廊坊市加油站作业工人健康状况调查

目的了解廊坊市加油站作业工人的健康状况及长期接触汽油及苯作业对加油工人健康的影响。方法对廊坊市273名加油站作业人员进行职业健康检查,检查项目包括:内科常规、神经科、血常规、尿常规、血清丙氨酸氨基转移酶、心电图及腹部B超等,并对体检结果进行分析。结果加油工人神经衰弱综合征检出率为7.0%,高血压检出率22.3%,血常规异常检出率12.5%,尿常规异常检出率21.6%,心电图异常检出率11.4%,腹部B超异常检出率19.4%,肝功异常检出率7.3%。趋势卡方检验表明,加油工高血压、血常规异常、尿常规异常、腹部B超异常、心电图异常检出率均有随年龄增长而增高的线性趋势(P0.05);高血压、血常规异常、尿常规异常、心电图异常检出率均有随工龄增长而增高的线性趋势(P0.05)。结论廊坊市加油站作业工人长期接触汽油及苯,对其神经系统、造血系统、泌尿系统、心血管系统等都造成一定程度的慢性损害。     

管状消化道吻合器在食管—胃吻合术中的应用

应用管状消化道吻合器为61例食管癌或贲门癌病人施行肿癌切除、食管胃吻合术。主动脉弓下吻合32例,主动脉弓上吻合29例。发生吻合口瘘1例,吻合口狭窄1例。本文介绍了器械吻合的手术方法,并重点讨论减少吻合口狭窄及吻合口瘘的措施。     

Revisiting physicians' financial incentives in Quebec: a panel system approach

Do Primary Care Physicians (PCPs) react strategically to financial incentives and if so how? To address this question, we follow a quasi‐natural experiment in Quebec, using a panel system technique. In so doing, we both correct for underestimation biases in earlier time series findings and generate new results on the issue of complementarity/substitution between consultations with varying levels of technicality. Under both techniques, we show that PCPs are sensitive to the enforcement and subsequent temporary removals of expenditure caps and more generally, to changes in consultations' relative prices over time. These results support the existence of a discretionary power over the choice of consultation, PCPs increasing strategically the number of the more technical (and therefore more lucrative) consultations when pressed to defend their income. This finding for primary care parallels the now well‐established DRG creep in hospitals. The panel system approach offers a better account of the complexity surrounding PCPs' decision‐making process. In particular, it successfully addresses issues of physician heterogeneity, jointness between consultations and temporal breaks and generates robust estimates of PCPs volume and quality reactions to regulatory changes. Copyright © 2005 John Wiley & Sons, Ltd.     

供方视角下的新农合可持续性问题研究——以江苏省新沂市王楼卫生院为例

新型农村合作医疗的可持性问题涉及多种因素,包括制度环境和治理结构等。文章从医疗服务供方的视角对新型农村合作医疗的现行制度进行审视,以新沂市窑湾镇为例,寻找出新型农村合作医疗资金使用不断增长的原因,分析制度设计中存在的故有问题,并给出相应的对策建议。在没有改变供方主导模式的情形下,对新型农村合作医疗进行费用控制是难于奏效的。     

汽油加油站加油人员免疫功能的研究

目的 研究汽油对人体免疫功能的影响。方法 使用血球计数仪检测汽油加油人员组及对照组白细胞总数和分类，使用生化分析仪检测该两组的免疫球蛋白及补体C3、C4的数据。结果 汽油加油人员组的T淋巴细胞（％）、IgG均比对照组低，而补体C3增高，且随接触汽油时间延长这种差异愈明显。结论 吸入汽油使人体免疫功能有下降趋势，且随接触汽油时间延长，这种趋势愈明显。