言论

那是最美好的时代,那是最糟糕的时代;那是智慧的年头,那是愚昧的年头;那是信仰的时期。那是怀疑的时期;那是光明的季节,那是黑暗的季节;那是希望的春天,那是失望的冬天;我们面前什么都     

健康家居 选择会“呼吸”的材料

家庭环境的好坏不是表面的金碧辉煌或单纯的奢侈豪华,更不是昂贵材料的堆砌。尊重材料本身的特性和天然的美感并结合富有创意的设计,方能制造空间的独特个性。     

肝脓肿199例临床分析

肝脓肿(liver abscess,LA)是肝脏外科常见的严重疾病,随着超声、CT的广泛应用和外科治疗技术的不断发展,以及公共卫生、健康条件的改善,抗生素的普遍应用等,肝脓肿的病死率已由原来的70%下降到近年来的15%以下,同时其临     

37例医疗纠纷技术鉴定案例分析

医疗纠纷,是指医患双方对医疗后果、产生的原因以及如何处理而发生的分歧,或者患者对医疗服务不满意,也可以发生纠纷.医疗纠纷的发生不仅直接关系到患者的切身利益,也关系到医疗机构的工作秩序、声誉,处置不当将影响社会的安定.如何预防和处置日趋上升的医疗纠纷,已成为卫生行政部门和医院机构所面临的一个严峻的问题.     

巧妙选药不再脱发

不管在什么年代,头发对人所起的作用都不仅仅限于生物学上的保暖、防御作用,更重要的是扮演着美容修饰等重要角色.拥有健康亮丽的头发可使人充满朝气和自信,然而,随着生活节奏的加快、精神压力的增加,脱发的人数也呈上升趋势,且出现年轻化的迹象.脱发,正成为越来越多现代人的烦恼.     

美国可能出台新的"仿制生物药法案"及"FDA审批管理条例"——访Y. Philip Zhang (张引) 博士

写在开“坛”之际： “高端访坛”——本刊一个新的栏目，也是一种新的尝试。 所谓“访坛”，是指本刊编辑部根据当今国际、国内医药界的热点议题，有目的地对有关人士进行访问，并将他们的观点、看法和建议通过这个“讲坛”转达给本刊的广大读者； 而之所以称之为“高端”，是因为在我们的计划中，选择的专访对象将定位在国内医药界那些具有创新意识、有自己独特的研究领域、并已经取得一定成就的学科带头人和近距离接触国际药学研究及管理先进理念的专家和学者。 我们希望从事医药教学、科研和管理的同行能从来到本“坛”、接受采访的嘉宾们独到的视角、缜密的思维、或卓有成效的分析和解决问题的模式中得到启发和帮助，使我国的医药研究和管理水平能跨上新的台阶，使中国的医药事业能更快更好地发展，为全中国乃至全世界的人民造福。     

浅谈如何加强医疗器械的管理

医疗器械的应用在疾病的诊断、治疗及预防等各个环节都发挥着不可替代的作用,其质量的好坏直接关系到人民群众的身体健康和生命安危.2000年国务院颁布了第一部医疗器械监管法规-<医疗器械监督管理条例>,标志着我国医疗器械监管正式走上了法制化轨道,但是由于种种原因,目前我国在医疗器械的生产、经营以及使用等各个环节都存在着较为普遍和严重的问题,其监管已显得相对滞后,成为食品药品部门监管中的一个"软肋",以至于频频出现像钢板等植入性器械断裂现象和发生举国震惊的"眼球事件".本文就我县医疗器械的经营、使用现状和如何加强对医疗器械的监管作以下分析和探讨.     

心血管疾病发病情况与肾脏移植排斥反应相关性的研究

肾移植的历史从某种意义来说,就是同排斥反应进行斗争的历史。肾移植后的排斥反应主要是由抗原识别,淋巴细胞的增值、分化,靶细胞的损伤这样一连串的免疫反应引起的。随着免疫抑制剂的不断进步,移植排斥反应的发生率降低,长期存活率提高,使得肾移植成为终末期肾病患者的最有效的治疗手段。本文主要探讨了肾移植前心血管疾病与移植后慢性排异反应(CVR)相关性做了细致研究。     

