From the end of the world to the top of the world

I've been on the road a bit this summer. Because of the kind generosity of my London broker, Lloyd and Partners, Ltd., I've been allowed the unique opportunity to have an insider's view of the London market. I observed an interesting renewal situation and sat with underwriters in their boxes amid the hallowed (at least to us insurance geeks) trappings of Lloyd's. I spent several lovely days in Hanover with my long‐time lead reinsurer, Hanover Re, while trying desperately to keep up with my own work back home. It's been stimulating and thought‐provoking, and I know I won't ever view the purchase of insurance in the same way.     

Relationship of the clinician and the pathologist at the turn of the millennium

The autopsy, once a fundamental and familiar component of medical practice based on the good cooperation of clinicians and pathologist, is now infrequently used. Recent data indicate that autopsies are performed only about one third of the cases in Hungary and less that 1 of 10 inpatients death in the united States. Explanation for this decrease is multifactorial, involving changing professional and patients attitudes, the advent of sophisticated antemortem diagnostic methods, socioeconomic factors, and medicolegal concerns as well. Teaching institutions need to reevaluate concerning the need and practice of the autopsy. "The final audit" not always reflect well on clinical diagnoses and management of patients. Many facts proves that our modern tools still not enough to reach always a correct and safe diagnoses. Errors are still common in medicine. About 10% of necropsies indicate a clinical managements different from what the patients received, 20% reveal additional diagnoses, and 60% of cases have teaching point. Though autopsy is expensive and time consuming, moreover the shortage of pathologist is evident, necropsy should remain the cornerstone of medicine in the new millennium as well. There are a broad range of different fields where pathologist and clinicians should work together in an everyday--setting--e.g. evaluate biopsy- or cytology-samples. Clinicopathological conferences are also important to discuss cases mainly for teaching purposes. Without maintaining the traditionally good cooperation neither clinicians nor pathologists will be able to give proper answers to the challenges and professional questions of the new era.     

从医方视角探解医患关系困境

目的：从医方视角探解医患关系困境。方法2013年10月-2013年11月,从本市几所主要医院中随机选择600例住院患者及医务人员进行研究。利用问卷调查法,对医患关系相关情况进行调查。结果调查发现,医务人员中有34.3％认为医患关系紧张,患者中有8.6%认为医患关系紧张。患方对医方不满的原因主要有沟通交流障碍和态度问题以及医疗质量问题等方面。结论面对医患关系的困境,医方需要积极的采取患者-医生-医院三位一体的应对策略,不断提高整体医疗质量,为患者提供人性化的医疗服务,努力改善医患关系。     

酶标仪检测数据的PC端处理及远程控制

本文利用串行通讯技术和灵活的计算机编程技巧，实现了酶标仪和计算机之间的数据通讯、分析和处理，并可脱离酶标仪面板，做到对酶标仪的远程控制。     

Appealing to the ''experience'' of the patient in the care of the dying

The care of dying patients in hospital is characterized by the copresence of four different frames: practical, medical, lay and psychological. Within the psychological frame, the staff define the patient as an experiencing subject, exposed to the staff members' knowledge and involvement. The psychological frame is used in two different circumstances. First, it is used by the staff members when the patient deviates from an expected identity within some other frame. The deviation creates a threat to the working conditions and moral order at the ward. The threat is managed through a shift into the psychological frame. Second, the psychological frame is used spontaneously in the accounts of their work given by staff members to the sociological field researcher. The image of care associated with the field researcher is characterized by a special awareness of the psychological issues. Thus the field researcher is inevitably a part of the functioning of the new kind of surveillance working through the psychological frame.     

氢化物发生—原子荧光光谱法测定牙膏中的铅

目的:建立了一种测定牙膏中微量铅的方法——氢化物发生—原子荧光光谱法。方法:采用硝酸—高氯酸消解,氢化物发生—原子荧光光谱法测定。结果:线性范围为0~100μg/L,检出限为0.23μg/L,样品加标回收率为91.7%~102.1%,用标准物质茶叶(GBW10016)对该法验证,验证结果与推荐值一致,相对标准偏差为1.18%。结论:该法检出限低,线性范围宽,精密度好,准确性高,适合牙膏中微量铅的检测分析。     

