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但是断句和语气已经养成了某种习惯。
2024年12月21日,此前,由于俄罗斯害怕一旦向中方开放远东地区,自身对当地的控制力会减弱,迟迟没有松口。现在改变主意,可能有两方面原因。
《年轻的妈妈韩剧》免费高清在线播放-全集剧情片-光棍...
什么钱都想赚太黑心了
营养还是蒸的好,现在天气热,就爱做这些简单的饭菜,百吃不腻上海证券基金评价研究中心孙桂平也表示,受资本市场持续动荡、折价率缩小、定增项目供应减少等众多因素影响,2022年的定增市场表现不及2021年同期,但是,对比最近十年的定增情况来看,2022年的折价率仍处于历史上的较高水平。他预计定增市场的回暖迹象有望持续,可适当关注高景气度和高成长板块,以及受疫情影响较大的板块等定增项目的投资机会。
buzaiyouyu,dainikandongyingchao20duiqiuduimingdeyingwensuoxie2020-11-06 16:19·ZMzuqiuxiaopengyouyingchaoliansaiyinweishizhuanbodeyuangu,womenzaikanzhibodeshihoupingmuzuoshangjiaoyibandushidachuqiuduiduimingdeyingwensuoxie。laoqiumitongguobianbieqiuyizhidaozheshinageqiudui,danyixieqiumihuanshizhinengtingjiangjieyuandejieshaocaizhidao。xianzainixiangyiyanjiuzhidaopingmushangyingwensuoxiedeshinageqiudui,womenyiqilaixuexiyixiaba(paimingbufenxianhou)。1.asenna——ARSquancheng:Arsenal F.C,chengliyu1886nian,julebujidiweiyulundunheluo(Holloway),shiyinggelandingjizuqiuliansaitingliudezuijiudejulebu。2.boenli——BURquancheng:Burnley F.C,chengliyu1882nian,shiyinggelanzuqiuliansaichuangshichengyuan,qiuduizhuchangweitefumoerqiuchang。3.bulaidun——BHAquancheng:Brighton & Hove Albion F.C.,chengliyu1901nian,shinanbuliansaidechuangshichengyuan,1920nianjiaruzuqiulianmeng。4.aifudun——EVEquancheng:Everton F.C.,chengliyu1878nian,julebulishiyoujiu,bitongchengsidiliwupuzaochengliliao14nian ,shizuqiulianmengheyinggelanliansaidechuangshichengyuan。5.fulemu——FULquancheng:Fulham F.C,chengliyu1879nian,zhuchangweikelawennongchangqiuchang。zai1896nianjiangzhuchangquedingweiCraven Cottagezhiqian,tamenmeiyouzijidezhuchang,zhinengsichuliulang。6.laisitecheng—— LEIquancheng:Leicester City F.C,chengliyu1884nian。qiuduiqianshenlaisitefusiyouweijiesidunxuexiaodeyiqunjiushengtuantiyu1884nianchuangli,1890nianjiaruyinggelanzuqiuxiehui。1894niancanjiayinggelanzuqiuyijiliansai,1919nianyizhanjieshuhouqiuduigengweixianming。7.langdui——WOLquancheng:Wolverhampton Wanderers F.C,“langdui”shiqiguanfangchuohao,chengliyu1877nian,shiyinggelanzuqiuliansaichuangshichengyuan。shiyinggelanweiyizengzaiwugebutongjibieliansaihuodeguanjundeqiudui。8.liwupu——LIVquancheng:Liverpool Football Club,chengliyu1892nian,youyuehan·huodingchuangli。qiuduidechenglishizaianfeierdeqiuchangdeyongyouzheyuehan·huodingyushengyihuobanaolierxianshengyongyoudeaifudunzuqiuduizhijianfashengliaoyicishejiduofangmianyuanyindezhengzhizhihouerjianlide。9.lizilian——LEEquancheng:Leeds United F.C,chengliyu1919nian,zhuchangshezaiailanluqiuchang。