Meeting health care needs of women experiencing complications of miscarriage and unsafe abortion: USAID's postabortion care program

Each year, an estimated 210 million women become pregnant. Worldwide, more than one fourth of these pregnancies will end in abortion or an unplanned birth. While many abortions may result from the desire to delay or avoid pregnancy, 15% to 20% of pregnancies will end in miscarriage or stillbirth with some causative agents being malaria, HIV/AIDS, and physical violence. Postabortion care (PAC) is needed to provide treatment for complications caused by incomplete or spontaneous abortion and critical family planning counseling and services to prevent future unplanned pregnancies that may result in repeat abortions. In 2003, the United States Agency for International Development (USAID) initiated a 5-year strategy wherein seven countries were provided financial funding and technical assistance. Since 2003, more than 3000 women have been seen in health centers and health posts for PAC services; more than 14,000 community members have received messages on unsafe abortion; family planning, and complications of unsafe abortion and miscarriage; and more than 600 documents were reviewed for inclusion in a global PAC resource package. This package has been used for developing Cambodia's national PAC policy and for developing patient education materials and provider job aids in Cambodia and Tanzania. These promising methodologies will be replicated in other countries.     

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.     

电气隔离在医疗设备控制系统上的应用

对医疗设备电气控制线路的各种隔离进行了详尽的分析讨论，提出了抑制干扰而采取的电气隔离的技术措施，从而保证医疗设备的正常工作。     

医疗侵权责任中的过失——论医师的注意义务

过失作为构成侵权行为的一个重要条件，在医疗侵权行为中主要表现为医师的过失，其本质是对“注意义务”的违反。因此正确认识医师的注意义务，对医疗侵权行为中的过失判断有着重要意义。     

医疗设备投资决策的敏感性分析研究

不恰当的医疗设备投资对医院及患者的利益均会造成损失，因此，在投资决策前进行严谨科学地可行性评估十分必要。通过对净现值的敏感性分析，医院的决策者可以了解各种不确定因素对投资方案经济效果的影响程度，以及投资方案对外部条件变化的承受能力，从而掌握风险条件下正确的决策原则和决策方法。     

病案质量问题与改进

病案作为记录医疗活动过程的重要载体,包含着各类丰富的信息。医疗服务质量评价有很多内容是通过病案实现的。作者分析了包括"三级医师查房"在内的20余项在病案中反映的医疗服务质量项目,指出影响质量判断的常见因素,并提出解决的对策与措施。     

阑尾炎单病种患者的费用分析

目的：分析实行医保单病种后医保病人与非医保病人阑尾炎治疗的费用差距，提出对医保进一步改革的思索。方法：用Excel 2003建数据表，对我院2005年2月至2006年8月期间收治的单病种收费阑尾炎患者和非单病种收费患者的费用和并发症进行分析并进行统计学处理。结果：阑尾炎治疗并发症发生率及痊愈率在两组间无显著性差异，费用比较两组间差异显著。结论：目前的单病种收费标准基本可以满足临床治疗阑尾炎的需要，同时在实行单病种收费后可以节约大量医疗费用。如进一步扩大单病种范围，用经济手段调动医院的自律机制，医疗费用有进一步下降的空间。