医学影像学诊断报告书写规范

1、opeai n orde h a ne pary and G<erment organs, r oosy damaging Ie m.eof the pary and Ie Go<ernment, undeminings flw Ie fasion, rval , seul a nd post cnsmpI on becme a smshwng、Ier id pactes. Cauued by pul c leva ns ' duyoig, cas fr prvae pupooes, voaI ng Ie leldisc plne rig ulIons a nd ee n

2、led t oIfc acc deI. Accdi ng I saisIcs frmelatd depamesposit onreated cnsum pin of cVi - rvants ha s bee ept by .a nce , consumer, egar dless of cst avga- and wase in Ie cVI sev ”" consmplon, abu. crru.nad embezement,eruptions mportat. Then, unde Ie conUI ons of make ecnomyhow to efomthe .g cvl

3、duty consumpti on maagemet exlores a sur t preve nt ad _rle post cnsumptin cruption ys -rrety a maor ue facedby hones w orkReenty I cn.ce. reseaconthis - ue,t his pr oblm on some humble opi nins. F M he - Sig pubic servant s' duty cnsumpti on t I e main pr e s n from" ” " and reasons,

4、irecent yeas, pubic sevas ' y cnsumpinused by Ie a buses a nd not a per sn of iegiy,i s one of Ie mjrproblms i t he pay in Gover nment iste realnshi p bewee pary ad Ie mases elec,opel ig up a I d e cnomc cns、rc.n. FomI Ccun. i ecet yeas of govena nne si i on se, posii ons cnsmpin in t he p. I f

5、"wno" phe I omenon r eddeig four a f ues a iposins stmlstha s due of biding, rigI is ge r t han ruls, a nd rg It s geae Ia nmehod of |heomeon mor ehghl i|I I i s i posins cnnumpti on inlhe Camea Obcua opeain, ng ems Wl posiins cnsumpI I n i nI ha s pe sona connumpI on, w l poinsI it I pesn

6、a pois to, maks| osIons cnsmpin insome ase - has ito posiins e|oy ad -lalng of meas thrie i s Iposii ons fa - , . mpesnaIr Tedof nngaie corruI on p'enome na -cis crruin ad miapprpriain, fup» 一sn 4 t he ive s”.n i nour county-ve s n”, s 1rpre.0” s ony the is . pu po-s 0rcnsumpI on I f many &

7、quot;w" phe nomenon i n wi ch peope relct the bggstproblms ae(< Ieofclca prblms Maiy inIrre asecs： one s the lage buss cs ex le.uie A iccrii I g I st!B's unti Novmbe 2003, XX C.uy Iwnship Dearment bus 159car w hic parme nt owns Ie bus 45 veicis, ad showd a n incras ng Ied Fiannjal -pess

8、cs pe bus pe yea I35000 yuan, and i ac evey cost up to 50000 yuan. Some uis as"ig ttmpoay dies and - pedtreon w. m andlubs.es Nessay I "kep a ca", but a so Ie pe I da ns", eoig I age elene s Secnd, gongchesiyng beed unheat hy Iedencies S ome pe ople beive t ha now sme I us dies u

9、se onet hid, one thi d ead ng prvae one Iid uued for ofcia puroses Some pulc - vats, pe iedi ngofas mot医学影像学诊断报告书写规范一、诊断报告书写规范是诊断质量的最终反映：医学服务涉及人的生命与健康，其服务质量的重要意义是不言而喻的。为此，医学I管理学就提出了质量保证与质量控制的种种规范与办法。发达国家的医学I质量保证，质量控制是由政府有关部门与医学I学术团体共同实施的。从我国近年来的实践看，也是由政府部门施加 一定的行政影响，并组织有关的 医学I团体制定统一质量保证与质量控制的规范与实施办法

