范永升教授运用青蒿治疗SLE临床经验

[目的] 总结全国名中医范永升教授运用青蒿治疗系统性红斑狼疮(systemic lupus erythematosus,SLE)的临床经验,提高对SLE的认识。[方法] 通过跟师学习,收集范教授诊治的SLE患者的临床资料,以及整理医案、查询相关文献,回顾分析范教授在SLE的不同阶段运用青蒿及并配伍相关药物的临床经验,并以验案佐证。[结果] 范教授通过辨证论治,以青蒿之清热解毒,治疗SLE轻型阴虚兼有热毒证;以青蒿之透邪滋阴,治疗SLE轻型余邪内伏证;以青蒿之清胆理气,治疗SLE重型肝郁血瘀证。所举病案中分别以解毒祛瘀滋阴方及蒿芩清胆汤治疗轻型及重型SLE,治疗后患者症状改善,SLE疾病活动(systemic lupus erythematosus disease activity index,SLEDAI)评分降低。[结论] 范教授针对SLE的不同阶段,运用青蒿清透虚热、凉血除蒸、解暑截疟,并配伍相关药物,疗效显著,其经验值得推广学习。     

加强总住院医师培养的思考

文章阐述了总住院医师阶段的培养特点,对现阶段总住院医师培养中存在的问题及原因进行了分析,认为总住院医师培养是医学人才培养中不可或缺的重要阶段。只有加强总住院医师阶段的培养,才能造就合格的医学人才。     

These are a few of my favourite things: reflections on the doctor-doctor relationship

The doctor-patient relationship is often spoken about and is typically characterized by one of trust and compassion. However, the doctor-doctor relationship is rarely discussed openly as it is too hurtful to reveal the truth. Lack of compassion, competitiveness and even cruelty abounds in the opinion of the author who exemplifies this by some personal anecdotes and is based on 30 years as a physician. Unfortunately the lessons to be learned occur too late for most individuals. Selection of medical graduates may also play an important role in the whole malady.     

Waiting time and doctor shopping in a mixed medical economy

Waiting time generally acts as a rationing mechanism in the public health care system. In theory, patients who have a higher valuation of time are more likely to seek alternative care (i.e. doctor shopping) if there is a parallel private sector than those who have weaker time preference. However, the existing settings of many health care systems do not allow patients to reveal their preference of such. The data presented in this study suggest a positive association between patients' expressed value of time and doctor shopping behaviour in Hong Kong. Patients who were assigned longer waiting times relative to their expected horizon were more likely to seek private alternative care.     

Interprofessional relations: case studies of working relationships between Registered Nurses and general practitioners in rural Australia

Interprofessional working relationships of nurses and doctors have been discussed in the literature but are less frequently the subject of research. A review of international research on nurse-doctor professional relationships conducted over 30 years (1966-99) shows that the relationship is of interest predominantly to nurses. From a series of interviews with nurses and doctors, as part of a case study of four rural health services, harmonious working relationships between nurses and doctors were examined. Further analysis reveals many aspects of nurse-doctor relationships that are traditional and common across many contexts. There are, however, some aspects that are specific to the rural nature of the working context and relate well to contemporary advances in nursing knowledge and confidence.     

加强口腔临床教学工作，培养合格口腔专业医师

临床教学是口腔医学专业教学中最重要、最关键的阶段，既是全面巩固专业基础知识的重要环节，又是医学生顺利转变为一名合格医师的重要阶段．加强学生的医德医风建设；提高临床医师的实习带教水平来为学生创造良好的育人环境；开展病例讨论式教学；充分利用实验室的有利条件，缓冲临床教学的负担和压力；改革毕业考核制度，确立科学的评估方法等途径来加强学生临床综合能力及实践能力的培养．以上措施大大增强了学生临床实习的主动性和自觉性，全面提高了学生临床实习的教学质量，培养了大批口腔专业合格医师．     

门诊医生工作站中电子处方模板的改进和应用

目的：执行国家卫生部和总后卫生部有关电子处方管理办法,结合医院实际,规范电子处方内容的打印.方法：基于门诊医生工作站的应用,在PB9环境下对门诊医生工作站电子处方打印模块进行改进.结果：解决了电子处方打印中婴幼儿患者的年龄问题,＂精一＂处方患者和代办人身份核查问题,备注栏内容打印问题等.结论：新的电子处方打印模块的应用提高医院门诊工作效率和社会效益.     

张磊老师成为时代名医的思考

张磊老师是国家第二批师承制导师,在当今国家大力发展中医的情况下,如何遵循中医药科学自身的发展规律,继承弘扬传统中医特色和优势,培养和造就一批名中医,是新形势下的一个重要命题。本文根据作者侍医过程中的心得体会,从写实的角度,思考张磊成为名医的必然性;文章从他艰苦勤奋的学习历程、充满强烈事业心和责任感的工作经历出发,结合其知识结构,治学态度,高尚情操,敬业精神,专业素养,以及个人人格魅力,展示张磊多才多艺的丰富医学人生,从而为大家学习中医树立榜样。     

王成荣研究员治疗经期延长特色摭拾

经期延长是以经期异常为主的病症,临床常见。王成荣研究员临证不拘泥于中医教材的症状诊断,而根据经前或经后出血的不同,将其分为经前漏下或经后漏下,并针对不同的诊断,分别选用中医或西医治疗。对中医药适应症的黄体功能不足或黄体萎缩不全之经前漏下或/和经后漏下的诊治思路作以介绍。