liziliandeqianshenshichengliyu1904niandelizichengzuqiujulebu。1919nianlizichengjiesanzhihou,lizilianzhengshichengli。10.mancheng——MCIquancheng:Manchester City Football Club,chengliyu1880nian。qianshenweichengliyu1880niande“shengmaketang”(West Gorton Saint Marks),1887niangaimingweiadeweike(Ardwick AFC),1894niangengweixianming。yingchao2020-21saijibisaiyongqiu11.manlian——MUNquancheng:Manchester United Football Club,chengliyu1878nian。qiqianshenshiyou1878nianyingguolankaixiajunyuyuekejuntielugongsidetielugongrenmensuozujiandeniudunxisiLYRzuqiudui。1908nian,niudunxisiLYRzhengshigengmingweimanchesitelianzuqiujulebu。yinggelanzuqiudingjiliansaiguanjunzuiduodeqiudui, yishiouzhouzutanduodeouzhousandabeidedamanguanzuqiujulebuzhiyi。12.nananpudun——SFCquancheng:Southampton F.C,chengliyu1885nian,qianzhuchangqiuchangweixiaoguqiuchang,zaishiyongchaoguo100nianhouzai2001nianbanqiandaoshengmaliqiuchang。dierzhiyouzhongguozibenjueduikonggudeyingchaojulebu。13.niukasierlian——NCUquancheng:Newcastle United F.C,chengliyu1881nian。qiuduichuqishiyouweiyuyinggelandongbeibudegongyezhongzhenniukasierxiquzuqiuduihedongquzuqiuduihebingzaiyiqi,chengliliaoniukasierliandui。buguozainageshihou,tahuanzhishizhiyouzuqiuaihaozhezuchengdeyeyuqiudui,zhidao1889nianniukasierlianduicaichengweiyizhizhuanyeqiudui,1893nianjiaruyinggelanzuzongcanjialiaoyinggelanyijiliansai。qiuduizhidao1930nian1yuecaiyongyoudiyiweizhujiaolian,ciqianyizhiyoujulebumishufulanke·wotelvling。14.qieerxi——CHEquancheng:Chelsea Football Club,chengliyu1905nian。1905nian3yue14ri,zaisitanfuqiaotiyuchangduimiande“tufuzhigou”jiuguanli,miersihehehuorenmenzhaokailiaohuiyi,juedingchengliyijiaxindezuqiujulebu。yikaishi,renmenduiyujulebudemingchenggeshujijian,“sitanfuqiaozuqiujulebu”、“kenxindunjulebu”、“lundunjulebu”dengdengtiyidubeifoujue,zuizhong,“qieerxizuqiujulebu”demingchengbeitongguobingyizhiyanyongzhijin。15.reci——TOTquancheng:Tottenham Hotspur F.C,chengliyu1882nian。tuotenamurecideqianshen“recizuqiujulebu”(Hotspur Football Club)shizai1882nianyouyiqunlaizi“shengyuehanchanglaopaijiaotuxuexiao”(St. John's Presbyterian School)ji“tuotenamuwenfaxuexiao”(Tottenham Grammar School)jiushengdebanqiuyuansuochenglide。tamenyouyuzaidongjishimeiyoubanqiubisai,bianshangyichengliyizhizuqiuduiyiweichitinengzhuangtai,recizuqiujulebuyouciyingshiersheng。16.shuijinggong——CRYquancheng:Crystal Palace F.C,chengliyu1905nian。julebuyu1905nianzaiSydenhamshandingdeboliwanggongchengli,zaonianyizhizhizaidijibiedeliansaijiaozhu,zhidao1969niancaishoucishengshangdangshidedingjiliansaiyingjia。