10、， 并加以贯彻与推广。诊断报告书能反映医学I影像的诊断质量。从一份规范的诊断报告书中可以看得出使用的 设备是什么，检查的操作技术或程序是怎样的，诊断者观察是否全面， 以及诊断的思路是否正确等等。因此，我们认为在逐步完善 医学I影像学质量保证或质量控制的进程中，第一步要走的路就是诊断报告书的规范化。二、规范化 医学影像学诊断报告的格式医学影像学诊断报告书的格式是一种形式，它反映的内容必须要符合质量保证与质量控 制要求。纵观现在国内、国外的诊断报告书，形式各种各样，大小与繁简程度也不一致。但 是从质量保证与质量控制角度出发，我们认为医学|影像学的诊断报告书的格式应包括以下5项。1、一股资料，往往是

11、表格式的。逐项填写：患者姓名、性别、年龄、科别、住院号、病区、病床、门诊号、X线号、CT号、MRI号、DSA号、X片序号、检查日期、报告日期等等。2、检查名称与检查方法或技术。、3、医学影像学表现。如X线所见、CT所见、MRI所见、DSA所见等。4、医学影像学诊断。5、书写报告与审核报告医师签名。三、规范化 医学1影像学诊断报告书的内容：规范化医学影像学诊断报告书的五个项目所包括的内容各不相同，但却有一定的联系， 它们与报告形式是统一的。我们将每一项目应书写的内容，建议如下。1、一般资料：各家可以根据各种不同设备的医学忸像学科具体情况设计各自的表格， 但必须是能精简地概括识别病员的标志、检查要

12、求、目的与简要的临床情况或诊断。报告书写者应逐一填写。我们建议检查号分成几项，即X线号、CT号、MRI号与DSA号等，”适用于较大 ,。如该院放射科还包括超声与核素成像，也可再加上相应的编号。 这是因为放射科的技术部们或某几位技师往往相对固定于几组机房。而医师分别轮转工作于几个如CT、MRI、DSA等工作室，并分别各自书写报告。而检查号则由技师统一编排。序号是从 属于检查号的。患者的姓名、送诊科室、住院号或门诊号是为了识别病员用的，对于同名同姓的患者，可根据住院号或门诊号，以及送诊科室的不同而加以识别。2、检查名称与检查方法或技术对于规模较小的放射科（指二类乙级以下标准的放射科）在影像诊断报告

13、书中 只用检查名称”一项就可以。这类科室一股均采用检查常规，一切按常规办事。或虽无书面的常规，但有科室人员相互默契的常规。例如会诊单上写胸部摄片”就一定是胸部正侧位。会诊单上写 鼻窦摄片”就一定是water位摄片等。但对于二甲以上标准 规模较大的放射 科，在报告中须增加 检查方法”或 检查技术”一项。这类科室开展项目很多，新开展项目出i 00 uposit onreated cnsum pin of cVi - rvants ha s bee ept by .a nce , consumer, egar dless of cst avga- and wase inIe cVI sev posl

14、in re d conlumpl on, abu. crru.nad embezement,eruptions mportat. Then, unde Ie conUI ons of make ecnom y how to rfm the sing cvl duy conlumpl on maagemet, exloresa sur t preve nt ad lie post cnsumptin cruption ys -rre a maor ue facedbyhonestworkReenty, I. reseaconthis-ue,thisproblmonsomehumbleopinin

15、s.FMhe-sigpubicservant s' duty cnsumpti on t I e main pr e s n from" ” " and reasons, irecentyeas,pubicsevas ' y cnsumpinusedbyIe a buses a nd not a per sn of iegiy,i s one of Ie mjrproblmsithepayinGovernmentisopeainordeh a negative party and Gvernme nt organs, seri ousy -ma.gje ma

16、ge of the party andIeGovernment,undemiigte realnshi p bewee pary ad Ie mases elec,opel ig up a I d e cnomc cns_I_in. FomI Ccuny i ecetyeasofgovenanne si ion se, posii ons cnsmpin in t Ie pl-icd I f "wno" phe I omenon r eddeig four a f ues a is posiins cnsumpI on sy stmlst ha s due of bidi

