美国临床肿瘤学会介绍

美国临床肿瘤学会（American Society of Clinical Oncology，ASCO）是全球领先的肿瘤专业学术组织，宗旨是预防癌症及改善癌症服务。学会规模日益壮大，有来自100多个国家约21500多名会员，会员包括肿瘤学领域及临床肿瘤科医师、参与认可的肿瘤学训练计划的医师和医疗专家、肿瘤科护士以及肿瘤科开业医师。学会会员专攻肿瘤学领域，包括医学、血液学、放射线治疗、外科与小儿科。ASCO对美国医疗服务有相当大的影响，其设有公关部门，负责向国会议员提出建议，推荐有关医疗政策及意见。     

广东省某市2013～2015年县级及以上医疗机构恶性肿瘤死亡报告情况分析

目的:分析广东省某市县级及以上医疗机构网络报告的2013～2015年因恶性肿瘤死亡的病例数据,为相关部门制定医疗机构恶性肿瘤的医疗资源分配方案提供数据支持.方法:收集2013 ～2015年某市县级及以上医疗机构恶性肿瘤死亡个案信息,死因分类按照国际疾病分类标准(ICD-10)进行编码,应用SPSS16.0软件对死亡资料进行统计分析.结果:2013 ～ 2015年广东省某市县级及以上医疗机构网络报告恶性肿瘤死亡病例3 632例,其中男性2 436例,女性1 196例,男女性别比为2.04:1;患者年龄0～101岁,平均年龄(59.69 ±16.95)岁.60岁及以上老年人群恶性肿瘤死亡病例数占全部恶性肿瘤死亡病例的52.97％(1 924/3 632).男性、女性死亡病例也均集中在60岁及以上老年人群,分别占男性和女性恶性肿瘤死亡病例数的54.06％(1 317/2 436)和50.75％ (607/1 196).前10位死因顺位依次为:肺癌、肝癌、结直肠癌、胃癌、白血病、食管癌、鼻咽癌、乳腺癌、胰腺癌、子宫颈癌,占全部恶性肿瘤死亡病例的82.21％.0～岁组恶性肿瘤的主要死因为白血病、脑癌,18～岁组主要死因为肝癌和白血病,40～岁组及65～岁组主要死因为肺癌、肝癌和结直肠癌.结论:肺癌是该市县级及以上医疗机构报告恶性肿瘤死因的首位;肺癌、消化系统恶性肿瘤是县级及以上医疗机构需重点关注的癌种.     

美国独立日感言

现在是2011年7月4日的晚上，我在儿子家照看小孙女伊莎贝拉。她的父母出门了，这是他们在第二个孩子即将出生以前的最后一次外出活动。我蜷缩在他家电视房的长沙发上，窗户敞开着，风扇开到最大档。新墨西哥州正处于干旱季节，火灾造成的烟雾笼罩着整个洛斯阿拉莫斯市的天空。一整天都燥热难当，眼睛被烟灰熏得生疼。     

合肥市属部分医疗机构消化道恶性肿瘤住院患者营养现状调查分析

目的:探讨合肥市属部分医疗机构消化道恶性肿瘤住院患者营养现状调查情况,为提高患者营养干预水平提供依据。方法:选择2017年1月至2019年1月合肥市第三人民医院、合肥市滨湖医院、合肥市第二人民医院治疗的消化道恶性肿瘤住院患者350例作为研究对象,所有患者均采用患者主观整体评估（PG-SGA）对患者营养状况进行调查,根据调查结果分为营养不良组与营养良好组。查阅病历资料,记录两组性别、年龄、吸烟、饮酒、家族肿瘤史、肿瘤病灶转移、肿瘤分期、是否接受放化疗等,对上述影响因素进行单因素及多因素Logistic分析。结果:合肥市属部分医疗机构消化道恶性肿瘤住院患者350例中85例营养不良,占24.29%。营养不良患者中中度营养不良占14.29%,重度营养不良占10.00%;单因素及多因素Logistic分析结果表明:合肥市属部分医疗机构消化道恶性肿瘤住院患者营养不良与性别、吸烟史、饮酒无统计学差异（P＞0.05）;合肥市属部分医疗机构消化道恶性肿瘤住院患者营养不良发生率与年龄、家族肿瘤史、肿瘤病灶转移、肿瘤分期、是否接受放化疗具有统计学差异（P＜0.05）。结论:合肥市属部分医疗机构消化道恶性肿瘤住院患者营养不良受到的影响因素较多,应加强患者营养筛查、评估及干预水平,改善患者预后。     

