医院继续医学教育管理中资源整合的探索

继续医学教育工作是不断提高医院卫生技术人员技术水平和业务能力的有效手段。天津市某三甲医院通过政策整合,打包宣传;课程整合,对接学分;多部门协作,临床需求整合,率先在医院继续医学教育管理中进行资源整合的探索实践,有效提高了医院继教管理的质量和效率。但从全过程管理的角度分析,依然存在待完善的环节。进一步提出通过整合学员考核结果、意见反馈;整合多项人事管理制度等手段提高医院继教管理质量的完善建议,旨在为医院继续医学教育实现优质高效的管理提供参考。     

关于改革康复学概论课程教学的体会与建议

康复学概论教学体会是:积极采取"互动"教学模式,应用多媒体教学手段,针对不同教学对象调整教学内容,侧重老年康复医疗教育.就此提出5点建议:①将康复医学教学与全科/家庭医生的培养相结合;②增加康复实(见)习机会;③适度增加教学时数,突出中医康复教学特色;④加强康复护理教学,培养康复护理人才;⑤控制授课班次人数.     

Effect of valerian on human sleep

The effect of an aqueous extract of valerian root on sleep was studied in two groups of healthy, young subjects. One group (N=10) slept at home, the other (N=8) in the sleep laboratory. Sleep was evaluated on the basis of questionnaires, self-rating scales and night-time motor activity. In addition, polygraphic sleep recordings and spectral analysis of the sleep EEG was performed in the laboratory group. Under home conditions, both doses of valerian extract (450 and 900 mg) reduced perceived sleep latency and wake time after sleep onset. Night-time motor activity was enhanced in the middle third of the night and reduced in the last third. The data suggest a dose-dependent effect. In the sleep laboratory, where only the higher dose of valerian was tested, no significant differences from placebo were obtained. However, the direction of the changes in the subjective and objective measures of sleep latency and wake time after sleep onset, as well as in night-time motor activity, corresponded to that observed under home conditions. There was no evidence for a change in sleep stages and EEG spectra. The results indicate that the aqueous valerian extract exerts a mild hypnotic action.     

Effect of zolpidem on sleep and sleep EEG spectra in healthy young men

A single 10 mg dose of zolpidem, an imidazopyridine hypnotic, was administered to young, healthy male volunteers prior to bedtime. The drug reduced REM sleep but did not significantly affect other sleep stages and subjective sleep parameters. All-night spectral analysis of the EEG revealed that power density in nonREM sleep was reduced in the low-frequency range (1.25–2.5 Hz; 5.25–10.0 Hz) and increased in the spindle frequency range (12.25–13.0 Hz). Significant changes in the EEG spectrum were present in the first 4 h of sleep. The pattern of the spectral changes was similar to those induced by other hypnotics that bind to the GABA_A/benzodiazepine receptor complex. There were no residual effects of zolpidem on psychomotor performance in the morning, on the self-rated state in the morning and at noon, and on sleep and EEG parameters in the subsequent drug-free night.     

我国化学医药工业的现状及对今后发展的意见

本文对我国化学医药工业的现状,从特点、生产完成情况、重点品种、用药结构等几方面进行了分析;同时,对今后医药工业的发展提出了两点主攻方向。     

脑卒中综合防治举措国际比较及启示

摘 要 为提高患者生命质量,本研究针对脑卒中发病率、致残率、死亡率和复发率高的特点,围绕综合防治体系开展研究。对国内外防治体系在健康教育、风险干预、急救及治疗与康复层面进行比较发行,我国各个环节上的体系基本健全,但还需通过联合社会力量共同开展健康教育和干预;落实诊疗规范,建立分级和梯度就诊制度;利用信息化网络,加强远程预诊和协作来进一步提高防治效果。     

The magnitude of nocebo effects in pain: A meta-analysis

The investigation of nocebo effects is evolving, and a few literature reviews have emerged, although so far without quantifying such effects. This meta-analysis investigated nocebo effects in pain. We searched the databases PubMed, EMBASE, Scopus, and the Cochrane Controlled Trial Register with the term “nocebo.” Only studies that investigated nocebo effects as the effects that followed the administration of an inert treatment along with verbal suggestions of symptom worsening and that included a no-treatment control condition were eligible. Ten studies fulfilled the selection criteria. The effect sizes were calculated using Cohen’s d and Hedges’ g. The overall magnitude of the nocebo effect was moderate to large (lowest g = 0.62 [0.24–1.01] and highest g = 1.03 [0.63–1.43]) and highly variable (range of g = −0.43 to 4.05). The magnitudes and range of effect sizes was similar to those of placebo effects (d = 0.81) in mechanistic studies. In studies in which nocebo effects were induced by a combination of verbal suggestions and conditioning, the effect size was larger (lowest g = 0.76 [0.39–1.14] and highest g = 1.17 [0.52–1.81]) than in studies in which nocebo effects were induced by verbal suggestions alone (lowest g = 0.64 [−0.25 to 1.53] and highest g = 0.87 [0.40–1.34]). These findings are similar to those in the placebo literature. As the magnitude of the nocebo effect is variable and sometimes large, this meta-analysis demonstrates the importance of minimizing nocebo effects in clinical practice.     

龙胆碱镇静催眠作用及对小鼠脑内5-HT、GABA含量的影响

目的探讨龙胆碱的镇静、催眠作用,并观察其对脑内递质5-HT、GABA含量影响,初步探讨龙胆碱镇静催眠作用的机制。方法腹腔注射不同剂量的龙胆碱溶液,观察其对ICR小鼠自主活动的影响,协同戊巴比妥钠对小鼠的催眠作用;ELASA法测定脑匀浆液中GABA、5-HT含量。结果龙胆碱高、低(200 mg/kg、50 mg/kg)均能减少小鼠自主活动次数(P<0.05),增加阈下剂量戊巴比妥钠致小鼠入睡的只数并延长小鼠睡眠时间,龙胆碱能够增加脑内GABA含量,但对5-HT含量无影响。结论龙胆碱具有良好的镇静、催眠作用,其作用与增加脑内GABA含量有关。     

农民工参加医疗保险的难点与政策建议

城市农民工对社会做出了巨大贡献,但他们中大部分却没有基本的医疗保障。笔者对农民工参加医疗保险的必要性、可行性和难点做了简单描述,并提出了一些建议和对策。     

职业化院长的涵义与实践进程

对职业化院长的概念、特点进行了详细的阐述,并以中、外对比的方式介绍了国内外院长职业化的背景和实践进程,通过对比分析找出了我国院长职业化难以实现的症结所在,进而提出了一些可以加速院长职业化实现的措施与保障。