构筑健康教育工程实现社会医院双赢

介绍了四川大学华西医院10年来构筑普及医疗卫生保健知识系统工程的认识体会、经验和取得的成效,指出医院在普及卫生保健知识中的职责和优势。     

关于引进双源CT的可行性分析

本文就双源CT的市场需求、特点和用途进行了详细分析,为医院引进双源CT提供参考。     

医疗照射剂量水平及其防护

本文讨论了医疗照射的频度、剂量水平和防护问题。诊断X线检查频度在发达国家为每年每千人300—900人次,在发展中国家为100—200人次/千人·年,我国为124.5人次/千人·年;平均有效剂量当量在发达国家为1mSv/年·人,全世界平均值为0.4mSv/年·人,我国为 0.5mSv/年·人;医疗照射所致超额死亡率在发达国家估计为10—15/百万人,我国为4.27/百万人。 我国的诊断X线检查频度和剂量水平将进一步增长,为减少医疗照射,我们必须采取预防措施。     

Medical education for minorities at a US medical school

The University of Washington School of Medicine (UWSM) has initiated new efforts to build a regional minority applicant pool and to expand its educational programmes to accommodate students from disadvantaged backgrounds. Specific interventions include: establishment of medical career planner position to coordinate region-wide outreach; pre-entry education; and support activities once enrolled. This study describes specific services and presents sociodemographic and performance data on 56 minority and 280 majority students entering the UWSM between 1981 and 1985. Economic status and educational background of minority students were significantly below that of majority students, several flexible academic policies enabled most students to achieve mastery in courses and to progress through the curriculum. The educational data base utilized in this study, and those at other institutions, can assume important roles in the identification of problem areas in the education of disadvantaged students and in evaluation of the interventions attempted.     

The ends of outcomes assessment

Outcomes assessment holds great promise to improve the quality and efficiency of health care. By subjecting practices to rigorous and systematic analysis, we should be in a position to make judgments about what does and does not work in clinical practice. However, the outcomes of outcomes assessment themselves should be approached with the same critical eye. Among the many sorts of criteria by which to evaluate outcomes assessment are several key parameters: foremost among them are cognitive outcomes, ethical outcomes, and economic outcomes. Only when these outcomes are thoroughly explored and taken into account will the fullest potential of outcomes assessment be realized.     

Students'' assessment of a course in obstetrics and gynaecology

A complete annual entry of 181 students were administered a questionnaire in which they were invited to make value judgements about all aspects of their 3-month course in obstetrics and gynaecology. The resulting performance indicators were used to compare individual staff and clinical firms.     

Can communication skills be assessed independently of their context?

In many examinations, communication skills tend to be treated as if they are a single attribute independent of the context of the communication. However, it is clear that such assessments are confounded by candidates' knowledge or lack of knowledge of the medical issues about which they are communicating. In the 1990 Part One examination for Membership of the Royal New Zealand College of General Practitioners candidates were provided with all the essential knowledge relevant to the problem they were to communicate about. Despite this, performance was still seen to be context specific, demonstrating that such specificity is not purely knowledge related. Candidates completing the examination were observed to share information about the cases with candidates about to commerce. There was no evidence that performance was enhanced by such breaches in examination security.     

How do clinicians learn to request permission for autopsies?

A postal survey of 434 clinicians at four local hospitals was undertaken in order to identify the methods by which clinicians learn how to request permission for hospital autopsies and to assess the preferred techniques and timing of relevant communication skills training. The majority of 128 responding clinicians had learnt through personal experience with some assistance from senior colleagues and peers. Few clinicians appeared to have learnt through formal training. The preferred methods for the provision of communication skills training were training in small groups (such as seminars or tutorials) and observation of clinicians at work. The most desirable time for the provision of this training was considered to be between the beginning of the final undergraduate year and the end of the pre-registration house officer year. The communication skills training provided within medical education is in need of improvement. More emphasis should be given to clinical-task- or situation-specific applications such as requesting permission for autopsies.     

复方硅橡胶对家兔输卵管上皮细胞内铜元素含量及超微结构的影响

本实验就复方硅橡胶栓堵剂（ＣＳＲ）对家兔输卵管上皮细胞趋微结构的影响进行了观察分析，并测定了上皮细胞内铜元素的含量变化，电镜观察表明：家充输卵管经复方硅橡胶栓堵后，其上皮细胞表面结构、细胞连接、细胞核等超微结构均未发生明显的形态改变：注药侧（右侧〕和对照侧（左侧）输卵管上皮细胞内虽有少数线粒体膨胀，但两组间无论在线粒体数目，膨胀线粒体百分率以及线粒体外膜比表面等方面均无差异（Ｐ＞０．１），电镜Ｘ—时线能谱分析表明：注药侧输卵管上皮细胞内铜元素的相对含量咯高于对照组，而且铜元素多畜集于线粒体内。