Plundering the poor: the role of the World Bank in the Third World

The World Bank, the most important so-called development assistance agency, annually dispenses billions of dollars to Third World governments, ostensibly to "develop" their economics through a variety of loan projects. But even a superficial analysis reveals that the Bank is the perfect mechanism to help (i.e., subsidize) the large transnational corporations from the industrial countries to expand their industrial, commercial, and financial activities in the Third World, at the expense of the latter and particularly at the expense of the rural and urban proletariat. This article discusses Cheryl Payer's recent book, The World Bank: A Critical Analysis, in which she analyzes the Bank's role in the Third World and sets forth the major reasons why poverty, hunger, and malnutrition, as well as unemployment, and all the adverse social phenomena associated with them, are on the increase.     

Estimating the effect of the run-in on the power of the Physicians' Health Study

In the Physicians' Health Study, a randomized, placebo-controlled, double-blind trial of aspirin in the reduction of cardiovascular mortality and beta-carotene in decreasing cancer incidence, 33,223 subjects were eligible and willing to enter the trial. Instead of randomizing this group immediately, all participants received identical calendar packs that contained active aspirin and beta-carotene placebo. Following an 18-week run-in, only 22,071 subjects who remained eligible and willing and had taken at least 2/3 of their pills were randomized. We estimated the effect of the run-in as follows: pill taking compliance increased 20-41 per cent; sample size decreased 34 per cent; duration of follow-up decreased 7 per cent which resulted in a 7 per cent decrease in the expected event rate for the placebo group. To estimate these changes, we made assumptions about compliance and outcome risk for those excluded by the run-in. Our conclusion, however, about the net effect of the run-in on the power of the study remains constant across variations in a number of those assumptions. The power with the run-in, with 22,071 good compliers was typically higher, and never more than negligibly lower, than the power without the run-in, with 33,223 good and poor compliers. In addition, savings from enrolling 11,152 fewer subjects in the trial resulted from the use of the run-in.     

新形势下对医院文化建设的思考

随着我国卫生医疗事业近年来飞速的发展和民众日益增长的需求,如何从容面对外部严峻的挑战以及如何抓住自身发展的机遇成为医院改革和发展不得不面对的问题,而医院文化建设正是推动医院发展、提高医院综合竞争实力的核心内容。同时,医疗改革的不断深化更是对医院的管理提出了新的要求,这就使得管理者必须科学地运用医院文化这一现代化的医院管理理论提高医院的管理水平,增强医院的综合实力。     

社区慢性精神分裂症患者康复技能训练疗效初探

目的探讨社区慢性精神分裂症应用康复技能训练的远期疗效。方法将100例稳定期精神分裂症患者随机分成技能训练组和对照组各50例。对技能训练组进行共4周的模式化训练,然后随访4周。采用阳性和阴性症状量表（PANsS）和白知力与治疗态度问卷（ITAQ）对患者进行评估。结果训练组患者的PAN—SS总分及其阴性量表分和一般精神病理量表分从训练第4周末分别为（54．86±2．94）分,（14．44±l_67）分,（27．98±1．97）分,明显优于对照组（60．22±2．83）分,（18．28±1．63）分,（29．70±2．131）分,差异具有显著性（P〈O．01）;训练组患者对疾病的自知力在训练第4周末为（10．68±1．95）分,明显强于对照组（8．64±2．19）分,差异具有显著性（P〈0．01）;随访4周两组均无复发。结论技能训练提高了药物治疗的疗效,弥补药物的不足,提高患者对疾病的认识,从而促进患者更好的康复。     

分光光度法测定瓜果类蔬菜中铁的含量

用分光光度法直接测定瓜果类蔬菜中铁的含量 ,方法简便快速准确 ,对指导人们合理食用瓜果类蔬菜进行补铁及进一步开发瓜果类蔬菜产品提供了可靠的理论依据。     

医疗技术发展的伦理监督和法律调控——兼对《医疗技术临床应用管理办法》的解读

医疗技术的违规使用问题日趋严重,对医疗技术的发展进行监管有其必要性;通过医疗技术发展实现目的·陛与规律性的统一、动机与效果的统一,达到技术发展与社会的协调。主张对医疗技术的发展、使用、推广进行监管：对医疗技术的发展进行伦理监督和法律监管;对医疗技术及其使用主体即医生、医疗机构实行准入制度。     

Seeing the forests for the more than the trees.

