走出低谷──再谈渐进式责任制护理

渐进式责任制护理是据国情产生的一个新生事物。其特征是全员参与，在完成功能制工作之后，每位护士负责一位重危病人的护理。其护理内容完全按照责任制护理进行。其不足之处是人员素质的差异，使责任制护理质量有别。不过，可随着条件的成熟，不断得到改进。     

小儿骨科“一日病房”工作模式的探讨

在小儿骨科医疗过程中，发现一些特殊情况，有些患儿病情需要连续观察治疗，而家长由于时间、经济条件或其他原因，不能住院治疗，但如果不连续治疗，又会影响治疗效果。为了适应新形势的需要，也方便儿童家长，我科特推出特色服务项目“一日病房”，科室专门腾出几间病房作为“一日病房”，由专门的医师和护士进行管理和治疗，一天多达三、四十人，深受患儿及家长的欢迎。     

试论医学院校“以学生为本”的管理实践

本文从行政管理的角度,探讨了北京大学医学部“以学生为本”的管理实践,具体涉及了四个方面的内容:为学生配备学业精深、素质优良的师资队伍;为学生营造有利于个人潜能发展的学习实践平台;为学生提供高水平的服务型管理;为学生提供人性化的公共硬件设施.     

无痛苫胃镜护理的探讨

无痛苦胃镜的应用受到广大患者的欢迎。通过对2009年1～12间月来我院实施无痛苦胃镜检查及治疗的1586名患者的观察及护理,总结近几年来对无痛苦胃镜的护理体会,分析护理存在的问题,探讨无痛苦胃镜的优缺点,完善护理的措施,指导患者如何配合检查及治疗和术后如何自我护理。     

Analysis of time taken to discuss new patients with head and neck cancer in multidisciplinary team meetings

Multidisciplinary team (MDT) meetings have an important role in the management of head and neck cancer. Increasing incidence of the disease and a drive towards centralised meetings on large numbers of patients mean that effective discussions are pertinent. We aimed to evaluate new cases within a single high volume head and neck cancer MDT and to explore the relation between the time taken to discuss each case, the number of discussants, and type of case. A total of 105 patients with a new diagnosis of head and neck malignancy or complex benign tumour were discussed at 10 head and neck cancer MDT meetings. A single observer timed each discussion using a stopwatch, and recorded the number of discussants and the diagnosis and characteristics of each patient. Timings ranged from 15 to 480 s (8 min) with a mean of 119 s (2 min), and the duration of discussion correlated closely with the number of discussants (r_s = 0.63, p < 0.001). The longest discussions concerned patients with advanced T stage (p = 0.006) and advanced N stage (p = 0.009) disease, the elderly (p = 0.02) and male patients (p = 0.05). Tumour site and histological findings were not significant factors in the duration of discussion. Most discussions on patients with early stage tumours were short (T1: 58% less than 60 s, mean 90) and fewer people contributed. Many patients, particularly those with early stage disease, require little discussion, and their treatment might reasonably be planned according to an agreed protocol, which would leave more time and resources for those that require greater multidisciplinary input. Further studies may highlight extended discussions on patients with head and neck cancer, which may prompt a review of protocols and current evidence.     

对大众艾滋病健康教育的探讨

目的:了解人们通过健康教育获得艾滋病知识后继续发生高危行为的情况,探讨艾滋病健康教育的方式和内容。方法:采用定性访谈的方法,对获得艾滋病基本知识后继续发生高危行为VCT求询者进行访谈。结果:求询者在掌握了艾滋病知识后继续发生高危行为的原因主要有自己或性伴(客人)不愿意用套;爱人感染后,因为很爱对方就继续发生性行为等几方面,不同性别的求询者继续发生高危行为的原因有统计学差异(P﹤0.05)。结论:对大众进行健康教育依然是预防艾滋病主要方式,但健康教育的内容需要做适当的调整,改变人们获得知识后继续发生高危行为的状况,降低HIV感染率。     

上消化道出血证治探讨

上消化道出血是内科常见病、急重症。本病发病突然,来势迅猛,病势严重,如不及时救治,可危及生命。作者收集近年来中医对本病的有关文献报道,结合临床探讨了上消化道出血的病机特点、诊治思路及中医药治疗上消化道出血的发展前景和研究方向。     

“雷公炮炙十七法”辩疑

“十七法”在炮制领域占有重要位置,对后世的炮制方法产生过一定影响,亦存在不少疑点。本文就“十七法”的来源、方法的记载、以及有异议的方法作一浅述。     

讨论式教学法在实习带教中的体会

以学生为主体，以问题为基础的讨论式教学方法，旨在培养学生逻辑思维能力，提高独立分析问题、解决问题的能力，