军队全科医学教育培养模式研究

开展全科医学教育,培养全科医学专业人才是军队基层卫生服务工作的一项迫切任务。采用问卷调查的方法,针对军队全科医学教育的培养模式展开了研究,提出了以岗位培训为重点的培训模式。     

中西医结合治疗突发性耳聋68例

目的探讨中西医结合治疗突发性耳聋的疗效。方法 68例突发性耳聋患者,其中对照组31例,予以改善内耳微循环、激素、脱水等治疗;治疗组35例,在对照组治疗的基础上,结合中医辨证论治方法,采用宣肺通窍汤加减及通窍活血汤加减。两组均在治疗后第4、7、11、15、21天复查听力,对两组疗效进行比较。结果参照中华医学会耳鼻咽喉科学会制定的突发性耳聋疗分级标准,治疗组与对照组治疗总有效率分别为91.42%和74.19%（P〈0.05）。结论中西医在突发性耳聋病因病机上是一致的,中西医结合治疗突发性耳聋能提高疗效。     

La Médecine de Famille (Médecine Générale): Quelles spécificités académiques et professionnelles?

Family Medicine, a true scientific and academic discipline, has been defined by the World Organization of National Colleges, Academies and academic associations of general practitioners / family physicians (WONCA) since 2002, as being a "clinical specialty oriented towards primary care". This paper details the specificities of Family Medicine: a horizontal specialty, primary care, providing comprehensive and continuous care, patient-centered and community-oriented. The promotion of Family Medicine in the Maghreb countries requires a multi-axial strategy based on the social marketing of Family Medicine, the recognition of Family Medicine as a medical specialty and of Family Medicine as a gateway to national health system, the establishment of a quality approach in basic health centers and free practice offices (centers of health centers) and regular validation of the Family Medicine diploma.     

A medical school's involvement in the development of a community-based health center

This paper presents a planning model developed by the Department of Community Medicine of the Mount Sinai School of Medicine to facilitate the interactions between the medical school and the community. The planning process involved application of the model, exemplified through the growth and development of a neighborhood health center governed by a community agency. The main characteristics of the medical school, of the community, and of the community agency are presented briefly and the seven-year history of the development of the neighborhood health center is summarized. In recapitulating that history three distinct phases are identified in the planning process: how the planning was planned, how the plan was prepared, and how the services program was implemented. The role of the Department of Community Medicine in each phase is analyzed.Dr. Merino is Assistant Professor, Department of Community Medicine, Mount Sinai School of Medicine, New York, NY 10029. Dr. Rose is Instructor, Departments of Medicine and Community Medicine, Mount Sinai School of Medicine, New York, NY 10029. Dr. Bosch is Professor and Deputy Chairman, Department of Community Medicine, Mount Sinai School of Medicine, New York, NY 10029.     

甘肃省保安族居民对中医药认知度及需求情况调查

目的了解保安族居民中医药认知度,摸清该目标人群对中医药的需要、需求及利用情况。方法自行设计调查问卷,对积石山县保安族聚居区居民进行问卷调查,分析该地区居民对中医药服务的需要、需求和利用情况。结果目标人群中医药服务需要迫切,需求未得到充分带动,利用率较低。相关影响因素有:当地居民对中医药卫生认知水平低下,当地中医药卫生服务能力低下。结论针对积石山县保安族聚居地区居民中医药服务需要迫切、需求未得到充分带动、利用率低的情况,可以考虑实行以下措施:对居民加强关于中医药相关知识的宣传教育,引进和培养中医药人才,调整中医药服务在"新农合"中的报销比例等。     

我国中医药人力资源的空间特征及动态演进

目的：分析我国中医药人力资源的空间分布及动态演进过程,为优化我国中医药人力资源配置提供科学依据。方法：运用探索性空间数据分析法、核密度估计、马尔科夫链模型对我国中医药人力资源的空间分布及动态演进过程进行研究。结果：我国中医药人力资源配置水平存在空间非均衡特征、空间正相关性和较强的稳定性。近年来,虽然这一配置水平有了较大提升,但省份间的差异却在逐渐扩大。结论：建议完善中医药人力资源管理体系,建立中部帮扶机制;发挥优质中医药资源辐射作用,推动地区协同发展;结合中医药人力资源配置水平实际,实施差异化发展政策;优化中医药人才培养模式,促进人员流动合理化。     

中医临床路径构建思路与方法

通过对临床路径特点的分析,结合中医学的整体观和辨证观提出了中医临床路径的可行性,并从中医院的实际出发,具体讲解了如何构建和实施中医临床路径,分析了医疗和护理工作中临床路径的作用,同时,提出了实施中医临床路径的优势和目前存在的主要问题.     

