ADR characteristics and corporate governance in the Greater China region

Available online at

https://www.sodocs.net/doc/1312728572.html,

Review of Development Finance2(2012)

43–52

ADR characteristics and corporate governance in the Greater China region

Lee-Hsien Pan b,?,Chien-Ting Lin a,K.C.Chen c

a School of Accounting,Economics,and Finance,Deakin University,Burwood,Victoria,Australia

b Department of Accounting and Information Technology,National Chung Cheng University,Chia Yi,Taiwan

c Craig School of Business,California State University-Fresno,USA

Available online23June2012

Abstract

We examine the relationship between?rm valuation and governance mechanisms,?rm characteristics,and institutional factors of the American Depository Receipts(ADRs)domiciled in the Greater China region.We?nd that China ADRs have the highest market-to-book value ratio followed by Hong Kong and Taiwan ADRs.It appears that Chinese?rms with the poorest external governance environment stand to bene?t the most from cross listing under the ADR programs.Listing in the U.S.that requires more stringent regulations and disclosure rules may strengthen the?rms’governance practices and thereby enhance their?rm value.Among the internal governance mechanisms,institutional ownership and insider ownership are important for?rm value.

?2012Production and hosting by Elsevier B.V.on behalf of Africagrowth Institute.

Keywords:External governance environments;Internal governance mechanisms;ADRs;Corporate governance;Greater China region;Firm valuation

1.Introduction

Good corporate governance mechanisms are value enhanc-ing,and their importance on?rm value has long been established since the pioneering work of Jensen and Meckling(1976)in a nexus of contracts among various stakeholders.Under the rubrics of principal–agent con?icts,Shleifer and Vishny(1997) emphasize that investor protection is https://www.sodocs.net/doc/1312728572.html, Porta et al. (1998,2000,2002),who examine the importance of external governance around the world,show that common-law countries provide better shareholder protection than civil-law countries, and better shareholder protection is associated with higher val-uation of corporate assets,and poor shareholder protection is penalized with lower valuations.

Recent research has focused on the combined determinants of corporate governance on?rm performance.In particular,board

?Corresponding author.

E-mail addresses:actlhp@https://www.sodocs.net/doc/1312728572.html,.tw(L.-H.Pan),Edlin@https://www.sodocs.net/doc/1312728572.html,.au (C.-T.Lin),kchen@https://www.sodocs.net/doc/1312728572.html,(K.C.Chen).

Peer review under responsibility of Africagrowth

Institute.

1879-9337?2012Production and hosting by Elsevier B.V.on behalf of Africagrowth Institute.

https://www.sodocs.net/doc/1312728572.html,/10.1016/j.rdf.2012.05.002structure(Yermack,1996;Boone et al.,2007;Linck et al.,2008), CEO characteristics(Hermalin and Weisbach,1998;Basu et al., 2007;Brookman and Thistle,2009),and ownership structure (Lemmon and Lins,2003;Ali et al.,2007)have been identi?ed as key determinants of a?rm’s governance practices.Firms with more independent directors and higher managerial ownership are linked to stronger governance and better?rm performance. Against the backdrops of these?ndings,Gillan(2006)provides a comprehensive review of internal and external governance systems,and their interactions.

In this study,we contribute to the literature as we examine ?rm performance across various external governance regimes under the American Depository Receipts(ADRs)programs.In particular,we examine?rm performance from the Greater China region,namely China,Hong Kong,and Taiwan,cross-listed in the U.S.with stronger law enforcement and investor protection (see La Porta et al.,1998).This is the case for both Level II and Level III ADRs that are required to follow the same strin-gent requirements on governance,disclosure requirements,and accounting standards as those of the U.S.?rms,especially after the Sarbane-Oxley Act in2002(see Durnev and Kim,2005; Doidge et al.,2003).1It could be argued that the ADRs from 1ADRs under Level I and144A rules are not listed on a stock exchange and do not need to comply with the same U.S.requirements.Level II ADRs use existing shares to satisfy investor demand and liquidity,and Level III ADRs are a public offering of new shares into the U.S.markets.Both Level II and Level III

44L.-H.Pan et al./Review of Development Finance2(2012)43–52

the Greater China region should bene?t higher market valuation from cross-listing in the U.S.

Part of our interest in examining the impact of ADRs from the Greater China region in relation to corporate governance on?rm value is motivated by the contrasting external legal environment and the internal governance mechanisms(or the lack of them) among these markets.Although China’s regulatory framework has evolved rapidly,its external and internal governance mecha-nisms remain the weakest in comparison to those of Hong Kong and Taiwan(see,e.g.,Sun and Tong,2003;Wei,2007;Tian and Estrin,2008).2According to La Porta et al.(1998),Taiwan that follows the civil-law regime coupled with weaker investor pro-tection is exposed to a poorer governance environment,whereas Hong Kong with its legal origin from the common-law regime tends to enjoy stronger legal enforcement.

It follows that while?rms based in the Greater China region enjoy close business ties and trades,their exposure to vari-ous governance environments should provide a fertile ground to examine the differential impact of the ADR listings on?rm value.Therefore,it is hypothesized that on average,China ADRs with the weakest governance mechanisms may bene?t the most in the form of higher?rm valuation,followed by Taiwan and Hong Kong ADRs,respectively.

Our results con?rm that China ADRs enjoy on average the highest market-to-book value ratio after controlling for gover-nance measures and?rm characteristics.It suggests that Chinese ?rms,moving from the poorest external governance regime to the U.S.,tend to bene?t the most via the ADRs experience.

However,Hong Kong ADRs,embedded with stronger gover-nance at home,have the next highest market-to-book ratio after listing in the U.S.and Taiwan ADRs that come from a weaker governance regime,on the other hand,appear to gain the least in terms of market valuation.In our view,these results may be driven by distinct?rm effects that exist among the three mar-kets.More speci?cally,Hong Kong ADRs include both Hong Kong-based private-sector?rms and China-based state-owned enterprises listed in Hong Kong,while Taiwan ADRs consist of ?rms exclusively in high-tech industries.This contrast in?rm type implies that Taiwan ADRs are likely to operate in more competitive industries than their Hong Kong counterparts.As Giroud and Mueller(2011)argue that product market com-petition may act as a substitute for corporate governance as competitive pressure imposes discipline on managers to max-imize?rm value,Taiwan ADRs should,therefore,experience stronger governance.It follows that Hong Kong ADRs,which tend to be in less competitive industries based on Giroud and Mueller’s proposition and thus weaker governance,should ben-e?t more than Taiwan ADRs from the ADR listings.

Among governance measures,both institutional ownership and insider ownership are important for?rm value.These results ADRs are traded on one of the three major U.S.exchanges,i.e.,NYSE,AMAX, or NASDAQ.

2The core regulatory framework consists of The Company Law since1993, the Securities Law since1998,and the Code of Corporate Governance for Listed Companies in China since2002.are consistent with prior studies(e.g.,McConnell and Servaes, 1990;Hartzell and Starks,2003;Cornett et al.,2007)that higher insider ownership reduces potential agency con?icts between insiders and minority shareholders,and institutional ownership seems to play an effective monitoring role for the ADR?rms. Our results complement Sun and Tong(2003)who document that share issue privatization in China is positively related to ?rm performance but state ownership is negatively related to ?rm performance.

The remainder of the paper is organized as follows.Section2 provides an overview of the corporate governance environment in the Greater China region.Section3discusses sample and methodology.Empirical results are reported in Section4and Section5concludes the paper.

2.Corporate governance in the Greater China region

2.1.China

China’s legal regime can be traced to German civil law, which is on average weaker than English common law in terms of investor protection(La Porta et al.,1998).Coupled with high proportions of state ownership and control for publicly listed?rms,the corporate governance environment in China is arguably the weakest among the three markets in the region(see Sun and Tong,2003;Wei,2007;Tian and Estrin,2008).3 Since1990s,China has adopted a two-tier board structure that comprises the board of directors and the supervisory board to improve governance.The aim is to impose a two-layer oversight on the duty and performance of the senior management.That is, the board of directors monitors senior managers,and the super-visory board monitors and evaluates the performance of both senior managers and the board of directors.The governance of the board structure has further been strengthened after the Code of Corporate Governance for Listed Companies in China was introduced in2002that requires some degree of board indepen-dence,and quali?cations and knowledge of supervisory board members.

However,Wei(2007)contends that although these gover-nance measures were already put in place,most corporate boards are still characterized by insider control and weak independence. Tam(2002),Lin(2004),and Wang(2007)also?nd that super-visory boards are ineffective in playing their roles of overseeing the performance of directors and managers.

The lack of independence of directors and supervisory mem-bers is perhaps not surprising as the predecessors of Chinese listed?rms are mostly state-owned enterprises(SOEs),whose managers are often appointed as directors of the newly privatized ?rms.The consequence is that directors are rarely independent and managers tend to dominate the governance of the board. Similarly,most supervisory members are considered insiders because they tend to come from political of?ces,labor unions, close friends,and allies of the senior management(Dahya et al., 3The majority of shares outstanding in Chinese?rms are non-tradable shares owned by state/local governments or their af?liated entities.

L.-H.Pan et al./Review of Development Finance2(2012)43–5245

2003).Furthermore,the supervisory board has limited access to ?rm information and has no power in removing directors and managers(Lin,2004;Wang,2007).

Despite the partial privatization of SOEs,much of the own-ership structure of Chinese?rms remains in the hands of the state,with the majority of shares outstanding held by the state as non-tradable shares.The institutional ownership,therefore, plays a subtle but yet important role on?rm performance,espe-cially in China.Consistent with this argument,Chen et al.(2006) examine the effect of outside directors on corporate fraud and document that Chinese?rms with a higher percentage of outside directors,such as institutional investors,tend to reduce corpo-rate fraud.Zhang et al.(2001)and Xu et al.(2005)also show that foreign ownership is positively related to the ef?ciency of Chinese industrial?rms.

2.2.Hong Kong

Unlike China,Hong Kong follows the common-law regime, or the Anglo-Saxon legal and governance https://www.sodocs.net/doc/1312728572.html, Porta et al. (1998)show that common-law countries provide both share-holders and creditors the strongest legal protection compared to countries of other types of legal regimes.Within the common-law countries,Hong Kong scores well above the average in ef?ciency of judicial system,rule of law,and corruption.Cheung et al.(2007)document that the stock market in Hong Kong exhibits similar characteristics and practices as those observed in developed economies.International rating agencies rank Hong Kong as one of the more advanced markets in the Asia-Paci?c region.

However,?rms in Hong Kong are characterized by less dif-fused ownership structure than?rms in developed markets.They tend to be family owned and managed by family members as commonly found in the region.It is not unusual that the chair-man of the board is also the chief executive of?cer of the?rm. Agency con?icts may therefore arise from this particular type of ownership structure between controlling families and minority shareholders.

