中医医疗机构市场定位的博弈分析

在市场化取向改革的体制转型时期，中医医疗机构具有三重目标主体角度的特征，由于各目标所代表的利益主体不一致而存在冲突性。本文分别从中医事业发展、中医医疗机构市场定位的目标决策和制度创新等方面用数学模型分析其博奕关系，并从机制建设和理顺关系的角度，以“三目标”的共同实现为出发点．提出中医医疗机构市场定位的若干建议。     

优化商品陈列 刷新销售业绩

研究表明：商品陈列面的大小变化、化妆品陈列的高低变化和化妆品的陈列时间等均会影响化妆品店的销售额。首先，商品陈列面的大小变化会引起销售额的变化。如由4个货位减少到2个货位，销售额锐减48％；由3个货位减少到1个货位，销售额锐减68％；由2个货位增加到4个货位，销售额增加40％。所以，在化妆品店的商品陈列中，要加大购买频率较高品种的陈列面，并以大陈列面形成聚焦点，刺激顾客购买。     

血透患者中枸橼酸西地那非的药代动力学及血流动力学变化

患有肾病的男性中ED发病率很高。枸橼酸西地那非是勃起功能障碍的高效治疗药物，严重肾功能不全会使该药清除率下降，但在血透治疗的终末期肾病患者中，该药的药代动力学和血液动力学研究尚未见报导。为了研究血透患者中，该药的药代动力学和血流动力学变化，Grossman EB等人让15例慢性门诊血透维持患者在血透前2h及血透后2h口服单剂西地那非，先服哪一次进行随机分配确定。     

Changes in T .lymphocyte subsets after severe traumatic brain inJury

BACKGROUND： Besides local changes of cranial parenchymal cells, hemorrhage, etc., severe traumatic brain injuries also cause the changes of total body fluid and various functions, and the changes of lymphocytes and T lymphocyte subsets should be paid more attention to. OBJECTIVE： To reveal the changing laws of T lymphocyte subsets after severe traumatic brain injury, and compare with mild to moderate brain injury. DESIGN： A comparative observation. SETTINGS： Department of Neurosurgery, Longgang District Buji People＇s Hospital of Shenzhen City; Central Laboratory of Shenzhen Hospital of Prevention and Cure for Chronic Disease. PARTICIPANTS： All the subjects were selected from the Department of Neurosurgery, Longgang District Buji People＇s Hospital of Shenzhen City from August 2002 to August 2005. Thirty patients with severe brain injury, whose Glasgow coma score （GCS） was ≤ 8 points, were taken as the experimental group, including 21 males and 9 females, aging 16 - 62 years. Meanwhile, 30 patients with mild traumatic brain injury were taken as the control group （GCS ranged 14- 15 points）, including 18 males and 12 females, aging 15 -58 years. All the subjects were in admission at 6 hours after injury, without disease of major organs before injury Informed consents were obtained from all the patients or their relatives. METHODS： （1） The T lymphocytes and the subsets in peripheral blood were detected with immunofluorescent tricolor flow cytometry at l, 3, 7 and 14 days after injury in both groups. （2） The conditions of pulmonary infections were observed at 4 days after injury. The differences of measurement data were compared with the t test. MAIN OUTCOME MEASURES： Changes of T lymphocytes subsets at 1 - 14 days after severe and mild or moderate traumatic injury. RESULTS： Finally, 28 and 25 patients with mild to moderate traumatic brain injury, whereas 25 and 21 patients with severe traumatic brain injury were analyzed at 7 and 14 days respectively, and the missed ones died due to the development of disease. （1） Changes of T lymphocyte subsets： At 1 and 3 days after injury, CD3, CD4, CD8, CD4/CD8 began to decrease, whereas CD8 increased in the experimental group, which were very significantly different from those in the control group （t =2.77 - 3.26, P 〈 0.01）, and began to recover at 7 days, which were significantly different from those in the control group （t = 2.06 - 2.24, P 〈 0.05）, and generally recovered to the normal levels at 14 days （P 〉 0.05）. （2） Conditions of pulmonary infections： At 4 days after injury, the rate of pulmonary infection was significantly different between the experimental group and control group [73% （22/30）, 0, x2=37.29, P 〈 0.01]. CONCLUSION： Patients with severe traumatic brain injury suffer from damages of cellular immune function at early period （within 7 days）, and they are easily to be accompanied by pulmonary infections.     

