危重患者心脏手术后氧代谢监测的价值

目的 探讨心脏直视术后危重患氧供需平衡的重要性和临床价值。指导救治,三疗效及预后,预防多器功能衰竭（ＭＯＦ）的发生,使ＩＣＵ监测水平跨跃到细胞水平。方法 对１４８例,心脏直视术后危重入ＩＣＵ后,分阶段动态监测动脉,混合静脉血气,心输出量,胃粘膜ＰＨ值,对代谢这各项监测值之间相关关系进行分析。结果 动静脉血气及其差值的变化与循环,呼吸功能变化呈正在关系;ＡＰＡＣＨＥⅡ评分高,ＳｖＯ２低的极重患     

Management challenges and markets

The scarcity of resources in healthcare systems has general causes and country-specific causes. Common to most healthcare systems is a strong emphasis on management and an increased attention to the role of the market. Management and market are concepts which need clarification: management applies not only to individual institutions but to systems of institutions. Market implies not only the pursuit of individual interests but also the assumption of responsibility. The design or redesign of healthcare systems must take into account the level of management skills which each system and its institutions can rely on. Cost patterns in a healthcare system develop around its institutional design. Different factors produce varying levels of costs in different healthcare systems. The same applies to the effort needed to reach a certain degree of effectiveness in output. An outline of strengths and weaknesses of options for the design of healthcare systems is presented in the final part of the article. These should always be considered together with the specific features of each country.     

What kind of healthcare ‘internal market’? A cross-europe view of the options

Many governments are trying to invent new types of 'internal' healthcare market that will expose health services to competitive pressures to innovate, contain costs, raise service quality, and respond better to consumer demands; but not expose them to 'market failures' which prejudice universal access to 'basic' health services. Policy debates in this area are muddled and constricted by a failure to differentiate the variants of internal market that are available. This article outlines a taxonomy of the main types of internal market: primary doctor purchasing; managed competition; competitive bidding; social insurance; and compulsory private insurance. It notes their main structural characteristics and differences. Although internal market reforms have been intended to support the commercialization of healthcare, the idea of designing new types of economic structure to avoid market failure in healthcare has wider and more radical implications than most policy-makers intend.     

Harm reduction in the developing world

This paper examines harm reduction from the perspective of poor countries. In considering which elements of the broad approach are suitable for adaptation and adoption by poor countries, there is a need to examine critically the arguments put forth in support of it and which, if any, of these are supported by evidence. There are also significant indirect influences that the approach is likely to have on how drug use is understood and interpreted by wider society. The likely impact of these on areas other than simply services directed to drug users needs to be assessed. There are some features regarding harm caused by alcohol and other drug use that are specific to poor countries. Most important among these is that levels of use which are not deemed to be harmful in rich societies cause grave harm through diverting meagre resources away from survival needs in the poor world. Alcohol, as well as other drugs, tends in deprived settings to cause dependence and other problems much earlier in people's drinking careers and at much lower levels of consumption than in rich countries.     

城市住宅新区医疗卫生服务需求的现状与对策

目的:了解城市住宅新区医疗卫生服务供给与需求的现状,为决策部门合理分配卫生资源提供参考依据。方法:根据浙江省城市地理位置和经济文化、发展程度,在全省范围内选择有代表性的城市,采用城、区街(居委会)住户4个层次随机抽样方法调查4810户家庭。结果:住宅新区个人和家庭医疗卫生服务需求大于供给,希望社区提供全天候卫生服务。医疗费用支出占家庭收入的6.20％,绝大多数家庭能承担各项医疗费用,家庭每年最多能支出医疗保健服务费用平均为2565.15元。     

河南省乡镇卫生院人力资源配置研究

该文在对河南省卫生院人力资源现状调查研究的基础上,分析了乡镇卫生院人力资源配置中存在的主要问题及成困,并从理论与实际相结合的角度,提出了实现卫生院人力资源合理配置的可行性对策。     

铁路危险品货运站空气污染指标的探讨

铁路危险品货运站（危货站）空气污染物种类多,空气污染严重,为探讨对其监测和评价的综合性能指标和方法,采用空气耗氧量（ＡＯＤ）和ＳＯＳ致遗传毒性原位监测法（ＳＯＳ原位法）,分别对危货站空气污染进行了研究。结果表明,危货站中各点所测ＡＯＤ值与对照区ＡＯＤ值,在统计学上差异均有显著性（Ｐ〈０．０５）。ＳＯＳ原位法显示,随采样体积的增加,β－半乳糖苷酶的量也增加,采样体积与酶诱导率之间存在剂量－反应关系。     

国家中药资源宏观管理系统的建立——中药现代化的基础

目的 :国家中药资源宏观管理系统通过现代化的管理 ,将先进的科学技术与行政管理有机地结合一起 ,从而达到中药资源和经济的可持续发展和强国富民的目的。方法 :以群落学、统计学、3S技术 (遥感RS、地理信息系统GIS、全球定位系统GPS)和计算机信息系统等高新技术手段为支柱 ,建立全国中药资源监测体系和保护体系。结果与结论 :建立围绕全国重点中药资源的使用、保护、蕴藏和耗损为主的宏观管理体系 ,将为中药企业及国家主管部门科学宏观管理提供依据。     

高效液相色谱法测定关黄柏不同采收期及黄檗不同部位的小檗碱、巴马汀含量

目的测定关黄柏不同采收期及黄檗不同部位的小檗碱、巴马汀的含量。方法采用高效液相色谱法测定。结果检测波长 345nm ,平均加样回收率分别为 96 9%和 97 2 % ,RSD =0 5 7%和0 6 2 %。结论沈阳地区关黄柏的最佳采收期为 10月 ;黄檗枝条中的小檗碱含量虽不及关黄柏 ,但枝条为再生资源     

泰州市卫生监督人力资源现状分析

目的:了解泰州市卫生监督机构的人力资源现状,为合理配置人力资源提供依据。方法:采用普查的方法,对泰州市卫生监督机构人员进行问卷调查。结果:泰州市平均1万人口仅配备0.45名卫生监督员,人力资源数量明显低于国家规定的标准;而在监督人员学历结构方面优于全国平均水平。结论:泰州市卫生监督人力资源数量不足、工作负荷过重、专业结构不够合理, 应适当增加卫生监督人员编制,引进和培养法律、工程、检验、卫生管理等专业人才。