美国军队特需药品勤务保障面临的挑战及启示

军队特需药品是卫勤保障的重要物资,美国是较早使用军队特需药品防治军人伤病的国家之一。文章介绍了美国军队特需药品的勤务保障现状与特点,并对美军在军队特需药品研发、生产、供应、使用中所面临的挑战进行了分析,为我国军队特需药品勤务保障提供借鉴。     

美军特需药品军民融合管理经验借鉴研究

军队特需药品(简称"军特药")是军队保障作战需要和维护国家安全的重要战略物资,历来受到各国军队高度重视.美军在长期的军特药管理中,取得了许多宝贵的经验与教训.该文通过整合分析美军与FDA的军特药在科研、采购、使用和储备等方面的军民融合管理现状,系统总结其成功经验,发现存在问题,并对我军探索适合自身特色的军特药军民融合管理提出系列建议.     

军队特需药品使用风险管理研究

由于军事勤务的需求,军队特需药品使用的风险/效益评估标准也与一般药品有所不同。对军队特需药品的使用进行风险管理并构建军队特需药品     

正确理解和科学运用《中国人民解放军特需药品管理办法》——纪念《中国人民解放军特需药品管理办法》颁发两周年

解放军三总部联合颁发的《中国人民解放军特需药品管理办法》(以下简称《管理办法》)已实施近两年了。《管理办法》的颁发实施是新形势下加强我军军事药学建设的重大举措,标志着军队特需药品(以下简称特需药品)的管理走上法制化、正规化、科学化轨道。两年来,军队各级卫生行政部门普遍开展了学习、宣传活动,使《管理办法》逐步深入人心,在实践中取得了较好成果,截止1997年上半年,全军已批准核发军用特需新药证书28个,批准文号20个,正在审理的军用特需新药12个。可以说,     

军队特需药品研发卫勤评估灰色系统评价分析

目的对军队特需药品研发立项环节的卫勤评估指标体系进行实证检验。方法依据军队特需药品研发勤务技术指导原则及其相关管理规定,结合已确定的特需药品研发卫勤评估指标体系,运用多层次灰色分析系统评价方法,对68种军队特需药品进行量化评估。结果根据多层次灰色分析系统评价方法,计算了68种军队特需药品的灰色关联系数,并进行了比较排序。结论多层次灰色关联系数排序结果与实际入选立项的特需药品基本一致,同时该方法直观可行,能避免一定的主观性,具有较大的实际意义。     

军队特需药品研发卫勤评估灰色系统评价分析

目的对军队特需药品研发立项环节的卫勤评估指标体系进行实证检验。方法依据军队特需药品研发勤务技术指导原则及其相关管理规定,结合已确定的特需药品研发卫勤评估指标体系,运用多层次灰色分析系统评价方法,对68种军队特需药品进行量化评估。结果根据多层次灰色分析系统评价方法,计算了68种军队特需药品的灰色关联系数,并进行了比较排序。结论多层次灰色关联系数排序结果与实际入选立项的特需药品基本一致,同时该方法直观可行,能避免一定的主观性,具有较大的实际意义。     

外军军队特需药品制剂研究进展

药物制剂直接影响到药物的使用方式和治疗效果，是军队特需药品研发的重要内容。外军在军队特需药品制剂的研发处于领先地位，其理念值得学习和借鉴。该文对外军军队特需药品进行了分析归类，综述了具有鲜明军事特色的药品剂型，从药剂学的角度分析了外军军队特需药品的特点，在此基础上，对外军军队特需药品制剂的发展方向作了预测和展望。     

论军队特需药品的特殊性及注册管理原则

药品注册是为了最大限度地保证公众的用药安全和有效，依照法定程序，对拟上市销售药品的安全性、有效性、质量可控性等进行系统评价，并做出是否批准的决定 。军队特需药品作为药品的一部分，同样需要通过注册审批；作为军队专用，又与普通药品的要求有所不同，那么，应当如何处理军队特需药品的特殊性、安全性、有效性的关系，本文对此做一粗浅的探讨。     

美军平时医疗用药政策的启示

用药政策是医疗卫生体制改革的重难点问题之一,美军在充分满足军人医疗用药需求的基础上,采取多种有效措施控制药品总费用。本文介绍了美军平时用药政策,包括运用经济学手段拟定军队处方集（uniform for-mulary）、设立个人支付费用标准、提供多种药品供应保障渠道、推行通用名药品优先使用政策等,并对我军合理医疗用药政策可借鉴之处进行了分析与讨论。     

外军卫勤研究系列讲座（41） 美陆军军用特需药品现状分析

军用特需药品是军队用于战伤和军事特殊环境引发疾病的药品,包括预防、治疗和诊断等用途的药品及试剂。美陆军医学研究与物资部2007年公布的《卫生产品手册》,基本列出了美陆军军用特需药品的所有类别。现主要根据该手册及相关资料,对其军用特需药品的现状简要分析如下。     

美军卫勤模拟仿真发展与启示

目的探讨美军卫勤模拟仿真的发展现状及对我军的启示。方法采用情报调研、文献计量、知识图谱等方法,分析美军卫勤模拟仿真的基本概念、体系框架、科研分布和重点领域。结果美军卫勤模拟仿真发展较为成熟,其全球影响力正逐渐扩大;美国空军和海军是从事卫勤模拟仿真研究最为重要的机构,与英国和加拿大军队也有一定的合作;美军卫勤模拟仿真研究的重点领域包括卫勤指挥模拟仿真和医疗救治模拟训练。结论我军应借鉴美军卫勤模拟仿真的成功经验,构建标准化平台,加强与地方高水平科研机构合作,围绕目前亟需解决的卫勤保障问题开展研究。     

