我院2003～2004年新技术与新项目开展情况分析

随着知识经济时代的来临，创新成为时代的要求和医学科学技术发展的需要。为此，我院以抓新技术、新项目为突破点，大力鼓励和支持医务人员开展医疗技术创新。2003～2004年全院科技人员共开展新技术、新项目60多项，医院从中评选出42项奖励项目，有效地促进了我院科技人才队伍的成长，提高了医疗技术水平。我们在此对我院2003-2004年新技术、新项目开展情况进行分析，以期对医院科技创新管理工作有所启示。     

吉林省1999-2004年医药卫生科技查新项目分析

目的 通过对吉林省卫生信息研究所1999—2004年医药卫生科技查新项目的统计分析，了解和掌握吉林省医药卫生科技工作基本情况；方法 采用SPSS version 11.5 for windows（社会科学统计软件包）对1999—2004年吉林省卫生信息研究所受理的医药卫生科技查新项目进行统计描述及统计分析；结果 6年间共完成了919项医药卫生科技项目的查新检索，项目涉及吉林省八个市（州）；临床医学查新项目在全部查新项目中占绝对优势；919名查新检索项目委托人中，76．3％的项目委托人具有高级职称，其次为中级职称；结论 科技项目查新是医药卫生科技管理的一项十分必要的工作，对减少医药卫生科技项目低水平重复和科技成果评审有着重要意义。     

医疗新技术期待规范管理

近年来，许多医疗机构热衷于引进开展新技术新项目，脏器移植、介入、不孕不育治疗等都是备受医院追捧的新技术。记者日前在西部某省采访时，得到一份该省医疗质量控制中心对省会14家二级以上医院医疗质量检查情况的报告。这份内部资料显示，14家医院中，存在的一个共同的问题是：对医疗新技术、新项日缺乏技术论证、评估和准人，都存在肓目上马的问题。有的医院一年要引进100多项新技术和新项目，但足不对这些技术进行评估，也没有对新项目建立相关资料；     

加强项目实施管理提高医院科研管理水平

对新技术、新项目的管理不仅要重视立项环节,在项目立项后还要注重实施常态管理.对科室新技术、新项目要进行全过程管理与监督,确保在规定的时间内按计划目标每半年书面报告一次项目进展情况,而且在完成项目论证评估后,要备案存档.获得资助的新技术、新项目要设立专帐管理;涉及科研立项、设备购置的过程,应按医院有关规定办理.     

医院开展新技术、新项目流程化管理的实践研究

开展新技术、新项目是医院提高医疗技术水平与综合竞争力的重要途径。但是,新技术、新项目开展风险大,必须进行科学的管理来规避医疗风险,保障患者安全。作者从某医院开展新技术、新项目实际情况入手,梳理该院开展新技术、新项目进行流程化管理的每一个步骤,着重描述了新技术、新项目的准入、患者知情同意、疗效评价、质控管理等环节。对新技术、新项目开展的结果与存在的问题进行讨论、分析,以进一步推动新技术、新项目的顺利开展。     

《全国医疗服务项目规范》执行过程中存在的问题及建议

《全国医疗服务项目规范》在规范医疗机构收费工作中发挥了积极作用，但也存在一些不足之处．一是部分医疗项目内涵过多；二是检验类部分项目没有方法学上的区别；三是部分治疗项目计价单位与实际不符：四是手术治疗类说明不够明确；五是口腔检查类部分项目除外内容过多、过细：六是全国医疗服务项目规范外新技术、新项目没有及时增补。建议有关部门及时征求各级医疗机构的意见．并组织有关方面专家进行修订.     

基层医院开展继续医学教育的实践与思考

近年来,我院通过业务学习（专题讲座、学术交流）、外出培训（进修学习）、参加学术会议和参加现代远程网络学习（好医生网、双卫网、北大医学网）、学历教育、开展新技术新项目、申请科研课题、撰写论文等多种形式、多种渠道的医学教育．推动了我院医学继续教育的发展．同时也使我院的医疗水平和服务水平稳步提高。     

上海市浦东新区医疗卫生服务新技术与新项目发展的三年策略行动方案研究

医疗卫生服务新技术与新项目的发展是医院医疗卫生工作的重要组成部分。文章作者根据在上海浦东新区35所医院目前开展医疗卫生服务新技术与新项目的调查结果，提出了浦东新区医疗卫生服务新技术与新项目发展的3年策略行动方案。作者对开展医疗卫生服务新技术与新项目的原则、人力与物力保障、医疗卫生服务新技术与新项目开展过程中的医疗道德问题等也进行了讨论。     