Since2005,every publicly listed?rm in Hong Kong is required to have a minimum of three independent non-executive directors on its board.Such requirement may mitigate agency costs of the?rm as outsiders tend to play a more effective role in monitoring managers.In sum,the corporate governance’s exter-nal environment and governance practices in Hong Kong are arguably the strongest in comparison to China and Taiwan.

2.3.Taiwan

Similar to China,Taiwan’s legal origin comes from German civil https://www.sodocs.net/doc/1312728572.html, Porta et al.(1998)report that Taiwan’s ef?ciency of judicial system and corruption are poorly ranked,compared to those countries with the same German legal origin.The overall poor investor protection in Taiwan due to its inef?cient legal environment suggests that internal governance may play a more critical role in enhancing?rm value than that in Hong Kong.

Following Germany’s corporate governance structure,board members in a Taiwanese?rm consist of both directors and supervisors.The role of supervisors is only to monitor direc-tors on their corporate decisions and to review and audit reports prepared for the shareholders.However,the supervisory board is not as independent as in the German two-tier system.Its mem-bers can be elected from family members of current employees and directors.

Lee and Yeh(2004)report that most controlling families in Taiwan often set up nominal investment?rms to increase their controls by sending family members or their designees to the board after the investment?rms are elected to the board.With these governance practices by controlling families,Young et al. (2008)discover that board independence is negatively related to managerial ownership and family control.They?nd that64% of?rms in Taiwan did not appoint an independent director and another21%of?rms elected only one independent director despite the mandatory requirement of two independent directors for IPO?rms in2002.

Given that legal regimes and internal governance vary con-siderably across the Greater China region,it could be argued that?rms in Hong Kong on average tend to be associated with the strongest governance mechanisms while those in China tend to exhibit the weakest governance practices.

3.Data and variable de?nitions

3.1.Sample

The initial sample includes all China,Hong Kong,and Taiwan ADRs listed on the NYSE,AMEX,or NASDAQ dur-ing2005–2010.All the ADRs in the sample belong to either Level II or III listing that requires the listing company to adopt the U.S.disclosure and governance rules.The starting year2005 was chosen because China,Hong Kong,and Taiwan should have adopted governance measures similar to those prescribed in the Sarbanes Oxley Act since2002.The listing information,?nan-cial and governance data of the ADRs were obtained from the Factset database,Compustat,Datastream,and SEC?lings.We then eliminated ADRs that contained missing?nancial and gov-ernance information.The?nal sample includes48China ADRs, 18Hong Kong ADRs,and8Taiwan ADRs for a total of74ADRs and444?rm-year observations.Not surprisingly,China has the largest number of ADRs relative to both Hong Kong and Taiwan.

3.2.Market-to-book ratio

Following Chen et al.(2006),Harford et al.(2008),Cheung et al.(2008),and Linck et al.(2008),we use the market-to-book value(M/B)ratio to measure?rm performance.Demsetz and Villalonga(2001)suggest that market-based measures such as M/B are more preferable than accounting-based pro?t ratios(i.e., ROA and ROE),because the former are forward looking mea-sures of corporate performance whereas the latter are backward looking constrained by accounting standards and practices.For example,accounting rules may be applied differently to valu-ing tangible and intangible capitals,and taxation systems may vary with?rms of different ownership structures.In contrast, M/B should fairly re?ect future pro?tability of a?rm perceived

46L.-H.Pan et al./Review of Development Finance2(2012)43–52

by the market without the accounting constraints.Furthermore, M/B tends to capture the market’s views on governance mecha-nisms as a means to reduce agency costs and enhance corporate performance.

Regarding explanatory variables,we follow extant literature and categorize metrics of governance mechanisms,?rm charac-teristics,and institutional factors into6groups as follows:board structure,CEO characteristics,ownership structure,?rm charac-teristics,legal regime dummies,and stock exchange dummies. These measures are de?ned in Appendix A.

3.3.Board structure

We include percentage of independent directors,CEO duality, and non-executive chairman when the chairman is not an execu-tive member of the company for measures under board structure. Independent directors,who are non-executive or non-employee directors,may play a more effective role in monitoring man-agement to meet shareholders’expectations.Borokhovich et al. (1996),Krivogorsky(2006),and Adams and Ferreira(2007) show that independent directors lower monitoring costs that in turn enhances?rm performance.

When the CEO is also the chairman of the board,Fama and Jensen(1983)contend that it may impede the effectiveness of board monitoring as the decision making and control is endowed within one individual.Rechner and Dalton(1991),and Bhagat and Bolton(2008)show that non-duality?rms outperform dual-ity?rms.Bai et al.(2004)also report a negative relationship between CEO duality and market value for Chinese?rms.

3.4.CEO characteristics

CEO characteristics refer to the number of years that a CEO has held the position.Hermalin and Weisbach(1991)suggest that CEO tenure does not seem to affect?rm pro?tability for shorter CEO tenures but?rm pro?tability declines when CEO tenure is more than15years.In a follow-up study,Hermalin and Weisbach(1998)conclude that board independence will generally decline with CEO tenure.When a CEO has worked for the company for a longer period of time,he/she tends to have more in?uence on the directors of the board,which is detrimental to board independence and the effectiveness of monitoring.

On the other hand,CEO tenure serves as a proxy for board leadership and measures the extent of CEO experience that may help companies to tackle dif?culties and increase pro?ts.This argument is supported by Linck et al.(2008)and Brookman and Thistle(2009),who show that CEO tenure has a positive effect on?rm performance.

3.5.Ownership structure

Insiders include employees,directors,and managers who enjoy information advantage about the?rm over the market. McConnell and Servaes(1990)?nd a strong curvilinear relation between corporate value and insider ownership,and a signi?-cantly positive relation between corporate value and institutional ownership.

Conversely,?rms whose managers have high levels of con-trol rights(relative to cash?ow rights)experience lower stock returns.Lemmon and Lins(2003)show that the corporate own-ership structure in eight East Asian countries plays an in?uential role in determining the incentives of insiders to expropriate minority shareholders during the times of declining investment opportunities.In examining the relation between ownership and market value among Chinese?rms,Bai et al.(2004)report that high ownership concentration is positively related to market value.

Based on the above?ndings,we include percentage of institutional ownership and percentage of insider ownership as proxies for ownership structure.However,McConnell and Servaes(1990)suggest that when the percentage of insider own-ership reaches a threshold,an increase in insider ownership may decrease?rm value.Hence,we also include a squared term of insider ownership as a measurement of the potential non-linear relationship between percentage of insider ownership and corporate value.

3.6.Firm characteristics and institutional factors

We further include?rm-speci?c and institutional-control variables to isolate the effect of governance measures on?rm performance.They include debt-to-equity ratio,trading volume, company age,and?rm size(natural log).Legal regime dummies (China,Hong Kong,and Taiwan)and stock-exchange dummies (NYSE,AMEX,and NASDAQ)are used to control for the?xed effects of legal regimes and stock exchanges.

4.Empirical results

4.1.Summary statistics

We?rst present the summary statistics of the sample ADRs in Table1.Panel A reports the aggregate statistics for the whole sample,and Panels B,C,and D present summary statistics for China,Hong Kong,and Taiwan,respectively.

We?nd that the average market-to-book(M/B)ratio is2.79 for the whole sample,a high market valuation relative to book value.It implies that the sample ADRs with high market val-uation are perhaps seeking external funding and/or increasing investor base beyond their local markets by listing on the U.S. stock exchanges.Among them,those from China enjoy the high-est market-to-book ratio of3.17,followed by those from Taiwan of1.99and Hong Kong of1.96.Firms from the weakest exter-nal governance regime(i.e.,China)appear to enjoy the highest market valuation relative to those from stronger governance regimes.

Consistent with the literature that CEO duality is more common in the region than in the U.S.or U.K.,31%of the sample ADRs appoint their CEOs as the chairman of the board (CEO DUALITY)and only4%with non-executive chairman (NONEXE CHAIR).As discussed in Section2,?rms in Hong Kong and Taiwan are more likely to be family-controlled such that CEOs who tend to be a family member also serve as chair-man of the board.Although CEO duality is lower for China

L.-H.Pan et al./Review of Development Finance2(2012)43–5247 Table1

Summary statistics of the sample?rms.

Variables Mean P25P50P75St.dev. Panel A:whole sample

M/B 2.790.97 1.76 3.30 3.28 CEO DUALITY0.310.000.00 1.000.47 NONEXE CHAIR0.040.000.000.000.20 INDEP PCT0.240.000.270.420.24 CEO TENURE 4.47 2.00 4.00 6.00 3.77 INST PCT18.68 4.1911.1225.4820.79 INSIDER PCT47.6921.3243.7374.2928.47 DEBT EQUITY24.540.00 1.4421.0372.99 AGE18.679.0013.0023.0015.11 VOLUME 1.060.120.32 1.17 1.81 SIZE 6.62 4.93 6.128.35 2.50 Panel B:China ADRs

M/B 3.17 1.08 1.87 3.64 3.75 CEO DUALITY0.270.000.00 1.000.45 NONEXE CHAIR0.010.000.000.000.12 INDEP PCT0.250.000.270.540.26 CEO TENURE 4.09 2.00 4.00 6.00 3.20 INST PCT20.35 2.909.7627.4224.16 INSIDER PCT51.1221.5847.6977.5729.39 DEBT EQUITY25.790.000.5018.4285.43 AGE18.059.0012.0020.0016.09 VOLUME 1.120.100.31 1.27 1.84 SIZE 6.41 4.95 5.917.82 2.30 Panel C:Hong Kong ADRs

M/B 1.960.61 1.46 2.61 1.83 CEO DUALITY0.360.000.00 1.000.48 NONEXE CHAIR0.130.000.000.000.34 INDEP PCT0.210.000.210.400.20 CEO TENURE 4.68 2.00 4.00 6.00 4.55 INST PCT13.41 3.038.9822.2612.51 INSIDER PCT52.1927.0364.4170.1923.48 DEBT EQUITY18.890.00 4.5322.4933.30 AGE20.7710.0015.0031.0014.84 VOLUME0.470.050.190.510.70 SIZE 6.37 4.18 5.648.90 2.99 Panel D:Taiwan ADRs

M/B 1.99 1.29 1.88 2.62 1.18 CEO DUALITY0.470.000.00 1.000.51 NONEXE CHAIR0.000.000.000.000.00 INDEP PCT0.260.000.330.380.20 CEO TENURE 6.17 3.00 5.007.50 4.32 INST PCT19.2612.4918.3225.488.17 INSIDER PCT20.007.7218.9436.2812.17 DEBT EQUITY26.950.08 4.3849.8438.23 AGE17.7511.0017.0024.507.60 VOLUME 1.810.540.95 1.89 2.58 SIZE8.287.068.819.56 1.97 This table presents the summary statistics of ADRs in the Greater China region during2005–2010.M/B is the stock price per share divided by book value per share. CEO DUALITY is a dummy variable that equals one when the CEO is also the chairman of the board,and zero otherwise.NONEXE CHAIR is a dummy variable that equals one when the chairman of the board is not an executive member,and zero otherwise.INDEP PCT is the percentage of independent directors on the board. CEO TENURE is the number of years the CEO has held his/her title.INST PCT is the number of shares held by institutional investors as a percentage of current total outstanding shares.INSIDER PCT is the number of shares held by insiders as a percentage of current total outstanding shares.DEBT EQUITY is the long-term debt-to-equity ratio;SIZE is the natural log of market capitalization,where the?rm’s market value is measured in millions of dollars.AGE is the number of years since the company starts(up to2010).VOLUME is the52-week average of the volume of shares traded.P25,P50,P75denote25th,50th,and75th percentile, respectively.

