关于我国体外诊断试剂监督管理改革的建议

本文综述了美国、欧盟、日本、中国目前对体外诊断产品（试剂）监督管理的现状以及我国存在的问题。并根据我国具体情况提出了对体外诊断试剂监督管理的改革建议。     

中国医药流通业的现状及发展策略

目的 :提升我国医药流通企业的竞争力 ,使之更好地适应WTO规则 ,以构建一条安全、高效、便捷的药品流通之路。方法 :走访全国22个省市的医药相关部门和企业 ,收集第一手资料 ;并查阅了大量文献。结果与结论 :政府应加强宏观管理 ,构建公平、统一、有序的全国市场 ;企业要“做大”、“做强” ,提高核心竞争力 ;行业协会应切实发挥微观协调作用。     

依托科学基金促进高校青年科技人才快速成长

本文分析了我校医科35岁以下青年科技人才面临的现状,他们申报、承担的以资助基础研究为主的科学基金的相关情况,探讨了科学基金对他们资助和培养中存在的问题,提出了青年科学人才适应科学基金发展要求以促进自身成长等建议.     

¿Cómo elaborar un proyecto de investigación en ciencias de la salud?

Knowing how to properly prepare a research proposal is a real challenge — and being able to prepare an excellent research proposal is increasingly a requirement to compete for funding with assurances of success. With this in mind, we aim to share with the reader our experience (in many cases, unsuccessful) as applicants on the most important aspects of preparing a research proposal and securing its approval and funding. This article aims not only to list theoretical recommendations but also to share some personal and eminently practical suggestions on the following elements of a research proposal: the title, the abstract, the introduction, the objectives, the methodology, the work plan or schedule, the proposal's consistency and coherence, its viability, its applicability, the importance of the principal investigator and the research team, the proposal's limitations and alternatives, its budget, its references, and, finally, the research proposal's form or wording. In summary, a research proposal is a carefully written plan that includes all the scientific, ethical and logistical aspects of the study to be conducted. Writing a good research proposal requires considerable effort and a great deal of time, but it's worth it.     

The Natural Evolutionary Relationships among Prokaryotes

Two contrasting and very different proposals have been put forward to account for the evolutionary relationships among prokaryotes. The currently widely accepted three domain proposal by Woese et al. (Proc. Natl. Acad. Sci. USA (1990) 87: 4576-4579) calls for the division of prokaryotes into two primary groups or domains, termed archaebacteria (Archaea) and eubacteria (Bacteria), both of which are suggested to have originated independently from a universal ancestor. However, this proposal, which is based primarily on genes involved in the information transfer processes, is inconsistent with the ultrastructural characteristics of prokaryotes as well as with many gene phylogenies and provides no explanation as to how the structural and molecular differences seen between these groups arose and how other prokaryotic taxa are related or evolved from the common ancestor. It also postulates that the last common ancestor of all organisms was a hypothetical entity lacking a cell membrane, which is contrary to the basic requirement of a cell membrane to define and separate all forms of life from the surrounding environment. A second alternate proposal for the evolutionary relationships among prokaryotes has emerged from extensive analyses of numerous conserved inserts and deletions found in various proteins (Gupta, R. S., Microbiol. Mol. Biol. Rev. (1998) 62: 1435-1491; FEMS Microbiol. Rev. (2000) 24: in press. This proposal points to a specific relationship between archaebacteria and Gram-positive bacteria, both of which are prokaryotes bounded by a single cell membrane (monoderm prokaryotes). Gram-negative bacteria, which are bounded by two different membranes (diderm prokaryotes), are indicated to comprise a structurally and phylogenetically distinct taxa originating from Gram-positive bacteria. This proposal postulates that the earliest prokaryote was a Gram-positive bacteria from which both archaebacteria and diderm prokaryotes evolved by normal evolutionary mechanisms in response to the strong selection pressure exerted by antibiotics produced by certain groups of gram-positive bacteria. This proposal accounts for both the molecular as well structural differences seen among the main groups of prokaryotes by known evolutionary mechanisms without invoking any hypothetical process or entity and thus is a closer representation of the natural relationships among prokaryotes than the proposal for two distinct domains. Based on this new proposal, it is now possible to logically deduce the branching order of different prokaryotic taxa from the common ancestor, which is as follows: Gram-positive bacteria (Low G + C) (? Archaebacteria) ? Gram-positive bacteria (High G + C) (? Archaebacteria)? Deinococcus-Thermus ? Green nonsulfur bacteria ? Cyanobacteria ? Spirochetes ? Chlamydia- Cytophaga-Green sulfur bacteria ? Proteobacteria-1 (ε, δ)? Proteobacteria-2 (α) ? Proteobacteria-3 (β) ? Proteobacteria-4 (γ). A surprising but very important aspect of the relationship deduced here is that the main eubacterial phyla are related to each other linearly rather than in a tree-like manner, suggesting that the major evolutionary changes within prokaryotes (bacteria) have occurred in a directional manner.     

