农村药品市场存在的问题及建议

目的调研农村药品市场存在的问题。方法跟随药品检测车深入到我市108个乡镇、自然行政村,对农村药品市场进行了认真、全面的调查。结果与结论农村药品市场通过整顿已取得显著成效,但现行的管理措施与法律法规尚不适应农村医药事业的发展要求,亟待完善。     

生活垃圾焚烧处理技术的发展分析与建议

分析了国外生活垃圾焚烧发展的特点和动力,对比分析了国内垃圾焚烧发展情况,充分借鉴国外先进的管理机制体制和技术经验,提出针对性的建议。     

新型医疗方舱配置应用评价与改进建议

通过演习及接近实战的应用,叙述了新型医疗方舱配置具有装备先进,适应性强;要素齐全,设备完备等优势,但同时指出了展开面积、设备配置及零部件耗材等方面存在的问题,并针对问题提出了相应的建议,为今后方舱改型增效提供了基本依据。     

专科医院计量工作实施初探

阐述了专科医院计量工作目前存在法律意识淡薄、计量设备频繁出现故障等问题,提出了加强计量机构人员与采购、使用科室的合作,加强各级计量设备的管理以及加强计量管理领导小组工作职能等改进医院计量工作的建议,对于保障医学诊疗水平,提高医院医疗质量具有重要的意义。     

浅析我国专科医院的发展与对策

文章对我国目前专科医院的分类、疾病类别和特点进行了介绍，分析了专科医院目前存在的问题和面临的困难，并提出通过加大投入、专科建设、强化监管等措施提高专科医院的医疗技术水平和管理水平。     

The partial positive allosteric GABAA receptor modulator EVT 201 is efficacious and safe in the treatment of adult primary insomnia patients

Objective: To evaluate polysomnographic (PSG) and self-reported measures of the efficacy and safety of EVT 201 in patients with primary insomnia.Patients and methods: Following clinical and PSG screening, 75 patients (mean age: 45.1 ± 11.2y; 50f, 25m) meeting DSM-IV criteria for primary insomnia entered this crossover study and were randomly assigned to double-blind treatment sequences of 1.5 mg or 2.5 mg EVT 201, or placebo using a balanced Latin square design. For each study condition study medication was administered on two consecutive nights and PSG and self-reported data were collected. Safety assessments included physical examination, clinical laboratory measures, electrocardiogram, documentation of adverse events, and the digit symbol substitution test (DSST) and self-reported sleepiness/alertness ratings to detect residual sedation. Data were collected at five US sleep laboratories. Efficacy analyses were performed for the 67 patients completing the study. Safety analyses included all 75 randomized patients.Results: On PSG measures compared to placebo, EVT 201 1.5 mg and 2.5 mg increased total sleep time (TST; 33.1, 45.0 min; both p < 0.0001), reduced wake after sleep onset (WASO; −16.7, −25.7 min; both p < 0.0001), reduced latency to persistent sleep (LPS; −17.0, −20.7 min; both p < 0.0001), and reduced the number of awakenings (−1.2, −2.6; both p < 0.0001). Significant reduction of wake time was seen with 1.5 mg during each of the first three quarters of the night (p < 0.0001–0.002), and with 2.5 mg in all four quarters (p < 0.0001–0.0005). Both doses also improved all key self-reported measures of sleep including total sleep time (rTST; 51.9, 51.1 min; both p < 0.0001), wake after sleep onset (rWASO; −29.3, −29.6 min; both p < 0.0001), sleep latency (rSL; −24.0 min, p < 0.004; −25.1 min, p < 0.0002), and number of awakenings (rNAW; −1.1, −1.2; both p < 0.0001). Sleep quality was also improved by both doses. Self-rated sleepiness in the morning did not differ from placebo for either dose; however, there was a small negative effect on the DSST for both doses. Both doses had similar effects on sleep architecture including an increase in Stage 2 sleep and REM latency and a small, but significant decrease in REM (REM −5.7, −8.3 min; p = 0.0175, p = 0.0006). No effect on other sleep architecture parameters, including SWS, was seen. EVT 201 was well tolerated. No serious or unexpected adverse events were reported.Conclusion: This first study of EVT 201 in adult patients with primary insomnia demonstrated improved measures of sleep onset and sleep maintenance, including during the third and fourth quarters of the night. Adverse events were infrequent and all were mild to moderate in severity.     

