基于医疗服务绩效信息透明的质量促进效果研究综述

利用描述性综述的方法,总结近10年来医疗服务绩效信息透明对医疗质量促进效果,根据纳入排除标准检索Web of Knowledge、Pubmed等数据库,最终纳入31篇密切相关文献。结果表明,国外一般通过医疗报告卡或网站向公众公开医疗服务绩效信息,改善了医疗服务行为,但对病人选择服务提供者和临床结果的改善作用有限。我国应制定相关政策,推动医疗服务绩效信息向更广泛的使用者公开,引导病人利用医疗服务绩效信息选择医疗服务提供者。     

ROCCIPI框架下互联网医疗发展的问题识别与分析

互联网医疗作为传统医疗服务和现代互联网信息技术的跨界融合,正如雨后春笋般的在当下互联网革命与社会变迁的浪潮中迅速崛起。目前国家政策导向、互联智能广泛应用、健康医疗市场需求、社会资本介入等齐为互联网医疗发展推波助澜。基于我国国情以及政策进程、公众认知差异等因素,冲破互联网医疗发展的藩篱依旧面临着重重困阻,运用ROCCIPI技术厘清我国互联网医疗发展遇到的阻碍和问题并进行分析。     

移动医疗服务热潮中的几点冷思考

通过阐述国内外移动医疗服务的形成与发展,介绍了移动医疗的主要应用领域,同时也分析了当前我国移动医疗服务中存在的不足,如健康数据可靠性问题、网络诊疗安全性问题、网络行医医师资质认定问题、移动医疗中医患法律责任界定问题等,并从监管、法律、政策等层面探讨了相应的解决对策。     

我国医养结合服务发展现状分析与政策建议

随着我国老龄化进程加快,医养结合在卫生政策与管理实践上已经成为普遍共识。现有研究主要从养老服务角度分析医养结合的概念、内涵以及实现路径,或从医学护理、医疗照护等方面探讨技术问题。医养结合模式,既不单纯是一种养老模式,也不单纯是一种医疗模式,而是医疗和养老融合的新模式,将改变传统的养老和医疗服务提供理念和方式,是解决我国老年人养老、医疗的创新之举,是建设健康中国的重要组成内容。本文从政策分析的角度出发,通过对医养结合概念的阐述、深入分析我国目前医养结合模式和存在的问题,提出政策建议。

     

个体化医疗技术与市场分析

个体化医疗是指根据病患的基因组信息与相关个体特征,为病患提供个性化治疗方案的一种医疗模式。随着医疗技术的发展及民众对健康需求的不断提升,个体化医疗技术快速发展,市场规模日益扩大。对个体化医疗的定义与界定、涉及的技术领域与技术趋势、市场规模与竞争态势进行调研,为我国个体化医疗产业的发展及相关政策的制定提供参考。     

公立医疗机构产权制度民营化改革的经济规范分析

????? 公立医疗机构民营化改制是我国医疗体制改革中颇受争议的热点。从经济学角度规范分析,医疗服务的私人物品特点是民营化的基本前提,收紧预算约束、提高效率是民营化的主要依据。在民营化过程中,地方政府充当了民营化改制的推力,条块冲突主要影响了民营化的整个进程。在目前回归公益为主的政策引导下,民营化将不会作为未来医疗体制改革的重点,但局部民营化仍应得到积极实施,兼顾机构职工与患者利益条件下未来民营化进程将呈现复杂形态,而分部门、分机构、分地区的改制试点将是下一阶段民营化发展的主要方向。

     

医疗联合体国内外研究现状及发展动态

医疗资源配置不均衡,医疗服务“断裂”以及“碎片化”的问题越来越受到国内外专家学者以及卫生政策制定者的关注。构建医疗联合体是医疗资源整合的方式之一。文章对医疗联合体的国内外研究现状及发展动态进行梳理和总结,旨在为我国医疗联合体的构建及发展提供一定的经验和启示。     

医疗联合体国内外研究现状及发展动态

医疗资源配置不均衡,医疗服务“断裂”以及“碎片化”的问题越来越受到国内外专家学者以及卫生政策制定者的关注。构建医疗联合体是医疗资源整合的方式之一。本文对医疗联合体的国内外研究现状及发展动态进行梳理和总结,旨在为我国医疗联合体的构建及发展提供一定的经验和启示。     

三级医院优质医疗资源下沉基层的实践与思考

介绍了通过面对面访谈形式对大连市某区内卫生服务中心人员进行调研,对社区卫生服务中心的软硬件、发展需求等情况进行全面了解,有针对性地借助信息化手段实施优质医疗资源的对接工作。 优质医疗资源下沉可以缓解看病难的问题,但各相关部门应积极给予政策上的引导和支持,以促进优质医疗资源下沉的深入和持久。     