48L.-H.Pan et al./Review of Development Finance2(2012)43–52

ADRs relative to Hong Kong and Taiwan ADRs,it remains high by western standards.

The average age of sample ADRs is more than18years across which Hong Kong ADRs are on average more mature(20.77 years)than their counterparts(18.05and17.75years for China and Taiwan ADRs,respectively).On the contrary,the average CEO tenure is only4.47years,with a range from4.09years of China ADRs to6.17years of Taiwan ADRs,implying frequent CEO turnovers.

Since the regulations in all three markets require mandatory independent directors,the average percentage of independent directors is relatively high at24%.However,the variability across these three markets appears to be small,with the highest percentage of independent directors of26%found from Taiwan ADRs.

Insider ownership on average nears50%,driven largely by high insider ownership of China and Hong Kong ADRs exceed-ing50%.In contrast,because Taiwan ADRs are skewed towards technology-related?rms characterized by more diffused owner-ship,the average insider ownership is relatively low of20%.

Finally,institutional investors seem to actively invest in the ADRs.They hold an average of18.68%of total shares outstand-ing.Most noticeably,China and Taiwan ADRs attract about20% of institutional investment compared to around13%for Hong Kong ADRs.It appears that institutional investors in recent years have shown more interest in Chinese?rms.Taiwan ADRs,a cluster of high-tech?rms,also appear to draw a similar level of institutional interest.

4.2.Univariate results

Table2presents the results of differences in means of M/B, governance measures,and?rm characteristics of the China, Hong Kong,and Taiwan ADRs reported in Table1.The?rst row for each variable under the“difference”column shows the sta-tistical difference,if any,between China and Hong Kong ADRs. The second row reports the difference between Hong Kong and Taiwan ADRs while the third row presents the difference between Taiwan and China ADRs.

As shown in Table2,China ADRs exhibit higher market valuations than Hong Kong and Taiwan ADRs.There appears, however,little difference in M/B between Hong Kong and Taiwan ADRs.We?nd that very few?rm characteristics or inter-nal governance measures shown in Table2are consistent with the differences in M/B.The legal regime where the external gov-ernance environment differs signi?cantly between China and the other two markets remains the primary candidate to explain the extent of the?rm valuation differences.

Before we conduct a multivariate regression analysis on the effect of governance measures on?rm performance,we calcu-late the correlations between governance measures to examine potential multicollinearity problems.Table3presents the cor-relations using both Pearson(in upper diagonal)and Spearman rank(in lower diagonal)estimates.

The cross correlations between the six governance variables are generally low with the exception between institutional and insider ownership(0.54or0.56).These two measures are,however,expected to contrast each other because a higher proportion of insider ownership implies a lower institutional ownership.Institutional investors also become less important in monitoring managers as agency costs tend to be lower when insiders hold a higher proportion of share ownership.To ensure regression results are robust to the potential multicollinearity problem,we run several regression estimates with various com-binations of controlled variables.

4.3.Regression results

Sequel to the preliminary results,we estimate the following regression to examine the effect of governance measures on?rm valuation:

M/B i=α+β1BS+β2CEO+β3OS+β4CC+β5LD

+β6SD+εi(1) where M/B i is the market-to-book value ratio for?rm i;BS, CEO,OS,and CC are vectors of board structure variables,CEO characteristics,ownership structure,and company characteris-tics,respectively;LD and SD are dummy variables for legal regimes and stock exchanges,respectively;andεi is the error term.

One common problem in examining the relationship between corporate governance and?rm performance is the potential endogeneity effect of governance measures documented in Himmelberg et al.(1999),Cho(1998),and Bhagat and Bolton (2008).An increase in?rm value may lead to better governance practices rather than what is being investigated here.To address such effect,we?rst use?rm size,debt-to-equity ratio,and return on equity as instrumental variables for institutional ownership, and we then use the predicted institutional ownership in the regression analysis.Furthermore,we consider lagged market-to-book ratio,lagged leverage,and lagged board structure.The results using these instrumental variables are robust to those reported in this section.We also follow Black et al.(2006)and Petersen(2008)by applying adjusted standard errors due to the correlations between the same companies in different years.

Table4reports the regression results based on Eq.(1).Col-umn1?rst shows the effect of board structure along with ?rm characteristics,legal regime dummies,and exchange dum-mies on the market-to-book value(M/B)ratio.Among the measures for board structure,only percentage of independent directors(INDEP PCT)is marginally but negatively signi?cant at the10%level.The negative relation therefore contradicts the standard agency theory,which posits that an increase in the proportion of independent directors reduces principal–agent con?icts.Including other governance measures,however,shows that it is not an important consideration for market valuation(see column4in Table4).

Similar to board structure measures,the duration of CEO tenure as shown in columns2and4carries little consequence on ADR performance.Given that the average tenure period is only4.47years(see Table1),the short CEO tenure and its lack of variability across ADRs may explain why it fails to account for?rm performance.

L.-H.Pan et al./Review of Development Finance2(2012)43–5249 Table2

Sample mean comparisons among China,Hong Kong,and Taiwan ADRs.

Variable Legal regime Mean SE Difference a N

M/B China ADRs 3.170.23 1.21***269 Hong Kong ADRs 1.960.20?0.0381

Taiwan ADRs 1.990.18?1.18**45 CEO DUALITY China ADRs0.270.03?0.09224 Hong Kong ADRs0.360.05?0.1183

Taiwan ADRs0.470.080.20***36 NONEXEC CHAIR China ADRs0.010.01?0.12***221 Hong Kong ADRs0.130.040.13**83

Taiwan ADRs0.000.00?0.01**36 INDEP PCT China ADRs0.250.020.04251 Hong Kong ADRs0.210.02?0.0484

Taiwan ADRs0.260.030.0143 CEO TENURE China ADRs 4.090.22?0.58213 Hong Kong ADRs 4.680.48?1.49**90

Taiwan ADRs 6.170.72 2.07***36 INST PCT China ADRs20.35 1.62 6.94***222 Hong Kong ADRs13.41 1.44?5.85***75

Taiwan ADRs19.27 1.26?1.0842 INSIDER PCT China ADRs51.12 1.87?1.08246 Hong Kong ADRs52.19 2.5732.19***83

Taiwan ADRs20.00 1.83?31.11***44 DEBT EQUITY China ADRs25.79 5.26 6.90264 Hong Kong ADRs18.89 3.75?8.0579

Taiwan ADRs26.95 5.52 1.1548 AGE China ADRs18.050.95?2.72285 Hong Kong ADRs20.77 1.45 3.02105

Taiwan ADRs17.75 1.10?0.3048 VOLUME China ADRs 1.120.110.65***280 Hong Kong ADRs0.470.07?1.34***88

Taiwan ADRs 1.810.370.69**48 SIZE China ADRs 6.410.140.04272 Hong Kong ADRs 6.370.32?1.91***86

Taiwan ADRs8.280.28 1.87***48 This table provides sample mean comparisons and t-test values for China,Hong Kong and Taiwan ADRs during2005–2010.

a Reports difference in means in the following order:between China ADRs and Hong Kong ADRs,between Hong Kong ADRs and Taiwan ADRs,and between Taiwan ADRs and China ADRs.

**Signi?cance level of5%.

***Signi?cance level of1%.

Table3

Cross correlations of governance measures.

CEO DUALITY NONEXE CHAIR INDEP PCT CEO TENURE INST PCT INSIDER PCT CEO DUALITY?0.14***0.18***0.27***?0.060.12** NONEXE CHAIR?0.15**0.17***?0.06?0.14**0.02* INDEP PCT0.26***0.20***?0.15**?0.030.05

CEO TENURE0.28***?0.08?0.17**0.01?0.19*** INST PCT?0.08?0.22***?0.050.05?0.54*** INSIDER PCT0.15**0.010.12*?0.11*?0.56***

This table presents the correlation coef?cients between the governance measures.The Pearson correlation coef?cients are above the diagonal and the Spearman rank correlation coef?cients are below the diagonal.

*Signi?cance level of10%.

**Signi?cance level of5%.

***Signi?cance level of1%.

50L.-H.Pan et al./Review of Development Finance2(2012)43–52

Table4

Regressions of?rm performance on governance measures.

(1)(2)(3)(4) INTERCEPT?2.49?1.64?4.77***?4.03*

(0.16)(0.36)(0.00)(0.06) Board structure

CEO DUALITY0.63 1.99**

(0.30)(0.03) NONEXE CHAIR0.710.08

(0.39)(0.91) INDEP PCT?2.22*?1.79

(0.07)(0.24) CEO characteristics

CEO TENURE0.060.03

(0.58)(0.85) Ownership structure

INST PCT0.07**0.10**

(0.03)(0.04) INSIDER PCT0.08***0.08**

(0.00)(0.04) INSIDER PCT2?0.08***?0.08*

(0.00)(0.06) Company characteristics

DEBT EQUITY0.01**0.00**0.01***0.01***

(0.01)(0.02)(0.00)(0.00) SIZE0.61***0.46***0.50***0.35**

(0.00)(0.00)(0.00)(0.01) AGE?0.00?0.000.00?0.01

(0.97)(0.55)(0.76)(0.37) VOLUME0.04?0.02?0.13?0.15

(0.68)(0.80)(0.18)(0.25) Legal regime dummies

Hong Kong ?1.10**?1.17*?0.67?1.13* (0.03)(0.05)(0.21)(0.09)

Taiwan?1.53**?1.27*?1.53**?2.15*

(0.01)(0.06)(0.01)(0.05) Exchange dummies

NASDAQ 3.31*** 3.00*** 2.92*** 2.82***

(0.00)(0.00)(0.00)(0.00)

AMEX 2.38** 1.66* 1.96*** 1.64

(0.04)(0.09)(0.00)(0.12)

Year dummies Yes Yes Yes Yes

N296293286184

Adj.R20.220.200.240.24

This table presents the regressions results of?rm performance as proxy by Market-to-Book ratio on governance measures.CEO DUALITY is a dummy variable that equals one when the CEO is also the chairman of the board,and zero otherwise.NONEXE CHAIR is a dummy variable that equals one when the chairman of the board is not an executive member,and zero otherwise.INDEP PCT is the percentage of independent directors on the board;CEO TENURE is the number of years the CEO has held his/her title.INST PCT is the number of shares held by institutional investors as a percentage of the current total shares outstanding. INSIDER PCT is the number of shares held by insiders as a percentage of the current total shares outstanding.INSIDER PCT2is the square of the insider ownership percentage.DEBT EQUITY is the long-term debt-to-equity ratio;SIZE is the natural log of market capitalization in millions of dollars.AGE is the number of years the company has been in existence(up to2010);VOLUME is the52-week average of the volume of shares traded;Legal regime dummies are dummy variables to indicate the legal regime the?rm belongs to.Exchange dummies are stock exchange dummy variables where the stock is traded.P-values are presented in the parentheses.