17、ng, rigt is ge r t han ruls, a nd rg It s geae Ia nmehod of "eomeonmore hghi i|I I i s i posins cnnumpti on inlhe Camea Obcua opeain, ngemsWl posiins cnsumpI I n i nI ha pe sona connumpI on, w l aepoins I it I pesna po、s to, maks|osIonscnsmpin insome ase - has ito posiins e|oy ad -lalngofmeasth

18、rie i s Iposii ons fa-,. mpesnaIr TedofnngaiecorruIonp'enomena-cis crruin ad miapp.priain. fup» s flw Ie fasin, , s l a nd pos cnsumpI on becm e a smsloWigl-l Iei id pailes. Cauued by p" c leva ns '.,cnsumpI on I f many "w" phe nomenon i n wi ch peope relct t he bggst pro

19、blms ae(< Ieofcilca prblms Maiy i nIrre ase cs one s t he lage buss cs ex leduie A ccrd I g I st!B's unti Novmbe 2003, XX Ccuy Iwnship Dearment bus 159caswhicparmentownsIebus45veicis,adshowda n incras ng Ied Fia nnjai - pess cs pe bus pe yea I35000yuan, and i ac evey cost up to 50000 yuan. So

20、meuisas"ig ttmpoay dies and - pedtre on w. m a nd lubsdes Ne ssay I "kep a ca", but a so de pe I da ns", eidig I age elenes. Secnd, gongcesiyngbee d unheat hy Iedencies S ome pe opie beive t ha now sme I us dies use onet hid, one thi d ead ng prvae one Iid uued for ofcia puroses

21、Some pulc-vats,mpecaiedi ng ofas mot oig, cas fr prvae pupooes, voaI ng Ie - id sc pie rig ulIons a nd ee n led t oIfc acc deI. Accdi ng I sastcs frm ela>d depamessi 4 t he ive s1ain i nour county- s n”, s 1rpre.” s only the is . pu po-s 0r现且科室治医师以上医师较多，各人常用检查技术可能不一致，这些情况应在 检查方法”一项中有所说明。传统的检查如银餐造

22、影等，均按统一常规操作，其它临床医师也知道是怎么回事，故在 检查方法”项中注明为 常规”即可，否则应对 检查方法”或技术作一交代。3、医学影像学表现过去普通平片与较简单的造影检查，摄片数目较少，多主|张对其表现作较全面的描述与讨论。例如对正常胸部正位片，要求对肺野、肺门、肺段、胸膜、横隔、纵隔，所见骨骼与 胸廓软组织进行较详细描述。当然也有少数医师只在医学|影像学表现项下书写 心、肺、膈无异常”一句，同时在 医学影像学诊断”项下书写相同的结论，我们认为这样书写不规范。现在不少检查项目观察内容很多，如CT增强前，后扫描的层面往往甚多，同一层面还可采用不同的窗位进行观察，书写报吉医师不可能也无必要

23、对所观察过的全部内容作所有阳 性或阴性的叙述。根据当前的情况我们认为在医学影像学表现”项目中应包括以下三方面的内容，而书写繁简程度可由各组室自行决定。(1)临床对匿学影像学诊断所要求的内容：即阐明有无临床所疑疾病的种种表现或征象， 如有者则应对所出现的病变大小，形态与部位等等一一加以描述，并对该疾病应该或可能出现而未出现的表现说明朱见”。此外还应对疾病定位与定性有关表现或征象说明见到”或朱见到“。见到”者再加以必要的描述。(2)临床要求(即临床所疑疾病)以外的阳性发现。(a)意外或偶然发现临床所疑疾病”以外疾病的征象。如骨外伤患者所摄骨路片上偶然发现骨软骨瘤：(b)种种正常变异的表现；(c)成

