部分国家和地区公立医院社会医疗保险制度比较

通过对法国、德国、日本、韩国和我国台湾地区5个实行社会保险制度的典型国家或地区公立医院基本情况的梳理,总结以上国家及我国台湾地区公立医院规模、布局、结构和功能等现状。提出公立医院改革的建议：医院规模和布局建设应遵循公平、效率与适应性原则,不断优化公立医院布局,严格控制公立医院成本。     

“十二五”末我国公立医院数量与规模配置评价

目的 对“十二五”中期我国公立医院数量与规模配置水平进行评价，为引导医疗资源合理配置和布局提供参考依据。方法 基于卫生资源集聚度的评价方法，分析我国各地区公立医院和床位的集聚度。结果 我国公立医院和床位集聚度普遍大于1，只有人口稀疏地区小于1，地理可及性较差。人口密集地区公立医院集聚度相对人口集聚度较低，床位集聚度则明显较高，公立医院规模过大，卫生资源集聚水平过高。结论 我国区域间公立医院数量、规模集聚度不平衡依然突出，公立医院规模扩张现象在人口密集地区较为严峻。     

依法推进医疗卫生资源优化配置战略的实施

文章以依法推进我国医疗卫生资源优化配置为主线,分别从依法明确公立医院功能定位,依法规划公立医院的规模、数量与布局,依法建立以人为中心的医疗卫生系统,依法充分发挥社会办医的作用,以及依法推进医疗卫生资源配置规划的编制与实施五个方面论述了资源配置战略,旨在为制订好“十三五”期间公立医院规模、数量与布局的规划提供了理论支撑。     

部分国家和地区公立医院单体规模比较研究

目的 分析不同卫生服务体制的部分国家和地区公立医院单体规模状况,为我国公立医院单体规模发展提供借鉴依据。方法 采用文献研究与描述性分析方法比较不同国家和地区公立医院单体规模。结果 服务人口和功能定位对公立医院单体规模影响较大,公立医院的单体床位规模一般不会超过1000张,经济发达国家或地区公立医院的床位规模偏小,人员配备充裕。结论 把控我国公立医院的单体规模,促进医院规模向集约型方式转变。     

我国公立医院结构布局优化的路径及思考?????? ——基于17个试点城市的经验

随着公立医院改革试点指导意见的出台，探索公立医院结构和布局优化成为公立医院管理体制改革的主要任务。文章总结了17个新医改试点城市优化医疗机构布局改革方案的异同，进行分析与探讨并得出相关启示，旨在为我国更好地推进公立医院改革提供借鉴。     

非营利性医院融资现状、关键因素与政策支撑体系研究

在分析我国非营利性医院各种融资方式现状的基础上,对影响融资的关键因素进行了识别,包括非营利性医院产权归属、补偿机制、规模与区域卫生规划三个方面,并从管理模式、治理结构、财政补偿、医疗保险制度、卫生资源配置和社会筹资等方面,构建了促进非营利性医院融资的政策支撑体系。     

拓展、创新与深化：对我国公立医院治理与改革的思考

我国公立医院改革在初步阶段已经取得一定成效。如在公立医院服务体系建设、县级公立医院改革、惠民便民措施推广以及多元化办医格局推进等方面取得一定进展。基于我国公立医院治理与改革的政策背景,从法人治理、协同治理、医药服务价格体系、激励机制以及基于多元化治理理念的公立医院监管五个方面,分析了公立医院治理与改革中面临的主要挑战,并对公立医院治理与改革的未来趋势作出判断与展望。     

上海黄浦区社区卫生服务绩效评价与SWOT分析

公立医院规划布局是卫生资源配置极为最重要的一个环节。公立医院的合理配置、优化布局有助于提高医疗资源运行效率,使居民获得最大健康产出。从系统角度出发,要更好地配置公立医院资源,必须更好地发挥公立医院与社区卫生服务机构的协同作用,建立有序的分级诊疗模式。因此,文章结合全民健康覆盖的四个条件,对上海市黄浦区社区卫生服务作绩效评估与SWOT分析,为社区卫生服务的进一步发展提供建议,也为更好地配置公立医院资源提供参考。     

实行全民卫生服务制度国家和地区公立医院功能研究

选取英国、香港、加拿大、印度、巴西五个国民卫生服务制度的国家或地区,梳理归纳这些国家公立医院的医院功能、区域分布、层级结构、总体数量和政府职责等。提出我国公立医院改革的建议：明确各级公立医院的功能,界定各级政府办医责任,建立良好的转诊机制。     