The emergence and potential impact of medicine 2.0 in the healthcare industry

Medicine 2.0 has emerged within healthcare information technology to enable more defined relationships among providers and patients. Physicians, hospitals, and patients are using Medicine 2.0 through social networking to maintain their foothold in the evolution of medical technologies. The authors' purpose was to determine potential improvements that Medicine 2.0 has on communication and collaboration of healthcare information. Research has shown that Medicine 2.0 has integrated into the healthcare industry and is enabling an increase in communication in healthcare matters. The provider-patient relationship is improving through the use of Medicine 2.0 and has positively impacted society so far.     

Effectiveness of medical school admissions criteria in predicting residency ranking four years later

BACKGROUND: Medical schools across Canada expend great effort in selecting students from a large pool of qualified applicants. Non-cognitive assessments are conducted by most schools in an effort to ensure that medical students have the personal characteristics of importance in the practice of Medicine. We reviewed the ability of University of Toronto academic and non-academic admission assessments to predict ranking by Internal Medicine and Family Medicine residency programmes. METHODS: The study sample consisted of students who had entered the University of Toronto between 1994 and 1998 inclusive, and had then applied through the Canadian resident matching programme to positions in Family or Internal Medicine at the University of Toronto in their graduating year. The value of admissions variables in predicting medical school performance and residency ranking was assessed. RESULTS: Ranking in Internal Medicine correlated significantly with undergraduate grade point average (GPA) and the admissions non-cognitive assessment. It also correlated with 2-year objective structured clinical examination (OSCE) score, clerkship grade in Internal Medicine, and final grade in medical school. Ranking in Family Medicine correlated with the admissions interview score. It also correlated with 2nd-year OSCE score, clerkship grade in Family Medicine, clerkship ward evaluation in Internal Medicine and final grade in medical school. DISCUSSION: The results of this study suggest that cognitive as well as non-cognitive factors evaluated during medical school admission are important in predicting future success in Medicine. The non-cognitive assessment provides additional value to standard academic criteria in predicting ranking by 2 residency programmes, and justifies its use as part of the admissions process.     

国外循证医学的问题及借鉴意义

文章介绍了国外学者在循证医学中发现的一些问题,并举出了具体的实例说明这些问题,提出了循证医学进一步完善和发展的思路和看法,以期对我国循证医学的发展有所借鉴。     

Future of family medicine workforce in the United States

In response to the Future of Family Medicine Leadership Committee's recommendations(1) The Ohio State University Department of Family Medicine convened 10 faculty development sessions covering the following strategic objectives: (1) Promoting a Sufficient Family Medicine Workforce, (2) the Role of Family Medicine in Academic Health Centers, (3)The New Model of Family Medicine, (4) Electronic Medical Records, (5) Family Medicine Education, (6) Lifelong Learning, (7) Enhancing the Science of Medicine, (8) Quality of Care, (9) Communications, and (10) Leadership and Advocacy. The focus of this editorial is on initiatives and programs to promote a sufficient family medicine workforce. In comparison to other industrialized countries, the United States ranked lowest in primary care functions and lowest in health care outcomes, but highest in health care expenditures. Despite this fact, the trend for United States medical school graduates to select subspecialty careers continues upward. Through collaboration and advocacy, we can all ensure a continued enthusiasm for the selection and retention of family medicine as a career.     

Community-oriented health services education: A strategy for international cooperation

This paper describes the approach of the Department of Community Medicine of the Mount Sinai School of Medicine in the education of local and foreign physicians and their participation in the development of community oriented health care systems. It also presents the first steps taken by this medical school to create an international program whose aims are to develop long-term partnership agreements with foreign universities by bringing together and integrating medical education with the development of community-oriented health care services.Samuel J. Bosch, M.D., is Charles G. Bluhdorn Professor of International Community Medicine, Department of Community Medicine, The Mount Sinai School of Medicine of the City University of New York. One Gustave L. Levy Place, New York, N.Y. 10029.Alan Silver, M.D. is Assistant Professor and Director of the Education Unit, Department of Community Medicine, The Mount Sinai School of Medicine of the City University of New York. One Gustave L. Levy Place, New York, N.Y. 10029     

环境与健康保护：从理论到行动的转化之路——“第六届环境与职业医学国际学术研讨会”纪要

＂第六届环境与职业医学国际学术研讨会暨《环境与职业医学》杂志创办30周年研讨会＂于2014年10月16—18日在上海市召开,会议的主题是＂环境与健康保护：从理论到行动＂。此次会议由上海市疾病预防控制中心、上海市预防医学研究院、上海市预防医学会、《环境与职业医学》杂志主办,复旦大学公共卫生学院、江苏省预防医学会、浙江省预防医学会协办。共有44位中外专家进行了报告,200余位参会者就＂环境相关疾病的预防与控制＂＂职业人群的健康保护＂＂环境与职业医学中的组学研究＂＂环境政策与公共卫生＂等内容展开讨论。本次会议收到中英文论文投稿近200篇,同时设置了壁报展示并评选出3份优秀壁报。在＂《环境与职业医学》编者、审者、作者交流会＂上,编委会成员和审稿专家共同回顾了杂志创办30年来的发展历程,为杂志的发展提出了缩短出版周期、提供增值服务、进入重要数据库等意见。本次会议的成功举办可望进一步加深加强上海与国际国内在相应领域的联系与合作,更好地促进环境与职业医学领域理论与实际的结合、基础与临床的整合、微观与宏观的融合,为环境健康研究注入新的活力。     