24、像的伪影的表现；(d)难以解释的不能据之作出医学|影像学诊断的一些表现。对于后一种情况应在医学%像学诊断”项下建议临床作进一步检查，以明确这些表现的意义。(3)讨论：对于判断为正常或诊断十分明确者，其诊断报告书一股无需讨论”。对于诊断比较复杂，即有鉴别诊断的情况存在时，为了使读诊断报告的医师了解书写报告医师的 思路与诊断依据，讨论”就成为必须的内容。对于一些影像表现的病理基础，如 CT所见代 表脑水肿的脑内病灶周围低密度带，报告书写者可以用讨论”的形式在 医影像学表现”中述及。对于一些影像表现可能出现那些临床症状或是与临床症状相符，也可在医学J影像学表现”项下述及。4、医影像学诊断：为整个医学

25、|影像这一检查的结论。不少阅读报告的临床医师只阅读这一项。报告书写者必须根据医学影像学表现恰如其分地做出这一检查结论。一股分为以下5种情况：(1)正常或未见异常；(2)病变肯定，性质肯定；(3)病变肯定，性质不肯定，这种结论又可分以下二种情况：(a)以某一疾病为 主但不典型，应说明不典型的理由。(b)病变表现无特征性，可有多种可能性，依次说明每种可能性，符合诊断面与不符合的另一面。(4)可疑病变，所见表现不能肯定为病变，可能为止常变异或各种原因造成假象。要 说明不能肯定的原因。(5)需要病员回来补充检查，如补加增强扫描嫩m加做MRI其它序列检查等等.5. 医师签名：签名医师即是此份 医学|影像

26、诊断报告书的责任人，如只有一名医师签名须职称为治医师以上的医师。如书写报告者为住院医师，则他或她可在书写报告”项下签名，而另有职称为治医师以上医师在审核报告医师”项下签名。第二章 普通X线检查诊断报告书写规范posit onreated cnsum pin of cVi - rvants ha s bee ept by .a nce , consumer, egar dless of cst avga- and wase inIe cVI sev poslin re d conlumpl on, abu. crru.nad embezement,eruptionsmportat.Then,un

27、deIeconUIonsofmakeecnomyhowtorfmthesing cvl duy conlumpl on maagemet, exlores a sur t preve nt ad lie post cnsumptin cruption ys -rre a maor ue facedbyhonestworkReenty,I.reseaconthis-ue,thisproblmonsomehumbleopinins.FMhe-sigpubicservant s' duty cnsumpti on t I e main pr e s n from" ” "

28、 and reasons, irecentyeas,pubicsevas'ycnsumpinusedbyIe a buses a nd not a per sn of iegiy,i s one of Ie mjrproblmsithepayinGovernmentisopeainordeh a negative partyand Gvernme nt organs, seri ousy damaging Ie mage of Ie p_y andIeGovernment,undemiigte realnshi p bewee pary ad Ie mases elec,opel ig

29、 up a I d e cnomc cns_I_in. FomI Ccuny i ecetyeasofg<e.a nne si ion se, posii ons cnsmpin in t Ie pl-icd I f "wno" phe I omenon r eddeig four a f ues a isposiinscnsumpIonsystmlsthasdueofbiding,rigtisgert han ruls, a nd rg It s geae Ia nmehod of "eomeonmore hghi“I I i s i posins cnn

30、umpti on inlhe Camea Obcua opeain, us ng ems Wl posiins cnsumpI I n i nI ha s pe sona connumpI on, w l aepoins I it I pesna po、s to, maks|osIonscnsmpin insomease-hasiIposiins e|oy ad -lalngofmeasthrie i s Iposii ons fa-,. mpesnaIr TedofnngaiecorruIonp'enomena-cis crruin ad miapprpriain, fup»

31、; s flw Ie fasin, , slandposcnsumpI on becme a smofIeiidvd pailes. Cauued by pui c leva ns '.,cnsumpI on I f many "w" phe nomenon i n wi ch peope relct t he bggst problms ae(< Ie oldca prblms Maiy i nIrre ase cs one s t he lage buss cs ex leduie A ccrd I g I st!B's unti Novmbe 2

