428例用药不合理医嘱分析

多种抗菌素问世后，用药方案与药物配伍不合理的现象逐渐引起人们的重视。笔者分别收集１９９１年－１９９３年共１４０７例住院病例医嘱，其中用药不合理４２８例（３５．６％），在４２８例中联合用药不合理３９７例（９２．８％），时辰用药不合理３１例（７．２％）。故临床用药中降低疗效或增加毒副作用，对疾病恢复增加了难度。     

农村居民医疗服务潜在需求量及影响因素分析

目的 了解农村居民医疗服务的潜在需求及其影响因素。方法 采用分层多阶段整群抽样方法，对湖北省宜昌地区5县1839名农村居民进行问卷调查。结果 该地区治病未就诊率为13．21％，男女性未就诊率分别为12．01％，15．56％，采用Logistic回归分析方法，筛选出影响患病未就治的主要因素为性别、健康状况、对健康的重视程度、婚姻状况以及不同县等。结论 在农村要完善合作医疗保障制度，对医疗机构建设应以提高服务质量、降低成本、遏制费用增长为主要目的，并能提供更多的医疗服务，使患能及时利用医疗服务。     

谈医疗设备漏电对人体的电击

医疗设备可以为临床工作提供大量诊断信息和治疗手段，而医疗设备的漏电也会使病人电击灼伤以至危及生命。国务院发布《医疗事故处理条例》以后引起了医疗界高度重视，临床诊疗活动中如何安全使用医疗设备也是预防医疗事故的重要方面。本文着重介绍了电击的种类、对人体的危害及防护措施。     

Internet tools in the medical classroom

Summary: The Internet contains a vast amount of medically relevant information. In order to access this information, however, many networks require one to master applications written in UNIX, an operating system considered by many not to be user friendly. Although these tools may be available on the campus, it is difficult to teach their use unless there is some immediate benefit to the already busy user. From that standpoint, it is important for instructors to realize that common UNIX applications can be utilized as classroom tools to significantly enhance the learning experience by facilitating teacher/student communication. Also, whilst the student enjoys greater communication with the instructor (and with other students) he/she is also becoming adept at using information management tools.     

Effects of cadaver dissection on the attitudes of medical students

Summary: Summary. A study was conducted to determine whether the attitudes of medical students to death and caring changed during the 3 months following exposure to cadaver dissection. All first-year students were invited to complete a questionnaire immediately before their initial cadaver dissection experience, after 6 weeks, and after a further 3 months. The questionnaire reflected attitudes to death, violent death, death of someone known to the respondent and caring when someone known to the respondent is seriously injured. Ethnicity and previous exposure to dying has no effect on responses, but overall men students' reactions were significantly less than for women ( P < 0.001). The responses given on the final part of the questionnaire after 3 months were significantly lower than those to most questions in the first part of the questionnaire. The exceptions were those questions where the subject in the given scenario was known to the respondent, where reactions were rated significantly greater ( P < 0.001) in the follow-up questionnaire and can be explained on the basis that they were a personal referent.
Students rapidly develop a coping mechanism which enables them to view cadaver dissection as an occupation quite divorced from living human beings. During these early months of training solicitude decreases for those who die who are unknown to them, but concern for personal referents increases. Educators should be aware of the dramatic change of attitudes among students and the process of professionalization which might influence their caring of future patients.     

The potential of an anaesthesiologist–manned ambulance service in a rural/urban district

The use of anaesthesiologists in prehospital emergency care is controversial. We wanted to assess the impact of an anaesthesiologist and a short time interval from acceptance of a mission to take–off at survival rates in a rural/urban emergency medical service. Prospectively registered data for 991 consecutive patients through a 12–month period were retrospectively evaluated by an independent foreign expert. Of all primary missions, 3.3% were considered probably lifesaving from site of injury to receiving hospital. Of these, the lifesaving result in 50% were dependent on both the qualifications of the anaesthesiologist and a short response time. Survival from hospital admission to discharge was 44%. All patients were discharged to their own homes, able to live a fully functional life. The consistent use of anaesthesiologists compared to less qualified personnel and the maintaining of response times below presently required minima doubles the potential for lives saved in services comparable to the one studied.     

沂蒙山区医院医疗质量管理现状调查

目的：调查本地区医疗质量管理现状，研究提高医疗质量的对策。方法：采用分层抽样调查方法，对本区域24所不同级别医院的医疗质量进行全面调查。结果：各医院在门(急)诊管理、医技、临床医疗、感染控制、护理管理等方面都不同程度地存在医疗质量缺陷。结论：落实各项规章制度，强化医疗服务，提高医护质量，确保医疗安全。     

红景天素抗肿瘤作用的研究

本研究通过体外培养５种人癌细胞（肝癌、胃癌、肺癌、Ｈｅｌａ细胞和咽癌）和小鼠移植性肿瘤实验，证明了红景天素可明显抑制３种癌细胞的生长增殖，可提高荷瘤小鼠的存活率，延长其生存期，抑瘤率在５０％以上。结果提示红景天素对体外培养３种癌细胞和小鼠Ｓ１８０。细胞均有一定的抑制作用。