苏州市农村合作医疗保险制度改革的分析与思考

对苏州市农村合作医疗的变迁以及新政策的具体状况作分析与思考,并提出进一步完善的思路,以供参考。     

Cooperative effects of hemicholinium-3 on high-affinity choline uptake by rat diaphragm

Choline uptake in the end-plate rich area of rat diaphragm is saturable between 0.7 and 16 μM. This choline uptake obeys hyperbolic kinetics and indicates the presence of high-affinity carrier with K_m values of 11.8 and 13.2 μM and V_max values of 37 and 31 nmol choline/h/g tissue respectively. In the presence of hemicholinium-3 the carrier shows sigmoidal kinetics, and hemicholinium-3 is apparently a cooperative effector of choline uptake. The carrier is more calcium than sodium dependent.     

Practice-based agromedicine: the need for client-centered research

During recent years, several client calls received from Clemson University Cooperative Extension Service office and private physicians have required client-oriented investigations. These have practical implications for preventive medicine and public service. The challenges for differential diagnosis across disciplines are not for the faint-of-heart or the narrow thinking specialist. Examples of incidents that have signaled a problem and resulting research projects are: 1) anaphylactic cardiovascular response to red imported fire ant venom (statewide morbidity survey); (2) unexplained contact dermatitis in tomato harvesters and floral designers (immunodermatologic study and statewide survey of florists); (3) concerns over two unexplained cancer deaths at an experimental agricultural research station (farmer's mortality study); (4) a household outbreak of organophosphate poisoning (statewide hospital morbidity survey); and (5) a woman in early pregnancy exposed to misapplication of chlordane in her house (literature review and update on trends in U.S. birth defects). These examples reflect a broad but responsive interdisciplinary approach to the needs of the clients of the South Carolina Agromedicine Program.     

农村合作医疗筹资额和补偿比间数量关系模型与检索表的研究

为科学测算农村合作医疗筹资额和补偿比,以保持合作医疗系统的正常运转,本研究在综合农村合作医疗和健康保险筹资额与补偿比测算研究方法的基础上,进一步对合作医疗筹资额和补偿比间数量关系模型作了研究;针对目前各地若干种不同补偿范围和项目的合作医疗,利用对山东省农村居民在不同级别医疗机构人均门诊、住院医药费用的调查结果,编制了筹资额和补偿比间数量关系检索表,使人均筹资额的测算和医药费用补偿比的确定更为简明易行、灵活多样、便于操作。该研究方法对在全国范围内恢复和发展农村合作医疗提供了一种科学的技术指导和决策思路。     

Impact of a dosimetry review program on radiotherapy in group trials

The impact of a quality assurance program on protocol compliance has been explored. A sample of 2258 patients, who received radiation therapy on 18 different NCI funded protocols, was selected for this study from the more than 6200 cases reviewed by the Quality Assurance Review Center (QARC) from 1974 to 1983. Analysis of this sample reveals a significant decrease in the protocol non-compliance rate as a function of QA participation time (35% down to 5%). The educational impact of the QA program is demonstrated by the drop in the protocol dose deviation rate from 11.4% (before QARC feedback) to 3.6% (after feedback, p less than .001). The corresponding drop in protocol deviations in treatment volume is from 21.5% to 10.5% (p less than .001). The effect of the "on-treatment" review process is studied; it is demonstrated that this process cuts the rate of major deviations in half. The technical discrepancies in dose are also analyzed and discussed.     

浅谈妇幼保健工作中的三级网建设

本文通过吉林省舒兰县实施妇幼卫生合作项目两年多的实践,介绍了该县加强三级网建设的基本思路、措施和取得的显著成效,指出了目前三级网建设存在的主要问题.文章提出,抓好三级网是各级政府加强妇幼卫生工作包括完成合作项目任务的关键;各级政府不仅要重视三级网的“软件”建设,更要解决好三级网建设的“硬件”问题,如人员配备、报酬兑现、房舍设备、经费投入等.文章强调,继续提高干部和群众的认识,把三级网建设始终摆在重要位置抓实抓好,因地制宜重点加强“网底”建设,强化三级网的服务功能,充分发挥三级网在整个妇幼卫生工作中的重要作用.     

影响农村合作医疗费用上涨的因素及控制办法

该文利用上海市3县（区）9乡（镇）的合作医疗调查资料,分析出影响医疗费用上涨的因素分别为参加合作医疗人员结构改变;村卫生室不适应农村卫生服务需求的变化;医疗机构补偿机制不健全以及合作医疗的管理费用高这4种,并对此提出相应的控制办法。     

医院国际交流中多元主体协同机制分析

世界经济一体化发展促进了各国之间的互通往来,随着国家“一带一路”“医改事业”的不断推进,医学领域的国际交流也逐渐频繁起来,现代化医院事业发展建设过程中,加强国际交流是提高医院自身医疗质量和实力的重要途径,是推进医院朝着国际化方向发展的必要条件。新时期,随着各国间交流日益频繁,以及多样化的交流形式,促使国际交流呈现出新的发展特点。医院在参与国际交流的过程中,除加强对多部门联动方面的重视外,还应当不断完善多部门协同处理工作机制,并借助“一站式”的合作模式,让各协同部门能够在医院国际交流中充分发挥效用,并进一步推进医院走向世界的发展步伐。基于此,该文主要分析了国际交流合作对医院发展的作用,对当前医院国际交流形式进行了综合归纳,进一步提出医院国际交流中多元主体协同机制这一建设策略。     

合作学习在医学高专涉外护理专业英语口语教学中的应用

合作学习是一种能够提高课堂实效性的教学模式，曾被运用于中学和中职学校的英语教学中，并取得了较好的效果。在医学高专涉外护理专业英语口语教学中引入合作学习理念，不仅能促进学生英语口语水平和口头交际能力的提高，而且还有利于合作意识和团队精神的培养。     

提高合作医疗抗风险能力的对策研究

采用系统分析、比较研究及统计学等方法，对如何提高地区合作医疗的抗疾病经济风险能力的对策进行研究。结果提示，合作医疗对于分摊门诊疾病经济风险具有较强的能力，对住院疾病经济风险抗御能力较弱。提高合作医疗的抗疾病经济风险能力的主要对策是：提高筹资水平，扩大库容量；调整经济结构，合理分流；提高管理层次，增加进水量；提供合理服务，节约用水。