对药品市场营销中代理环节监督管理的思考

随着我国药品分销市场的对外放开,传统的批发零售经营方式发生了根本变化,代理配送制将成为医药流通的主要方式.药监工作人员要准确掌握药品分销市场的现状及发展趋势,抓好药品市场营销中代理环节的监督管理.     

加强质量体系建设,提高技术监督水平

本文对药品检验机构建立和完善质量体系的重要性，质量体系的内涵，建立和完善质量体系应注意的主要问题进行了分析并提出了建议。     

构筑健康教育工程实现社会医院双赢

介绍了四川大学华西医院10年来构筑普及医疗卫生保健知识系统工程的认识体会、经验和取得的成效,指出医院在普及卫生保健知识中的职责和优势。     

Fallopian tube malignancies: experience of Social Security Agency Aegean Maternity Hospital

The aim of the study was to determine the clinical characteristics and management of fallopian tube malignancies together with the results there unto that had been diagnosed and treated in our oncology department retrospectively. Twelve cases of fallopian tube malignancies, of a total of 2155 gynecologic malignancies (0.55%), that had been diagnosed in or referred to our hospital between January 1986 and December 2001 were evaluated retrospectively. Eight of 12 cases were diagnosed after surgical intervention in our department. Staging laparotomies were applied to all of the eight cases. Complementary surgeries of other four cases who were referred to our department were done according to the same principles of cytoreductive surgery. Staging of the cases was done according to Federation of International Gynecologists and Obstetricians (FIGO). Adjuvant chemotherapy was applied to all of the cases except two (10 cases, 83.3%). Second-look laparotomy (SLL) was applied to two of the cases. Mean age of the cases was 54.2 (range 35-72) years. Histopathology of the cases was as follows: serous adenocarcinoma in 10 cases (83.3%), endometrioid adenocarcinoma in one case (8.3%), and undifferentiated carcinoma in one case (8.3%). Adjuvant chemotherapy (PAC regimen to eight of the cases and PP regimen to two cases) was applied to 10 of the cases (83.3%). SLL was applied to two cases. Another case had died because of local recurrence at the 27th month of the follow-up. Mean follow-up period of the cases was 37.8 months (range 1-144 months). Fallopian tube malignancies are very rare malignancies. Diagnosis can be made generally peri- or postoperatively. More extensive clinical research must be performed in order to have definite etiologic, diagnostic, management modalities, and prognostic markers.     

Development of sample handling procedures for foods under USDA's National Food and Nutrient Analysis Program

The National Food and Nutrient Analysis Program (NFNAP) was implemented in 1997 to update and improve the quality of food composition data maintained by the United States Department of Agriculture (USDA). NFNAP was designed to sample and analyze frequently consumed foods in the U.S. food supply using statistically rigorous sampling plans, established sample handling procedures, and qualified analytical laboratories. Methods for careful handling of food samples from acquisition to analysis were developed to ensure the integrity of the samples and subsequent generation of accurate nutrient values. The infrastructure of NFNAP, under which over 1500 foods have been sampled, mandates tested sample handling protocols for a wide variety of foods. The majority of these foods were categorized into several major areas: (1) frozen foods; (2) fresh produce and/or highly perishable foods requiring refrigeration; (3) fast foods and prepared foods; (4) shelf-stable foods; (5) specialized study and non-retail (point of production) foods; and (6) foods from remote areas (e.g. American Indian reservations). This paper describes the sample handling approaches, from the collection and receipt of the food items to the preparation of the analytical samples, with emphasis on the strategies developed for those foods. It provides a foundation for developing sample handling protocols of foods to be analyzed under NFNAP and for other researchers working on similar projects.     

Participation in patient self‐management programs

Objective

Participation in evidenced‐based arthritis self‐management programs (SMPs) has not been well documented. The purpose of this study was to investigate the participation rate and participant characteristics in a closed cohort of subjects in a geographic region where arthritis SMPs have been offered multiple times and continuously for 2 decades.

Methods

Data were from osteoarthritis (OA) and rheumatoid arthritis subjects participating in the Arthritis, Rheumatism, and Aging Medical Information System (ARAMIS) who resided in the San Francisco (SF) Bay area who had responded to questions about ever participating in an SMP. Differences between participants and nonparticipants were examined by t‐tests and chi‐square tests.

Results

Questions added to the Health Assessment Questionnaire were returned by 1,176 patients; 618 resided in the SF Bay area. Of the SF Bay area sample, 41.9% had participated in an SMP. Small group SMPs, which had been offered multiple times, in diverse settings, continuously over the past 2 decades, were attended by the highest proportion (28%) of participants. Characteristics of participants and nonparticipants in the SF Bay area were similar (～70 years old, 15 years of education, and the majority had OA [～72%]). However, a higher proportion of participants were white (88% versus 82%; P = 0.046) and female (82% versus 73%; P < 0.05).

Conclusion

When arthritis SMPs were offered multiple times in diverse settings and continuously over many years, >40% of the cohort was reached. More research is needed with larger samples and different geographic regions to identify participation rates in more diverse populations.     

加强实验技术队伍建设和实验室管理的思考

实验技术队伍建设和实验室管理是当今高校改革的一个重要环节，教辅工作是整个教学、科研活动中不可缺少的重要组成部分，而实验技术人员又是师资队伍里一个不能分割的群体。目前，多数高校存在着实验技术队伍薄弱，缺乏自我提高意识，实验室管理松懈等现象，在此提出了一些建设性的意见和观点，以利于高校实验室教学和科研工作健康、有序地发展。     

2001年与2004年抗菌药物应用情况比较

目的　了解抗菌药物应用的基本情况。方法　将 2 0 0 1年 3月 14 3 0例住院患者病历与 2 0 0 4年 3月的 2 0 66例住院患者病历进行回顾性调查和对比分析。结果　 2 0 0 1年的 14 3 0例中有 948(66 3 % )例 ,和 2 0 0 4年的 2 0 66例有 10 60例 (5 1.3 % ) ,应用了抗菌药物。结论　定期检查考评 ,严格掌握用药指征 ,是加强抗菌药物应用管理的关键。     

To market! To market! A new dawn for community care?

The public sector in Britain has been subjected to over a decade of major reform aimed at breaking up public service monopolies, at containing costs while at the same time opening services up to greater consumer choice. Health and social services have not been exempt from this revolution in the organization and management of public sector services. The long-standing policy of care in the community is being subjected to market principles and the introduction of a ‘contract culture’ very similar to the NHS reforms introduced in 1991. This paper reviews the origins of these developments in the doctrines of ‘new public management’, a movement which has proved attractive to policy-makers in many countries. Local authority social services departments have been identified as the lead agency for the development of a mixed economy of care following a review of community care policy by the government's health adviser, Sir Roy Griffiths, and a subsequent white paper. This paper examines the limited empirical evidence available on how managers and providers are meeting the challenge bestowed upon them, and concludes that most authorities are moving ahead cautiously if at all. Only a handful of authorities studied have embraced the reforms with any degree of enthusiasm. The paper concludes with an assessment of the reforms from two perspectives: a pessimistic one and an optimistic one. There are many worrying features of the reforms, not least among these being a lack of clarity over their intended purpose. Tensions and contradictions are plentiful, which places in jeopardy the certainty of the reforms in becoming user led rather than provider driven. A more optimistic scenario is that the changes are leading to a loosening up of services and practices which have often suffered from sclerotic tendencies, paternalism and sometimes complacency. If the reform process is skilfully handled and not rushed and if the ends are clearly established and communicated then users and carers could prove to be the principal beneficiaries.