，2020），63-67。
段然、魏慧萍 138 陈惟格 男 17 低 HSK3 12 1 說明：受試提供的英語水平成績多樣，共包括4類：O-NET成績（即泰國高考英語科目的成績），TOEFL成績，TOEIC成績和IELTS成績。此處對英語水平的劃分參考幾類考試對分數的官方解釋和等級劃分，確定劃分高、低兩個水平的依據為：TOEFL成績以72分為標準；TOEIC成績以550分為標準；IELTS成績以6分為標準；O-NET成績以48分為標準。 (㆓)、訪談內容 ⼆語習得和三語習得的相關研究都認為，來源語⾔（source language）與⽬的語的異同是影響遷移發⽣的重要因素。25⼿術⼑模型和語⾔臨近模型更進⼀步認為，三語習得涉及的是語⾔逐個特徵的掌握。由此，為使訪談內容更加清晰，我們參考類型學語序對比理論和做法。26參考劉⽉華等、裴曉睿、薄⽂澤、張道真的著作，對漢、英、泰三種語⾔的語序進⾏細緻對比，發現三語之間的語序異同主要呈現出以下三種模式，詳細的異同說明如表 2所⽰： A. 英、泰相似，而與漢語不同，例如地點狀語與謂語動詞，主語關係從句與中心語； B. 英、漢相似，而與泰語不同，例如雙賓句； C. 漢、英、泰三者個不相似，例如數量、指示+動詞（短語）或主謂短語作定語時與中心語的位置。 表 2 訪談內容涉及語法點語序對比詳細情況 序號 漢語語法點 漢、英、泰異同情況 英、泰對應的語序特徵 1 主語關係從句+ 中心語（三級） 漢—英/泰 英：中心語+主語關係從句 例：the student who is presenting the paper 25 劉珣，《對外漢語教育學引論》，185-190；De Angelis, Third or Additional Language Acquisition, 19-39. 26 MS, Dryer, “The Greenbergian Word Order Correlations,” Language 1.68 (Washington, DC: 1992.03): 81-138.
第三語言習得視角下的語言遷移探索—基於泰國學習者漢語作為第三語言語序習得及相關遷移現象的調查 139 例：正在宣讀論文的學生 泰：中心語+主語關係從句 例：นกัเรียน ที) นาํเสนอ กระดาษ（學生—的—宣讀—論文） 2 數量、指示+動詞短語或主謂短語+中心語（四級） 例：一個學習漢語的學生 漢—英—泰 英：數量、指示 +中心語+動詞短語或主謂短語 例：a student who is learning Chinese 泰：中心語+動詞短語或主謂短語+數量、指示 例：กเรียน ที) กาํลงั เรียนภาษาจีน หนึ)ง （學生—的—正在—學漢語—一個） 3 「介詞+處所」短語+謂語動詞 介詞範圍：在（一級）、從（二級） 例：在學校門口等車 漢—英/泰 英：謂語動詞+「介詞+處所」短語 例：wait for the bus in front of the school 泰：謂語動詞+「介詞+處所」短語 例：รอรถ ที) ประตูหนา้ โรงเรียน（等車—在—前門—學校） 4 雙賓句「主語+動詞+間接賓語+直接賓語」（二級） 動詞範圍：給予類 例：媽媽給我一本書。 漢/英—泰 英：主語+動詞+間接賓語+直接賓語 例：Mother gives me a book. 泰：主語+動詞+直接賓語+間接賓語 例：แม่ ให ้หนงัสือ ฉนั（媽媽—給—書—我） 說明：漢語語法點後括號中標註的是該語法點在《漢語水平等級標準與語法等級大綱》和《國際中文教育中文水平等級標準》中對應的等級；符號「/」表示兩種語言在該語法點上的語序相似；符號「—」表示兩種語言在某一語法點上的語序不同。 由此，在實際訪談中，我們將以上述 4個語法點的語序特徵為例，結合具體例句與學習者進⾏討論。27結合前⽂所述，其中地點狀語與謂語動詞，關係從句與中⼼語，數量、指⽰和動詞（短語）或主謂短語作定語時與中⼼語的語序都是泰國學習者語序偏誤較為集中的語法點。28訪談提綱主要圍繞以下 5 個⽅⾯展開：（1）三種語⾔間對比的意識和⾏為︔（2）漢語學習的主要困難及其原因︔（3）對泰語和英語的遷移影響的感知︔（4）已有的語⾔學習經驗對漢語學習的作⽤︔（5）對 4個語 27 訪談中所使用的例句均來源於「全球漢語中介語語料庫」中泰國學習者出現的偏誤，例句將在附錄中呈現。 28 胡永梅，《泰國學生漢語習得偏誤現象解析》，（濟南：山東大學碩士論文，2008），3-10。
第三語言習得視角下的語言遷移探索—基於泰國學習者漢語作為第三語言語序習得及相關遷移現象的調查 143 知基礎。儘管⼤部分學習者能夠明確感知到漢語和泰語在語序上的差異，但是身處漢、英、泰所組成的多語系統中，學習者仍舊認為這並不是巨⼤的差距，在訪談中表述為只是「就⼀點點」不同。⽽漢泰之間的基本語序、某些相似的語法點（如「了」的使⽤，量詞的使⽤），甚至是語⾳乃至⽂化上的相似都影響他們對漢泰間語序相似度進⾏判斷。與之相對照，英語因其形態變化等語法規則層⾯的差異，⽽被學習者感知為：英語在語序上與漢語和泰語都有著巨⼤差異。訪談摘錄如下： 當然會比較漢語和泰語……我覺得語序很像，比如「了」吧，如果說，我吃完了，泰語是 ฉันกนิเสรจ็แลว้，也是後面用「了」，這就是一樣的，很簡單……不一樣的也有吧，就一點點。（YLL-H-2） 泰語跟漢語很多地方都差不多，都有聲調吧，很多詞也差不多……語序有點不一樣吧，但是我覺得不難……都是有主語，有動詞。（SMT-H-1） 英語的順序很不一樣，我比較過的，就是太不一樣……英語很多那些 tense，像do\did\done這樣的，這個很難學，漢語沒有這些，我覺得很好。（XLF-M-2） (㆓)、㈻習者傾向於更關㊟語序的相似性而非差異性 累積強化模式和語⾔類型優選模型的理論認為，學習者在習得第三語⾔的時候，為了節省認知成本，更經濟、省⼒地習得語⾔，會更加關注語⾔特徵的相似性，進⽽對相似的語⾔特徵進⾏遷移，提升第三語⾔的學習效率。在訪談中，學習者的表現回應了這⼀觀點。可⾒，語際的相似性對語⾔遷移的影響比語⾔間的差異性更⼤，這點也在三語習得的相關研究中得到了證實。32由此說明，學習者通過語⾔間的對比，尋找語⾔之間的相似性，為⾃⼰的三語習得建⽴便利條件，進⽽降低三語習得的難度。在漢語作為三語的泰國學習者漢語語序習得中，學習者基於對比⽽獲 32 Cenoz Jasone, “The Effect of Linguistic Distance L2 Status and Age on Cross-linguistic Influence in Third Language Acquisition,” in Cross-linguistic Influence in Third Language Acquisition: Psycholinguistic Perspectives, eds. Jasone Cenoz, Britta Hufeisen and Ulrike Jessner. (Clevedon: Multilingual Matters, 2001), 8-20; Ringbom Hakan, “Lexical transfer in L3 production,” in Cross-linguistic influence in third language acquisition: Psycholinguistic perspectives, eds. Jasone Cenoz, Britta Hufeisen and Ulrike Jessner. (Clevedon: Multilingual Matters, 2001), 90-114.
