试论收益最优的卫生资源配置模式

一直以来，医院不够重视医疗服务过程中所消耗的人力、物力、信息等资源，尤其在资源的控制和利用等管理环节显得薄弱。医疗市场竞争的日益激烈，医院必须在摈弃旧的运作体系和管理同时，建立一种使医院能够实现收益最大化的卫生资源配置模式，充分利用人力、物力、财力和信息等的同时，实现可持续发展。卫生资源包括人力、财力、物力和科技信息等，对卫生资源若采用平均使用，没有倾斜的方式，后果往往是”收效微、效益差”，毕竟资源是有限的，卫生资源更是有限的。     

健康教育人员必须具备的基本素质

随着经济发展和社会进步，人们更加关注身心健康和生活质量的提高。由于部分传染病、性病、艾滋病、结核病等未能得到有效控制，传染性非典型肺炎与禽流感等新发传染病不断出现，不良生活方式引起的糖尿病、肿瘤、冠心病和高血压等慢性疾病的发病率居高不下，因此，普及基本卫生常识，倡导健康生活方式，消除或减轻影响健康的危险因素，     

硫酰氟熏蒸剂量计算方法

硫酰氟（sulfuryl fluoride）是一种能有效杀灭各种生活期的昆虫和鼠类等有害生物的广谱熏蒸剂。由于其具有不燃烧，不消耗同温层的臭氧，渗透力强，熏蒸用量小，解吸快，对金属、棉织品、毛类、皮革、塑料、工艺品等商品无腐蚀、无色泽影响的特点，并可在有仪器和电子设备的“敏感”区域使用，且使用时不需辅助热源，具有使用方便，熏蒸时间灵活等优点，因此，深受熏蒸人员的青睐。目前美国、瑞士、意大利、英国、加拿大、法国、西班牙、比利时、德国和特立尼达、澳大利亚等国家，已经应用于食品行业的有害生物控制。     

冬季防治“小卒中”

冬季气候寒冷，中老年人如果在动脉粥样硬化、脑动脉狭窄和颈动脉受压等的基础上，活动少、喝水少和进食过多的高脂食物等，则很容易发生“小卒中”，出现手足无力、偏瘫失语、视物不清和跌倒受伤等症状；如不及时请医生治疗，则可发展为脑梗塞（包括脑血栓形成和脑栓塞），危及生命。     

护理干预对2型糖尿病患者生活质量及焦虑状况的影响

2型糖尿病又称非胰岛素依赖型糖尿病，常并发视网膜、肾脏和外周神经等病变，严重影响患者的身心健康。药物治疗、饮食控制和运动等疗法是治疗2型糖尿病的常用方法，但临床效果并不明显，患者多因病情困扰表现出自卑、悲观和焦虑等负性情绪，而影响治疗效果，     

做好慢性病防治工作的体会

“慢性病”全称是慢性非传染性疾病，不是特指某种疾病。慢性病主要以心脑血管疾病（高血压、冠心病、脑卒中等）、糖尿病、恶性肿瘤、慢性阻塞性肺部疾病（慢性气管炎、肺气肿等）、精神异常和精神病等为代表的一组疾病，具有病程长、病因复杂、健康损害和社会危害严重等特点。慢性病的危害主要是造成脑、心、肾等重要脏器的损害，易造成伤残，影响劳动能力和生活质量，且医疗费用极其昂贵，增加了社会和家庭的经济负担。几年来在慢性非传染性疾病综合防治过程中笔者感到有一些问题还需要解决和探讨，使慢性非传染性疾病的防治工作更加科学化和规范化。     

冠心病的食疗

应减少饮食热能以控制体重，减少脂肪总量及饱和脂肪酸和胆固醇的摄入量，增加不饱和脂肪酸，限制单糖和双糖摄入量，供给适量的矿物质及维生素。可以随意进食的食物。谷物，尤其是粗粮：豆类，尤其是大豆及其制品：蔬菜，尤其是葱球、大蒜等；菌藻类，如香菇、木耳、海带、紫菜等；各种瓜果和水果、茶叶。适当进食的食物。瘦肉，包括瘦的猪、牛肉和家禽（去皮）；鱼类，包括多数河鱼和海鱼；植物油包括豆油、菜油、玉米油、红花油、芝麻油等：奶类，如牛奶、羊奶等：鸡蛋每周2-3个（高胆固醇血症者尽量少吃）。     