*Signi?cance level of10%.

**Signi?cance level of5%.

***Signi?cance level of1%.

For the effect of ownership structure,we include the percentage of institutional and insider ownership.Since the effect of insider ownership may potentially be curvilin-ear,we also include a squared term.Columns3and4 of Table4show that these two governance mechanisms are positively related to the M/B ratio.While these results are consistent with the standard?nance theory that higher insider and institutional ownerships lower agency con?icts between management and minority shareholders,their rela-tionships do not appear to be economically signi?cant.An increase of one standard deviation in insider ownership and institutional ownership corresponds with a2.1%and2%change

L.-H.Pan et al./Review of Development Finance2(2012)43–5251

in M/B,respectively.It suggests that their impacts on market valuation are limited.

In contrast to the limited effects of governance measures and?rm characteristics,we?nd that legal regime explains greater variations in the M/B ratio.As shown in Table4, China ADRs experience signi?cantly higher M/B than both Hong Kong and Taiwan ADRs.In fact,switching from China ADRs to either Hong Kong or Taiwan ADRs on average low-ers market equity relative to book equity by more than a factor of1.As China has the weakest governance environ-ment in the Greater China region,the Chinese?rms under the ADR programs have the most to bene?t from listing in the U.S.

However,Hong Kong ADRs enjoy a higher market valuation than Taiwan ADRs after listing in the U.S.This result appears to contradict the hypothesis that ADRs from a weaker governance regime should bene?t more from the ADR programs.However, when we investigate?rm types between Hong Kong and Taiwan ADRs,we found that Hong Kong ADRs are made up of not only Hong Kong-based?rms but also China-based state-owned enter-prises listed in Hong Kong,whereas all Taiwan ADRs consist of?rms in high-tech industries.The apparent?rm effects sug-gest that Taiwan ADRs are likely to operate in more competitive industries compared to Hong Kong ADRs.According to Giroud and Mueller(2011),Taiwan ADRs should on average experi-ence stronger governance because product market competition serves as a good substitute for corporate governance.Conse-quently,Hong Kong ADRs with weaker governance on average tend to gain more from the ADR listings.

5.Conclusion

In their seminal papers on corporate governance,La Porta et al.(1998,2000,2002)show that external governance regime is an important determinant for?rm performance.Stronger gov-ernance that provides better investor protection leads to higher ?rm value.We extend their studies by comparing the perfor-mance of?rms from the Greater China region that cross-list in the U.S.under the ADR programs.In particular,we compare ?rm valuation between ADRs domiciled in China,Hong Kong, and Taiwan,which although share close business and trade ties differ signi?cantly in their external governance backgrounds.

Consistent with the extant literature,we?nd that Chinese ?rms with the weakest governance environment tend to gain the most under the ADR programs after subject to the stringent regu-lations and disclosure rules in the U.S.In comparison,the ADRs from Hong Kong and Taiwan experience relatively lower market valuation due to their stronger external governance environments at home.

Despite the importance of some?rm characteristics and inter-nal governance mechanisms on?rm value,our results suggest that the impact of external governance backgrounds far out-weighs those within the?rms.They imply that policy efforts should be directed more at the macro level than at the?rm level as the former appears to be more in?uential in lowering principal–agent con?icts.Appendix A.

Variables are classi?ed into seven categories:performance measure,board structure,CEO characteristics,ownership struc-ture,company characteristics,legal regime dummies,and stock exchange dummies.

Variable De?nition

Performance measure

M/B Price per share of common stock divided by book

value per share of common stock,measured in

percentage

Board structure

CEO DUALITY Dummy variable equals one when the CEO is also

the chairman of the board,and zero otherwise NONEXE CHAIR Dummy variable equals one when the chairman of

the board is not an executive member,and zero

otherwise

INDEP PCT The percentage of independent directors in the board CEO characteristics

CEO TENURE The number of years the CEO has held his/her title Ownership structure

INST PCT The number of shares held by institutional investors

as a percentage of the current total shares

outstanding

INSIDER PCT The number of shares held by insiders as a

percentage of the current total shares outstanding Company characteristics

DEBT EQUITY Debt to equity ratios,which is long term debt

divided by total equity measured in percentage SIZE The natural log of market cap,where the market cap

is measured in millions of U.S.dollars

AGE The number of years the company has been in

existence(up to2010)

VOLUME The52-week average of the volume of shares

traded,which is measured in millions of shares Legal regime dummies

China Dummy variable to indicate which legal regime a

?rm is from,one is China and zero otherwise Hong Kong Dummy variable to indicate which legal regime a

?rm is from,one is Hong Kong and zero otherwise Taiwan Dummy variable to indicate which legal regime a

?rm is from,one is Taiwan and zero otherwise Stock exchange dummies

NYSE Dummy variable which equals one if a?rm’s stock

is listed on NYSE,and zero otherwise

AMEX Dummy variable which equals one if a?rm’s stock

is listed on AMEX,and zero otherwise

NASDAQ Dummy variable which equals one if a?rm’s stock

is listed on NASDAQ,and zero otherwise

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《药品不良反应事件报告表》的填写要求

《药品不良反应/事件报告表》填写要求 《药品不良反应报告和监测管理办法》第十三条明确规定：药品生产、经营企业和医疗卫生机构必须指定专（兼）职人员负责本单位生产、经营、使用药品的不良反应报告和监测工作，发现可能与用药有关的不良反应应详细记录、调查、分析、评价、处理，并填写《药品不良反应/事件报告表》，每季度集中向所在地的省、自治区、直辖市药品不良反应监测中心报告，其中新的或严重的药品不良反应应于发现之日起15日内报告，死亡病例须及时报告。 （一）填写注意事项： 1．《办法》第十四条规定：《药品不良反应/事件报告表》的填报内容应真实、完整、准确。 2．《药品不良反应/事件报告表》是药品安全性监测工作的重要档案资料，手工报表需要长期保存，因此需用钢笔、签字笔书写，填写内容、签署意见（包括有关人员的签字）字迹要清楚，不得用报告表中未规定的符号、代号、不通用的缩写形式和花体式签名。其中选择项画“√”，叙述项应准确、完整、简明，不得有缺漏项。 3．每一个病人填写一张报告表。 4．个人报告建议由专业人员填写，可以是诊治医务人员、药品生产、经营企业专（兼）职人员及专业监测机构人员。 5．尽可能详细地填写报告表中所要求的项目。有些内容无法获得时，填写“不详。 6．对于报告表中的描述性内容，如果报告表提供的空间不够，可另附A4纸说明。在纸的顶部注明“附件”，所有的附件应按顺序标明页码，附件中必须指出描述项目的名称。

7．补充报告：如需作补充报告时，请注意与原报表编号保持一致，并在报告左上方注明“补充报告”，与原报表重复的部分可不必再填写。补充报告也可不填写报告表，只需附纸说明补充内容即可，但须注明原报表编号、单位名称、补充报告时间、报告人。 （二）填写详细要求 1．新的、严重、一般： 新的ADR：是指药品说明书中未载明的ADR。 严重ADR：是指因服用药品引起以下损害情形之一的反应： ⑴引起死亡； ⑵致癌、致畸、致出生缺陷； ⑶对生命有危险并能够导致人体永久的或显著的伤残； ⑷对器官功能产生永久损伤； ⑸导致住院或住院时间延长。 一般的ADR：是指除新的、严重的ADR以外的所有ADR。 2．单位名称：填写医疗卫生机构、药品生产企业或经营企业的完整全称。如：“镇江市第一人民医院”，不可填“一院”。 3．部门：填写报告单位的具体报告部门, 应填写标准全称或简称，如：“普通外科二病房”或“普外二”，如连锁药店应填具体的门店，零售药店可填写药店名称。

药品不良反应分析报告报告材料

药品不良反应分析报告 药品不良反应（ADR）监测是合理用药的重要依据，是关系到广大患者用药安全，减少医患纠纷的一项重要工作。我院2019年第一季度共收集报告146例，现就2019年第一季度的ADR报告进行统计、分析，了解ADR发生的一般规律和特征，为临床合理用药提供参考。 一、ADR监测统计结果及分析 1、性别与年龄分布 我院2019年第一季度共收到146例ADR报告，其中男性66人，占比45.21 %，女性80人，占比54.79%。患者的年龄分布见表1： 表1 发生ADR患者的年龄分布 年龄/岁例数/n 构成比/% 0～10 32 21.92 11～20 4 2.74 21～30 8 5.48 31～40 14 9.59 41～50 24 16.44 51～60 19 13.01 > 60 45 30.82

合计146 100.00 2、患者家族史、既往史情况 146例ADR报告中，患者既往有过敏史的26例，占17.81%；无过敏史的113例，占77.40%；不详的7例，占4.79%。146例患者中有家族药物过敏史的0例，占0%；无家族药物过敏史的51例，占34.93%；不详的95例，占65.07%。

3、患者转归情况 146例ADR中，其中痊愈77例，占52.74%；好转45例，占30.82%；不详24例，占16.44%。大多数患者经积极治疗均好转或痊愈（占83.56%），不详占16.44%，主要因为观察时间不够长，说明我院医务人员发现药品不良反应能够及时上报。 4、药品剂型及用药途径分布 药品剂型 146例病例报告涉及药品剂型17种，以注射剂为主。本季度涉及药品剂型分布及所占比例见表2。 表2 药物剂型分布 剂型例次/n 构成比/% 注射剂142 64.25 粉针剂21 9.50

