解决医患矛盾,需权威第三方

大多数国家不会让医生承担风险持枪合法的美国如何保护医生的安全和职业尊严?"这是暴行,滥杀无辜!""3·23哈医大血案"发生后,首都医科大学宣武医院神经外科的凌锋教授出奇愤怒。积水潭医院风湿免疫科主任医师伍沪生的第一反应则     

住院精神科患者伴发躯体疾病的临床分析

为了解我院精神科患者在住院期间伴发躯体疾病类型与精神疾病病期关系及与抗精神病药物使用之间的关系,我们将1997年～1999年5月的住院患者291例伴发躯体疾病情况作了分析,现报告如下:     

急性心肌梗塞病人的心理与护理

本文是作者对急性心肌梗塞病的心理分析与护理经验的表述。     

Association of cystatin C level and cardiovascular prognosis for patients with preexisting coronary heart disease： a meta-analysis

The association of circulating levels of cystatin C （CysC） and risk of recurrent cardiovascular events in patients with preexisting coronary heart disease are uncertain. To qualitatively and quantitatively address this issue, we performed a random meta-analysis of results from prospective studies on the topic. We searched elec- tronic and printed sources （up to 16 October 2011） using keywords and retrieved articles for seven prospective studies according to the selection criteria. Data were abstracted and meta-analysis was performed using the random-effects model （RevMan 5.0.23 software）. The cohorts involved 4,576 patients with preexisting coronary heart disease （CHD） and normal or mild chronic kidney disease, and follow-up ranged from 5.6 to 40.6 months. Highest versus lowest baseline CysC level was signifi- cantly associated with increased risk of cardiovascular events （OR 2.30, 95 % CI 1.80-2.94）, all-cause mortality （OR 5.69, 95 % CI 3.70-8.74）, but not with recurrent MI （OR 1.75, 95 % CI 0.77-4.00）. In heterogeneity testing for studies reporting cardiovascular events and all-cause mor- tality, no significant heterogeneity was found, and exclu- sion of any single study did not alter the overall finding. For risk of recurrent MI, significant heterogeneity was found among the five trials （Z2= 13.16, P=0.01, 12 = 70 %） and exclusion of the Taglieri et al. [12] study from the analysis resulted in a rise in relative risk （OR 2.36, 95 % CI 1.09-5.15）. In conclusion, for patients with established CHD, high baseline level of CysC is associated with increased risk of cardiovascular events and all-cause death during long-term follow-up.     

国外如何化解医患纠纷——医患之间缺少“第三者”

既然有医保，为什么还要患者先付医药费？专家指出，医院过度医疗、收费过高的根源就在于此——医生的诊疗无人约束。     

原发性醛固酮增多症发生率低于预期

根据既往研究，原发性醛固酮增多症在高血压患者中的比例近10％。但希腊一项为期20年的观察性研究显示，原发性醛固酮增多症仅占顽固性高血压的11．3％，其中只有45．6％出现低钾血症。据此研究者指出，原发性醛固酮增多症在未经选择的高血压病人群中的比例远低于人们的预期[Lancet 2008，371（9628）：1921]。