论高校危机管理中法律的形式理性

当前高校危机的层出不穷对高校危机管理提出了较高的要求，而现行危机管理中存在的问题归根结底是没有纳入法制化运行的轨道，法律在介入高校危机管理活动的过程中面临以实质理性还是形式理性为优先的问题。分析高校危机及管理与法律的关系，得出高校危机管理法制建设应以规则、程序优先的形式理性为优先的结论。     

浅谈临床实验室质量控制在药物临床试验工作中的重要性

临床实验室质量管理是医院全面质量管理的重要组成部分,同时也是医院药物临床试验管理规范(GCP)建设的重要内容。检验科实行全面的质量管理是为了向临床提供精准的、可信赖的、高品质的检验结果,并得到药物临床试验受试者、临床医师或研究者和药物临床试验机构办公室的信赖与认可。但是在实际工作中,仅通过检验科实行全面的质量管理还不够,同时还需要与各个临床科室进行多种形式的有效沟通,以此来实现检验科质量管理的提升。所以把检验科质量控制增加到GCP质量管理体系是非常有必要的,与此同时还要和医院质量管理体系有机结合才能使医院的医疗质量得到了显著的提升,GCP的研究水平也就得到了相应的提升。     

现代医院中药管理理论与模式在我院药学管理实践中的应用

目的:探索现代医院中药管理新模式,提高医院药事管理水平。方法:根据有关法规,参照《现代医院中药管理学》的理论与模式,结合我院实际开展药学管理的工作实践,阐述我院在加强药学人员培养、加强调剂管理、加强临床药学工作、重视药学科研工作、搞好制剂管理等方面取得的成绩。结果与结论:现代医院中药管理理论与模式既规范了我院药学管理,又提升了药学管理水平,符合当前新"医改"形势下医院药事管理的要求,是一种值得借鉴、参考的医院药事管理理论与模式。     

医药商业企业与社区医院合作开发药房信息化管理的工作实践

随着社区医疗卫生服务工作的全面深入开展,医院药房实行信息化管理已成为提高医院综合管理水平和效率不可短缺的组成部分。但是在药品实行零差率收费,政府对社区医疗投入未充分的情况下,医药商业企业凭借自身成熟而强大的物流信息管理系统和管理经验,与社区医院合作开发药房信息管理系统,参与医院药房管理,对帮助社区医院快速提升药房信息管理水平,有着十分积极的探索意义。本研究就广州医药有限公司与广州市荔湾区若干医院合作开发信息系统对药房进行管理的实践收获,作几点介绍。     

Crisis management strategies.

This paper discusses the different facets of crisis as experienced within the pharmaceutical industry but which are also prevalent throughout other industries. It highlights the importance of early identification and management of crises and issues, which in return are strongly intertwined with a fundamental positive internal corporate climate. A corporate philosophy should always embrace crisis management with the attitude of 'when' and not 'if'; therefore, a company should act today and not tomorrow once a crisis is on its doorstep. Preparation is of utmost importance and there are several items that can be addressed even before a crisis has arisen. Further, this paper also provides guidance on how to deal with the media, what to do and what not to do, and how to appoint the appropriate spokesperson. In this era of fast exchange of information, crisis, which previously may have stayed behind corporate doors, may not do so any longer. Image is very important and should therefore not be risked. Crisis and issue management should therefore be integrated in every company's philosophy and standard operating procedures.     

Investigation and multivariate statistical analysis of the factors influencing risk management

A questionnaire survey for medical practitioners was conducted to clarify their basic awareness and concepts of risk management. One hundred and sixty-three medical practitioners participated in the fourth. Chugoku Yakugaku Kenkyukai. More than 50% of the participants (n = 83, aged 39.7 +/- 10.8 years) answered correctly questions about the awareness of risk management and the existence of a risk management committee in their medical institution. All of those survey participants had experienced common risk managements incidents (approximately 12 times/year) during working hours. When multivariate statistical analysis was performed on the survey results, the factors influencing the presence of a risk management committee in a medical institution were a system for the submission of incident reports, the number of beds, and the presence of a person assigned to manage risk. The analysis showed that in a number of cases medical institutions did not have a system for incident reports and did not appoint risk management staff. Moreover, the analysis showed that factors influencing the presence of a risk management committee were staff age, experience in submitting incident reports, and participation of the top executive in the operation of the risk management committee. Participants younger than 40 years of age were dissatisfied with the reporting system of risk management committees those older. The younger group usually reported incidents to those older than 40 years of age, who only accepted the reports and did not submit them to the risk management committee. In conclusion, our results suggest that in a risk management program it is important to establish a committee and a system for the submission of incident reports. Incident reports should not only include expressions of regret for medication errors but also propose a plan for improvement.     

