由“梁静事件”引发的对当前医患关系的反思——兼论医务人员的职业倦怠

从梁静事件的发生反思医患关系，得到四个结论：部分医务人员也是弱势群体，医疗机构才是强势群体；相对于那些对医疗期望值过高的非理性患者，医务人员也处于弱势群体地位；制度才是医患关系恶化的根源；医务人员的职业倦怠状况非常严重。     

一起学生食物中毒事件引发的思考

目的查明引起该起20名学生食物中毒的原因，为制定预防食物中毒措施提供依据。方法采用流行病学方法进行调查，对中毒者临床表现和实验室检测结果进行综合分析。结果20名中毒学生均进食炒河粉；在炒河粉和16名中毒学生的肛拭子样本中均检出致病性大肠埃希菌。结论20名食物中毒者均食用了受致病性大肠埃希菌污染的炒河粉所致。根据中毒情况及发生原因提出预防的设想和做法。     

对重症病人实施评估积分的效果评价与思考

为加强护理质量评价，建立了重症病人评估积分法，评估积分共５个方面，即１２项生理参数积分、年龄积分、意识积分、脏器衰竭积分、护理干预积分。通过对重症病从评估积分共为护理管理者在重症护理方面提供了监控指导依据；客观科学评价科室护理工作量及病人的危重程度；护理人力资源调配利用的合理性得到增强。     

从对死亡的缺失思考谈死亡的哲学内涵

死亡是生命不可超越的终极归宿，正是生之有限造成了人们对死亡本能的恐惧，但是对死亡的逃避和漠视将会导致人们缺乏对生命真谛和意义的整体把握和领悟。通过对死亡内涵的哲学追问，引发了对生命本质的哲学反思，由死观生，就会使人们更加善待生命，从而度过一个有意义的人生。     

Transport properties of the mesothelium and interstitium measured in rabbit pericardium

The contribution of the pleural mesothelium to pleural liquid and protein transport is still vigorously debated. Recent in vitro studies of stripped pleural membrane and free-standing pericardium have demonstrated active ion solute coupled transport of liquid and transcytosis of protein. However, the relative contribution of the passive transport properties of the pleural mesothelium compared to the pleural interstitium has not been extensively studied. In in vitro studies, we measured the albumin diffusion coefficient, reflection coefficient, hydraulic conductivity and electrical resistance of rabbit pericardium. We used two techniques, treatment with 40 muM nocodazole and a 1-min hypotonic cell lysis with distilled water, to eliminate the effect of the two mesothelial layers on diffusional and hydraulic resistances. Each technique increased the albumin diffusion coefficient and hydraulic conductivity 3- to 4-fold. In hydraulic conductivity experiments using tracer 125I-albumin, nocodazole reduced the reflection coefficient to zero, rendering the pericardium completely permeable to albumin. We applied the cell-lysis technique to the pleural and pericardial mesothelium in sequence to evaluate the separate contribution of each mesothelium. Both diffusional and hydraulic resistances, but not electrical resistance, of the mesothelium were overestimated by the cell-lysis technique. The pleural mesothelium contributed at most 30% of diffusional resistance, 10% of hydraulic resistance and 14% of electrical resistance of the total pericardial resistances. We conclude that the pleural mesothelium is not the primary barrier to protein diffusion or bulk flow of liquid from the pericardial microcirculation to the pleural liquid.     

Using Guided Reflection to Link Cultural and Service Learning in a Study Abroad Course

The literature indicates that service learning integrated into a study abroad course results in cultural learning, personal growth, and professional development. However, there are inadequate examples of strategies to achieve cultural learning in the context of study abroad. The purpose of this article is to briefly describe the authors' collaboration with leaders of an international health system in developing a faculty-led study abroad course and describe strategies to promote guided reflection to achieve cultural learning. The preparation phase of the course was delivered with two video conferences and an online learning management system for students on three campuses. Service learning with clinic nursing staff of the international health system and children in a residential home was purposefully incorporated in the study abroad phase of the course. During the first week of study abroad, specific prompts for daily journaling were introduced to the students to promote guided reflection as a critical component of service learning. During the second week, students discussed concepts that had been introduced during the preparation phase. The students wrote a final summary reflection paper with the guidance of additional prompts and an evaluation rubric. In summary, preparation phase learning activities, study abroad phase daily journaling and group discussion combined with a summary reflection paper were used as strategies to achieve cultural learning.     

加强教学医院师资队伍建设的实践与思考

教学医院的教学工作,涵盖了临床医学理论教学和临床实习带教两个方面,对师资队伍的整体素质有着更高的要求.高素质的师资队伍,对于提高教学质量、培养合格的临床医师有着至关重要的影响.本文结合江苏省泰州市人民医院教学管理工作的实践经验,对教学医院如何构建长效机制,加强师资队伍建设,提高临床教学质量,促进医院教学与医疗、科研同步提升进行了思考和探讨.     

卫生人力资源配置对医疗服务公平性影响的伦理思考

卫生人力资源合理配置是维护公共医疗的公益性,提高医疗卫生运行效率和服务水平、质量,满足人民群众多层次、多样化需求医疗服务公平的基本要素,而人力资源管理体制不完善、绩效考核体系不完备、地域经济发展不平衡、医疗执业环境不佳等,影响了卫生人力资源合理配置和医疗服务的公平性。     

邢台市艾滋病中医药治疗的回顾和思考

目的探讨适合邢台市艾滋病中医药治疗的模式和对策。方法采用回顾分析的方法 ,对邢台市艾滋病中医药治疗现状进行分析。结果邢台市中医药工作者经过多年的探索研究,在艾滋病中医药治疗方面积累了宝贵的经验,但还有许多工作要做。结论邢台市艾滋病中医药治疗工作已取得一定的成绩,进一步发挥中医药在治疗中的优势具有现实意义。