在美国参与管控药物和传染病的一点经历和随想

发达国家都有一套专业架构,这是工业文明过程中发展起来的,科网有搞科技政策研究的如曹聪等老师,对科技的专业架构是内行,我是搞医学的,身在其中而感受到与国内的巨大差距,这也可以大致回答稽少臣老师提出的"为什么国内造不出黑鹰水平的直升机",国内没有独立完整的专业架构。国内对海外人才的吸引,多是行政高层的战略决策,而并无相应的架构来吸收,这些人才除了少部分在克隆发达国家的小架构中生存,绝大部分是难以生根的,实际是表面热内部冷,而回去的多数中低端海归在原有的架构中能产生的效用是有限的,这就产生了贾伟老师的归海有潮的现象。而建立新的架构必然影响现在的国内同行,而产生另一种排挤效应,所以国内最好是专业内的反省和改良,自我更新,再从外部吸收养分来自我提高,这一点日本是亚洲国家里做得最好的。国内对所谓人才的鉴别,基本还是靠头衔和职位,施一公院士问题引起的热议就很能说明问题,真正管事的并不懂专业,     

国外药物靶标开发的现状及特点分析

药物通过结合并调节特定的蛋白或核酸靶标的活性而发挥其治疗作用.大量的药物靶标已经被开发并用于创新药物的发现过程.目前的研究重点是寻找新的靶标和对现有靶标进行更为深入地研究.分析药物靶标开发的现状和特点将有助于我们理解药物的分子作用机制,发现药物靶标开发中涉及的一些规律性的东西,为我国的创新药物开发提供参考.     

Voluntary alcohol and cocaine consumption in "low" and "high" stress plasma catecholamine responding rats

Alcohol (ethanol) and cocaine preference in a free-choice, two-bottle situation was measured in two groups of male and female "low" and "high" plasma catecholamine stress responding rats. Alcohol intake of a 5% solution (percent or mg/kg) showed markedly different but individually consistent intake among animals. "High" plasma catecholamine stress responders consumed more ethanol than did "low" responders. A similar finding was made when animals consumed a 10% solution; fluid intake fell but total ethanol intake remained the same. "High" responders drank more than did "low" responders. After a period of 4 weeks of water only, animals were reexposed to 5% ethanol and a significant positive correlation was seen in the drinking habits of the animals. Afterwards, exposure to a 0.02% cocaine solution resulted in cocaine intake which varied among animals, but was consistent for an individual rat and did not correlate with alcohol consumption. In general, ethanol and cocaine consumption correlated positively with the plasma catecholamine stress response. No significant differences in drinking habits were observed between the sexes. Thus, alcohol preference is a relatively stable characteristic of an animal, is higher in "high" as compared to "low" plasma catecholamine stress responders and does not correlate with voluntary cocaine consumption.     

对“医院药房托管”的思考

目的:探讨"医院药房托管"模式是否有利于降低药品价格、减少患者医药费用支出、更好地让利于民,以及是否有利于医院的管理。方法:通过对"医院药房托管"模式可能导致医院药品经营新垄断出现、导致"新型医药代表"的产生、形成新"利益共同体"、更有利于医师开"大处方",同时从价格链上也并未对药价"虚高"构成威胁,反而可能导致医院监管难度加大、药品质量下降等方面进行分析论述。结果与结论:在目前这种医疗技术和劳务收入不能体现其实际价值,以及药品供求之间的信息不对称的情况下,"医院药房托管"不可能使医院从繁杂的药事事务中解脱出来,也不一定能降低"虚高"药价、减少患者医药费用支出、更好地让利于民。     

“Y” 形及半 “Y” 形延髓梗死的临床特点及影像学对比分析

摘要： 目的 探讨 “Y” 形及半 “Y” 形延髓梗死患者的临床和影像学特点, 并对两者的临床特点进行对比分析。方法 对我院神经内科收治的11例延髓腹、 中及背三部分 （VMD） 同时发生梗死的延髓内侧梗死 （MMI） 患者进行回顾性分析。结果 11例累及VMD的MMI患者中, 6例发生双侧梗死, 呈 “Y” 形; 单侧梗死者5例, 呈半 “Y” 形。延髓 “Y” 形梗死组常见的症状和体征为饮水呛咳或吞咽困难 （6例）、 头晕或眩晕、 肢体无力、 构音障碍 （5例）、 感觉障碍 （5例）、中枢性呼吸障碍 （3例） 等。延髓半 “Y” 形梗死组常见的症状和体征为头晕或眩晕、 肢体无力、 构音障碍 （4例）、 感觉障碍 （4例） 等, 2组间吞咽困难及呼吸困难发生比例差异明显。“Y” 组和半 “Y” 组梗死存在椎动脉先天变异均较常见, 均为3例。MMI患者除呼吸衰竭者外预后可。结论 延髓 “Y” 形梗死患者出现吞咽困难及呼吸衰竭比例远高于延髓半 “Y” 形梗死患者, 一侧椎优势的椎动脉变异是VMD同时受累的MMI患者的重要解剖基础。     

Prospective evaluation of "crack-vial" ingestions

The "crack" (cocaine alkaloid) epidemic has resulted in an increasing number of hospitalizations of "crack-vial body-stuffers," or patients who ingest "crack-vials" in an attempt to avoid prosecution. Management strategies for this type of ingestion are lacking because of the paucity of data. This report discusses the demographics and symptomatology of 23 patients with "crack-vial" ingestions, as well as the value of abdominal radiographs and the utility of varied strategies for decontamination in this patient population.     

