中西医结合治疗脑血管疾病30例

中西医结合治疗脑血管疾病３０例山西省中医药研究院（太原０３００１２）柏晋梅自１９９５年２月～１９９６年５月，我们用中药制剂川芎嗪注射液、西药脑复康注射液，治疗脑血管疾病３０例，收到满意效果，现报告如下。临床资料以中华医学会第二次全国脑血管会议第三次修...     

开展全程化药学服务,促进抗菌药物合理应用

目的探讨促进抗菌药物合理应用的有效途径。方法分析和评价全程化药学服务在促进抗菌药物合理应用中的作用。结果全程化药学服务是促进抗菌药物合理应用的有效途径。结论医院药学应积极开展全程化药学服务,以促进抗菌药物合理应用,使有限的抗菌药物资源得到最大限度的利用。     

区级卫生监督机构绩效评估指标体系研究

作者通过文献查阅、焦点小组访谈和专家咨询论证方法研制区级卫生监督机构绩效评估指标体系。研究所得绩效评估指标体系包括要素系统、指标系统和操作系统三个部分。其中,要素系统包括投入、产出、结果、效率和解释变量五个部分,指标系统包括39个一般指标,12个关键指标,操作系统给出了每个指标的概念、作用、统计口径和数据搜集方法。     

The RETAIN project: dicom teleradiology over an ATM-based network

The RETAIN project (Radiological Examinations Transfer on an ATM Integrated Network) has aimed at testing videoconferencing and DICOM image transfers to get advice about difficult radiological cases over an asynchronous transfer mode (ATM)-based network, which affords a more comfortable interface than narrow-band networks and allows exchange of complete image series using the DICOM format of studies. For this purpose, an experimental ATM network was applied between six university hospitals in four different countries. An assessment of the functionalities of the system was performed by means of log-file analysis, video recording of the sessions and forms filled out by the participants at the end of each session. Questionnaires were answered by the users at the end of the project to bring out perspectives of utilisation and added value. We discussed 43 cases during 20 sessions. For technical or organisational problems, only 20 of the 36 planned sessions took place. The throughput over ATM (10.5 Mbit/s, 20 times faster than six ISDN B-channels) was adequate. Despite the experimental configuration of the network, the system was considered as satisfactory by all the physicians. In 72 % of the sessions, the expected result (answer to the question) was gained. By common consent, videoconferencing was unanimously regarded as a prominent tool in improving the interaction quality. Asynchronous transfer mode is an efficient method for fast transferring of radiologic examinations in DICOM format and for discussing them through high-quality videoconferencing. Received: 26 October 1998; Revised: 25 February 1999; Accepted: 2 April 1999     

对社区人群进行性病/艾滋病健康教育的效果评价

目的 :探讨在社区人群中进行性病 /艾滋病健康教育的可行性。方法 :在南京市已开展社区卫生服务的某区内 ,整群抽取 4个居委会 ,170 0户居民 ,随机分成对照组与干预组。干预组以连续 5次发送“致居民信”的形式进行性病 /艾滋病的健康教育。结果 :对性病 /艾滋病有关知识的知晓率、态度正确率、相关行为正确率 ,干预组人群由干预前的 5 3.3%、4 5 .5 %、77.7%上升到干预后的6 9 .9%、5 8.4 %、82 .7% (P <0 .0 1)。对照组人群由干预前的 4 4 .6 %、37.5 %、6 9.2 %上升到干预后的6 4 .5 %、5 7.2 %、82 .8% (P <0 .0 1)。干预组与对照组均有不同程度的增高。结论 :利用社区卫生服务网络在居民中开展性病 /艾滋病健康教育是有意义的 ,但对不同人群应采取针对性内容。     

Can we identify the poorest quality of life? Assessing the importance of quality of life using the WHOQOL-100

