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女，胃大部分切除术后8小时未排尿，下腹部胀痛难忍，有尿意但不习惯床上排尿。 医嘱：给该病人实施导尿术，插尿管的深度是多少( )。
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Some drug makers pay key leaders in a field of medicine, such as chairs of departments in medical schools, tens of thousands of dollars if they are saying the right things about their product. They manipulate medical education sessions, lectures, articles in medical journals, research studies, even personal conversations between physicians to get their product message across. Now a huge collection of drug company internal documents—revealed as part of a law-suit-offers a wealth of detail. In 1996, Dr. David Franklin, an employee of the drug company Parke-Davis, filed the lawsuit under federal whistleblower statutes alleging that the company was illegally promoting a drug called Neurontin for so called "off-label" uses. Under federal law, once the FDA approves a drug, a doctor can prescribe it for anything. But the law specifically prohibits the drug company from promoting the drug for any unapproved uses. In 2004, the company, by then a division of Pfizer admitted guilt and agreed to pay $ 430 million in criminal and civil liability related to promoting the drug for off-label use. Spokespeople for Pfizer say that any wrong doing occurred before Pfizer acquired the company. But Pfizer fought hard to keep all the papers related to the suit under seal. A judge denied the request and they are now part of the Drug Industry Document Archive at the University of California, San Francisco. What is most interesting is not the illegal actions they reveal, but the details of activities that are perfectly legal. And according to people familiar with the industry, the methods detailed in these company memos are routine. One tactic identifies certain doctors as "thought leaders,"—those whose opinions influence the prescribing pattern of other doctors. Those whose views converge with the company goals are then showered with rewards, research and educational grants. In the Parke-Davis case 14 such big shots got between $10,250 and $158,250 between 1993 and 1997. "Medical education drives this market," wrote the author of one Parke-Davis business plan in the files. Many state licensing boards require physicians to attend sessions in what is called continuing medical education (CME) to keep current in their field. At one time, medical schools ran most CME courses. Now, an industry of medical education and communications committees(MECCs) run most of the courses. These companies with innocent sounding names like Medical Education Systems set up courses, sometimes in conjunction with medical meetings, at other times often in fancy restaurants and resorts. The drug companies foot the bill, with the program usually noting it was financed by an "unrestricted educational grant" from the company. Using MECCs, Parke-Davis set up conference calls so that doctors could talk to one another about the drugs. The moderators of the calls, often thought leaders or their younger assistants, received $ 250 to $ 500 a call. Drug company reps were on the line, instructed to stay in a "listen only" mode, but monitoring to be sure the pitch met their expectations. Clearly, many of the physicians in these schemes are not innocent bystanders. Whether it is ghost writing, making telephone calls to colleagues or leading a CME session, many of the doctors got paid well. Others received a free meal or transportation to a resort to listen to an "educational session." Physicians often claim they are not influenced by payments from the pharmaceutical industry. But with the methods so thoroughly detailed in these papers, drug companies clearly believe they are getting their money’s worth. The drug companies are willing to pay leading doctors to
Some drug makers pay key leaders in a field of medicine, such as chairs of departments in medical schools, tens of thousands of dollars if they are saying the right things about their product. They manipulate medical education sessions, lectures, articles in medical journals, research studies, even personal conversations between physicians to get their product message across. Now a huge collection of drug company internal documents—revealed as part of a law-suit-offers a wealth of detail. In 1996, Dr. David Franklin, an employee of the drug company Parke-Davis, filed the lawsuit under federal whistleblower statutes alleging that the company was illegally promoting a drug called Neurontin for so called "off-label" uses. Under federal law, once the FDA approves a drug, a doctor can prescribe it for anything. But the law specifically prohibits the drug company from promoting the drug for any unapproved uses. In 2004, the company, by then a division of Pfizer admitted guilt and agreed to pay $ 430 million in criminal and civil liability related to promoting the drug for off-label use. Spokespeople for Pfizer say that any wrong doing occurred before Pfizer acquired the company. But Pfizer fought hard to keep all the papers related to the suit under seal. A judge denied the request and they are now part of the Drug Industry Document Archive at the University of California, San Francisco. What is most interesting is not the illegal actions they reveal, but the details of activities that are perfectly legal. And according to people familiar with the industry, the methods detailed in these company memos are routine. One tactic identifies certain doctors as "thought leaders,"—those whose opinions influence the prescribing pattern of other doctors. Those whose views converge with the company goals are then showered with rewards, research and educational grants. In the Parke-Davis case 14 such big shots got between $10,250 and $158,250 between 1993 and 1997. "Medical education drives this market," wrote the author of one Parke-Davis business plan in the files. Many state licensing boards require physicians to attend sessions in what is called continuing