美军联合战场创伤系统的发展及应用

联合战场创伤系统是美军为了提高伊拉克和阿富汗战场上的战伤救治效果而建立的一种创伤救治系统。2004年美军开始在伊拉克战场应用该系统,2005年开始在伊拉克和阿富汗战场全面应用。本文梳理了美军联合战场创伤系统的发展历史,探讨了该系统的任务、目标及组织构成,分析了其在伊拉克和阿富汗战场上的应用效果。     

美军心理健康维护进展

美军自2001年参加阿富汗战争和2003年参加伊拉克战争以来,创伤性脑损伤、自杀、创伤后应激障碍等成为其日益关注的问题。本文围绕目前美军心理健康维护的工作重点,介绍了其在心理健康维护方面的科研和工作进展。     

Temporal lobectomy for refractory epilepsy in the U.S. military

OBJECTIVES: To determine the characteristics, seizure outcomes, and quality-of-life outcomes for military beneficiaries undergoing partial temporal lobectomy for refractory epilepsy at the only U.S. military medical center with a comprehensive epilepsy surgery program. METHODS: The records of all 84 patients treated with partial temporal lobectomy between 1986 and 2000 at Walter Reed Army Medical Center were retrospectively reviewed. Outcome measures included seizure frequency according to the Engel classification system, driving, employment, anticonvulsant use, and military service. RESULTS: The study cohort consisted of 72 military dependents, 10 active duty military members, and 2 military retirees. Two years after surgery, 65 (92%) of 71 patients had seizure improvement (Engel classes I-III) and 46 (66%) of 71 had seizure remission (Engel class I). Driving and employment rates increased after surgery, whereas anticonvulsant use decreased. Five (50%) of 10 active duty patients achieved seizure remission postoperatively and continued to serve in the Armed Forces. Active duty patients had a later age of seizure onset, shorter duration of epilepsy, and greater proportion of lesional epilepsy, compared with nonactive duty patients. CONCLUSIONS: Epilepsy surgery outcomes in the U.S. military are similar to those reported from nonmilitary centers, with the majority of patients experiencing seizure remission and improvements in quality-of-life measures. Complete seizure remission after successful anterior temporal lobectomy enables some active duty military members to continue service in the U.S. Armed Forces.     

Military medical statistics: the status, problems and outlook

The reform of medical service of the RF Armed Forces has objectively required the conduction of quite definite changes and military and medical statistics as an applied science, the teaching subject and field of practical activity of medical service. The results obtained during analysis of experience of the Armed Forces personnel medical support for the last years have shown that it is necessary to widen the scope of military and medical statistics applications by military physicians, medical specialists of medical service head-quarters in the form of their informative and statistic activity which is one of the integrated part of medical service in military men. The article presents the main results of military and medical statistics reformation, as well as principal trends of its further improvement.     

Factors associated with heavy alcohol consumption in the U.K. armed forces: data from a health survey of Gulf, Bosnia, and era veterans

BACKGROUND: Little is known about the patterns of alcohol use in the U.K. Armed Forces or the factors associated with heavy drinking. METHODS: Analysis of existing data from the King's Military Cohort was conducted of a large, randomly selected cohort of service personnel. The original sample consisted of 8,195 service personnel who served in the U.K. Armed Forces in 1991: a third deployed to the Gulf (1990-1991), a third deployed to Bosnia (1992-1997), and the final third, an "Era" comparison group, in the Armed Forces in 1991 but not deployed. For the purposes of this study, female serving personnel were excluded. The study used a "case-control" study design nested within the above cohort; "heavy drinkers" (those who drank >30 units/week) were compared with "light drinkers" (those who drank <21 units a week). RESULTS: Heavy drinking was associated with current military service and being unmarried or separated/divorced. Heavy drinking was more common in younger personnel who had deployed to Bosnia. Those who drank heavily were also more likely to smoke; heavy drinking was associated with poorer subjective physical and mental health. CONCLUSIONS: Certain subgroups of the Armed Forces appear to be more at risk and it may be possible to target resources to such individuals to improve detection and allow prompt treatment.     

美军人道主义救援与减灾桌面推演做法及启示

通过参加美军举办的以“全球卫生参与（ GHE）”课程为基础的桌面推演,明确GHE概念,进一步了解美军参加人道主义救援与减灾行动的原则、计划、行动、监管,以期对我军今后开展此类行动及相关训练提供启示。     

Infectious diseases investment decision evaluation algorithm: a quantitative algorithm for prioritization of naturally occurring infectious disease threats to the U.S. military

Identification of the most significant infectious disease threats to deployed U.S. military forces is important for developing and maintaining an appropriate countermeasure research and development portfolio. We describe a quantitative algorithmic method (the Infectious Diseases Investment Decision Evaluation Algorithm) that uses Armed Forces Medical Intelligence Center information to determine which naturally occurring pathogens pose the most substantial threat to U.S. deployed forces in the absence of specific mitigating countermeasures. The Infectious Diseases Investment Decision Evaluation Algorithm scores the relative importance of various diseases by taking into account both their severity and the likelihood of infection on a country-by-country basis. In such an analysis, the top three endemic disease threats to U.S. deployed forces are malaria, bacteria-caused diarrhea, and dengue fever.     

Humanitarian service and recruitment and retention of uniformed services medical personnel

A recent voluntary survey of 410 personnel from the U.S. Armed Forces Medical Departments and the Public Health Service indicated that humanitarian service experience has positive effects on recruitment and retention: 48% of respondents indicated that the opportunity to provide humanitarian service was a factor in their decision to join a uniformed service and 62% indicated that humanitarian service opportunities positively influenced their decision to remain in uniform. Humanitarian service requirements were a disincentive to remain in uniform for 25%. Pending further study, these preliminary implications can be applied to personnel policies and programs to recruit and retain uniformed health care professionals.