最新医学名词解释

医学名词解释

检验医学名词解释(一) 2007-9-26 16:43:39 检验医学名词解释100 检验医学名词解释 1.中毒颗粒 在严重感染时中性粒细胞内出现的染成紫黑色的粗大颗粒。 2.亚铁血红素 血红蛋白色素部分，由铁原子及原卟啉区组成。 3.点彩红细胞 红细胞中残存的嗜碱性物质，是RNA变性沉淀的结果。 4.中性粒细胞核左移 外周血中性杆状核粒细胞增多（出现晚、中、早幼粒细胞以致原粒细胞）。 5.血型 是人体血液的一种遗传性状，是指红细胞抗原的差异。 6.ABO血型抗体 一般分为二类；"天然"抗体和免疫抗体，都是通过免疫产生 的。 7.病理性蛋白尿 蛋白尿持续超过0.15g/d，常为病理性，是肾脏疾病的可靠指标。 8.肾小管蛋白尿系肾小球滤过膜正常，但原尿中正常滤过的蛋白质不能被肾小管充分回吸收所致。 9.本周氏蛋白 是免疫球蛋白的轻链单体或二聚体，属于不完全抗体球蛋白。常出现干骨髓瘤患者尿中，有诊断意义。 10.网织红细胞 是介于晚幼红细胞和成熟红细胞之间尚未完全成熟的红细胞。11.瑞氏染液 是由酸性染料伊红和碱性染料美蓝组成的复合染料，溶于甲醇后解离为带正电的美蓝和带负电的伊红离子。 12.异型淋巴细胞在某些病毒性感染或过敏原刺激下使淋巴细胞增生，并出现一定的形态变化称为异型淋巴细胞。 13.退行性变白细胞

白细胞出现胞体肿大、结构模糊、边缘不清、核固缩、肿胀或 溶解等变化。 14.核右移 外周血中性粒细胞五叶核以上者超过3％称为核右移。 15.红斑狼疮细胞 SLE患者血液（体液中）存在LE因子，在体外可使受累白细胞核DNA解聚，形成游离均匀体，被具有吞噬能力的白细胞所吞噬而 形成。 16.内源性凝血系统 指凝血始动反应因子Ⅻ的激活[Ⅸ a-PF3-Ⅷ-Ca]复合物的形成以及激活因子Ⅹ。 17.外源性凝血系统 指Ⅶ因子激活及因子Ⅲ以组织损伤后所释放出的组织凝血活酶起动外源性凝血途径为特点。 18.血凝的固相激活 指Ⅻ因子接触到一种带电荷的表面，即被激活为Ⅻa的过程（简意： 即Ⅻa激活过程）。 19.血凝的液相激活 指激肽释放酶原转变为激肽释放酶后迅速激活Ⅻa这一反馈作用又称酶激活。 20.Rh血型 红细胞上含有与恒河猴红细胞相同的抗原为Rh血型。 21.渗透压差 是体内水重吸收的动力，浓度差和电位差是一些溶质重吸收的动力。 22.真性糖尿 因胰岛素分泌量相对或绝对不足使体内各组织对葡萄糖的利用率降低所致。 23.肾性糖尿 指血糖处于正常水平，由于肾小管对糖的再吸收能力减低所致。24.血红蛋白尿 指当发生血管内溶血时，产生的血红蛋白超过结合珠蛋白的结合能力而由尿中出现的现象。

药品不良反应报告表填写示例及填写说明

药品不良反应/ 事件报告表 首次报告□ 跟踪报告□ 编码： 报告类型：新的□ 严重□ 一般□ 报告单位类别：医疗机构□ 经营企业□ 生产企业□ 个人□ 不良反应事件名称：不良反应事件发生时间：年月日不良反应/ 事件过程描述（包括症状、体征、临床检验等）及处理情况（可附页） 不良反应/ 事件的结果：痊愈□好转□ 未好转□ 不详□ 有后遗症□ 表现： 死亡□ 直接死因：死亡时间：年月日 停药或减量后，反应/ 事件是否消失或减轻？是□ 否□不明□ 未停药或未减量□再次使用可疑药品后是否再次出现同样反应/ 事件？是□ 否□ 不明□ 未再使用□

电子邮箱： 签名：××× 药 品 不 良 反 应 / 事 件 报 告 表示例 不良反应 / 事件过程描述（包括症状、体征、临床检验等）及处理情况（可附页） 一般格式为：患者因×××疾病于×××月×××日（必要时应详细到×××时分）以×××途径给予×××药品，×××剂量，用药×× ×时间出现×××反应（反应描述须明确、具体） ，×××时间后给予是否停药及×××处理（包括以×××途径给予×××药品及×××剂 和其他处理措施） ，处理后×××时间患者转归情况。 对原患疾病的影响： 不明显□ 病程延长□ 病情加重□ 导致后遗症□ 导致死亡□ 报告人评价： 肯定□ 很可能□ 可能□ 可能无关□ 待评价□ 无法评价□ 签名：××× 报告单位评价： 肯定□ 很可能□ 可能□ 可能无关□ 待评价□ 无法评价□ 签名：××× 报告人信息 患者姓名：××× 性别：男□女□ 出生日期： 年 月 日 或年龄： ×× 民族：×× 体重（ kg ）：×× 联系方式：×××××× 原患疾病：指患者此次入 诊的主要疾病（如果有多 疾病可以补充在相关重要 是备注里面），不能写字 院或就 种慢性 信息或 母缩写。 医院名称：三亚市中医院 病历号 / 门诊号：××××（务必 填写） 既往药品不良反应 / 事件：有□需提供药品通用名称及具体反应 无□ 不详□ 家族药品不良反应 / 事件：有□需提供药品通用名称及具体反应 无□ 不详□ 报告单位类别：医疗机构□ 其他□ 相关重要信息： 吸烟史□ 饮酒史□ 妊娠期□ 肝病史□ 肾病史□ 过敏史□此处是提供有否食物等过敏史 首次报告□ 跟踪报告□ 报告类型：新的□ 严重□ 一般□ 编码： 经营企业□ 生产企业□ 个人□ 其他□ 药 品 批准文号 商品 名称 通用名称 （含剂型） 生产厂 家 生产批号 用法用量 （次剂量、 途径、 日次数） 用药起止时 间 用药原因 怀 疑 药 品 国药准字 此处填写药品的 通用名 称。注射剂 包含注射液和粉 针剂，请认真选择 正确剂型 本次使用药 物的生产批 号 包括每次用药剂 量、 给药途径、 每日给药 次数， 例如，5mg ， 口服， 每日 2 次。 指使用药品 的同 一剂量 的开始时 间 和停止时间 填写使用该药品的原因，应详 细填 写。例如：患者高血压病 史，此次因肺部感染而注射氨 苄青霉素引起不良反应，用药 原因栏应填写肺部 感染 并 用 药 品 同上 量， 不良反应 / 事件的结果：痊愈□ 死亡□ 好转□ 直接死因： 未好转□ 不详□ 有后遗症□ 表现： 死亡时间：× 年 × 月 × 日 停药或减量后，反应 / 事件是否消失或减轻？ 再次使用可疑药品后是否再次出现同样反应 / 事件？ 是□ 否□ 是□ 否□ 不明□ 不明□ 未停药或未减量□ 未再使用□ 关联性评价 联系电话：务必正确填写 职业：医生□ 药师□ 护士□ 其他□ 不良反应 / 事件名称：应填写不良反应中最主要、最明显的症状。 不良反应 / 事件发生时间：× 年 × 月× 日（应填写发生不良反应 / 事件 的确切时间）

常用医学术语汇总

医学术语 一、词根（roots）：每个单词的基本部分。 For example：port----transport,export,support,portable 来源于拉丁文“portare”，意为“运送”。 simil----simulate,similarity,assimilate 词根通常是末端开放的单词。 For example：gastr- 胃 pneumon- 肺 在组合词根时,需要加“o”在词根间（但需凭经验判断 何时不用加“o”）。 For example：gastr-o-enter-itis——胃肠炎 celio-gastr-otomy——剖腹胃切开术 二、组合词根时的排序原则： 首先命名近端结构，其次是远端结构。 For example：duoden-o-jejun-itis十二指肠空肠炎 esophag-o-gastr-ectomy食管胃切除术 当不存在自然的解剖连续性时，则按照流动方向决定词根的相对位置。For example：cholecyst-o-jejun-ostomy胆囊空肠吻合术 pancreatic-o-enter-ostomy胰管小肠吻合术

三、常用的解剖学词根 an：肛管（anal canal） celio：体腔（body cavity） arter：动脉（artery） cholecyst：胆囊（gallbladder）cec：盲肠（cecum） choledoch：总胆管（choledochus）chole ：胆汁（bile） duoden：十二指肠（duodenum）col：结肠（colon） enter：小肠（small intestine）crani：颅骨（cranium） esophag：食道（esophagus） cyst：囊（sac） lapar：腹部，髂窝（abdomen,flank）gastr：胃（stomach） lith：结石（calculus,stone）hepat：肝（liver） mast：乳腺（mammary gland,breast）hem,hemat：血（blood) lysis：打碎，破坏（destruction）ile：回肠（ileum） jejun：空肠（jejunum）pancreat：胰腺（pancreas） phleb：小静脉（small vein）splen：脾脏（spleen） bronch：支气管（bronchus）ven：静脉（vein） card：心脏（heart）phren：呼吸膈（respiratory diaphragm） thorac：胸（chest） trache：气管（trachea）colp：阴道（vagina） oophor：卵巢（ovary）salping：输卵管，子宫管（fallopian tube, uterine tube）pyel：肾盂（pelvis of the kidney）ureter：输尿管（ureter）vesic：膀胱（urinary bladder） urethr：尿道（urethra）四、具有两个不同词根的器官或结构 子宫（uterus）： hyster, metrium 肾脏（kidney）：nephr,ren 管（vessel）：angi——不一定是血管。

药品不良反应报告和监测体系运行(修订版)【新版】

目的：确保药品不良反应报告和监测工作的有效开展，有效控制药品风险，保障公众用药安全，建立药品不良反应组织机构及运行体系。 适用范围：适用于公司药品不良反应报告和监测工作。 责任人：药品不良反应办公室、质量保证部、后勤部、销售公司、科研中心 内容： 1.组织机构简图 2. 体系运行 2.1 信息采集途径 2.1.1 信息采集途径包括被动收集：销售人员、400热线投诉电话，和主动收集：上市前和上市后的临床研究、文献检索、国内外政府网站。 2.1.2 信息采集技巧：第一时间了解：判断事情的严重性。是否停药？是否上报？是否召回？ 第一时间控制：控制医生态度，控制患者情绪； 第一时间反馈：及时反馈至ADR管理员或药品不良反应办公室主任； 长期应对准备：掌握我公司产品主要不良反应及质量特性等，并具有一定的ADR判断能力，若不能独立解答患者疑问，切忌给予医疗服务建议，药品不良反应办公室给予支持。 信息收集要全：因其他原因不能全面收集ADR信息，至少收集以上四要素及时反馈至ADR管理员处，协助做好相关沟通工作。 2.2 单个病例管理 2.2.1 单个病例处理流程：收集（多渠道）→报告公司关联性评价→随访→上报ADR监测系统→纳入公司不良反应病例数据库。 2.2.2 出现药品不良反应及出现其他情况均应报告，即使没有伴随具体的不良事件，如： ·说明书已知一般不良反应、严重不良反应和新的不良反应 ·因药品停用而发生的事件 ·超适应症用药 ·孕妇暴露

