重视医学信用伦理的研究与开发

医疗行业市场化是必然趋势。在医疗行业市场化进程中，医学伦理道德除了道德价值之外，还含有积极的经济内涵。医学伦理道德也是重要的医疗资源，通过参与医疗市场资源的配制和运作，也可以产生经济效益，转化为医疗资本。医疗行业要重视医学伦理道德资源的开发。信用伦理是在市场经济条件下形成的，这是医学伦理学所面临的新课题。笔者认为，不说谎、不期诈，兑现承诺，保证医疗质量，发扬医学人道主义，是医学信用伦理的四项基本标准。     

一种有效去除脂血对血清多种生化指标测定干扰的方法

目的 :探讨一种去除脂血对血清生化项目测定干扰的方法。方法 :沉淀、离心沉淀去除血清中过量的乳糜微粒。结果 :该法简便去脂效果彻底 ,不影响测定结果。结论 :获得了一种满意的去脂方法     

Measuring the Quality of Hospital-based Domestic Violence Programs

OBJECTIVE: To obtain consensus among a panel of experts on performance measures useful for evaluating the quality of hospital-based domestic violence (DV) programs. METHODS: The Delphi process of consensus development was used with a panel of 18 experts including DV researchers, program planners, and advocates. Three rounds were conducted over a period of six months, with each round involving the completion of a written questionnaire. Panelists were instructed to concentrate on structure and process measures of DV program performance. Health outcome measures were not considered. During each round, panelists rated (scale of 1-5) their level of agreement with each measure, in terms of the measure's usefulness for evaluating hospital-based DV programs. Data were entered into SPSS on a personal computer and frequency distributions, measures of central tendency, and variance were computed for each measure. Consensus development was defined as a reduction in the item-specific variance from one round to the next. RESULTS: A total of 37 performance measures were agreed upon. These measures fell within nine different domains of DV program activities, including: Policies and Procedures, Hospital Physical Environment, Hospital Cultural Environment, Training of Providers, Screening and Safety Assessment, Documentation, Intervention Services, Evaluation Activities, and Collaboration. CONCLUSIONS: A number of measures have been identified as useful for evaluating hospital-based DV programs. Use of these measures should assist researchers, program planners, and administrators in assessing the quality of hospital-based DV programs.     

Quality in Clinical Practice

This paper reports the proceedings of the discussion panel assigned to look at clinical aspects of quality in emergency medicine. One of the seven stated objectives of the Academic Emergency Medicine consensus conference on quality in emergency medicine was to educate emergency physicians regarding quality measures and quality improvement as essential aspects of the practice of emergency medicine. Another topic of interest was a discussion of the value of information technology in facilitating quality care in the clinical practice of emergency medicine. It is important to note that this is not intended to be a comprehensive review of this extensive topic, but instead is designed to report the discussion that occurred at this session of the consensus conference.     

State and output feedback design for robust tracking of linear systems with rate limited actuators

A design technique (Control of Uncertain Systems with Bounded Inputs, Tarbouriech S, Garcia G, (Eds), Lecture Notes in Control and Information Sciences, vol. 227 , Springer: Berlin, 1997; 173–186) recently proposed for stabilization of a linear system with rate‐limited actuators is utilized to design feedback laws that cause the system output to track a desired command signal. This design technique combines two design techniques recently developed for linear systems with position limited actuators, piecewise‐linear LQ control (Automatica, 1994; 30 : 403–416) and low‐and‐high gain feedback (IEEE Trans. Automat. Control, 1996; 41 : 368–378), and hence takes advantage of both design techniques, while avoiding their disadvantages. In the case that only the output is available for feedback, the performance of the state feedback law is preserved by the use of a fast observer. An open‐loop exponentially unstable fighter aircraft is used to demonstrate the effectiveness of the proposed control design method. Copyright © 2002 John Wiley & Sons, Ltd.     

善存片联合健脾理气中药预防肿瘤患者化疗所致口腔溃疡的临床观察

目的观察在全身化疗前应用善存片联合健脾理气中药对肿瘤患者口腔溃疡的预防作用。方法将66例肿瘤患者随机分配为治疗组和对照组，每组33例。在全身静脉化疗前3天开始，治疗组每天口服善存片1片及健脾理气中药1剂，对照组服用维生素B：治疗，两组服药化疗后10天为1个疗程。每周期化疗结束后统计口腔溃疡的发生率，共4周期。结果治疗组口腔溃疡的发生率显著降低（P〈0．01）。结论善存片联合健脾理气中药可有效预防及治疗肿瘤患者化疗所致的口腔溃疡。     

罂硝软膏的制备及质量控制

目的 :制备罂硝软膏 ,并建立质量控制方法。方法 :以硝酸甘油、盐酸罂粟碱、双氯芬酸钾为主药研制软膏剂 ,用紫外分光光度法及酸碱滴定法分别测定硝酸甘油、盐酸罂粟碱、双氯芬酸钾3组分的含量。结果 :硝酸甘油、盐酸罂粟碱、双氯芬酸钾的平均回收率分别为100 65 %、99 86 %、100 55 %,相对标准差分别为0 4945 %、0 1719 %、0 3205 %(n=3)。结论 :该软膏制备工艺可行 ,质量可控 ,性质稳定。     

血糖水平对18F-FDG PET/CT图像质量的影响

目的 研究血糖水平对18F-脱氧葡萄糖(FDG) PET/CT图像质量的影响.方法 80例行体格检查或评价肿瘤性质的受检者,按空腹血糖水平分为9组(组间距为1mmol/L),第1组为血糖正常组,即血糖＜6.0mmol/L(10例);第2～9组血糖水平高于正常,分别为6.0～6.9mmol/L(11例),7.0～7.9mmol/L(13例),8.0～8.9mmol/L(11例),9.0～9.9mmol/L(11例),10.0～10.9mmol/L(8例),11.0～11.9mmol/L(6例),12.0～12.9mmol/L(5例),≥13.0mmol/L(5例).受检者做完PET/CT检查后,图像质量由2位有经验的医师独立判断.同时根据肝不同层面的标准摄取值(SUV)最大值(SUVmax)及SUV平均值(SUVavg)分别计算肝图像噪声.采用SPSS 12.0软件进行统计学处理.结果 (1)9组之间图像质量评分、肝噪声差异有统计学意义(P均＜0.05).将第2～9组图像质量评分、肝噪声分别与第1组进行比较,第2～7组与第1组差异无统计学意义(P均＞0.05);第8,9组与第1组比较差异有统计学意义(P均＜0.05),且评分低于第1组.(2)血糖水平与图像质量评分呈负相关(r=-0.52,P＜0.05);血糖水平与肝噪声呈正相关(SUVmax、SUVavgr值分别为0.33和0.60,P均＜0.05);SUVavg所算噪声与血糖水平的相关性优于SUVmax.结论 图像质量随血糖水平的升高而下降,血糖＜12.0mmol/L时与血糖正常者PET/CT图像质量差异无统计学意义,但当血糖水平≥12.0mmol/L时图像质量将显著下降.     

对高等教育大众化背景下中医药高等院校专业建设问题的思考

中医药高等院校专业建设应随着社会的进步发展和社会的需求而不断拓宽、延伸其专业领域，本文从中医药高校的专业延伸的必要性、建设原则以及专业延伸的思路等三个方面对中医药高等院校的专业建设工作提出了几点思考。