段然、魏慧萍 148 對比中逐漸發現，通過英語能夠更有效率地掌握漢語的詞彙。⽽這⼀策略在以往的⼆語學習策略相關研究中並未得到關注。33 同時，有 19 位受訪者明確表⽰，英語能夠更好地幫助他們理解漢語的詞義。這⼀點引起了我們的注意。在三語詞匯習得領域，部分研究認為，學習者總是通過發現和利⽤ L3詞彙與先前詞彙知識的相似點來習得 L3詞彙的，學習者會努⼒以盡可能少的冗餘實現 L3 詞彙向已存在的詞彙網路中的融入。也被稱為「寄⽣學習策略」。34與語序習得相似，學習者總是更關注語⾔間的相似並加以利⽤，從⽽實現更⾼效的⽬的語學習。 另⼀⽅⾯，結合⼼理語⾔學的研究，詞彙的習得是⼀個由字形、詞⾳到詞義、語⽤的連續體。35其中任何⼀個層⾯的習得都是學習者在已有知識經驗的基礎上對⽬的語詞語進⾏感知、攝入、編碼、保存的結果。可⾒，學習者在無法藉助母語知識經驗的情況下，轉⽽求助於 L2英語，並在實際的詞彙習得中，發現在 L2英語的基礎上理解、編碼、儲存 L3 漢語詞彙更加⾼效。⽽對⼼理詞彙研究的共識是，語⾔在⼼理上分形式和意義兩個層次表徵，詞的形、⾳、義三個層⾯的儲存並不存在對應關係，各個語⾔包括詞形資訊和語⾳信息在內的詞彙表徵（lexical representation）是獨⽴的。36語義概念特徵即概念表徵（concept representation）則是共同的。37因此，在泰國三語學習者的認知系統中，除了部分源⾃英語的漢語⾳譯外來詞在詞⾳⽅⾯也呈現出⼀定的對應關係外，其他漢語詞彙和英語詞彙在字形、語⾳形式上差距較⼤，但是仍舊能夠在概念層⾯、語義層⾯上產⽣聯繫，從⽽通過L2（英語）幫助掌握 L3（漢語）的詞義信息。訪談摘錄如下： 很多詞如果你直接從泰語翻譯過來，你會發現太怪了，不是你想表達的。 33 江新，〈漢語作為第二語言學習策略初探〉，《語言教學與研究》，第 1期（北京：2000.03），61-68；吳勇毅，《不同環境下的外國人漢語學習策略研究》，（上海：上海師範大學博士論文），2007。 34 Ecke Peter, “Lexical Retrieval in a Third Language: Evidence from Errors and Tip-of-the Tongue States,” in Cross-linguistic Influence in Third Language Acquisition: Psycholinguistic Perspectives, eds. Jasone Cenoz, Britta Hufeisen and Ulrike Jessner. (Clevedon: Multilingual Matters, 2001), 90-114. 35 桂詩春，〈認知與外語學習〉，《外語教學與研究》，第 4 期（北京：1992.08），2-9+80；孫藍，〈從認知制約看心理詞彙〉，《外語教學》，第 4期（西安：2001.07），24-26。 36 姜孟，〈概念遷移:語言遷移研究的新進展〉，《寧夏大學學報(人文社會科學版) 》，第 3期（銀川：2010.05），166-167。 37 郭桃梅、彭聃齡，〈非熟練中-英雙語者的第二語言的語義通達機制〉，《心理學報》，第 1期（北京：2003.01），24。
第三語言習得視角下的語言遷移探索—基於泰國學習者漢語作為第三語言語序習得及相關遷移現象的調查 149 如果用英語翻譯成中文，就差不多可能有百分之 90是對的。（MM-H-2） 有時候我會把漢語翻譯成英語，然後再把英語翻譯成泰語，這樣我能理解得更準確。（YSY-M-2） 很多時候，我都會看英語是什麼詞，什麼意思，那樣我能理解，但是看泰語，就不明白什麼意思。（CWG-M-1） 我覺得英語幫助我學詞語，很多詞在泰語裡面都沒有，或者有很多個，就是很奇怪，我不理解，看英語能幫助我理解，有時候我是直接記住英語。（YPP-H-2） (㈤)、㈻習者在㆔語習得過程㆗的元語言意識得以提升 元語⾔意識即對語⾔本身的認識，包括對形式的注意和對語⾔單位的運⽤的注意。38涉及元語⾔意識的三語習得研究表明，多語習得有利於學習者積累語⾔學習的經驗，促進元語⾔意識的發展，進⽽反過來促進學習者多語⽔平的提⾼，39多語習得者在⽬的語的習得中表現出更多優勢，體現在在語⾳、句法、詞彙和語⽤意識⽅⾯。40在訪談中，有 27位學習者都明確表⽰，已有的語⾔學習經驗有助於其他語⾔的習得，主要體現在： （1）在英語學習中，已經掌握的語言學習必須的相關概念，例如「主語」、「動詞」等，使漢語學習更方便； （2）在英語學習中，行之有效的學習方法將會在漢語習得中繼續使用； （3）對學習外語任務將面臨的困難有充足的心理準備； （4）對語言間相互干擾的敏銳感知以及對積極因素充分利用的意識； （5）在漢語學習過程中積累的好方法，也會有助於英語的繼續學習。 38 梁利娟、陳寶國，〈元語言意識對第二語言習得的影響及其與其他因素的交互作用〉，《外語教學理論與實踐》，第 2期（上海：2013.05），21-22。 39 Park Jiin（朴智仁），《作為第二語言的英語對韓國初級漢語學習者語法習得的影響》，2-10。 40 Charlotte, Kemp, “Metalinguistic Awareness in Multilinguals: Implicit and Explicit Grammatical Awareness and its Relationship with Language Experience and Language Attainment,” Abstract (PhD diss., University of Edinburgh, 2001); 曾麗，《苗族學生在三語習得中元語言意識的發展》，（重慶：西南大學博士論文，2010），144-148。
段然、魏慧萍 156 35-45+55。 [27] 尹正莉，《漢、泰語狀語語序的比較研究及泰國學⽣習得狀語的偏誤分析》，（西安：西安外國語⼤學碩⼠論⽂，2011）。 [28] 於靜，《漢語為第三語⾔的狀語語序偏誤研究》，（太原：山西⼤學碩⼠論⽂，2021）。 [29] 張道真，《張道真英語語法⼤全》，（上海：世界圖書出版公司，2019）。 [30] 中 華 ⼈ 民 共 和 國 教 育 部 ，2018年 來 華 留 學 統 計 ， https://www.moe.gov.cn/jyb_xwfb/gzdt_gzdt/s5987/201904/t20190412_377692.html，瀏覽⽇期為2022年9⽉18⽇。 [31] 朱華、曾昭聰，〈泰國學⽣漢語語序學習的偏誤分析及教學對策〉，《雲南師範⼤學學報（對外漢語教學與研究版）》，第6期（昆明：2010.11），78-84。 ㆓、西文著作 [1] Bjom, Hammarberg, “Roles of L1 and L2 in L3 Production and Acquisition,” In Cross-Linguistic Influence in Third Language Acquisition: Psycholinguistic Perspectives, Eds. Jasone Cenoz, Britta Hufeisen and Ulrike Jessner. (Clevedon: Multilingual Matters, 2001), 21-41. [2] Camilla, Bardel, Ylva, Falk, “The Role of the Second Language in Third Language Acquisition: The Case of Germanic Syntax,” Second Language Research 4.23 (LONDON EC: 2007.10): 459–484. [3] Carol, Jaensch, “L3 Enhanced Feature Sensitivity as a Result of Higher Proficiency in the L2,” In Third Language Acquisition and Universal Grammar, Eds. Yan-kit Ingrid Leung. (Bristol: Multilingual Matters, 2009), 115-143. [4] Charlotte, Kemp, “Metalinguistic Awareness in Multilinguals: Implicit and Explicit Grammatical Awareness and its Relationship with Language Experience and Language Attainment,” (PhD diss., University of Edinburgh, 2001). [5] Dryer, MS, “The Greenbergian Word Order Correlations,” Language 1.68