17.asidunweila——AVIquancheng:Aston Villa F.C,chengliyu1874nian。qiuduishiyoubominghandiqujiaotangchengyuanzuchengchuanglide,yinggelandingjiliansaizuqiulianmengchuangshichengyuanzhiyi,ji1888nianjiazuliansai(yinggelandiyigezuqiuliansai)ji1992nianyinggelanzuqiuchaojiliansaishoujiesaishiqiudui。18.xibuluomuweiqi——WNSquancheng:West Bromwich Albion,chengliyu1878nian,zhuchangweishanzuoqiuchang。julebuzaishanzuoqiuchangbisaichaoguo100niandelishi,zhegeheixiang(Black Country,yinggelanmidelandiqunansitafugongkuangqu)qiuchangshizuoshijidiyigexingjianjiqiyong10-11qiuyuangerenbiaozhun(20ren)yongdeyinggelanliansaizuqiuchang,erqiezhiyongsigeyueshijian。19.xihanmulian——WHUquancheng:West Ham United F.C,chengliyu1895nian。qiuduideqianshenshiyoutaiwushigangtiechangdegongtouhedangdiliansaicaipandaifu·taile(Dave Taylor)yushangrenanuode·xiersi(Arnold Hills)gongtongchengliliaotaiwushigangtiechangzuqiujulebu(Thames Ironworks FC)。1900nian6yuezhengshijiesan,tongnian7yue5ri,julebuzhongjianbingyixihanmulianmingming。20.xiefeierdelian——SHUquancheng:Sheffield United F.C,chengliyu1889nian。xiefeierdeyizhibeiyuweiyingguozuqiudeguxiang。 zuizaodediyichangliurenqiusaishizai1793nian。1889niande3yue22hao, zaiyigehuiyili, xiefeierdelianhebanqiuduijuedingzujianyizhizuqiudui。gangkaishideshihou,xunzhaoqiuyuanchengliaoyigeshouyaodewenti,danshizaiguanggaohuodongzhihou,julebubuchangzai1889nian3yue29rixuanbu,tamenyijingxunzhaodaoliaoquanbusuoxudeduiyuanliao,xiefeierdeliandeyiyingyunersheng。zuqiu,zheheibaixiangjiandexiaowanyi,shideduoshaorenweizhichimichikuang。xiwangbenwendejianjienengduiniyousuobangzhu,fangbiannigengduodiliaojiezuqiu。#woyaoshangtoutiao##yingchaoliansai##2020shengjishengdahui#ruguoshifangzaixunchangpingyuandiqudejiuyuan,zhongguodezhuduoxinghaozhishengji,keyipingjieshulianghexingnengshangdeyoushi,zhixinggengjiajianjuderenwu。
总(窜辞苍驳)计(闯颈):94.5元(驰耻补苍)
诲补苍驳濒耻苍迟补苍锄丑耻肠丑颈谤别苍虫耻补苍产耻虫颈耻虫颈蝉丑颈箩颈补苍蝉丑颈,飞补苍驳辩颈补苍驳肠辞苍驳锄耻辞飞别颈蝉丑补苍驳锄丑补苍辩颈蝉丑别苍濒补颈,锄辞耻诲补辞濒颈补辞濒颈丑耻补诲别尘颈补苍辩颈补苍,蝉丑辞耻濒颈迟颈锄丑耻辞测颈驳别产补辞锄丑耻补苍驳箩颈苍驳尘别颈诲别濒颈丑别。迟补濒颈尘补辞别谤肠丑别苍驳锄丑颈诲颈蝉丑耻辞:“濒颈苍惫蝉丑颈,锄丑别蝉丑颈飞辞飞别颈苍颈苍锄丑耻苍产别颈诲别测颈诲颈补苍虫颈苍测颈,虫颈飞补苍驳苍颈苍苍别苍驳驳辞耻虫颈丑耻补苍。”谤别苍箩颈虫颈补苍驳肠丑耻测颈诲颈苍驳肠丑别苍驳诲耻蝉丑补苍驳锄耻颈飞别颈箩颈产别苍诲别诲辞苍驳虫颈蝉丑颈虫耻测补辞锄耻辞诲补辞诲别,诲补苍蝉丑颈锄耻颈飞别颈箩颈产别苍诲别诲辞苍驳虫颈,锄补颈驳耻补苍虫颈肠耻苍锄补颈测颈诲颈苍驳诲别箩耻濒颈蝉丑颈,丑耻颈丑耻蝉丑颈。肠辞苍驳别谤丑耻颈谤补苍驳谤别苍苍别颈虫颈苍产耻蝉丑耻蝉丑颈,办别蝉丑颈诲补苍驳苍惫虫耻苍别颈虫颈苍锄丑辞苍驳锄丑别测补苍驳诲别产耻蝉丑耻蝉丑颈蝉丑颈测颈锄丑辞苍驳肠丑颈箩颈耻虫颈苍驳诲别辩颈苍驳办耻补苍驳,丑耻颈测颈苍驳虫颈补苍驳诲补辞苍惫别谤诲别丑耻苍测颈苍蝉丑别苍驳丑耻辞,蝉丑别苍锄丑颈办别苍别苍驳丑耻颈肠丑别苍驳飞别颈迟补尘别苍蝉丑别苍驳丑耻辞锄丑辞苍驳诲别尘补辞诲耻苍。
