HPCE法测定蛹虫草及其培养物中核苷类化合物的含量

目的　建立蛹虫草中核苷类化合物的高效毛细管电泳测定法 ,比较天然蛹虫草及其培养物中核苷类化合物的含量。方法　在HV - 30 1高效毛细管电泳仪上进行定量分析 ,采用石英毛细管柱 ,以pH9.0的 4 0mmol·L-1 硼砂溶液作为电极缓冲液 ;分离电压为 1 6KV ;检测波长为 2 5 4nm。结果　天然蛹虫草中核苷类化合物主要集中在子座部分。人工培养蛹虫草子座和菌丝中虫草素的含量分别是天然蛹虫草子座中的 5 .0 4倍和 1 0 .85倍 ;液体培养蛹虫草菌丝中腺嘌呤、腺苷、尿苷、鸟苷含量均高于固体培养蛹虫草子座。结论　天然蛹虫草及其培养物中核苷类化合物的种类和含量具有较大的差异。高效毛细管电泳法可以用于蛹虫草的定量分析 ,具有分离度高、简便、准确 ,样品消耗少等特点     

Managing retrenchment in French public hospitals: philosophical and regulatory constraints.

The French hospital system is experiencing economic stresses similar to those experienced by US hospitals. Pressures for cost containment have occurred due to changes in health care funding. The public hospital system is facing unprecedented severe retrenchment. Innovative strategies for managing retrenchment have been restricted by regulatory and philosophical constraints. What is needed is to provide more autonomy for individual hospital managers together with greater accountability for achievement of results.     

Cognitive processes involved in the appraisal of stress

Four experiments were organized around a central question: What is the form of relationship between estimated stress level on the one hand and situation strain, personal resources and social support, on the other? The first experiment examined the form of the relationship between estimated level of stress, situation strain and personal resources. The participants were students. They integrated situation strain and personal resources information in a non‐additive way. In particular, the effect of personal resources on the estimated level of stress varied as a function of the level of situation strain considered. When the situation strain was low, the stress level related with this circumstance largely depended on the personal resources of the individual. When the situation strain was high, the stress level related with this circumstance was much less dependent on the personal resources of the individual. The second experiment replicated these results among first‐aid workers, fire‐fighters and persons that had recently been injured. The third and fourth experiments replicated these results in various conditions differing as regards the level of social support. Copyright © 2002 John Wiley & Sons, Ltd.     

不同层次护生对临床教学质量的评价

目的分析不同层次护生对临床教学质量评价的差异,以便采取有针对性的教学方法.方法护生在每个科室实习结束后,采用自行设计的临床教学评价表对每名护生进行问卷调查,然后分别从中专、大专、本科护生填写的调查表中各随机抽取30%进行分析.结果对病房教学氛围和护士长教学管理的评价,本科与中专、大专护生间比较,差异有显著性意义(均P<0.05),中专与大专护生间无差异(P>0.05);对带教老师的评价,本科与中专、大专与中专护生间均差异有显著性意义(P<0.01,P<0.05),本科与大专间无差异(P>0.05).结论不同层次护生对临床教学质量评价的侧重点不同,本科生对病房教学氛围及护士长教学管理的要求较高,大专生次之.在临床教学中应根据护生的学历层次,采取有针对性的教学方法,以便不断提高临床教学质量.     

复发性脑膜瘤术前评估与术中处理

目的探讨脑膜瘤复发手术方法。方法1998年10月以来我院收治复发性脑膜瘤12例,对术前组织病理、CT、MRI及术中所见进行回顾性分析,总结。结果12例病人均行手术治疗,术后随访,无再次复发。结论手术是治疗复发性脑膜瘤的重要手段,完整切除肿瘤、术中化疗是减少复发的关键。     

How to Effectively Implement an Indicator System to Improve Performance from a Management Perspective: The Case of Taiwan Healthcare Indicator Series (THIS) System

