Something to be done: treating HIV/AIDS. River Path Associates

Largely because of disparities in access to drug treatment and care, AIDS morbidity and mortality have fallen in the developed world but continue to rise among developing countries. Achieving more equitable access to AIDS drugs is hindered by high drug prices, technical complexities related to the provision of health care, and conflict among stakeholders. Recognition that health is vital to the prospects of the emerging global society must be combined with new mechanisms to help all stakeholders work together cooperatively. Tiered drugs pricing should be coupled with investment in health services. An independent "Global Task Force," able to act as an "active think tank," could build consensus about the way forward.     

Health care and education: on the threshold of space

The studies described herein represent some of the most sophisticated social and technical experiments ever attempted in education and health care delivery. It is hoped that the lessons learned from them will bring us much closer to the goal of providing good quality health care and education in areas that are away from metropolitan centers.     

从“和法”探析柴胡三参汤加减治疗冠心病室性期前收缩

室性期前收缩是冠心病患者最常见心律失常并发症之一,轻者仅表现为心悸症状,重者可至严重心律失常,甚至可能猝死,西医主要采用抗心律失常药物及导管消融术治疗,但导管消融术并不适用于全部室性期前收缩,抗心律失常药物副作用明显且可致心律失常,而中药治疗室性期前收缩疗效明显,副作用较少。刘建和教授在临床中运用"柴胡三参汤加减"治疗冠心病室性期前收缩取得了明显的疗效,重点从"和法"探析"柴胡三参汤加减"治疗冠心病室性期前收缩。     

Small area variations in health care delivery

Health information about total populations is a prerequisite for sound decision-making and planning in the health care field. Experience with a population-based health data system in Vermont reveals that there are wide variations in resource input, utilization of services, and expenditures among neighboring communities. Results show prima facie inequalities in the input of resources that are associated with income transfer from areas of lower expenditure to areas of higher expenditure. Variations in utilization indicate that there is considerable uncertainty about the effectiveness of different levels of aggregate, as well as specific kinds of, health services. Informed choices in the public regulation of the health care sector require knowledge of the relation between medical care systems and the population groups being served, and they should take into account the effect of regulation on equality and effectiveness. When population-based data on small areas are available, decisions to expand hospitals, currently based on institutional pressures, can take into account a community's regional ranking in regard to bed input and utilization rates. Proposals by hospitals for unit price increases and the regulation of the actuarial rate of insurance programs can be evaluated in terms of per capita expenditures and income transfer between geographically defined populations. The PSRO's can evaluate the wide variations in level of services among residents of different communities. Coordinated exercise of the authority vested in these regulatory programs may lead to explicit strategies to deal directly with inequality and uncertainty concerning the effectiveness of health care delivery. Population-based health information systems, because they can provide information on the performance of health care systems and regulatory agencies, are an important step in the development of rational public policy for health.     

Cognitive recovery in socially deprived young children: the Bucharest Early Intervention Project

In a randomized controlled trial, we compared abandoned children reared in institutions to abandoned children placed in institutions but then moved to foster care. Young children living in institutions were randomly assigned to continued institutional care or to placement in foster care, and their cognitive development was tracked through 54 months of age. The cognitive outcome of children who remained in the institution was markedly below that of never-institutionalized children and children taken out of the institution and placed into foster care. The improved cognitive outcomes we observed at 42 and 54 months were most marked for the youngest children placed in foster care. These results point to the negative sequelae of early institutionalization, suggest a possible sensitive period in cognitive development, and underscore the advantages of family placements for young abandoned children.     

Rationing health care: the choice before us

Rapid technological advances and upward pressure on wages of hospital personnel are leading to a steady increase in health care spending that is absorbing an ever-larger fraction of gross national product. Eliminating inefficiencies in the system can provide brief fiscal relief, but rationing of beneficial services, even to the well-insured, offers the only prospect for sustained reduction in the growth of health care spending. The United States, which has negligible direct experience with rationing, can learn about choices it will face from the experience of Great Britain where health care has been rationed explicitly for many years.     

鲁西地区猪胸膜肺炎放线杆菌流行病学调查

1材料与方法 1．1材料 1．1．1病料及鼻拭子。疑似传染性胸膜肺炎猪的肺病料186份以及545份无临床症状健康猪鼻拭子均来自鲁西地区的22个猪场。     

匹茨堡大学医学中心腔镜微创食管切除术101例临床分析

目的了解匹茨堡大学医学中心施行101例腔镜微创食管切除术的疗效。方法分析101例腔镜微创食管切除术的基本手术技术、手术时间、住院时间、出血量、吻合口瘘发生和死亡情况。结果腔镜微创食管切除、食管胃胸腔内成功吻合93例,手术平均时间6．5h,术中转开腹2例、开胸6例,平均出血量300mL,淋巴结清扫平均为15．6个。术后患者在重症监护室的时间平均为1d,平均住院时间7d,食管胃吻合口瘘2例,死亡1例。结论腔镜微创食管切除术安全、可靠,患者术后恢复快,并发症少,并可进行相关区域淋巴结的根治性清扫。     

