健康谣言:患上腰椎间盘突出一定要手术 85％以上的腰突症和腰椎管狭窄症患者都可以经过正规的保守治疗得到缓解和治愈.只有15％左右的病人经过保守治疗以后无效、或是症状极为严重才需要手术治疗.而正规的保守治疗大多花费无几.建议患腰突症的病友到正规的大医院找有经验的医生就诊,听取医生的专业意见,不应盲目手术,目前没有一种手术方式是完美无缺的.

编者按:每年的3月8日为"国际劳动妇女节".爱美之心人皆有之,尤其是女性,都希望自己越来越美丽.皮肤,是人体的"万里长城",幅员广阔,是人体表面的第一道屏障,保护着人体免受各种细菌、病毒和危险的侵害.

新型外科手术技术的评估流程十分复杂,对外科手术创新中进行高质量的客观评估存在着种种困难,IDEAL(Idea,Development,Exploration,Assessment,and Long-term follow up)是目前被广泛认可的外科领域临床研究方法学框架,包括(1)思路创新阶段,(2a)发展阶段,(2b)探索阶段,(3)评估阶段,(4)长期随访阶段.详细介绍IDEAL框架的5阶段研究思路,并结合案例分析,旨在推荐国内外科临床研究者使用IDEAL方法遴选外科新技术问题、开展外科临床研究,最终改善外科研究的大环境,提高外科手术或其他复杂干预临床研究的质量.

Objective To systematically review the worldwide experiences of lung cancer screening using low-dose CT.Methods 36 projects were selected from the national and international databases according to the inclusion and exclusion criteria and were reviewed systematically.Overall detection rate and its 95% CI were calculated and forest plot was drawn by meta-analysis.Results Baseline prevalence rate of lung cancer was 0.9%.The incident rate of annual repeated screening for lung cancer was 0.5%.The overall detection rate was 1.3%.Of the 1946 cases with histopathological diagnosis,52% were adenocarcinoma.70.8% were defined as stage I NSCLC.Conclusion Given that the medical resources are relatively insufficient in our country,it needs further study and ethical concerns to apply low-dose CT screening to the communities.

Objective To study the perceptions of the safetyeffectivenesseconomy and ethics of physicians and managers in Orthopedics on the application of 3D printings.Methods Questionnaire surveys were conducted among all orthopedic physicians and some related hospital administrators in 4 tertiary hospitals in Shanghaiand qualitative interviews were adopted in 4 orthopedic experts.Results 3 hospitals have applied 3D printing technology in Orthopedicsbut the number of operations is limited.The advantages perceived by the surveyed physicians and managers are 3D printing in Orthopedics has shorter operation durationmakes operation convenience and has higher operation success rate.While the disadvantages include high cost and pricelack of standards and professional normsand process complexity and time consuming.Conclusion Clinical evaluation on safety and effectiveness of 3D printing in Orthopedics needs long term follow up.The regulation needs to be built up for rational use of 3D printing in Orthopedics.

Objective To assess the effect of clinical application of three-dimensional printing technology (3D printing) in Orthopedics.Methods Comparing the effect of clinical application of three-dimensional printing technology with traditional Standardized technology,through using a systematic review and Meta Analysis.Results Meta analysis of 25 studies included in the research showed that application of 3D printing reduced operation time by 26 minutes,decreased intraoperative blood loss by 77 ml,and increased accuracy rate or success rate of screw implanting(increased by 2.10 times compared with tradit onal standardized technology).Conclusion The application of 3D printing in Orthopedics has good short-term effect But its deVelopment in clinical application should be cautious.

Objective To study onclinical researches of 3D printing technology in Orthopedics.Methods Through literature search,107 literatures were included and systematically reviewed,and the status of clinical researches of 3D printing technology in orthopedics was described.Results The clinical researches of 3D printing technology in Orthopedics were mainly focused on males and adults population conducted from 2007 to 2012.3D printing technology frequently used in Orthopedics were reduction and internal fixation,deformity correction,pedicle screw placement,tumor resection,revision and reconstruction,and knee replacement.Conclusion 3D printing technology in Orthopedics is still at an initial stage of clinical development.