医疗保险知识简介（一）

医疗保险——是指以保险合同约定的医疗行为的发生为给付保险金条件,为被保险人接受诊疗期间的医疗费用支出提供保障的保险。医疗保险以合同的方式预先向受疾病威胁的人收取医疗保险费,当被保险人患病并去医疗机构就诊而发生医疗费用后,     

医生心情：让我们相互感激

我们都知道只有学习非常优秀的学生才能考上医学院,能获得医学硕士和博士头衔的则更是得出类拔萃了.所以你在大城市的大医院里随便挂个号,即便是个娃娃脸看着很嫩的小大夫,其实个个都是过五关斩六将,经过激烈竞争后才有了坐在诊室的资格的.     

美国肿瘤预防控制概况

恶性肿瘤是美国中老年人死亡的主要原因。2007年美国癌症死亡人数为56万,占全部死亡人数的23%。预计2011年美国新发癌症病例将达到160万,有57万人死于癌症。但大多数的癌症可以通过干预措施得以预防,比如控烟、改善饮食习惯、加强体育锻炼和控制肥胖。同时早期诊断也是美国控制恶性肿瘤的工作重点。定期进行癌症筛查,能够实现癌症的早期诊断,降低癌症患者的死亡率,延长生存期,提高生命质量。     

人工髋关节置换技术管理规范（2012版）

为规范人工髋关节置换技术的临床应用，保证医疗质量和医疗安全，根据《医疗技术临床应用管理办法》，制定本规范。本规范为医疗机构及其医师开展人工髋关节置换技术的基本要求。     

美国医界怎样攻克癌症

自20世纪90年代开始,美国癌症发病人数、发病率、死亡率出现了下降,这在人类攻克癌症的征途中就像一缕晨光撒向大地,令人们振奋和鼓舞.     

分析肿瘤医院医疗服务投诉，提升服务水平

为探索医疗服务投诉发生的规律,提高医疗质量,回顾性分析中国医学科学院肿瘤医院2009～2011年共126例医疗服务投诉的科室、人员分布及投诉缘由。发生投诉数量前三名的科室依次为腹外科（28例,22．2％）、病案室（19例,15．1％）、胸外科（18例,14.3％）。医疗服务投诉的主要对象中高级职称医师占71％,手术缺陷引起的投诉占30％。医院应针对性狠抓外科手术、高级职称医师、病案管理等,以期不断提高医疗质量和服务质量,提升患者满意度。     

Incidence of leukemia in Asian migrants to the United States and their descendants

Objective: To generate clues regarding the causes of leukemia we compared leukemia incidence rates among Asian-American immigrants and their descendants to those of United States-born whites. Methods: 535 Asian and 6629 white residents diagnosed with leukemia were identified through the Surveillance, Epidemiology and End Results Program during 1973 through 1986 in Hawaii, San Francisco/Oakland, and western Washington. A special tabulation of the 1980 US census was used to estimate the size and composition of the population at risk in these three areas. Results: The incidence of leukemia, either considered as a whole or as individual types, did not appreciably vary between US-born and foreign-born Asian Americans. For all forms of leukemia combined the rates per 100,000 person-years among males were 6.5 for foreign-born Chinese, 7.4 for foreign-born Japanese, and 7.5 for foreign-born Filipino as compared to 7.5 for US-born Chinese, 7.1 for US-born Japanese, and 5.4 for US-born Filipino. The rates in foreign-born Asian females and US-born Asian females were also similar. Asian Americans had a lower incidence of leukemia than US whites (rate of 13.3/100,000 person-years), particularly for chronic lymphocytic leukemia. Conclusions: Irrespective of birthplace, Asian Americans possess one or more characteristics which make their risk for leukemia less than that of US whites.     

