湖北省县级公立医院改革试点医院人力资源配置分析

??????? 目的 了解县级公立医院改革试点医院人力资源配置现状,为合理配置县级公立医院人力资源提供依据。方法 采用现场问卷调查的方法对湖北省12家县级公立医院的960名医护人员进行调查,并对结果进行描述性统计和Spearman秩相关分析 。结果 (1)县级公立医院人力资源数量低于全国平均水平; (2)县级公立医院规模扩张,但是人力资源补给不足;(3)医务人员素质偏低。结论 宏观调控县级公立医院人力资源、促进县级医院的人才引进和培养、增强人力资源质量建设,以提高县级公立医院医疗服务水平。     

Effects of lactoferrin feeding on growth,feed intake and health of calves

Abstract

Lactoferrin (LF) exhibits a broad spectrum of anti-microbial properties and may have regulatory functions in the immune system. In the present study, 40 calves (20 males, 20 females) were used to examine the effects of supplemental bovine LF added to colostrum and milk replacer (at 0.16%) on health, weight development and feed intake during a 70-day experimental period. The calves were allocated to a treatment group (n = 20) and a control group (n = 20); the groups were balanced in terms of sex, live weight and date of birth. Body weight and feed intake were measured at regular intervals. Blood and colostrum samples were collected to determine the content of IgG. In addition, colostrum and milk replacer samples were analysed for their LF concentrations. Significantly higher IgG values were observed in the LF treated than in the control group during the entire feeding experiment from week 2 to week 6. Calves receiving LF had less days of disease with less serious cases of diarrhoea than the control group. Body weight and feed intake were not significantly different between the treatments; in male calves LF-treated animals tended towards higher weight gains. This study indicates that LF is advantageous for health and may therefore be a beneficial supplement in the diets for neonatal calves.     

Climatic effects in Central Europe on the frequency of medical treatments of dairy cows

In the present study, the relationship between the temperature–humidity index (THI) and the incidence of medical treatments in lactating dairy cows in Lower Saxony, Germany, was investigated. Records of all veterinary-treated cases over 2 years (2003 and 2005) from eight Holstein–Friesian dairy herds raised in loose-housing systems (55 to 170 cows per herd) were evaluated. After exclusion of management-dependent and climate-independent cases, a total of 5547 treatments were analyzed. Treatments were clustered into the following groups: metabolism, fertility, udder and foot/leg. Meteorological data were compiled from the nearest weather station (average distance ± s.d. 39 ± 13 km). Hourly temperatures and relative humidity values were used to calculate the THI, which was divided into classes. Out of the total number of treatments, 37.4%, 32.9%, 21.6% and 8.1% belonged to metabolism, udder, fertility and foot/leg, respectively. Data were analyzed with a mixed model that included THI class, season and year as fixed effects and farm as random effect. In general, incidences were neither affected by the year (P > 0.05) and season (P > 0.05) nor by THI classes (P > 0.05). In tendency, incidences of metabolic treatments increased with increasing THI and incidences of udder treatments increased with decreasing THI. In conclusion, indications of moderate heat stress during summer months in Central Europe were found in the present study, although THI and season did not affect the different disease complexes significantly.     

我国现行医疗卫生政策的相关问题分析

医疗卫生是构建和谐社会的重要因素之一,也是关乎百姓切身利益的重大问题之一,近年来,医疗体制的不断改革,医疗卫生的相关政策的不断出台,已经大大地改善了我国广大人民群众的“看病难,看病贵”等问题,增加了医保的覆盖人群,减轻了城市低收入人群及农村的医疗负担,但是,我们仍面临着巨大的挑战,新的问题也不断涌现,医疗卫生政策不适应现在的医疗需求发展、经济发展不均衡、不同层次群众的医疗需求有差异等,都是医疗卫生改革中面临的问题,医疗改革的不断推进势在必行。我国的医疗保障制度覆盖率已经达到95％,但是,现行的医疗保障制度的还不能从根本上解决人民群众的“就医难,治病贵”的问题,其他医疗保险不能与现行的医疗保障制度相适应,从而,影响了我国整体的医疗水平的提高。     

介入治疗成人非创伤性股骨头缺血性坏死的疗效分析

目的：分析介入治疗对于成人非创伤性股骨头缺血性坏死的疗效。方法：采用介入方法治疗95例共117髋非创伤性股骨头缺血性坏死。对比介入治疗前后DSA造影分型结果及血供异常例数。结果：117患髋中,Ia型的31病髋中,11髋（35．48％）介入治疗后动脉主干再通;Ib型的27髋中,24髋（88．89％）介入治疗后分支再通;II型的11髋中,5髋（45．45％）实质期股骨头缺损面积缩小;III型的10髋中,8髋（80．00％）静脉期见股骨头浓密染色明显减轻;Ⅳ型的33髋中,28髋（84．85％）可见动脉主干再通、分支增粗、实质期股骨头缺损面积缩小和静脉期股骨头染色减轻等。治疗前117病髋异常率为95．73％。经过介入治疗后,异常率为30．77％。治疗后异常率明显低于治疗前异常率（P〈0．01）。结论：介入治疗可有效改善非创伤性股骨头缺血性坏死血供异常,增加股骨头血供,具有操作简单、创伤小、疗效确切等优点。关键阗：股骨头缺血性坏死;介入治疗;数字减影血管造影     

