抗菌药物临床应用管理架构、技术支持体系与策略

抗菌药物管理是一个世界性难题,本文对抗菌药物管理的各个方面,包括其定义、目标、组织架构、技术支持体系、管理策略等进行详细阐述,同时就我国目前抗菌药物管理工作存在的问题进行剖析.我国应学习和借鉴国际经验,结合自身情况的复杂性进行实践、研究和创新.     

Intraoral Luting: Modified Prosthetic Design to Achieve Passivity,Precision of Fit,and Esthetics for a Cement‐Retained,Implant‐Supported Metal‐Resin‐Fixed Complete Denture

An intraoral luting technique between electroformed gold copings and a metallic framework for a cement‐retained, implant‐supported metal‐resin‐fixed complete‐denture is presented. The peculiarity is the different prosthetic design with the metallic framework that was 1.5 mm shorter than the margin of the electroformed copings. As a consequence, the conventional thick prosthesis margin (electroformed copings, cement for the luting phase, framework) was modified into a thin electroformed prosthesis seal (0.3 mm) just beyond the apical limit of the esthetic material. Passive fit between the framework and the electroformed gold copings was achieved during the intraoral luting phase. The procedure was efficient and standardized and enhanced esthetics.     

加强政府公共财政对公共卫生事业投入的针对性和有效性

我国作为世界最大的发展中国家，根本的特征是人口多、底子薄，发展不平衡，政府对公共卫生事业发展的投入不可能参照发达国家的水平和标准，但要提高和改变现有财政投入的比率和方向，加强投入的针对性和有效性。     

深圳市社区卫生服务投入的成本效益分析

目的分析政府对社区卫生服务投入的成本效益。方法通过调查深圳市2006年社区卫生服务在"社区常见病"的平均服务费用、总门诊服务量、本年度综合医院在"社区常见病"的平均服务费用,与2006年度政府对社区卫生服务的投入经费进行比较,计算目前深圳市社区卫生服务的实际成本效益;设计一个模型:每2万人左右设置一个社区卫生服务中心,在社区实行"社区首诊负责制",政府对社区卫生服务实行"全成本"投入。在此模型下,通过调查社区常见病的两周患病率及社区卫生服务的"全成本",计算深圳市社区卫生服务的预计成本效益。结果目前深圳市社区卫生服务的实际成本效益为5.57,预计成本效益为6.28。结论政府对社区卫生服务的投入,其成本效益是非常显著的,利用社区卫生服务中心解决群众"看病难、看病贵"问题是一项经济、快速和有效的举措。     

城市生活垃圾转运站经济合理性研究

应用技术经济学理论,分别计算建与不建垃圾转运站时各自的固定投资以及运行成本,考虑资金时间价值,讨论其经济合理性,形成城市生活垃圾转运站经济合理性判定模型,并将该模型应用到重庆主城区生活垃圾转运站选址、建设的经济分析中.     

包埋料和热处理对自研贵金属合金铸造适合性的影响

目的　比较不同包埋料和热处理方法对牙科铸造贵金属合金BS 1金合金铸件铸造适合性的影响。方法　采用 2种包埋料 (F 1和Z 1包埋料 )包埋模拟后牙冠的帽状代型蜡型 ,用BS 1金合金铸造 ,铸件经过不同的热处理 (软化热处理 ,硬化热处理和恒温时效硬化热处理 )后试合于各自的石膏代型 ,在体视显微镜和金相显微镜下分别测试铸件的边缘适合性和组织面密合度 ,求各自的平均值 ,统计分析各组之间的统计学差异性。结果　F 1包埋料组的边缘差异明显小于Z 1包埋料组 (P <0 0 5 )。热处理对金合金铸件的铸造适合性无显著性影响。结论　BS 1金合金用F 1包埋料包埋铸造的铸件其铸造适合性优于Z 1包埋料组。热处理对其铸造适合性无显著性影响     

How Do Older Chinese Women View Health and Cancer Screening? Results from Focus Groups and Implications for Interventions

Objective. To qualitatively assess Chinese American women's views of health and illness and the potential influences of culture and language on cancer screening behavior.

Design. Data were generated by five focus groups, each consisting of 9–12 Chinese American women aged 50 and older. Participants responded to open‐ended questions assessing their perceptions of health and illness, knowledge about cancer, beliefs about and barriers to cancer screening, and screening and healthcare experiences in the USA. All conversations were tape‐recorded and analyzed in the context of PRECEDE framework concepts of predisposing, enabling, and reinforcing factors.

Results. The 54 participants had a mean age of 65 years, with an average age of immigration to the USA at 51 and average length of residence in the USA of 15 years. Participants considered outdoor exercise in the morning for fresh air and a hot–cold balanced diet as important means to health. None mentioned the importance of regular medical checkups or cancer screening. When talking about cancer prevention, a sense of fatalism was evident, such as ‘no control of life and death’ and ‘what will happen will happen’. Lack of English capability was a major enabling barrier to healthcare. In addition, these women reported the need for help with transportation, especially for those living in suburban areas where public transportation is not readily available. Physician recommendation was identified as the most important reinforcing factor for cancer screening.

Conclusion. Our results suggest traditional Chinese beliefs, such as those pertaining to fatalism, self‐care, and the hot and cold balance, influence the perceptions of older Chinese women regarding health, illness, and use of preventive healthcare. Interventions to improve cancer screening in this population should be tailored to the specific predisposing, enabling, and reinforcing factors of this population, including cultural views, language barriers, doctor–patient communication, and access to healthcare.     

构建卫生服务质量的概念框架

卫生服务质量包括可及性和有效性两个根本维度，体现在卫生服务结构、过程和结果三个过程中。有效性包括临床服务和人际服务两个关键成分。当研究群体卫生服务质量的时候，应该引入公平性和效率的概念。作者强调政府和卫生服务提供者应该重视卫生服务质量，而不仅是医疗服务质量；重视临床和人际服务质量，而不仅是临床服务质量。按照本文提出的质量概念框架，作者对建立我国卫生服务质量评价指标体系进行讨论。