从天价医药费事件折射出当前我国医疗机构存在的问题

目前，我国许多医院的医疗卫生工作人员在为患者进行医疗卫生服务的过程中，为了医院和个人的经济利益，存在着过度医疗消费现象。最典型的是哈尔滨医科大学第二附属医院发生的天价医药费事件。导致这种现象出现的原因是由于法律的不健全、制度的不完善等而导致的监督力度不够，加之有些医务工作者在经济利益的驱使下使自己的职业道德滑坡，从而导致了老百姓看病贵现象的出现。     

医改尚未成功,路在何方?

目前我国医疗制度改革尚未取得成功,这与计划经济向市场经济转轨这历史时期及卫生工作的特殊性有关,出现问题,甚至失误,在所难免。提出(1)医改的目的是确保全国人民健康,人人享有医疗保健。(2)把卫生系统推向市场,医疗机构商业化,不是医改的方向。(3)预防为主,健全预防医学制系。(4)国家增加投入。(5)制定公立及私立医院各项制度,保护医务人员的合法权益。(6)加强社区基层医疗机构的建设。     

加强医疗仪器设备管理提高医疗仪器设备使用效益

加强医疗设备管理,提高设备使用效益,制定合理的计划,正确选购设备,为医院提供品种、性能、精度适当的技术装备。     

Introducing dental students to clinical patient care: The complete denture prosthodontics transition clinic

Using complete denture treatment as an introduction to clinical patient care for dental students, the purposes of the Complete Denture Prosthodontics Transition Clinic at the University of Colorado School of Dentistry are to reduce the time lapse between the preclinical complete denture prosthodontics course and the first denture patient experience, and to encourage development of student self-confidence and skills. In the 2002 spring semester, faculty at the University of Colorado School of Dentistry initiated the Complete Denture Prosthodontics Transition Clinic for DS-II (second-year) dental students, as an introduction to clinical patient care. Each patient was assigned to a team of two dental students. Three Division of Prosthodontics faculty members staffed each clinic session, providing a student-to-faculty ratio of approximately 6.6:1 and a patient-to-faculty ratio of approximately 3.3:1. All DS-II students in the Class of 2004 delivered their first complete dentures no later than 8 months (average, 184 days) after the last day of the preclinical complete denture prosthodontics course. The time from the diagnostic appointment through the denture placement appointment averaged 39 days for patients treated in this program, compared with an average of 98 days or more for previous classes. The program was successful in achieving the goal of reducing the time lapse between the preclinical complete denture prosthodontics course and the first denture patient experience.     

医学生抑郁情绪与家庭及生活事件的相关性研究

目的 探讨医学专业大学生抑郁情绪与家庭及生活事件的相关性，为早期干预提供科学理论依据。方法 采用自拟量表对482名医学专业在校大学生调查，并做影响因素分析。结果 大学生无抑郁或极轻微192人占39．8％；轻度209人占43．4％；中度58人占12％；重度23人占4．8％。生源地、父亲文化程度、专业满意度、人际关系的敏感、学习压力的大小、丧失因子、受惩罚因子和健康适应因子对大学生抑郁情绪的产生有显著影响，而性别、家庭类型和经济情况对医学专业大学生抑郁情绪产生关系不大（P〉0．05）。结论 要重视学生中存在的抑郁情绪问题，采取积极有效措施帮助学生消除抑郁情绪。     

关于高等医学教育管理体制与学制改革的思考

高等医学教育管理体制与学制改革是二十一世纪社会发展的需要。文章阐述了医学教育小规模、长学制、高投入的基本特征,强调了遵循医学教育规律的重要性,分析了医学院在综合性大学的重要地位,医学院与附属医院以及相关院系的关系。文章还依据社会发展的需要和医学教育国际化的趋势,分析了医学教育学制调整的必要性以及学制调整思路。     

上海市农村合作医疗筹资与补偿调查分析

目的：为改革和完善上海市农村合作医疗的政策，制度，规划，计划，措施提供科学依据。方法：使用调查研究，比较研究，描述性统计及SAS统计分析等方法。结果：调查分析了上海市1997－1999年8区（县）合作医疗资金来源，数量，比例，补偿等。结论：1997年以来，上海市农村合作医疗得到了快速发展，仍存在保障水平，补偿比例，投保率低下及发展不平衡，资金使用不合理等问题。     

Teaching psychiatric ethics

In the last decade, we have witnessed a burgeoning of interest in ethical issues amongst psychiatrists. Teaching of the subject, however, remains at a rudimentary stage. Various approaches to such instruction are available, particularly modelling (students observe their experienced counterpart), the case method (examining specific clinical situations which involve a need for ethical decision-making), and the seminar approach (trainees are exposed to a core body of knowledge, mainly theoretical in nature). Faced with these different teaching models, the University of Oxford Department of Psychiatry has opted for a blend of all three approaches, which incorporates two goals: an increase in the trainees' sensitivity to the many intricate moral dilemmas facing the psychiatric profession; and their familiarity with salient concepts in moral philosophy which constitute a basis for ethical reasoning and which have a bearing on clinical practice. The teaching programme comprises the following: a pair of trainees prepares a presentation on an aspect of psychiatric ethics under the supervision of a senior psychiatrist. A moral philosopher assumes the role of discussant of the ethical problems raised by the trainees; this is followed by a general discussion. Topics have included involuntary hospitalization, dual loyalty, suicide, psychiatric diagnosis, and ethical issues in various spheres of psychiatric practice such as sex therapy, psychotherapy and child psychiatry. The approach has worked effectively and proved rewarding to all participants involved.     

Gestion des risques et choix de maintenance à l'hôpitalRisks management and maintenance choices at the hospital

Regulations evolve and risks management becomes one of the biomedical engineers' preoccupations. Thus, risks are various, and consequently it is difficult to identify, to manage and to bring them under control. Furthermore, regulations exist for sectors like healthcare technology monitoring, but it is not the same thing for instance for the risks linked to the maintenance. Thus regulation in the sector of maintenance evolves and the decree of the 1^st July law of health safety is going to modify the biomedical environment. The goal of this work is to study the tools and the methods of risks management that have been used for several years in the industrial field and to use them for some biomedical equipment like monitors or IV pumps. These methods adapted to these equipment will allow us to determine some appropriate rules of maintenance.     

A follow‐up study of electromagnetic interference of cellular phones on electronic medical equipment in the emergency department

Objective: Considering the growing use of cellular phones and the fast appearance of new phone models, the electromagnetic interference of currently popular cellular phones on electronic medical equipment was tested. Methods: Three Personal Communication System cellular phones were put at different distances from multiple electronic medical devices, the interference effect was observed and the electromagnetic field strength measured with a spectrum analyser. Results: Only two small pieces of equipment, the CO₂ airway adapter and the haemoglucostix meter were affected and then only when the phone was in very close proximity. Conclusion: Compared to the results of our study in 1997 testing Global System for Mobile Communication phones, the Personal Communication System phones generated less electromagnetic interference. However a much larger scaled study and an accurate international electromagnetic interference standard are recommended before any change in the current restrictive hospital policy on mobile phone usage could be recommended.