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1.
J B Robbins R Schneerson M P Glode W Vann M S Schiffer T Y Liu J C Parke C Huntley 《The Journal of allergy and clinical immunology》1975,56(2):141-151
Antigenic structures may be shared among naturally occurring polymers, including proteins and polysaccharides. Proteins are polymers of amino acids. Cross-reactions between proteins are due to similarities in their overall shape rather than their individual amino acid components. Cross-reactions have been demonstrated among proteins with similar evolutionary development and structure, such as serum albumins or immunoglobulins. Polysaccharides are polymers of monosaccharides. In contrast to proteins, antigenic specificities may be conferred by mono-, di-, and trisaccharides. Since there are about 150 known naturally occurring monosaccharides, it is not unexpected that cross-reactions are demonstrable between polysaccharides from widely divergent sources. 相似文献
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S B Knoebel 《The American journal of cardiology》1985,56(5):32C-34C
When health care cost containment is tied to unit pricing, the system may become price-driven rather than care-driven. Although the incentives engendered by unit pricing may not necessarily result in practices detrimental to the young or the patient with relatively pure disease, the potential for adverse effects on the elderly, the poor and the chronically ill is real. Hospitals will soon emphasize quick turnover, efficiency and intensive care. Diagnostic evaluations and chronic disease care will be moved out of hospitals into physician owned-and-operated facilities and out-of-hospital settings, respectively. The health care system will fractionate, and quality control will require restructuring to achieve the present level of quality assurance. Cardiologists, as well as other physicians, will need to alter their teaching style and teaching locations. Better methods for predicting outcomes will need to be developed; we will no longer have the safety net of following a patient closely and altering management plans according to the patient's response. Cost containment may occur under diagnosis related groups, preferred provider organizations, health maintenance organizations and other prepaid or "capped" systems. There are, however, many issues relative to cost versus quality that need to be resolved if severe detrimental effects on care are to be avoided. 相似文献
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医院院长必须要处理好的几个关系 总被引:1,自引:5,他引:1
蔡忠军 《中华医院管理杂志》2004,20(1):53-58
文章阐述了院长必须处理好的几个关系:一是必须正确处理办院方向与贯彻党的方针政策的关系;二是必须正确处理与上级的关系;三是必须正确处理两个一把手的关系;四是必须正确处理与副职的关系;五是必须正确处理与科主任的关系;六是正确处理与员工的关系。 相似文献
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Eiji Wada Mitsuru Fukui Kazuhisa Takahashi Daisaku Takeuchi Hiroshi Hashizume Masahiko Kanamori Noboru Hosono Tsukasa Kanchiku Yuichi Kasai Miho Sekiguchi Shin-ichi Konno Mamoru Kawakami Kazuo Yonenobu 《Journal of orthopaedic science》2019,24(1):57-61
Background
In 1999, the Japanese Orthopaedic Association decided to develop a new Cervical Myelopathy Evaluation Questionnaire (JOACMEQ). The final version of the JOACMEQ, comprising 24 questions and five domains (cervical spine function (CF); upper extremity function (UF); lower extremity function (LF); bladder function (BF); and quality of life (QOL)), was established after three nationwide investigations. The fourth investigation, reported in this paper, was performed to confirm the responsiveness of the questionnaire.Methods
A total of 137 patients with cervical myelopathy were included in the study. Each patient was interviewed twice using the JOACMEQ before and after treatment. At the second interview, the patients self-rated their condition in five domains for “worse,” “somewhat worse,” “no change,” “somewhat better,” or “better,” and these scores were defined as the external assessment rating. The difference of the points in five domains between the first and the second interview was calculated against each external assessment. Based on the results, substantial clinical benefit (SCB) thresholds for the JOACMEQ were determined.Results
The statistically significant median values of the acquired points were 17.5 for CF, 16.0 and 21.0 for UF, 27.0 and 20.5 for LF, 13.0 for BF, and 29.0 for QOL. After consideration of the results, the committee decided that an acquired point ≥20 could be interpreted as representing an SCB threshold for the JOACMEQ.Conclusion
We have concluded that a treatment can be judged to be effective for a patient if 1) The patient give all answers for the questions necessary to calculate the functional score of a domain and an increase of ≥20 points is obtained for that score, or 2) The functional score after treatment is > 90 points even if the answer for the unanswered questions was supposed to be the worst possible choice. 相似文献9.
本文论述了在医疗市场竞争条件下,民营精神病院科主任的地位、作用,以及如何协调好医院和病区的关系,如何做好病区医疗安全防范。协调好科室各类人员,做好增收节支,使一个科室能够在现有的医疗体制下高速并有效地运转。 相似文献
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Seventy-nine per cent of a series of 48 patients with implanted pacemakers developed arrhythmias during exercise. There were 23 patients without known previous competition, and in 69.5 per cent of them arrhythmias developed during exercise.No serious arrhythmias developed, but there were three cases of repetitive firing or short bursts of ventricular tachycardia, five instances of pacing on the apex of the T wave, and one instance of R-on-T phenomenon. None of these cases of ventricular tachycardia was preceded by spike-on-T or R-on-T stimulation.Based on these observations, recommendations for selection of the proper pacemaker have been made. 相似文献