实施医德考评归档制度着力构建医院管理的长效机制

以医德教育为先导,建立坚实的思想道德素质基础;不断完善医德考评制度,规范道德评价体系;以医德考评归档制度为手段,推动医院管理长效机制建设,不断提高医疗质量和管理水平,探讨医德考评制度与医院管理年相结合,进一步完善医德考评制度以规范医院管理的新模式.     

高级职称五年任期责任制考评试点及体会

我院是编制 10 0张床位的小驻军医院。 2 0 0 2年 ,接受了军区高级职称 5年任期责任制考评的试点工作 ,13名任期 5年以上的高职人员和 4名拟进高职的医务人员接受了考评。考评结果与医院平时掌握的被考人员实际情况基本相符 ,具有一定的可靠性。对受考的高职人员根据考评结果做出了续任、不续任、亮黄牌等处理 ;对拟进高职的人员也科学地排了队。实行专业技术职务任期责任制 ,打破了以往的高职终身制 ,促进了医务人员钻研业务技术的积极性 ,责任制试点取得了较为满意的效果。1　考评对象、内容和方法1.1　考评对象　除当年底退休的高职人员…     

军队研究型医院医疗质量考评体系构建

介绍在军队推进研究型医院建设的背景下,为适应研究型医院内涵建设、医疗卫生体制改革发展、研究型医院管理创新的需要,医院参照相关法律法规的基础上,依据可控制、可操作、可导向、可激励的原则,建立研究型医院医疗质量考评体系,以提高医疗技术水平和服务质量;通过构建三级医疗质量监督考核体系,设置关键医疗指标进行考评,实现依法管理、规范管理,精准管理;突出研究型医院特点,完善医院医疗质量考评体系,推动研究型医院建设与发展.     

专业技术干部任期考评标准及方法

专业技术干部任期考评标准及方法张韵萍张顺旺董是栋高娅玲金吕平刘建新作者单位：０５００８１石家庄市，解放军四六七医院（张韵萍、张顺旺、董是栋）；北京军区空军后勤部卫生处（高娅玲）；解放军四六四医院（金吕平、刘建新）专业技术干部实行任期考评目的，是为了通...     

针对疗养学科特点提高任期考评质量

为探讨提高科技干部任期考评的工作质量，本结合疗养学科特点，阐述了加强组织领导；开展思想教育；合理制定标准；坚持考用一致；为搞好科技干部任期考评工作提供经验。     

血站综合目标考评实践

建立科室考评小组-站考评组-站考评委员会三级考评组织并明确职责,从日常考评、年终考评两部分进行综合目标考评。将各科室考评结果与科室绩效分配、中层干部任期评价、年内评选先进科室和先进个人以及聘期内职称晋升等相结合,提高了科室、职工的自我管理、自我约束效力,推动了无偿献血事业的全面发展。     

军队医院专业技术干部考评原则与改进

专业技术干部考评工作对增强专业技术干部素质，提高医院医疗服务质量具有重要意义。本文对专业技术干部的考评原则、考评存在的问题及完善措施等进行分析，旨在提高考评工作质量，促进专业技术干部队伍建设，推动医院发展。     

我院高职任期考评工作的做法

我院于１９９８年４月～７月对１９９７年底满一个任期的５２名高级专业技术职务的干部进行了任期考评试点工作。在这些干部中因种种原因不能参加考评的１２人，实际参加任期考评的４０人。考评结果，其中定为优秀的８人，称职的２９人，基本称职的２人，不称职的１人。整...     

新时代建立医院廉政教育长效机制的探索

目的：探讨新时代背景下医院廉政教育长效机制的建立途径。方法：分析当前医院廉政教育形势，参考相关文献，结合医疗工作环境，进行系统分析和客观研究。结果：提出通过完善领导体制、学习制度、考评制度、廉洁家风等，促进医院廉政教育长效机制的建立。结论：新时代医院廉政教育长效机制的建立途径可包括：完善领导体制，健全工作机制；建立学习制度，引导廉洁自律；完善考评制度，责任落实到人；建设廉洁家风，塑造廉政文化；抓好医院廉政教育效果评价。     

医院内部审计的新领域及政策措施

随着市场经济的进一步发展,医院内部管理体制及经营运行机制越来越适应市场经济的需要,新的医院财务制度和会计制度的实施,给医院财务管理和经济运行提出了更高要求。与此相适应,医院内部审计的内容必须随之更新,相关措施必须配套,才能更好地发挥内部审计的作用。一、医院内部审计的新内容（一）参加医院院长任期经济责任审计。为了考核院长任期目标经济责任,保证完成任期目标,在院长任期内的每个年度,医院内部审计机构必须对院长任期经济目标责任进行审计,检查任务目标完成进度,加大日常监督力度,保证院长离职时高质量地完成任…     

