重视高学历技术干部的培养和管理

我院着眼于医院的长远建设，狠抓高学历人员的培养，取得了明显成效。主要做法：（1）全面提高高学历人员的整体素质注重在实践中提高临床技能，提高科研能力、培养自主意识和创新能力。（2）对高学历人员要强化3种意识，即乐于奉献的意识、以病人为中心的意识、积极进取的意识。（3）为鼓励高学历优秀人才脱颖而出优化成才环境，即为高学历人才施展才华－搭台子、压担子、送梯子。（4）对高学历人员实行优胜劣汰的动态管理，对平庸和无作为的人员淘汰出局。     

某医院培养临床科研复合型人才的探索

本文介绍了某医院推进人才培养措施,促进更多的临床医技人员成为临床科研复合型人才的经验,一系列举措最终提升了医院的综合实力,也取得了一定的成效。要使临床“匠才”成为临床科研复合型人才,需要采取加强引导,强化科研意识;搭建平台,提高科研能力等措施。     

实施人性化管理 稳定聘用人员队伍

随着医院的快速发展，聘用人员已成为推动医院全面建设的一支重要力量。通过规范管理，保障聘用人员合法权益；以人为本，营造诚心留人环境；培养使用，搭建施展才化平台等措施，激发聘用人员工作的积极性，增强其向心力、凝聚力，保留骨干，稳定队伍，以促进医院整体技术水平的提升。     

重视创新教育培养高素质人才

为做好医院医务人员的业务培训工作，本文阐述了把创新教育作为主导方向，即：充分认识创新的时代意义，培养综合素质，提高各种能力；营造成材环境，培养创新骨干。积极发挥业务培训工作在医院开展创新工作中的作用。     

临床高学历专业人员业务水平的多因素Logistic回归分析

为了促进临床高学历人员的业务发展，探讨对高学历人员专业发展的影响因素。选择了自1998年以来以普通高等学校毕业且被分配到同一单位的120名高学历临床医疗专业人员进行了5年随访和公众认可分级打分，将其分为“成功”和“一般”，采用Logistic回归分析法探讨了各变量对“成功”的贡献率，建立回归方程。结果发现，发表论文数量和水平、出版著作情况、科研项目得分、开展诊疗新技术得分、专家对其临床实践操作评分、外语水平6个变量，为影响高学历人员能否成功的主要因素，应在上述方面加强对高学历人员培养和训练。     

高学历住院医师综合能力培训

为探索高学历住院医师临床综合能力的培养路径,本文从分析高学历住院医师综合能力存在的问题入手,提出建立规范化培训管理体系,制定个体化培训方案和严格规范化培训考核制度等培养策略与方案,并指出强化培训意识、注重导师选拔、科学选择培训方法、增强创新意识和沟通能力等重点问题.     

创建特色信息技术基地 辅助打造数字化医院

如何创建有特色的全军医院信息化研究与技术支持基地,其主要任务是：坚持自身建设与医院信息化建设相结合,始终为医院数字化建设服务的指导思想,努力当好营造数字化医院网络环境的设计师、当好搭建数字化应用平台的策划人。以“军字一号”工程为基础,提高基地人员技术支持能力;以开发软件为核心,提高基地人员技术创新能力;以引进软件为纽带,提高基地人员技术管理能力。按照数字化医院发展目标,积极创建有特色的信息技术基地。     

临床科技成果管理的思考和对策

从三个方面剖析了临床科技成果管理中存在的困惑现象：临床科技成果的“商品”属性；临床科技成果管理在医院中的地位；临床科技成果开发过程中出现的社会问题。同时，针对以上问题提出了相应的对策：引进价值规律，强化激励机制；引进竞争意识，强化运行机制；引进法规观念，强化监督机制。     

深化医学教学改革提高外科学临床实习质量

随着医学教学改革的不断深化，保证并提高外科学临床实习质量倍受社会的关注。作者针对本校近年来外科临床带教中暴露出来的主要问题提出几点教学改革设想：①注重素质教育，在思想上培养学生刻苦好学精神；②加强“三基”训练，尤其是“基本操作技能”的训练，严格要求，严把“出科关”；③实行专科带教教师负责制；④建议改变现行的五年制医学本科生直接报考硕士研究生的政策；⑤针对学生爱好及社会的不同需求分层管理，分类侧重培养；⑥进一步提高教师的综合素质。经以上措施，有可能提高临床实习教学质量，达到培养和造就社会需要的高素质医学人才之目的。     

适应军事变革需要谋求医院快速发展

为适应军事变革需要，提高卫勤保障能力．本文就如何谋求医院快速发展进行了有益地探索和尝试。一是在学科建设上打“特色牌”：发展传统特色优势学科，培养新兴特色优势学科，并积极打造优势学科群，提升医院核心竞争力。二是在人才培养上打“优质牌”：培植医务人员高尚的人格品质；促进医学人才专业技能的提升；搭建人才成长高平台。三是在医院管理上打“创新”牌：实行科主任领导下的主诊医师负责制；建立优质服务满意率测评链；完善机关绩效评价机制，打造“学习型机关团队”。     

Die sogenannte Vinylchlorid-Krankheit—eine berufsbedingte Systemsklerose?

