Key issues and trends of health manpower management in the world / 中华医院管理杂志

Health manpower is key to the functioning of the health system. There exists a general need to strengthen health human resources in countries at large as they achieve universal health coverage. Through the systematic collection and sorting out of the declarations, initiatives, guidelines in the world and topics at the World Health Assemblies on health manpower-related issues since 2000, this paper summarized and analyzed the key issues and trends on health manpower planning, education and training, international migration, and compensation management, in order to provide reference for China′s health manpower management and practice.

Progress and challenge of health human resources development in China / 中华医院管理杂志

The authors systematically reviewed the progress of health human resources development, personnel management system and conceptual changes from 2011 to 2020 in China, and analyzed the status quo in this regard. The past 10 years have witnessed rapid progress of health human resources, namely better personnel management system and constant innovation in human development concepts. As required by the strategy of empowering the country with talents in the new era, as well as the overall promotion for the Healthy China initiative and the high-quality development of the health industry, higher requirements have been put forward for the quantity and quality, structural distribution and management innovation of health human resources. Therefore it is necessary to further expand the coverage of talents work and innovate talents policy, thus keeping the upgrade of the capability and competence of health talents.

Investigation and analysis of staff turnover in health institutions / 中华医院管理杂志

Objective:To investigate and analyze the loss of personnel in health institutions, and put forward the suggestions.Methods:The staff turnover in various health institutions was analyzed based on a continuous monitoring data from 2012 to 2019.Results:In 2012-2019, the turnover rate of health institutions had generally remained at about 1.5%-2.0%. In 2015-2019, the natural attrition rate was 0.44%-0.70% and the job-changing rate was 0.06%-0.12%. Among all kinds of institutions, the loss of staff in township health centers and Centers for Disease Control and Prevention were the most serious.Conclusions:Some new characteristics have emerged in the flow of health personnel, which have gradually adapted to the demand for health services, and the role of market mechanisms in the allocation of health human resources has gradually emerged.For the institutions with serious attrition, it is suggested to strengthen policy integration, guide the rational flow of health personnel.

Analysis on the department distribution and workload of physicians in China / 中华医院管理杂志

Objective:To analyze the department distribution and workload of China′s physician team, and promote the establishment of a well-structured physician team.Methods:Based on the relevant data of Health Statistics Yearbook, the distribution of departments and workload of diagnosis and treatment of physicians during the 13th Five-Year Plan period were analyzed. Results:During the " 13th Five-Year Plan" period, the number of physicians increased by an average of 6.11% per year, of which the average annual growth rate in medical cosmetology and rehabilitation medicine exceeded 10%, and the number of infectious disease physicians declined. The daily visits per physician decreased by an average of 4.67% per year, and the daily inpatients per physician decreased by 4.14%. Among them, the daily visits per physician in infectious diseases, preventive health care, oncology had increased overall, and the daily inpatients per physician in medical cosmetology, dental had decreased the most.Conclusions:It is suggested to optimize the professional structure and department distribution in accordance with the principle of " matching medical service needs with a certain workload" , and promote the establishment of a physician team with reasonable distribution to better meet medical service needs.

Investigation and analysis of the status quo of staffing and service provision in blood banks of Zhejiang Province / 中国输血杂志