地方政府在推动双向转诊的作用和路径研究

双向转诊在我国属新生事物，各地还处在一个摸索和实践过程，仍处于自发阶段，尚存在很多问题。本文运用个案访谈，文献分析等研究方法，并结合国际经验，对双向转诊的概念、目前存在的问题、地方政府的作用、创新的动力等方面进行探讨和分析，并建议地方政府应以新公共管理理念和思维为基础，依托民营组织、社会组织等力量，取得地方公众以及基层政府的支持，积极进行制度创新；如打破条块分割、整合有限资源，导入新的服务模式、促进不同种类服务之间的合作与协调，积极发挥经济杠杆作用、促使病人合理分流，因地制宜、制定明确的转诊程序和标准等。     

公立医院新员工岗前培训需求与效果分析

作为现代医院管理的重要组成部分，岗前培训在强化新员工认同，促进新员工角色转换，充实医院人才队伍等方面具有重要作用。本文采用问卷调查和电话访谈法，基于湖州市某公立医院2023年新员工岗前培训调查数据，发现新员工更倾向于5-7天的培训时长和1小时以下的授课时长，更希望了解薪酬待遇、职称晋升与职业发展、业务技能与临床规范和管理制度等内容，最喜欢的授课方式为实践演练。岗前培训满意度、实用性和工作表现等调查结果显示，岗前培训效果较好。对于存在的课程针对性不强、内容重复、授课方式传统、组织欠妥等方面的问题，本文从授课模式、以培促教和组织安排等方面提出了解决思路。     

硫酰氟安全应用技术研究

硫酰氟（sulfuryl fluoride）是国际上常用的一种广谱熏蒸剂，能有效杀灭各种生活期的昆虫和鼠类，在建筑物、交通工具、仓库等熏蒸处理中应用已有近五十年的历史。由于其具有不燃烧，不消耗同温层的臭氧，渗透力强，熏蒸用量小，解吸快，对金属类、棉织品、毛类、皮革、塑料、工艺品等商品无腐蚀、无色泽影响的特点，并可在有仪器和电子设备的“敏感”区域使用，且使用时不需辅助热源，具有使用方便，熏蒸时间灵活等优点，因此，在有害生物控制业中，越来越受业内人士的青睐。目前美国、瑞士、意大利、英国、加拿大、法国、西班牙、比利时、德国和特立尼达等国家，已经将其应用于食品行业的有害生物控制。     

Antioxidant characteristics of a newly developed vermouth wine

INTRODUCTION: The polyphenol compounds can be responsible for the beneficial physiological effects of the wine, specially of the red wine. The supposed mechanism in health protecting effect due to the polyphenol components in the wine can be grouped to several biochemical reactions. One of the most important and mostly examined characteristics is their antioxidant and radical scavenging effect. AIM OF THE STUDY: Examination of the antioxidant characteristics of a newly developed vermouth wine. METHODS: Antioxidant characteristics of a newly developed vermouth wine (marked with FB) till now not in the market were studied comparing with those of three red and three white wines as well as of one rose wine. The total polyphenol content, the hydrogen donor activity, the reduction capacity and the complex building activity were determined. RESULTS: Hundred ml of the vermouth wine involves 18.8 mg alcohol, as well as 220 mg polyphenol compounds, comparing to the mean polyphenol content of white wine with 10.5 mg alcohol and 35 mg polyphenol contents. CONCLUSIONS: Usual consumption of one unit from the vermouth wine examined in this paper is medically acceptable, furthermore the organism can have those polyphenol compounds which play substantial role in the protection against oxidative stress.     

To Wine or Not to Wine

Abstract

This paper examines wine consumers' personal involvement with wine. We use the notion of a Personal Involvement Inventory (PII) to segment wine consumers into wine enthusiasts (those highly involved with wine) and wine novices (those with limited personal involvement). Using a large and representative data set and employing a multivariate logistic regression framework, we find that a typical wine enthusiast can be classified as someone who has a strong personal preference in her wines, buys wine for pleasure, has a high level of knowledge on wines, and spends significant amounts of money in purchasing wines on a monthly basis. Our findings have important implications for wineries and other wine marketers and in the development of successful wine lists.     