论药品生产企业质量管理标准问题

本文论述了什么是质量管理，指出GMP不是质量管理，只是质量管理的一部分。不能用GMP作为质量管理的标准。制药企业应以ISO9000族标准为质量管理和质量保证的标准，并把GMP与ISO9000结合起来。     

Pharmacological treatment of bowel obstruction in cancer patients

INTRODUCTION: Malignant bowel obstruction (MBO) is a common complication of advanced cancer, occurring most frequently in gynaecological and colorectal cancer. Its management remains complex and variable. This is in part due to the lack of evidence-based guidelines for the clinicians involved. Although surgery should be considered the primary treatment, this may not be feasible in patients with a poor performance status or advanced disease. Advances have been made in the medical management of MBO which can lead to a considerable improvement in symptom management and overall quality of life. AREAS COVERED: This review emphasizes the importance of a prompt diagnosis of MBO with early introduction of pharmacological agents to optimize symptom control. The authors summarize the treatment options available for bowel obstruction in those patients for whom surgical intervention is not a feasible option. The authors also explore the complexities involved in the introduction of parenteral hydration and total parenteral nutrition in this group of patients. EXPERT OPINION: It is not always easy to distinguish reversible from irreversible bowel obstruction. Early and aggressive management with the introduction of pharmacological agents including corticosteroids, octreotide and anti-cholinergic agents have the potential to maintain bowel patency, and allow for more rapid recovery of bowel transit. A combination of analgesics, anti-emetics and anti-cholinergics with or without anti-secretory agents can successfully improve symptom control in patients with irreversible bowel obstruction.     

浅谈我院药房管理存在的问题和对策

药房在医院药品管理中发挥着重大作用,但目前医院药房普通存在着制度不规范、管理不科学、药学服务人员整体素质不高等问题,这严重影响了医院的对外形象,同时对医院安全用药也产生了不良影响。制定相关制度,加强管理是改善药房现状的主要措施,这对提高药品管理、医院管理水平具有重大意义。     

儿科护理管理中风险分析与对策

目的为了说明儿科护理管理中风险管理的重要性,详细分析了儿科护理工作的风险因素,并提出了防范对策。方法分别对专科护理知识缺乏、规章制度落实不到位、护理专科技术水平低、缺乏沟通技巧、责任心不强、护理风险管理组织体系不健全等风险因素进行分析,并针对这些风险因素提出了相应的防范对策。结果应用防范对策能有效预防护理风险的发生,将护理差错事故降低到最小限度。结论分析儿科护理管理中的风险因素并提出防范措施,对保证医疗护理工作安全具有重要的临床意义。     

Treatment of chronic obstructive pulmonary disease in older patients: a practical guide

Chronic obstructive pulmonary disease (COPD) is a common disability, largely encountered in the elderly population, in whom it causes significant morbidity and mortality. The general perception of health professionals is that COPD is often a self-inflicted disorder affecting the more socio-economically disadvantaged segment of the population with significant comorbidity. COPD is the least funded in terms of research in relation to illness burden compared with other chronic diseases. However, recently published guidelines of both the British Thoracic Society and the Global Initiative for Chronic Obstructive Lung Disease have highlighted best management strategies both of chronic symptoms and acute exacerbations in this patient group. The chronic management of COPD should, like asthma, involve a stepwise approach with smoking cessation being pivotal for all severities of COPD, regardless of patient age. The mainstay of therapeutic treatment remains regular bronchodilators, both beta(2)-adrenoreceptor agonists and anticholinergic agents. Current evidence suggests that long-acting beta(2)-adrenoreceptor agonists such as salmeterol and the new long-acting anticholinergic agent tiotropium bromide are more efficacious than their shorter acting equivalents such as salbutamol and ipratropium bromide in terms of bronchodilation, improved well-being and a reduction in acute exacerbation rates. Additionally since they are taken once or twice daily compliance should be improved. The role of long-term inhaled corticosteroids in the chronic management of COPD is contentious. Only those patients with COPD who have been shown to respond to a formal corticosteroid trial, preferably with a 2-week course of oral corticosteroid, should receive long-term inhaled corticosteroids. In the management of acute exacerbations in acidotic patients nasal ventilation is the treatment of choice in addition to conventional treatment with bronchodilators and oral corticosteroids. Antibacterials need not be prescribed universally in all exacerbations of COPD. Pulmonary rehabilitation classes either individually or in groups have been shown to be beneficial in the management of patients with COPD and their use in secondary care is to be encouraged. Most treatment modalities do not improve pulmonary function in patients with severe COPD. Therefore, pulmonary function including spirometry should be used to make the diagnosis of COPD but not as a monitor of efficacy of treatment. Assessment of severity of COPD and improvement with treatment modalities is best done with dynamic exercise testing such as 6-minute walk tests and incremental shuttle walk tests or with the administration of disease-specific physical disability and quality-of-life questionnaires. Most COPD research does not specifically target the older COPD patients and these patients may merit special consideration for their optimum assessment and management.     

