医患纠纷的现状与成因分析

通过2002年9月以来吉林省医学会和长春市医学会医疗事故鉴定材料以及对省内县级以上医疗机构的医务人员和就诊患者进行的问卷调查,分析他们对医患关系现状的看法,探讨医患纠纷的形成原因,为缓解医患纠纷提供参考。     

801例医患纠纷第三方调解案例分析与研究

目的 统计分析医疗纠纷第三方调解案例,为在医院、患方、医患纠纷人民调解委员会三方中解决医患纠纷提供更有效的依据。方法 收集2008—2013年南京市某区医患纠纷调解委员会调解的801份医患纠纷案例进行统计分析,并结合医院、患者、医疗纠纷调解委员会的访谈。结果 医患纠纷调解委员会调解成功率高达98.63%,影响患者获赔额高低的主要因素为医方态度、患者现状和有无医学鉴定;结论 医患双方对医患纠纷调解委员会工作较为认可,促进了医患和谐,但调解工作仍存在困难,建议法律赋予医患纠纷调解委员会一定的调查权和鉴定权。     

医患双方对医患纠纷人民调解认知差异的比较分析

目的 了解医患双方对医患纠纷人民调解认知的差异,从而对医患纠纷人民调解的健康发展提出具有针对性的对策和建议。方法 对广州市6家医疗机构219名医务人员和290名患者进行问卷调查。结果 医方对医患人民调解的知晓情况比患方更好,但总体水平偏低;医患双方均怀疑医患纠纷人民调解解决纠纷的能力;医患双方更看重人民调解的公平公正中立和专业化调解优势;医患双方对医患纠纷人民调解的作用有良好共识。结论 加强宣传力度、创新宣传形式,提高医患双方知晓率和知晓水平;完善调处机制,提高纠纷调处能力;保持中立、维护公平;加强专业性优势建设。     

基于《医疗服务重点环节沟通指南》的和谐医患关系构建

当前医患矛盾和纠纷事件时有发生,与医患之间的沟通不到位有着密切的关系。无锡市人民医院通过调研、实践,明确医疗服务沟通中的重点环节,建立标准化的医患沟通模式,编出符合当前实际的“医疗服务重点环节沟通指南”,并将其应用于临床,从而实现强化以医方为主导的医患沟通理念、提升沟通能力、融洽医患关系、促进医院发展的目标。     

论法律视野中医患关系的性质

医患关系法律性质的准确界定是医患纠纷妥善解决的基本前提。目前，我国关于医患关系法律性质的四种主流观点往往把医患关系归属于某种法律关系，这样的做法都显得会以偏概全或牵强附会。医患关系的基本法律属性是民事法律关系，但具有区别于一般法律关系的特征，是特殊的民事法律关系，在医患纠纷阶段，是民事侵权关系。     

浅论神经外科医患沟通的特点、困境和技巧

近年我国医患矛盾频发、医患关系紧张。有效的医患沟通,有助于提高医疗服务质量,保障医疗服务安全;有助于避免或减少医疗纠纷,构建和谐医患关系。神经外科疾病类型多,变化快,诊断复杂,进展迅猛,治疗风险和费用高,容易发生医患纠纷;优秀的神经外科医生应该掌握良好的医患沟通技巧,维系和谐医患关系。     

不同国家医患纠纷处理方式研究

现阶段我国的医患纠纷日益增多,医患矛盾尖锐。寻求合理的医患纠纷处理方式具有重要现实意义。对于医患纠纷的处理,世界各国均有较多尝试。美国、德国、日本、中国台湾地区等也出现了诸多处理方式。通过对这些处理方式的比较与分析,旨在吸取经验,为改善医患关系,提高医疗服务质量抛砖引玉。     

我国医患纠纷处理的几种尝试及思考

现阶段我国的医患纠纷日益增多,医患矛盾尖锐。寻求合理的医患纠纷处理方式具有重要现实意义。对于医患纠纷的处理,世界各国均有较多尝试,美国、德国、日本、中国台湾地区等也出现了诸多处理方式。通过对这些处理方式的比较与分析,旨在吸取经验,为改善医患关系,提高医疗服务质量抛砖引玉。     

医患关系双方认知差异比较研究

目的 为了解医患双方对医患关系认知的差异,从而对构建和谐医患关系提出具有针对性的对策和建议。方法 对北京、武汉和成都的6家医疗机构的375名医务人员和702名患者进行问卷调查。结果 医方认为医患关系紧张的比例明显高于患方,医患关系现状对医方影响较大;医患双方均认为医疗体制、媒体舆论是医患关系的主要影响因素;医患双方对现行医患纠纷的防范和解决措施认可度均较低。结论 加强医患间的有效沟通;健全医疗体制,促进和谐医患关系;树立舆论宣传的正确导向作用;建立健全有效的医患纠纷的解决机制,探索有效的预防措施。     

