浅谈医院实施药学服务的必要性

目的医院实施药学服务，通过药师参与临床用药，提高临床用药的安全性、有效性、合理性。方法搜集有关介绍医院施行，临床药学服务的文献资料，分析医院施行药学服务的重要性。结果医院有必要加强对药学服务的认识，改革现有的药学教育模式和药房管理与服务模式。结论药师参与临床用药前景广阔，需要得到临床的配合和信任。     

基于价值观视角下的临床科主任价值取向思考

临床科室在医院工作中处于举足轻重的地位，是医院管理工作的基础，从某种程度上说，临床科主任是医院建设的中坚力量，是医院的支柱。临床科主任的价值取向直接影响到广大医务人员的思想道德和价值观，帮助临床科主任构建正确的价值取向，对树立医院形象，促进医德医风建设及医院发展，具有十分重要的意义。     

无锡市第四人民医院

无锡市第四人民医院创建于1976年，是卫生部首批三级医院、苏州大学附属第四医院和南京医科大学教学医院，开放病床1018张，医院是以肿瘤诊治为主要特色的综合性医院，拥有省级临床重点专科肿瘤科、麻醉科。市级临床重点专科胸心外科，无锡市肿瘤防治研究所、无锡市心胸外科治疗中心、苏州大学临床肿瘤和分子生物研究中心等均设在医院。     

论医院信息管理系统

医院信息管理系统是医院管理现代化的必备条件。目前，医院信息管理系统已应用于医院管理、临床医疗及信息服务等方面，并且取得了一定的经济效益和社会效益，其今后的发展方向应以临床、远程医疗和大规模一体化医院信息系统为重点。     

医院图书馆与临床科研

图书馆是系统收藏文献并提供文献信息服务的机构。医院图书馆是医学科技创新体系的重要组成部分，是开展医疗、教学和科研工作的重要信息支撑。临床科研是现代化综合性医院的重要职能，加强为临床科研服务是新时期医院图书馆工作的主要方向。充分发挥医院图书馆在临床科研中的作用，对提高医院的科研水平有重要的作用。本文探讨医院图书馆服务、医院及临床科研工作之间的关系。     

临床科室主任作为管理者的基本思路

临床科室是医院基本的技术和服务单元，作为医院整体功能的一部分，临床科室承担着医疗、教学、科研的各项具体工作，直接面对患者和服务人群，是医院的窗口之一和医院目标任务执行完成的重要终末环节。临床科室的重要地位表现在：①有特定的技术服务范围和就医人群；②既是医院的一部分，又在本专业内发挥主导作用；③科室的发展受到医院大环境的影响，但也能在众多的科室之中脱颖而出，成为医院的优势学科和品牌。从一定角度而言，临床科室是一所医院的雏形，临床科室主任不仅起上传下达的桥梁作用，而且要充分进行科室管理，使科室成为有活力有生命力的实体，不断发展壮大，保证持久的技术和服务能力。临床科室主任肩负着科室发展现实和历史的责任，作为管理者工作千头万绪，但择其要者应为以下几个方面。     

病历书写常见缺陷、错误浅析

为了帮助临床医师提高病历书写质量，将病案中所发现的病历书写常见错误及容易忽略的问题加以分析，通过总结旨在帮助临床医师提高书写水平，同时也是临床医师的职责和必须掌握的基本技能，是医院管理人员了解医院工作状态、提高医疗质量的重要手段之一，是加强医院管理、提高医院管理水平的重要措施。     

武警海南省总队医院

武警海南省总队医院组建于1988年7月，开诊于1991年10月，同时设立医务处、政治处、院务处、临床科和非临床科，编制床位100张，随着医院的不断发展和各级党委的重视，医院也不断扩大，到1998年开设病床105张，同年被武警总部后勤部评为“二级甲等”医院。     

医院制剂的回顾与展望

医院制剂是医院药学的重要组成部分，在保障临床用药、满足医疗科研需要等方面起着重要作用。首先医院制剂为医院药学保留了一块科、教、研的重要阵地和发展空间，其次医院制剂为临床提供了质量可靠、剂型科学的产品，也为医院创造了可观的经济效益。但现实并不乐观：一方面，国家为了降低药费的比例，出台了医药分开核算办法，而部分人错误     

二级综合医院口腔科的管理体会

随着医改的深入，医院对临床科室的管理提出了新的和更高要求。科主任是临床科室的主要领导和第一责任人，临床科室管理工作的好坏直接影响着医院的医疗护理质量、经济效益和精神面貌，同时也影响着医院的声誉和形象。如何搞好科室管理，共同推进医院发展，结合我科情况，谈点粗浅的看法。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.