Zusammenfassung Es wurden 13 Arbeiter untersucht, die zwischen 1 3/4 und 18 Jahren in einem PVC-herstellenden Betrieb beschäftigt waren. 8 von ihnen wiesen sklerodermieartige Hautveränderungen (Abb. 2) auf, die histologisch charakterisiert sind durch Verbreiterung und Homogenisierung der kollagenen Faserbündel (Abb. 3 u. 4) sowie Fragmentation und Rarefizierung der elastischen Fasern (Abb. 5). Bei 7 Patienten bestanden trommelschlegelartige Auftreibungen einzelner Fingerendphalangen (Abb. 1). 11 Patienten zeigten Durchblutungsstörungen der Extremitäten (4 von diesen ein Raynaud-Syndrom) und 6 Patienten Acroosteolysen einzelner Fingerendphalangen (Abb. 6, Tabellen 1–3).Darüber hinaus bestand bei allen Patienten eine Thrombocytopenie, bei 12 Patienten eine Splenomegalie, bei 11 Patienten eine Einschränkung der Leberfunktion (erhöhte BSP-Retention). An der Leber ließ sich histologisch bei den 5 laparoskopierten Patienten eine deutliche Fibrosierung der Portalfelder nachweisen. Bei 4 Patienten bestanden Oesophagusvaricen (Tabellen 4 u. 5). 8 Patienten zeigten eine Partialinsuffizienz mit Hinweisen für vorwiegend restriktive Veränderungen.Die hier beschriebenen Veränderungen gehen weit über das bisher bekannte Acroosteolysesyndrom hinaus. Es wird der dringende Verdacht geäußert, daß langfristige Vinylchlorid-Exposition dieses komplexe Krankheitsbild verursacht. Daher wird für diese systemische Krankheit die Bezeichnung Vinylchlorid-Krankheit vorgeschlagen.Wir danken Frau E. Voigtländer für die Herstellung der klinischen und histologischen Abbildungen.     

Empathic processes: perception by medical students of patients'' anxiety and depression

Perceptions by medical students of patients' affective states were investigated, and the effect of the students' own emotions on such perceptions. One hundred and one fourth-year medical students rated the levels of anxiety and depression of three women patients presented on videotape, rated their own levels of anxiety and depression and completed a questionnaire on aspects of the rating process. Students had widely different and often inappropriate perceptions of patients' levels of anxiety and depression. Students who consistently overrated anxiety or depression in patients, compared to those who consistently underrated, were themselves significantly more anxious or depressed. These data suggest a need in medical education for systematic teaching of empathic skills and for recognition of potential bias in clinical decision-making arising from the clinician's own emotional state.     

The reported incidence of work-related ill-health in Scotland (2002-2003)

BACKGROUND: Although incidence data for work-related ill-health in the UK are available, more detailed information for smaller geographical areas has hitherto been unpublished. AIMS: To estimate the incidence of work-related ill-health reported by clinical specialists in Scotland, 2002-2003. METHODS: THOR (The Health and Occupation Reporting network) is a UK wide reporting scheme for work-related ill-health. In 2002-2003, 241 out of 2162 physicians in THOR were based in Scotland. We have summarized the reported cases and calculated incidence rates for categories of ill-health by age, gender and industry. The UK Labour Force Survey (2002) was used to provide denominator data, with comparisons made between rates for Scotland and the rest of the UK. RESULTS: In 2002-2003, 4043 estimated cases were reported from Scotland. Mental ill-health was most frequently reported (41%); followed by musculoskeletal disorders (31%), skin disorders (16%), respiratory disease (10%), hearing disorders (2%) and infection (1%). The reported average annual incidence rate per 100,000 employees for all work-related ill-health in Scotland was 86.0. The highest reported rate for mental ill-health was found for employees in public administration and defence (76.7 per 100,000), and health and social work (72.3 per 100,000). The construction industry had the highest reported rate of musculoskeletal disorders (41.6 per 100,000), while hairdressers appeared at most risk of developing occupational contact dermatitis (rate=86.4 per 100,000). CONCLUSIONS: Despite its limitations, THOR has indicated types of work-related ill-health and related industries for targeted disease prevention in Scotland.     

Function of the protein RPE65 in the visual cycle

A protein called RPE65 performs a key role in the trans-cis isomerization of retinol in the retinal pigment epithelium of the eye. The palmitoylation of RPE65 serves to switch off the visual cycle in darkness and to switch it on in the light.     