【Objective】 To investigate and analyze the current situation of the human resources as well as blood collection and supply of blood banks of Zhejiang Province, so as to understand the problems existing in the development of human resources and put forward suggestions. 【Methods】 Questionnaires were issued to Blood Center of Zhejiang Province, municipal central blood stations, and county-level central blood banks to investigate the relevant data in 2015 and 2019. Meanwhile, some data were obtained through the Zhejiang Blood Management Information System (BIS3.0), symposiums, and querying medical service data. Statistical analysis was carried out. 【Results】 Among the 28 blood banks, filled the questionnaires, 927 personnel were in accordance with the authorized strength, accounting for 62.26% (927/1 489), and 1069 health technicians, accounting for 71.519% (1 060/1 489). From 2015 to 2019, the annual growth rate of human resources in blood banks was 2.02%, lower than the annual growth rate of whole blood collection volume 4.83% and the annual growth rate of clinical blood supply (red blood cell) 4.82%, lagging behind the annual growth rate of 6.55%, 8.71% and 12.36% in the number of diagnoses, inpatients and surgeries in the hospitals across the province. The average annual growth rate of doctors and nurses in blood banks was 0.17% and 1.67%, lower than that of licebsed doctors and registered nurses of the province, which was 6.78% and 8.27%, respectively. 【Conclusion】 With the development trend of blood collection and supply, the personnel allocation and the proportion of health technicians of blood banks across Zhejiang Province is insufficient. It is suggested to establish a manpower allocation standard suitable to the business volume, give priority to properly solvement of the current employment, strengthen training, and improve the efficiency of physical examination consultation, testing and phlebotomy positions.

Study on health management service specification and support systems for chronic patients / 中华医院管理杂志

This article introduces the health management service specification for a chronic patient population. The concept of this specification comes from the whole process of people-centered and integrated health management of the chronic patient population. It is also based on the World Health Organization′s integrated chronic patient population management model. The completion of the specification has gone through several rounds of expert discussion in related fields in China. The contents include seven key links: suspect selection, clinical diagnosis, health assessment, intervention plan development, intervention plan implementation, follow-up, and health reassessment. It also includes establishing a professional team and developing a support system and mechanism of financing, compensation, and incentives. The specification aims at integrating regional health resources through standardizing service technology and scientific management concepts. It would help to improve the efficiency and quality of health management of chronic patient population in China, thereby reducing the economic burden of chronic diseases for patients and their families, and achieving the goal of improving residents′ health.

Effect of needle arrangement on the lung dose in interstitial brachytherapy for lung cancer / 中华放射肿瘤学杂志

Objective To analyze the effect of needle arrangement on the lung dose in interstitial brachytherapy for lung cancer. Methods For 15 patients undergoing interstitial brachytherapy for lung cancer, a virtual radiotherapy plan in which needle arrangement was not restricted by the ribs was designed and compared with the original plan. For the two plans, V5, V20, V30, and mean lung dose(MLD)of the whole lung were determined when the prescribed doses were 10,30, 60, and 120 Gy, respectively. The data were analyzed by Wilcoxon signed-rank test. Results The lung V5,V20, V30, and MLD were significantly smaller in the virtual plan than in the actual plan(all P<0.05). Conclusions Irregular needle arrangement prevents a further reduction in the lung dose in interstitial brachytherapy for lung cancer. In the implantation surgery, therefore, the needles should be arranged as regularly as possible.

A study of the iso-center point coincidence between accelerator and radiotherapy planning system / 中华放射肿瘤学杂志

Objective To study the iso-center point coincidence of two accelerators with treatment planning system (TPS) based on γ passing rates of intensity-modulated radiotherapy (IMRT) plan verification.Methods Twenty-one IMRT plans were verified by Varian accelerator and twenty by Elekta accelerator with a gamma criterion of 3 mm/3％.The passing rates were measured when the iso-center point of TPS had-2,-1,0,1,and 2 mm shift in the x or y direction.A binomial curve of γwas fit to figure out the values of the two accelerators on the x and y axes when γ value reached the maximum.The γ pass rate difference was analysed by x2 test.Results The mean values of γ-2,γ-1,γ0,γ1,and γ2 in the x direction were (92.56±3.27) ％,(96.53± 1.82) ％,(96.13± 1.41) ％,(90.14± 2.87) ％,and (82.28± 4.69) ％ for Varian accelerator,and (94.82± 2.04) ％,(97.05± 2.02) ％,(98.38± 1.33) ％,(97.96± 1.44) ％,and (94.49±2.34)％ for Elekta accelerator.There was no significant difference in the mean value of γ0between the two accelerators (P=0.332).When γvalue reached the maximum,the values on the x and y axes were0.65 and-0.30 mm for Varian accelerator and 0.01 and 0.30 mm for Elekta accelerator,respectively.Conclusions In the same TPS,different accelerators have different degrees of coincidence of the actual field center point with the iso-center point of TPS,to which more attention should be paid in clinical practice.