第三語言習得視角下的語言遷移探索—基於泰國學習者漢語作為第三語言語序習得及相關遷移現象的調查 157 (Washington, DC: 1992.03): 81-138. [6] Eric, Kellerman, “Now You See It Now, You Don’t,” In Language Transfer in Language Learning, eds. Gass, Susan, Selinker, Larry. (Rowley: Newbury House, 1983), 112-134.. [7] Gessica de Angelis, “Interlanguage Transfer of Function Words,” Language Learning 3.55 (Mississauga, ON: 2005.09): 379–414. [8] Gessica de Angelis, Larry Selinker, “Interlanguage Transfer and Competing Linguistic Systems in the Multilingual Mind,” In Cross-linguistic Influence in Third Language Acquisition: Psycholinguistic Perspectives, Eds. Jasone Cenoz, Britta Hufeisen and Ulrike Jessner. (Clevedon: Multilingual Matters, 2001), 42–58. [9] Gessica, de Angelis, Third or Additional Language Acquisition. (Clevedon: Multilingual Matters Ltd, 2007). [10] Hakan, Ringbom, “Lexical Transfer in L3 Production,” In Cross-linguistic Influence in Third Language Acquisition: Psycholinguistic Perspectives, Eds. Jasone Cenoz, Britta Hufeisen and Ulrike Jessner. (Clevedon: Multilingual Matters, 2001), 90-114. [11] Jason, Rothman, “Linguistic and Cognitive Motivations for the Typological Primacy Model (TPM) of Third Language (L3) Transfer: Timing of Acquisition and Proficiency Considered,” Bilingualism 18.2 (New York, NY: 2015.04): 179–190. [12] Jason, Rothman, “On the Typological Economy of Syntactic Transfer: Word Order and Relative Clause High/low Attachment Preference in L3 Brazilian Portuguese,” International Review of Applied Linguistics in Language Teaching 2-3.48 (Berlin: 2010.06): 245–273. [13] Jason, Rothman, Amaro, Jennifer Cabrelli, “What Variables Condition Syntactic Transfer? A Look at the L3 Initial State,” Second Language Research 2.26 (LONDON EC:2010.01): 189–218. [14] Jasone, Cenoz, “The Effect of Linguistic Distance L2 Status and Age on Cross-linguistic Influence in Third Language Acquisition,” In Cross-linguistic Influence in Third Language Acquisition: Psycholinguistic Perspectives, Eds. Jasone Cenoz, Britta
段然、魏慧萍 158 Hufeisen and Ulrike Jessner. (Clevedon: Multilingual Matters, 2001), 8-20. [15] Leung Yan-kit Ingrid, “Failed Features vs. Full Transfer Full Access in the Acquisition of Third Language: Evidence from Tense and Agreement,” In Proceedings of the 6th Generative Approaches to Second Language Acquisition Conference GASLA 2002: L2 Link, Eds. Juana M. Liceras, Helmut Zobl and Helen Goodluck. (Sommerville MA: Cascadilla Proceedings Project, 2003a), 199–207. [16] Leung Yan-kit Ingrid, “Functional Categories in Second and Third Language Acquisition: A Cross-linguistic Study of the Acquisition of English and French by Chinese and Vietnamese speakers,” (PhD diss., McGill University, 2003b), https://www.proquest.com/dissertations-theses/functional-categories-second-third-language/docview/305243865/se-2. [17] Marit, Westergaard, Natalia, Mitrofanova, Roksolana, Mykhaylyk, Yulia, Rodina, “Crosslinguistic Influence in the Acquisition of a Third Language: the Linguistic Proximity Model,” International Journal of Bilingualism 6.21 (London EC: 2017.12): 666-682. [18] O’Connor, Cliodhna, Joffe, Helene, “Intercoder Reliability in Qualitative Research: Debates and Practical Guidelines,” International Journal of Qualitative Methods 19 (Thousand Oaks, CA, 2020.01): 1-13. [19] Peter, Ecke, “Lexical