Acute symptoms following work with pesticides

BACKGROUND: Serious accidental poisoning by pesticides is rare in the UK, but more minor pesticide-related illness may be under-reported. Anecdotally, use of sheep dip has been linked with flu-like symptoms. AIM: To explore the frequency, nature and determinants of acute symptoms following work with pesticides. METHODS: A postal survey of men in three rural areas of England and Wales provided data on occupational use of five categories of pesticide, occurrence of 12 specified symptoms within 48 h of using pesticides and tendency to somatize. Risk factors for pesticide-related symptoms were assessed by modified Cox regression. RESULTS: Of 10 765 responders (response rate = 31%), 4108 had at some time used pesticides occupationally, including 935 (23%) who reported symptoms following such work on at least one occasion. In two areas, acute symptoms were most frequent following use of sheep dip (29 and 32% of users), but in the third area the rate was significantly lower (13% of users). The relative frequency of symptoms was similar for all five categories of pesticide, and flu-like symptoms did not cluster unusually among users of sheep dip. Risk of pesticide-related symptoms increased with somatizing tendency (prevalence ratio for highest versus lowest category 2.4, 95% confidence interval 2.0-3.0) and was higher in men who had used pesticides most often or handled concentrate. CONCLUSION: Acute symptoms are common following work with pesticides, but in many cases the illness may arise through psychological rather than toxic mechanisms.     

The Life Events Inventory: re-scaling based on an occupational sample.

The objective of this study was to compare the validity of the original weightings used by the Life Events Inventory (LEI) with those obtained from a contemporary occupational sample. Fifty male and 62 female manufacturing employees (age range 16-55 years) assigned scores to each item on a slightly modified version of the LEI scale. The current sample consistently assigned higher weights to events/items than did the original sample, but there was high agreement in terms of item ranking. Some distinct age and gender differences in scoring were apparent, and are discussed further. It was concluded that when separate weightings are employed for age and gender groups, the LEI remains a useful tool for quantifying background levels of stress in both workplace stress audits and epidemiological studies where statistical control for non-occupational sources of stress is required.     

Maxillofacial injuries related to work accidents: a new concept of a hospital-based full electronic occupational trauma surveillance system

The objective of this study was to investigate the occurrence of occupational maxillofacial injuries using a newly installed relational database. Twenty-six injuries were identified out of 28,624 patients admitted to the emergency unit during a 12 month period. Falls from height or being struck by moving objects were common causes of these injuries. Two-thirds of those identified were construction workers. This paper demonstrates the power of modern databases to identify specific occurrences that may provide the basis for prevention in the future.     

Rôles physiologiques des endocannabinoïdes dans le contrôle de l’homéostasie énergétique

Endocannabinoids are endogenous lipids which modulate the release of neurotransmitters and activate different signaling pathways, through the binding to cannabinoïd receptors, CB1 and CB2. Endocannabinoids are involved in the control of a variety of behavioural and neuroendocrine functions, including feeding behaviour. In the central nervous system, they essentially modulate the expression of orexigen or anorexigen neuropeptides thus resulting in the stimulation of food intake. Their peripheral targets are mainly the liver and the white adipose tissue where they stimulate lipogenesis, through the modulation of several enzymes and proteins expressions. Cannabinoïd receptor agonists are nowadays prescribed to improve appetite of people suffering from cancer or AIDS. In the same way, CB1 antagonist, such as Rimonabant, could provide efficient treatment of obesity.     

Stress in police officers: a study of the origins,prevalence and severity of stress-related symptoms within a county police force

BACKGROUND: High levels of stress-related illness are causing concern across industry. Against a background of impending legislative moves to try to improve this situation, there is a need to identify key work-related stressors. Police work tends to be regarded as inherently stressful because of the personal risk of exposure to confrontation and violence and the day-to-day involvement in a variety of traumatic incidents. As a result, high levels of stress-related symptoms might be expected in this population. OBJECTIVE: To examine the sources of stress-related symptoms within police officers and measure the prevalence of significant associated mental ill-health. METHOD: A cross-sectional questionnaire survey of a population of 1206 police officers was performed to assess levels of strain associated with a series of potential home and work related stressors. Participants were then split into low and high scoring groups on the basis of a General Health Questionnaire (GHQ) threshold score in order to identify those stressors most associated with mental ill-health effects. RESULTS: Occupational stressors ranking most highly within the population were not specific to policing, but to organizational issues such as the demands of work impinging upon home life, lack of consultation and communication, lack of control over workload, inadequate support and excess workload in general. The high scoring group constituted 41% of the population and differed significantly from those with low scores in perception of all stressors, ranking both personal and occupational stressors more highly, and from personality constraints appeared significantly more 'stress-prone'. A significant association between gender and mental ill-health was found, with females more likely to score more highly on the GHQ than males. CONCLUSION: This study confirms previous findings of organizational culture and workload as the key issues in officer stress. Given that the degree of symptomatology appears to be worsening, management action is required. Further research is indicated within the police population into a possible increased susceptibility in female officers.