三维CT血管造影在颅内动脉瘤夹闭术后复查中的应用

目的:评价三维CT血管造影(3D-CTA)在颅内动脉瘤夹闭术后复查中的应用价值.方法:选取我院神经外科2010年8月至2012年1月间,共42例颅内动脉瘤夹闭术后患者(45个动脉瘤),分别于动脉瘤夹闭术后5-7天,5-6个月,12个月接受三维CT血管造影(3D-CTA)和数字减影血管造影(DSA)检查,以DSA为金标准,判断CTA对动脉瘤术后残留、血管闭塞狭窄等检出的灵敏度和特异度.结果:3D-CTA发现4例瘤颈残留,1例吻合血管闭塞,28例载瘤动脉通畅,6例术中阻断的载瘤动脉不显影,61个动脉瘤夹均可清晰辨识,与DSA结果一致.3D-CTA评价瘤颈残留与载瘤动脉、吻合血管通畅的灵敏度和特异度均为100％,一致性为1.0.结论:3D-CTA检查操作简便,结果真实可靠,临床应用价值极高,能够很好的显示动脉瘤夹闭术后改变,可作为颅内动脉瘤夹闭术后长期多次随访的主要方法.     

A meta‐analysis of cardio‐metabolic abnormalities in drug naïve,first‐episode and multi‐episode patients with schizophrenia versus general population controls

A meta‐analysis was conducted to explore the risk for cardio‐metabolic abnormalities in drug naïve, first‐episode and multi‐episode patients with schizophrenia and age‐ and gender‐ or cohort‐matched general population controls. Our literature search generated 203 relevant studies, of which 136 were included. The final dataset comprised 185,606 unique patients with schizophrenia, and 28 studies provided data for age‐ and gender‐matched or cohort‐matched general population controls (n=3,898,739). We found that multi‐episode patients with schizophrenia were at increased risk for abdominal obesity (OR=4.43; CI=2.52‐7.82; p<0.001), hypertension (OR=1.36; CI=1.21‐1.53; p<0.001), low high‐density lipoprotein cholesterol (OR=2.35; CI=1.78‐3.10; p<0.001), hypertriglyceridemia (OR=2.73; CI=1.95‐3.83; p<0.001), metabolic syndrome (OR=2.35; CI=1.68‐3.29; p<0.001), and diabetes (OR=1.99; CI=1.55‐2.54; p<0.001), compared to controls. Multi‐episode patients with schizophrenia were also at increased risk, compared to first‐episode (p<0.001) and drug‐naïve (p<0.001) patients, for the above abnormalities, with the exception of hypertension and diabetes. Our data provide further evidence supporting WPA recommendations on screening, follow‐up, health education and lifestyle changes in people with schizophrenia.     

Simple and noninvasive method for assessment of digestive efficiency: Validation of fecal steatocrit in greenfinch coccidiosis model

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Badgers prefer cattle pasture but avoid cattle: implications for bovine tuberculosis control

Effective management of infectious disease relies upon understanding mechanisms of pathogen transmission. In particular, while models of disease dynamics usually assume transmission through direct contact, transmission through environmental contamination can cause different dynamics. We used Global Positioning System (GPS) collars and proximity‐sensing contact‐collars to explore opportunities for transmission of Mycobacterium bovis [causal agent of bovine tuberculosis] between cattle and badgers (Meles meles). Cattle pasture was badgers’ most preferred habitat. Nevertheless, although collared cattle spent 2914 collar‐nights in the home ranges of contact‐collared badgers, and 5380 collar‐nights in the home ranges of GPS‐collared badgers, we detected no direct contacts between the two species. Simultaneous GPS‐tracking revealed that badgers preferred land > 50 m from cattle. Very infrequent direct contact indicates that badger‐to‐cattle and cattle‐to‐badger M. bovis transmission may typically occur through contamination of the two species’ shared environment. This information should help to inform tuberculosis control by guiding both modelling and farm management.     

Genes,symptoms, and the “asymptomatic ill”: toward a broader understanding of genetic discrimination

Since the early 1990s, the term “genetic discrimination” has been used to designate adverse treatment on the grounds of genetic makeup. However, the full spectrum of possible disadvantage associated with genetic information has not been addressed by either the international scientific debate or statutory arrangements on genetic discrimination. Informed by legal contexts, they almost all focus on one specific group: the “asymptomatic ill.” On the basis of the sociological study, “Genetic Discrimination in Germany,” this article proposes to revise the terms of the debate and discusses some limitations of the concept. Drawing on the experiences reported by affected individuals, it advocates a more expansive social understanding which does not require that a person has to be healthy to be at risk of genetic discrimination.