关于医学院校开展双语教学的思考

大力推行双语教学,是我国深化教育教学改革的重大举措。本文通过分析目前医学院校在开展双语教学过程中存在的问题和不足,探讨了双语教学过程中应进一步加强在师资队伍、学生外语应用水平、教材选用、课程开展的环节控制、网络课程建设、激励机制以及双语教学研究与交流等方面的建设,使得双语教学工作稳步有序地展开。     

构建和谐医患关系的对策研究——全国十城市典型调查

针对全国十城市医患关系现状典型调查结果及影响医患关系和谐的因素分析研究，本文从政府责任、医疗保障、法律、医方、心理学、伦理学及医学教育等七个方面对构建和谐医患关系的对策进行多维的跨学科研究。     

关于完善医院经济管理和职工收入分配改革方案的探讨

财政部、卫生部颁布和印发的《医院财务制度》、《医院会计制度》对药品分开核算，分别管理、固定资产分类核算、采用折旧方法计提修购基金、医疗药品成本核算、结余分配模式等诸多医院经济管理内容提出了新的要求和规范。文章就医院在医疗机构改革、医疗保险改革、执行新的医院财会制度框架下，如何进一步推进改革进程，继续搞好职工收入分配，提高经济管理水平的问题，提出探讨性意见。     

Moving from institutional dependence to entrepreneurialism. Creating and funding a collaborative research and practice development position

Aims of the paper. The paper describes the creation of, the rationale behind and the external funding of a collaborative research‐clinical practice development position. The paper also demonstrates the benefits of nursing's collaboration with external funding bodies and the value of moving from our traditional position of assuming that ‘the hospital’ will always provide. Background. There is a constant refrain that nursing must become more ‘research‐based’ and develop an active research culture. In harsh financial times however, funding for research development is scarce. Nurses can respond to this by bemoaning the lack of money or by taking an entrepreneurial approach, creating innovative project proposals that develop new partnerships and attract external funding. Discussion. Institutional support for clinical research is often more verbal than financial as most health care systems are experiencing extreme financial stringencies. Nurses need to reconsider the notion that every initiative must automatically be funded by the institution. In this paper we show how in a busy major hospital, clinicians and researchers collaborated to create and fund the kind of innovative research and practice development position that may be impossible to fund through existing budgets. Conclusion. With creativity and determination, nurses can challenge the orthodoxy that they are solely dependent on institutional funding. If there is a clear project vision, a convincing rationale, a strongly argued ‘business case’ and a passionate and persistent team, then innovative new projects and positions can be realized. Relevance to clinical practice. Developing clinical focused, practice based research is now a worldwide policy and practice imperative for nurses. Unfortunately, current levels of institutional funding are unlikely to support research promotion positions and initiatives. This paper outlines an approach to securing funding for research initiatives that can create exciting new positions and develop productive partnerships between researchers, clinicians and external agencies.     

再生障碍性贫血治疗中超适应证用药调查分析及管理建议

目的:了解再生障碍性贫血常用药品中超适应证用药情况,为加强超适应证用药管理、减少不合理用药、规避执业风险提供依据。方法:选择2011年1—5月所有住院再生障碍性贫血患者,针对本病治疗药品的使用情况进行统计分析。结果:共调查再生障碍性贫血患者590例,其中有超说明书适应证用药的患者537例,占总病例数的91.02%。结论:再生障碍性贫血治疗中,超适应证用药广泛存在,应对超适应证用药进行分类管理以提高工作效率、规避执业风险。