养阴益气胶囊的降血糖作用研究

目的：研究养阴益气胶囊的降血糖作用。方法：采用正常动物和糖尿病模型动物进行养阴益气胶囊降血糖作用的药效学研究。结果：养阴益气胶囊对正常小鼠和链脲霉素诱发的糖尿病大鼠均有明显降血糖作用,作用与剂量有关。糖尿病大鼠给养阴益气胶囊0．5h后即出现明显降血糖作用,并可维持12h以上。养阴益气胶囊对肾上腺素性高血糖小鼠也有明显降血糖作用。结论：养阴益气胶囊对正常动物与糖尿病模型动物均有明显的降血糖作用。     

Assessment of cocaine and other drug dependence in the general population: "gated" versus "ungated" approaches

BACKGROUND: There is a need for large-scale epidemiological surveys to be (a) faithful to diagnostic specifications and (b) constrain time and participant burden associated with each section of a possibly lengthy interview. OBJECTIVE: To examine whether one "gating" approach devised for recent large-scale international psychiatric surveys results in a reduced number of identified cases of drug dependence and/or biases in estimated associations with background characteristics. DESIGN AND SETTING: Data from a recently released cross-sectional, nationally representative household survey, the United States National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) were analysed. PARTICIPANTS: Forty-three thousand ninety-three English speaking adults aged 18 years and over. MAIN OUTCOME MEASURES: Dependence upon cocaine and other illegal drug dependence, defined in two ways: "ungated" and "gated". "Ungated" dependence included all persons meeting criteria for DSM-IV dependence, without regard for DSM-IV drug abuse clinical features. "Gated" dependence required at least one feature of DSM-IV drug abuse. RESULTS: There was no statistically robust decrement in the estimated prevalence of cocaine or other drug dependence using a "gated" assessment. Patterns of association of cocaine dependence with background characteristics were not appreciably different when the gated and ungated approaches were applied. CONCLUSIONS: In panoramic mental health surveys, the inefficiency of an ungated approach must be balanced against the anticipated number of cases of dependence without associated social role impairments or harm. In this study, the reduction in the number of identified cocaine dependence cases appeared to be so small that even in a sample of over 40,000 participants, attenuation in population prevalence would prove difficult to detect.     

药物经济学与“me -too”药物研发

目的:探讨药物经济学如何应用于"me -too"药物研发过程中。方法:首先探讨"me -too"药物目前所处的境况,即对"me -too"药物研发的优势和可能付出的代价进行分析,指出药物经济学研究在"me -too"药物研发过程中应用的必要性,并阐述药物经济学在"me -too"药物研发过程中的应用阶段,应用时如何进行方法的选取及应用时可能出现的问题与对策。结果与结论:药物经济学能够促进"me -too"药物研发的合理性。     

Criminal undercover agents or "bad people" doing "good things"

Information and intelligence have always been, and will remain, the most essential components of policing and indeed all law enforcement and security work, including the variety of drug control efforts. Sources of information are varied, ranging from everyday interactions of officers of the law with the public, anonymous reports, the use of paid and unpaid informants from the criminal underworld to law enforcement's and security services' use of agents. This presentation, based on interviews with "handlers" of informants who are offenders, who supply information and evidence against other criminals, and who may have been former comrades of the criminals, explores the dilemmas that informers and their handlers face at each stage of the operation from recruitment to operation in the field, until they "finger" their targets and become state witnesses. During each stage of the operation, agents' motivations, fears, sense of betrayal (being betrayed and betraying others), being snitches, the need to protect their identities, as well as their dependency upon their handlers, are the primary issues to be considered and resolved. Handlers may have to tolerate agents' commission of crimes during operations and often may also have to "treat" the informant's spouse. Borrowed identity, which is the main meaning and dynamic of the informants' actions and of any undercover work, will also be analyzed. This presentation, designed to allow for a presentation of relevant parameters so as to permit the comparative study and classification of undercover work by criminals, will also note critical unresolved issues in this area as well as suggest future needed research.