抗生素不良反应及合理用药.doc2

　 抗生素的不良反应及合理用药

　摘 要： 近年来，抗生素滥用受到学术界极大重视，但抗生素滥用势头尚未得到有效规范和控制，大有愈演愈烈之势［1］。抗菌药物的不合理应用会导致诸多不良后果，如不良反应的增多，细菌耐药性的增长，治疗的失败，给患者健康及生命造成重大影响。

　现实生活中尤其中老年人群中，每年因用药不当而发生不良反应者的人数相当惊人，其中滥用抗生素引起的药源性疾病占了相当大的比例，这不能不引起我们的极大警惕。自从抗生素诞生进入抗生素时代以来，怎样利用和管理这一资源，就摆在广大卫生工作者的面前。抗生素的种类随着科学的发展不断推出新品种，应用越来越广泛，为人类的健康作出了重要贡献。同时，其应用中普遍存在抗菌药物滥用、乱用等问题，导致人体菌群失衡，造成大量急性耐药菌株、耐药菌株和多重耐药菌株的产生，引起了严重的医院感染，消耗了大量的人力、物力和财力。为此，科学地管理好、利用好这一资源显得尤为必要，现就这一问题谈点看法及相关的回顾性调查分析作一简要的报告。

　?关键词：抗生素 不良反应 合理用药 1、抗生素的功与过

　70多年前，因感染细菌引起的疾病而命丧黄泉的人比比皆是。自1928年研制出了青霉素，当时几乎可以对付各种因细菌引起的疾病，因为它能干扰细菌的正常代谢，使细菌无法生存，从而挽救了无数人的生命。可是，任何事物都有两面性，抗生素同样如此。抗生素尤其是广谱抗生素，不但能杀死有害细菌，而且也能杀死有益细菌；既能抑制敏感的细菌，却又能使对抗生素不敏感的细菌大量繁殖，以致使部分细菌 加猖獗，导致“二度感染”。也有的是因为人们在正常情况下没有按规定剂量、时间合理用药，当停药后便有少量病菌残留苟活并在人体继续繁殖，当聚集到一定能量，就使疾病“卷土重来”。还有的病菌遗传物质发生了改变，对原有的药物产生了耐药性，再用这类抗生素就不再起作用了。人类为了战胜病菌，从而使新型抗生素药品品种越来越多，从而出现了药用量越来越大、作用越来越小的可悲现象。而且，抗生素本身就能产生毒副作用，比如：青霉素虽然毒副作用小，但危险的变态反应不断增加，有时能将人置于死地；链霉素能损伤第八对脑神经（听神经），引起耳鸣、耳聋、口四周和四肢麻木；氯霉素可引起血中粒性细胞缺乏症等。可见，抗生素可治病，但使用不当则可致病，甚至造成生命危险。

　1.1抗生素的不良反应

　1.1.1头孢菌类抗生素 是以头孢菌培养得到的天然头孢菌素C为原料，在其母核7-氨基头孢烷酸（7-A-CA）加接不同的侧链而制成的一类广谱半合成抗生素。头孢菌类药物以其菌谱广，杀菌力强，耐酸，耐酶，毒副作用相对较小等优点而广泛应用于临床。但随着临床应用的增多，其不良反应也时有报道，其中又以包括头孢哌酮、头孢噻肟、头孢曲松、头孢他啶等在内的第三代头孢菌素的不良反应报道最为普遍，已引起了医药界的广泛关注。

　1．1．2头孢菌类抗生素?

　?过敏反应过敏反应为头孢菌素类药物最主要的不良反应，发生率约为0.5%~10%［2］。临床主要表现为皮疹、药物热、哮喘，严重者可致药物过敏性休克，甚至死亡。据调查，第三代头孢菌素类药物过敏反应发生率呈上升趋势，其过敏性休克的发生率居头孢菌素之首。头孢哌酮、头孢噻肟、头孢曲松的皮疹发生率分别为2.2%、1.8%、1.3%。在头孢菌素类药物致过敏性休克的病例中，头孢噻肟占17.7%，头孢哌酮占13.3%，头孢曲松占11.3%［3］。

　1．1．3氨基糖苷抗生素

　包括卡那霉素、庆大霉素、新霉素、西索米星、奈替米星、阿米卡星、阿司米星、小诺米星等，对儿童肾脏和第8对颅神经——听神经有严重损害，造成药物性肾炎或部分小儿永久性听力下降和丧失，故儿童尽量不用。

　1． 2青霉素类抗生素

　包括青霉素Ｇ、普鲁卡因青霉素、苄青霉素、苯唑西林、氯唑西林、双氯西林、甲氧西林、氨苄西林、阿莫西林、羧苄西林、磺苄西林等，以及头孢菌素类抗生素，易致过敏反应，使用前应做皮肤敏感试验。

　青霉素的毒性很低，但过敏反应较常见，有时可危及生命，约有3%的病人可以发生过敏反应，最常见的是荨麻疹和过敏性皮炎，可以在注射后半小时出现，其次为关节肿痛，发热，肌肉疼和淋巴肿大等，多在用药后7-14天出现，这些反应多在停药后自行消失．有少数病人可以出现极为严重的过敏性休克，即在注射后数秒至数分钟内出现呼吸困难，血压下降，昏迷，最后惊厥，患者可于1－2小时内死亡。

　1．3喹诺酮类

　如诺氟沙星、氧氟沙星、依诺沙星、环丙沙星、培氟沙星、洛美沙星、妥舒沙星、左氧氟沙星，，有很高的大便浓度，口服500毫克，1日2次，大便浓度达207—2716微克/毫升，血浓度约2.5微克/毫升，肠壁浓度为3.4微克/毫升，而对志贺氏菌的最低抑菌浓度仅为0.1微克/毫升。临床实践也证明，氟呢酸为目前最佳抗痢药物，可使年幼动物软骨损害，使承重关节细胞出现水泡，少数病例曾出现严重关节痛和炎症，且不易恢复，对16岁以下的儿童不宜使用。

　1．4 四环素类抗生素?