Retrieval in a Third Language: Evidence from Errors and Tip-of-the Tongue States,” in Cross-linguistic Influence in Third Language Acquisition: Psycholinguistic Perspectives, Eds. Jasone Cenoz, Britta Hufeisen and Ulrike Jessner. (Clevedon: Multilingual Matters, 2001), 90-114. [20] Philip, Herdina, Ulrike, Jessner, “The Dynamics of Third Language Acquisition,” In English in Europe: The Acquisition of a Third Language, Eds. Jasone Cenoz, Ulrike Jessner. (Clevedon: Multilingual Matters, 2000), 84-98. [21] Puig-Mayenco, Eloi, Alonso, Jorge Gonzalez, Rothman, Jason, “A Systematic Review of Transfer Studies in Third Language Acquisition,” Second Language Research 1.36 (London EC: 2020.01): 31-64.
第三語言習得視角下的語言遷移探索—基於泰國學習者漢語作為第三語言語序習得及相關遷移現象的調查 159 [22] Rebecca, Foote, “Transfer and L3 Acquisition: The Role of Typology,” In Third Language Acquisition and Universal Grammar, Eds. Yan-kit Ingrid Leung. (Bristol: Multilingual Matters, 2009), 89–114. [23] Roumyana, Slabakova, “The Scalpel Model of Third Language Acquisition,” International Journal of Bilingualism 6.21 (London EC: 2017.12): 651-665. [24] Sirirat Na Ranong, Leung Yan-kit Ingrid, “Null Objects in L1 Thai–L2 English–L3 Chinese: An Empiricist Take on a Theoretical Problem,” In Third Language Acquisition and Universal Grammar, Eds. Yan-kit Ingrid Leung. (Bristol: Multilingual Matters, 2009), 162-191. [25] Suzanne, Flynn, Claire, Foley, Inna, Vinnitskaya, “The Cumulative-Enhancement Model for Language Acquisition: Comparing Adults’ and Children’s Patterns of Development in First, Second and Third Language Acquisition of Relative Clauses,” International Journal of Multilingualism 1.1 (Oxon: 2004): 3–16. 附錄—訪談㈾料 ㆒、訪談提綱： （1）你在學習漢語時遇到的主要困難是什麼？為什麼覺得困難？ （2）你覺得泰語、英語、漢語之間有什麼異同嗎？ （3）你在學習⼀個新的句⼦時，是否會對比漢泰、漢英？ （4）您覺得泰語和英語對漢語習得有什麼阻礙和幫助嗎？ （5）你在遇到表達困難的時候，怎麼解決的？ （6）你覺得學英語的經驗是否對漢語學習有幫助？ （7）（出⽰不同例句），你覺得這個句⼦對嗎？為什麼？你覺得出現這樣的語序是
「與科大卓越同行—前沿學術發展動態專欄」 169 新與可持續發展國際交流論壇」於澳⾨威尼斯⼈西西⾥宴會廳順利開幕。是次論壇獲得澳⾨特別⾏政區政府教育基⾦資助（DSEDJ, FE）、經濟及科技發展局（DSEDT）、澳⾨科學技術發展基⾦（FCDT）、國際⽔利與環境⼯程學會（International Association for Hydro-Environment Engineering and Research）和⽔利部珠江⽔利委員會（Pearl River Water Resources Commission Ministry of Water Resources P.R.C.）⽀持。本次論壇將分別於 3⽉ 28⽇至 3⽉ 31⽇期間展開⼀系列的主題演講、會議以及實地考察。 澳⾨科技⼤學副校監、校長李⾏偉講座教授在論壇開幕式上致歡迎辭，表⽰「2022 年參訪多間葡萄牙著名⼤學，對海岸環境以及 AI 創新創業相關的科技有很深印象。是次論壇進⼀步探討氣候變化適應的科學研究和創新創業科技，澳⾨科技⼤學澳⾨環境研究院和剛成⽴的澳⾨海岸帶⽣態環境國家野外科學觀測研究站正在積極承擔氣候變化研究和關鍵數據觀測收集的責任。澳科⼤也正在進⾏重⼤的投入，與各國和地區合作。本次論壇中將看到許多與氣候變化和⽔相關的創新和創業精神。」同時特邀第 127任澳⾨總督韋奇⽴將軍講話，他指出「澳⾨科技⼤學作為被中央政府指定為⼤灣區發展科技的重點⼤學，積極履⾏了⼤學職責，為社會建設做出了重⼤貢獻，為解决氣候變化問題、政治合作和社會發展的提供了重要的交流平台，同時建⾔獻策，幫助國際社會和地區實現可持續發展。」 葡萄牙⾥斯本⼤學⾼等理⼯學院（Instituto Superior Técnico）副院長 Fatima Montemor 教授在致辭中表⽰，「本次論壇將會讓中葡之院校機構建⽴⼀個更強⼤聯盟，在海洋資源保護等關鍵領域，葡萄牙⾥斯本⼤學和澳⾨科技⼤學都是重要領導者，兩者在科學和科技⽅⾯已準備迎接氣候變化等挑戰，皆有能⼒培養優秀的科學家、企業家和管理者等專業⼈才。」葡萄牙國家⼟⽊⼯程實驗室（LNEC）負責⼈Helena Alegre博⼠在發⾔時表⽰，「LNEC作為葡萄牙重要國家研究機構，⼀直致⼒於在⼟⽊⼯程研究領域進⾏研究和創新。本次論壇是⼀個非常難得的好機會，讓葡萄牙的學者跟中國、新加坡等國家和地區的科研企業⼈員相互瞭解並進⾏合作，相信將來展開的合作研究會更多。」最後，美國⾺⾥蘭⼤學環境科學中⼼（University of Maryland Center for Environmental Science）校長 Peter Goodwin教授在視頻致辭中，分享了氣候變化導致的嚴重環境危機的例⼦，如微塑膠污染和⽔體營養化，指出「我們⾯臨和新冠肺炎類似的困境，需要全世界進⼀步加強互信合作，從危機中
