贯彻实施《母婴保健法》 促进山区妇幼卫生工作的发展

《中华人民共和国母婴保健法》（下称《母婴保健法》）的颁布实施,标志着我国妇幼卫生工作纳入了法制化管理的轨道。我县依法开展了各项妇幼卫生工作,进一步推动了山区县妇幼卫生工作的发展。１　加强领导　广泛宣传自１９９６年６月１日实施《母婴保健法》以来,我县在县政府和县卫生局领导下,通过多种形式和多种渠道广泛宣传,使《母婴保健法》家喻户晓,深入人心,提高了全社会贯彻实施《母婴保健法》的积极性和自觉性,为依法开展妇幼卫生工作打下了良好的思想基础。２　强化妇幼保健服务功能２１　根据《母婴保健法》关于婚前医学…     

儿童疾病单病种质量管理体系的研究

在总结分析武汉地区儿童疾病结构用度春诊疗规律的基础上,运用现代医院全面质量管理的理论,建立了以儿科常见病、多发 为主,兼纳部分专科疾病的２４个儿童疾病单病种质量控制标准及规范的组织管理和考核评价第统。形成以增强病种质量控制能力为核心的儿童疾病单病种质量管理体系。该管理体系运用后,医院医疗质量管理水平和社会、经济效益得到了同步提高,并了医务人员的医疗行为,使医院步入优质、低砂和高效的运营轨道。     

Orbital infarction and melting in a patient with systemic lupus erythematosus

OBJECTIVE: To present a patient with systemic lupus erythematosus who developed infarction and melting of the orbit secondary to her systemic disease. DESIGN: A case report. PARTICIPANT: A 61-year-old white woman with a 5-year history of systemic lupus erythematosus. METHODS: The patient presented with left orbital pain, limitation of extraocular movements, and a fistula from the ethmoid sinus to the upper eyelid. A detailed examination with computerized tomography, ultrasound, and a comprehensive medical evaluation with laboratory testing was performed. Histopathologic analysis with special stains of the orbital tissues was also performed. RESULTS: Histopathologic examination of the biopsy specimens revealed the features of an inflammatory process involving the orbit, similar to a panniculitis. These include a lymphocytic reaction with a predominance of plasma cells, vasculitis with occlusion, and thickening of the vessel walls, necrosis, and hyalinization of fat. CONCLUSION: This is a unique case in which infarction and melting of the entire orbital structures occurred in the presence of systemic lupus erythematosus. The underlying disease process is a lupus-related panniculitis. The authors stress that this is a very rare entity and that other diseases should be ruled out before entertaining this diagnosis.     

Retrograde intubation dacryocystorhinostomy for proximal and midcanalicular obstruction

Objective

Retrograde intubation of canaliculi during dacryocystorhinostomy can restore canalicular patency in cases otherwise managed with bypass tubes. The surgical technique and success for this procedure are discussed.

Differential diagnosis of anterior segment cysts by ultrasound biomicroscopy

BACKGROUND: To describe the ultrasound biomicroscopic (UBM) features of anterior segment cysts. DESIGN: A retrospective case series. PARTICIPANTS: One hundred eighteen eyes with anterior segment cysts examined by UBM at The New York Eye and Ear Infirmary between August 1992 and November 1997 were included in this study. INTERVENTION: The authors reviewed demographic and diagnostic data from the medical record including ocular and medical history, age, race, gender, and intraocular pressure. Ultrasound data concerning the type, number, position, and acoustic characteristics of cysts were recorded. The authors then correlated the written, clinical, and UBM characteristics. RESULTS: One hundred eyes (92.6%) had neuroepithelial cysts. Ninety (83.3%) of these had primary neuroepithelial cysts, 10 (9.3%) had cysts associated with uveitis, 7 (6.5%) had implantation cysts, and 1 (0.9%) had a cavitated ciliary body tumor. Neuroepithelial cysts typically were round or ovoid, thin-walled, and echolucent. Of the 90 eyes with primary neuroepithelial cysts, 56 (62.2%) had 3 or fewer cysts; multiple cysts (>3 per eye) were found in 34 eyes (37.8%). The multiple cysts occupied more than 180 degrees in 12 patients (13.3%). Primary neuroepithelial cysts were located at the iridociliary junction (74.2%), pars plicata (14.0%), pars plana (6.8%), and iris (5.0%). Implantation cysts (seven eyes) tended to have thicker walls and two contained a copious, echogenic material. CONCLUSION: The UBM results provide important information regarding location and extent of anterior segment cystic lesions. Ultrasound characteristics may help differentiate between neuroepithelial, implantation, and neoplastic cysts.     

