医院等级评审对平均住院日的影响及意义

目的 研究医院等级评审工作对降低医院平均住院日指标的效果,分析其作用和意义。方法 收集医院2013年度医疗数据,运用描述性统计学方法、相关性分析和线性回归对一系列迎评医疗管理举措和平均住院日的相关性进行分析。结果 住院患者手术比率、出院患者当日出院比率、诊断符合率与平均住院日显示相关关系,线性回归分析具有统计学意义。结论 医院等级评审系列工作对平均住院日有显著影响,对提升医院医疗质量建设具有关键导向性作用。     

临床路径对短暂性脑缺血患者影响的ITS分析

目的 了解某医院实施临床路径改革对短暂性脑缺血发作（transient ischemic attack,TIA）患者药费、检查费和住院日的影响。方法 使用间断时间序列分析方法（ITS）分析方法对医院2012年12月至2015年5月TIA患者药费、检查费和住院日进行分析。结果 检查费、住院日显著性下降,药费下降但无统计学意义。结论 实施临床路径改革对缩短患者住院日和控制医疗费用具有积极作用。     

辽宁省医疗资源纵向整合模式特征及效果分析

通过对辽宁省县级综合医院的调查,分析了自2008年以来辽宁省启动实施医疗资源纵向整合改革的特征和效果。反映出通过医疗资源纵向整合的实施,推动城市大医院的优质医疗资源向县及县以下流动,有利于改变医疗卫生资源配置不均衡的状况;提升县医院医疗服务效率,增强医疗服务能力;有利于增加医院住院医疗服务数量,降低新农合县外转诊率增幅。     

影响平均住院日的主要因素分析与对策

平均住院日是评价医院效率、医疗质量、管理水平的综合性指标之一。通过对医院近3年来平均住院日等相关核心医疗指标的分析,找出影响医院平均住院日的主要因素,深入研究并提出对策,以便采取科学合理的措施,在确保医疗质量和医疗安全的同时,有效缩短平均住院日,降低患者医疗费用,提高医院的社会效益和经济效益。     

辽宁省县级医院医疗技术纵向整合现状调查分析

通过对辽宁省县级医院医疗技术纵向整合情况的调查,了解到开展医疗技术纵向整合有效地促进了调查县级医院医疗技术水平的提高,但整合机制和制度有待进一步完善,应建立信息化整合工作平台,并加大财政支持力度。     

综合性医院平均住院日绩效指标集的构建与应用

目的 构建以平均住院日为核心的绩效指标集,在此基础上,制定绩效目标及关键控制举措,并跟踪实际的执行效果。方法 收集2008年12月—2013年6月共计55个月的重点科室平均住院日数据,运用相关性分析和多元线性回归提取影响平均住院日的显著因素,根据模型结论,研究分析绩效控制目标和举措并进行应用。结果 现阶段有效缩短平均住院日应主要解决“收容收治比及床位资源的利用效率”两对关键矛盾,模型应用后,医院院整体平均住院日由原来的15.7天降低为11.6天,重点科室平均住院日由19.2天降低为14.6天。结论 平均住院日绩效指标集的应用有助于优化医院资源配置,达到显著提高整体运营效率的目的。     

实施当日出院制度对平均住院日的影响及意义

目的 探讨实施当日出院制度对缩短平均住院日指标的效果,分析其作用和意义。方法 收集医院2013年度医疗数据,运用描述性统计学方法和线性回归当日出院和平均住院日的相关性进行分析。结果 2012年11月—2013年10月,全院平均住院日呈逐月下降趋势;同时住院患者当日出院比例增长明显。平均住院日和当日出院比例散点图显示相关性,线性回归分析具有统计学意义,两者呈高度负相关（r＝-0.739,P＝0.006）。结论 住院患者当日出院比例对平均住院日有显著影响。为进一步缩短平均住院日,相关职能部门可以采取优化流程,加快出院结算,放开住院病患当日出院服务的政策措施。     

基于灰熵关联的平均住院日影响因素研究

目的:分析医疗指标与平均住院日的关联程度,为医院有效缩短平均住院日提供参考依据。方法:建立基于灰熵优化的加权灰色关联度模型,对影响平均住院日的医疗指标进行重要程度的分析。结果:根据关联程度分析,可知影响平均住院日的医疗指标重要程度依次为开放床位数、床位周转次数、治疗有效率、床位使用率、年门诊量、住院手术人次和出院人数。结论:基于灰熵优化的加权灰色关联分析方法可以有效分析医疗指标对平均住院日的影响程度,提高医疗服务质量。     

三级综合性医院平均住院日影响因素分析

平均住院日是衡量医院医疗技术水平、医疗服务质量的综合性指标,平均住院日的长短反应医院的医疗工作效率及医院综合管理水平。运用病历分析及问卷调查相结合的方法,初步筛选出影响平均住院日的因素,然后通过因子分析法对初步筛选出的因素进进行降维、数据浓缩等处理,最终将影响平均住院日的因素按照重要程度进行排序。旨在更好的有针对性的管理这些因素,从而科学地缩短平均住院日,最终保证医疗质量水平的提高。     

2002—2009年我院平均住院日变化及效果分析

目的 分析2002—2009年平均住院日等住院指标的变化。方法 通过绘制时间序列图和计算指标间的偏相关系数说明医院住院指标的变化情况。结果 医院平均住院日呈不断下降趋势,同时床位周转率不断加快,病人的医疗费用负担并没有增加,病人总体治疗效果得到提升。结论 近年来平均住院日不断缩短,这有利于医院业务发展、减轻患者负担。     

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.