复合矫治弓丝接头的力学性能及接头组织观察

目的　测试复合矫治弓丝接头的机械性能及分析接头、接头断口变化。方法　测试复合矫治弓丝接头的拉伸强度、剪切强度、扭转强度、弯曲形变残余角,TiNi形状记忆合金丝超弹性,扫描电镜观察及分析接头、断口组织变化。结果　复合矫治弓丝接头抗拉伸强度为32 0～36 0MPa ,剪切强度为2 2 0～2 5 0MPa ,抗扭转强度为30～4 0N·m、断裂时扭转角度不小于1 4 4 0°,弯曲形变残余角为1 2～1 7°;钎焊异质接头中TiNi形状记忆合金丝超弹性几乎没有破坏;接头钎料与TiNi形状记忆合金界面不存在扩散层,与不锈钢丝界面之间有一较宽的扩散层,接头断裂多发生在钎料与TiNi形状记忆合金超弹界面处,部分发生在钎缝中心。结论　复合矫治弓丝机械性能符合正畸临床要求,可应用于临床。     

40例老年急性肾功能衰竭的临床分析

由于老年人肾脏的解剖生理变化导致应变能力的相应下降，易发生急性肾功能衰竭（ARF）。我院自2000年开展血液透析治疗以来，提高了对老年ARF的治愈好转率。笔者收集院1998年1月～2005年1月老年ARF病例40例进行临床分析，报道如下：     

谈足疗的神奇功效

足疗是我国传统医学的宝贵遗产之一,它是在中医理论的指导下,运用各种特定或变化的手法在足部反射区进行有效的刺激,通过这种良性的物理刺激缓解人体的紧张状态,促进足部经络气血运行,进而调节全身各系统的生理变化以达到治疗、预防、保健等目的的保健治病方法。     

分娩期保健——分娩前宣教

“妊娠人生大事，务使母婴安全”，是WHO提出的号召，意在保障母婴健康，提高人口出生素质。《中华人民共和国母婴保健法》为此强调了孕期保健服务：虽然分娩是一个自然生理过程，可它对人类却往往是一件重大的应激事件，尤其是初产妇，非常容易出现复杂的心理变化，对分娩产生不良的影响。因此，近年来心身医学正在日益受到广泛重视，     

医院信息系统设计中的安全分析与建模

本文深入到当前的医院信息系统内部,揭示出这些系统中令人不安的却又极其重要的安全问题.通过比较与分析现实中的两个案例,我们逐步构建起有自身特色的可信赖的安全模型并演示了非常具体的实现过程,从而使医院信息系统可以在当今复杂的网络环境中得以生存.     

训练Wistar大鼠急进高原并运动力竭后血气变化与肺损伤的干预防护研究

本文通过训练大鼠急进高原模型从血气分析与肺的损害,研究干预对训练大鼠肺组织和呼吸功能的损伤与防护。作者在1520m环境设实验组(EG)使用中药抗疲Ⅰ号加入常规饲料中喂养;对照组(CG)常规饲料喂养。EG、CG各40只游泳训练4周后,各选30只3h急进3850m静息1.5h,从中各选10只作为静息对照采集标本,其余EG、CG各20只游泳至力竭后,1h、24h雌雄不分采集股动脉血分析血气。结果:EG与CG相比,血气变化均有显著性差别(P<0.05,P<0.01),肺组织HE染色CG肺泡壁结构不清晰,有红细胞和液体渗出;EG肺泡结构清晰,肺泡内无渗出。这一结果表明:没有防护…