Neutropenia, fever, and infection

With the advances in the management of various neoplastic diseases and subsequent improvement in "disease-free" states, complications of therapy--particularly, infectious complications--have evolved as stumbling blocks to survival. Among neutropenic (absolute neutrophil count below 1,000/mm3) patients with cancer, infection is the major autopsy-determined cause of death. With expected "cure rates" of childhood leukemia approaching 60 to 70 percent, it seems unreasonable to lose such patients to an infectious cause of death, yet this, indeed, happens. The purpose of this review is to (1) define the magnitude of the problem; (2) describe the various agents responsible for infections in neutropenic patients; (3) attempt to more sharply define degrees of neutropenia and mechanical defenses; and (4) consider various approaches to studying and treating these infections.     

38所综合医院病种质量管理调查分析

搜集整理吉林省 38所二、三级综合医院为期一年的 31个病种3.4万份病例的信息资料,对其治疗转归、平均住院日和平均住院费用进行了统计分析,为制定病种质量控制标准和深入广泛开展病种质量管理提供了可靠依据。     

从药品的特殊属性谈医药企业的服务营销

目的 :探讨我国医药企业在市场竞争日益激烈的现状下的服务营销策略选择。方法 :分析处方药品和非处方药品的服务特性 ,并介绍药品市场营销的新观念———服务营销的发展及应用。结果与结论 :医药企业的服务营销应针对处方药品走服务的差异化、有形化、规范化道路 ;针对非处方药品走服务的标准化、技巧化、品牌化道路。     

参合农民对新农合定点医疗机构服务质量的评价

目的现场调查参合农民对新农合定点医疗机构服务质量的评价情况,为有关卫生主管部门改进新农合定点医疗机构服务质量提供科学依据.方法随机整群抽样,以问卷方式调查抽取的部分云南省寻甸县参合农民对新农合定点医疗机构服务质量的意见和建议.结果参合农民对各级定点医疗机构医疗技术水平、服务态度、收费、卫生资源配置情况的评价分布差异分别都有统计学意义(P＜0.001).经非条件Logistic回归分析表明,村卫生室虽然设备较差,只有部分需要的药,但医务人员治疗一些常见病的医疗技术水平尚可,距离近,收费低,可信度和满意程度较高,参合农民选择就诊的可能性相应较高.结论各级定点医疗机构服务质量一般,卫生资源配置不合理,县级医疗机构服务态度较差,收费过高.建议有关卫生主管部门大力提高乡村医生的医技水平,合理配置卫生资源,改善县级医疗机构的服务态度,降低并统一新农合定点医疗机构的收费.     

Estimating numbers of injecting drug users in metropolitan areas for structural analyses of community vulnerability and for assessing relative degrees of service provision for injecting drug users

This article estimates the population prevalence of current injection drug users (IDUs) in 96 large US metropolitan areas to facilitate structural analyses of its predictors and sequelae and assesses the extent to which drug abuse treatment and human immunodeficiency virus (HIV) counseling and testing are made available to drug injectors in each metropolitan area. We estimated the total number of current IDUs in the United States and then allocated the large metropolitan area total among large metropolitan areas using four different multiplier methods. Mean values were used as best estimates, and their validity and limitations were assessed. Prevalence of drug injectors per 10,000 population varied from 19 to 173 (median 60; interquartile range 42–87). Proportions of drug injectors in treatment varied from 1.0% to 39.3% (median 8.6%); and the ratio of HIV counseling and testing events to the estimated number of IDUs varied from 0.013 to 0.285 (median 0.082). Despite limitations in the accuracy of these estimates, they can be used for structural analyses of the correlates and predictors of the population density of drug injectors in metropolitan areas and for assessing the extent of service delivery to drug injectors. Although service provision levels varied considerably, few if any metropolitan areas seemed to be providing adequate levels of services.