药(Yao)物(Wu)不(Bu)良(Liang)反(Fan)应(Ying)你(Ni)问(Wen)我(Wo)答(Da)系(Xi)列(Lie)(一(Yi))2015-05-21 08:53·南(Nan)京(Jing)市(Shi)第(Di)一(Yi)医(Yi)院(Yuan)问(Wen)题(Ti)一(Yi):何(He)谓(Wei)药(Yao)物(Wu)不(Bu)良(Liang)反(Fan)应(Ying)?按(An)照(Zhao)WHO国(Guo)际(Ji)药(Yao)物(Wu)监(Jian)测(Ce)合(He)作(Zuo)中(Zhong)心(Xin)的(De)规(Gui)定(Ding),药(Yao)物(Wu)不(Bu)良(Liang)反(Fan)应(Ying)(adverse drug reactions,简(Jian)称(Cheng)ADR)系(Xi)指(Zhi)正(Zheng)常(Chang)剂(Ji)量(Liang)的(De)药(Yao)物(Wu)用(Yong)于(Yu)预(Yu)防(Fang)、诊(Zhen)断(Duan)、治(Zhi)疗(Liao)疾(Ji)病(Bing)或(Huo)调(Diao)节(Jie)生(Sheng)理(Li)机(Ji)能(Neng)时(Shi)出(Chu)现(Xian)的(De)有(You)害(Hai)的(De)和(He)与(Yu)用(Yong)药(Yao)目(Mu)的(De)无(Wu)关(Guan)的(De)反(Fan)应(Ying)。该(Gai)定(Ding)义(Yi)排(Pai)除(Chu)有(You)意(Yi)的(De)或(Huo)意(Yi)外(Wai)的(De)过(Guo)量(Liang)用(Yong)药(Yao)及(Ji)用(Yong)药(Yao)不(Bu)当(Dang)引(Yin)起(Qi)的(De)反(Fan)应(Ying)。我(Wo)国(Guo)是(Shi)WHO国(Guo)际(Ji)药(Yao)物(Wu)监(Jian)测(Ce)合(He)作(Zuo)计(Ji)划(Hua)的(De)成(Cheng)员(Yuan)国(Guo),在(Zai)ADR监(Jian)测(Ce)工(Gong)作(Zuo)中(Zhong)应(Ying)遵(Zun)守(Shou)WHO所(Suo)规(Gui)定(Ding)的(De)ADR定(Ding)义(Yi)进(Jin)行(Xing)ADR报(Bao)告(Gao)。为(Wei)正(Zheng)确(Que)理(Li)解(Jie)WHO的(De)ADR定(Ding)义(Yi),现(Xian)将(Jiang)原(Yuan)文(Wen)摘(Zhai)录(Lu)如(Ru)下(Xia):A reaction which is noxious and unintended ,and which occurs at doses normally used in man for the prophylaxis, diagnosis, or therapy of diseases ,or for the modification of physiological function.This definition excludes accidental or deliberate excessive dosage or maladministration.问(Wen)题(Ti)二(Er):药(Yao)物(Wu)不(Bu)良(Liang)反(Fan)应(Ying)如(Ru)何(He)分(Fen)类(Lei)?药(Yao)物(Wu)不(Bu)良(Liang)反(Fan)应(Ying)有(You)多(Duo)种(Zhong)分(Fen)类(Lei)方(Fang)法(Fa),通(Tong)常(Chang)按(An)其(Qi)与(Yu)药(Yao)理(Li)作(Zuo)用(Yong)有(You)无(Wu)关(Guan)联(Lian)而(Er)分(Fen)为(Wei)两(Liang)类(Lei):A型(Xing)和(He)B型(Xing)。A型(Xing)药(Yao)物(Wu)不(Bu)良(Liang)(Type A adverse drug reactions)又(You)称(Cheng)为(Wei)剂(Ji)量(Liang)相(Xiang)关(Guan)的(De)不(Bu)良(Liang)反(Fan)应(Ying)(dose-related adverse reactions)。该(Gai)反(Fan)应(Ying)为(Wei)药(Yao)理(Li)作(Zuo)用(Yong)增(Zeng)强(Qiang)所(Suo)致(Zhi),常(Chang)和(He)剂(Ji)量(Liang)有(You)关(Guan),可(Ke)以(Yi)预(Yu)测(Ce),发(Fa)生(Sheng)率(Lv)高(Gao)而(Er)死(Si)亡(Wang)率(Lv)低(Di),如(Ru)苯(Ben)二(Er)氮(Dan)zhuo类(Lei)引(Yin)起(Qi)的(De)瞌(Zuo)睡(Shui),抗(Kang)血(Xue)凝(Ning)药(Yao)所(Suo)致(Zhi)出(Chu)血(Xue)等(Deng)。B型(Xing)药(Yao)物(Wu)不(Bu)良(Liang)反(Fan)应(Ying)(Type B adverse drug reactions),又(You)称(Cheng)剂(Ji)量(Liang)不(Bu)相(Xiang)关(Guan)的(De)不(Bu)良(Liang)反(Fan)应(Ying)(non-dose-related adverse reactions)。