牙疼不可随便用药

很多人都会遇到牙疼的情况,有些人的牙疼经常反复发作,严重影响生活。有些人听信传言,用一些所谓的偏方治疗,病情也不见好转。正确的做法是:要为牙疼选好药,首先要清楚引起牙疼的原因和疾病的状况。临床上,最容易引起牙疼的疾病有牙髓炎、根尖周炎、冠周炎等。     

重视新生儿临床用药研究

新生儿是特殊的儿童群体,其药代动力学和药效学与年长儿和成年人有显著差异,既往将年长儿或成年人用药经验用于新生儿群体疾病治疗,曾造成严重后果。由于新生儿药物临床试验存在费用高、风险大、伦理学问题及受试者招募困难等问题,新生儿临床用药研究仍亟待加强。目前各国已制定相应的法律、法规推动和规范儿童药物试验,新的研究技术和方法也不断应用于新生儿临床药物研究,新生儿科医师、临床药师及其他科研工作者有必要通力合作加大新生儿用药研究,确保新生儿用药的安全性和有效性。     

女人,别与酒精做朋友

男女有别长期的研究和观察发现,酒对女性的危害要大于男性.男性长期酗酒出现酒精中毒症大约需要10～15年,而女性只要5～10年.这是因为女性体内雌激素的分泌能妨碍乙醛脱氢酶的作用,而乙醛脱氢酶正是人体内分解酒精的代谢产物乙醛,减少其毒性的重要物质.所以女性饮酒后,体内乙醛含量很容易增加,酒精的毒性作用也更强.     

Gatekeeping strategies for clinical trials that do not require all primary effects to be significant

In this paper we describe methods for addressing multiplicity issues arising in the analysis of clinical trials with multiple endpoints and/or multiple dose levels. Efficient 'gatekeeping strategies' for multiplicity problems of this kind are developed. One family of hypotheses (comprising the primary objectives) is treated as a 'gatekeeper', and the other family or families (comprising secondary and tertiary objectives) are tested only if one or more gatekeeper hypotheses have been rejected. We discuss methods for constructing gatekeeping testing procedures using weighted Bonferroni tests, weighted Simes tests, and weighted resampling-based tests, all within the closed testing framework. The new strategies are illustrated using an example from a clinical trial with co-primary endpoints, and using an example from a dose-finding study with multiple endpoints. Power comparisons with competing methods show the gatekeeping methods are more powerful when the primary objective of the trial must be met.     

医院管理应具先进文化性

在回顾总结20多年来我国医院管理取得的成绩和存在问题的基础上，提出了医院管理应具先进文化性的理念，强调医院管理要引进入人文管理理念，引入六西格玛管理语境，引入质量实时监控举措。     

浅谈磁共振设备不容忽视的安全问题

MR相关人员必须对磁共振设备的安全问题保持清醒的认识，本文着重从强磁场、强射频场、制冷剂等几方面加以分析。     

Decision-making capacity should not be decisive in emergencies

Examples of patients with anorexia nervosa, depression or borderline personality disorder who have decision-making capacity as currently operationalized, but refuse treatment, are discussed. It appears counterintuitive to respect their treatment refusal because their wish seems to be fuelled by their illness and the consequences of their refusal of treatment are severe. Some proposed solutions have focused on broadening the criteria for decision-making capacity, either in general or for specific patient groups, but these adjustments might discriminate against particular groups of patients and render the process less transparent. Other solutions focus on preferences expressed when patients are not ill, but this information is often not available. The reason for such difficulties with assessing decision-making capacity is that the underlying psychological processes of normal decision-making are not well known and one cannot differentiate between unwise decisions caused by an illness or other factors. The proposed alternative, set out in this paper, is to allow compulsory treatment of patients with decision-making capacity in cases of an emergency, if the refusal is potentially life threatening, but only for a time-limited period. The argument is also made for investigating hindsight agreement, in particular after compulsory measures.