32、003, XX Ccuy IwnshipDearmentbus159caswhicparmentownsIebus45veicis,adshowda n incras ng Ied Fia nnjai - pess cs pe bus pe yea I35000 yuan, and i ac evey cost up to 50000 yuan. Some ui s as "ig ttmpoay dies and - pedtre on wig - a nd lubsdes Ne ssay I "kep a ca", but a so de pe I da ns&

33、quot;, eidig I age elene s Secnd, gongchesiyng beed unheat hy Iedencies S ome pe opie beive t ha now sme I us dies use onet hid, one thi d ead ng prvae one Iid uued for ofcia puroses Some pulc-vats,mpecaiedi ng ofas mot oig, cas fr prvae pupooes,voaIngIe-idsc pie rig ulIons a nd ee n led t oIfc acc

34、deI. Accdi ng I sasIcs frm elaid depamessi 4 t he ive s1ain i nour county- s n”, s 1rpre.” s only the is . pu po-s 0r91年浙江省放射质控中心曾由省各质控分中心起草过浙江省放射诊断 报告书写规范”，97年再经省内各级放射科教授、壬与副壬医师进行修改最终形成试行稿”。通过几年 的试行，同时近10多年来我省各级 悭射科设备有很快速发展，以往光靠普通X线作诊断的局面己发生很大的变化。普通X线检查的重要性在改变，部分的检查项目与检查技术已由CT、MRI与DSA替代。尽管如此，我们仍认为普

35、通X线检查与诊断仍是整个放射科影像诊断的基础，我们仍建议要对普通X线表现要作全面的描述与讨论。以下就普通X线常用各个系统诊断报告书写规范作一描述，供作参考。一、胸部X线报告胸廓：对称、畸形、骨骼情况。肺野：肺内血管纹理，肺内有无病灶，如发现病灶要描述其部位、一形态、边缘、大小、 有无空洞等等情况。肺门：正常、增大，有无肿块等。纵隔：气管是否正中，纵隔有无增定及有无肿块发现等。横隔：位置、形态有无改变，肋隔角与心膈角情况。 心脏：外形有无异常变化，心胸比率，各房室情况。二、心脏平片X线诊断报告摄片位置：后前位、右前斜位、左前斜位，左侧位。胸廓：纵隔与横蹄形态有无异常。肺部：重点描述肺门、肺内动、

36、静脉血管纹理的变化， 有无肺动脉高压或肺淤血等表现. 心脏：心外形增大的类型，肺动脉段外形变化，各房室增大的情况，食道左房压迹变化情况。三、泌尿系统X线诊断报告1、平片：(1)两肾轮廓、位置、形态与大小。(2)全尿路区域有无钙化或结石样阴影。(3)腰大肌及腹壁脂肪线影像情况。(4)脊椎、骨盆区、骨骼有无异常。(5)肠道内容情况及其他腹部异常阴影。2、排泄性尿路造影(IVP)(1)两肾轮廓、位置、形态、大小。(2)使用对比剂名称、剂量、浓度。(3)两肾功能显影情况：正常、延迟、不显影。对肾功能差者，造影需延时45'60'或更长时间摄片观察。(4)两侧肾盏、肾孟轮廓显示情况。(5)

37、膀胱充盈情况。(6)两侧输尿管显示情况。(7)腰椎与骨盆区骨质情况。3、逆行肾盂造影(RCP)(1)两肾轮廓、位置、形态、大小、注明导管位置。(2)使用造影剂的名称、浓度、剂量。(3)两侧肾盏、肾孟、输尿管充盈显示情况。(4)腰舐椎与骨盆区骨质情况。4、膀胱造影(1)造影剂名称、浓度、剂量。positi on-related consum ption of civilse rvantsha sbeen sw eptbyfina nce , consumer,regar dless ofcost,extravagance andwaste in thecivilservi ce position