Health and urban living

The majority of people now live in urban areas and will do so for the foreseeable future. As a force in the demographic and health transition, urbanization is associated with falling birth and death rates and with the shift in burden of illness from acute childhood infections to chronic, noncommunicable diseases of adults. Urban inhabitants enjoy better health on average than their rural counterparts, but the benefits are usually greater for the rich than for the poor, thus magnifying the differences between them. Subject to better evidence, I suggest that the main obstacles to improving urban health are not technical or even financial, but rather are related to governance and the organization of civil society.     

Chinese Honey Positioning and Price Trend in Domestic Market

China's bee industry is a small proportion of domestic agriculture with fewer farmers, and the government didn't attach much attention to or give supports to it. Agricultural production sector does not fully recognize the economic value of honeybee pollination. Chinese beekeepers gain profits only from products such as honey, royal jelly and bee pollen. Because of the production mode that aims at gathering and producing more honey while neglecting the health care of bees and the quality of products; export enterprises lack guidance and knowledge in export inspection and quarantine and technical regulations, and thus, the average price of China's bee honey exports is much lower than that of other countries in the world. Meanwhile, in domestic market, given the sustained development of China's macro economy and increasing incomes of residents, people show increasing interests in the health care function of honey. Based on the survey data of honey market in Beijing, Hangzhou, Qingdao, Zhengzhou and Chengdu from 2012 to 2015, the paper analyzes the price feature of China's honey market and its formulation basis, and also compares prices of honey with the same quality in different markets. Moreover, the paper combines data from fixed observation places of honey products production, which is carried out by the economic research group of bee industry in 11 provinces, to discuss reasons for continuous honey price rising in domestic market. Lastly, the paper uses the honey as an example to analyze pricing strategy of agricultural products with health care functions. The paper hold the opinions that the keys to solve the problem that high quality agricultural material couldn't sell in high price and good and bad are mixed in the market, is to build up quality and price mechanism in the processing of raw material purchasing to the terminal market, publicize more products information and superior customer attractiveness on health care effect.     

Protection of privacy and confidentiality

A multistate, cooperative program seeking to develop better methods for the effective and efficient gathering. storing, analyzing, and utilizing of mental patient records has made a comprehensive effort to protect the confidentiality and privacy of these psychiatric patient records. Administrative, technical, and legal safeguards have been implemented. The discussion of legal safeguards involves two areas: the protection of the system itself, located at Rockland State Hospital; and the specific legal environment of confidentiality and privacy of mental health records and information in the group of cooperating jurisdictions. On the whole, adequate legal and administrative protection can be afforded the confidentiality and privacy of an electronic data system in the mental health field, and access to the records can be restricted for the welfare of the patients. At the same time, access to aggregate data in the system can be allowed, under proper standards, for important research and planning purposes. The methods adopted by MSIS to preserve confidentiality and privacy by limiting access to such records could well prove an important model for the development of protective methods in other electronic data programs-not only those in psychiatry, but those in other fields where the data collected are sensitive and confidential.     

洋葱深加工综合利用途径及展望

简要介绍洋葱的营养及医疗保健价值、深加工的综合利用途径及技术特点,综述了洋葱深加工的研究进展和应用现状,同时展望了洋葱深加工产品未来的发展趋势。     

油菜花粉研究概况

近几年来，伴随着人们对医疗健康的重视及天然药物制剂的快速发展，油菜花粉中所富含的药用成分及保健作用渐渐被发现和研究。综述了油菜花粉的化学成分、药理作用、保健作用及临床应用，以期为油菜花粉的开发利用提供一定的科学依据。     

基于社交平台的老年用户健康信息采纳行为影响因素研究——以微信为例

[目的/意义]基于人口老龄化的社会背景,本文旨在探究社交平台中老年用户健康信息采纳行为的影响因素,为社交平台筛选健康信息,优化老年人群健康信息服务提供借鉴。[方法/过程]采用质性研究方法,选取27位正在使用微信平台获取健康信息的老年用户作为研究对象。采用半结构化访谈就老年用户健康信息采纳行为影响因素获取一手访谈数据。采用主题分析法为主导工具对访谈数据进行分析。[结果/结论]结果表明,个体特征、信息质量、技术支持、生活环境是影响老年用户健康信息采纳的关键因素。基于此,本文最终构建了基于社交平台的老年用户健康信息采纳行为影响因素模型并深入探讨了各类因素与采纳行为之间的作用机理。此外,为促进社交平台发展,提升其健康信息服务能力,本文分别从社交平台开发方以及使用方两个方面提出了相关建议。     

Genomic medicine and the future of health care

Genomic technologies and computational advances are leading to an information revolution in biology and medicine. Simulations of molecular processes in cells and predictions of drug effects in humans will advance pharmaceutical research and speed up clinical trials. Computational prognostics and diagnostics that combine with genotyping and molecular profiling may soon cause fundamental changes in the practice of health care.     

