北京市区域医疗联合体系建设问题探究

为解决城乡和区域间医疗资源配置不均衡、不合理,基层医疗机构服务能力薄弱等问题,北京市2013年开展了区域医疗联合体系建设工作,虽然取得了一定的成绩,但从实践情况看来,政策实施的效果与预期还存在一定差距。以北京市区域医疗联合体系为研究对象,通过理论、实例相结合的方式,分析其在运行过程中出现的问题及造成这些问题的原因,为北京市区域医疗联合体系更好地发挥作用提供政策建议。     

新医改背景下佛教团体举办医疗机构的可行性研究

从政策环境、经济环境、社会环境、行业环境、上海现代佛教事业的发展等五个方面对上海佛教团体出资举办医疗机构的可行性进行了全面分析，并对佛教团体举办的医疗机构的定位及运行模式提出设想。通过分析认为，成立上海佛教医疗机构不仅有政策扶持和经济基础，还有社会和行业环境培育的良好条件，更是上海佛教事业发展的必然产物。     

民办非营利性医疗机构发展问题及对策

新医改方案中提出鼓励和引导社会资本发展医疗卫生事业,鼓励社会资本依法兴办非营利性医疗机构。发展民办医疗机构尤其是民办非营利性医疗机构对深化医药卫生体制改革具有重要意义。然而当前民办非营利性医疗机构的发展困难重重。试图从民间组织理论的视角出发,从社会环境、内部治理和外部监督管理等方面对民办非营利性医疗机构发展面临的问题进行分析,进而提出政策建议,希望为进一步发展民办非营利性医疗机构提供思路和经验借鉴。     

地市级大型公立医院临床研究型发展模式可行性研究

地市级大型公立医院选择临床研究型发展模式是国家政策的引导、区域医疗的需求以及医疗市场竞争和医疗机构自身发展的需要。确立“临床研究型医院”战略、建设“临床研究型医院”管理体系、学科人才、创新平台和文化氛围是“临床研究型医院”的主要发展路径。同时,建设“临床研究型医院”必须妥善处理好临床医疗与科研教学、规模扩张与内涵提升、自主创新与引进吸收的关系。     

北京市环境污染水平和经济增长关系的计量模型

选取1992-2008年北京市主要环境污染物排放量作为北京市的环境污染水平表征指标,以人均GDP表示经济发展水平,通过分析北京市主要环境污染物的排放量与人均GDP之间的关系并建立计量模型,以此探究北京市的经济发展对与环境质量的影响.研究表明,北京市1992-2008年的人均GDP和主要污染物排放量之间的关系可以用EKC曲线进行描述,而且目前的北京部分污染物如工业废水、工业COD、石油类、工业烟尘等的排放量随着人均GDP的增加呈显著下降的趋势,表明现在主要污染物的排放量均已越过拐点,北京市进入经济与环境协调发展的阶段.分析其因为,主要得益于研究时段内北京市产业结构大力调整、环境污染治理投资增加和严格的环境管理政策等多项措施的综合实施.基于过去的经验分析,北京市在发展经济的同时,应该进一步深化调整产业结构,减少工业生产污染物排放并加强环境政策的制定和实施力度,才能保证经济进一步发展的同时使环境得到持续改善.     

新疆地区综合型医院门诊医疗服务品质评价指标体系的构建和应用

综合型医院门诊医疗服务品质是新医改时期医疗机构建设与发展的全新课题,而科学、合理地评价医疗机构的服务品质对推进医院自身建设和发展均具有重要意义。研究采用理论研究与实证分析相结合的研究方法,试图构建一套符合新疆地区民情,体现病人需要与期望的、可信而有效的综合型医院门诊服务品质测评指标体系,为医院医疗服务质量的评价与改善提供客观的测量工具,以便于掌握和分析不同类型患者对医疗机构的服务需求。     

医疗机构推诿艾滋病病毒感染者/艾滋病病人应对策略

通过分析非定点医疗机构推诿艾滋病病毒感染者和艾滋病病人的表现形式和发展过程,认为：政策落实不到位、监督机制不健全、定点医疗机构诊疗能力弱、非定点医疗机构维护自我利益、相关保障机制不健全等是医疗机构推诿的主要原因。在分析的基础上,提出了解决的策略：完善政策、提高定点医疗机构的诊疗能力、加强培训、完善防护措施、健全补偿机制、加强与病人的沟通、加大监督力度。     

对医保定点医疗机构支付方式改革的思考

医保对定点医疗机构支付方式改革势在必行,应由传统的被动支付向管理型支付方向发展。在需方对医疗机构支付方式上,应确定与参保对象承受能力相适应的费用分担比例,同时组合应用多种支付方式;在医保对医疗机构支付方式上,应由后付制转向预付制、由单一的支付方式转向混合型支付方式。支付方式改革要辅之以加强对医疗机构的监管、加快卫生信息化建设、建立医保谈判机制和注重配套政策支撑等。     

公私合营模式下医疗机构服务外包的发展和规范

医疗机构为集中精力提供高效、专业临床诊疗服务,将其非临床诊疗业务、临床支持业务等外包给第三方专业机构。同时,随着国家鼓励公私合营模式发展的政策不断完善,医疗机构服务外包作为公私合营模式在医疗服务供给领域的实践体现具有巨大发展潜力。文章旨在通过分析我国医疗机构服务外包的现状,为其健康发展提供相应的政策建议。     