中小型公立医院卫生人力资源配置存在问题与对策

随着医改的不断深入,中小型公立医院卫生人力资源配置面临着新的发展机遇和挑战,这就需要医院管理者对中小型公立医院的卫生人力资源进行深入思考。针对中小型公立医院卫生人力资源管理存在的诸多问题,从更新理念、人力规划、人才培养、构建团队、考核机制、契约机制以及医院文化等方面进行探讨,提出了卫生人力资源管理新策略。     

Distribution of N,P, K,Ca, Mg,S, Zn,Fe, Mn and Cu in groundnut

Summary Concentration of N, P, K, Ca, Mg and S in summer groundnut crop was higher than in kharif while Zn, Fe, Mn and Cu contents were higher in summer crop. Kernel's N, P and Zn; Leaflet's Ca and Mn; Stem's K and Fe; Root's S and Cu and Petiole's Mg contents were highest. Shell's N, P, K, Mg, S, Zn and Cu; Kernel's Ca, Fe and Mn contents were the least. N, P, K, S, Zn and Cu concentrations decreased linearly as the crop grew. Ca, Mg, Fe and Mn concentrations did not display any distinct pattern. Ca concentration was positively correlated with pod yield in both the seasons.     

Uniform hypothesis of cell behavior--movement, contact inhibition of movement, adhesion, chemotaxis, phagocytosis, pinocytosis, division, contact inhibition of division, fusion.

The cell has been represented as a charged liquid drop. Contrary to the DLVO-theory, the effect of the surface potential upon the value of the interfacial tension of the cell membrane has also been taken into consideration. The cell membrane has visco-elastic properties and its constituents may move against each other. Cell movement is caused by the appearance of a small number of the electrically charged constituents of the cell membrane on the leading edge of the cell. This produces a local decrease in the surface tension and the cell membrane expansion. At the moment of contact between two cells proton transfers occur between the strongly negatively charged microvilli of one cell and the body of the other, analogous to a condenser breakdown. This, through the effect on the surface tension, causes contact inhibition of movement. The distribution of the proton dissociable groups modifies the interaction between the cells (differentiation) and between the cell and the substratum (adhesion). Adsorption of the charged compounds at the surface of the cell membrane, decreasing the surface potential and increasing the surface tension, causes the phenomena of chemotaxis, phagocytosis and pinocytosis. Cell division, considered in the terms of the surface energy, requires an adequate supply of considerable quantities of energy inversely proportional to the surface potential value. In case of a reduction of the distance between the cells, their surface potential and the energetic barrier of the cell division processes increases, and causes contact inhibition of cell division. Due to their high charge, division of neoplastic cells is inhibited much later than division of normal cells, or is completely ininhibited due to geometric conditions. Fusion of the cell membrane in the intra-cellular and intercellular processes is a reverse process in relation to the cell division.     

The effect of malathion,diazinon, and various concentrations of zinc,copper, nickel,lead, iron,and mercury on fish

Acute and chronic toxicity tests for malathion, diazinon, copper (Cu), mercury (Hg), lead (Pb), zinc (Zn), nickel (Ni), and iron (Fe) were conducted. Mortalities ofBarilius vagra andCyprinus carpio (common carp) were variable but LC50-96 hr were similar for pesticides. AdultB. vagra seem to be more sensitive to malathion than juvenile carp. Both juvenile carp and adultB. vagra were extremely sensitive to diazinon. Long-term exposure to pesticides modified morphology and behavior. The LC50-96 values for Cu, Hg, and Pb were 0.3, 0.16, and 0.44, respectively, for smaller fish and 1.0, 0.77, and 1.33, respectively, for larger fish. Replicate LC50 values for Zn, Ni, and Fe were somewhat variable, and for these metals, the size of the fish seemed to affect response because LC50 values increased as fish size increased. Cooper, Pb, Zn, and Fe residues following exposure to sublethal concentrations of these metals for 15 d were significantly greater in whole juvenile common carp than in controls.     

Further studies of the sieve-element plastids of theCaryophyllales includingBarbeuia,Corrigiola, Lyallia,Microtea, Sarcobatus,andTelephium

The sieve-element plastids of 69 species of theCaryophyllales were investigated by transmission electron microscopy. All contained the specific subtype-P3 plastids characterized by a peripheral ring of protein filaments. The presence or absence of an additional central protein crystal and their shape being either polygonal or globular as well as the average sizes of the sieve-element plastids are useful features in the characterization of some families.—Barbeuia contains sieve-element plastids that confirm its placement within thePhytolaccaceae. Lyallia differs fromHectorella by including small starch grains in their sieve-element plastids, which otherwise by their globular crystals negate a closer connection to theCaryophyllaceae. The lack of a central protein crystal in its form-P3fs plastids placesMicrotea best within theChenopodiaceae. Sarcobatus, a so far uncontested member of theChenopodiaceae, contains form-P3cf plastids, i.e., including a central crystal not found elsewhere in this family.Telephium andCorrigiola, shifted back and forth betweenMolluginaceae andCaryophyllaceae, have form-P3cf(s) plastids with a polygonal crystal which favor their placement within theCaryophyllaceae.     