我国医疗服务项目成本核算研究述评 ——基于演变历程的视角

目的 了解我国医疗服务项目成本核算文献研究进展和政策推进情况。方法 检索中国知网、万方数据库、重庆维普数据库1978—2016年医疗服务项目成本核算相关文献和政策文件,进行内容分析。结果 通过对文献研究主题、数量与时间分布的三维匹配,将我国医疗服务项目成本核算演变历程分为起步（1979—1991年）、探索前期（1992—2001年）、探索中期（2002—2009年）、探索后期（2010年至今）4个阶段。结论 不同时期医疗服务项目成本核算政策推进均滞后于学术研究,缺乏政策导向性;医疗服务项目成本核算仍处于探索阶段,亟待标准化;核算技术标准化是医疗服务项目成本核算标准化的核心;未来医疗服务项目成本核算功能应向医疗质量安全成本一体化扩展;夯实核算基础与完善配套政策是开展医疗服务项目成本核算的关键。     

Recent advances in the study of Kaposi's sarcoma-associated herpesvirus replication and pathogenesis

It has now been over twenty years since a novel herpesviral genome was identified in Kaposi's sarcoma biopsies. Since then, the cumulative research effort by molecular biologists, virologists, clinicians, and epidemiologists alike has led to the extensive characterization of this tumor virus, Kaposi's sarcoma-associated herpesvirus(KSHV; also known as human herpesvirus 8(HHV-8)), and its associated diseases. Here we review the current knowledge of KSHV biology and pathogenesis, with a particular emphasis on new and exciting advances in the field of epigenetics. We also discuss the development and practicality of various cell culture and animal model systems to study KSHV replication and pathogenesis.     

The structure, reproduction and taxonomy of Vidalia and Osmundaria (Rhodophyta, Rhodomelaceae)

Comprises species occurring mostly in subtidal habitats in tropical, subtropical and warm-temperate areas of the world. An analysis of the type species, V. spiralis (Sonder) Lamouroux ex J. Agardh, a species from Australia, establishes basic characters for distinguishing species in the genus. These characters are (1) branching patterns of thalli, (2) flat blades that may be spiralled on their axis, (3) width of the blade, (4) primary or secondary derivation of sterile and fertile branchlets and (5) position of sterile and fertile branchlets on the thalli. Application of the latter two characters provides an important basic method for separation of species into three major groups. Osmundaria , a genus known only in southern Australia, was studied in relation to Vidalia , and its separation from the Vidalia assemblage is not accepted. Species of Vidalia therefore are transferred to the older genus name, Osmundaria. Two new species, Osmundaria papenfussii and Osmundaria oliveae are described from Natal. Confusion in the usage of the epithet, Vidalia fimbriala Brown ex Turner has been clarified, and Vidalia gregaria Falkenberg, described as an epiphyte on Osmundaria pro/ifera Lamouroux, is revealed to be young branches of the host, Osmundaria prolifera.     

New or rare chromosome counts in Artemisia L. (Asteraceae, Anthemideae) and related genera from Kazakhstan

Fifteen chromosome counts of six Artemisia taxa and one species of each of the genera Brachanthemum, Hippolytia, Kaschgaria, Lepidolopsis and Turaniphytum are reported from Kazakhstan. Three of them are new reports, two are not consistent with previous counts and the remainder are confirmations of very scarce (one to four) earlier records. All the populations studied have the same basic chromosome number, x = 9, with ploidy levels ranging from 2x to 6x. Some correlations between ploidy level, morphological characters and distribution are noted.     

肝癌中HBV和HCV基因和抗原的分布及意义

采用原位分子杂交方法检测HCV RNA及HBV X基因;采用免疫组织化学方法研究HCV核心抗原,非结构区C33c抗原及HBxAg在肝细胞肝癌中的定位及分布.结果表明(1)HCV RNA、HBV X基因在肝细胞肝癌组织检出率分别为40%(55/136)和82%(112/136).HCV RNA定位于癌细胞的胞浆内,阳性细胞呈散在、灶状及弥漫分布三种形式;HBV X基因在肝癌细胞中的分布呈胞浆型、核型及核浆型,阳性细胞也呈上述三种分布形式;(2)HCV C33c抗原、核心抗原在肝细胞肝癌中的阳性率为81%(133/164)及86%(141/164).C33c抗原定位于癌细胞及肝细胞的胞浆内;核心抗原既定位于癌细胞核中,又可定位于胞浆中.C33c抗原阳性细胞以灶状分布为主;而核心抗原阳性细     

Selection with two alleles and complete dominance

For a plant selection model with frequency-independent viabilities, fertilities and selfing rates, it is shown that apart from global fixation, for certain parameter combinations a protected polymorphism and facultative fixation (either allele may become fixed according to initial frequencies) may both occur. Facultative fixation requires different selling rates for the dominant and recessive type. Protection of the polymorphism requires resource allocation for male and female function. In this connection the problem of purely genetically caused population extinction is discussed.
For general frequency dependence and regular segregation, the chances for establishment of a completely recessive gene are compared to those of a completely dominant gene. It is proven that the process of establishment of the recessive gene, despite a fitness advantage, may be considerably endangered by drift effects if random mating prevails. The recessive gene may reach the same effectivity in establishment as a dominant gene, only if the recessive homozygote mates exclusively with its own type during the period of establishment.