medical education (CME) to keep current in their field. At one time, medical schools ran most CME courses. Now, an industry of medical education and communications committees(MECCs) run most of the courses. These companies with innocent sounding names like Medical Education Systems set up courses, sometimes in conjunction with medical meetings, at other times often in fancy restaurants and resorts. The drug companies foot the bill, with the program usually noting it was financed by an "unrestricted educational grant" from the company. Using MECCs, Parke-Davis set up conference calls so that doctors could talk to one another about the drugs. The moderators of the calls, often thought leaders or their younger assistants, received $ 250 to $ 500 a call. Drug company reps were on the line, instructed to stay in a "listen only" mode, but monitoring to be sure the pitch met their expectations. Clearly, many of the physicians in these schemes are not innocent bystanders. Whether it is ghost writing, making telephone calls to colleagues or leading a CME session, many of the doctors got paid well. Others received a free meal or transportation to a resort to listen to an "educational session." Physicians often claim they are not influenced by payments from the pharmaceutical industry. But with the methods so thoroughly detailed in these papers, drug companies clearly believe they are getting their money’s worth. It can be inferred from the passage that the author
简述故意杀人罪与因危害公共安全导致他人死亡的犯罪的区分。
Most people would not object to living a few years longer than normal, as long as it meant they could live those years in good health. Sadly, the only proven way to extend the lifespan of an animal in this way is to reduce its calorie intake. Studies going back to the 1930s have shown that a considerable reduction in consumption (about 50%) can extend the lifespan of everything from dogs to nematode worms by between 30% and 70%. Although humans are neither dogs nor worms, a few people are willing to give the calorie-restricted diet a try in the hope that it might work for them, too. But not many—as the old joke has it, give up the things you enjoy and you may not live longer, but it will sure seem as if you did.Now, though, work done by Marc Hellerstein and his colleagues at the University of California, Berkeley, suggests that it may be possible to have, as it were, your cake and eat it too. Or, at least, to eat 95% of it. Their study, to be published in the American Journal of Physiology—Endocrinology and Metabolism, suggests that significant gains in longevity might be made by a mere 5% reduction in calorie intake. The study was done on mice rather than people. But the ubiquity of previous calorie-restriction results suggests the same outcome might well occur in other species, possibly including humans. However, you would have to fast on alternate days.(41)__________Cancer is the uncontrolled growth of cells. For a cancer to develop efficiently, it needs multiple mutations to accumulate in the DNA of the cell that becomes the tumor’s ancestor.(42)__________A slower rate of cell division thus results in a slower accumulation of cancer-causing mutations.(43)__________Heavy water is heavy because the hydrogen in it weighs twice as much as ordinary hydrogen(it has a proton and a neutron in its nucleus, instead of just a proton). Chemically, however, it behaves like its lighter relative. This means, among other things, that it gets incorporated into DNA as that molecule doubles in quantity during cell division.(44)__________Dr Hellerstein first established how much mice eat if allowed to feed as much as they want. Then he set up a group of mice that were allowed to eat only 95% of that amount. In both cases, he used the heavy-water method to monitor cell division. The upshot was that the rate of division in the calorie-restricted mice was 37% lower than that in those mice that could eat as much as they wanted—which could have a significant effect on the accumulation of cancer-causing mutations.(45)__________[A] To stop this happening, cells have DNA-repair mechanisms. But if a cell divides before the damage is repaired, the chance of a successful repair is significantly reduced.[B] Bingeing and starving is how many animals tend to feed in the wild. The uncertain food supply means they regularly go through cycles of too much and too little food (it also means that they are often restricted to eating less than they could manage if food were omnipresent).[C] But calorie-reduction is not all the mice had to endure. They were, in addition, fed only on alternate days: bingeing one day and starving the next. So, whether modern man and woman, constantly surrounded by food and advertisements for food, would really be able to forgo eating every other day is debatable.[D] Why caloric restriction extends the lifespan of any animal is unclear, but much of the smart money backs the idea that it slows down cell division by denying cells the resources they need to grow and proliferate. One consequence of that slow-down would be to hamper the development of cancerous tumors.[E] So, by putting heavy water in the diets of their mice, the researchers were able to measure how much DNA in the tissues of those animals had been made since the start of the experiment (and by inference how much cell division had taken place), by the simple expedient of extracting the DNA and weighing it.[F] The second reason, according to Elaine Hsieh, one of Dr Hellerstein’s colleagues, is that cutting just a few calories overall, but feeding intermittently, may be a more feasible eating pattern for some people to maintain than making small reductions each and every day.[G] At least, that is the theory. Until now, though, no one has tested whether reduced calorie intake actually does result in slower cell division. Dr Hellerstein and his team were able to do so using heavy water as a chemical "marker" of the process. 44（）
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