"立交桥"高职护理人才培养模式初探

为探讨中等卫生学校毕业就读高等护理专业学生（即“立交桥”高职）的培养模式，在坚持高等教育培养目标及职业特色的前提下，结合学生特点，进行课程设置、教学方法及临床实践等方面的改革，以发挥学生的优势，弥补学生的不足，培养适应现代护理发展需要的高质量护理人才。     

医疗卫生服务价格改革方向初探

医疗卫生服务价格改革是要理顺价格构成成份之间量的关系，使每个构成成份的价格值都在供求关系的约束中，在政府的有效管制中，从而成为医疗卫生资源合理配置的有效工具。为此：①对生产要素分别定价；②对劳动定价；③对资本和自然资源定价；④确定医疗卫生机构内部管理时劳动价格；⑤价格中的所有构成成份价格都置于供给和需求关系约束下；⑥确定医疗卫生服务价格的理想传递方式。     

做好当前临床外科教学工作的思考

应从提高教师队伍素质、提倡主动式教学、专科教育、指导学生处理好医患关系、提高法律意识和自我保护意识、制定统一的教学内容和目标等方面，做好临床教学工作。     

护理学基础课程技术操作教学改革与实践

目的培养高素质实用型护理人才，塑造护生良好形象，使之更加适应现代护理工作需要。方法教师在护理学基础课程技术操作教学过程中，注意通过课前引导学生预习操作内容、精心设计教案、规范操作流程、善于灵活运用示教和多媒体、演练情景剧、开放实验室、强化训练、开展技能考核与比赛等方式培养学生动手操作能力。结果2001年以来，已先后有3届学生进入临床实习。通过问卷调查，学生、带教教师、病人满意度分别达到98．5％、98．2％、97．0％。     

谈医院改革趋势

由于我国经济体制的转轨，经济增长方式的转换，正在带动、辐射、影响并制约着医院的建设和发展，医院改革将朝着以下趋势深化：一是在区域卫生发展规划指导下建设医院；二是开展社区服务是医院服务保障模式改革的大趋势；三是医院体制改革将寻求实现政府计划与市场调节的最佳结合；四是社会医疗保险制度改革将对医院带来重大影响；五是深化和完善补偿机制与价值体系改革仍是医院的重要课题；六是加大法规建设力度形成依法治院的新格局。     

境外医院领导体制概述

介绍了境外部分国家和地区的医院类型、政府在医院管理中的职能和有关医院领导体制的基本情况,侧重介绍了医院最高领导机构和决策者的组成和特征。指出:要转变政府职能,强调医院的自主经营和自主管理,医院的发展需要有一支高效率、高管理水平的医院领导队伍。     

对药学无机化学的教学体会

根据药学专业无机化学的学科特点出发，就课堂授课过程中如何改革教学方法、激发学生学习兴趣、设计合理的教学过程等方面进行探讨，以提高学生认知能力和自主学习的欲望，达到善于总结和提高学习效率的目的。     

Subchondroplasty in the treatment of bone Marrow lesion in early Knee Osteoarthritis: A systematic review of clinical and radiological outcomes

BackgroundKnee osteoarthritis (KOA) is increasingly prevalent in North American society. The significant societal burden it represents makes it essential to promote and target new treatments in earlier phases of the disease. Among others, subchondroplasty is a newly documented technique using calcium phosphate injection targeting the osteochondral lesions preceding KOA, also known as Bone Marrow Lesions (BMLs). This article aimed to review the existing literature on clinical and radiological outcomes of subchondroplasty in the treatment of BMLs in KOA.MethodA systematic review was performed using PubMed, Embase, Medline and Cochrane Database of Systematic Reviews. Studies on calcium phosphate injections into BMLs for KOA and its clinical and radiological outcomes were screened and reviewed by independent evaluators.ResultsAfter screening, ten articles were included, totaling 540 patients. Follow-up ranged from 6 months to 7 years. Overall, the procedure showed significant functional and quality of life improvement, as well as pain relief, as shown by Patients-Reported Outcomes Measures (PROMs). There were very few complications reported, the most important being leakage of calcium phosphate outside the targeted site. Conversion rate to total knee arthroplasty (TKA) ranged from 14 % to 30 % at 2 years post-procedure. Long term radiological outcomes have been poorly documented.ConclusionsSubchondroplasty is a promising avenue for the treatment of KOA. However, quality evidence is still required before any real conclusions and practical management guidelines can be drawn. Prospective, randomized studies with a control group and a rigorous assessment of long-term clinical and radiological outcomes are recommended.     

CR-lipped bearing is an adequate functional solution to patients with perioperative excessive laxity in cruciate retaining total knee arthroplasty

BackgroundThe cruciate retaining lipped (CR-lipped) bearing is designed to provide more anterior-posterior (AP) stability and could be employed to resolve excessive intraoperative laxity during the cruciate retaining TKA (CR-TKA). The aim of the study was to determine whether the CR-lipped bearing in CR-TKAs with a perioperative excessive laxity allows equivalent functional results as compared to the standard CR articulation.MethodsA cohort of 111 TKAs with CR-lipped bearings was matched to a cohort of conventional CR bearings regarding age and sex. The CR-lipped bearing was used in patients with excessive knee AP laxity and the regular CR bearing was used in patients without excessive AP laxity during TKA. Various PROMs (WOMAC, KSS, SF-36) were assessed preoperatively and at 5-years postoperative in combination with revision rate and Range of Motion (ROM).ResultsPROMs did not differ significantly between both groups 5-years postoperatively. Mean ROM (flexion) 5-years postoperatively was not significantly different. The implant survivorship was 100% for both cohorts with revision for any reason as end point.ConclusionBased on these results, the CR-lipped bearing is a safe and effective solution for mild interoperatively assessed PCL laxity during CR-TKA without loss of function or decreased survivorship at 5 years. Peroperative conversion to a PS-TKA in order to obtain satisfactory functional scores might therefore not be necessary when mild PCL laxity is observed during surgery. Further research should focus on verifying this approach and longer follow-up is needed to generate data on long term survivorship.Level of evidenceLevel IV therapeutic, retrospective, cohort study.