Simultaneous measurement of the trace elements Al, As, B, Be, Cd, Co, Cu, Fe, Li, Mn, Mo, Ni, Rb, Se, Sr, and Zn in human serum and their reference ranges by ICP-MS

The goal of this article was to establish reference ranges of the concentration of trace elements in human serum and to compare these results with those reported by other authors. We describe the sample preparation and measurement conditions that allow the rapid, precise, and accurate determination of Al, As, B, Be, Cd, Co, Cu, Fe, Li, Mn, Mo, Ni, Rb, Se, Sr, and Zn in human serum samples (n=110) by inductively coupled plasma-mass spectrometry (ICP-MS). Accuracy and precision were determined by analyzing three reconstituted reference serum samples by comparison with other methods and by the standard addition procedure. The advantages of the ICP-MS method include short time of analysis of the elements mentioned, low detection limit, high precision, and high accuracy. Disadventages include a high risk of contamination due to the presence of some of the elements of interest in the environment, the relatively delicate sample handling, and the high cost of the equipment.     

The Effect of Age and Gender on Al, B, Ba, Ca, Cu, Fe, K, Li, Mg, Mn, Na, P, S, Sr, V, and Zn Contents in Rib Bone of Healthy Humans

The effect of age and gender on major, minor, and trace element contents in the intact rib bone of 80 relatively healthy 15–55-year-old women and men was investigated. Contents or upper limit of contents of 16 chemical elements in the rib bone were determined by inductively coupled plasma atomic emission spectrometry (ICP-AES). Mean values (M?±?SΕΜ) for the mass fraction of Ba, Ca, Cu, Fe, K, Li, Mg, Na, P, S, Sr, and Zn (milligram per kilogram of dry bone) were as follows: 2.54?±?0.16, 171,400?±?4,050, 1.35?±?0.22, 140?±?11, 1,874?±?71, 0.049?±?0.011, 2,139?±?38, 5,378?±?88, 75,140?±?1,660, 1,881?±?51, 291?±?20, and 92.8?±?1.5, respectively. The upper limits of contents of Al, B, Mn, and V were <7.20, <0.65, <0.36, and <0.03, respectively. Statistically significant tendency for the Ca, Mg, and P content to decrease with age was found in the human rib bone, regardless of gender. The mass fraction of Fe in the male rib bone increases with age. It was shown that higher Ca, Mg, Na, P, and Sr mass fractions as well as lower Fe content were typical of female ribs as compared to those in male ribs.     

Synthesis,tautomerism, and antimicrobial,anti-HCV,anti-SSPE,antioxidant, and antitumor activities of arylazobenzosuberones

2-Dimethylaminomethylene-1-benzosuberone 1 was coupled with diazotized aniline derivatives to afford a series of the hitherto unreported 2-arylazo-1-benzosuberones 3a–i. The tautomeric structure and the effect of substituents on the tautomeric form (s) of the products 3a–i were discussed. Similar coupling of the enaminone 1 with diazonium salts of heterocyclic amines gave the respective fused azolotriazino-benzosuberones. Some of the newly synthesized compounds showed potent antimicrobial, anti-HCV, antioxidant, antitumor (as topoisomerase I inhibitors), and antimicrobial activities.     

Definitions,measurements, and classifications of stimuli,situations, and environments

A review is presented of issues relevant to the definition, measurement, and classification of stimuli, situations, and environments. Problems such as the lack of adequate definitions of concepts, error and bias in measurement procedures, confusion between measurement of a concept and measurement of its behavioral effects, and the lack of agreement among alternative measures are emphasized. It is suggested that concepts be defined in terms of objective characteristics while allowing for the study of the transactional relationship between organism and environment. The work of the ethologists in defining stimuli while studying their relationship to different organismic states and situational contexts is emphasized in this regard. Following Brunswik, it is also suggested that wherever possible there be a representative sampling of variables in natural settings. Note from the editors: From time to time, Human Ecology will publish a review article. Our first in this series is a review by a psychologist of basic definitional and conceptual problems in environmental studies.This paper was prepared while the author was a Visiting Research Fellow at the Educational Testing Service. The support of ETS and my colleagues in the Division of Psychological Studies is gratefully acknowledged. The review was also supported in part by a grant from the Rutgers University Research Council.