医学外文图书采访工作改革

分析了医学外文图书采访工作存在的问题,提出了改革医学外文图书采访工作的若干建议.     

The Application of Number Needed to Treat (NNT) to Clinical Problems in Radiotherapy

The goals of this report are: 1) to review the number needed to treat (NNT) concept, which, although well established in many sectors of medicine, is still relatively new to the radiotherapy community; 2) to discuss several clinical radiotherapy examples illustrating the inherent advantages of the NNT approach; and 3) to discuss potential future roles of the NNT concept within radiotherapy.     

Report from the 1st Japanese Urological Association-Japanese Society of Medical Oncology joint conference, 2006: ''A step towards better collaboration between urologists and medical oncologists''

The 1st Japanese Urological Association-Japanese Society of Medical Oncology Joint Conference, titled 'A step towards better collaboration between urologists and medical oncologists', was held to coincide with the 44th Meeting of the Japan Society of Clinical Oncology, Tokyo, in October 2006. The main theme of the conference addressed the need for a subspecialty of medical oncologist within urology to keep abreast of advances in medical oncology. Urologists should become more involved in the postoperative management of urologic cancer. Consensus on the optimal way to move forward in the treatment of urological cancer is needed. The conference featured eight lectures surveying the present status of uro-oncology in Europe, the USA, Korea, Singapore, and Japan; the relationship between surgical oncologists and medical oncologists; global trends and international clinical trials in uro-oncology; and the future of urologic oncology. These were followed by a general discussion titled 'Achieving better collaboration between the surgical oncologist and the medical oncologist.' This report presents a roundup of the 1st Japanese Urological Association-Japanese Society of Medical Oncology Joint Conference.     

The poor pay more: Health-related inequality in Thailand

This paper examines the equality of utilization for equal need and equity of out-of-pocket expenditure for health services in a large urban area in Thailand. Data from a household health interview survey were used to explore patterns of perceived morbidity, utilization of various treatment sources, and out-of-pocket payment. Financial access to health care, as reflected in medical benefit/insurance cover, appeared to influence reported illness and hospitalization rates. Gross lack of access to health care amongst lower socio-economic groups was not the main problem in this densely populated urban area because people could choose and use alternative health services according to their ability and willingness to pay. The corollary, however, was an inequitable pattern of out-of-pocket health expenditure by income quintile and per capita. The underprivileged were more likely to pay out of their own pocket for their health problems, and to pay out of proportion to their household income when compared with more privileged groups. Furthermore, the underprivileged were least likely to be covered by government health benefit schemes, in contrast in particular to civil servants, who paid less out of pocket and did not contribute to their medical benefit fund. The private health sector (private clinics and private hospitals) was the major provider of health care to urban dwellers for both outpatient and inpatient services. Policy options for the short and long term to improve the equity of payment systems for health care are discussed.     

小血管套叠粘接吻合法在血液透析者中建立动静脉内瘘的应用

慢性肾病患者常需要建立动静脉内瘘进行透析，常规间断缝合法吻合动静脉难度大、耗时长。为了缩短吻合时间，提高远期通畅率，进行了套叠粘接吻合法建立动静脉内瘘的实验研究，并将这一方法应用于透析患者建立动静脉内瘘的血管吻合。将动脉端套入静脉端，只需吻合两针，用医用胶封闭吻合口。经８个月观察，通畅率达１００％，血流量均超过３００ｍｌ／ｍｉｎ。达到了透析需要。     

医科职业中专生与医科本科生孤独,抑郁,自尊状况的比较研究

目的探讨医科职业高中生与医科本科生的心理健康状况的差异。方法采用ＵＣＬＡ、自尊量表、抑郁量表、感情与社会孤独量表及自编情况调查表对３５０名在校职业高中医士班、医学院本科学生进行评定。结果职业高中学生的孤独及抑郁量表得分高于医学院学生，自尊量表得分低于医学院学生。职高组轻度和中度抑郁占４２．６２％，大学组轻度和中度抑郁占２０％。结论职业高中学生心理健康水平低于医学本科生     

五所医院特需医疗服务状况调查

通过对上海医科大学附属华山医院、协和医院、北京同仁医院、中山医科大学附属第一医院、浙江医科大学附属第二医院开展的特需医疗服务情况的调查，论述了五所医院的具体做法，在对调查结果进行分析的基础上，就特需医疗服务的管理提出了建议。     

高氧医用液在高位硬膜外麻醉中低张性缺氧的应用

目的　研究高氧医用液在高位硬膜外麻醉中治疗和预防低张性缺氧的效果和安全性。方法　将10 0例胸壁手术患者随机分成高氧液治疗组 (A组 )和同等量细胞外液治疗组 (B组 ) ,均在高位硬膜外麻醉下完成胸壁手术 ,入室后输液速度第 1小时为 10ml (Kg·h) ,以后 6ml (Kg·h) ;A组输入高氧液 ,B组输入林格氏液 ;两组患者出现SPO2 <95 %时面罩给氧 ,氧流量 3～ 5L min ;两组于麻醉前和麻醉后 30、6 0、90min及术毕麻醉平面消失后 5个时点各抽取动脉血 1ml进行血气分析 ,同时观察生命体征和术中不良反应。结果　两组各时点血气结果各项指标均在正常范围内波动 ,组间、组内比较均无显著性差异 (P >0 .0 5 ) ,术中A组无需面罩给氧治疗 ,B组全部需面罩给氧治疗 ;A组生命体征各指标在各时点无显著性差异 (P >0 .0 5 ) ,B组在麻醉后初期呼吸频率增快 ,较麻醉前和A组比较均有显著性差异 (P <0 .0 5 ) ;术中两组患者均无寒战、烦躁、头痛、过敏、气栓等不良反应发生。结论　高氧医用液为术中高位硬膜外麻醉所致的缺氧提供了全新的供氧方法 ,且有使用方便、安全性强、疗效确切等优点。     

种植义齿修复的医学伦理问题

种植义齿是一项新的修复缺失牙方法，本文从医学伦理学的角度出发，探究种植又齿修复过程中应遵循的医德原则，医师高度的责任心、精湛的医术和正确的口腔宣教是保证种植义齿修复成功的关键。     

Resuscitation training for medical students in the United Kingdom — a comparison with the United States of America

Resuscitation training for medical students and junior doctors in the United Kingdom and United States was compared using questionnaires sent to medical schools in both countries. A marked deficiency in the provision of cardiopulmonary resuscitation training has been demonstrated in the United Kingdom; however, in the United States, the availability of uniform certifiable teaching is now widespread. Suggestions for the improvement of training in the United Kingdom are expected to increase medical student proficiency in cardiopulmonary resuscitation. The need for training in basic and advanced resuscitation prior to graduation from medical school is stressed.