Acupoint Exploration A PRELIMINARY EXPLORATION OF THE CHARACTERISTICS OF SELECTING ACUPOINTS FOR EIGHT CATEGORIES OF PATTERNS OF IMBALANCE

With the help of computers,we have made statistics as to the frequency of se-lecting points for the eight categories of patterns of imbalance.We suggest that for the heat syn-drome,the points in the upper part should usually be selected,for the cold syndrome,the points inthe lower part should generally be adopted;for the exterior syndrome,the points on the yang surfaceshould mostly be selected,for the interior syndrome,the points on the yin surface should generally beadopted;for the asthenic syndrome,the points in the trunk should mostly be selected,for the sthenicsyndrome,the points at the extremities generally be adopted.     

General justifications for public health regulation

Convention holds that government intervention designed to promote population health and well-being is an unmitigated good. However, government should justify interventions because, almost invariably, they intrude on individual rights and interests and incur economic costs. This paper presents three general justifications for government intervention: (1) risk to others; (2) protection of incompetent people; and (3) risk to self. The first justification is the standard, well-accepted idea that government may intervene to prevent harm to others or punish individuals for inflicting harm. The second justification supports government action to protect the health and safety of those who are incapable of safeguarding their own interests. The third justification, and by far the most controversial, is paternalism; the protection of the health or safety of competent individuals irrespective of their own expressed wants or desires. This paper argues that the government gains the greatest legitimacy when regulating for the protection of harms to others, but even paternalism can support state action when health risks are socially embedded and harmful to the public.     

重度创伤急救原则的临床研究

目的探讨重度创伤(ISS评分≥16分)的急救原则。方法应用"ATP三原则"救治重度创伤:①外科主治以上医师(Attending)首诊并全权、全程指挥抢救原则;②患者入院后立即成立急救小组(Teamwork)救治原则;③抢救、检查、诊断同时进行,使抢救时间最短的并联(Parallel)原则。分析比较应用"ATP三原则"前、后各2年救治重度创伤的临床效果。结果应用"ATP三原则"前2年(2002-01-01~2003-12-31)共抢救、收治重度创伤388例,ISS评分(25.9±6.4)分,死亡152例,死亡率39.2%,抢救室抢救时间、入院至急诊手术时间分别为(102.8±16.7)min、(140.3±20.6)min。应用"ATP三原则"后2年(2004-01-01~2005-12-31)共抢救、收治重度创伤438例,ISS评分(28.6±7.8)分,死亡87例,死亡率19.9%,抢救室抢救时间、入院至急诊手术时间分别为(69.5±11.5)min、(89.6±9.3)min。两组治疗前ISS评分比较差异无统计学意义(P>0.05);两组治疗后死亡率、抢救时间、入院至手术时间比较差异均有统计学意义(P<0.05),应用"ATP三原则"后均明显降低。结论应用"ATP三原则"救治重度创伤能显著缩短抢救时间,降低创伤死亡率。     

坚持党管人才 构筑人才高地

人才是医院发展的动力与源泉,"党管人才",是党致力于改革和完善党的领导方式与执政方式、提高党的执政能力而作出的重大决策,是指导人才工作的根本原则。在公立医院改革进程中,医院党委应发挥党的组织力、凝聚力、协调力,优新人才机制、优惠人才政策、优化用人环境,构筑人才高地,推动医院的可持续发展。     

从医患关系模式的角度分析中国医疗领域中的“自主性原则”

通过调研和访谈从医患关系的模式角度分析了当前中国医疗领域中的“自主性原则”,对医生来说,虽然医生对患者的自主性表示尊重和接受,但很多时候仍将患者自主式作为医生履行职责的障碍;对患者来说,患者也没有将自主视为理想医患关系的要素,反而认为自主在很多情况下会损害自身的利益,提出在西方医疗实践的影响下,医患关系的模式处于传统的家长制和西方的消费主义两种极端模式相重叠的阶段,自主性原则在两种模式中被赋予了截然不同的价值,因而导致了自主性原则在当前中国医疗实践中的两难处境.     