「與科大卓越同行—前沿學術發展動態專欄」 171 在醫學⽅⾯，澳科⼤醫學部成⽴以⾸次舉辦⼤型學術峰會。4 ⽉ 3 ⽇「第⼆屆『探索醫學前沿』峰會：轉化醫學與藥物研發」在澳科⼤ D座禮堂隆重揭幕。是次峰會同步以線上形式播出，讓更多海內外學者專家能共襄盛舉。特區政府政策研究和區域發展局局長張作⽂、橫琴粵澳深度合作區民⽣事務局副局長馮⽅丹、科學館館長邵漢彬、科學技術發展基⾦委員鄭冠偉、教育及青年發展局⾼等教育廳廳長許嘉路、藥物監督管理局註冊廳廳長李志洋，澳科⼤校監、校董會主席廖澤雲，副校監、校長李⾏偉，校董會秘書長陳季敏，副校長唐嘉樂、譚廣亨、姜志宏，校董蘇⾹玫，協理副校長朱依諄、梁⽂慧，澳科⼤諮詢委員會委員以及院所代表及師⽣出席是次講座。 澳科⼤副校監兼校長李⾏偉代表⼤學致歡迎辭時表⽰，「本次峰會是醫學部成⽴以來⾸次舉辦的校慶活動。醫學部著重於科研與教育的發展，以應對現時對教學、研究、創新和服務需求的急速變化。醫學部由原來的醫學院（包括已合併到醫學院的藥學院）、中醫藥學院、醫學⼈⼯智能實驗室及再⽣醫學中⼼整合⽽成，以提升⼤學在全球的競爭⼒和影響⼒，並融入國家、⼤灣區及澳⾨「⼤健康」戰略發展，他期望透過本次峰會，醫學部能充分發揮優勢，在教學、科研等⽅⾯持續發展。」與此同時，峰會很榮幸邀請兩位諾⾙爾得獎者擔任主講嘉賓。4⽉ 3⽇，曾於 1991年獲得「諾⾙爾⽣理學或醫學獎」、德國哥廷根⾺克斯普朗克⽣物物理化學研究所膜⽣物物理系主任、澳⾨科技⼤學埃爾⽂內爾博⼠⽣物物理與創新藥物實驗室主任、澳科⼤特聘教授、澳科⼤榮譽博⼠埃爾⽂・內爾教授 (Professor Erwin Neher)以“ Advances in Cellular Signaling and Structural Biology: New Options for Drug Development and Cancer Research”（細胞信號和結構⽣物學的研究進展：藥物開發和腫瘤研究的新選擇）為題之主旨演講︔4⽉ 4⽇，曾於 1996年獲得「諾⾙爾⽣理學或醫學獎」、墨爾本⼤學杜赫提研究所贊助⼈、榮譽教授，⽥納西州孟菲斯 St. Jude 兒童研究醫院免疫學系⽣物醫學研究主席Michael F Tamer、澳科⼤榮譽博⼠彼得・杜赫提教授 (Professor Peter Doherty)以“What’s Next with Pandemics and What Should We Do?”（如何⾯對下⼀役的⼤流⾏病）為題之主旨演講。兩場主旨演講吸引不少海內外學者專家參與，並於演講後與兩位諾⾙爾得獎者展開深入交流。
《澳門科技大學學報》編輯部曾幸麒 172 「第二屆『探索醫學前沿』峰會：轉化醫學與藥物研發」與會人士現場合影 除了⽉球探索、環境⼯程與醫學領域有重⼤突破外，語⾔學領域亦再次獲世界知名⾼等教育機構青睞。3 ⽉ 8 ⽇，英國劍橋⼤學劍橋科⽂中⼼創始主任、英國皇家學會院⼠、英國劍橋⼤學克雷爾學院院⼠克萊頓（Nicola Clayton）教授及其團隊來訪澳科⼤作學術演講，並代表劍橋⼤學劍橋科技⽂化融合中⼼與國際學院簽署合作備忘錄。譚廣亨副校長和龐川副校長親切接⾒嘉賓並出席是次活動，國際學院張洪明院長致歡迎辭時對劍橋⼤學來訪貴賓作介紹。其後克萊頓教授為以“Ways of Thinking：From Crows to Children and Back Again”為題演講，她指出「在跨學科融合⼈類學與⼼理學的專業視角下，以烏鴉和孩⼦的比喻描述思維場域如何實現過渡轉變。」演講⽣動精彩，現場反響熱烈，掌聲經久不息。劍橋⼤學劍橋科技⽂化融合中⼼亞洲分中⼼澳⾨辦事處主任吳恩銓先⽣向現場師⽣介紹赴英國劍橋⼤學訪學的暑期交流項⽬細節，指出本項⽬旨在促進國際⾼等教育發展，溝通院校合作，並歡迎澳科⼤優秀師⽣前往劍橋⼤學交流學習。澳科⼤國際學院是澳⾨⾸個與英國劍橋⼤學劍橋科技⽂化融合中⼼進⾏深度合作的學院，此舉將進⼀步推進澳⾨⾼校參與國際合作與活動，為澳⾨⾼等教育注入活⼒與競爭⼒。本次合作不僅為澳科⼤師⽣開拓學術視野提供嶄新平台，更為澳科⼤與國際頂尖⾼校的深度交流提供
「與科大卓越同行—前沿學術發展動態專欄」 173 契機。10 張洪明院長（右二）與克萊頓教授（左二）為雙方代表簽署合作備忘錄 其後於 5⽉ 27⽇，國際中國語⾔學學會第 29屆年會（The 29th Annual Conference of the International Association of Chinese Linguistics，IACL‐29）在澳科⼤ D座禮堂順利舉⾏開幕式。本屆年會為國際學院主辦，承蒙教育部中外語⾔交流合作中⼼、澳⾨科技⼤學基⾦會、國際中國語⾔學學會與歐亞基⾦會贊助，以及澳⾨語⾔學會、澳⾨郵電局與永利澳⾨有限公司⽀持。中聯辦教育與青年⼯作部副處長徐之平，海峽兩岸關係協會駐澳⾨辦事處主任王剛，澳⾨政府教育及青年發展局⾼等教育廳代廳長馮家健，國際中國語⾔學學會會長⽵越孝（Takashi Takekoshi），澳科⼤校長李⾏偉，永利澳⾨有限公司總裁、董事會副主席、澳科⼤校董陳志玲、內地⾼校代表以及逾 300名專家學者參與。李⾏偉校長指出「澳科⼤的戰略規劃包括多樣性、國際化，以及跨學科性，⽽國際化則是澳科⼤發展的重要⽅向。澳科⼤已在多個領域與內地和國際⼀流⼤學建⽴了教育和研究合作關係，他期待在中國語⾔學領域也能 10 請參閱「澳科大國際學院與英國劍橋大學劍橋科技文化融合中心簽署合作備忘錄」，「最新動態」，載 於 澳 門 科 技 大 學 科 研 管 理 處 網 頁 （ 2023 年 3 月 10 日 ）， 網 址 為 ：https://www.must.edu.mo/rtao/news/49339-article20230310，瀏覽日期為 2023年 8月 2日。
《澳門科技大學學報》編輯部曾幸麒 176 Research（IJTR）之主編 5月 月球與行星科學國家重點實驗室研究團隊獲批第二輪超重實驗基金計劃 6月 29日 澳科大蔡占川教授入選中國科協海智計劃特聘專家 三、學術研究成果 （中國銀行學術研究優秀獎、國際銀行學術研究獎與 Best Research Output Award之申報成果） 獎項 論文/成果 期刊 作者 所屬學院 Best Research Output Award (商業與酒旅領域) Does Economic Policy Uncertainty Drive Volatility Spillovers in Electricity Markets: Time and Frequency Evidence Energy Economics 馬如飛 副教授 商學院 Best Research Output Award (社會科學含藝術人文) Temporal Variations in Calls for Police Service During COVID-19: Evidence From China Crime & Delinquency 代孟良 助理教授 法學院 Best Research Output Award ( 生物醫藥領域) Suppression of PD-L1 release from small extracellular vesicles promotes systemic anti-tumor immunity by targeting ORAI calcium channels Journal of Extracellular Vesicles 于海杰 副教授 中藥質量研究國家重點實驗室 Best Research Output Award (工程及應用科學領域) Rethinking Sustainable Sensing in Agricultural Internet of Things: From Power Supply Perspective IEEE Wireless Communications 李 東 副教授 計算機科學與工程學院 中國銀行學術研究優秀獎 [2] Advanced Carbon-Based Anodes for Potassium-Ion Batteries Advanced Energy Materials 張 偉 副教授 中藥質量研究國家重點實驗室 中國銀行學術研究優秀獎 [2] Task-Oriented Feature-Fused Network With Multivariate Dataset for Joint Face Analysis IEEE Transactions on Cybernetics 梁延研 副教授 計算機科學與工程學院 國際銀行學術研究獎 [2] The effects of supply chain diversification during the COVID-19 crisis: Evidence from Chinese manufacturers Transportation Research Part E: Logistics and Transportation Review 林永佳 副教授 商學院 國際銀行學術研究獎 [2] A study of how LGBTQ tourists’ perceptions of residents’ feelings about them affect their revisit intentions: an emotional solidarity perspective Journal of Sustainable Tourism 黃穎祚 副教授 酒店與旅遊管理學院 四、大學慶典/重大紀事 日期 活動名稱 3月 27日 23 周年校慶暨榮譽博士學位頒授典禮 5月 26日 第十三屆全國政協副主席、國務院港澳事務辦公室主任夏寶龍、中央駐澳聯絡辦公室主任鄭新聰及經濟財政司司長李偉農親臨澳科大考察兩所國家重點實驗室 7月 與劍橋大學設立「廖澤雲博士獎學金」 7月 2日 中醫藥學院獲授牌成為「中醫藥適宜技術澳門交流中心」