医疗服务合同的特征分析及立法调整建议

文章着重分析揭示医疗服务合同存在的特点 ,在此基础上论证对医疗服务合同予以专门立法调整的必要性 ,并结合这种合同的特点 ,从立法的指导思想、基本原则到具体制度内容等方面提出明确的立法建议。     

Evaluation of the discriminative stimulus effects of the novel sedative-hypnotic CL 284,846

CL 284,846,N-[3-(3-cyanopyrazolo[1, 5-a]pyrimidin-7-yl)phenyl)]-N-ethylacetamide, is a novel non-benzodiazepine sedative-hypnotic with benzodiazepine-like sedative effects, but with less apparent liability for accompanying undesired side effects. In an effort to further characterize its pharmacological activity, CL 284,846 (3.0 mg/kg, IP, 30 min pretreatment) was established as a discriminative stimulus (DS) in rats (n=7). CL 284,846 (0.3–10.0 mg/kg) showed a dose-related increase in drug-appropriate responding up to the training dose and a dose-related decrease in response rate. The benzodiazepine agonist triazolam (0.1–1.0 mg/kg), the benzodiazepine partial agonist Ro 17-1812 (0.3–3.0 mg/kg) and the triazolopyridazine CL 218,872 (1.0–3.0 mg/kg) substituted for CL 284,846 in all rats, whereas the imidazopyridines zolpidem (3.0–10.0 mg/kg) and alpidem (10.0–30.0 mg/kg), the benzodiazepine partial agonist bretazenil (0.03–10.0 mg/kg) and the novel putative anxiolytic CL 273,547 (10.0–56.0 mg/kg) substituted in most, but not all, rats. Ro 17-1812, bretazenil, and CL 218,872 had no effect on response rate while the other drugs showed a concomitant decrease in rate. The 5-HT_1A agonist buspirone (1.0–10.0 mg/kg) and the barbiturate pentobarbital (3.0–17.0 mg/kg) failed to substitute for CL 284,846 up to rate-decreasing doses. The benzodiazepine antagonist flumazenil (3.0–10.0 mg/kg) blocked the DS effects of CL 284,846 in most rats with no effect on response rate. Taken together, these results suggest that the DS effects of CL 284,846 are mediated via benzodiazepine receptors; however, the DS profile of CL 284,846 remains distinct from both benzodiazepine and non-benzodiazepine sedative-hypnotic drugs.     

800份病案知情同意书填写质量调查分析

目的了解我院知情同意书实施的情况.方法抽查我院2003年7-12月出院,需要建立知情同意书的内、外科病案,共800份进行统计.结果在抽查的800份病案中,全部符合要求的581份,占72.6%,存在问题的219份,占27.4%;有40份没有填写知情同意书,有36份只建立在电子病案中,未能及时打印出来让患者签名,无患者或家属签字的有22份.结论写好知情同意书,必须要转变观念,提高对知情同意书重要性的认识,要进一步规范对患方家属签名的要求.     

县级中医医院中医药服务现状分析及政策建议

县级中医院是农村三级中医药医疗服务网络的龙头单位,对农村中医药服务推广与应用起着重要的作用。通过对北京、甘肃、陕西、吉林、安徽等省市农民进行抽样调查分析农民对县级中医药服务的满意度及利用情况研究的基础上,结合文献研究及国家统计数据,分析了现阶段县中医院中医药服务开展和推广应用的现状及存在的问题,并从加强县级中医院中医药服务能力建设、县级中医药人才培养、强化中医药服务特色和大力推广中医药适宜技术等4个方面提出政策建议,以进一步促进中医药在农村的推广应用,保障在具有中国特色的农村医疗保障体系建设中积极发挥县级中医院的领导和示范作用。