病案管理中的医学伦理

病案管理是现代医疗质量管理的重要组成部分,医学伦理原则体现在病案管理的各个环节.病案管理要求各项病案管理操作满足符合患者利益、保护患者隐私权、尊重患者知情权及遵守法律等医学伦理要求.医学伦理贯穿于病案管理的始末,包括病案书写中的住院问诊、临床检查、诊疗计划、手术治疗、日常查房,病案归档中的纸质病案和电子病案的收集、整理、汇总和保存等,病案提供中的患者或第三方对病案资料的获取、临床或科研人员对病案资料的获取等方面.     

Continuation from a flat to a round Earth model in the coplanar orbit transfer problem

In this article, we focus on the problem of minimization of the fuel consumption for the coplanar orbit transfer problem. This problem is usually solved numerically by a shooting method, based on the application of the Pontryagin Maximum Principle; however, the shooting method is known to be hard to initialize, and the convergence is difficult to obtain because of discontinuities of the optimal control. Several methods are known in order to overcome that problem; however, in this article, we introduce a new approach based on the following preliminary remark. When considering a 2D flat Earth model with constant gravity, the optimal control problem of passing from an initial configuration to some final configuration by minimizing the fuel consumption can be very efficiently solved, and the solution leads to a very efficient algorithm. Based on that, we propose a continuous deformation from this flat Earth model to a modified flat Earth model that is diffeomorphic to the usual round Earth model. The resulting numerical continuation process thus provides a new way to solve the problem of minimization of the fuel consumption for the coplanar orbit transfer problem. Copyright © 2011 John Wiley & Sons, Ltd.     

关于教学工作评估指导原则的解读与哲学思考

本文结合高等院校实际情况,运用辩证统一的思想方法,对教学工作评估指导原则的深刻内涵和重要意义,进行了认真剖析和理性思考,认为抓好重点建设、及时纠错改过、选择最佳切入点、立足于长远发展,不但是教学工作评估指导原则的精髓,更是迎评准备中应当把握的要领。     

医疗费审查原则及应用研究

目的本文通过对医疗费审查原则及其应用的分析,以期提高医疗费审查结论的客观、合法和关联性,为法庭审判提供可采信的证据,扼止医疗费虚高现象。方法从法律法规、行政规章、司法解释及医疗技术规范等方面结合特殊案例对医疗费审查的原则及其应用进行分析。结果医疗费除其客观性及合法性外,医疗费的关联性是审查的关键点,也是难点,要求审查人员具备扎实的临床医学和法医学理论知识。结论在医疗费文证审查时应严格按照客观、合理、合法的原则进行,在遵守原则的基础上灵活运用临床医学和法医学知识才能作出较为客观公正的文证审查意见。     

H NMR-based metabonomic study on the metabolic changes in the plasma of patients with functional dyspepsia and the effect of acupuncture

Functional dyspepsia (FD) is a common gastrointestinal disorder with multiple pathogenic mechanisms seen in clinical practice, and acupuncture may potentially be an alternative therapy for it. In order to investigate the biological effects of FD and the effect of acupuncture on metabolism, ¹H nuclear magnetic resonance (NMR)-based metabonomic techniques have been used to compare the plasma metabolic profiles of six female FD patients with those of six female healthy control subjects. Plasma metabolic profiles of FD patients treated by acupuncture at the Foot-Yangming Meridian were also collected and compared. Data obtained from NMR spectroscopy were subjected to principal components analysis (PCA). The results show that there are relatively higher levels of glucose, acetate, high-density lipoprotein (HDL), and phosphatidylcholine (PtdCho), and lower levels of lactate, leucine/isoleucine, N-acetyl glycoprotein (NAc), and low-density lipoprotein/very low-density lipoprotein (LDL/VLDL) in FD patients than in healthy controls. Acupuncture treatment of FD patients significantly changed the levels of leucine/isoleucine, lactate and glucose, and slightly changed lipids level towards those of the healthy controls, demonstrating its therapeutic effects on the relief of FD symptoms. Due to the limited number of subjects, the present work is just a proof-of-principle study and further researches with larger number of subjects are needed. Our work shows the potential of an NMR-based metabonomic approach in the study of biological effects of acupuncture.