国家食品药品监督管理局国家药品标准(新药试行标准转正式标准)颁布件

为处理组密钥管理中的"1影响n问题",曹国梁等人提出了组密钥与个体密钥之间存在广义猫映射关系的组播加密算法及其密钥管理方案.我们进一步分析其密码强度、前向/后向保密性和可扩展性问题.解析结果表明:对已知明文攻击的脆弱性使该密码不适合提供组播数据保密性安全服务;通信开销以组规模为渐近下界,使该方案不满足大型组播组中密钥管理低带宽开销的QoS要求.分析方法对其他密码算法转化为组密钥更新协议的研究亦有积极作用.     

加强医疗质量管理对提高病案书写质量的分析

目的通过医疗质量管理干预了解病案书写质量是否有所改变。方法对比在经过医疗质量管理干预之后病案书写质量和干预之前病案书写质量,进行分析研究。结果 2012年1月实行医疗质量管理干预后病案甲级数量明显增多,甲等率为91%,而在医疗质量管理干预之前,医院病案的甲等率只有70%,干预之前和干预之后存在明显的差异。结论通过有效合理的医疗质量管理干预,可以提高医院病历质量,这在医院管理中有着重大的意义。     

Dyspepsia: how to manage and how to treat?

Recent guidelines for dyspepsia, defined as pain or discomfort centred in the upper abdomen, emphasize that in younger patients with no alarm features and not taking nonsteroidal anti-inflammatory drugs, testing for Helicobacter pylori and treatment of the infection if present is a standard of care. If H. pylori is not present, empirical management (e.g. acid suppression) is often prescribed. It is further recommended that if patients relapse or fail to respond to treatment then upper endoscopy be undertaken. However, these guidelines have become controversial for a number of reasons. Firstly, the prevalence of H. pylori infection is falling as is the incidence of peptic ulcer disease due to the infection. Idiopathic peptic ulcer disease is also being increasingly recognized. Furthermore, the cost-effectiveness of endoscoping treatment failures has been questioned, as the yield is low and patient management is usually not altered. Finally, it remains controversial whether the treatment of H. pylori infection in functional dyspepsia is of value, and two recent high quality meta-analyses have reached diametrically opposite conclusions. Alternative strategies, such as initially treating with acid suppression and then considering H. pylori infection in those who fail have been suggested, as has in low H. pylori prevalent regions the abandonment of a test-and-treat strategy. However, appropriate management trials of these alternative strategies in primary care are lacking. The management of patients with functional dyspepsia who fail initial antisecretory therapy is now difficult; prokinetics have fallen into some disrepute. Tricyclic antidepressants (at a low dose) may be useful in a subset, but adequate trials are lacking.     

Dyspepsia: how to manage and how to treat?

Recent guidelines for dyspepsia, defined as pain or discomfort centred in the upper abdomen, emphasize that in younger patients with no alarm features and not taking nonsteroidal anti-inflammatory drugs, testing for Helicobacter pylori and treatment of the infection if present is a standard of care. If H. pylori is not present, empirical management (e.g. acid suppression) is often prescribed. It is further recommended that if patients relapse or fail to respond to treatment then upper endoscopy be undertaken. However, these guidelines have become controversial for a number of reasons. Firstly, the prevalence of H. pylori infection is falling as is the incidence of peptic ulcer disease due to the infection. Idiopathic peptic ulcer disease is also being increasingly recognized. Furthermore, the cost-effectiveness of endoscoping treatment failures has been questioned, as the yield is low and patient management is usually not altered. Finally, it remains controversial whether the treatment of H. pylori infection in functional dyspepsia is of value, and two recent high quality meta-analyses have reached diametrically opposite conclusions. Alternative strategies, such as initially treating with acid suppression and then considering H. pylori infection in those who fail have been suggested, as has in low H. pylori prevalent regions the abandonment of a test-and-treat strategy. However, appropriate management trials of these alternative strategies in primary care are lacking. The management of patients with functional dyspepsia who fail initial antisecretory therapy is now difficult; prokinetics have fallen into some disrepute. Tricyclic antidepressants (at a low dose) may be useful in a subset, but adequate trials are lacking.     

Review article: current antiviral therapy of chronic hepatitis B

Background The long‐term goals of therapy for chronic hepatitis B are to reduce serum HBV DNA to low or undetectable levels and ultimately reduce or prevent the development of cirrhosis and hepatocellular carcinoma. Aim To review the current treatment of chronic hepatitis B, with a focus on diagnosis and management of resistance and active management of suboptimal responses. Methods A systematic review of the literature, with a focus on recent guidelines, was undertaken. Results Among the six drugs licensed for the treatment of chronic hepatitis B in the US, the preferred agents in 2008 will include entecavir, peginterferon alfa‐2a, possibly telbivudine, and tenofovir following licensure. When using an oral agent, a major focus of management is on the selection of a drug with high potency and low rate of resistance, and active on‐treatment management to optimize therapy. Preventing the sequelae of antiviral drug resistance and appropriate management when resistance is initially detected are also the major focus of current management. The addition of an antiviral agent that is not cross‐resistant is critical to restore suppression of viral replication. Conclusions Newer agents and modified treatment strategies, especially using combination therapy, hold promise to optimize the management of patients with chronic hepatitis B by achieving the high potency and the lowest rate of resistance.