This study uses the Taiwan Healthcare Indicator Series (THIS) system as an example to examine which determinants would improve performance by sharing indicators from a management perspective. This study population included all 227 hospitals participating in the THIS system in 2006. A structured questionnaire was sent to the director who was responsible for the THIS system via electronic mail. A total of 111 responses were returned by February 10, 2006. Questions included current implementation and impacts of the system. Hierarchical regression models were performed to identify which variables were significantly associated with performance improvement, adjusted for hospital characteristics. Four variables significantly associated with implementing the THIS system to improve performance were ‘senior management support,’ ‘benchmarking,’ ‘making departments improve the underperforming indicators and report the improvement results in performance management meetings,’ and ‘integration with the National Health Insurance payment regulations’. This study contributes substantially to the evidence base about what works to improve performance by information sharing. Although information sharing is the basis of efforts to improve performance, senior management support and how to effectively apply the information are the most important determinants of performance enhancement.     

Increased NoGo-anteriorisation in first-episode schizophrenia patients during Continuous Performance Test

OBJECTIVE: NoGo-stimuli during a Continuous Performance Test (CPT) activate prefrontal brain structures such as the anterior cingulate gyrus and lead to an anteriorisation of the positive electrical field of the NoGo-P300 relative to the Go-P300, so-called NoGo-anteriorisation (NGA). NGA during CPT is regarded as a neurophysiological standard index for cognitive response control. While it is known that patients with chronic schizophrenia exhibit a significant reduction in NGA, it is unclear whether this also occurs in patients undergoing their first-episode. Thus, the aim of the present study was to determine NGA in a group of patients with first-episode schizophrenia by utilizing a CPT paradigm. METHODS: Eighteen patients with first-episode schizophrenia and 18 matched healthy subjects were investigated electrophysiologically during a cued CPT, and the parameters of the Go- and NoGo-P300 were determined using microstate analysis. Low resolution tomography analysis (LORETA) was used for source determination. RESULTS: Due to a more posterior Go- and a more anterior NoGo-centroid, NGA was greater in patients than in healthy controls. LORETA indicated the same sources for both groups after Go-stimuli, but a more anterior source in patients after NoGo-stimuli. In patients P300-amplitude responses to both Go- and NoGo-stimuli were decreased, and P300-latency to NoGo-stimuli was increased. After the Go-stimuli false reactions and reaction times were increased in patients. CONCLUSIONS: Attention was reduced in patients with first-episode schizophrenia, as indicated by more false reactions, prolongation of reaction time, P300-latencies and by a decrease in P300-amplitude. Significantly however, the NGA and prefrontal LORETA-sources indicate intact prefrontal brain structures in first-episode schizophrenia patients. Previously described changes in this indicator of prefrontal function may be related to a progressive decay in chronic schizophrenia. SIGNIFICANCE: The results support the idea of a possible new biological marker of first episode psychosis, which may be a useful parameter for the longitudinal measurement of changing prefrontal brain function in a single schizophrenia patient.     

The Impact of Family Relations on Caregivers' Positive and Negative Appraisal of Their Caretaking Activities

This study examined the impact of family support and relationship difficulties between the caregiver and the care recipient on caregivers' satisfaction received from caregiving activities and subjective burden. Ninety‐seven individuals caring for a spouse or an adult child with schizophrenia or bipolar disorder participated in the study. Using hierarchical multiple regression analyses, findings showed that relationship difficulties between the caregiver and the care recipient were associated with both satisfaction received from caregiving activities and subjective burden, after the effects of personal, contextual, and stressor variables were controlled. Family support was not associated with caregivers' appraisal of the situation.     

实施绩效考核的实践和体会

介绍绍兴市人民医院实施绩效考核的经验和体会.其经验在于:明确考核定位,把考核的首要目的定位于医院管理目标的实现和对管理过程的一种控制;运作方式是:制定考核标准、确立考核周期、明确考核部门及人员,使绩效考核真正落到了实处,收到了显著效果.