In this study, WHOQOL survey data obtained from 4802 sick and well participants in 15 countries were used to investigate the relationship between judgements about different dimensions of quality of life (QOL) (core scores) and the importance attributed to them. As a theoretical framework, we applied the WHOQOL Group's (1995) definition of QOL which indicates that those who report the very poorest QOL will be least likely to have met their own '...goals, expectations, standards and concerns'. Those with the poorest QOL would therefore be expected to show the biggest difference between core and importance scores, and therefore be distinguishable from respondents whose QOL was poor, better or best. The main effects from overall analyses confirmed that those reporting the largest negative differences tended to report the poorest QOL and also attached a high degree of importance to these dimensions. Evidence for a decreasing differential across the four groups (poorest to best) was confirmed for the majority (18) of facets. However facet level analyses comparing groups with different levels of QOL showed that only five facets distinguished those with the poorest QOL from those whose QOL was poor, so the theory is not well supported. Furthermore the contribution of core-importance facet differences reduced the overall prediction of QOL, when compared with a regression of core scores alone. Importance information about specific facets may have limited potential to be used alongside the main instrument to identify areas of the poorest QOL for clinical or social action.     

基本卫生技术包应用研究概述

影响卫生服务提供绩效的主要因素之一是服务提供的过程（即临床诊疗流程）及所需的各类卫生技术（包括人力资源、设备、设施、药品等）.基本卫生技术包（EHTP）是一种优化临床诊疗流程和卫生技术配置的管理工具,可通过这种核心技术,对卫生技术实施优化干预,以促进和改善服务提供的绩效.作者介绍了基本卫生技术包的方法学原理、技术路线、研究设计和其在单病种质量管理中应用的可行性,以便为决策者提供循证依据,将有限的卫生技术投入到最具成本效果的服务项目上.     

国家卫生系统绩效测量与统计指标的概念框架

卫生系统绩效评价是2000年世界卫生组织提出的先进的卫生系统绩效评价方法,建立绩效测量与统计指标的概念框架是完善国家卫生服务系统功能的基础.定义衡量目标实现进度的关键绩效指标（KPI）,并建立KPI测量标准和标尺是得出绩效评分和位次的主要步骤.本研究根据国家卫生信息标准基础框架——国家卫生信息数据模型,对模型中的超级实体“卫生业务”中的“绩效目标”子实体做了扩展,兼顾国际可比性和我国的实用性,提出了由8个KPI组成的国家卫生系统绩效测量指标集,并阐述了指标的内容、测量标准及其意义,同时还简要讨论了数据元的标准化、指标标尺的制定等有关问题.     

1396名小学3～6年级儿童适应行为的评价研究

目的通过对儿童适应行为的评价，探讨儿童适应技能发展的现状及规律。方法采用美国精神迟滞学会编制的适应行为量表（AAMD—ABS），对1396名（男性709人，女性687人）3～6年级小学生进行评价。结果儿童的正常适应行为的评价得分随年龄的增长而增加；同年级女生的得分要高于男生。与1994年资料相比，第一、二因子的得分显著增加，而第三因子的得分有所降低。结论儿童的适应能力随年龄的增长而提高，并且在男、女生之间存在着一定的差异；与10年前相比，也有明显的提高，但是不良适应行为有增加的趋势。     

HPLC法和FPIA法检测卡马西平血药体积百分比的比较研究

目的高效液相色谱法(HPLC)和荧光偏振免疫法(FPIA)测定血清中卡马西平体积百分比的比较研究。方法收集广州市精神病医院服用CBZ的21例癫痫患者血样。用本实验室已经建立的HPLC法和FPIA法分别检测卡马西平对照品的甲醇溶液、卡马西平对照品标准血清、患者血清中卡马西平体积百分比,采用配对t检验考察两种方法分别测定卡马西平对照品的甲醇溶液、卡马西平对照品标准血清、患者血清中卡马西平体积百分比有无显著性差异。结果HPLC法与FPIA法检测卡马西平对照品甲醇溶液、卡马西平对照品标准血清中卡马西平体积百分比无显著性差异(t值分别为-1.009、0.767,P值分别为0.325、0.452);检测患者血清中卡马西平血药体积百分比有显著性差异(t=4.919,P<0.05),FPIA法检测患者血清中卡马西平血药体积百分比较HPLC法偏高。结论FPIA法检测患者血清中卡马西平血药体积百分比过程中,CBZ的活性代谢产物环氧化卡马西平(carbamazepine-10,11-epoxide,CBZ-E)可能对FPIA法测定CBZ有干扰,导致结果偏高。