医药团结合作 建设放心药房

总结了全国放心药店现场交流会后,全国各地放心药房建设的情况。强调了建设放心药房工作的意义,指出建设放心药房是中医医疗机构精神文明建设的重要部分,是落实中央指示,加强药品管理的具体行动,是加强中医医疗机构内涵建设的重要内容,是保证中医医疗质量的关键环节。对进一步做好放心药房建设工作提出了要求:规范进货行为,把好药品进货关;不断深化改革,加强内部管理;认真贯彻国家有关法规,继续整治药品回扣违法行为;加强医药团结合作,建立稳定的供需关系;加强领导,务求实效,使“放心药房”建设深入持久地开展下去。     

Bulimia in male patients

Bulimia is not exclusively a disorder of women. Twelve men with bulimia were evaluated and found to have demographic variables and eating behaviors similar to those of female bulimia patients. Eleven of the 12 men were binge eating more than once a day, and ten of the 12 also self-induced vomiting on a regular basis. Three patients had initiated bulimic behavior in association with athletic training. Eight patients followed through with treatment referrals and responded favorably to therapy.     

Long-term survival of patients with multiple myeloma and acute renal failure at presentation

Eight patients presented with simultaneous multiple myeloma and acute renal failure requiring hemodialysis. Patients had no known pre-existing renal disease nor exposure to nephrotoxic agents or x-ray contrast dye. Renal failure was attributed to light chain nephropathy in all cases. In 4 of these patients the diagnosis of myeloma was initially unsuspected. Renal biopsies in 3 of these patients, and post-mortem material in a fourth revealed the changes of "myeloma kidney." No patient regained renal function and all required chronic hemodialysis. Among these eight patients, three survived for periods greater than 21 months.     

乡镇卫生院产科现状分析

目的:了解信阳市乡镇卫生院妇产科现状。方法:组织专业人员使用统一调查表,深入到46所乡镇卫生院进行妇产科房屋、人员、设备及转诊情况等调查。结果:平均每所卫生院妇产科用房面积为33.53 m2,布局合理的27所,占58.70%。无高级技术职称,中级技术职称16人,占10.39%,初级职称129人,占83.77%,无职称9人,占5.84%;9所卫生院有多普勒胎心监护仪;2所卫生院有婴儿喉镜及气管插管。结论:乡镇卫生院的产科质量近几年虽有较大提高,但目前还存在着应急抢救能力不强,人员技术水平偏低、转诊制度不完善、管理不力等问题,必须引起各级政府和卫生行政部门的重视。     

中国民营医院发展现状与趋势研究

采用文献分析法对我国民营医院的发展现状和趋势进行分析,结果认为我国民营医院发展速度较快,但规模偏小、医疗市场份额低,整体水平还远不具备与公立医院分庭抗衡的实力;在发展和政策支持上民营医院地区间发展不平衡,东部优于中西部;民营医院的发展面临空前大好的政策环境,以公有制医疗机构为主体,多种所有制形式与经营方式并存,公平竞争、共同发展的医疗服务体系新格局开始逐步形成.     

营造和谐环境突出中医医院办院特色

目的 分析中医医院发展中所遇到的困难，找出影响和阻碍其发展的主要因素，以供决策者和同道参考。方法 对抽样单位院长进行深度访谈、员工座谈和问卷调查。结果 坚持中医办院方向却面临生存挑战，中医药特色保持现状不容乐观，突出中医药特色的专科、专病不失为中医医院发展的可行之路。原因 中医医院发展与政策环境、人才短缺有很大关系。建议 从把握机遇、突出特色专科、政府加大投入力度、按中医药自身规律培养人才、政策环境保障等方面提出建议。     

Clear-cell Renal Cell Carcinoma: Molecular Characterization of IMDC Risk Groups and Sarcomatoid Tumors

IntroductionRecent trials have suggested predictive biomarkers in advanced clear-cell renal cell carcinoma (accRCC): International Metastatic RCC Database Consortium (IMDC) good risk or angiogenic gene signature for sunitinib and IMDC intermediate/poor risk for ipilimumab-nivolumab and T-effector cell signature or sarcomatoid dedifferentiation for atezolizumab-bevacizumab. We hypothesized that earlier described molecular subtypes, ccrcc1 to ccrcc4, could provide similar information as a single generic biomarker and molecularly characterize the heterogeneous intermediate-risk group.Patients and MethodsPatients with accRCC treated with systemic therapies were included. We assessed associations between the 5 biomarkers and their impact on progression-free survival (PFS) and response rate (RR) on first-line sunitinib or pazopanib. The cutoff percentage of sarcomatoid dedifferentiation with optimal discriminative value was determined.ResultsIn total, 430 patients were included (163 with molecular data). The molecular ccrcc2 subtype identified tumors with higher angiogenic gene expression across IMDC risk groups: prevalence was high in IMDC good risk and low in IMDC poor risk (P < .001). Molecular subtype, IMDC, and angiogenic gene expression had comparable C-indices to predict PFS and RR (range, 60%-66%). The ccrcc2 subtype and angiogenic gene expression were positive predictors of PFS in IMDC intermediate-risk patients (P = .006; P = .04). Immune signature did not differ between IMDC groups, but was strongly correlated with molecular subtype (P = .8 and P = .0007). A cutoff value of 25% sarcomatoid differentiation discriminated tumors with distinct molecular characteristics and therapeutic sensitivity.ConclusionIn accRCC, molecular subtypes can explain differences in IMDC risk group, expression of angiogenesis and immune response genes, and sarcomatoid dedifferentiation. They can identify molecularly different patient populations within the heterogeneous IMDC intermediate group and select patients for systemic therapies.     

国家儿童医学中心青年儿科医师培养机制研究

目的 探讨对国家儿童医学中心(以下简称为本中心)青年儿科医师培养机制研究现状.方法 选择2020年本中心430位在职青年儿科医师(年龄≤45岁)为调查对象.采用本研究自行设计的《国家儿童医学中心青年儿科医师培养机制调查问卷》,主要包括①纳入调查对象基本情况;②本中心为纳入调查对象提供科研条件情况;③本中心对纳入调查对象...     

新型冠状病毒肺炎疫情期间全国儿科消化内镜开展情况调查

目的总结新型冠状病毒肺炎（coronavirus disease 2019,COVID-19）疫情期间全国儿科消化内镜开展诊疗经验,为下一步临床诊疗工作提供防控指导。方法中华医学会消化内镜学分会儿科协作组对全国47所儿科消化内镜中心2020年1月24日—3月1日内镜诊治开展情况以问卷调查表的形式进行了调查。结果疫情期间,儿科消化内镜中心采用了停止常规内镜诊疗、严格术前流行病学排查、增加特殊术前检查、术前内镜医师会诊制度、候诊区管理、精简工作人员、不同岗位不同防护级别、特殊麻醉管理、重视诊疗区域消毒、加强内镜清洗消毒及医疗废物管理等防控措施。47所医院在2020年1月24日—3月1日38 d内共完成536例儿科消化内镜诊疗,其中治疗210例（39.2%）,诊断326例（60.8%）,未发生一例院内感染。结论COVID-19疫情期间,全国儿科消化内镜中心根据国家疫情防控政策及相关指南要求,结合儿科特点及医院实际情况,在严格把握内镜诊疗指征、严密防护的前提下,安全开展了儿科消化内镜诊疗。