Ingestion of red wine significantly increases plasma phenolic acid concentrations but does not acutely affect ex vivo lipoprotein oxidizability

BACKGROUND: Reduced lipoprotein oxidizability by red wine phenols has been proposed as the basis for a relatively lower incidence of coronary heart disease in red wine drinkers. We showed previously that caffeic and protocatechuic acids isolated from red wine exhibit antioxidant activity in vitro. However, there is no information in the literature on the absorption of these compounds after red wine ingestion. OBJECTIVES: We sought to determine whether certain phenolic acids can be detected in the circulation after red wine consumption and if their presence has an acute effect on serum and LDL oxidation ex vivo. DESIGN: Twelve healthy male nonsmokers consumed red wine, phenol-stripped red wine, dealcoholized red wine, or water, each at a separate visit, in random order and 1 wk apart. Beverages were consumed over 30 min and blood was sampled just before beverage consumption and 1, 2, and 4 h after consumption. Plasma caffeic, protocatechuic, and 4-O-methylgallic acids were measured by gas chromatography-mass spectrometry. We also measured copper-induced serum and LDL oxidizability ex vivo and serum uric acid. RESULTS: Caffeic acid and 4-O-methylgallic acid concentrations increased significantly (P < 0.025) after consumption of red wine and dealcoholized red wine compared with water or phenol-stripped red wine. Uric acid increased significantly (P < 0.001) after ingestion of red wine, phenol-stripped red wine, and dealcoholized red wine. There was no effect on ex vivo serum or LDL oxidation after any of the beverages. CONCLUSION: Although red wine and dealcoholized red wine consumption acutely increase plasma phenolic acid and serum uric acid concentrations, the increase is insufficient to influence ex vivo lipoprotein oxidation.     

Immunoglobulin-E reactivity to wine glycoproteins in heavy drinkers

N-glycans from plant and invertebrate allergens can induce extensive immunoglobulin-E (IgE) cross-reactivity in vitro. IgE antibodies against these N-glycans, also termed cross-reactive carbohydrate determinants or CCDs, are prevalent in alcohol drinkers. This study investigated the prevalence and biological significance of IgE antibodies to N-glycans from wine glycoproteins in heavy drinkers. A structured questionnaire, skin prick tests, serum IgE levels, IgE-immunoblotting to wine extracts, and basophil activation tests were used to characterize 20 heavy drinkers and 10 control subjects. Eleven heavy drinkers (55%) showed IgE binding to proteins in wine extracts. The proteins were identified by mass spectrometry as grape-derived vacuolar invertase and thaumatin-like protein. Immunoblot reactivity was closely associated with the presence of IgE to CCDs and was inhibited by preincubation with a glycoconjugate containing bromelain-type N-glycans. The same conjugate, CCD-bearing allergens, and wine extracts activated basophils in patients with high-titer CCD-specific IgE but not in healthy controls. There was no relationship between immunoblot reactivity and consumption of any specific type of wine. No patient reported symptoms of hypersensitivity to Hymenoptera venom, food, or wine. In conclusion, heavy drinkers frequently show IgE reactivity to the N-glycans of wine glycoproteins. Glycans and wine glycoprotein extracts can induce basophil activation in sensitized alcoholics. The clinical significance of these findings remains to be elucidated.     

Exogenously applied abscisic acid to Yan73 (V. vinifera) grapes enhances phenolic content and antioxidant capacity of its wine

Yan73 is a ‘teinturier’ red wine variety cultivated in China and widely used in winemaking to strengthen red wine colour. The objective of this study was to evaluate the effect of exogenous abscisic acid (ABA) applied to the grapevine cluster on the antioxidant capacity and phenolic content of the wine made from Yan73. Two hundred mg/l ABA was applied on Yan73 grapevine cluster during veraison. As they mature, these ABA-treated and untreated grape berries were transformed into wines, respectively, and the phenolic content and antioxidant capacity of these wines were compared. The results showed that phenolic content (total phenolics, tannins, flavonoids and anthocyanins) and antioxidant capacity were higher in the wine produced with ABA-treated Yan73 grapes than those in the wine from untreated grapes. Compared to Cabernet Sauvignon wine, Yan73 wine had higher phenolic content and stronger antioxidant capacity. These strongly suggest that exogenously applied ABA to Yan73 grapes can enhance phenolic content and antioxidant capacity of its wine, and Yan73 wine has the higher utilization value and potential for development.     

