Abstract:
:In scarcely more than 30 years, the People's Republic of China has progressed from limited health care available only to a privileged few to a countrywide system providing basic services to one fifth of the world's population. The author gives his impressions of the current situation, based on a recent visit. :There has been a marked improvement in the health status of China's 1 billion inhabitants during the last 20 years due to the government's decision to develop a primary health care (PHC) system rather than to promote a system of specialized health care for a small segment of the population. Chairman Mao emphasized that the major task of medical personnel was to provide care for workers, peasants, and military personnel. He advocated the use of both traditional and modern health care practices. During the cultural revolution medical training was sharply curtailed, but since 1977 medical training has been given a high priority. In recent years the major focus has been on providing PHC services for the workers in the cities and for the 80% of the population living in rural areas. At the present time there are 117 modern medical schools and 24 traditional schools. Even those enrolled at the modern schools receive some training in traditional medicine. Since 1977 modern medical training has been provided in a 5-year program, including a year of hospital internship. Students enter medical school immediately upon graduation from high school and must pass competitive exams prior to acceptance. The top members of the medical class are provided with additional training and prepared for research and teaching posions. The students in the lower portion of the class are assigned to rural areas and provincial hospitals upon graduation. Traditional medical school; emphasize preventive and promotive health care. Currently, health services are provided by 360,000 modern doctors, 250,000 traditionally trained physicians, 420,000 middle doctors, 1.6 million barefoot doctors, 400,000 nurses, 120,000 herbalists, and 70,000 midwives. Barefoot doctors are individuals elected by their fellow workers to receive training primarily in preventive heath care. Following training they serve as health educators for their follow workers. Middle doctors have varied training ranging from 6 months to several years and work primarily in urban or factory clinics. The progress made in the provision of PHC is evidenced in the increase in life expectancy from 35 years to 60-62 years during the last 3 decades. During this same period, infant mortality decreased from 11.76-1.035% and the maternal death rate decreased from 0.7-0.015%.
journal_name
Postgrad Medjournal_title
Postgraduate medicineauthors
Taylor RBdoi
10.1080/00325481.1981.11715824subject
Has Abstractpub_date
1981-08-01 00:00:00pages
69-76issue
2eissn
0032-5481issn
1941-9260journal_volume
70pub_type
杂志文章abstract::Several risks can be posed by travel, even when the stay is not protracted nor the destination exotic. Air travelers should consider the potential problems associated with decreased cabin pressure, hypoxia, and circadian dysrhythmia, problems that can contraindicate flying for some. Motion sickness can affect those tr...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1983.11698368
更新日期:1983-04-01 00:00:00
abstract:BACKGROUND:Adults with attention-deficit/hyperactivity disorder treated with atomoxetine were examined for time-to-onset and -resolution of common treatment-emergent adverse events (TEAEs) and male sexual dysfunction, and for changes in blood pressure (BP) and heart rate (HR) upon atomoxetine discontinuation. METHODS:...
