妊娠糖尿病的治疗 问题不是是否需要治疗，而是如何治疗及哪些人需要治疗？

妊娠糖尿病是妊娠期最常见的合并症。随着糖尿病患病率的不断升高，育龄妇女合并糖尿病成为一个越来越严峻的问题。在相对应的系统性回顾和荟萃分析（见本期第302页，doi：10．1136／bmj．c1395）中，Horvath等评估了妊娠糖尿病的筛查、诊断和治疗方法的有效性。这一回顾性结论是治疗组的部分特定“复合”终点事件（围产期死亡、新生儿肩难产、骨折、神经麻痹等）以及产伤（胎儿及母体）显著降低。     

Not if, but how: one way to talk with patients about forgoing life support

May the common clinical conversation be used to explore whether or not seriously ill patients want to talk about possible limitations of life support? In order to answer this question, a series of 20 seriously ill patients took part in an interview. The clinical conversations were taped and transcribed, and recurrent themes were identified and organised into categories. After talking about their diagnosis and prognosis, most patients said it was natural to talk about possible limitations of life support, and a substantial number immediately indicated that they did not want any life-sustaining treatment. Although their emotional reactions were different, no one seemed to be upset by talking about such issues. Many but not all patients said that they wanted a family member and possibly also a nurse to participate in the conversation. Every doctor learns to conduct a clinical conversation and this approach may be applied when talking with seriously ill patients about difficult treatment decisions.     

关键是你怎么说而不是说什么

现代医生的职责就是把治疗方案一五一十地告诉病人，由病人来决定是否接受这种治疗。其实任何治疗都是存在风险的，而每种治疗方案都可以用很多种方法进行描述，不同描述可以对病人的积极性产生不同的影响。一项研究发现，当人们得知需治人数（NNT）（即为预防某一事件的发生，而需要接受治疗的平均人数）的信息后，     

五脏六腑皆能令人汗而非独心也

汗是人体生理和病理状态下常见的一种表现,汗症是临床常见的一类症状,文章论述了汗的生理及病理,认为五脏六腑皆能令人汗而非独心也。     

五脏六腑皆能令人汗而非独心也

汗是人体生理和病理状态下常见的一种表现,汗症是临床常见的一类症状,文章论述了汗的生理及病理,认为五脏六腑皆能令人汗而非独心也。     

浅谈抓好班级管理工作的"三要素"

班级管理工作千头万绪、琐碎繁杂、无固定模式，需要班主任在实践中不断总结经验，进行探索和创新。如何搞好班级管理，笔者将体会总结如下。     

"Not thrush again!" Women's experience of post-antibiotic vulvovaginitis

OBJECTIVES: To examine the frequency of post-antibiotic vulvovaginitis (PAV); describe how women prevent and treat PAV; and determine whether concern about PAV affects their decisions about taking antibiotics. DESIGN: Cross-sectional survey using a written questionnaire. SETTING AND PARTICIPANTS: Five general practice waiting rooms in north-western Melbourne, in February 2000. 1298 women aged 18-70 years were surveyed. MAIN OUTCOME MEASURES: Self-reported symptoms and management of vulvovaginitis and PAV. RESULTS: The response rate was 86%. Thirty-five per cent of women reported ever having PAV and 73% reported ever having symptoms suggestive of vulvovaginal candidiasis. Antifungal medications and lactobacillus products or yoghurt were most popular for both prevention (49%, 40%) and treatment (63%, 43%) of PAV. Other home remedies such as tea tree oil, vinegar, and dietary and clothing modification were infrequently used by the women surveyed. Twenty-three per cent of women who had taken antibiotics in the previous month had experienced symptoms of vulvovaginitis. Of women who had ever had vulvovaginitis, 35% were moderately to very concerned about developing PAV when prescribed antibiotics. Because of this concern, around a fifth of these women would not take prescribed antibiotics. CONCLUSIONS: Concern about PAV affects women's decision-making regarding antibiotic use. Many women use unproven complementary therapies to prevent or treat PAV. When prescribing antibiotics, doctors should discuss the risks of PAV and its management with patients.     

浅析医疗管理活动中的不作为行为

医疗管理活动中的不作为行为,作为一种隐性腐败行为,给社会带来了诸多负面影响,本文对医院的管理中出现的不作为行为的表现、危害、原因进行了分析,并提出了预防和控制不作为行为的一些建议。