它(Ta)是(Shi)一(Yi)种(Zhong)与(Yu)正(Zheng)常(Chang)药(Yao)理(Li)作(Zuo)用(Yong)无(Wu)关(Guan)的(De)异(Yi)常(Chang)反(Fan)应(Ying),一(Yi)般(Ban)和(He)剂(Ji)量(Liang)无(Wu)关(Guan)联(Lian),难(Nan)于(Yu)预(Yu)测(Ce),发(Fa)生(Sheng)率(Lv)低(Di)(据(Ju)国(Guo)外(Wai)数(Shu)据(Ju),占(Zhan)药(Yao)物(Wu)不(Bu)良(Liang)反(Fan)应(Ying)的(De)20~25%)而(Er)死(Si)亡(Wang)率(Lv)高(Gao),如(Ru)氟(Fu)烷(Wan)引(Yin)致(Zhi)的(De)恶(E)性(Xing)高(Gao)热(Re),青(Qing)霉(Mei)素(Su)引(Yin)起(Qi)的(De)过(Guo)敏(Min)性(Xing)休(Xiu)克(Ke)。在(Zai)药(Yao)物(Wu)不(Bu)良(Liang)反(Fan)应(Ying)中(Zhong),副(Fu)作(Zuo)用(Yong)、毒(Du)性(Xing)反(Fan)应(Ying)、过(Guo)度(Du)效(Xiao)应(Ying)属(Shu)A型(Xing)不(Bu)良(Liang)反(Fan)应(Ying)。首(Shou)剂(Ji)效(Xiao)应(Ying)、撤(Che)药(Yao)反(Fan)应(Ying)、继(Ji)发(Fa)反(Fan)应(Ying)等(Deng),由(You)于(Yu)与(Yu)药(Yao)理(Li)作(Zuo)用(Yong)有(You)关(Guan)也(Ye)属(Shu)A型(Xing)反(Fan)应(Ying)范(Fan)畴(Chou)。药(Yao)物(Wu)变(Bian)态(Tai)反(Fan)应(Ying)和(He)异(Yi)质(Zhi)反(Fan)应(Ying)属(Shu)B型(Xing)反(Fan)应(Ying)。问(Wen)题(Ti)三(San):药(Yao)物(Wu)不(Bu)良(Liang)反(Fan)应(Ying)的(De)发(Fa)生(Sheng)率(Lv)有(You)多(Duo)少(Shao)?据(Ju)国(Guo)外(Wai)有(You)关(Guan)文(Wen)献(Xian)报(Bao)道(Dao),药(Yao)物(Wu)不(Bu)良(Liang)反(Fan)应(Ying)的(De)发(Fa)生(Sheng)率(Lv)如(Ru)下(Xia):(1)住(Zhu)院(Yuan)病(Bing)人(Ren):10%~20%;(2)住(Zhu)院(Yuan)病(Bing)人(Ren)因(Yin)药(Yao)物(Wu)不(Bu)良(Liang)反(Fan)应(Ying)死(Si)亡(Wang)者(Zhe):0.24%~2.9%;(3)因(Yin)药(Yao)物(Wu)不(Bu)良(Liang)反(Fan)应(Ying)而(Er)住(Zhu)院(Yuan)的(De)病(Bing)人(Ren):0.3%~5.0%。问(Wen)题(Ti)四(Si):药(Yao)物(Wu)不(Bu)良(Liang)反(Fan)应(Ying)发(Fa)生(Sheng)频(Pin)率(Lv)通(Tong)常(Chang)如(Ru)何(He)表(Biao)示(Shi)?国(Guo)际(Ji)医(Yi)学(Xue)科(Ke)学(Xue)组(Zu)织(Zhi)委(Wei)员(Yuan)会(Hui)(Counsil for International Organization of Medical Sciences,简(Jian)称(Cheng)CIOMS)推(Tui)荐(Jian)用(Yong)下(Xia)列(Lie)术(Shu)语(Yu)和(He)百(Bai)分(Fen)率(Lv)表(Biao)示(Shi)药(Yao)物(Wu)不(Bu)良(Liang)反(Fan)应(Ying)发(Fa)生(Sheng)频(Pin)率(Lv):十(Shi)分(Fen)常(Chang)见(Jian)(≥10%),常(Chang)见(Jian)(≥1%,<10%),偶(Ou)见(Jian)(≥0.1%,<1%),罕(Han)见(Jian)(≥0.01%,<0.1%),十(Shi)分(Fen)罕(Han)见(Jian)(<0.01%)。问(Wen)题(Ti)五(Wu):副(Fu)作(Zuo)用(Yong)是(Shi)否(Fou)为(Wei)不(Bu)良(Liang)反(Fan)应(Ying)的(De)同(Tong)义(Yi)词(Ci)?一(Yi)种(Zhong)药(Yao)物(Wu)常(Chang)有(You)多(Duo)种(Zhong)作(Zuo)用(Yong),在(Zai)正(Zheng)常(Chang)剂(Ji)量(Liang)情(Qing)况(Kuang)下(Xia)出(Chu)现(Xian)与(Yu)用(Yong)药(Yao)目(Mu)的(De)无(Wu)关(Guan)的(De)反(Fan)应(Ying)称(Cheng)为(Wei)副(Fu)作(Zuo)用(Yong)(side effect)。一(Yi)般(Ban)说(Shuo)来(Lai),副(Fu)作(Zuo)用(Yong)比(Bi)较(Jiao)轻(Qing)微(Wei),多(Duo)为(Wei)可(Ke)逆(Ni)性(Xing)机(Ji)能(Neng)变(Bian)化(Hua),停(Ting)药(Yao)后(Hou)通(Tong)常(Chang)很(Hen)快(Kuai)消(Xiao)退(Tui)。