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。     

论医疗纠纷处理技巧与防范程序的建立

近年来,医院发生医疗纠纷的频率有上升态势,处理纠纷难度亦日益加大,是医院管理者经常面临的难题。依据多年从事医院医疗质量管理的实践经验和相关资料分析认为:医疗纠纷增多的现象不仅与医务人员的医疗技术、服务态度、管理人员素质、管理作风和医院对纠纷处理的方式有关,与公民的社会保健知识和法律意识的增强等因素亦有相关性。令人满意的医疗纠纷处理办法在于是否能从错综复杂的医疗纠纷中寻找其发生、发展和解决的规律,处理医疗纠纷重在把握好三个基本原则和运用技巧。此外,认为解决纠纷与防范纠纷具有同等的重要性,并对医疗缺陷防范程序的建立以及在现代医院管理中的意义进行了初步探讨。     

垂体功能异常的蝶窦影像学诊断意义

为探讨蝶窦变的像学诊断与垂体功能异常的关系，分析７例垂体功能异常的蝶窦病变的影像学表现；结果示７例垂体功能异常者重体影像均异常，     

The cognitive-spiritual dimension - an important addition to the assessment of quality of life: Validation of a questionnaire (SELT-M) in patients with advanced cancer

Questions of meaning and challenge by illness, i.e., the spiritual dimension of quality of life (QL) traditionally played an important role in anthroposophically oriented medicine and have gained importance in palliative medicine and supportive care. In the context of a research project on QL in patients with advanced cancer, we therefore investigated the psychometric properties of a questionnaire covering spiritual QL issues, with the aim of providing a module for the assessment of cognitive-spiritual QL.Patients and methods: We investigated 89 patients with advanced breast and gastro-intestinal cancer. Construct validity of a modified version of the SELT (Skalen zur Erfassung von Lebensqualität bei Tumorkranken), the SELT-M was tested by multitrait scaling analysis. Discriminant and convergent validity were also tested. The EORTC QLQ-C30 was used as a standard for validation.Results showed the SELT-M as feasible in administration. Four of the five SELT-M subscales were internally consistent (Cronbach's Alpha = >0.7). The subscale on spiritual QL showed higher within than outside subscale correlations for six of its eight items. Association of the SELT-M with the EORTC QLQ-C30 was good for the items and subscales covering the same aspects of QL in both questionnaires: emotional (Spearman r = 0.61), physical functioning (r = –0.54) and fatigue (r = –0.75). In accordance with expectations, there was no association between spiritual QL with any EORTC QLQ-C30 subscales. Self-assessed spiritual QL in the SELT-M corresponded well with interviewer assessments (test for trend accross ordered groups, P = 0.0023).Conclusions: Overall there is confirming evidence for the hypothesised structure of the SELT-M, especially for the newly developed module on spiritual QL. This module may be used as a module together with other cancer specific QL questionnaires.     

医用高分子材料的Ames试验研究

男性绝育药输精管粘堵剂、男性避孕材料水凝胶、医用组织复合膜、胶原膜、复合缝线、铬制复合型可吸收缝线、药物载体聚乳酸、固定材料聚酯醚等８种医用高分子材料，经Ａｍｅｓ试验的标准菌株ＴＡ９７、ＴＡ９８、ＴＡ１００、ＴＡ１０２测试，均未诱发回复突变菌落数增加，对Ａｍｅｓ试验菌株无诱发突变作用。用这种方法测试不同类型的医用高分子材料是可行的。     

血脂平胶囊质量标准研

采用薄层层析法对处方中川芎和山楂进行定性鉴别；采用薄层扫描法对样品中大黄进行含量测定。此法简便，结果可靠，可作为控制该制剂质量的指标。     

The Follicular Endocrine Environment in Stimulated Cycles of Women with Endometriosis: Steroid Levels and Embryo Quality

Objective: To assess the endocrine milieu in follicles of stimulated cycles comparing women with and without endometriosis. Steroids were measured in follicular fluid (FF) and in in vitro culture of granulosa-luteal cells, and this status was related to the quality of the embryos obtained after IVF.

Design: Case-control study.

Setting: IVF program at the Instituto Valenciano de Infertilidad.

Patient(s): Twenty-four women with laparoscopically documented endometriosis and 26 controls undergoing IVF.

Intervention(s): Individual follicular aspiration, oocyte isolation, FF storage, and preparation of luteinized granulosa cells for culture; oocyte insemination and embryo cleavage in standard IVF.

Main Outcome Measure(s): Serum (day of ovum pickup) and FF measurements of estradiol, progesterone, testosterone, and androstenedione. Secretion of progesterone was measured in the cell-conditioned medium. Results were compared between patients with endometriosis and controls, as well as between oocytes that yielded embryos of different quality.

Result(s): Levels of progesterone in the FF increased with the severity of the disease, whereas testosterone accumulation in the FF decreased with the severity of the disease. An increase in progesterone accumulation in vitro was observed in basal and hCG-induced granulosa cell cultures. No difference was observed in terms of embryo quality, and no steroid marker was able to identify follicles with oocytes that displayed embryos of good or bad quality under the inverted microscope.

Conclusion(s): The data show differences in the steroidogenesis of follicles from stimulated women with and without endometriosis. These changes indicate good endocrine health but are not predictive of embryo quality.     

三叶木通种子品质性状研究

目的探讨三叶木通种子品质对栽培用种价值的影响。方法用电子天平测定种子净度及饱满度,用水分仪测定种子含水量,通过发芽试验确定种子发芽率。结果三叶木通鲜种子的种子净度、百粒质量、千粒质量、含水量、生活力、发芽率及发芽势分别为98.7%、6.64g、66.6g、43.1%、94.5%、82.6%、52.8%;风干10、60d时,三叶木通种子含水量分别为28.5%、7.8%,发芽率分别为64.3%、14.7%。结论三叶木通种子宜在30℃下清水浸种24h,5~12℃室温下湿沙层积发芽,当种子含水量低于8%时,失去栽培用种价值。     

毛脉酸模药材质量标准研究

目的制定毛脉酸模药材质量标准,为该药用植物资源的开发利用提供科学依据。方法生药学研究,浸出物测定法,灰分测定法,水分测定法,薄层色谱法及HPLC色谱法。结果对毛脉酸模的性状、显微特征进行了描述;对14个不同产地毛脉酸模的浸出物、总灰分、酸不溶性灰分和水分进行了测定;同时进行了薄层定性鉴别和HPLC色谱的定量研究。结论通过研究制定了毛脉酸模的质量控制标准。