182 The Journal Submission Guidelines of Macau University of Science and Technology (Revised in February 2023) 1. The Journal of Macau University of Science and Technology is a comprehensive academic publication, which covers in various fields, such as Humanities and Social Sciences, Natural Sciences, Engineering Technology, Traditional Chinese Medicine, Science and Technology, and Management. We welcome all professional manuscripts from different experts and scholars from home and abroad. 2. Make sure submit final version of manuscript. Once your manuscript is accepted for publication and received at the Journal of Macau University of Science and Technology no further changes can be made. 3. Do not submit papers to Journal of Macau University of Science and Technology if they have been published somewhere else, or are being considered for publication elsewhere. 4. Submit your paper only as a Word file. The article must use Traditional Chinese and English and cannot be over 30,000 words (except for the special article). The Journal of Macau University of Science and Technology is a Quarterly one published in March, June, September and December. 5. The article must provide no more than 500 words of Chinese and English abstract and five keywords. Define all non-standard abbreviations when they first appear. Remember to include a title, all author names and affiliations, and the corresponding author’s email address. 6. If your paper uses figures, tables, or parts of text that have been published elsewhere, you need permission from the copyright holder. Number tables and figures, ensure they all have a legend. Define the meaning of any bold or italic formatting in your tables. Figures should be high-resolution and in a common image format. (e.g. .eps or .tif) 7. All references should be readable and accurate. The article must need to follow the format references to the Journal of Macau University of Science and Technology style when you first submit your paper.
183 8. Include acknowledgements, conflict-of-interest declarations and details of funding sources and grant numbers at the end of your paper. Include the full funder name. Use author initials to indicate which authors received grants. 9. Include all supplementary data files, which is the application from, with your submission. Use Word’s ‘Insert equation’ and ‘Insert symbol’ functions to insert symbols or special characters. Do not use images. Times New Roman and Arial Unicode MS typically provide the widest range of symbols and special characters. 10. After we have reviewed your manuscript, we may ask for editable files, higher resolution figures, or edited files to fit journal style. 11. The article must follow the “Committee on Publication Ethics Rules”. If we have clear evidence that findings are plagiarism, unreliable, a result of major error, fabrication, falsification, or published elsewhere without proper attribution to previous sources or disclosure to the editor, permission to republish, or justification of article, the Journal of Macau University of Science and Technology will retract the further article. 