空调隔尘网粉螨、真菌、细菌污染状况调查

[目的]了解空调隔尘网病原生物污染状况.[方法]对360份采自学校、饭店、娱乐场所、医院病房空调隔尘网表面的积尘样本,用直接镜检法分离、鉴定粉螨,并用普通营养琼脂培养,乳酸酚棉蓝染色法鉴定菌种.[结果]360份积尘样本中,粉螨孳生率为72.78%(262/360),孳生密度为(7.68±3.44)只/g;学校、饭店、娱乐场所、医院病房空调隔尘网表面粉螨的孳生率分别为44.57%(41/92)、78.57%(88/112)、88.57%(62/70)和82.56%(71/86),差异有统计学意义(X2=279.71,P＜0.001);粉螨孳生密度分别为(2.59±0.64)、(7.59±1.76)、(10.22±3.37)、(8.52±2.91)只/g,差异有统计学意义(F=82.94,P＜0.001);360份积尘样本直接镜检获螨2012只,隶属3科9属12种,其中麦食螨科占65.90%(1326/2012);食甜螨科占12.82(258/2012);粉螨科占21.27%(428/2012).另外,共采集1800份标本,真菌阳生率53.61%(965/1800),学校、饭店、娱乐场所、医院病房分别为36.09%、73.93%、77.14%和26.74%(X2=352.49,P＜0.001),共检出真菌22种;细菌阳性率35.67%(642/1800),学校、饭店、娱乐场所、医院病房分别为29.35%、45.36%、48.00%、19.77%(X2=101.50,P＜0.001),共检出细菌13种.[结论]空调隔尘网表面病原生物污染严重,空调使用者应重视对空调器的清洁与净化,防止或减少粉螨的孳生及微生物的污染.     

手持式呼吸峰流量仪替代肺功能仪进行 尘肺合并慢阻肺支气管舒张试验的可行性研究

摘要：目的 比较两种肺量计在尘肺合并慢阻肺患者支气管舒张试验中的应用效果，探讨小型化仪器替代的可行性。方法：同时应用科时迈PFT3型肺功能仪和某品牌手持式呼吸峰流量仪，对160名尘肺合并慢性阻塞性肺病的患者，进行支气管舒张试验检查。对比两种设备肺通气功能检查及使用舒张剂后肺功能相关指标的变化率及变化值的差异，进行一致性分析。结果：以科时迈PFT3型肺功能仪检测结果为标准，得出手持式呼吸峰流量仪特异度为92.8%，符合率93.7%；手持式呼吸峰流量仪的FVC、FEV1、FEV1/FVC和科时迈PFT3型肺功能仪FVC、FEV1、FEV1/FVC、PFE指标的一致性符合度高。结论：手持式呼吸峰流量仪价格低廉，操作与科时迈PFT3型肺功能仪相比更加简便；两种设备诊断结果数据进行比较，其特异度、符合率等都较高；在临床上，特别是偏僻乡村基层医院对尘肺合并慢性阻塞性肺疾病的患者的筛查、诊断、病情监测及用药指导都有显著意义。     

阴道冲洗液绒毛膜促性腺激素和甲胎蛋白检测诊断胎膜早破

目的 探讨阴道冲洗液β绒毛膜促性腺激素(β-human chorionic gonadotropin,β-hCG)和甲胎蛋白(alpha fetoprotein,AFP)检测在胎膜早破诊断中的临床价值。 方法 应用微粒子化学发光分析法对42例胎膜早破和38例正常晚孕待产孕妇阴道冲洗液进行β-hCG和AFP定量测量。 结果 胎膜早破组阴道冲洗液β-hCG、AFP测量中位数值分别为294.2 IU/L和143.4μg/L,明显高于对照组的4.4 IU/L和5.0×10-2μg/L(P<0.001);四分位数间距分别为422.8 IU/L和179.2μg/L,明显高于对照组的11.0 IU/L和0.3μg/L(P<0.001);以β-hCG≥40.1 Iu/L或AFP≥16.3μg/L为阳性参考值,阳性检出率分别为97.6%(41/42)和100.0%(42/42);其诊断的敏感性分别为95.2%和97.6%;特异性分别为89.5%和100.0%。 结论阴道冲洗液β-hCG和AFP,尤其是AFP检测是胎膜早破准确及快速的诊断方法。     