基于多源数据分析的北京市中心城绿色空间时空演变研究（1992—2016）

随着城市化不断推进,北京市中心城社会经济发展和环境破坏严重威胁着绿色空间发展,理清绿色空间的演变机制为绿地系统规划方案制定提供重要的理论依据。研究以北京市中心城为对象,选择1992年、2000年、2008年和2016年4个重要节点,对其遥感影像进行解译,探究北京中心城绿色空间的时空变化并分析其转变影响因素。研究表明,研究期北京市中心城耕地、林地和湿地及水域面积减少,草地面积增加,总绿色空间大面积减少;中心城用地间的转换主要集中在耕地向建设用地、林地的转换,林地和草地向建设用地的转换上;社会经济发展对北京市中心城绿色空间面积演变影响显著,自然因素对绿色空间演变起到一定限制作用,政策因素对于结构性大型绿色空间的建设具有积极的推动作用。     

The multifaceted roles of Eph/ephrin signaling in breast cancer

Eph receptors and their membrane-bound ligands are intimately involved in the control of morphogenic processes during embryonic development and adult tissue homeostasis. By their ability to orchestrate cell migration, pattern formation and tissue integrity they are also prone to be involved in carcinogenic growth. In this review we concentrate on their involvement in the normal and carcinogenic development of the breast. In this context we summarize their multi-faceted functions as tumor suppressors, tumor promoters, angiogenic inducers and regulators of stem cell homeostasis.     

The multifaceted roles of Eph/ephrin signaling in breast cancer

Eph receptors and their membrane-bound ligands are intimately involved in the control of morphogenic processes during embryonic development and adult tissue homeostasis. By their ability to orchestrate cell migration, pattern formation and tissue integrity they are also prone to be involved in carcinogenic growth. In this review we concentrate on their involvement in the normal and carcinogenic development of the breast. In this context we summarize their multi-faceted functions as tumor suppressors, tumor promoters, angiogenic inducers and regulators of stem cell homeostasis.     

Becoming a Developer: Processes of Personhood in Urban Community-driven Development,Indonesia

ABSTRACT

Community-driven development in Indonesia requires the recruitment of volunteers: local residents with the will to develop themselves and others. By revealing the processes of personhood in light of volunteers’ own theories of self, I aim to disrupt simple readings of subjectification in the anthropology of development. Local volunteers understand their recruitment as having the opportunity to occupy a social position that is aligned with their jiwa (nature), and their participation as satisfying their hati (seat of emotion). Rather than assess the success or failure of state actions to regulate or constitute citizens through discursive and affective means, I take seriously this understanding of development as a process of locating and recruiting people predisposed to becoming the subjects of state development. Doing so prompts new lines of enquiry that have been overlooked in understanding processes of subjectification in development: namely the reason why some people are recruited as development subject, while the majority are not.     

Microglia in development: linking brain wiring to brain environment

Microglia are enigmatic non-neuronal cells that infiltrate and take up residence in the brain during development and are thought to perform a surveillance function. An established literature has documented how microglia are activated by pathogenic stimuli and how they contribute to and resolve injuries to the brain. However, much less work has been aimed at understanding their function in the uninjured brain. A series of recent in vivo imaging studies shows that microglia in their resting state are highly motile and actively survey their neuronal surroundings. Furthermore, new data suggest that microglia in their resting state are able to phagocytose unwanted synapses and in this way contribute to synaptic pruning and maturation during development. Coupled with their exquisite sensitivity to pathogenic stimuli, these data suggest that microglia form a link that couples changes in brain environment to changes in brain wiring. Here we discuss this hypothesis and propose a model for the role of microglia during development in sculpting brain connectivity.     

Are mAbs different?

Apart from the nifty science behind their development, are monoclonal antibodies (mAbs) different than other new technologies? As highlighted by Cohen and Wilson in their interesting new paper, mAbs are distinctive from most traditional pharmaceuticals in some ways: their relatively high prices; their high costs of development; their mode of administration; the fact that, unlike many other drugs, they offer disease modification not simply symptomatic relief; the frequency of supplemental indications and off-label use – much of it recognized in drug compendia and reimbursable; and the lack of a clear pathway for their generic substitution.     

The synapsins: multitask modulators of neuronal development

Neurons are examples of specialized cells that evolved the extraordinary ability to transmit electrochemical information in complex networks of interconnected cells. During their development, neurons undergo precisely regulated processes that define their lineage, positioning, morphogenesis and pattern of activity. The events leading to the establishment of functional neuronal networks follow a number of key steps, including asymmetric cell division from neuronal precursors, migration, establishment of polarity, neurite outgrowth and synaptogenesis. Synapsins are a family of abundant neuronal phosphoproteins that have been extensively studied for their role in the regulation of neurotransmission in presynaptic terminals. Beside their implication in the homeostasis of adult cells, synapsins influence the development of young neurons, interacting with cytoskeletal and vesicular components and regulating their dynamics. Although the exact molecular mechanisms determining synapsin function in neuronal development are still largely unknown, in this review we summarize the most important literature on the subject, providing a conceptual framework for the progress of present and future research.     

植物发育与microRNA

microRNA为动、植物的一类内源、非编码小分子RNA,其长度约为23nt,对动、植物的发育具有非常重要的调节作用.microRNA作为调节类的核酸分子,通过识别和负调控靶基因来行使其生物学功能,多数microRNA的表达具有时空特异性,它们对植物的发育有多向性调节,在发育的多个层面具有重要的功能,有些microRNA的调节作用还要受到外因的诱导.该文对近年来国内外有关microRNA在植物发育过程中的功能及其研究进展进行综述.     

龙眼胚胎发育研究进展(综述)

总结20多年来龙眼胚胎发育的研究进展,提出该研究领域存在的问题,并展望今后的发展方向。