处方专项点评在精神病患者用药中的应用及其对合理用药的影响

目的探讨药物处方专项点评在精神病患者用药中的应用及其对合理用药的影响。方法收集2019年1月~2019年12月精神病患者1583例作为对象,共抽取门诊处方1644张,分析精神病患者药物使用情况,包括抗精神病药物使用、药物使用类型、使用金额,统计药物使用强度、限定日费用(DDC),分析用药合理性。结果2019年门诊合计收集抗精神病处方1644张,其中单联用药1047张,占63.69%,2联用药554张,占33.70%;共列出我院2019年全院抗精神病药物38种,药物金额排在前三位的分别为:奥氮平片(国产)(基)、氨磺必利片(国产)(基)及奥氮平片(奥兰之);抗精神病药物使用强度前三位分别为:奥氮平片(国产)(基)、氨磺必利片(国产)(基)、富马酸喹硫平片(国产)(基),DDDs分别为:555876.00、410669.50和207660.87;合计罗列10种抗精神病药物,DDC排在前3位的分别为:甲磺酸齐拉西酮粉针、富马酸喹硫平片(进口)(基)、棕榈酸帕利哌酮注射液(基)。结论精神病患者药物使用相对合理,开展药物处方专项点评能有效干预不合理用药,提高患者用药安全性。     

结肠癌患者术后肠内肠外营养辅助化疗的合理性和安全性研究

目的 探讨结肠癌患者经手术治疗后增加肠内肠外营养辅助化疗的合理性和安全性.方法 随机选取2011年6月-2013年2月在我院行结肠癌手术治疗的患者99例,随机分为3组：肠外营养组（TPN）、肠内营养组（TEN）和肠内外联合营养组（TPN＋ TEN）,每组各33例,观察3组患者手术前后体质量（BM）、上臂肌围（MAMC）、三头肌皮褶厚度（TSF）、血浆白蛋白（Alb）及血红蛋白（Hb）水平、氮平衡情况、胃肠道功能变化和并发症等.结果 各组患者经过营养支持后,BM、MAMC、TSF、血浆Alb及Hb等与治疗前比较差异无统计学意义（P＞0.05）;3组患者术后负氮平衡逐日改善,与术后第1天相比,差异有显著统计学意义（P＜0.01）.组间比较术后第2-7天的氮平衡及累计氮平衡,TEN与TPN及TPN＋TEN差异均有显著统计学意义（P＜0.01）,TPN与TPN＋TEN比较差异无统计学意义（P＞0.05）.3组患者并发症发生情况无明显差异,肠道恢复时间TEN最快,组间比较差异有显著统计学意义（P＜0.01）.结论 肠内和肠外营养辅助支持治疗在结肠癌患者术后化疗期间均存在一定的优势与劣势,在临床应用中要做到合理运用,提高其支持有效率,降低并发症的发生率.     

药学服务对骨科Ⅰ类切口手术预防用抗菌药物干预效果研究

目的探讨药学服务对骨科Ⅰ类切口手术预防用抗菌药物的干预途径,规范医院骨科Ⅰ类切口手术围术期抗菌药物预防性应用与管理。方法选择我院骨科Ⅰ类切口手术患者100例作为观察组,另选择我院同期不接受干预的骨科Ⅰ类切口手术患者100例设为对照组,研究药学服务预防性应用抗菌药物合理性,并对选用的抗菌药物品种、用程、用药频度、联合用药等方面进行了统计、对比与评价。结果①与对照组比较,观察组硝基咪唑类、第3代头孢、林可酰胺类使用频次较低,而大环内酯类、第1代头孢使用频次明显较高;②观察组单用药使用频次较高,联合用药使用频次明显较低,与对照组比较差异有统计学意义（P〈0.05）;③观察组非限制级抗菌药物应用频次明显提高,限制及特殊级抗菌药频次下降,与对照组比较差异有统计学意义（P〈0.05）;④两组预防用药时间比较差异有统计学意义（t=6.29,P〈0.05）,观察组住院的各项费用与对照组比较明显较低（P〈0.05）;⑤接受药学服务预防性应用抗菌药物后合理用药比例明显高于对照组,差异有统计学意义（P〈0.05）。结论恰当的药学服务措施能有效提高医院Ⅰ类切口手术围术期预防性应用抗菌药物的合理水平。     

关于限制使用医疗技术准入的伦理评估依据的探讨——医疗技术合理性的道德批判

分析了限制使用医疗技术合理性的本质规定。医疗技术的合理性是合规律性与合目的性的统一,是工具性与合人文性的统一,是技术与社会的统一。这是确立医疗技术准入的伦理评估的依据。     