基于变异系数评价重症医学科DRG分组效能研究

目的 评价重症医学科DRG分组的效能,发现存在的问题,为DRG付费或绩效考核提供建议.方法 采用DRG分组器获得样本医院2016-2019年出院患者的分组结果.在2555名重症医学科出院患者中选取病例数排名前5位的DRG组作为DRG研究组.在351148名全院出院患者中筛选出DRG研究组的所有病例.对入组同一个DRG组...     

The role and functions assumed by a department of community medicine in planning a group practice.

This paper describes the technical assistance role and the functions assumed by the Department of Community Medicine of the Mount Sinai School of Medicine in a planning process that led to the development of a group practice in the Department of Medicine of the Mount Sinai Hospital. Three distinct phases are identified in the process: how the planning was planned, how the plan was prepared, and how the implementation was planned. The role of Community Medicine in each phase is analyzed.     

中药炮制前后微量元素的变化及其对功效的影响

目的:找出炮制对微量元素的影响,以及微量元素的变化与炮制品功效相应变化的相关性。方法:查阅炮制方法对微量元素影响的相关文献,依据中医药理论,同时结合笔者近年来的科研生产经验进行了综述。结论:分析了微量元素对中药疗效的重要性,并从微量元素角度对以后的炮制和临床用药提出建议。     

Transformation and trends in preventive and social medicine education at the undergraduate level in a Brazilian medical school

In the present study we discuss some transformations in undergraduate training in Preventive and Social Medicine in the Department of Social Medicine of the Faculty of Medicine of Ribeiro Preto, University of So Paulo, from 1993 to 1999. Aspects of the relationship between medical training and the reorganization of local services of the Brazilian national health system, and between graduate teaching in Preventive and Social Medicine and medical education as a whole are discussed. The crisis in Preventive and Social Medicine and its influence of medical training are evaluated. Trends for the application of a body of knowledge of the specialty and for the relationship between the department and the medical school are discussed.     

补肾活血法治疗输卵管积水性不孕症的研究进展

输卵管积水是输卵管性不孕症的重要病因,目前西医主要以手术对症治疗积水和辅助生殖技术获得妊娠。中医从整体观念和辨证论治的角度出发,认为输卵管积水性不孕症的基本病机是肾虚血瘀,肾虚为本,血瘀为标。病位在胞宫,故以补肾培元和活血通络为治疗大法。中药内服和外用并举,在改善患者临床症状和提高妊娠率方面均有显著疗效。现代药理学也进一步证实补肾活血中药的明确作用机制,以补肾活血法为代表的中医疗法治疗输卵管积水性不孕症有独特优势。综述补肾活血法与输卵管积水性不孕症的理论探讨及研究进展。     

Definition of terms and concepts applicable to clinical preventive medicine

This article defines the terms and concepts applied to the teaching of clinical preventive medicine by the Curriculum Development Project—a joint venture of the Center for Educational Development in Health (CEDH) at Boston University and the Association of Teachers of Preventive Medicine Foundation (ATPMF).Dr. Stokes is Professor of Medicine (Section of Preventive Medicine and Epidemiology), Boston University, Boston, MA 02118; Dr. Noren is Director (Administrative Medicine), University of Wisconsin, Madison, WI 53706; and Dr. Shindell is Professor and Chairman (Department of Preventive Medicine), Medical College of Wisconsin, Milwaukee, WI 53233.Supported in part by grants from the National Fund for Medical Education and the Kellogg Foundation.     

Introducing the new laboratory standard for HbA1c determination in Hungary

A new laboratory standard, specific for HbA1c was prepared by the International Federation of Clinical Chemistry and Laboratory Medicine. Consequently, manufacturers will supply their calibrators with the International Federation of Clinical Chemistry and Laboratory Medicine standard. Laboratories in Hungary switch to this new method in April 1, 2011. After this date, results of HbA1c measurements will be reported in International Federation of Clinical Chemistry and Laboratory Medicine units (mmol/mol) and in the derived National Glycohemoglobin Standardization Program units (%) calculated by master equation from the International Federation of Clinical Chemistry and Laboratory Medicine/National Glycohemoglobin Standardization Program methods. Using the new standardization the HbA1c measurements will be traceable to the International Federation of Clinical Chemistry and Laboratory Medicine reference method and interlaboratory comparisons will be possible.