镍化合物致人胚肺细胞转化及细胞周期的研究

目的 探讨镍化合物与职业性肺癌的关系。方法 用水不溶性氧化镍和二硫化三镍体外转化人胚肺细胞（ＭＲＣ－９和ＩＭＲ－９０）,并用流式细胞术分析这些转化细胞的细胞周期改变。结果 细胞在染毒３～５个月后,ＭＲＣ－９和ＩＭＲ－９０细胞均被诱发形态转化,包括转化灶的形成、无序重叠交叉生长和类上皮细胞化等。并且有的转化细胞能在软琼脂培养基中生长并形成集落。流式细胞术分析发现,转化细胞细胞周期发生改变。如未处理的     

Bioactive Compounds and Antioxidant Properties of Goji fruits (Lycium barbarum L.) Cultivated in Serbia

Objective: Goji fruit extracts, methanol (MGE) and hexane (HGE), were subjected to evaluation as potential source of phenolic antioxidants and antiradical activity.

Methods: Some phenolic compounds (gallic, protocatechuic, vanillic, chlorogenic, coumaric, caffeic and ferulic acid and catechin and rutin), vitamin C and carotenoids were identified and quantified by HPLC. Antioxidant activity was tested by measuring ability to scavenge DPPH and hydroxyl radicals. Also, reducing power of goji fruit extracts was determined.

Results: HPLC analysis results showed predominance of gallic acid (40.44 mg/g g.f). Vitamin C content in MGE was 716.91 mg vitC/100 g g.f. IC₅₀^DPPH· varied from 26.64 μmolTEAC/g for HGE to 62.15 μmolTEAC/g for MGE, while RP_0.5 values varied from 952.23 μmolTEAC/g for MGE to 1360.48 mg/mL for HGE. IC₅₀·^OH for MGE was 1844.01 μmolTEAC/g.

Conclusions: Our results support the use of goji fruits as rich sources of phytochemicals for further utilization in the food industry as supplements and functional food ingredients.     

燃煤型砷中毒皮肤病变中P16、P21WAF1/CIP1/、CyclinD1蛋白的表达及意义

目的　探讨砷中毒与皮肤病变的关系。方法　用免疫组织化学法检测燃煤型砷中毒患者皮肤病变中P16、P2 1WAF1/CIP1、CyclinD1蛋白的表达情况。结果　P16的表达强度和密度随患者皮肤病变程度的加重而逐渐减弱 ,P16蛋白在癌变组 (A组 )、癌前病变组 (B组 )和过度角化组 (C组 )中普遍缺失表达 ,明显低于一般增生病变组 (D组 )和正常组 ;P2 1WAF1/CIP1、CyclinD1的表达强度和密度随患者皮肤病变程度的加重而逐渐加强 ,P2 1WAF1/CIP1在各病变组中普遍强表达 ,明显高于正常组 ,各病变组间也有不同程度的差异 ;CyclinD1在A、B、C组中普遍强表达 ,明显高于D组和正常组。以上差异具有统计学意义。结论　皮肤过度角化可能是皮肤癌变的先兆 ;P16和CyclinD1蛋白的异常表达可作为皮肤癌变的预警标志 ;P16、P2 1WAF1/CIP1和CyclinD1在燃煤型砷中毒致皮肤病变尤其癌变的过程中共同起重要作用 ,动态监测P16、P2 1WAF1/CIP1和CyclinD1蛋白的表达水平有助于砷中毒致皮肤癌的早期发现、早期治疗和预后判断     

Relative bioavailability of micronized,dispersible ferric pyrophosphate added to an apple juice drink

Background

Food iron fortification is a sustainable and relatively simple strategy to reduce/prevent iron deficiency but is a challenge for the food industry because of possible adverse organoleptic changes caused by the added iron. A micronized dispersible ferric pyrophosphate, trademarked as SunActive Fe^®, has recently been developed. SunActive Fe^® has a small particle size, is water soluble and may be suitable for fortifying liquid products.

Aim of the study

To determine the relative bioavailability of SunActive Fe^® and its suitability for addition to pure apple juice.

Methods

Iron absorption from SunActive Fe^® added to pure apple juice (Minute Maid^®) was compared with absorption from ferrous sulphate, a highly bioavailable form of iron, in 15 women with relatively low iron stores. Both forms of iron were enriched with an iron stable isotope and iron absorption from the apple juice drinks was calculated from the isotopic enrichment of red blood cells 14 days after the last test meal.

