开放管理的康复治疗与常规治疗精神分裂症的对照研究

本文报导了对阳性症状基本缓解或残留部分阳性症状而以阴性症状为主的精神分裂症病人进行开放管理的康复治疗与常规治疗的对照研究。入组病例均为男性,平均年龄34.3±9.1岁,平均病程10.7±6.8年。入组时平均住院日数341±210天。全部病例分为实验组与对照组,每组40例,用SANS、BPRS、NORS作为评定指标,经过9个月临床试验,SANS、NORS量表评分治疗前后差数比较,实验组明显高于对照组,差异非常显著。     

特色医疗管理体系建立和技术推广方法研究

介绍了特色医疗的定义和适用范围与当前存在的问题，对特色医疗的管理和应用推广提出了相应的看法和建议，介绍了杭州市的一些经验，针对医学信息部门的优势提出了一些对策。     

Building the Information Infrastructure Required for Managed Care

Purpose: To describe the information used by health care purchasers, policymakers, and administrators when making the decisions required in a managed-care environment and what the profession must do to develop an information infrastructure to demonstrate its contribution to patient outcomes.
Scope: Managed care has created a competitive environment for all health care organizations in which they must offer the best value for their dollar. The purchasing processes germane to managed care rely heavily on information for the selection of cost-effective providers and the provision of efficient care. lnformation used in these processes is derived from transaction systems that largely describe physician and other health care worker's services, but not nursing care. Data analysis by computers requires that data be obtained using a standardized language. Currently, nursing lacks a unified approach to the use of a standardized nursing language.
Conclusions: Individual nurses, nurse managers, executives, and educators should strive to develop an information infrastructure that will overcome barriers. Nurses should both adopt a unified approach to a standardized language, and develop a nationwide information infrastructure that will demonstrate nursing's contribution to patient outcomes.     

建立健康管理系统提高器官移植患者规范化随访管理水平

器官移植健康管理系统是针对专科疾病特点的特殊数据管理系统,作为医院管理系统的补充,协助医护人员分析判断,做出正确的决策。随诊是指医疗卫生部门为了解曾在医院做过一定医疗处理患者的预后、远期疗效及生存质量,定期或不定期采用家庭诊视、     

The impact of representative payee services on medication adherence among unstably housed people living with HIV/AIDS

Rates of viral suppression among people living with HIV/AIDS remain low, especially within marginalized populations such as people who are unstably housed. Representative payee is a service in which the US Social Security Administration appoints an individual or an organization to provide financial management for vulnerable individuals who are unable to manage their finances including housing payments. Little or no published research examines the association between financial management services such as representative payee and HIV clinical adherence. We conducted a pilot study with 18 unstably housed participants living with HIV/AIDS to examine the impact of representative payee services on viral suppression. Of the 11 participants who were not virally suppressed at baseline, 9 (81.8%) of them had achieved viral suppression at six-month follow-up (p?=?.004). Our findings suggest that providing unstably housed people living with HIV/AIDS with representative payee services may help them to improve their housing stability and clinical adherence. Additional research is needed to fully explore correlations between representative payee services and viral suppression.     

COPD并自发性气胸行肺大疱切除加单侧肺减容术临床分析

目的报道急诊或亚急诊肺大疱切除加单侧肺减容术治疗COPD并自发性气胸的临床结果。方法对32例COPD并自发性气胸患者实施肺大疱切除加单侧肺减容术,术后随访24个月,分别于术后第6、12、24个月测定动脉血气分析值。结果术后第6、12、24个月与术前相应数值比较,均有明显好转（P〈0.05）。全组无手术死亡,术后并发症发生率在35%左右。结论肺大疱切除加单侧肺减容术可以改善COPD并自发性气胸患者的临床症状,且手术死亡率低,尽量切除肺大疱及病变侧过度气肿的肺组织和防止残肺漏气为手术关键,做好围手术期的处理,能明显减少术后并发症。     

应用微机管理治疗高血压345例的临床分析

目的：应用WHO－ISH1999高血压分级标准，对345例进入微机管理NAH方案治疗网的病人，进行疗效和相关临床资料分析及评估。方法：将345例一般情况，家族史、烟酒史、既往史，实验室相关资料、体重指数等数据进行整理。最高血压、入网时血压和治疗后血压分级统计，了解变化。依降压程度分析疗效，并比较顺从性好与失访三个月的血压。按危险度分层对治疗和予后进行评估。结果：治疗后血压较入网时比较有显著性差异（P＜0.001）。降至正常者达55．94％。入网血压在1－3级者，治疗后94．33％血压均有下降，本组显效率为72.6％，总有效率为89％。失访三个月与顺从性好者血压控制有差异（P＜0．05）。本组危险性分层有264人（76．52％）为非常高危病人。结论：高血压防治应重视危险因子的作用。三低现象亟待改变。顺从性好，有规律地服药是控制高血压的关键。微机管理NAH方案疗效肯定，适合我国国情，应普及推广。扶危险度分层，指导制定个体化治疗方案，有助于减少心血管事件的发生，降低病死率，提高高血压患者的生活质量。     

基于风险管理的我国医疗器械不良事件监测政策优化理论分析

医疗器械是与药品一样需要评价风险与效益的产品。利用西方学者提出的“动态博弈”理论，试图从动态博弈角度理论分析基于风险管理的不良事件监测制度，以找到适合我国国情的医疗器械风险管理机制优化途径并提出建议。     

Retrospective analysis of 162 consecutive cases of ruptured intracranial aneurysms. Total mortality and early surgery

Summary A retrospective analysis of 162 consecutive cases with ruptured intracranial aneurysm treated during the years 1979–1981 is presented. Total mortality was 33 %. Eighty-four patients were in Botterell grades I–II and 62 were operated with a direct attack on the aneurysm. Thirty-eight were operated early with a mortality of 5% compared with 13% for those operated late. There was no difference in morbidity between the two groups. Of the patients operated with clipping, 66% made a complete recovery and 21% were classified as independent.Signs of delayed ischaemia were recorded in 42% of patients operated early as compared with 25% in the late surgery group. The frequency of rebleedings in the total material was 15%. Hospitalization time was significantly reduced in the early operated group. The importance of analysing the total management mortality and morbidity for evaluation and comparison between early and delayed surgery is discussed.     

“医院-社区-家庭”护理干预模式在老年糖尿病患者中的应用体会

目的探讨提高老年糖尿病患者自我管理能力的有效途径。方法 2008年1月1日开始我科实施"医院-社区-家庭"护理干预模式,采用自制问卷进行调查,评价患者1年后的糖尿病自我管理能力。结果干预组患者的糖尿病自我管理能力及糖化血红蛋白达标高于对照组患者,差异均具有统计学意义(P0.01)。结论 "医院-社区-家庭"护理干预模式有助于提高老年糖尿病患者的自我管理能力。