新型农村合作医疗基金分配与使用模式选择

各地新型农村合作医疗基金的分配与使用方案是筹资与补偿的中间环节,它关系到资金的安全管理,制约着对需方的补偿,是对新型农村合作医疗制度的运行进展、存在问题和对策进行研究必须要掌握的问题。将当前我国新型农村合作医疗制度各试点地区的基金分配与使用情况大致划分为5种模式:(1)大病统筹基金;(2)大病统筹基金 家庭账户(门诊)基金;(3)大病统筹基金 家庭(门诊)账户基金 大病基金;(4)大病统筹基金 家庭账户(门诊)基金 防保基金;(5)大病统筹基金 家庭账户(门诊)基金 防保基金 大病基金。最后,结合新型农村合作医疗制度本身运行特点、试点地区的经济发展状况和农民的经济收入能力等现实状况讨论了各种模式的使用和选择空间,以期为新型农村合作医疗制度试点及今后的推广工作有所裨益。     

人用药品注册技术要求国际协调会议关于通用技术文件的协调进展及其启示

本文旨在遵从药品注册技术要求一致化的原则下,对人用药品注册技术要求国际协调会议(ICH)所倡导执行的通用技术文件(CTD)进行比较全面的阐述和理解,详细介绍CTD在ICH6上的进展情况,就美国食品药品监督管理局对CTD的实施过程予以简介和研究,并深入探讨其对于我国药品注册规范等方面的影响和启示。     

Fostering Internal Cooperation Through the Use of Imagery in the Treatment of Dissociative Identity Disorder

ABSTRACT

Most clinicians working with dissociative identity disorder (D.I.D.) recognize the importance of working towards a cooperative system especially during the initial stages of treatment. However, achieving this can be a monumental task given the inner war that goes on inside the mind of an individual diagnosed with D.I.D. From an ego-state theoretical framework, this article will demonstrate through clinical cases and artwork, the value of imagery techniques in changing internal perceptions, especially with regards to introject ego states. These changes can assist in eliciting more internal cooperation, a necessary task prior to working towards a collaborative, co-conscious system or what some theorists would call integration.     

Leukocyte Esterase Versus ICM 2018 Criteria in the Diagnosis of Periprosthetic Joint Infection

BackgroundA leukocyte esterase (LE) test is inexpensive and provides real-time information about patients suspected of periprosthetic joint infections (PJIs). The 2018 International Consensus Meeting (ICM) recommends it as a diagnostic tool with a 2+ cutoff. There is still a lack of data revealing LE utility versus the ICM 2018 criteria for PJI.MethodsThis is a retrospective study of patients who underwent revision total hip and total knee arthroplasty at a single institution between March 2009 and December 2019. All patients underwent joint aspiration before the arthrotomy, and the LE strip test was performed on aspirated joint fluid. PJI was defined using the 2018 ICM criteria.ResultsAs per the 2018 ICM criteria, 78 patients were diagnosed with chronic PJI and 181 were not infected. An LE test with a cutoff of $\ge$1+ had a sensitivity of 0.744, a specificity of 0.906, a positive predictive value of 0.773, an accuracy of 0.825 (95% confidence interval 0.772-0.878), and a negative predictive value of 0.891. The positive likelihood ratio (LR+) was 7.917. Using an LE cutoff of 2 + had a sensitivity of 0.513, a specificity of 1.000, and an accuracy of 0.756 (95% confidence interval—0.812).ConclusionLE is a rapid and inexpensive test which can be performed at the bedside. Its performance is valuable as per ICM criteria. Based on the findings of this study and the given cohort, we suggest using the cutoff of LE1+ (result = negative or trace) as a point of care test to exclude infection, whereas LE at 2 + threshold has near absolute specificity for the diagnosis.     

人性化护理在维和二级医院健康体检中的应用

目的 探讨人性化护理在维和二级医院健康体检中的应用与效果.方法 营造优美、舒适的体检环境,针对不同语言、文化、宗教信仰、民族习惯、生活方式、道德观念的体检者,设计不同的服务套餐,并把体检护理流程化,提供体检前、中、后人性化护理.结果 检查中未出现漏项、差错和医疗纠纷,体检满意度为100.00%.结论 开展人性化护理可以...     

Zero-P用于颈椎前路手术的护理配合

目的探讨零切迹颈前路椎间融合固定系统（Zero—P）用于颈椎前路融合固定术的手术配合。方法熟悉手术步骤，掌握常规器械和专用器械用法，掌握Zero—P用于颈椎前路融合固定术的配合要点，术前充分准备，术中密切配合。结果35例手术顺利完成，术后原有症状改善明显，恢复快，无并发症发生。结论Zero—P用于颈椎前路融合固定术具有手术时间短、术中创伤小、出血少，术后疼痛轻、恢复快等优点，是一种安全有效的手术方式；充分的术前准备和熟练的术中配合，是提高手术成功率、减少并发症的保证。     

基层医院急诊科心肺脑复苏的院内急救

目的：探讨基层医院心、肺、脑复苏的院内急救护理最佳配合。方法对本院2010年5月～2013年5月19例心肺脑复苏成功患者的急救与护理配合进行回顾性分析。结果19例患者经瞬间评估判断、畅通气道、人工呼吸、胸外心脏按压、电击除颤、合理给药、脑部降温等急救措施的实施，复苏成功。结论积极有效的急救护理配合是保证复苏成功的关键。     

胆囊炎并发胆结石保守疗法与护理配合

老年胆囊疾病患者多数为慢性结石性胆囊炎,该病临床表现无特异性,起病缓慢,大多由急性胆囊炎反复发作迁延而至。由于年岁所限患者多采取保守疗法。如消炎利胆片、舒胆通、等口服药,起到了缓解病情的作用,但难根治。我院内科在治疗上加用了中药制剂,起到了疏肝理气、利胆通腑的药物疗效。同时护理人员注意调节好患者情志,使患者气血调和、气体通畅,加上规律饮食,确保患者及早康复。