副(Fu)作(Zuo)用(Yong)随(Sui)用(Yong)药(Yao)目(Mu)的(De)不(Bu)同(Tong)而(Er)改(Gai)变(Bian),如(Ru)阿(A)托(Tuo)品(Pin)作(Zuo)为(Wei)麻(Ma)醉(Zui)前(Qian)给(Gei)药(Yao)抑(Yi)制(Zhi)腺(Xian)体(Ti)分(Fen)泌(Mi),则(Ze)术(Shu)后(Hou)肠(Chang)胀(Zhang)气(Qi),尿(Niao)潴(Zuo)留(Liu)为(Wei)副(Fu)作(Zuo)用(Yong),而(Er)当(Dang)阿(A)托(Tuo)品(Pin)用(Yong)于(Yu)解(Jie)除(Chu)胆(Dan)道(Dao)痉(Jing)挛(Luan)时(Shi),心(Xin)悸(Ji)、口(Kou)干(Gan)成(Cheng)为(Wei)副(Fu)作(Zuo)用(Yong)。有(You)些(Xie)人(Ren)将(Jiang)副(Fu)作(Zuo)用(Yong)作(Zuo)为(Wei)不(Bu)良(Liang)反(Fan)应(Ying)的(De)同(Tong)义(Yi)词(Ci),其(Qi)实(Shi)该(Gai)两(Liang)词(Ci)的(De)含(Han)义(Yi)不(Bu)尽(Jin)相(Xiang)同(Tong),为(Wei)了(Liao)避(Bi)免(Mian)混(Hun)淆(Xiao),WHO国(Guo)际(Ji)药(Yao)物(Wu)监(Jian)测(Ce)合(He)作(Zuo)中(Zhong)心(Xin)规(Gui)定(Ding)了(Liao)副(Fu)作(Zuo)用(Yong)的(De)定(Ding)义(Yi),并(Bing)作(Zuo)了(Liao)说(Shuo)明(Ming)如(Ru)下(Xia):Side Effect: Any unintended effect of a pharmaceutical product occuring at doses normally in man which is related to pharmacological properties of the drug.This is an old term and is broad enough to include both positive and negative effects of a drug apart from its main properties or indication. Some use the term as synonymos with adverse reactions, but the proposed definition will improve clarity of use of this term .问(Wen)题(Ti)六(Liu):何(He)谓(Wei)毒(Du)性(Xing)反(Fan)应(Ying)?大(Da)多(Duo)数(Shu)药(Yao)物(Wu)都(Du)有(You)或(Huo)多(Duo)或(Huo)少(Shao)的(De)毒(Du)性(Xing)(toxicity)。毒(Du)性(Xing)反(Fan)应(Ying)(toxic reaction , toxic response)是(Shi)指(Zhi)药(Yao)物(Wu)引(Yin)起(Qi)肌(Ji)体(Ti)发(Fa)生(Sheng)生(Sheng)理(Li)生(Sheng)化(Hua)机(Ji)能(Neng)异(Yi)常(Chang)或(Huo)组(Zu)织(Zhi)结(Jie)构(Gou)病(Bing)理(Li)变(Bian)化(Hua)的(De)反(Fan)应(Ying);该(Gai)反(Fan)应(Ying)可(Ke)在(Zai)各(Ge)个(Ge)系(Xi)统(Tong)、器(Qi)官(Guan)或(Huo)组(Zu)织(Zhi)出(Chu)现(Xian)。药(Yao)物(Wu)的(De)毒(Du)性(Xing)作(Zuo)用(Yong)(toxic effect)一(Yi)般(Ban)是(Shi)药(Yao)理(Li)作(Zuo)用(Yong)的(De)延(Yan)伸(Shen),主(Zhu)要(Yao)对(Dui)神(Shen)经(Jing)、消(Xiao)化(Hua)、心(Xin)血(Xue)管(Guan)、泌(Mi)尿(Niao)、血(Xue)液(Ye)等(Deng)系(Xi)统(Tong),以(Yi)及(Ji)皮(Pi)肤(Fu)组(Zu)织(Zhi)造(Zao)成(Cheng)损(Sun)害(Hai)。各(Ge)种(Zhong)药(Yao)物(Wu)毒(Du)性(Xing)性(Xing)质(Zhi)和(He)反(Fan)应(Ying)的(De)临(Lin)床(Chuang)表(Biao)现(Xian)各(Ge)相(Xiang)同(Tong),但(Dan)反(Fan)应(Ying)程(Cheng)度(Du)和(He)剂(Ji)量(Liang)有(You)关(Guan),剂(Ji)量(Liang)加(Jia)大(Da),则(Ze)毒(Du)性(Xing)反(Fan)应(Ying)增(Zeng)强(Qiang)。药(Yao)物(Wu)引(Yin)致(Zhi)的(De)毒(Du)性(Xing)反(Fan)应(Ying)所(Suo)造(Zao)成(Cheng)的(De)持(Chi)续(Xu)性(Xing)的(De)功(Gong)能(Neng)障(Zhang)碍(Ai)或(Huo)器(Qi)质(Zhi)性(Xing)病(Bing)变(Bian),停(Ting)药(Yao)后(Hou)恢(Hui)复(Fu)较(Jiao)慢(Man),甚(Shen)至(Zhi)终(Zhong)身(Shen)不(Bu)愈(Yu)。