临床科室工作量评价方法及其应用

目的：探讨测量、评价临床科室工作量的指标和方法，加强医院科室管理，促进效益评价与核算。方法：应用医院病案和报表资料，每月计算科室工作强度指数并进行排位，用相对比方法初步分析科室临床工作量和排位变动的状况。结果：选取了实际占用床位数、危重病人抢救次数、门急诊人次数、出会诊人次数、出院病人数5项指标，计算出各科室工作强度指数和排位，并对各科室工作量排位变动进行了比较。结论：临床工作量评价指标和方法的代表性、灵敏性和可靠性较好，实际评价效果也较客观地反映了各临床科室的实际工作量大小。     

网络模式下临床医师绩效评价指标体系研究

为了充分利用医院信息网络信息，更为全面、客观地对医生进行评价，阐述建立网络模式下临床医师绩效评价指标体系的原则、方法，并对的建立指标体系的可信度及合理性进行了分析。     

基于实验均方误差F值的基因表达数据最佳聚类评判方法研究

目的 近年来产生了一些用于分析基因表达数据的聚类算法，却很少有关于评价聚类算法方法的研究。本研究的目的是尝试建立一个定量的评价基因表达数据聚类结果的方法。方法 本研究提供了一个系统的评价聚类结果的方法，利用我们提出的实验均方误差F值对几个常见的聚类算法进行比较。结果 利用F值对类质量的评价和利用已有的生物学知识对类进行分析的结果一致。结论 实验均方误差F值可以定量地评判用于基因表达数据的聚类算法。     

A comprehensive strategy for the evaluation and triage of the chest pain patient: A cost comparison study

BACKGROUND: Our objective was to determine the cost-effectiveness of a comprehensive, risk-based triage system, composed of multiple critical pathways, with the use of early myocardial perfusion imaging (MPI) in low-risk patients. We found previously that a chest pain evaluation system that uses MPI in low-risk patients was safe and effective, but the cost-effectiveness of this approach was not studied. METHODS AND RESULTS: We compared two groups. The Acute Cardiac Team (ACT) group (n = 874) was assigned prospectively to 1 of 4 risk levels by emergency department (ED) physicians. Level 1, 2, and 3 patients were admitted; level 4 patients were evaluated in the ED. Level 3 and 4 patients underwent ED MPI. The control group (n = 713) represented consecutive patients evaluated in the prior year according to standard care and assigned retrospectively to an ACT level based on the presenting electrocardiographic and clinical data. Record and hospital administrative data were assessed for clinical variables, outcomes, lengths of stay, and all expenses incurred within 30 days of the index visit. The baseline characteristics of the two groups were similar, including age, sex, myocardial infarction prevalence, and 30-day revascularization rates within each level or between the two groups. Mean costs per encounter were reduced for the ACT patients for each level, which was significant when all patients were compared ($5,030 +/- $7,081 vs $6,044 +/- $10,432, P =.02). Use of MPI in the low-risk patients was associated with reduced costs (level 3, $4,958 +/- $4,948 vs $5,051 +/- $7,036; level 4, $1,529 +/- $2,664 vs $1,794 +/- $6,854) and was associated with a significantly lower angiography rate and shorter length of stay. CONCLUSIONS: Implementation of a comprehensive strategy for chest pain evaluation and triage reduced overall costs for patients with chest pain on presentation. Acute MPI in the ED setting did not increase net cost.     

利用CO_2培养箱敞开式不换液羊水细胞培养方法的改进

本文对羊水培养方法进行了改进研究,探讨了培养液 pH 值对羊水细胞生长的影响。结果表明用 CO_2培养箱敞开培养,在 CO_2浓度为5.4%时羊水细胞最容易贴壁生长,一次性加液中间不换液可保持细胞生长的微环境稳定,是羊水细胞培养成功的关键。     

173例支气管哮喘特异性脱敏治疗的进一步评价

对173例支气管哮喘特异性脱敏治疗的疗效及影响疗效的因素进行了分析。结果表明:显效为30.6%(53/173).有效为56.1%(97/173),无效为13.3%(23/173)。影响疗效的因素与病情的程度有关,而与年龄、病程、皮试阳性反应强弱及脱敏治疗前4个疗程内是否应用曲安缩松等无关。并对特异性脱敏治疗支气管哮喘的优缺点进行讨论。     

医院文化的哲学伦理内核及其在现代医院管理中的重要作用

医院管理不是孤立自存的现象,由于管理者和被管理都生活在一定的医院文化氛围之中,因此,医院文化的哲学内核是现代医院管理知识的精髓,医院组织的价值观念、道德准则和思维方式,深刻地影响和制约着现代医院管理的原则和方法,决定着现代医院管理的实施和成败。     

Clinical evaluation of a potassium nitrate dentifrice for the treatment of dentinal hypersensitivity

Abstract The effectiveness of a 5% potassium nitrate dentifrice as a daily home treatment for dentinal hypersensitivity was evaluated in a double-blind study in 36 Japanese subjects who complained of cold and/or tactile hypersensitivity. The subjects were divided into 2 groups, with 18 being given a 5% potassium nitrate dentifrice (treated group) and the other 18 a vehicle paste (control group). Both groups were instructed to brush their teeth 2 × a day. The hypersensitivity levels of the affected teeth were assessed by 2 stimuli, one tactile and the other cold air, and by the perception of pain. The results of all 3 assessment methods indicated that the potassium nitrate dentifrice significantly decreased the level of hypersensitivity at weeks 4, 8, and 12. In the treated group, a rapid decrease of positive scores for both the cold air stimulus and the subjective symptoms appeared from week 2. Although a significant decrease of the assessment score was also observed in the control group, the reduction rate of the score was much greater in the treated group by ail 3 assessment methods at weeks 4, 8, and 12. Complete relief of subjective symptoms throughout the 12 weeks’examination was noted in 67% of the subjects in the treated group, but in only 6% in the control group. These results suggest the usefulness of a 5% potassium nitrate dentifrice in Japanese patients with dentinal hypersensitivity.     

同济医科大学控烟活动及效果评价

我校自1993年开展控烟工作，1995年9月开始创办无吸烟大学校园，采取了卫生宣教和行政干预等综合措施，并进行了效果评价。高强度干预措施实施前期（1995年3月）和中期（1996年10月）相比，男医学生和男女学生平均吸烟率分别从16.3％和11．4％下降到9．6％和5．94％；男教工和男女教工平均吸烟率分别从28．6％和13．8％下降到13．9％和8．86％。