我国医疗器械面临的市场机遇和竞争压力

本文介绍了我国医疗器械行业良好的增长形势,展示了我国医疗器械广阔的市场机遇,指出了国产医疗器械存在的竞争压力。     

介入放射学的机遇:介入技术在生物靶向治疗中的应用与优势

介入技术改变了传统的治疗模式,为一些疾病的治疗带来了契机.随着新世纪生物治疗时代的来临,也为介入医学展示了更为宽阔的用武之地.现阶段生物治疗包括基因治疗、细胞移植治疗、多种大分子物质如细胞因子、肿瘤抗体或疫苗、重组蛋白等生物免疫药物制剂治疗,另外放射性粒子治疗及一些靶向性材料等,均可通过介入手段局部给药.有高度靶向性的介入技术与靶向输送的生物技术的良好结合,具有创伤小、效率高、治疗效果强、系统不良反应相对小的优势.目前各种生物治疗技术正在蓬勃发展,我们应该抓住机遇,拓宽介入放射学的领域.     

Clinical study on acupuncture plus medication for chronic atrophic gastritis due to spleen-stomach deficiency

Objective： To observe the clinical efficacy of combining acupuncture and medication in treating chronic atrophic gastritis （CAG） due to spleen-stomach deficiency.
Methods： Totally 176 patients with CAG were randomized into two groups by the random number table. The 91 subjects in the treatment group were intervened by acupuncture and oral Chinese patent medication; the other 85 subjects were by oral Chinese patent medication alone. The clinical efficacies were compared at the end of intervention.
Results： After a treatment course, the total effective rate was 87.9% in the treatment group versus 75.3% in the control group; according to the gastroscopy and pathological biopsy examinations, the total effective rate was 85.7% in the treatment group versus 74.1% in the control group. There were significant differences in comparing the clinical efficacy, gastroscopy and pathological examinations between the two groups （P〈0.05）.
Conclusion： Combining acupuncture and medication can produce a better therapeutic efficacy than medication alone in treating CAG due to spleen-stomach deficiency.     

Time-bound opportunity costs of informal care: consequences for access to professional care, caregiver support, and labour supply estimates

The opportunity costs associated with the provision of informal care are usually estimated based on the reduced potential of the caregiver to partake in paid work (both in terms of whether they are able to undertake paid work, and if so the hours of work undertaken). In addition to the hours of informal care provided, these opportunity costs are also likely determined by the necessity to perform particular informal care tasks at specific moments of the day. The literature, to date, has largely overlooked this dimension of informal care. We used Dutch data from time use diaries which report patterns of informal care throughout the day which enables investigation of when particular activities are undertaken. We found that whereas some tasks must be performed at a relatively fixed time of day, others are shiftable and can be performed at other times or even on different days. Household and organisation activities are more likely to be undertaken by employed caregivers, and seem largely to be shiftable; whereas personal care contains unshiftable activities. This implies additional opportunity costs of providing personal care tasks - we term these "time-bound" opportunity costs. Since the care recipient's need for care may in part relate to unshiftable tasks, we conclude that one should be careful with using care need as an instrument of informal care in labour supply equations.     

In care,aftercare and caring for those in care: my successful care journey

Coyle and Pinkerton identify gaps in the care leaving system in Northern Ireland regarding social work training and meeting the challenges of transitioning from care. The primary focus of this article is to provide a perspective of care and leaving care which could contribute to social work education and practice in these areas. Framed within a strengths perspective, the article draws on my own care journey from service user to social work student to newly qualified social worker. As a final-year social work student on Placement Learning Opportunity in a children's home which mainly provided long-term care, I reflected on my own care journey and what I thought made it successful. I concluded that a number of resilience-enhancing factors existed both at the personal and environmental levels including my own level of motivation, meaningful roles, positive school experiences and surrogate relationships. I also considered the relevance of my care journey to my qualifying social work training, including the importance of relationships in residential social work, learning responsibility and understanding the reality of independent living. Implications for social work education and practice include use of personal knowledge and engaging with duality, which means recognition of an individual actively combining and integrating lived service user or carer experience and professional training in their social work qualifying training and professional practice. However, this article emphasises that elements of my care journey should not be used as a checklist for current and former “looked after” children as each child's and young person's care journey is lived and experienced in different ways.     

Tobacco smoking during pregnancy and risk of adverse behaviour in offspring: A follow-up study

ObjectivesThis study examines associations between prenatal exposure to tobacco smoking and adverse behaviour in the offspring.MethodsWe included 1016 pregnant women from Greenland and Ukraine (526 from Greenland and 490 from Ukraine). Serum cotinine measurements were used to identify smoking pregnant women. When the children were from five to nine years of age, the parents assessed the child’s behaviour using the Strength and Difficulties Questionnaire (SDQ).ResultsOverall, smoking in pregnancy was not associated with a higher probability of adverse behaviour assessed by the total SDQ score. However, in the crude analysis smoking was associated with a higher mean difference of SDQ-total score. In Greenland the SDQ-total mean difference (MD) was (MD (95% CI) = 1.31 points (0.42; 2.19)) and in Ukraine (MD (95% CI) = 0.18 points (−1.2; 0.91)), whereas the adjusted mean differences were statistically non-significant.ConclusionsIn utero exposure to tobacco smoking was not associated with a significant higher risk of adverse behaviour in the offspring, but elevated risk of adverse behaviour among children prenatally exposed to smoking cannot be excluded.     

A Pilot Randomized Controlled Trial on the Effects of a Progressive Exercise Program on the Range of Motion and Upper Extremity Grip Strength in Young Adults With Breast Cancer

Background

The diagnosis of breast cancer in young women (aged 18-45 years) has been increasing. Women are commonly left coping with treatment-related disabilities of the upper limb that can persist for > 2 years postoperatively.

Access to high-volume surgeons and the opportunity cost of performing radical prostatectomy by low-volume providers

Background

Evidence suggests that redirecting surgeries to high-volume providers may be associated with better outcomes and significant societal savings. Whether such referrals are feasible remains unanswered.

强直性脊柱炎中医治法的时机选择问题

强直性脊柱炎(AS)是一种主要累及中轴关节的慢性炎症性疾病,晚期可导致畸形、残疾,严重影响患者的生活质量。中医治疗强直性脊柱炎取得了较好的疗效,但在中医治法的选择上,还存在着一定的盲目性。现从文献的角度,通过对近10年文献的整理分析,归纳出针灸联合中药治疗强直性脊柱炎的应用时机,以期为临床更有效的应用中医治法治疗强直性脊柱炎,提供指导与参考。     

公共卫生教育面临的机遇和挑战及其思考

21世纪,我国公共卫生面临着诸多的机遇与挑战。经济模式、健康模式、医学模式、社会需求的改变以及国际化要求等对我国现行的公共卫生教育体制产生了强烈的冲击,要解决公共卫生教育与社会需求之间的矛盾,应当从根本上改革公共卫生的教育模式。建立长学制公共卫生教育和研究生教育体制,拓宽教学内容,加强对医学生的人文与社会科学的教育,加强预防医学与临床医学的结合,改革灌输式教学方法,采用互动式、启发式、讨论式、科研式教学方法,培养学生的主动性和创造性,把目标定位于培养既能够进行科学研究,又具有丰富医学知识和人文科学知识,而且能够从事预防医学实践和管理的公共卫生人才。