·药品无效 ·用药错误 ·死亡结局 ·出现未预期的治疗/临床益处 2.2.3 临床试验安全性信息报告 临床试验定义：任何在人体（病人或健康志愿者）进行的药物系统性研究，以证实或揭示试验药物的作用、不良反应或试验药物吸收、分布、代谢和排泄，其目的是确定试验药物的疗效与安全性。 临床试验类别：I、Ⅱ、Ⅲ、IV期临床试验、生物等效性试验、重点监测、一致性评价、临床有效性试验及其他安全与疗效对比研究等。 上报流程： 研究者上报所有不良事件；申办方上报严重不良事件（时限：死亡和危及生命为7天，其他情况15天），以电话、传真或EMS邮寄的形式向CFDA注册司、BFDA注册处及卫计委提交首次报告，及时提交随访报告，并将收集的所有不良事件报告1个工作日内反馈至公司不良反应办公室；不良反应办公室按法规时限要求上报上市后临床研究不良反应，上市前不良反应长期保存，待产品上市后纳入不良反应数据库并带入PSUR中。 2.2.4 个例不良反应/事件评价、上报 2.2.4.1 不良反应/事件类型： 依据《药品不良反应和监测管理办法》对一般的、新的和严重的不良反应的定义，对比说明书中不良反应描述，确定不良反应/事件的类型。 2.2.4.2 不良反应/事件关联性评价： 从时间相关性、药理作用/同类药物反应、去激发、再激发、剂量等方面对不良事件与药品之间关系进行评定。同时考虑的其他因素：原患疾病、相互作用、伴随药物、伴发疾病。时间相关性：用药前、用药过程中或延迟发生不良反应的可能。 2.2.4.3 药理作用/同类药物反应：不良事件发生时间是否与药理/毒理反应一致，同类药物的不良反应。 去激发：停药观察，去激发是否为阳性 再激发：去激发后再次给药观察，再激发是否为阳性。 给药剂量：规定给药剂量与实际给药剂量是否一致。 原患疾病：分析不良事件是否为原患疾病的症状，或治疗适应症的自然进程。 药物相互作用：协同作用、拮抗作用、配伍禁忌。 伴随药物/伴发疾病：是否导致不良事件的发生。 其他因素：是否存在其他风险因素，如吸烟史、饮酒史、过敏史、家族病史及不良反应病史等。

临床医学名词解释

1腹泻： 指排便次数增多，粪质稀薄或带有黏液、脓血或未消化的食物。 2、呕血： 指由上消化道疾病（屈氏韧带以上的消化器官）或全身性疾病所致的急性上消化道出血，血液经胃从口腔呕出 3、谵妄： 以兴奋性增高为主。意识模糊，定向力丧失，感觉错乱，躁动不安，言语杂乱。 4、肺炎： 终末气道、肺泡和肺间质等在内的肺实质炎症。 5、咳嗽： 由延髓的咳嗽中枢受到刺激引起，各种传入的刺激导致咳嗽中枢将冲动传向运动神经，从而导致咽肌、膈肌等运动完成咳嗽动作，剧烈的呼气冲出狭窄的声门裂隙发出声音。 6、支气管哮喘： 由多种细胞如嗜酸性粒细胞、中性粒细胞等和细胞组分参与的气道慢性炎症性疾病。 7、心源性呼吸困难： 心衰（尤其是左心衰竭）引起，夜间阵发性呼吸困难，卧位加重，坐位减轻，肺底有湿罗音，咳粉红色泡沫痰。 8、心力衰竭： 各种心脏结构或功能性疾病导致心室充盈及射血能力受损而引起的一组综合征。 9、高血压： 一种以体循环动脉压升高为主要特点的临床综合症。原发性高血压：以血压升高为主要临床 表现伴有或不伴有心血管危险因素的综合症。 10、水肿： 细胞外间隙有过多的液体积聚使组织肿胀 11、镜下血尿： 红细胞大于3个/hp，尿液外观无血色者。 12、肿瘤： 机体在各种致癌因素作用下，局部组织细胞在基因水平上失去对自身生长的调 控，导致机体异常增生而形成的新生物 13、血尿： 尿内含有一定量的红细胞时称为血尿，见于肾结石、肾结核 14、发绀： 血液中还原血红蛋白增多使皮肤和粘膜呈青紫色改变的一种状态 15、湿罗音： 由于吸气时气流通过呼吸道内稀薄分泌物，形成水泡破裂所产生的声音，呼吸音以外的附加音短暂而急促 16、黄疸： 由于血清中胆红素升高致皮肤、粘膜和巩膜发黄的症状和体征。 17、被动体位： 患者不能自己调整或改变身体的位置，见于极度衰竭或意识丧失者。 18、生命征： 是评价生命活动存在与否及其质量的指标，包括体温、呼吸（12-20次/分钟）、脉搏

严重药品不良反应事件定义及关联性评价说明

附表1制表单位：国家食品药品监督管理局 药品不良反应/ 事件报告表 报告类型：新的□严重□一般□首次报告□跟踪报告□报告来源：医疗机构□药品经营企业□药品生产企业□其他□ 除非得到允许，报告表中的个人信息将予以保密。

严重药品不良反应/事件是指因使用药品引起以下损害情形之一的反应/事件： 1) 导致死亡； 2）危及生命； 3）致癌、致畸、致出生缺陷； 4）导致显著的或永久的人体伤残或器官功能的损伤； 5）导致住院或住院时间延长 6）其他有意义的重要医学事件。如，尽管事件不会立即危及生命或导致死亡和/或需住院，但为了预防出现任一上述所列情况可能需要进行治疗，通常也被认为是严重的。 关联性评价说明： 肯定：用药及反应发生时间顺序合理；停药以后反应停止，或迅速减轻或好转；再次使用，反应再现，并可能加重（即激发试验阳性），同时有文献资料佐证，并已排除原患疾病等其他混杂因素影响。 很可能：无重复用药史，余同“肯定”，或虽然有合并用药，但基本可排除合并用药导致反应发生的可能性。 可能：用药与反应发生时间关系密切，同时有文献资料佐证；但引发ADR/ADE的药品不止一种，或原患疾病病情进展因素不能排除。 可能无关：ADR/ADE与用药时间相关性不密切，反应表现与已知该药的ADR/ADE不吻合，原患疾病发展同样可能有类似的临床表现。 待评价：报表内容填写不齐全，等待补充后再评价，或因果关系难以定论，缺乏文献佐证。 无法评价：报表缺项太多，因果关系难以定论，资料又无法补充。 其他说明 合并用药：指发生此药品不良反应/事件时患者除怀疑药品外得其他用药情况，其中也包括患者自行购买的药品或中草药等。 报告的处理 所有的报告将会录入数据库，专业人员会分析药品和不良反应之间的关系。我们会考虑风险是否普遍或严重，然后决定我们是否需要采取行动，例如在药品说明书中加入警示信息，更新药品如何安全使用的信息，如，限制使用剂量或在某些特定人群中限制使用。极少数情况下，我们会把产品撤市，只有当我们认为产品的风险大于效益时。