Objective:To analyze the medical resources and services of traditional Chinese medicine(TCM) in public medical institutions of Pudong New Area in Shanghai in order to provide the information for decision making in future development of TCM in Pudong New Area as well as in other areas of China.Methods:All public medical institutions of Pudong New Area in Shanghai were surveyed to collect the overall and TCM-specific data on beds,human resources, medical devices and medical services.Results:In 2014,there were 742 TCM beds and 975 medical professionals specialized in TCM. The increase rate of TCM services exceeded that of medical professionals specialized for TCM during 2010-2014. The income of TCM decoction pieces increased even more than 100% during the same period.Conclusion:The medical professionals specialized in TCM were not relatively sufficient. It is suggested that the utilization of TCM decoction pieces be paid attention to in Pudong New area.

Objective To evaluate the safety and efficacy of clinical application of three-dimensional printing technology (3D printing) in Orthopedics.Methods The safety and effectiveness of clinical application of three-dimensional printing technology in Orthopedics were analyzed by systematic review of non-control studies.Results Non-control studies showed that cortical perforation rate of screws was 3.83％ (calculated by the number of screw).Complication rate was 2.13％,surgical infection rate was 0.28％,prosthesis problematic rate was 0.79％,the average operation time was 139.23 minutes,and some results of the indicators for safety and effectiveness were similar between studies with and without control groups.Conclusion Although 3D printing application in Orthopedics has some clinical value,and its extension needs economic assessment.

Objective: To analyze the status of non-public medical institutions in Pudong New Area.Methods: The questionnaire survey was conducted in all non-public medical institutions in Pudong New Area to collect the data related to non-public and public medical institutions in 2014 in Pudong New Area.Results: In 2014,the number of non-public medical institutions in Pudong New Area was 583,which was 1.24 times of that of public medical institutions.The non-public medical institutions were distributed more in the street or towns of Lu Jia Zui,Jin Qiao,Zhang Jiang,and Gao Qiao.But the number of outpatient and emergency care and the number of inpatient care in non-public medical institutions were only 17％and 7％of those in public medical institutions,and the income of non-public medical institutions was only 15％of that in public medical institutions.Conclusion: Non-public medical institutions had larger number,but smaller size.The guidance and surveillance of the government and the changes of non-public medical institutions in their believes and strategies are necessary for the healthy development of non-public medical institutions.

Objective:To make a strategic plan for A hospital based on the theory of strategic management and comprehensive analysis on internal and external environments of one tertiary Chinese and western medicine integrated hospital(Hospital A)in Shanghai. Methods:Existing data were collected,a questionnaire survey was conducted,and focus group discussions of 31 hospital managers were made. Results:There were opportunities and threats in the external environments for the development of Hospital A,and there were strengths and weaknesses in the internal environments. Hospital A drafted a strategic plan according to internal and external environment. Conclusion:It is suggested that Hospital A continue to utilize its strengths and enhance its competitive competence in order to meet the medical needs of the country,Shanghai and Pudong New Area and to satisfy the patient demands for medical care.

目的:调查上海市某大学公共卫生(以下简称“公卫”)专业毕业生的职业发展及业余生活,为公卫专业的规划发展和公卫人才培养提供借鉴.方法:采用自制问卷,运用方便抽样方法对上海市某大学362位公卫专业毕业生进行问卷调查,对8位毕业生进行半结构式深度访谈.结果:47.7％毕业生对工作满意表示比较满意和满意,71.6％对业余生活表示比较满意和满意;52.5％毕业生对职业发展综合评价为“高”,77.16％对业余生活综合评价为“高”;工作单位类别影响职业满意度、科研、外语水平及职业规划影响职业综合发展.结论:公卫专业毕业生业余生活总体较为丰富且满意,而职业发展综合水平并不太理想.表明公卫专业在校学生应加强职业规划,培养积极向上生活态度.

美国卫生保健研究和质量机构开发了一套用于评价医疗质量的指标体系.通过阅读官方网站和查阅文献资料,对美国AHRQ医疗质量评价体系的构成、基础指标及应用进行介绍,并指出其局限性,以期为卫生相关部门医疗质量评价提供参考.