论以服务对象为中心的医院管理道德原则

以服务对象为中心，就是医院管理者在医院工作管理过程中，从维护病人和服务对象的利益出发，将以为服务对象服务，满足服务对象合理医疗保健需求作为医院各项工作的中心，把服务对象至上、一切为了病人和服务对象的医院管理道德要求落实到各项管理措施之中。     

新生儿脐炎85例脐部分泌物细菌学分析

目的：了解新生儿脐部感染细菌学状况，为临床提供预防及治疗参考。方法：调查我院1997年1月－2002年6月收治的有完善细菌学资料的新生儿脐炎85例，对所获得的98例致病菌的种类及药敏状况进行分析。结果：社会获得性感染主要致病菌为G^ 球菌（70．5％），金黄色葡萄球菌占比例较高。医院感染主要致病菌为C^-杆菌（51．4％），以大肠埃希菌占比例较高。两类感染所分离的细菌均具有多重耐药性，但对氨基糖苷类及喹诺酮类耐药率较低，其次是第三代头孢菌素类抗生素。结论：临床对新生儿脐部感染，特别是有严重感染中毒症状时，应首先考虑使用第三代头孢菌素类抗生素。     

联勤后我分部医院开展优质服务的做法

为探讨军队医院联勤后开展联勤优质服务工作的管理，本介绍了我分部所属医院开展优质服务的做法，即：端正服务态度，增强服务意识，狠抓内涵建设，提高服务质量，改善医疗设备，美化诊疗环境，完善制度措施，加强监督管理等落实联勤优质服务。     

Candidaemia: a 10-year study in an Indian teaching hospital

Retrospective evaluation of candidaemia patients was performed in an Indian teaching hospital over a 10-year period. The incidence of patients with candidaemia increased eleven-fold in the second half of the study period (55 patients) compared with the first half (5 patients). Haematological malignancies (11 patients), neonatal septicaemia (9), cardiac abnormalities and cardiac surgery (9) were the commonest underlying diseases in these patients. Candida albicans (50%), C. guilliermondii (17%), C. tropicalis (15%) and C. parapsilosis (8%) were the most common fungal pathogens isolated from blood culture. Therapy with two or more antibiotics (92%), corticosteroid administration (25%), intravascular catheter use for over 24 h (78%) and neutropenia (48%) were the accountable predisposing factors. Prolonged hospitalization (mean average 22.2 days as compared with 11.2 days in other patients) was an added risk factor in these patients.     

Abnormal behavior of elderly people residing in institutions of medical and social welfare systems

Abstract We investigated factors correlated with abnormal behavior in the elderly residing in a special nursing home (group A) and a psychiatric hospital (group B) using the dementia behavior disturbance scale, the mini mental state examination, the Japanese version of the Philadelphia Geriatric Center morale scale, and the ADL assessment scale. The cognitive function of group B was decreased compared with that of group A, but most activities of daily living (ADL) in the latter group were disrupted compared with those in the former. Only a few categories of ADL correlated with abnormal behavior in group A, whereas cognitive function, quality of life, and most categories of ADL correlated with abnormal behavior in group B. These results suggest that factors correlated with abnormal behavior in the elderly differ within institutions of medical and social welfare systems.     

University and Community Hospital Medical Student Emergency Medicine Clerkship Experiences

Objective : To determine whether there is a significant difference between educational opportunities for fourth-year medical students rotating at a university hospital (UH) compared with several community hospitals (CHs) during a mandatory emergency medicine (EM) clerkship.
Methods : A self-reported clinical tool was completed in real time by each student rotating for 2 weeks at the UH and 2 weeks at 1 of 4 CHs (3 affiliated and 1 unaffiliated). Students are required to document the number of patients seen and the number of procedures performed on each of 20 six-hour shifts. They rated the EM attending clinical teaching by site using a 5-point scale at the end of the clerkship.
Results : Most (95%) of the 87 students in the 7 clerkship blocks of the 1996–97 academic year rotated at the UH and a CH. Most (71%) students rated both the UH and the CH for the quality of teaching by attendings. There was a significant difference in the mean number of patients evaluated/shift (2.2 ± 0.10 vs 2.8 ± 0.10, UH vs CH; p < 0.001) and the mean number of procedures performed/shift (0.36 ± 0.04 vs 0.56 ± 0.05, UH vs CH; p < 0.001). Attending clinical teaching scores were significantly higher (p = 0.03) at the CHs.
Conclusions : The educational opportunities for students in an EM clerkship to evaluate patients and perform procedures were significantly greater at the community hospitals. Inclusion of community hospital settings in a medical student EM clerkship may optimize the clinical experience.     

医院药品历史数据利用的实验

药品管理是医院管理的一个重要方面,在传统模式基础之上,如何利用新的技术改善管理也是管理人员和信息技术人员所关注的.本文介绍的实验就是采用数据仓库技术,结合医院的应用,进行的有意义尝试,并对实验过程中的数据源、平台搭建、数据抽取、定义、处理,以及工具的选择等方面,进行了详细的介绍.     

腹部多脏器损伤的救治

报告了腹部多脏器损伤１５８例的救治情况。致伤因素中交通事故和高空坠落伤占６７．０％，抢救存活１３２例，存活率８３．５％；死亡２６例，病死率１６．５％。作者分析了病死率与致伤暴力强、现场急救延误、就诊时间及受伤的脏器数的密切关系。作者认为院前救护、院内正确诊断、及时治疗、果断手术是抢救成功的重要环节；术中应仔细探查、止血，术后应注意防治多脏器衰竭的发生。     

优势医院在医院重组和集团组建中作用的研究

目的:研究优势医院在医院重组和集团化中的作用;方法:借鉴优势企业理论,从医疗、科研、领先学科和人才等因素分析,确立优势医院;结果:三级医院尤其是大学附属教学医院是当之无愧的优势医院;结论:发挥优势医院在医院重组和集团化以及建立“小病进社区,大病到医院”两级医疗服务模式改革中的作用,才能带动区域内医疗水平的提高。