12. We now use the new system for submission. The author should register and submit the article on the system. However, we still keep the email submission method. The author should attach the submission form and further necessary documents to the journal’s email: publication@must.edu.mo (please write information clearly as “date_author_article title”). We will reply to the author in ten days and confirm whether your article is accepted for the next stage or not. In general, the processing of articles will take around 30-40 working days. If we do not reply for over six months, the author can deal with it by himself. 13. The Journal of Macau University of Science and Technology has the final decision of publication, editorship and right of interpret for each article.
188 香港電台(RTHK)，「Travelling with Water: Joseph LEE (I)」(與水同游/遊：李行 偉 教 授 ) ， Our Scientists (English Version) ，https://podcast.rthk.hk/podcast/item.php?pid=1344&eid=105927&lang=zh-CN，瀏覽日期為 2022 年 6 月 23 日。 (2)英文書目之引用(Bibliography) † 英文徵引書目之引用需留意作者/譯者/編者名字先(First Name)而姓氏後(Last Name)。如遇多位作者，只需調整第一位作者即可。如出現四位或以上作者，於註釋第一作者後以 et al.表示，但在徵引書目必須詳列所有作者。 I. 西文專書(Books) Ø 作者—書名─版次 ed.─(出版地點: 出版公司, 出版年分)─頁碼。 初引：Nathan Henry, The History of Fashion, 1500-1900, 2nd ed. (Hongkong: University of Hongkong Press, 2020), 50-80. 再引：Nathan, The History of Fashion, 1500-1900, 50-70. 徵引書目：Henry, Nathan. The History of Fashion, 1500-1900, 2nd ed. Hongkong: University of Hongkong Press, 2020. Ø 作者—書名—,ed./trans.編⁄譯者姓名—(出版地點: 出版公司,出版年分)—頁碼。 初引：Walter Bagehot, The English Constitution, ed. Miles Taylor (Oxford: University of Oxford, 2001), 32-80. 再引：Bagehot, The English Constitution, 20-25. 徵引書目：Bagehot, Walter. The English Constitution. Edited, Miles Taylor. Oxford: University of Oxford, 2001. Ø 章節作者—“章節標題”—in 書名—,ed(s).編者—(出版地: 出版者, 年份)—頁碼。（譯者亦如是—,trans 譯者） 初引：Ina Zweiniger-Bargielowska, “Prince Philip: Sportsman and Youth Leader,” in The Man Behind the Queen: Male Consorts in History, eds. Charles Beem and Miles
189 Taylor. (London: Palgrave Macmillan, 2014), 223-239. 再引：Ina Zweiniger-Bargielowska, “Prince Philip: Sportsman and Youth Leader,” 223-239. 徵引書目：Zweiniger-Bargielowska, Ina. “Prince Philip: Sportsman and Youth Leader.” in The Man Behind the Queen: Male Consorts in History. Eds. Charles Beem and Miles Taylor, 223-239. London: Palgrave Macmillan, 2014. †只需調整單一章節作者即可，編者不需調整姓氏與名字次序。 II. 期刊論文(Journals and Articles) Ø 作者—“篇名,” —期刊名稱—期.卷數—(出版地:年份/月份)—:頁數。 初引： Yan, Hao-Chen, Lam, Man-Yue, Lee, Joseph Hun-Wei, “Field Measurements and Numerical Modeling of Hydraulic Transients in HDPE Pipeline with PRV Interaction,” Journal of Hydraulic Engineering 147.6 (ASCE: 2021.06): 67. 再引：Yan, Hao-Chen, Lam, Man-Yue, Lee, Joseph Hun-Wei, “Field Measurements and Numerical Modeling of Hydraulic Transients in HDPE Pipeline with PRV Interaction,” 67. 徵 引 書 目 ： Hao-Chen, Yan, Lam, Man-Yue, Lee, Joseph Hun-Wei, “Field Measurements and Numerical Modeling of Hydraulic Transients in HDPE Pipeline with PRV Interaction.” Journal of Hydraulic Engineering 147.6 (ASCE: 2021.06): 1-67. 研討會或論文集，未經正式出版之成果(Unpublished manuscripts, Lectures and Working papers)，引註如下： ◎作者—“篇名”—(研討會名稱/參與地:參與場所,日期)—頁數。 初引： 1. David G. Harper, “The Several Discoveries of the Ciliary Muscle” (PowerPoint presentation, 25th Anniversary of the Cogan Ophthalmic History Society, Bethesda, MD, March 31,2012), 24. 2. Deborah D. Lucki and Richard W. Pollay, “Content Analyses of Advertising: A Review of the Literature” (working paper, History of Advertising Archives, Faculty of