Assessing the health effects of deforestation is difficult because of the rate at which the world's forests are disappearing. From 1990 to 1995 alone, the world lost a total area of forest cover nearly twice the size of Italy. Deforestation, which is caused by human population growth and encroachment, clearance for agricultural production, and the growing worldwide demand for wood products, has been linked with effects ranging from local changes in climatic and disease patterns to global climate change and biodiversity loss. Deforestation is responsible for about 25% of net annual releases of carbon dioxide into the atmosphere and also lessens the amount of forest available to absorb greenhouse gas emissions. Deforestation also causes a tremendous loss of biodiversity worldwide. It is estimated that over the next 50 years deforestation will rank as the single greatest cause of species loss.     

控烟工作中的难点与策略

分析了控烟工作中存在的难点,提出了提高控烟工作效果的策略：（1）加强控烟的关键是扩大禁烟的场所和明确控烟法规的执行主体;（2）从宣传吸烟有害健康转变为宣传被动吸烟有害健康;（3）消除人们为吸烟所找的借口;（4）大力宣传不吸烟、不敬烟和不在他人面前吸烟;（5）控烟应从卫生工作者开始。     

Vaccinology: the name, the concept, the adjectives

The visibility of the term vaccinology has become more pronounced in the 21st century in defining a scientific field that has absorbed aspects from different scientific domains until finally acquiring an identity of its own. As a result, vaccinology brings together a long tradition of researchers who have operated within a linear paradigm and incorporates new generations of scientists who have forged an exciting and diverse network of knowledge within this field. The term vaccinology, which initially appeared in isolation at the time of Jenner and once again with the emergence of the Pasteurian model, acquired further prominence thanks to the efforts of the vaccinologists who chronicled the production of vaccines in the last third of the 20th century. The term has since become truly consolidated, with the appearance of new adjectives during this century. This study provides a historical perspective for the frequency of use and evolution of this increasingly widespread term.     

医院感染监控管理综合评估在医院管理中的应用

目的 对医院感染监控管理进行全面、综合的评估。方法 应用综合评估指标体系，对监控工作进行量化评估。结果 甲、乙、丙医院综合评定状态(SA)分别为78．0、21．7、12．9，甲医院感染监控质量高。结论 建立的医院感染监控管理综合评估体系具有较强的科学性和可行性。     

优化结构提高效率实现医院可持续发展

随着我国医疗保险的大范围实施，医院只有优化结构、提高效率，才能实现可持续发展。以财务管理为出发点，分析了目前大型医院所面临的现行国家医疗政策、外部环境以及内部约束等条件，提出强化医疗业务管理．建立科学合理的医疗业绩考核指标体系：平均住院天数、出院人数、手术量、门诊预约率，促进医疗业绩的提高：强化财务管理，建立现代医院财务考核指标体系：结余率、人均结余、病人人均费用，对各个科室的经济效益进行考核，促进医院经济效益的提高。     

Healthy community indicators: the perils of the search and the paucity of the find

The Canadian Healthy Communities Project (CHCP) is an ambitiousattempt to implement principles of health promotion and healthypublic policy at the municipal level. The aim of CHCP is tofoster local community organization and action around issueswhich threaten or may enhance residents' well-being. To participatein the project, communities must be prepared to monitor andevaluate their progress using indicators that are relevant,sensitive and easy to collect, and that will facilitate comparisonswith other communities. The perils of the search for indicatorswhich meet the criteria above coalesce around five main issuesincluding lack of guidance about how to proceed; lack of expertise;gathering the data itself; lack of resources and finally theconcern about how the results will be used. The paucity of thefind is not isolated to the Canadian Healthy Communities Project,but experienced by WHO Healthy Cities Europe project participantsas well. Finding one-size-fits-all indicators is doubtful giventhat the contextual dependence of relations are unique to eachlocal community. This paper addresses practical and theoreticalquestions about the role of indicators in the CHCP.     

增强法律意识，为新形势下高校基建工作护航

通过对新形势下高校基建所面临的形势和问题进行分析，从而为高校基建管理者提出相应的对策和建议，并希望建设方的管理者应增强法律意识，在日常工作中注意学习法律知识，了解最新的国家、地区的行业规定，用法律武器充分保卫学校的利益。