药品临床宣传资料中存在的问题与思考

目的 :探讨药品临床宣传资料中存在的问题及其解决办法。方法 :随机抽取本院药库35份药品的临床宣传资料 ,分别与其生产企业提供的药品说明书进行对照分析 ,着重比较其适应证和用法用量。结果 :有8份 (22 86 % )药品临床宣传资料与药品说明书内容不符 ,主要表现为扩大适应证、用法用量不一致。结论 :应从根本上提高企业和促销人员自身的科技含量和综合素质 ,药品监管部门应对药品上市后的营销行为给予一定的法律制约。     

磷酸川芎嗪缓释透皮贴剂的制备及体外释放度测定

目的制备磷酸川芎嗪缓释透皮贴剂并优化其处方。方法通过正交实验,筛选缓释透皮贴剂的处方组成。结果采用聚丙烯酸树脂EUDRAGITE100为控释骨架和压敏胶材料,1.0%氮酮作为渗透促进剂制备胶粘剂骨架型经皮给药系统,药物从胶粘剂骨架/药物储库(压敏胶层)中恒速释放,体外释放度表明,贴剂的释放符合零级方程。结论所研制的磷酸川芎嗪缓释透皮贴剂具有理想的释药特性。     

Patient-controlled intranasal diamorphine for postoperative pain: an acceptability study

A patient acceptability study was conducted using patient-controlled intranasal diamorphine. Patients undergoing nonemergency orthopaedic or gynaecological surgery self-administered intranasal diamorphine for 24 h postoperatively. Pain, pain relief, sedation, respiratory rate, nausea and vomiting were assessed regularly. After 24 h, patients and their attending nurses completed a questionnaire assessing satisfaction and practical aspects of the technique. Satisfaction was reported as good or complete by 69% of patients and 69% of nurses. Pain relief was assessed as better than expected by 45% of patients and better than normal by 50% of nurses. Seventy-nine per cent of patients would be pleased to use patient-controlled intranasal diamorphine again and 89% of nurses would be happy for their patients to use it again. Sedation was uncommon and mild and there were no episodes of significant respiratory depression. Fifty-three per cent of patients reported no nausea and 74% did not vomit at any stage. There were seven withdrawals, four due to problems with the device and three due to therapeutic problems. The nasal spray may need modification to improve reliability. However, we found patient-controlled intranasal analgesia an effective technique, which was well tolerated by patients and nurses and was without unpleasant side-effects. Further work to determine how it performs compared with intramuscular or intravenous analgesia is now needed.     

Pseudophakic accommodation with translation lenses – dual optic vs mono optic

PURPOSE: To investigate the pseudophakic accommodation effect in dual and mono optic translation accommodative intraocular lenses (AIOL) using linear matrix methods in the paraxial space. METHODS: Dual (anterior optic of power +32 D linked to a compensatory posterior optic of negative power) and mono lens power was determined in the non-accommodated state using linear geometric optics based on the Gullstrand model eye. The position of the AIOL was calculated from a regression formula. Pseudophakic accommodation was assessed with three systems: (1) forward shift of the mono optic lens, (2) anterior translation of the anterior optic in the dual optic lens system with an unchanged position of the posterior minus lens and (3) symmetrical anterior and posterior translation of the anterior and posterior lens. The Gullstrand model eye was modified by changing the axial length (and proportionally changing the phakic anterior chamber depth) to investigate the accommodative effect in myopic and hyperopic eyes. RESULTS: The dual optic lens system (2) yields a nearly constant accommodation amplitude of 2.4-2.5 D mm(-1) movement over the total range of axial lengths. The mono optic lens (1) provides a higher accommodative effect only in extremely short eyes (high refractive power of the lens), whereas for normal eyes (1.4-1.5 D mm(-1) movement) and for long (myopic) eyes the accommodative effect is much less than the dual optic lens. The dual optic lens system under condition (3) yields less accommodation amplitude compared with the dual optic system under condition (2) over the total range of axial length but provides higher accommodation amplitude compared with the mono optic lens system (1) with axial lengths greater than 22.3 mm (lens power 25.5 D). In the accommodated state, with lens translation of 1 mm, the absolute value of the lateral magnification increases with the refractive power of the mono optic lens (1) and decreases in both dual optic lens systems (under conditions 2 and 3). CONCLUSIONS: A mathematical strategy is presented for calculation of the accommodative effect of mono-optic and dual optic AIOL. The dual optic lens yielded a nearly constant accommodation amplitude of about 2.4-2.5 D mm(-1) translation, whereas the mono optic lens yielded an accommodative response of <2 D mm(-1) translation in long myopic or normal eyes. Only in extremely short eyes is the accommodative amplitude of the mono-optic lens higher than the dual optic lens.     

