中国医学科学院肿瘤医院肿瘤研究所1992-2003年科学论文统计分析

本文对中国医学科学院肿瘤医院肿瘤研究所1992—2003年被SCI及CSTPCD收录的科学论文及其被引情况进行了总结和分析，并对科研发展趋势及科研人员投稿倾向进行了初步探讨。这些信息有助于我们对既往的管理措施进行反思，促使我们对未来的管理方式加以思索。我们认为对本机构的科学论文情况进行科学客观的了解、总结、分析对提高机构的科研管理水平是十分有益的。     

甲型肝炎流行促进了“大卫生”的诞生

我国一贯重视卫生工作,但长期局限于狭义卫生,缺乏全社会大卫生的概念。1988年上海30万人的甲型肝炎(甲肝)流行,经过系统调查,确定为一次由生食带甲肝病毒毛蚶引起的暴发流行。通过长期禁食毛蚶、接种甲肝疫苗后,甲肝发病率已降到1/10万以下的水平。甲肝防治和毛蚶控制与环保、水产、商业、卫生、防疫、食品安全等各个行业有关,上海在甲肝疫情控制中实施了“大卫生”。上海市通过重视“大卫生”,加强了公共卫生体系的建设,提高了市民卫生意识,促进了全社会的卫生水平。     

Family practices registration networks contributed to primary care research

BACKGROUND AND OBJECTIVE: Family physicians (FP) play a key role in the diagnosis and treatment of health problems in the community and for evidence-based guidance clinical research must be based on primary care data. This paper analyses the state-of-the-art approaches to collection of data and the building of databases in family practice. METHODS: Experience in the Netherlands in family practice-based research networks (PBRNs) is explored in registering and analyzing primary care data, illustrated with four examples of PBRN studies. RESULTS: PBRNs bring together practices and FPs with a research interest to collect data and pursue research under routine patient care conditions. This directs research at relevant questions of family practice. Important features of success are practitioners' ownership of data and the use of data in improving care of patients in the participating practices. International standardization of terminology and definitions in the international classification of primary care improves the scientific quality of data recorded in registration networks and PBRNs. CONCLUSIONS: Through primary care registration networks and PBRNs it is possible to tap-in unselected care of patients and at the same time produce scientifically rigorous data. This enables research that represents the realities of primary care with valid data.     

New trial ordered because patient contributed to own harm

The North Carolina Supreme Court affirmed a psychiatrist's request for a new trial in a civil suit filed by a client who claimed he was misdiagnosed and improperly treated for depression. Michael Cobo received an award of $850,000 from a jury that found his treatment by Dr. Ernest Raba failed to arrest his self-destructive tendencies, including having unprotected sex with men. Raba diagnosed Cobo as having chronic depression, requiring psychoanalysis four times a week, and at Cobo's request, did not prescribe medications. When Cobo learned that he was HIV-positive, he took the prescribed medicine. Cobo switched psychiatrists and his mental state improved, after which, he sued Raba. The court ruled that Cobo contributed to his own infection; as a physician specializing in infectious diseases, Cobo should have known that his behavior put him at risk. Under North Carolina law, a plaintiff is barred from recovering damages if he fails to avoid unreasonable risks. Cobo has since died, and his wife continued the litigation.