加强行业管理规范人体器官移植技术

人体器官移植技术历经近半个世纪的发展历程．在上个世纪70年代我国逐步开展对肝脏、心脏和肾脏等器官移植技术的研究工作。近5年来，随着国际医学研究交流频繁，国内一些大型医疗机构加大了对器官移植技术上的投入．使人体器官移植技术发展迅猛。但同时也伴随着一些医疗费用过高、买卖供体等问题的出现。因此，如何规范人体器官移植技术．是当前的一个重要研究课题。     

无菌医疗器械生产企业在实施GMP中存在的问题和建议

对无菌医疗器械生产企业在实施GMP过程中存在的普遍问题进行阐述,并对目前企业实施GMP的薄弱环节提出一些建议,使无菌医疗器械生产企业能更好地实施GMP,切实将无菌医疗器械生产管理水平提升到新的高度.     

Design and Evaluation of a Self-Care Educational Activity as a Student Learning Experience

Objective. To design an educational activity and evaluate its effectiveness on increasing third-year pharmacy students’ knowledge and confidence to recommend self-care products to patients.Design. Faculty members created a self-care activity, the Amazing Self-Care Race, for educational use in a pharmaceutical care laboratory course. Student teams worked competitively to complete 15 stations focused on self-care. A complex, real-world case was presented at each station. Student recommendations were presented to a facilitator. Prior to and following the activity, students were invited to complete an online anonymous survey instrument.Assessment. Eighty-six students completed presurvey and postsurvey instruments to assess their knowledge and perceived confidence to recommend a self-care product to a patient prior to and following participation in the Amazing Self-Care Race. Students demonstrated a significant increase in their ability and confidence to recommend self-care products following the activity (p<0.001).Conclusion. The Amazing Self-Care Race is an effective educational activity that increases student knowledge and confidence in self-care therapeutics. The activity helped students to develop self-care skills, enabled them to learn through doing, encouraged them to synthesize information while making self-care recommendations, and helped them to develop confidence by thinking on their feet.     

Prevalence of Obesity: A Public Health Problem Poorly Understood

This review article discusses the Dietary Guidelines for Americans (DGA) in support of a total diet approach to achieving diet and health goals, especially as they relate to the obesity epidemic. However, some scientists and organizations have identified one food, food group, or nutrient as the cause of the obesity epidemic and recommend that simply reducing that food/food group/nutrient will solve the problem. This is simplistic and unlikely to be effective in long term management of the obesity problem. This article also acknowledges discrepancies in the literature and the lack of consensus opinions from systematic reviews. Failure to consider the evidence as a whole can lead to inaccurate reports which may, in turn, adversely influence clinical practice, public policy, and future research. This article also considers where the line should be drawn between individual choice and responsibility and public regulation. Using sugar sweetened beverages as an example, the article considers the lack of a consistent association between added sugars and weight in the literature and calls for policy recommendations that are based on science and emphasizes the need for evidence-based policies rather than policy-based evidence.     

Endocrine-Disrupting Chemicals: Prepubertal Exposures and Effects on Sexual Maturation and Thyroid Activity in the Female Rat. A Focus on the EDSTAC Recommendations

In 1996, the US Environmental Protection Agency was given a mandate by Congress to develop a screening program that would evaluate whether variously identified compounds could affect human health by mimicking or interfering with normal endocrine regulatory functions. Toward this end, the Agency chartered the Endocrine Disruptor Screening and Testing Advisory Committee in October of that year that would serve to recommend a series of in vitro and in vivo protocols designed to provide a comprehensive assessment of a chemical's potential endocrine-disrupting activity. A number of these protocols have undergone subsequent modification by EPA, and this review focuses specifically on the revised in vivo screening procedure recommended under the title Research Protocol for Assessment of Pubertal Development and Thyroid Function in Juvenile Female Rats. Background literature has been provided that summarizes what is currently known about pubertal development in the female rat and the influence of various forms of pharmaceutical and toxicological insult on this process and on thyroid activity. Finally, a section is included that discusses technical issues that should be considered if the specified pubertal endpoints are to be measured and successfully evaluated.     

The Breast Health Global Initiative: clinical practice guidelines for management of breast cancer in low- and middle-income countries

Breast cancer is an increasingly urgent problem in low- and mid-level resource countries of the world. Despite knowing the optimal management strategy based on guidelines developed in wealthy countries, clinicians are forced to provide less-than-optimal care to patients when diagnostic and/or treatment resources are lacking. For this reason, it is important to identify which resources commonly applied in resource-abundant countries most effectively fill the healthcare needs in limited-resource regions, where patients commonly present with more advanced disease at diagnosis, and to provide guidance on how new resource allocations should be made in order to maximize improvement in outcome. Established in 2002, the Breast Health Global Initiative (BHGI) created an international health alliance to develop evidence-based guidelines for countries with limited resources (low- and middle-income countries) to improve breast health outcomes. The BHGI serves as a program for international guideline development and as a hub for linkage among clinicians, governmental health agencies and advocacy groups to translate guidelines into policy and practice. The BHGI collaborated with 12 national and international health organizations, cancer societies and nongovernmental organizations to host two BHGI international summits. The evidence-based BHGI Guidelines, developed at the 2002 Global Summit, were published in 2003 as a theoretical treatize on international breast healthcare. These guidelines were then updated and expanded at the 2005 Global Summit into a fully comprehensive and flexible framework to permit incremental improvements in healthcare delivery, based upon outcomes, cost, cost–effectiveness and use of healthcare services.     

Micronutrients

Micronutrients are essential dietary components and play a fundamental role in the prevention of disease. 30 are essential and cannot be synthesized by the body on a daily basis, making dietary sources critical. Micronutrients have an array of biochemical functions which are fundamental in the homoeostatic regulation of body function. It is at any point in a metabolic pathway that the chemical reaction may be unable to continue along its nature cascading pathway because the essential micronutrient is lacking. The normal metabolic regulation of the body will have been disturbed and ill health may occur due to the absence of a specific micronutrients. Several population groups with specific nutritional requirements, complex social, environmental and economic circumstances may be at risk of inadequate micronutrient intakes due to poor consumption or excessive losses, and hence maybe unable to meet their recommended requirements of micronutrients. This group may benefit from micronutrient supplements. Infants/children are a specific population group who are at risk of micronutrient deficiency states making adequate intakes essential to ensure normal growth and development. The paediatric group will be discussed here, with reference to current recommendations for their micronutrient and supplementation requirements based on current evidence available to advisory groups.     

创伤后应激障碍合并酒精使用障碍的访谈与治疗

本文目的是通过报道病例诊疗全过程,呈现创伤后应激障碍(PTSD)合并酒精使用障碍的临床诊疗思路及治疗方案。咨客,男性,55岁。12岁时目睹母亲自杀的全过程,随后出现恐惧、孤独、失眠、回避谈论创伤相关话题、反复出现与创伤相关的梦境、易激惹、疼痛及酗酒等一系列情绪、认知、躯体及行为改变,并持续至今。社会功能明显受损,近1年和妻子离婚后症状加重而前来咨询。经过本次咨询,被诊断为PTSD合并酒精使用障碍。建议采用生物-心理-社会的综合干预方法,鼓励咨客进行规律运动,使用选择性5-羟色胺和去甲肾上腺素再摄取抑制剂(SNRI)及第二代抗精神病药物改善情绪、缓解疼痛;心理治疗方面,推荐延迟暴露疗法和认知调整;社会资源方面,在症状缓解后,鼓励咨客积极寻找工作,创造挽回其前妻的可能性。