医学统计学名词解释复习资料

1. 总体(population)：根据研究目的所确定的同质观察单位的全体。只包括(确定的时间和空间范围内)有限个观察单位的总体，称为有限总体(finite population)。假想的，无时间和空间概念的，称为无限总体(infinite population)。 2. (总体)参数(parameter)：总体的统计指标或特征值。总体参数是事物本身固有的、不变的。 3. 样本(sample)：从总体中随机抽取的部分个体。 4. 样本含量(sample size)：样本中所包含的个体数。 5. 变量(variable)：观察对象个体的特征或测量的结果。由于个体的特征或指标存在个体差异，观察结果在测量前不能准确预测，故称为随机变量(random variable)，简称变量(variable)。变量的取值称为变量值或观察值(observation)。根据变量的取值特性，分为数值变量和分类变量。 6. 数值变量(Numerical variable)：又称为计量资料、定量资料，指构成其的变量值是定量的，其表现为数值大小，有单位。对每个观察单位用定量的方法测定某项指标的数值，组成的资料。 7. 计数资料：将全体观测单位按照某种性质或特征分组，然后再分别清点各组观察单位的个数。 8. 抽样(sampling)：从总体中抽取部分观察单位的过程称为抽样。 9. 抽样误差(sampling error)：由于抽样造成的统计量与参数之间的差别，特点是不能避免的，可用标准误描述其大小。 10. 误差(error)：统计上所说的误差泛指测量值与真值之差，样本指标与总体指标之差。主要有以下二种：系统误差和随机误差 。 11. 可信区间(confidence interval, CI)：按一定的概率或可信度(1-α)用一个区间估计总体参数所在范围，这个范围称作可信度1-α的可信区间，又称置信区间。 12. 总体均数的可信区间：按一定的概率大小估计总体均数所在的范围(CI)。常用的可信度为95％和99％，故常用95％和99％的可信区间。 13. 变异(variation)：同质事物间的差别。由于观察单位通常即为观察个体，故变异亦称为个体变异(individual variation)。 16. 平均数(average)：也叫平均值，是一组(群)数据典型或有代表性的值。这个值趋向于落在根据数据大小排列的数据的中心，包括算术平均数(arithmetic mean)、几何平均数(geometric mean)、中位数(median)等。 17. 中位数(median)：将一组观察值按升序或降序排列，位次居中的数，常用M 表示。适用于偏态分布资料或不规则分布资料和开口资料。所谓“开口”资料，是指数据的一端或两端有不确定值。当n 为奇数时，M=X (n+1)/2；当n 为偶数时，M=[X n/2+ X n/2+1]/2。 18. 百分位数(percentile)：是一种位置指标，以P x 表示，一个百分位数Px 将全部观察值分为两个部分，理论上有x%的观察值小于Px 小，有(1-x%)的观察值大于Px 。 19. 变异系数(coefficient of variance, CV)：亦称离散系数(coefficient of dispersion)，为标准差与均数之比，常用百分数表示。100%X s/CV ?=, 变异系数没有度量衡单位，常用于比较度量单位不同或均数相差悬殊的两组或多组资料的离散程度。 20. 频率(relative frequency)：在n 次随机试验中，事件A 发生了m 次，则比值 22. 概率(probability)：在重复试验中，事件A 的频率，随着试验次数的不断增加将愈来愈接近一个常数p ，这个常数p 就称为事件A 出现的概率(probability)，记作P(A)或P 。 描述随机事件发生的可能性大小的数值，常用P 来表示。 23. 统计量(statistic)：由样本所算出的统计指标或特征值。 24. 相关系数(correlation coefficient)：用以说明具有直线关系的两个变量间相关关系的密切程度和相关方向的指标，称为相关系数，又称为积差相关系数(coefficient of product-moment correlation)，总体相关系数用希腊字母ρ表示，而样本相关系数用r 表示，取值范围均为[-1, 1]。 25. 回归系数(regression coefficient)：直线回归方程Y ?= a+b X 的系数b 称为回归系数，也就是回归直线的斜率(slope)，表示X 每增加一个单位，Y 平均改变 b 个单位。 26. 参考值范围(reference range)：也称为正常值范围(normal range)，医学上常把绝大多数正常人的某指标值范围称为该指标的正常值范围。绝大多数：可以是90%、95%、99%等等，最常用的是95%。正常人：不是指健康人，而是指排除了影响所研究指标的疾病和有关因素的同质人群。又称参考值范围，是指特定健康人群的解剖、生理、生化等各种数据的波动范围。习惯上是确定包括95%的人的界值。 28. 统计推断(statistic inference)：从总体中随机抽取一定含量的样本进行研究，目的是通过样本的信息判断总体的特征，这一过程称为统计推断。 29. 标准误(standard error, SE)：在统计理论上将样本统计量的标准差称为标准误，用来衡量抽样误差的大小。据此，样本均数的标准差X σ称为标准误。 30. 参数估计(parameter estimation)：由样本信息估计总体参数。它包括两种：点估计和区间估计。 点估计：直接用样本统计量作为对应的总体参数的估计值。 区间估计：按一定的概率或可信度(1-α)用一个区间估计总体参数所在范围，这个范围称作可信度1-α的可信区间(confidence interval, CI )，又称置信区间。这种估计方法称为区间估计。 33. 95%可信区间含义：如果重复若干次样本含量相同的抽样，每个样本均按同一方法构建95%可信区间，则在这些可信区间中，理论上有95个包含了总体参数，还有5个未估计到总体均数。 34.Ⅰ类错误(type Ⅰerror)：统计学上规定，拒绝了实际上成立的H 0，这类“弃真”的错误称为Ⅰ型错误或第一类错误，Ⅰ型错误的概率用α表示。 35.Ⅱ类错误(type Ⅱerror)：统计学上规定，不拒绝实际上不成立的H 0，这类“存伪”的错误称为Ⅱ型错误或第二类错误，Ⅱ型错误的概率用β表示。 36. 检验效能(power of a test)：又称把握度，即两总体确有差别，按α水准能发现它们有差别的能力。 37. 参数检验：总体分布已知，对其中一些未知参数进行估计或检验。这类统计推断的方法叫参数统计或参数检验。 38. 参数检验：假定比较数据服从某分布,通过参数的估计量(x , s)对比较总体的参数(μ)作检验，统计上称为参数法检验(parametric test)。如t 、u 检验、方差分析。 39. 率(rate)：又称频率指标，用以说明某现象发生的频率或强度。常以百分率(%)、千分率(‰)、万分率(1/万)、十万分率(1/10万)等表示。其计算公式为： 40. 构成比(proportion)：又称构成指标，它说明一种事物内部各组成部分所占的比重或分布，常以百分数表示。 41. 比(ratio)：又称相对比，是A 、B 两个有关指标之比，说明A 为B 的若干倍或百分之几，它是对比的最简单形式。其计算公式为：比=A/B 。 统计学（Statistics ）：运用概率论、数理统计的原理与方法，研究数据的搜集；分析；解释；表达 的科学。 总体（population ）：大同小异的研究对象全体。更确切的说，总体是指根据研究目的确定的、同质的全部研究单位的观测值。 样本（sample ）：来自总体的部分个体，更确切的说，应该是部分个体的观察值。样本应该具有代表性，能反映总体的特征。利用样本信息可以对总体特征进行推断。

急诊医学名词解释

1急诊医学:是一门临床医学专业，贯穿在院前急救，院内急诊，急危重病监护过程中的对急危重症，创伤，和意外伤害评估，急诊处理，治疗和预防的学科专业体系。 2急诊医学专业特点：危重复杂性，时限急迫性，病机可逆性，综合相关性，处理简捷性。 3心脏骤停的临床表现及诊断要点：典型表现包括意识突然丧失、呼吸停止和大动脉波动消失的“三联征”；诊断要点：1、意识突然丧失，面色可有苍白呈现发绀；2、大动脉搏动消失，触摸不到颈、股动脉搏动。3、呼吸停止或开始叹息杨呼吸，逐渐缓慢，继而停止；4、双侧瞳孔扩大；5、可伴有短暂抽搐和大小便失禁，伴有口眼歪斜，随即全身松软；6、心电图表现：心室颤动、无脉性室性心动过速、心室静止、无脉心电活动 4成人基本生命支持开放气道，人工呼吸，胸外按压，电除颤 5心肺复苏有效的指证：心电波出现，大动脉搏动，循环体征改善，冠状动脉灌注压大于15mmHg,，皮肤渐转正常颜色，瞳孔缩小，对光有反应。自主呼吸恢复。 6终止ＣＰＲ的指标：又作３０ｍｉｎ以上，仍无自主呼吸、无心跳脉搏、深度昏迷生理反射消失、可以考虑病人真正死亡终止复苏； 7机械通气：借助人工装置，呼吸机的力量产生和辅助呼吸工作，达到增强和改善呼吸功能的一种治疗措施和方法； 8机械通气禁忌症：呼吸衰竭并大咯血、呼吸衰竭合并气胸、肺大泡、多发性肋骨骨折、低血压 9机械通气通气模式：控制通气（ＣＶ应用）、辅助通气、控制／辅助通气（Ａ－ＣＶ）、同步间歇性指令通气压力支持通气、气道双水平正压通气； 10休克由于各种致病因素作用引起的有效循环血量急剧减少，导致器官和组织微循环灌注不足，致使组织缺氧、细胞代谢紊乱和器官功能受损的综合征。根据病因分低血容量性休克、心源性休克、感染性休克、过敏性休克和神经源性休克。 11休克治疗原则：去除病因诱因、恢复有效循环血量、纠正微循环障碍、增进心脏功能 12常用检测指标：血压、脉搏、意识、尿量、肢体温度及色泽13低血容量性休克的紧急处理：对心脏呼吸呼吸骤停者立即进行心肺复苏。对病情危急者采取边救治边检查边诊断，或先救治后诊断的方式进行抗休克治疗。同时采取以下措施：1、尽快建立2条以上静脉通道补液和使用血管活性药物；2、吸氧，必要时气管内插管或机械通气；3、检测脉搏、血压、呼吸、中心静脉压、心电图等生命指证；4、对开放性外伤立即行止血包扎固定；5、向患者或陪护着询问病史和受伤史，并做好记录；6、采血（查血型、配血、血常规、血气分析、血生化）；7、留置导尿管，定时查体以查明伤情，必要时进行腹腔穿刺和床旁超声、X线片等辅助检查，在血压尚未稳定前限制搬动患者；9对多发性原则上按胸、腹、头、四肢等顺序进行处理；10、定手术适应症，作必要术前准备，进行确定性急诊手术。 20、低血容量微循环恢复灌注良好指标为：①尿量＞0.5ml/kg ②SBP＞100mmhg；③脉压＞30mmhg；④CVP 5.1~10.2cmH2O 22、多器官功能障碍综合征（MODS）在多种机型致病因素所 机体原发病基础上相继引发2个或2个以上器官同时或者贯出现的可逆性功能障碍； 24、MODS治疗原则：控制原发病去除病因、合理应用抗 素、加强器官功能支持和保护、改善氧代谢纠正组织氧、重视营养和代谢支持、免疫和炎症反应调节治疗、医药治疗； 25、中毒：有毒化学物质进入人体后达到中毒量而产生全身 损害； 26、中毒机制：局部腐蚀刺激作用、缺氧、麻醉作用、抑制 的活力、干扰细胞或细胞器的生理功能、受体竞争；27、中毒治疗原则：立即脱离中毒现场终止于毒物继续接触 迅速清除体内已被吸收或尚未吸收的毒物，如有可能尽使用特效解毒药、对症支持治疗、预防并发症； 清除体内尚未吸收的毒物：催吐、洗胃、导泻、全肠道灌注28、特殊解毒药的应用：金属中毒——氨羧螯合剂（依地酸 钠）高铁血红蛋白症——甲基蓝（美蓝）氰化物中——亚硝酸盐-硫代硫酸钠疗法有机磷杀虫剂——阿品、长托宁、碘解磷定中枢神经抑制剂中毒——纳洛（阿片受体抑制剂）、氟马西尼（苯二氮唑类特效解毒药29、创伤：各种物理化学生物等致伤因素作用于机体，造成 织结构完整性损害或功能障碍； 30、急救创伤医疗体系由院前急救、医院急救、后续专科治 三部分构成 31、创伤基本生命支持：通气、止血包扎、固定和搬运 32、多发伤：指在同一机械致伤因素作用下机体同时或相继 受两种以上解剖部位或器官的较严重的损伤，至少一次伤危及生命或并发创伤性休克，称为多发伤。CRAS PLAN顺序检查：心脏、呼吸、腹部、脊柱、头部、盆、四肢、动脉、神经 34、复合伤：两者或两种以上致伤因素同时或相继作用于人 所造成的损伤； 35、挤压综合征：当四肢和躯干肌肉丰富的部位被外部重物 时间挤压，或长期固定体位的自压，接触压迫后出现肢肿胀、肌红蛋白尿、高钾血症为特点的急性肾功能衰竭；36筋膜间隔综合征：四肢肌肉和神经都处于由筋脉形成的间中，当筋脉间隔内压力增加，会影响该处血流循环机组功能，最后导致肌肉缺血坏死，神经麻痹甚至危及生命；37房颤的典型表现心音强弱不等、心律快慢不等、搏动短拙； 41、颈内静脉穿刺术：（一）适应症：①短时间内需要快速输