Results

Although mean absorption of iron from SunActive Fe^® was significantly lower than from ferrous sulphate (5.5% compared with 9.1%), the mean bioavailability of SunActive Fe^® iron relative to ferrous sulphate was 0.6, indicating that it is a good source of bioavailable iron. Iron Absorption from SunActive Fe^® was positively correlated (r = 0.97, P = 0.01) with absorption from ferrous sulphate, and negatively correlated with serum ferritin concentration (ferrous sulphate r = ?0.81, P < 0.001; SunActive Fe^® r = ?0.76, P = 0.01).

Conclusions

SunActive Fe^® was well absorbed from apple juice and is a potentially useful fortificant for liquid food products.

     

Comparison of the Danish Physical Activity Questionnaire with a validated position and motion instrument

Objective To compare the Danish Physical Activity Questionnaire (DPAQ) estimating physical activity energy expenditure (PAEE) and physical activity level (PAL) and the pattern of physical activity (including health-related physical activity) with measurements from a validated position and motion instrument (ActiReg^®). Methods One hundred and thirty-eight healthy Danish volunteers aged 20–59 years participated. Participants filled in the DPAQ at the end of the day every day for seven consecutive days and carried the ActiReg^® on the same days as the DPAQ were filled in. Results A small, but statistically significant difference was seen between the DPAQ and the ActiReg^® for PAEE (mean: ?0.32 MJ·d^?1; 95% limits of agreement: ((?2.88)–2.24 MJ·d^?1); P = 0.003) and PAL (?0.03; ((?0.37)–0.31); P = 0.02) for the whole group and for women (P < 0.008 for PAEE and PAL), but not for men. The correlation between methods was good for PAEE (r = 0.71, P < 0.001) and PAL (r = 0.64, P < 0.001). No difference was observed for time spent in moderate plus vigorous physical activity (MVPA) (P = 0.40). Time reported in MVPA with the DPAQ was positively correlated with time spent in MVPA measured by the ActiReg^® (ρ = 0.53, P < 0.001). Conclusions Although the volunteer sample may influence the representativeness of the results, the DPAQ provided a close estimate of PAEE, PAL (2–5% underestimation) and health-related physical activity (MVPA) in healthy adults at group level. The results indicate that the questionnaire can be used to rank individuals according to energy expenditure and level of total physical activity and to provide information on health-related physical activity.     

Effect of the Herbicide Roundup<Superscript>®</Superscript> on <Emphasis Type="Italic">Perkinsus olseni</Emphasis> in vitro Proliferation and in vivo Survival when Infecting a Permissive Host,the Clam <Emphasis Type="Italic">Ruditapes decussatus</Emphasis>

Coastal habitats are increasingly being exposed to herbicide contamination from urban and agricultural catchments. Data on its toxicity on aquatic ecosystems, especially those based on sediment, are relatively scarce. This study aimed at investigating whether the susceptibility of an aquatic filter-feeding organism, the carpet-shell clam (Ruditapes decussatus) to the parasite Perkinsus olseni was influenced by the herbicide Roundup and its active ingredient glyphosate. The effect of Roundup and glyphosate on P. olseni in vitro proliferation was also evaluated and appeared to confirm the higher toxicity of Roundup when compared with technical grade glyphosate.     

Activation of GABAA Receptor/Cl− Channel and Capacitation in Rat Spermatozoa: HCO3− and Cl− are Essential

This study was designed to determine whether HCO₃^? and Cl^? are required for the activation of the GABA_A receptor/Cl^? channel (GBRC) by GABA and the subsequent capacitation of rat sperm. Spermatozoa from adult Sprague Dawley rats were incubated in four different media: modified complete rat fertilization medium (mRFM), Cl^?-deficient (Cl^?-DF) mRFM, HCO₃^?-DF mRFM, and Cl^?-DF HCO₃^?-DF mRFM, with or without GBRC agonists (GABA and progesterone) or GBRC antagonists (bicuculline and picrotoxin) for 0–6?h under capacitating conditions. Sperm capacitation and hyperactivation were assessed by chlortetracycline staining and computer-assisted sperm analysis, respectively. The results showed that GABA added to the mRFM accelerated capacitation and hyperactivation, followed by increase in the acrosome reaction, reaching maximum value after 5?h. Progesterone also accelerated sperm capacitation and hyperactivation. Bicuculline and picrotoxin, antagonists of GABA, blocked the effects of both GABA and progesterone acceleration of sperm capacitation and hyperactivation. Sperm capacitation required both Cl^? and HCO₃^?. These results indicate that activation of GBRC may contribute to sperm capacitation and hyperactivation, and that both HCO₃^? and Cl^? are essential. This is the first report of a close relationship between HCO₃^?/Cl^? transport and the activation of GBRC in rat sperm capacitation and hyperactivation.