190 Commerce, University of British Columbia, Vancouver, 1980), 46. 再引： 1. David G. Harper, “The Several Discoveries of the Ciliary Muscle”, 24. 2. Deborah D. Lucki and Richard W. Pollay, “Content Analyses of Advertising: A Review of the Literature”, 46. 徵引書目： 1. David G. Harper, “The Several Discoveries of the Ciliary Muscle” PowerPoint presentation, 25th Anniversary of the Cogan Ophthalmic History Society, Bethesda, MD, March 31,2012. 2. Deborah D. Lucki and Richard W. Pollay, “Content Analyses of Advertising: A Review of the Literature” Working paper, History of Advertising Archives, Faculty of Commerce, University of British Columbia, Vancouver, 1980. III. 電子書(Electronic Books) Ø 作者—書名—(出版地: 出版社,年份)—電子書類型—頁數. 初引：John Jowett, et al, The Oxford Shakespeare: the Complete Works, 2nd ed, (Oxford: Clarendon Press, 2005), EPUB, 60. 再引：John Jowett, et al, The Oxford Shakespeare: the Complete Works, 2nd ed, EPUB, 60. 徵引書目：Jowett, John, William Montgomery, Gary Taylor, Stanley Wells. The Oxford Shakespeare: the Complete Works, 2nd ed. Oxford: Clarendon Press, 2005, EPUB. IV. 報紙(Newspapers) Ø 作者/機構—“標題”—報刊名稱—月日,年/期數—版數(如有)—URL/資料庫(如有). 初引：Georgina Rannard, “Five planets to line up in rare planetary conjunction” BBC News Climate & Science, June 24, 2022, https://www.bbc.com/news/science-environment-61910977 再引：Georgina Rannard, “Five planets to line up in rare planetary conjunction”, BBC News Climate & Science, June 24, 2022. 徵引書目：Rannard, Georgina, “Five planets to line up in rare planetary conjunction”
191 BBC News Climate & Science, June 24, 2022, https://www.bbc.com/news/science-environment-61910977. V. 碩博士學位論文(thesis and dissertations.) Ø 作者—“論文名稱” —章節—(碩/博士論文,畢業大學,年份)—頁數—URL(如有). 初引：Melanie Subacus, “Duae Patriae: Cicero and Political Cosmopolitanism in Rome,” abstract (PhD diss., New York University, 2015), v, http://pqdtopen.pro quest.com/pubnum/3685917.html. 再引：Melanie Subacus, “Duae Patriae: Cicero and Political Cosmopolitanism in Rome,” abstract, v. 徵引書目：Subacus, Melanie, “Duae Patriae: Cicero and Political Cosmopolitanism in Rome.” PhD diss., New York University, 2015, http://pqdtopen.proquest.com/pubnum/3685917.html VI. 檔案與政府文件(public and Legal documents) Ø 作者—檔案匯編名稱/卷/冊數—(出版地: 出版商,年份)—頁數. Ø 作者(如有)—檔案/文件名稱—日期(如有)—檔案/文件編號—收藏機構(如有)—頁數(如有). 初引： 1. Arthur Christopher, Viscount Esher, The Letters of Queen Victoria: A Selection from Her Majesty’s Correspondent between the Years 1837-1861, Vol. III(London: John Murray, 1908, Published by Authority of Her Majesty the King), 163-178. 2. Act of Settlement, 1701,12 & 13 Will. 3, c. 2. 再引： 1. Arthur Christopher, Viscount Esher, The Letters of Queen Victoria: A Selection from Her Majesty’s Correspondent between the Years 1837-1861, Vol. III, 163-178. 2. Act of Settlement, 1701,12 & 13 Will. 3, c. 2. 徵引書目： 1. Christopher, Arthur, Viscount Esher. The Letters of Queen Victoria: A Selection from
192 Her Majesty’s Correspondent between the Years 1837-1861, Vol. III. London: John Murray, 1908, Published by Authority of Her Majesty the King. 2. Act of Settlement, 1701,12 & 13 Will. 3, c. 2. VII. 其他網絡資源(Websites resources) Ø 作者/機構/其他名稱—“標題” 網站名稱—瀏覽/最後修改日期—網址. 初引、再引與徵引書目： 1. Alliance for Linguistic Diversity, n.d. “Balkan Romani.” Endangered Languages. Accessed April 6,2016. http://www.endangeredlanguages.com/lang/5342. 2. Google. 2016. “Privacy Policy.” Privacy & Terms. Last modified March 25,2016. http://www.google.com/policies/privacy/.