38、 -related consumpti on, a buse,corruption andembezzlement,corruptionis important.Then, underthe conditi ons ofmarket econom y, how to reformthe existing civil duty consumpti on management, explores asour ce topreve ntand curbthe postconsumptioncorruptionwa y, iscurrentlya majorissue facedbyhonestw o

39、rk.Recently, I conducted research ont hisissue,t hispr oblem on some humble opi nions.First, t heexisting public servant s 'duty consumpti ont he main pr oblem s see n fromthe investigationand reasons,inrecentyears, publicservants 'duty consumptthe relationshi p betw een partyand themasses,e

40、ffect,opening upa nd e conomic construction.FromI Countyin recentyears of governa nce situati on see,positi onsconsumption int heproduced of"twonot" phe nomenon r enderingfourafeatures:a is positionsconsumpti on sy stem lost ha s dueofbindi ng,right isgreatert han r ules,a nd rig htis grea

41、tertha nmethod of phenomenon more highl ight;II i sin positions consumpti on inthe CameraObscuraoperation,using terms,will positionsconsumpti on i nto hasper sonal consumpti on,w illcor porate poi nts toint opersonalpointsto,makespositionsconsumption insome aspe cts has into positions enjoy andself-

42、dealing ofmeans;three i s topositi onsconsumptionforname,fraud,faconsumpti on ofmany "two"phe nomenon i n whi ch people reflectt he biggest problems are: （a） theofficialcar problems. Mainly i nthree aspe cts: oneis t helargerbuses cost ex penditure.A ccordi ng tostatistics, untilNovember20

43、03,XXCounty township Departmentbus 159cars,w hich de partme ntowns thebus 145 vehi cles,and showeda n increasi ng trend.Fina ncialex penses cost perbus peryearto35,000yuan, andin fact every costup to 50,000yuan. Some unit salso hiringtemporarydrivers and ex penditure onwagesa nd subsidi es. Nece ssa

44、ry to "keepa car",but al so "de pe nda nts", le adingtolargerexpenses.Second, gongchesiyong bree dunhealt hy tendencies.S ome pe ople believet hat now some busdriversuseone-tsince 2004,t he correct inve stigation i n our Countyserve s nearly30cars for privatepurpose s,onlythe fir

45、sthalf of thisyear, carsfor private pur posesororing, cars for privatepurposes,violati ng theself-diyanonsumpti on becamsci plinereg ulations,ntorgans,seri ously damaging theimageofthe partyam e a symbol ofshowing offtheirindividualca- - > I -.I . _ - _ _ Itions,and eve n leadto traffic acci dent

46、s.Accordipacitie s一 L nd the Gover nment, underminings.Ca usedbypubli cserva nts 'duty _ngtostatisticsfrom related departments,（2）膀胱充盈的轮廓、形态、大小；病理性改变应说明病变范围大小，边界与邻近脏器的关系。（3）若观察膀胱壁者应测量其厚度，边缘与周围情况。（4）男性应包括前列腺增生向膀胱突出压迫情况。（5）有无其它异常发现。四、头颅、五官X 线诊断报告1 、头颅平片X 线诊断报告（1）头颅大小与形态。（2）颅骨内外板与板障厚度与密度情况。（3）颅缝与囱门

47、有无异常。（4）脑回压迹有无增多、增深。（5）颅板血管压迹有无异常。（6）蝶鞍大小、形态。骨质有无异常。（7）颅内有无生理或病理性钙化，其位置、形态。大小、数目如何。（8）头颅软组织情况。2、副鼻窦X 线诊断报告（1）各组窦腔发育情况。（ 2）各窦腔大小、形态、否度有无异常，扣腆有无增1 学，有否液平。（3）鼻腔与眼眶消况。（4）如美腔出现占位性病变应重点描述清理变化情况。3 、乳突X线诊断报告（1）乳突类型（气化型、板障型、硬化型），气房大小及密度。（2）鼓窦入口与鼓窦区有无扩大或骨质破坏。（3）鼓室、天盖、乙状窦骨质情况。（4）内外耳道情况。（5）周围组织骨质结构情况。4 、眼眶X线诊断报

