我国公立医院功能、规模、布局、结构的历史回顾

通过对我国公立医院的规模、结构、布局、功能等方面进行文献研究,收集相关数据,客观呈现我国公立医院规模、结构、布局等发展的历史进程、现状,发现当前公立医院在规模、结构、布局等方面存在的问题,提出相应的建议：明确卫生体制的基本价值取向,合理调整卫生资源布局与结构,提高医疗卫生服务提供的公平与效率,加强政府的宏观调控和统筹规划及监管能力。     

试论政府职能转变与公立医院管理体制改革

当前,如何加快推进政府行政管理体制改革,实现政府职能重构,已成为我国经济社会整体转型的现实要求。公立医院改革是我国医疗卫生体制改革的核心乃至关键环节,只有把公立医院改革提升到体制改革的层面,实现政府医疗卫生服务管理职能的重构与转变,才能推动公立医院管理体制和治理结构改革,也才能构建与市场经济体制和社会需求相适应的基本医疗卫生制度,从而实现全社会医疗福利最大化的医改最终目标。     

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。     

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。     

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。     

科学配置医疗资源 提升卫生服务能力

在分析了南京市科学配置医疗资源的现状与实践的基础上,总结了提升卫生服务能力所面临的困难和挑战。在推进改革的进程中,南京市从修订医疗机构设置规划入手,优化卫生资源配置,引入竞争机制,推动城区二级医院转型;通过创新驱动,实施“三名战略”,提高医疗卫生整体服务水平;通过加强基层医疗卫生服务、公共卫生和应急能力建设,关口前移,重心下沉,打造“十五分钟健康服务圈” ,探索公立医院运行机制改革的新思路。     

积极推进公立医院改革的关键举措——《“十二五”期间深化医药卫生体制改革规划暨实施方案》评述

《“十二五”期间深化医药卫生体制改革规划暨实施方案》明确积极推进公立医院改革是3个重点突破的领域之一。公立医院作为医疗服务供给的主要单位,其改革的成功与否,最终将直接关系到深化医药卫生体制改革的成败。指出规划更具操作性,在公立医院改革方面具有3个显著特点,并提出在具体实施中要处理好3个关系,即改革优先顺序的关系、职能与资源的关系、基础环境与改革的关系。

     

中小城市公立医院基础设施建设的必要性分析

公立医院改革是医药卫生体制改革方案确定的五项重点改革内容之一,中小城市公立医院是改革的重中之重。通过SWOT分析、统计数据分析和市场需求分析,进一步探讨中小城市公立医院建设的必要性,提出了优化资源配置、加强医院建设、合理医疗布局、完善服务体系对提高医疗服务的可及性和基层医疗服务能力具有积极的促进作用。     

对城市大型医院优质医疗资源下沉若干问题的思考

改革县级公立医院的运行机制,提升县级公立医院服务能力,发挥县级公立医院的区域基本医疗中心的作用,是体现公立医疗机构的公益性,解决基层群众就医需要的关键措施。文章结合我国医疗资源配置的区域失衡,通过对浙江省城市大型医院与县级公立医院通过托管等不同形式建立协作关系的情况和效果进行了总结,对城市大型医院优质医疗资源下沉到县区开展医疗服务的活动进行了评价和分析,并且进一步阐述了从根本上改变区域医疗资源失衡、完善医疗服务体系、促进医疗卫生事业健康发展的策略。     

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.