在计生服务机构组建生殖与性医学科的理论探索

计划生育服务系统亟需改革和创新，而生殖与性医学科的发展和完善，必将成为计生系统发展的契机，实现进一步满足民众需求，提高人口素质，促进社会和谐建设的目的。     

汶川地震四川灾区医疗卫生服务秩序恢复与基本医疗卫生服务保障

汶川特大地震造成四川省20个市（州）161个县受灾。10243个卫生机构不同程度受损,卫生人员遇难264人。中央和四川省从政策、法规、资金等多方面强力组织灾后恢复重建。灾区各级医疗卫生机构毫无保留地将药品器械和资金投入救灾,免费提供基本医疗卫生服务。灾区医疗卫生服务机构经历了“坝坝医院”、临时急救站、野战医院、帐篷医院、板房医院、维修加固医院和新建医院等逐步更新换代、发展完善的过程。积极协商部队建立了21所野战医院。不能用的医疗机构房屋被拆除,可修复的抓紧修复使用,必要时租用房屋。I临时急救站、野战医院、帐篷医院、板房医院相继建立。全国各地向灾区提供各种支援。灾区34万余名医疗卫生人员立即投入工作。对口支援的医务人员是重灾区因灾减员人数的12倍,且职称较高,经验丰富。各项医疗保障制度恢复,各项规章制度恢复运行。多方筹措经费支持。基本医疗和公共卫生服务基本得到有效保障,实现了大灾之后无大疫。     

Direct medical costs for surgical and medical treatment of condylomata acuminata

OBJECTIVE: To determine which treatment modalities for condylomata acuminata are associated with the lowest direct medical costs. DESIGN: Cost-effectiveness analysis. SETTING: Ambulatory private practice, primary or specialty care. PATIENTS OR OTHER PARTICIPANTS: Adults with no presenting complaints other than condylomata acuminata. INTERVENTIONS: Construction of a cost-effectiveness model. From a literature review, extraction of commonly accepted guidelines regarding duration and frequency as well as reports of efficacies of typical treatment regimens; from Medicare physician fee schedules, costs of physician visits and physician-administered treatments; from published data, average wholesale prices of medications. MAIN OUTCOME MEASURE: Estimated direct medical costs per complete clearance associated with different treatment options for condylomata acuminata. RESULTS: Mean direct medical costs per complete clearance are lowest for surgical excision ($285). Other low-cost modalities are loop electrosurgical excision procedure ($316), electrodesiccation ($347), carbon dioxide laser ($416), podofilox ($424), and pulsed-dye laser ($479). Higher-cost modalities are cryotherapy ($951), trichloroacetic acid ($986), imiquimod ($1255), podophyllum resin ($1632), and interferon alfa-2b ($6665). CONCLUSION: Surgical modalities, including excision, electrodesiccation, loop electrosurgical excision procedure, and laser, as well as podofilox are low-cost options for the treatment of condylomata acuminata.     

非战争军事行动"三防"医学救援医疗后送模式构想

为了进一步提高应对多种安全威胁、完成多样化军事任务卫勤保障能力,笔者通过分析非战争军事行动"三防"医学救援医疗后送影响因素,总结不同任务形式危害类型规律特点.建立非战争军事行动核化和生物危害两种医疗后送方案.研究指出战略发展的机遇期,救治理论的进步,全面建设现代后勤物质成果等有力条件是推动"三防"医学救援医疗后送体制建设切实可行的战略支撑与技术手段.     

国际医疗救援的组织与实施

2003午5月～2006年6月，我幽叫际医疗救援队先后5次参加了赴阿尔及利亚、伊朗、巴基斯坦、印度尼西业海啸及地震等灾区的国际氏疗救援任务。国际医疗队的人员、涉及的专业逐渐增多，人员装备以野外生存装备为主。医疗队早期在灾区的医疗活动完全依靠自身携带的药品及医疗设备。在联合国领导下建立救援信息网络，开展国际医疗合作。卫生防疫丁作得到重视。灾后帮助当地重建医疗体系。成功的国际医疗救援行动必备条件包括：①快速的应急反应机制，②训练有素的医疗急救人员，③充分的思想物质准备，④高效灵活的现场救灾方案，⑤有效的国际医疗救援合作，⑥畅通的救援信息交流。     

中国医学救援的进程与实践

中国面临各种灾害的威胁。中国的急救、灾害医学专家于1985年参加世界急救、灾害医学协会的活动,多次参加世界急救、灾害医学大会。2001年成立中国灾害防御协会救援医学会,同年成立“中国地震灾害紧急救援队”（对外称为“中国国际救援队”）。2003年成立中国医师协会急救复苏专业委员会。2006年《中国急救复苏与灾害医学杂志》创刊。2007年武警医学院建立中国第一个急救医学本科专业。2007年,国家颁布了《中华人民共和国突发事件应对法》。2009年确定每年5月12日为“全国防灾减灾日”。一大批专家、医务人员和其他有关人员长期从事医学救援工作。北京急救中心建立起一支装备齐全、精壮强干的应急救援队伍。2003年至今,中国国际救援队参加了7次国外大型地震灾害的救援活动。2008年,四川汶川地震中许多急救人员投入救援,发挥了巨大的作用。     

Sample size and power analysis in medical research

Among the questions that a researcher should ask when planning a study is "How large a sample do I need?" If the sample size is too small, even a well conducted study may fail to answer its research question, may fail to detect important effects or associations, or may estimate those effects or associations too imprecisely. Similarly, if the sample size is too large, the study will be more difficult and costly, and may even lead to a loss in accuracy. Hence, optimum sample size is an essential component of any research. When the estimated sample size can not be included in a study, post-hoc power analysis should be carried out. Approaches for estimating sample size and performing power analysis depend primarily on the study design and the main outcome measure of the study. There are distinct approaches for calculating sample size for different study designs and different outcome measures. Additionally, there are also different procedures for calculating sample size for two approaches of drawing statistical inference from the study results, i.e. confidence interval approach and test of significance approach. This article describes some commonly used terms, which need to be specified for a formal sample size calculation. Examples for four procedures (use of formulae, readymade tables, nomograms, and computer software), which are conventionally used for calculating sample size, are also given.     

医学院校性科学知识普及教育现状与对策:以安徽省为例

由于缺乏性科学相关的知识与信息,大多数性活跃的医学生对意外妊娠、不安全人工流产、生殖道感染、STD/AIDS等造成的严重后果缺乏正确的认识,从而使他们面临发生非意愿妊娠、生殖道感染、人工流产、性暴力、STD/AIDS的危险性增加,严重影响着医学生的身心健康.关注医学生性科学知识普及教育是保障医学生身心健康、满足患者性与生殖健康、AIDS反歧视教育以及 STD/AIDS职业防护的多重需要.教育者应转变思想观念,加强师资队伍建设,在遵循医学生身心发展规律的基础上,开展科学、合理的教育活动,在医学生性科学知识普及教育方面发挥主导作用.