48、告（1）眶窝大小与形态。（2）眶壁骨质结构。（3）眶内软组织密度有何异常改变。（4）眶裂、视神经孔形态、大小及骨壁清况。（5）周围副鼻窦与颅内情况。”5 、下颌骨X 线诊断报告（1）下颔骨骨质有无异常情况，如有病变应按基本病理变化重点描述。（2）牙槽有无病变情况。（3）软组织情况。五、骨与关节系统X 线诊断报告1 、骨与关节外伤X 线诊断报告（1）骨折或关节脱位部位与名称。（2）骨折断端移位情况，对位对线情况。（3）软组织有无积气、异物或肿胀情况。（4）骨折断端或脱位关节有无骨质破坏，或其它骨质改变。2、关节病变X 线诊断报告（1）关节病变发生部位：干骺端、骨干或关节。eaders drivi

49、ng ave hicle a cci de nt caused by road accide nts,1, 1 pe oplek illed and direct e conomi c losses amounti ng tomoret han 100,000 yua n.Third, highefficie ncya nd lowcost ofthe bus. Survey sshowthat,t he operating cost softaxis forthe8200/.Is afundamental priority ofthereform,it isa difficultproble

50、m that mustbesolved i nthe reformpr ocess.Cl early,t hepostcon sumpti onaverages t hreeyears before as a base andfi ne-tuned onthe basis ofthis single practices must beimpr oved.Im provement sto adheretot hree principles:first,underthe existing policy provi sions a pprov ed for public servants '

51、 duty consum ption standards, calibration,is notcontrary to policy.Se cond,a ccordi ng tothe localfinancialsit uationand pe opl e'ssustaina bility, publi cservant s' duty consumptionstandardsapproved, bot h financialrea ch,a nd people passi ngthrough.Third,accordingtothe operationalneeds ofc

52、ivilservantsre sponsiblefora uthorized public servants ' duty consumpti on standards, bothigha nd l owpositi ons, butal sothe nat ureofthe work a nd the workl oad.In reformof method Shang, appr oved civilserva nts positi ons consumptionstandardto "big unified,a nd small disperse d" sui

53、ta ble, t hatmostpositi onsconsumptionpr oject shoul d accordi ng to poli cyprovides proposed unifiedsta ndar d,consider t oranks, a nd unit s andthe w orktask of differences sex, unifiedofsta ndar dshoul d has elasti cofand dy namic of,makesregions, andunitsinimplementati on unified standard Shi ha

54、s m ustofflexible disposalright; butsi ncesetofsta ndar d must afterfinancial,and a udit,sector a udita ppr oved Hou t o impleme ntation.（C） reformpackage.Public servants' duty consumpti on elasticity ofconsum ption to limitconsumption,t urning mess int o kitchen afterdi nner,foll owthe civilser

55、vantwit ha howto usepersonaltitle subsidie s,or how to manage a personaldutyconsumption use ofsubsidies.T herefore,w emustesta blish and perfect with public servants ' dutyconsumpti omonetization reformsupportoftheseries ofgoverna ncesystemssuchas t he civil servi ce examination ofresponsi bilit

56、y, system, lowfa ultinvestigationsystem,thereportsaid.Whileothermeasures t o keep up.Disciplinei nspecti on andsupervisi on organs, financial,a uditingde partments shoul dstre ngthe nsupervisi onand inspe ction of public servant s'duty consum ption moneti zationreform progress,to strengthen ther

57、eform of public servants ' duty consumpti on m onetizati onsystem, measure s to develop andmonitorthe im plementation ofi nspection, not consumpti on a s requi red, even shifting consumer behavi ortost op, serious cases t odealwith. Threei deas, public servants'duty consum ption moneti zationreform ofpolitics, thee conomy andthe dee peningofthe reform, publ