Prior Medical Conditions and Medication use and Risk of non-Hodgkin lymphoma in Connecticut United States Women

OBJECTIVE: To further investigate the role of prior medical conditions and medication use in the etiology of non-Hodgkin lymphoma (NHL), we analyzed the data from a population-based case-control study of NHL in Connecticut women. METHODS: A total of 601 histologically confirmed incident cases of NHL and 717 population-based controls were included in this study. In-person interviews were administered using standardized, structured questionnaires to collect information on medical conditions and medication use. RESULTS: An increased risk was found among women who had a history of autoimmune disorders (such as rheumatoid arthritis, lupus erythematosus, Sjogren's syndrome, and multiple sclerosis), anemia, eczema, or psoriasis. An increased risk was also observed among women who had used steroidal anti-inflammatory drugs and tranquilizers. A reduced risk was found for women who had scarlet fever or who had used estrogen replacement therapy, aspirin, medications for non-insulin dependent diabetes, HMG-CoA reductase inhibitors, or beta-adrenergic blocking agents. Risk associated with past medical history appeared to vary based on NHL subtypes, but the results were based on small number of exposed subjects. CONCLUSION: A relationship between certain prior medical conditions and medication use and risk of NHL was observed in this study. Further studies are warranted to confirm our findings.     

The training of radiotherapists in the United States

The 1980 Survey of Training of Radiotherapists in the United States reveals important and significant facts: the number of institutions offering training has diminished; there has been a drop in the number of residencies offered; more than one-third of these are not filled; the number of young American graduates choosing this specialty has leveled off. The proportion of foreign medical graduates and of females among those receiving training in the United States is higher than average for other specialties.     

Cancer treatment cost in the United States

BACKGROUND:

There has not been a comprehensive analysis of how aggregate cancer costs have changed over time. The authors present 1) updated estimates of the prevalence and total cost of cancer for select payers and how these have changed over the past 2 decades; and 2) for each payer, the distribution of payments by type of service over time to assess whether there have been shifts in cancer treatment settings.

METHODS:

Pooled data from the 2001 through 2005 Medical Expenditure Panel Survey and the 1987 National Medical Care Expenditure Survey were used for the analysis. The authors used an econometric approach to estimate cancer‐attributable medical expenditures by payer and type of service.

RESULTS:

In 1987, the total medical cost of cancer (in 2007 US dollars) was $24.7 billion. Private payers financed the largest share of the total (42%), followed by Medicare (33%), out of pocket (17%), other public (7%), and Medicaid (1%). Between 1987 and the 2001 to 2005 period, the total medical cost of cancer increased to $48.1 billion. In 2001 to 2005, the shares of cancer costs were: private insurance (50%), Medicare (34%), out of pocket (8%), other public (5%), and Medicaid (3%). The share of total cancer costs that resulted from inpatient admissions fell from 64.4% in 1987 to 27.5% in 2001 to 2005.

CONCLUSIONS:

The authors identified 3 trends in the total costs of cancer: 1) the medical costs of cancer have nearly doubled; 2) cancer costs have shifted away from the inpatient setting; and 3) the share of these costs paid for by private insurance and Medicaid have increased. Cancer 2010. Published 2010 by American Cancer Society.     

基于医院现状的设备管理流程与方法改进探讨

随着现代化管理方法应用于医院,医疗设备管理成为医院后勤管理中的重要一环。如何将大卫生的理念和管理方法应用于医疗设备的管理,如何在管理中提高工作效率与加强全程的质量控制值得思考。全文对现阶段医院设备管理状况进行分析,针对主要环节进行管理方法应用与改进,以完善医疗设备管理,提高工作效率。