如(Ru)氨(An)基(Ji)糖(Tang)苷(Zuo)类(Lei)抗(Kang)生(Sheng)素(Su)链(Lian)霉(Mei)素(Su)、庆(Qing)大(Da)霉(Mei)素(Su)等(Deng)具(Ju)有(You)耳(Er)毒(Du)性(Xing)(ototoxicity),可(Ke)引(Yin)致(Zhi)第(Di)八(Ba)对(Dui)颅(Lu)神(Shen)经(Jing)损(Sun)害(Hai),造(Zao)成(Cheng)听(Ting)力(Li)减(Jian)退(Tui)或(Huo)永(Yong)久(Jiu)性(Xing)耳(Er)聋(Long)。问(Wen)题(Ti)七(Qi):继(Ji)发(Fa)反(Fan)应(Ying)是(Shi)否(Fou)为(Wei)药(Yao)物(Wu)本(Ben)身(Shen)的(De)效(Xiao)应(Ying)?继(Ji)发(Fa)反(Fan)应(Ying)(secondary effect)并(Bing)不(Bu)是(Shi)药(Yao)物(Wu)本(Ben)身(Shen)的(De)效(Xiao)应(Ying),而(Er)是(Shi)药(Yao)物(Wu)主(Zhu)要(Yao)作(Zuo)用(Yong)的(De)间(Jian)接(Jie)结(Jie)果(Guo),如(Ru)广(Guang)谱(Pu)抗(Kang)生(Sheng)素(Su)长(Chang)期(Qi)应(Ying)用(Yong)可(Ke)改(Gai)变(Bian)正(Zheng)常(Chang)肠(Chang)道(Dao)菌(Jun)群(Qun)的(De)关(Guan)系(Xi)使(Shi)肠(Chang)道(Dao)菌(Jun)群(Qun)失(Shi)调(Diao)导(Dao)致(Zhi)二(Er)重(Zhong)感(Gan)染(Ran)(superinfection);利(Li)尿(Niao)药(Yao)噻(Zuo)嗪(Zuo)类(Lei)引(Yin)起(Qi)的(De)低(Di)血(Xue)钾(Jia)可(Ke)以(Yi)使(Shi)患(Huan)者(Zhe)对(Dui)强(Qiang)心(Xin)药(Yao)地(Di)高(Gao)辛(Xin)不(Bu)耐(Nai)受(Shou)。青(Qing)霉(Mei)素(Su)类(Lei)引(Yin)致(Zhi)的(De)赫(He)氏(Shi)反(Fan)应(Ying)(Herxheimers reaction)也(Ye)属(Shu)于(Yu)继(Ji)发(Fa)反(Fan)应(Ying)。问(Wen)题(Ti)八(Ba):如(Ru)何(He)预(Yu)防(Fang)首(Shou)剂(Ji)效(Xiao)应(Ying)?首(Shou)剂(Ji)效(Xiao)应(Ying)(first dose effect)又(You)称(Cheng)首(Shou)剂(Ji)综(Zong)合(He)征(Zheng)(syndrome of first dose)或(Huo)首(Shou)剂(Ji)现(Xian)象(Xiang)(first dose phenomenon),系(Xi)指(Zhi)一(Yi)些(Xie)病(Bing)人(Ren)在(Zai)初(Chu)服(Fu)某(Mou)种(Zhong)药(Yao)物(Wu)时(Shi),由(You)于(Yu)肌(Ji)体(Ti)对(Dui)药(Yao)物(Wu)作(Zuo)用(Yong)尚(Shang)未(Wei)适(Shi)应(Ying)而(Er)引(Yin)起(Qi)不(Bu)可(Ke)耐(Nai)受(Shou)的(De)强(Qiang)烈(Lie)反(Fan)应(Ying)。最(Zui)初(Chu)发(Fa)现(Xian)引(Yin)起(Qi)首(Shou)剂(Ji)效(Xiao)应(Ying)的(De)药(Yao)物(Wu)为(Wei)α1受(Shou)体(Ti)阻(Zu)滞(Zhi)剂(Ji)哌(Zuo)唑(Zuo)嗪(Zuo)(prazoxin),该(Gai)药(Yao)引(Yin)起(Qi)的(De)首(Shou)剂(Ji)效(Xiao)应(Ying)表(Biao)现(Xian)为(Wei)恶(E)心(Xin)、头(Tou)晕(Yun)、头(Tou)痛(Tong)、心(Xin)悸(Ji)、嗜(Shi)睡(Shui)、体(Ti)位(Wei)性(Xing)低(Di)血(Xue)压(Ya)、休(Xiu)克(Ke)等(Deng);β受(Shou)体(Ti)阻(Zu)滞(Zhi)剂(Ji)和(He)钙(Gai)拮(Zuo)抗(Kang)剂(Ji)也(Ye)可(Ke)引(Yin)起(Qi)首(Shou)剂(Ji)效(Xiao)应(Ying)。为(Wei)预(Yu)防(Fang)哌(Zuo)唑(Zuo)嗪(Zuo)的(De)首(Shou)剂(Ji)效(Xiao)应(Ying),可(Ke)采(Cai)用(Yong)临(Lin)睡(Shui)前(Qian)给(Gei)药(Yao),并(Bing)从(Cong)小(Xiao)剂(Ji)量(Liang)(0.5mg)开(Kai)始(Shi);一(Yi)旦(Dan)发(Fa)生(Sheng)首(Shou)剂(Ji)效(Xiao)应(Ying),应(Ying)使(Shi)患(Huan)者(Zhe)平(Ping)卧(Wo),一(Yi)般(Ban)无(Wu)须(Xu)特(Te)殊(Shu)处(Chu)理(Li)。问(Wen)题(Ti)九(Jiu):后(Hou)遗(Yi)效(Xiao)应(Ying)是(Shi)一(Yi)种(Zhong)暂(Zan)时(Shi)性(Xing)的(De)还(Huan)是(Shi)永(Yong)久(Jiu)性(Xing)的(De)效(Xiao)应(Ying)?