医患关系困境的制度影响因素及策略分析

目的 从制度角度探讨医患关系恶化的原因,并给出制度角度上具体的实施建议。方法 运用文献研究法及专题小组讨论法得出医患关系的制度影响因素集合,根据问卷调查结果进行因子分析研究。结果 医患关系深深嵌入到复杂的社会制度体系中,制度、道德文化、目标等八个领域决定医患关系和谐程度,基于因子分析结果,投入制度、强制约束制度和运行与管理制度是医患关系问题的深层制度根源。结论 通过立法建立可持续投入机制,建立解决医患冲突的法律法规、仲裁机制和责任分担制度,采取分级诊疗分化医疗费用压力,加强制度手段对医患关系的统筹管理。     

Embryo and Endosperm Function and Failure inSolanumSpecies and Hybrids

Although the importance of the endosperm as a food store inmany angiosperm seeds is well known, its significance duringearly embryogenesis has been neglected. In many interspecifichybrids, and in some other situations, embryos do not developfully and abort. It has often been stated that this is causedby the endosperm failing to conduct sufficient nutrients tothe embryo, but seldom has it been suggested that the endospermactively controls most of the early stages of morphogenesisof the embryo. Information gleaned from a broad survey of theliterature, combined with additional evidence presented here,obtained fromSolanum incanumand interspecific hybrids, indicatethat the endosperm is dynamic and very active in regulatingearly embryo development. This requires highly integrated geneticcontrol of rapidly changing metabolism in the endosperm. Ininterspecific hybrids, lack of coordination may cause unbalancedproduction of growth regulating substances by the endospermand hence abortion of the embryo, or even unregulated productionof nucleases and proteases resulting firstly in autolysis ofthe endosperm and then digestion of the embryo. The endospermmay thus serve to detect inappropriate hybridization of speciesor ploidy levels and so prevent waste of resources by producingseeds that would result in sterile hybrids or unthrifty subsequentgenerations. This discriminatory function of the endosperm hasdiminished during evolution and domestication of the crop plantSolanummelongenaL.Copyright 1998 Annals of Botany Company Solanum, embryo morphogenesis, endosperm, hybrid, seed development.     

HIFs and tumors--causes and consequences

For most organisms oxygen is essential fo life. When oxygen levels drop below those required to maintain the minimum physiological oxygen requirement of an organism or tissue it is termed hypoxia. To counter act possible deleterious effects of such a state, an immediate molecular response is initiated causing adaptation responses aimed at cell survival. This response is mediated by the hypoxia-inducible factor-1 (HIF-1), which is a heterodimer consisting of an alpha- and a beta-subunit. HIF-1 alpha protein is stabilized under hypoxic conditions and therefore confers selectivity to this response. Hypoxia is characteristic of tumors, mainly because of impaired blood supply resulting from abnormal growth. Over the past few years enormous progress has been made in the attempt to understand how the activation of the physiological response to hypoxia influences neoplastic growth. In this review some aspects of HIF-1 pathway activation in tumors and the consequences for pathophysiology and treatment of neoplasia are discussed.     

Pragmatic Women and Body Politics and Maternities and Modernities: Colonial and Postcolonial Experiences in Asia and the Pacific

Pragmatic Women and Body Politics. Margaret Lock and Patricia A. Kaufert. eds. Cambridge, UK: Cambridge University Press, 1998. xii +364 pp.
Maternities and Modernities: Colonial and Postcolonial Experiences in Asia and the Pacific. Kalpana Ram and Margaret Jolly. eds. Cambridge, UK: Cambridge University Press, 1998. xiv. 305 pp.     

环腺苷酸应答元件结合蛋白与学习记忆

环腺苷酸(cAMP)应答元件结合蛋白(cAMP response element binding protein,CREB)是一种核转录因子,可与cAMP反应元件结合,调节基因转录,具有调节精子生成,昼夜节律,学习记忆等功能.近年来关于其在学习记忆中的作用成为医学研究热点.CREB是神经元内多条信息传递途径的汇聚点,参与长时记忆形成和突触可塑性.长时记忆(long-term memory)形成需依赖CREB介导的基因转录,干扰或抑制CREB活性可破坏长时记忆.长时程增强(long-term potentiation,LTP)是研究学习记忆的理想模型,在LTP诱导和维持过程中均可观察到CREB活性持续升高.但增龄过程中,海马CREB活性下降,影响学习记忆功能,与许多神经退行性疾病发生有关.     

Morphological and constitutional features and self-esteem in children and adolescents

Studies of human constitution and mental features are traditionally among the main concepts of anthropological research. In this research, we attempted to discover connections between morphological and constitutional features and self-esteem in children and adolescents. Such a connection was discovered in some studied age groups. The obtained results could serve as a basis for further studies in this field.