女性青少年门诊就诊疾病特征分析——以重庆市妇幼保健院为例

目的:了解重庆市女性青少年门诊就诊疾病的现状及特点,为青少年健康宣教提供依据,促进青春期保健工作更加有效地实施.方法:选择2014年1月-2017年12月35 649例在重庆市妇幼保健院门诊就诊的女性青少年作为研究对象,分别针对不同年龄组就诊人次数、前5类就诊原因及不同年龄的疾病热点进行分析.结果:随着年龄增长,就诊人次数逐渐增加;前5类就诊原因分别为妇科内分泌疾病、妊娠及相关疾病、计划生育、妇科炎性疾病、健康体检;10岁组以妇科炎性疾病为主,11~17岁各组以妇科内分泌疾病为主,18~19岁2组妊娠及相关疾病、计划生育问题为主要原因.结论:妇科内分泌疾病为女性青少年就诊的主要原因,不同年龄组女性青少年就诊主要疾病谱存在差异,青春期保健应针对青少年就诊的疾病热点开发更适宜的健康教育课件,采取多种形式进行健康宣教,政府主导、医教联动,做好青春期保健工作.     

新生代农民工城市融入的困境与对策

改革开放背景下成长起来的新生代农民工逐渐成为外出农民工的主体,却依然面临着制度供给、政治参与、文化认同及素质提升等方面的重重障碍,被排斥在城市边缘;传统的城乡二元结构正逐步在演变为城市内部新的二元结构。新形势下,促进新生代农民工的城市融入,需要为他们创造一个公平、公正的社会制度环境,加强他们的组织化程度,提高他们的技能水平,强化他们的社会支持网络,逐步将他们纳入教育、医疗、住房等社会保障体系,使其充分享有"同城待遇"。     

湖南省公共医疗卫生支出效率及其影响因素实证分析

利用DEA-Tobit两阶段分析法，计算出2009-2013年5年间湖南省14个地级市政府公共医疗卫生支出的综合技术效率值、纯技术效率值、规模效率值三种效率值，分析出湖南省各地级市政府公共医疗卫生支出所处规模报酬阶段，并对反映卫生支出资金配置的综合技术效率水平的外部影响因素加以回归分析.结果发现：湖南省各地区公共医疗卫生效率水平整体水平偏低并且存在明显的差异性，除长沙以外的其他地级市政府公共医疗卫生支出均处于不同程度的非充分效率水平.湖南省各地区人均生产总值及城市化水平对公共医疗卫生支出效率有显著的促进作用.教育水平、人口密度、居民人均可支配收入对湖南省公共医疗卫生支出效率的提高有阻碍作用.     

仔猪黄痢防治技术研究

仔猪黄痢是新生仔猪的一种常见病,常造成新生仔猪死亡或生长发育不良,由于现有预防和治疗药剂的药效不高或成本高,成为我国发展养猪业的严重障碍之一.本研究通过选用新研制的动物保健饮料"仔畜壮"对仔猪黄痢进行预防和治疗试验研究,结果表明:用"仔畜壮"预防和治疗仔猪黄痢均收到较好效果.在黄痢的预防试验中,使用"仔畜壮"的试验组预防效果达到99.5%,而使用庆大霉素的对比组预防效果为67%;在对发病猪进行治疗的试验中,使用"仔畜壮"的试验组治愈率为100%,而使用庆大霉素的对照组治愈率为66%;在对仔猪的保护性试验中,使用"仔畜壮"的试验组保护率为100%,而使用庆大霉素的对照组保护率为90.8%.     

Ethics for an international health profession

These thoughts about an ethic of international health can be summarized in a very free revision of the Hippocratic Oath: I will share the science and art by precept, by demonstration, and by every mode of teaching with other physicians regardless of their national origin. I will try to help secure for the physicians in each country the esteem of their own people, and in collaborative work see that they get full credit. I will strive to eliminate sources of disease everywhere in the world and not merely set up barriers to the spread of disease to my own people. I will work for understanding of the diverse causes of disease, including the social, economic, and environmental. I will promote the well-being of mankind in all its aspects, not merely the bodily, with sympathy and consideration for a people's culture and beliefs. I will strive to prevent painful and untimely death, and also to help parents to achieve a family size conforming to their desires and to their ability to care for their children. In my concern with whole communities I will never forget the needs of its individual members.