Design and validation of synchronous exposure control system of dental cone beam CT / 生物医学工程学杂志

In the design of oral cone beam CT, cooperation between synergic control of X-ray source, real-time acquisition of flat detector and motion of mechanical structure affects the CT image quality. Based on the full analysis of the flat detector's timing signal characteristics, this research was carried out with microprocessor controller (MCU), complex programmable logic device (CPLD), and light couplings to design and realize synchronous exposure control system. To evaluate whether the design of the synchronous exposure control system in this project could reach the required imaging accuracy, we employed the projected images in the system to analyze its stability, linear consistency, signal to noise ratio and precede the FDK construction.

The leadership competency evaluation of the hospital deans based on the analysis of situational judgment test / 中华医院管理杂志

ObjectiveThe research provided the constructive ideas for evaluation and training of deans of tertiary hospital by analyzing the leadership status quo through using the situational judgment test based on the leadership contingency theory.MethodsBased on the leadership contingency theory,we designed situational judgment test for the dean of tertiary hospital.There were 215 participants involved in the leadership evaluation. Results The coaching leadership style occupied the mainly leadership style of deans of tertiary hospital.In the management situation matched by the coaching leadership style,the leadership of the deans was significantly higher than other management situations.Conclusion The main conclusion included,firstly,the coaching leadership style was the mainly leadership style of deans of tertiary hospital.It was strongly correlated with the deans＇ background thatthey were mainly from clinical professionals.Secondly,the leadership of the deans was at middle level;therefore,it needed to increase the capacity building of deans through management training.

Design of a mechanical system for the balanceable system of ambulance / 生物医学工程学杂志

This is the design of a mechanical systems for use in the balanceable system of ambulance, which can keep the medical service bed at the ambulance level, whatever the terrain is. A level detector will detect the level state of the bed and turn it to a signal. The central processing unit will use this signal to analyse and control the movement of the motor. By this design (which uses the rolling rail as a drive transmission and makes three supports of the bed go up and down), the bed will keep level. With the use of this design, the balanceable system of ambulance can counteract 35 degrees. The error is controlled within +/- 1 degree. And the response time is within 0.3 s. The method of registration can be effective for keeping the bed at the ambulance level, and for reducing the chance of making the patient get hurt on the way to hospital.

RELATIONSHIP BETWEEN NEURONAL INJURIES AND REACTION OF ASTROCYTES FOLLOWING CEREBRAL ISCHEMIA REPERFUSION IN RAT / 神经解剖学杂志

The involvement of astrocytes and correlation between neuronal injury and astrocyte response were studied. Blockingmiddle cerebral artery and reperfusing o. 5～48 h, H-E staining, immunoccytochemistry single-and double-labeling, dotble label-ing combined with TUNEL and GFAP immunocytochemistry were used to investigate neuronal injury and astrocyte response.The is chemic area peaked at 24 h of reperfusion. The neurons presented irreversible degeneration at 6 h of reperfusion. At24 h,ischemic area in the preoptic area developed into infarcted area; astrocytes exhibited differential morphological features: reactive,malnourished and degenerative changes. At 48 h of reperfusion, the number of astrocytes began to go up. The astrocytes in is-chemic area didn't proliferate within 48 h. By contrast, a few astrocytes underwent apoptosis. In conclusion, these data indicatethat the reaction of astrocytes is closely connected with the extent of neuronal injuries. The reactive astrocytes imply that astro-cytes positively respond to the neuronal injuries, which might play a role in promoting neuronal survival.