journal_title:Postgraduate medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1080/00325481.2015.1083394
更新日期:2015-01-01 00:00:00
abstract::Preview Hereditary hemochromatosis, once believed to be rare, is now known to affect 1 in 250 to 300 people of northern European descent. Untreated, the disorder can have serious complications, but for patients in whom it is discovered and treated early, the prognosis is good. In this guide to diagnosis and management...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1994.11945914
更新日期:1994-11-01 00:00:00
abstract::Is the degree of risk involved in providing health care to people infected with human immunodeficiency virus (HIV) acceptable? Every health care worker, even if only for a few anxious minutes, has certainly worried about this risk. Drs Wilson, Williams, and Robinson discuss these concerns and summarize the indications...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1990.11704737
更新日期:1990-09-01 00:00:00
abstract::Cardiovascular disease (CVD) is the major cause of morbidity and mortality in patients with type 2 diabetes mellitus (T2DM). Recent major publications, such as the Action to Control Cardiovascular Risk in Diabetes trial, the Advance in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation tria...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2011.11.2501
更新日期:2011-11-01 00:00:00
abstract::Scleroderma, psoriasis, lichen planus, and other skin disorders may signal a more serious internal disease. Physicians who recognize such clues can initiate early treatment while disease is in its early stages. The authors of this article describe several of the more common dermatologic conditions linked to systemic d...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1997.06.227
更新日期:1997-06-01 00:00:00
abstract::In a large percentage of patients with upper airway disease, asthma and sinusitis occur concomitantly. As many as 88% of patients with asthma exhibit the symptoms of rhinitis, and half of rhinitic patients have asthma. In this article, Dr Muller explores the interrelationship of sinusitis and asthma, including charact...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2000.10.1263
更新日期:2000-10-01 00:00:00
abstract::Evidence from epidemiologic, lipid intervention, and coronary angiographic studies demonstrates the importance of high-density lipoprotein cholesterol (HDL-C) in coronary artery disease (CAD) risk. Data from these studies strongly support the measurement of HDL-C in all patients screened for CAD. Patients with low lev...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1990.11704654
更新日期:1990-05-15 00:00:00
abstract:BACKGROUND:Binge eating disorder (BED) is now a formal diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). However, post-DSM-5 patient profiles and viewpoints on BED diagnosis and treatment remain unclear. This study used a focus group methodology to examine demographic and cl...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.3810/pgm.2014.09.2800
更新日期:2014-09-01 00:00:00
abstract::Politicians may have written a temporary obituary for healthcare reform, but as anyone in medicine knows, reform is alive and (debatably) well. Mergers, acquisitions, and practice changes are happening all across the land, and many a physician is going from being a small-business owner to being an employee. Difficult ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:
更新日期:1994-11-15 00:00:00
abstract::Captopril (Capoten) and minoxidil (Loniten) have recently become generally available for treatment of hypertension, and calcium channel blockers, although not yet officially approved for this indication, clearly have potential as antihypertensive agents. Captopril, the only available inhibitor of angiotensin-convertin...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1983.11698326
更新日期:1983-01-01 00:00:00
abstract::There are three key goals in current management of the diabetic pregnancy. Normal diabetes control before conception and during the first trimester in an attempt to reduce the incidence of congenital abnormalities. This implies that all diabetic women of childbearing age should have counseling before pregnancy. Routin...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1985.11698879
更新日期:1985-02-01 00:00:00
abstract::Pruritus scroti is a common clinical disorder that is caused by various inflammatory disorders, infections, infestations, and neoplasms. Laboratory evaluation, including bacterial and fungal cultures, microscopic examination, skin biopsies, and measurement of blood glucose levels, is useful in establishing the diagnos...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1990.11716424
更新日期:1990-11-01 00:00:00
abstract::A general guideline to successful treatment of headache focuses on a diagnosis that satisfies both physician and patient. Thorough history taking, patient and family education, aggressive approaches, and careful follow-up help patients reach therapeutic goals. Successful long-term therapy for headache enables patients...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1998.11.406
更新日期:1998-11-01 00:00:00
abstract::Preview The risks associated with diagnostic cardiac catheterization have declined through the years, but the question remains as to which patients should be referred for the procedure. In this article, Drs Walder and Schaller examine present guidelines for different types of heart disease and also review qualificatio...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1995.11945967
更新日期:1995-03-01 00:00:00
abstract::With increased survival of increasing numbers of cancer patients as a result of therapy, the consequences, early and late, of the therapies must be realized. It is the treating physician's duty to preserve as much reproductive potential as possible for patients, consistent with adequate care. With radiotherapy this me...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1979.11715159