试纸条快速检测法测定酒中氰化物的验证试验

目的通过加标实验，验证试纸条快速检测法对酒中氰化物定量测定的准确性。方法将不同浓度的氰化物标准溶液加入酒样中，用试纸条快速检测法测定加标后酒样中的氰化物浓度。结果该法测定水样中的氰化物含量时，结果较为准确；在测定酒样中氰化物含量时，能判定是否含有氰化物，但其测定结果不够准确。结论方法具有快速、简便的优点，适于水样中氰化物的定量测定及酒样中氰化物的定性测定。     

Cultural history of wine, the theoretical background of wine therapy

The knowledge of wine and grapes as old as the cultural history of human population. The small consumption of wine could be advantageous. Also it has been well established for several thousands of years, that it could cause acute and chronic injuries after higher consumption. Its antiinfectious effect in dermatological drugs had been known in the archeological ages. The unguents containing wine polyphenols are advantageous in some dermatological injuries and also in the treatment of muscular and articular alterations. Moderate consumption of wine may decrease the mortality rate of cardiovascular diseases. In healthy individuals consumption of one-two dl of wine can decrease the mortality rate of cardiovascular diseases. This quantity, however, may be injurious in pregnancy, in children, and in various organic diseases, especially in liver disease, as well as if combined with common drugs.     

Nutrition and health--favorable effect of wine and wine flavonoids on cardiovascular diseases

Epidemiological studies have shown a favourable effect of moderate alcohol consumption with regard to atherosclerotic disorders. In addition to alcohol, wine contains a large number of other components including polyphenols. These polyphenols mainly originate from the skins and seeds of grapes and, because of differences in vinification, their variety and concentration is higher in red wine than in white wine. In vitro and ex vivo studies have shown that some of these polyphenols are able to slow down LDL-cholesterol oxidation, stimulate NO production, influence prostaglandin synthesis and inhibit platelet aggregation. However, little is known about their resorption, bioavailability and effectiveness in vivo. Since data from intervention studies with wine polyphenols are also lacking, no statement can yet be made about any clinically relevant effect of these components, in either red or white wine, in terms of cardiovascular diseases.     

葡萄酒中抗癌活性成分反式白藜芦醇含量及其环境因素的影响

目的：利用高效液相色谱法测定葡萄酒中抗癌活性成分反式白藜芦醇的含量,并研究其含量的环境影响因素。方法：采用高效液相色谱法,使用ZORBAX C18色谱柱（4.6 mm±250 mm,5μm）,流动相为30％乙腈水溶液;流速为1 ml/min;检测波长为306 nm;柱温为室温;分离测定葡萄酒中反式白藜芦醇的含量,并研究光照、温度及密封状况对其含量的影响。结果：张裕干红葡萄酒中反式白藜芦醇的含量为（1.01±0.03）mg/L,长城干红解百纳中反式白藜芦醇的含量为（2.36±0.02）mg/L。阳光照射、温度升高及密封状况差均会导致反式白藜芦醇含量下降。结论：不同品牌的葡萄酒中反式白藜芦醇含量相差较大,且应在低温、避光和密封的条件下贮存葡萄酒。     

果酒中功效成分研究

摘要:目的　水果含有丰富的营养物质和植物化学物,果酒则是以各种水果（包括野果）为原料发酵而成。由于果酒中所含活性成分缺乏系统研究报道,因此,本研究拟通过分析酒中所含活性成分,为果酒提供基础科学资料。方法　选取不同原料的市售果酒（5种）,检测其所含的有机酸、黄酮及酚类物质,并用氧自由基吸收能力测定抗氧化性。结果　有机酸是果酒的主要功效成分之一,总有机酸之和在3 485.95～6 313.76 mg/L之间,不同果酒的有机酸组成均有差异;黄酮类化合物也是果酒的主要功效成分,蓝莓酒中种类最丰富,但含量低于山楂酒和红酒;另外,HPLC法还检测出多种酚类物质,山楂酒和红酒中种类最少,但含量高于其他果酒,特别是山楂酒中的表儿茶素（873.57 mg/L）和红酒中的没食子酸（550.62 mg/L）;果酒的ORAC值在1 331.6～21 001.5 μmol Trolox当量/ml之间,蓝莓酒最高。结论　果酒含有丰富的有机酸、黄酮类和多酚类物质,并具有很强的抗氧化能力。