Electromotive administration of intravesical bethanechol and the clinical impact on acontractile detrusor management: introduction of a new test

PURPOSE: It is often difficult to determine the functional status of the detrusor muscle in patients with detrusor areflexia. We performed a clinical study to establish a test defining residual detrusor capacity in such patients. MATERIALS AND METHODS: In phase 1, 5 controls with detrusor areflexia were tested with an intravesical instillation of 20 mg. bethanechol in 150 cc of sodium chloride 0.3% with and without 20 mA. of pulsed current applied via an electrode catheter through the saline. Cystometry simultaneously recorded intravesical pressure changes. In phase 2, 45 patients with detrusor areflexia were tested with electromotive administration of intravesical bethanechol. In phase 3, 25 mg. bethanechol given orally once daily were prescribed for 15 patients and voiding control was assessed after 6 weeks of therapy. RESULTS: Neither bethanechol without current nor current through saline only led to increased intravesical pressure. However, we noted a mean pressure increase of 34 cm. water during the electromotive administration of bethanechol in 24 of 26 patients with areflexia and neurological disease compared to only 3 cm. water in 3 of 11 with a history of chronic bladder dilatation. Oral bethanechol restored spontaneous voiding in 9 of 11 patients who had had a positive response to the electromotive administration of bethanechol, whereas all 4 without a pressure increase during the electromotive administration of bethanechol did not void spontaneously. CONCLUSIONS: Electromotive administration of intravesical bethanechol identifies patients with an atonic bladder and adequate residual detrusor muscle function who are candidates for restorative measures, such as oral bethanechol and intravesical electrostimulation. Those who do not respond to the electromotive administration of bethanechol do not benefit from oral bethanechol and are candidates for catheterization.     

基于Excel软件的二室模型血管外给药的方案设计

为获得一种简便的二室模型血管外给药的给药方案设计方法 ,采用 Excel软件编写与给药方案相关的各种数值的计算程序。Excel规划求解法计算 tpeak、cmax,Excel单变量求解获得最大给药剂量 dmax(或最低有效剂量 dmin)。结果显示 ,输入基本参数α、β、ka、k2 1 、V1 、吸收分数 ( F )、滞后时间 ( tlag) ,以及给药间隔 (τs)、最低有效浓度 ( MEC)或最小中毒浓度 ( MTC)后 ,输入选定的维持量、给药周期 ( n)后 ,电子表格显示第 n周期 (或稳态 )第 s次给药后的瞬时血药浓度、达坪分数、负荷剂量 ,并采用单变量求解获得给药间隔内的有效血药浓度累积时间 ( tec)。     

口腔颊粘膜给药系统及其质量评价

介绍了口腔颊粘膜给药系统,并对其制剂的粘附力、粘附时间、膨胀率、均匀度和有效性等质量评价方面进行了综述。作为新型给药系统,颊粘膜给药系统的成熟与发展还需要在质量评价等方面进行深入研究。     

医院管理研究的相关主题词分析

目的 分析国外医院管理的研究现状和研究新动向、新趋势，为我国开展医院管理的研究和实践提供借鉴。方法 遵循文献计量原理．编制相关主题词分析软件，采用相关主题词分析法，对MEDLINE数据库中收录的2000-2005年期间所有医院管理文献中的加权主题词进行分析。结果 前5年国外关于医院管理的研究主要集中在医院急诊室、医院信息系统、卫生保健质量、医院管理艺术等方面，逐渐地与医院管理相关的伦理学问题、法律问题和经济学等也成为人们研究的热点．并且在今后的研究中可能会有较大的发展。     

医院管理创新与竞争战略的构建

从医院的现状和未来出发,不断加强医院管理创新的研究,制订出最佳的竞争战略,是医院管理者面临的新课题。医院管理模式只有适应医疗市场的发展变化,全面了解和准确把握医院内部条件和外部环境变化,将潜在的核心能力转化成现实的核心竞争力,医院才能不断发展壮大,才能保持可持续、协调地发展,才能在激烈的市场竞争中取得主动。笔者探讨我院在管理理念、管理结构、管理制度、管理机制等方面的创新,旨在强化和推动医院发展定位、中长期规划、质量建设、数字化建设的构建和实施。     

浅谈结构化综合布线系统的设计

结构化综合布线系统是一种包含着多种先进技术的高技术系统,是一种内容极其丰富的复合结构和功能广泛的计算机管理系统,是一种提供各种服务项目的公共服务系统,还是一种需要专业人员安装、管理、维护的专业系统。结构化综合布线系统是医院管理信息系统的通用平台,是向所有具有通信要求的设备提供通信线路的最底层的系统,布线系统的先进性、灵活性和可扩充性将极大地影响整个医院管理信息系统的先进性、灵活性和扩充能力,应事先将不确定因素考虑在内,使布线系统可以满足用户不断发展的需求,而布线系统的性能在很大程度上受到设计质量的影响。