医疗同意权主体合理性探究

医疗同意权是患者充分了解自己病情诊断以及可供选择的治疗方案信息后,作出接受治疗与否以及选择何种治疗方案的人格权利。患者医疗同意权作为患者的一项重要权利越来越受到关注。在借鉴、吸收学术界研究成果的基础上,对如何更好地维护患者的医疗同意权作了初步探讨。     

Validation crisis in animal models of drug addiction: Beyond non-disordered drug use toward drug addiction

In standard drug self-administration settings, animals have no choice than drug use. As a result, serious doubt exists about the interpretation of drug use in experimental animals. Is it symptomatic of an underlying addiction state or merely an expectable response to lack of choice? This incertitude in turn casts a shadow over many behavioral and neurobiological changes that have been well documented in animals following extended drug self-administration. Do they reflect pathological dysfunctions or normal neurobiological adaptations? Here I address these questions by focusing on intravenous cocaine self-administration in the rat as a paradigm example. Overall, available evidence shows that when a valuable behavioral option, even a biologically or physiologically inessential one, is made available during access to cocaine self-administration, most rats readily abstain from cocaine use in favor of the alternative reward regardless of the amount of past cocaine use. Only a small minority of rats continue to self-administer the drug despite the opportunity of making a different choice. This pattern of results (i.e., abstinence in most rats; cocaine preference in few rats) maps well onto what is currently known about the epidemiology of human cocaine addiction. It is thus possible that the minority of cocaine-preferring rats would be homologous to the minority of human cocaine users with a diagnosis of addiction while the remaining majority of abstinent rats would be resilient to cocaine addiction. Choice could represent an objective method of selection of addicted animals for future research on the neurobiological dysfunctions that are hypothesized to underlie cocaine addiction. Other competing interpretations of the same pattern of results are also discussed at the end of this review.     

Homo Heuristicus: Why Biased Minds Make Better Inferences

Heuristics are efficient cognitive processes that ignore information. In contrast to the widely held view that less processing reduces accuracy, the study of heuristics shows that less information, computation, and time can in fact improve accuracy. We review the major progress made so far: (a) the discovery of less‐is‐more effects; (b) the study of the ecological rationality of heuristics, which examines in which environments a given strategy succeeds or fails, and why; (c) an advancement from vague labels to computational models of heuristics; (d) the development of a systematic theory of heuristics that identifies their building blocks and the evolved capacities they exploit, and views the cognitive system as relying on an “adaptive toolbox;” and (e) the development of an empirical methodology that accounts for individual differences, conducts competitive tests, and has provided evidence for people’s adaptive use of heuristics. Homo heuristicus has a biased mind and ignores part of the available information, yet a biased mind can handle uncertainty more efficiently and robustly than an unbiased mind relying on more resource‐intensive and general‐purpose processing strategies.     

合理防治SARS-CoV-2感染的思考

Every epidemic of communicable diseases (CD) or spreading of pathogens can lead great threats to individuals and societies. Rational prevention and treatment of infectious diseases (ID) including CD through series strategies are the baselines for stability and prosperity of all countries. The essentials should be strengthened on intactness and high efficiency of national system of prevention and treatment of ID, credible personal knowledges and skills of ID prophylaxis, and reasonable treatment of patients. National promotion of prevention and treatment of ID worth to be expected during and after the ravages of     

抗菌药物的应用现状及对策

目的了解抗菌药物的应用情况,分析其使用的合理性。方法随机查阅2006年至2010年我国抗菌药物方面的文献资料进行回顾性分析。结果使用抗菌药物是人类预防和治疗疾病的重要手段,但其不合理使用现象日趋突出。结论随着科学研究的深入,发现抗菌药物的不合理应用或滥用会带来很多的危害,需及时采取有效对策。     

盐酸哌甲酯片使用合理性分析

目的:了解我院门诊患儿盐酸哌甲酯片的用药情况,评估药物使用的合理性.方法:通过回顾性处方调查方法,统计我院2008年2月～7月门诊盐酸哌甲酯片处方共579张,对性别、年龄、用药频率、使用情况进行分析,并以限定日剂量(DDD)、药物利用指数(DUI)为指标进行统计、分析及评价.结果:我院盐酸哌甲酯片处方男女比例为5: 1;7～10岁患儿处方占70.00%;在用法上,早上一次和早上、中午各一次占98.96%;DUI值为0.72.结论:我院门诊患儿盐酸哌甲酯片的使用情况基本合理.