急救复苏的实施关系着抢救的成功率,是临床医师的必备技能和住院医师规范化培训中的必备项目.受临床诊治条件的限制,急救复苏的培训科目难以直接开展.医学模拟教学可以模拟急救情景,为受训人员提供实践急救诊治和技术的机会,使急救复苏实践培训的开展成为可能.本文探讨了急救复苏培训工作的临床价值和现状,在医学生教育、住院医师培训和医学继续教育中实践急救模拟教学的方案和重点.以我们的急救模拟培训为基础,结合国内外的培训经验,论述医学模拟教学在急救复苏培训中的实践构想和设计方案,包括建立急救病例库和教学培训团队,资源共享和远程模拟教学模式.同时,探讨了急救模拟培训的推广策略,为急救复苏规范化培训在国内的开展提供了理论基础和实践方法.

通过对门诊电子病历书写时间短、计算机操作水平参差不齐和书写习惯改变等推广难点进行分析,从门诊电子病历系统设计理念、功能设计、推广经验等方面对门诊电子病历系统升级改造实践进行总结,并展望人工智能、区域互联互通等在门诊电子病历中的发展应用.

从人口老龄化的视角对三级医院预约挂号的实践现状进行了分析,介绍了北京医院在老年患者预约挂号便利服务方面的举措,从加强宣传引导、推动创新和个性化服务、提高资源整合等方面提出了进一步改进预约挂号服务的建议.

With the rapid development of thoracic surgery, the proportion of difficult operation has been gradually increasing, which stimulates staff capacity building and technology development of anesthesiology. Also, the contents of thoracic anesthesia training for residents are getting more complicated. The theory, standards and techniques involved are constantly updated, so it is of great value to establish a standardized thoracic anesthetic training program. It should include airway management, ventilation strategy, multimodal analgesia and post-operative enhanced recovery management. This paper reviews the current situation of thoracic anesthesia training to fill the gap in this field. The research focuses on the development of a competent faculty, the training cycle, evaluation and feedback mechanism. By establishing a standardized training program which may achieve the goal of training qualified anesthesiologists, improve peri-operative safety and accelerate post-operative rehabilitation.

Objectives Under the new urbanization perspective,to realize the present situation and problems of health services on the migrant labors,and put forward suggestions.Methods 230 migrant laborers and 136 local la-bors were investigated through Multi-stage random sampling by questionnaire survey and interview,and descriptive statistics,t-test,chi-square test and nonparametric test methods were used for analysis.Results Most migrant la-bors tended to be young,with low level of education,good health,week health consciousness,unstable income and other characteristics.Significant difference existed between migrant and local labors on subjective feeling of the med-ical expenses burden (χ2 =8.77,P <0.05).Migrant Labors received a average hospitalization expense reimburse-ment rate of 1 9.53%,which was significantly different from that of local labors (t =2.53,P <0.05 ).Significant difference existed between these two types of labors on the cognition that whether the medical equality could be af-fected by the household registration(χ2 =1 7.85,P <0.05).Conclusions The system construction and policy prop-aganda should be strengthened.The role of community should be fully given play to.And the trans-regional trans-ferring of the new rural cooperative medical care system should be perfected.

This paper compared the practice and service mode of general practitioners ( GPs) from a selection of typical countries and regions and discovered that GPs from most of the countries were self-employed, with various forms of employment, freedom to practice and work in different institutions;fixed practices were supplemented, and service types were transformed from individual services to the multi-disciplinary team of services. Result: GPs’ free-dom to practice in different institutions requires a certain social environment and circumstances. The multi-disciplina-ry team of practices has become the development direction for the service modes of GPs. GPs have played different roles in establishing the referral system in the health systems of different countries. Consequently, the paper suggests that establishing a diverse and relaxed practice environment to provide conditions for the transformation of the service mode of GPs. The construction of a multi-disciplinary team to promote changes in community service modes was must be strengthened. Health insurance regulations should be encouraged to establish the gatekeeper system and realize a grading of systems. Social capital should be encouraged to organize general medical services to promote the develop-ment of the health care industry.

The realization of inter -provincial remote medical treatment of floating labor force is not only of great theoretical significance for the healthy development of health insurance system but also of realistic value for meeting the actual demands of floating labor force and relieving the difficulty of floating labor force in receiving medical services .In this study , we analyzed the necessity of the realization of inter -provincial remote medical treatment of floating labor force , discussed the fundamental role of provincial remote medical treatment in the realization of inter -provincial remote medical treatment of floating labor force from the perspectives of settlement mode , technological skills and policy implementation , and investigated the realization foundation of inter -provincial remote medical treatment .

药物治疗是临床护理工作的重要内容，护理人员是医嘱的执行者，是药物治疗的实施者和管理者，参与病人用药的全过程，其行为直接影响病人的用药安全。急诊科病人病种多样、病情复杂、用药繁多、人员流动性大、输液量大，治疗环境嘈杂拥挤，护理人员工作繁忙琐碎，导致护理差错的发生率增加[1]。为进一步规范用药操作流程，有效降低用药风险事件，根据急诊留观区的工作特点，改进护理用药操作流程，并在临床应用中取得了良好效果。现介绍如下。

[目的]了解临床护士开展护理研究的现状及其影响因素,采取相应的对策提高护理人员的科研素质。[方法]采用自设问卷对北京协和医院内、外、妇儿、五官科临床护理人员100人进行调查。[结果]有近半数人(48.0%)在过去5年内没有发表过文章,发表的文章中科研型文章仅占12.0%;96.0%的护士都认为进行护理科研存在困难;不同学历的人群在"没有接受过科研训练""查阅文献"方面比较,差异有统计学意义(P<0.05或P<0.01)。[结论]绝大多数护理人员认为进行护理科研存在困难,医院应采取针对性措施,提高护理人员的科研能力,使护理人员有机会接受科研训练,尤其是查阅文献、统计分析方面的训练。