医学复习资料：名词解释

Hunt综合征：表现为耳后、乳突剧烈疼痛，外耳道疱疹及周围性面神经麻痹，伴有泪腺、唾液腺分泌障碍，见于带状疱疹病毒引起的膝状神经节炎。Brown-sequard综合征：脊髓半切征，病变侧损伤平面以下深感觉障碍和上级运动神经元瘫痪，对侧损伤平面以下痛、温度觉缺失。见于脊髓占位性病变、脊髓外伤。 Gerstman综合征：四主症，即计算不能（失算）、手指失认，左右侧认识不能，书写不能（失写），见于优势半球顶叶角回皮质损伤。 三偏综合征：内囊完全损伤导致病变对侧偏瘫、偏盲和偏身感觉障碍，常见于脑出血和脑梗塞。wallenberg综合征：①眩晕、恶心、呕吐、眼震（前庭神经核损害），②真性球麻痹：吞咽困难、构音障碍、同侧软腭麻痹及咽反射消失（舌咽、迷走神经及疑核损伤），③病灶侧肢体共济失调（绳状体、部分小脑损害）④Horner综合征（颈部交感神经受损）⑤同侧面部痛、温度觉丧失，触觉存在，呈核性分布（三叉神经脊束核受损）⑥对侧痛温度觉消失（脊髓丘脑侧束损伤）⑦呃逆（网状结构中呼吸中枢损伤） Millard-Gubler综合征：脑桥腹下部综合征，表现为①病变侧展神经麻痹及周围性面神经麻痹，②对侧中枢性偏瘫，③对侧偏身感觉障碍。见于脑桥基底部的展神经、面神经、锥体束、脊髓丘脑侧束及内侧丘系损伤。 Weber综合征：①病变侧动眼神经麻痹，②对侧肢体中枢性偏瘫，主要见于损害大脑脚底，影响了动眼神经和锥体束。Benedict综合征：红核综合征，表现为①病变侧动眼神经麻痹，②对侧肢体不自主运动或共济失调。动眼神经、黒质、红核受损而锥体束未受损。吉兰-巴雷综合征：又称为急性炎症性脱髓鞘性多发性神经病，是一组急性或亚急性发病，病理改变为周围性神经炎性脱髓鞘，临床表现为四肢对称性弛缓性瘫痪，伴有手套或袜套样感觉障碍及脑神经损害的自身免疫病，实验室检查有脑脊液蛋白-细胞分离现象及神经电生理异常。 foster-kennedy综合征：表现为病变侧因肿瘤压迫而出现视神经萎缩，对侧颅内压增高导致视神经乳头水肿。见于额叶底面肿瘤。 Fisher综合征：以眼外肌麻痹、共济失调和腱反射消失三联征为主要临床表现，可有轻度四肢肌力减弱。 frohlich综合征：肥胖性生殖无能综合征：表现向心性肥胖、性器官发育迟缓、男性睾丸较小、女性原发性闭经。下丘脑腹内侧核及结节部附近，因性激素分泌和释放不足。 west综合征：婴儿痉挛综合征，出生后一年内发病，男孩多见，表现为波及头、颈、躯干或全身的频繁肌痉挛，精神发育迟滞和高幅失律三联征。lennox-Gastaut综合征：好发于1-8岁，表现为多种癫痫发作类型并存，精神发育迟滞和棘慢复合波及睡眠中10Hz快节律三联征，对常用抗癫痫药耐药，易出现癫痫持续状态。 Horner 综合征：患侧眼裂变小，眼睑低垂，瞳孔缩小，眼球内陷，同侧额面部少汗或无汗，常见于颈部交感神经受压受损。

最新社会医学名词解释整理

社会医学：是研究社会（社会因素）与医学（健康或疾病）的联系与规律的一门交叉性边缘学科。 积极健康观：健康不仅仅是没有疾病或虚弱，而是一种身体、心理和社会的完好状态。 大卫生观：卫生事业本质上是一种“人人需要，共同受益”的社会公益事业，提高人群的健康水平需要全社会的积极行动和参与。 医学模式：人们对于健康和疾病现象的总的看法、基本观点和实践原则，亦称医学观。 神灵主义的医学模式：认为疾病是鬼神作怪，天遣神罚，健康与生命乃神灵赐与，总之归之于某种无所不在的神灵。 自然哲学的医学模式：把健康、疾病与人类生活的自然环境与社会环境联系起来观察与思考的朴素、辩证、整体的医学观念，称为自然哲学的医学模式。 机械论的医学模式：把人体当成是“自己发动自己的机器，疾病是机器某部分故障失灵，需修补完善”，人和动物不同在于“多几个弹簧和齿轮”，这就是机械论的医学模式。 生物医学模式：是建立在生物科学基础上，反映病因、宿主与自然环境之间的变化规律的医学观和方法论。认为每种疾病都必然并且可以在器官、细胞或分子上找到可以测量的形态学或化学改变，都可以确定出生物的或理化的特定原因，都应该能够找到治疗的手段。 生物-心理-社会医学模式：健康是躯体、心理和社会的完美状态，而不仅是没有疾病和虚弱。亚健康状态：指机体虽然无明确的疾病，但呈现出活力降低，适应能力呈不同程度减退的一种生理状态。 亚临床疾病：无症状疾病，无临床症状体征，但有临床检测证据。 整体病因论：疾病不是由单一因素引起的，而是生物、心理、社会综合作用结果的复合体。健康投资：人们为了获得良好的健康而消费的食品、闲暇时间和卫生服务等资源。 人口流动：人口在地理空间位置上的变动和阶层职业上的变动。 社会制度：指在一定历史条件下形成的社会关系和社会活动的规范体系，是社会经济、政治、法律、文化制度的总和。 人际关系：指人与人之间在社会生活中相互作用形成的一种极其复杂的关系，这种关系可以表现为亲密，也可以是疏远和敌对。 社会支持：即个体从社会网络所获得的物质和情感帮助。 城市化：城市数量增加或城市规模扩大的过程，其结果表现为城市人口在社会总人口中的比例逐渐上升。 文化（广义）：人类在其生产和生活活动中所创造的一切社会物质财富和精神财富的总和。狭义的文化特指精神文化，指人类一切精神财富的总和。 人格：是稳定地表现于个体的心理特质，由遗传和环境共同决定。 心理压力：人们生活中的各种刺激事件和内在要求在心理上所构成的困惑或威胁，表现为身心紧张或不适。 社会事件：指个体在现代社会中遇到的重大正负性生活变化及危机。 文献研究：利用已有资料，采用整理、综合、分析等手段，最终达到研究目的的一种研究方法。 定性研究：指以人群为对象的研究，阐述事物的特点及其发生和发展规律，与定量研究相结合，揭示事物的内在本质。 定量研究：通过调查收集人群发生某种事件的数量指标，或者探讨各种因素与疾病和健康的数量依存关系的研究称之为定量研究。

药品不良反应事件报告表(借鉴内容)

附表1 药品不良反应 / 事件报告表 首次报告□跟踪报告□编码： 报告类型：新的□严重□一般□报告单位类别：医疗机构□经营企业□生产企业□个人□其他□ 患者姓名：性别：男□女□出生日期：年月 日 或年龄： 民族：体重（kg）：联系方式： 原患疾病：医院名称： 病历号/门诊号：既往药品不良反应/事件：有□无□不详□家族药品不良反应/事件：有□无□不详□ 相关重要信息：吸烟史□饮酒史□妊娠期□肝病史□肾病史□过敏史□其他□ 药品批准文号 商品名 称 通用名称 （含剂型） 生产厂家生产批号 用法用量 （次剂量、途径、日次数） 用药起止 时间 用药原因 怀 疑 药 品 并 用 药 品 不良反应/事件名称：不良反应/事件发生时间：年月日 不良反应/事件过程描述（包括症状、体征、临床检验等）及处理情况（可附页）： 不良反应/事件的结果：痊愈□好转□未好转□不详□有后遗症□表现： 死亡□直接死因：死亡时间：年月日 停药或减量后，反应/事件是否消失或减轻？是□否□不明□未停药或未减量□ 再次使用可疑药品后是否再次出现同样反应/事件？是□否□不明□未再使用□ 对原患疾病的影响：不明显□病程延长□病情加重□导致后遗症□导致死亡□ 关联性评价报告人评价：肯定□很可能□可能□可能无关□待评价□无法评价□签名：报告单位评价：肯定□很可能□可能□可能无关□待评价□无法评价□签名： 报告人信息 联系电话：职业：医生□药师□护士□其他□ 电子邮箱：签名： 报告单位信息单位名称：联系人：电话：报告日期：年月日生产企业请 填写信息来源 医疗机构□经营企业□个人□文献报道□上市后研究□其他□ 备注

填写说明 一、严重药品不良反应是指因使用药品引起以下损害情形之一的反应： 1) 导致死亡； 2）危及生命； 3）致癌、致畸、致出生缺陷； 4）导致显著的或者永久的人体伤残或者器官功能的损伤； 5）导致住院或者住院时间延长； 6）导致其他重要医学事件，如不进行治疗可能出现上述所列情况的。 二、新的药品不良反应是指药品说明书中未载明的不良反应。 药品不良反应在说明书中已有描述，但不良反应发生的性质、程度、后果或者频率与说明书描述不一致或者更严重的，按照新的药品不良反应处理。 三、报告时限 新的、严重的药品不良反应应于发现或者获知之日起15日内报告，其中死亡病例须立即报告，其他药品不良反应30日内报告。有随访信息的，应当及时报告。 四、关联性评价指标 肯定：用药及反应发生时间顺序合理；反应符合该药已知的不良反应类型；停药或减量后，反应停止或减轻；再次使用可疑药品，反应再现；已排除并用药、原患疾病等其它因素影响。 很可能：用药及反应发生时间顺序合理；反应符合该药已知的不良反应类型；停药或减量后，反应停止或减轻；已排除并用药、原患疾病等其它因素影响。 可能：用药及反应发生时间关系密切；反应表现与已知该药ADR不相吻合；无法排除并用药、原患疾病等其它因素影响。 可能无关：用药及反应发生时间相关性不密切；反应表现与已知该药ADR不相吻合；无法排除并用药、原患疾病等其它因素影响。 待评价：需要补充材料才能评价。 无法评价：评价的必需资料无法获得。 五、其他说明 怀疑药品：是指患者使用的怀疑与不良反应发生有关的药品。 并用药品：指发生此药品不良反应时患者除怀疑药品外的其他用药情况，包括患者自行购买的药品或中草药等。 用法用量：包括每次用药剂量、给药途径、每日给药次数，例如，5mg，口服，每日2次。 六、报告的处理 所有的报告将会录入数据库，专业人员会分析药品和不良反应/事件之间的关系。根据药品风险的普遍性或者严重程度，决定是否需要采取相关措施，如在药品说明书中加入警示信息，更新药品如何安全使用