老年人行结肠镜检查相关问题探讨

结肠镜检查是一项广泛用于临床的直观有效的诊断结肠疾病的方法。对于整体机能减退的老年人来说,我们可从结肠镜前准备工作中的三个方面:肠道准备用药的比较选择、基础合并症的处理以及医患交流和心理护理提高老年患者对结肠镜的耐受性。     

Consumer behaviour in an unregulated market: the satisfactions and dissatisfactions of illicit drug consumption

Here the case of recreational drug consumption by youths in the West of Scotland is applied to evaluate some prevailing models of consumer satisfaction and dissatisfaction (CS/D). The findings suggest dissatisfactory and satisfactory outcomes do not always result in the types of future consumption behaviours proposed by some models of consumer CS/D. Although, as some models of CS/D suggest, satisfactory experiences tended to reinforce the desire to repeat consumption, when consumption was dissatisfactory, users tended to employ several strategies to justify further use. Whereas users attributed positive or pleasurable experiences to the narcotic effect of the substances consumed, dissatisfactory outcomes were attributed to other factors. Users develop sophisticated responses to dissatisfaction, such as deferment and denial. The findings have important implications for some theories and models of CS/D for consumer expectation: in particular, the effect of dissatisfactory experiences on future consumption intentions. Copyright © 2002 Henry Stewart Publications.     

手术戒毒:"非常规"医疗探索下的社会视阈

"手术戒毒"是以一种"非常规"的方式毁损一部分人脑记忆和意识,来探索戒断毒瘾的有效途径."非常规"的手术戒毒挑战了长久以来公众对毒品的"常规"认识以及现行的戒毒政策和方法,从技术、伦理以及观念、权益、法律规制和政策支持等社会层面考量了这一项"非常规"手术.     

我院门诊应用抗菌药物处方分析

为了解我院门诊抗菌药使用状况,随机抽取全院2006年10月门诊处方1000份,统计并综合分析了使用抗菌药物的比率、抗菌药物种类及联合用药情况等项目。结果显示,门诊抗菌药的使用比率为20．90％,联合用抗菌药的比率为7．26％;合理用药处方占84．7％,但在某些方面还存在不合理现象。宜制定相应措施,提高用药合理性。     

关注老年癌症止痛

虽然肿瘤的发病率在老年人并不低,但社会对老年人的关注度并不高。几乎所有肿瘤药物临床试验都把老年人排除在外,因此,不少药品说明书特别注明“缺乏老年人资料”。老年癌痛治疗领域也存在同样的问题。老年癌痛的病理生理及心理特点很独特,加之对老年癌病重视不够及缺乏正确评价,所以老年癌痛的研究相当复杂,因而癌痛的处理犹如癌症一样也需要综合治疗。癌痛治疗药物可分成两大类：非阿片类及阿片类药物。非阿片类药物中首选对乙酰氨基酚治疗轻度癌痛,非甾体类抗炎药,特别是选择性COX2抑制剂可在对乙酰氨基酚无效时应用。阿片类药物则广泛应用于中度到重度的癌痛治疗。辅助治疗药物包括三环抗抑郁药、抗惊厥药、苯二氮蕈类药物等。可用于癌痛三阶梯治疗的任一阶段,能够治疗特殊类型疼痛,改善癌痛以外的症状,增加主要药物镇痛效果,减轻副作用,但不推荐常规使用。总而言之,对于老年癌症患者更要强调以镇痛为主的姑息治疗,特别在重症老年患者,可能成为最重要的治疗,有时甚至是唯一有效妁治疗。     

从"反应停"到透皮治疗系统--新药研发思路的转变

通过对“反应停”与透皮治疗系统研发过程的回顾与研发思路的比较,探讨新药研发思路的转变对于药物安全的重要性。     

Rate dependency, behavioral mechanisms, and behavioral pharmacology.

Behavioral pharmacology has become increasingly independent of the experimental analysis of behavior. At its beginning, behavioral pharmacology was closely related to the experimental analysis of behavior, with developments in each field aiding the other. Early attempts to systematize data in behavioral pharmacology culminated with the development of the rate-dependency concept, but as this principle was found to have more limited generality than originally was hoped, a theoretical void developed. This circumstance was followed by increased reliance on pharmacological theory as a basis for experimentation and interpretation, with an attendant decrease in emphasis on environmental variables and behavioral interpretations. Lack of interplay between behavioral pharmacology and the experimental analysis of behavior is detrimental to both disciplines because each could contribute significantly to the other. The current trend might be reversed if more research were directed at elucidating behavioral mechanisms of drug action.     

How research in behavioral pharmacology informs behavioral science

Behavioral pharmacology is a maturing science that has made significant contributions to the study of drug effects on behavior, especially in the domain of drug-behavior interactions. Less appreciated is that research in behavioral pharmacology can have, and has had, implications for the experimental analysis of behavior, especially its conceptualizations and theory. In this article, I outline three general strategies in behavioral pharmacology research that have been employed to increase understanding of behavioral processes. Examples are provided of the general characteristics of the strategies and of implications of previous research for behavior theory. Behavior analysis will advance as its theories are challenged.     

Healthy Children As Subjects in Pharmaceutical Research

Recruitment of healthy children for drugresearch has emerged due in part to several newAmerican laws and policies that have led to asurge in pharmaceutical research involvingchildren-subjects. In this paper, I review theethical and scientific issues and the argumentsin favor and against this new practice.     

Drug discrimination under a concurrent fixed-interval fixed-interval schedule.

Pigeons were trained to discriminate 5.0 mg/kg pentobarbital from saline under a concurrent fixed-interval (FI) FI schedule of food presentation on which, after pentobarbital administration, responses on one key were reinforced with food under an FI 60-s component and responses on the other key were reinforced under an FI 240-s component. After saline administration, the schedule contingencies on the two keys were reversed. After both pentobarbital and saline, pigeons responded more frequently on the key on which responses had been programmed to produce the reinforcer under the FI 60 component of the concurrent schedule. The schedule was changed to concurrent FI 150 FI 150 s for drug-substitution tests. In each bird, increasing doses of pentobarbital, ethanol, and chlordiazepoxide produced increases in the proportion of responses on the key on which responses had been reinforced under the FI 60 component after pentobarbital administration during training sessions. The proportion of responses on that key was slightly lower for ethanol than for chlordiazepoxide and pentobarbital. At a dose of pentobarbital higher than the training dose, responding decreased on the key that had been reinforced under the FI 60 component during training sessions. Phencyclidine produced less responding on the key programmed under the FI 60-s component than did pentobarbital. Methamphetamine produced responding primarily on the key on which responses had been reinforced under the FI 60-s component after saline administration.