为企业服务促协会发展--访中国保健科技学会健康产业促进会会长刘建文

中国保健科技学会健康产业促进会自1998年成立以来，致力于健康产业的发展．承担了繁重的任务。经过5年的发展壮大，健康产业促进会已拥有一批涉及多领域的优秀专家队伍。针对健康产业在国民经济中的地位及发展趋势．结合世界健康产业的发展动向．进行宏观分析，提出建议及战略措施，积极促进健康产业的现代化；加强与科研院所、高等学校的专家学者联系．促进科技成果转化为生产力；为新项目、新方法、新技术．新产品进行评估、包括保健食品、医疗器械、保健用品、药品、酒类等等；举办学术研讨及论坛，促进健康产业的信息畅通和资源共享。     

建立健全医学科技项目查新咨询档案的意义及作用

科技项目查新咨询档案的建立是提高科研管理水平的一项重要环节，是科技档案的一种形式，是为用户进行查新咨询工作过程种形成的具有保存价值的文字、图表、数据等真实记录，是一个很好的信息资源库，即可供查新咨询人员借鉴和参考，又可供科技人员借鉴和参考。然而由于查新咨询档案管理工作在我国起步较晚。各种规章制度还不够健全，特别是建立健全科技项目查新咨询档案工作，更是没有引起普通的重视，其管理工作不规范，例如，建立初期对科技查新项目登记不全面，资料散失较多，因此，有些科技项目查新的原始资料目前无从查起。因此，没有完整的科技查新咨询档案，查新咨询管理工作就不完善，所以建立好查新档案是十分必要的。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

The human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.     

Worker education in the primary prevention of occupational dermatoses

This paper reports the evaluation of a skin care education programmeconducted on a fine chemicals manufacturing site where over1,000 employees are located. Approximately 60% are involvedin chemical manufacture. Over a 12 month period production staffreceived training in prevention of occupational dermatoses linkedto a site-wide poster initiative. The incidence of new casesof occupational dermatoses fell from 0.055 (70 cases in 1,277employees) to 0.021 (27 cases in 1,277 employees) before andafter the intervention respectively (p<0.0001). After otherfactors such as chemicals handled, observer bias and changesin reporting related to socioeconomic climate were taken intoaccount it is concluded that this study demonstrates the importanceof worker education as a tool for primary prevention of disease.Training materials such as video and poster presentations maybe effectively used in the chemical manufacturing industry asan adjunct to prevention and control of exposure to substanceshazardous to the skin. Such methods may also be used in otherindustries where there are significant risks of dermatoses.     

Regional Variation in Travel-related Illness acquired in Africa,March 1997–May 2011

To understand geographic variation in travel-related illness acquired in distinct African regions, we used the GeoSentinel Surveillance Network database to analyze records for 16,893 ill travelers returning from Africa over a 14-year period. Travelers to northern Africa most commonly reported gastrointestinal illnesses and dog bites. Febrile illnesses were more common in travelers returning from sub-Saharan countries. Eleven travelers died, 9 of malaria; these deaths occurred mainly among male business travelers to sub-Saharan Africa. The profile of illness varied substantially by region: malaria predominated in travelers returning from Central and Western Africa; schistosomiasis, strongyloidiasis, and dengue from Eastern and Western Africa; and loaisis from Central Africa. There were few reports of vaccine-preventable infections, HIV infection, and tuberculosis. Geographic profiling of illness acquired during travel to Africa guides targeted pretravel advice, expedites diagnosis in ill returning travelers, and may influence destination choices in tourism.     

The design of hazard risk assessment matrices for ranking occupational health risks and their application in mining and minerals processing

Two hazard risk assessment matrices for the ranking of occupational health risks are described. The qualitative matrix uses qualitative measures of probability and consequence to determine risk assessment codes for hazard-disease combinations. A walk-through survey of an underground metalliferous mine and concentrator is used to demonstrate how the qualitative matrix can be applied to determine priorities for the control of occupational health hazards. The semi-quantitative matrix uses attributable risk as a quantitative measure of probability and uses qualitative measures of consequence. A practical application of this matrix is the determination of occupational health priorities using existing epidemiological studies. Calculated attributable risks from epidemiological studies of hazard-disease combinations in mining and minerals processing are used as examples. These historic response data do not reflect the risks associated with current exposures. A method using current exposure data, known exposure-response relationships and the semi-quantitative matrix is proposed for more accurate and current risk rankings.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.