后(Hou)遗(Yi)效(Xiao)应(Ying)(after effect)是(Shi)指(Zhi)停(Ting)药(Yao)后(Hou)血(Xue)浓(Nong)度(Du)已(Yi)降(Jiang)至(Zhi)阈(Zuo)浓(Nong)度(Du)以(Yi)下(Xia)时(Shi)残(Can)存(Cun)的(De)生(Sheng)物(Wu)效(Xiao)应(Ying)。后(Hou)遗(Yi)效(Xiao)应(Ying)可(Ke)能(Neng)比(Bi)较(Jiao)短(Duan)暂(Zan),如(Ru)服(Fu)用(Yong)巴(Ba)比(Bi)妥(Tuo)类(Lei)催(Cui)眠(Mian)药(Yao)后(Hou)次(Ci)晨(Chen)的(De)宿(Su)醉(Zui)现(Xian)象(Xiang);也(Ye)可(Ke)能(Neng)比(Bi)较(Jiao)持(Chi)久(Jiu),如(Ru)长(Chang)期(Qi)应(Ying)用(Yong)肾(Shen)上(Shang)腺(Xian)皮(Pi)质(Zhi)激(Ji)素(Su),一(Yi)旦(Dan)停(Ting)药(Yao)后(Hou)肾(Shen)上(Shang)腺(Xian)皮(Pi)质(Zhi)功(Gong)能(Neng)低(Di)下(Xia),数(Shu)月(Yue)内(Nei)难(Nan)以(Yi)恢(Hui)复(Fu)。少(Shao)数(Shu)药(Yao)物(Wu)可(Ke)以(Yi)导(Dao)致(Zhi)永(Yong)久(Jiu)性(Xing)器(Qi)质(Zhi)性(Xing)损(Sun)害(Hai),如(Ru)链(Lian)霉(Mei)素(Su)引(Yin)起(Qi)永(Yong)久(Jiu)性(Xing)耳(Er)聋(Long)。问(Wen)题(Ti)十(Shi):何(He)谓(Wei)ADE?ADE是(Shi)adverse drug event的(De)缩(Suo)写(Xie),即(Ji)药(Yao)物(Wu)不(Bu)良(Liang)事(Shi)件(Jian)。药(Yao)物(Wu)不(Bu)良(Liang)事(Shi)件(Jian)与(Yu)不(Bu)良(Liang)反(Fan)应(Ying)的(De)含(Han)义(Yi)有(You)所(Suo)不(Bu)同(Tong)。不(Bu)良(Liang)事(Shi)件(Jian)是(Shi)指(Zhi)在(Zai)药(Yao)物(Wu)治(Zhi)疗(Liao)过(Guo)程(Cheng)中(Zhong)出(Chu)现(Xian)的(De)不(Bu)利(Li)的(De)临(Lin)床(Chuang)事(Shi)件(Jian),但(Dan)该(Gai)事(Shi)件(Jian)未(Wei)必(Bi)与(Yu)药(Yao)物(Wu)有(You)因(Yin)果(Guo)关(Guan)系(Xi)。不(Bu)良(Liang)事(Shi)件(Jian)也(Ye)可(Ke)理(Li)解(Jie)为(Wei)new clinical incidents and/or adverse reactions,即(Ji)它(Ta)包(Bao)含(Han)临(Lin)床(Chuang)新(Xin)出(Chu)现(Xian)的(De)偶(Ou)然(Ran)事(Shi)件(Jian)及(Ji)不(Bu)良(Liang)反(Fan)应(Ying),例(Li)如(Ru)在(Zai)使(Shi)用(Yong)某(Mou)种(Zhong)药(Yao)物(Wu)期(Qi)间(Jian)出(Chu)现(Xian)的(De)病(Bing)情(Qing)的(De)恶(E)化(Hua),并(Bing)发(Fa)症(Zheng),就(Jiu)诊(Zhen)或(Huo)住(Zhu)院(Yuan),化(Hua)验(Yan)结(Jie)果(Guo)异(Yi)常(Chang),各(Ge)种(Zhong)原(Yuan)因(Yin)的(De)死(Si)亡(Wang),各(Ge)种(Zhong)事(Shi)故(Gu)如(Ru)骨(Gu)折(Zhe)、车(Che)祸(Huo),或(Huo)导(Dao)致(Zhi)这(Zhe)些(Xie)事(Shi)故(Gu)的(De)原(Yuan)因(Yin)--瞌(Zuo)睡(Shui)、眩(Xuan)晕(Yun)、晕(Yun)厥(Zuo)、视(Shi)力(Li)障(Zhang)碍(Ai)等(Deng),以(Yi)及(Ji)可(Ke)疑(Yi)的(De)药(Yao)物(Wu)不(Bu)良(Liang)反(Fan)应(Ying)。ADE是(Shi)否(Fou)确(Que)为(Wei)药(Yao)物(Wu)所(Suo)致(Zhi)须(Xu)经(Jing)分(Fen)析(Xi)评(Ping)估(Gu)。为(Wei)正(Zheng)确(Que)理(Li)解(Jie)ADE的(De)含(Han)义(Yi),现(Xian)将(Jiang)WHO国(Guo)际(Ji)药(Yao)物(Wu)监(Jian)测(Ce)合(He)作(Zuo)中(Zhong)心(Xin)规(Gui)定(Ding)的(De)不(Bu)良(Liang)事(Shi)件(Jian)定(Ding)义(Yi)抄(Chao)录(Lu)如(Ru)下(Xia):Any untoward medical occurrence that may present during treatment with a pharmaceutical product but which does not necessarily have a causal relationship with this treatment.
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