更新日期:1979-05-01 00:00:00
abstract::Although the link between cigarette smoking and its cardiovascular effects is well established, the mechanisms through which smoking raises blood pressure remain to be clarified. Possible mechanisms include nicotine-induced peripheral and central sympathetic nervous system stimulation, persisting levels of nicotine in...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1996.11.114
更新日期:1996-11-01 00:00:00
abstract::Asthma and chronic obstructive pulmonary disease (COPD) are disorders that affect millions of people in the United States and other countries in the world. Asthma is a chronic inflammatory disease of the airways that has cellular and molecular pathways. Affected patients have recurrent episodes of wheezing, dyspnea, c...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.12.2005.suppl44.232
更新日期:2005-12-01 00:00:00
abstract::While a wide variety of thyroid function tests are currently available, all are sometimes abnormal in patients without thyroid disease. To interpret test results properly, the clinician needs to be aware of factors altering thyroid function tests. In every instance, the clinician needs to begin by asking whether the p...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1989-04-01 00:00:00
abstract::Common variable immunodeficiency (CVID) is readily considered in patients presenting with recurrent sino-pulmonary infections, however this disease has a broad range of clinical manifestations and diagnosis can be delayed by several years. We present the case of a 44-year-old postpartum female who presented with nause...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.2016.1199250
更新日期:2016-08-01 00:00:00
abstract::The toxic effects of cocaine are becoming more widely recognized as the popularity of the drug increases. Although overdose is usually fatal, treatment is available for users who experience agitation, seizure, arrhythmias, severe hypertension, or other side effects. Hospital admission is often necessary to allow monit...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1992.11701173
更新日期:1992-01-01 00:00:00
abstract::A carefully taken history and thorough physical examination are the first steps in establishing the cause of a neck mass. Location, size, consistency, and mobility of the mass provide clues and are useful for comparison during follow-up. Further studies are ordered on the basis of the impressions gathered from this ev...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1987.11699816
更新日期:1987-05-01 00:00:00
abstract::It is often difficult to determine the true extent of a burn, but most small thermal burns can be easily evaluated and managed by primary care physicians. In this article, the authors review the characteristics of different types of burns, describe those that require treatment in a burn center, and discuss appropriate...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1995-05-01 00:00:00
abstract::A carefully taken history and thorough physical examination remain the most crucial aspects of diagnosing rheumatic disorders. Non-rheumatologic conditions also need to be kept in mind. Laboratory tests should be looked on as mostly supportive or confirmatory, because many of the tests are relatively nonspecific and m...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1991.11700818
更新日期:1991-02-01 00:00:00
abstract::Preview Although no one theory on aging explains satisfactorily why or how this process occurs, we know that aging causes physiologic changes and a progressive decline of functional organ reserve. The implications of these changes are increasingly important as the elderly segment of the population grows. In this artic...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1996.11946121
更新日期:1996-05-01 00:00:00
abstract:OBJECTIVES:There is evidence that increasing severity of hypertriglyceridemia increases the risk of acute pancreatitis. There is a debate about superiority of treatment methods and previous works have specifically called for direct comparison between IV insulin and apheresis techniques. Identify patient characteristics...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.2018.1470439
更新日期:2018-06-01 00:00:00
abstract::The case described here illustrates the need to consider milk-alkali syndrome in the differential diagnosis of hypercalcemia, even in this age of histamine2 blockers and mucosal protectors. Thorough history taking and gastrointestinal workup help rule out alternative causes of hypercalcemia, such as cancer, hyperparat...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1993.11701690
更新日期:1993-05-01 00:00:00
abstract::Most patients with type 2 diabetes present with comorbid overweight or obesity. Reaching and maintaining acceptable glycemic control is more difficult in overweight and obese patients, and these conditions are associated with increased risk for cardiovascular and other diseases. Glycemic management for these patients ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2010.05.2148
更新日期:2010-05-01 00:00:00
abstract::While more remains to be learned about the natural history of deep vein thrombosis and pulmonary embolism, better information is now available on which to base decisions about diagnosis and treatment. Several retrospective and prospective studies have placed the value of lung scanning, venography, and pulmonary angiog...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1986.11699336
更新日期:1986-03-01 00:00:00
abstract:PURPOSE:To evaluate patient access, provider productivity, and patient satisfaction during a 24-month redesign process of an academic medical center, which requires balance between clinical and educational missions. METHODS:A series of activities were conducted to optimize primary care across 17 attending physicians, ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.2020.1773685
更新日期:2020-09-01 00:00:00