　 ?可与骨骼和牙齿中的钙相螫合，从而引起牙齿的色素沉着，发生黄褐色的龋齿、四环素牙，所以上世纪80年代曾用过四环素的儿童至今全留有一口“黄牙”，故对新生儿或8岁以下儿童禁用。

　（1）消化道反应：常见恶心、呕吐、食欲减退、腹泻等。还可引起口角炎、舌炎、舌光滑、舌黑色、咽喉炎、食道炎、胃炎、胃灼热、胃肠充气、直肠炎、肛门有刺激症状、瘙痒，并可出现裂隙、溃疡及出血。

　 （2）肝损伤：黄疸、氨基转移酶升高、呕血便血、昏迷、死亡。

　 （3）肾损伤：对神功能不全者可加重肾损害，可引起氮质血症。

　 （4）影响牙齿和骨发育：牙齿色素沉着、影响幼儿骨发育。

　 （5）过敏反应：主要是药物热、皮疹等，偶可发生血管神经性水肿、丘疱疹、轻度剥脱性皮炎、哮喘发作或伴休克杨症状。偶可诱发或加剧全身播散性红斑狼疮。

　 （6）二重感染：较为多见，轻者引起维生素不足，也常见由于白色念珠菌和其他耐药菌引起的二重感染，难辨梭菌性伪膜性肠炎也可发生。

　 （7）神经系统症状：婴儿应用四环素，可引起颅内压增高，前卤饱满；成人可引起脑膜刺激症状、视乳头水肿等颅内压增高症。

　 （8）赫氏反应：本类药物治疗布鲁氏菌病时可发生赫氏反应，表现为寒战、发热及虚脱，体温进一步升高。

　 （9）局部刺激：局部剧痛、炎症、坏死、静脉炎、血栓。故本类不宜肌注或静滴时宜用稀浓度缓缓滴注。

　 （10）血液系统：偶见粒细胞缺乏症、血小板减少症及血液凝固延缓等。

　（11）四环素族同类药物可有交叉过敏；四环素和氯霉素亦有可能有交叉过敏现象。

　使用中应严格掌握适应症及剂量，切勿滥用，持续时间不可过长，疗程一周以上者，应与复合维生素B合用。本类药物易透过胎盘和进入乳汁，孕妇、哺乳期妇女及8岁以下儿童禁用。急性肾功能衰竭、尿毒症患者禁用。避免与制酸药、铁剂、牛奶同服。

　毒性反应指药物引起的生理化机能异常和结构的病理变化，严重程度随剂量增加或疗程延长而增加。抗生素的毒性反应临床较多见，如及时停药可缓解和恢复，但亦可造成严重后果。主要有以下几方面：

　①神经系统毒性反应；氨基糖甙类损害第八对脑神经，引起耳鸣、眩晕、耳聋；大剂量青霉素G或半合成青霉素或引起神经肌肉阻滞，表现为呼吸抑制甚至呼吸骤停。氯霉素、环丝氨酸引起精神病反应等。

　②造血系统毒性反应；氯霉素可引起再障性贫血；氯霉素、氨苄青霉素、链霉素、新生霉素等有时可引起粒细胞缺乏症。订大霉素、卡那霉素、先锋霉素Ⅳ、Ⅴ、Ⅵ可引起白细胞减少，头孢菌素类偶致红细胞或白细胞，血小板减少、嗜酸性细胞增加。

　③肝、肾毒性反应：妥布霉素偶可致转氨酶升高，多数头孢菌素类大剂量可致转氨酶、硷性磷酸脂酶Ⅰ和Ⅱ、多粘菌素类、氨基甙类及磺胺药可引起肾小管损害。

　④胃肠道反应：口服抗生素后可引起胃部不适，如恶心、呕吐、上腹饱胀及食欲减退等。四环素类中尤以金霉素、强力霉素、二甲四环素显著。大环内脂类中以红霉素类最重，麦迪霉素、螺旋霉素较轻。四环素类和利福平偶可致胃溃疡。

　2.坚持合理使用抗生素

　2．1坚持科学用药

　一定要有严格的用药指征，不可滥用抗生素。如病毒性感冒，用抗生素不但无用反而有害，坚决不要滥用。

　细菌性疾病，最好作药敏试验，然后选用最敏感的抗生素，以求最佳疗效。

　指征明确，用药量要足，并坚持按疗程用药（即用药时间），不可以随便减少药量或缩短用药时间。

　根据病情需要必须联合用药的，要注意这样的原则：一般以两种联用为宜，且能起到协同或相加的作用；或因一种药要达到血液有效浓度时用药量太大，毒副作用对健康不利，另一种作用相似但可减少前一种药的用量。

　使用某种抗生素疗效不好时，应考虑剂量、用药时不要随意将抗生素作为预防感染用药；皮肤、粘膜的间、给药方式等因素，但不要随意更换新的一种抗生素，以免产生耐药性。局部疾病应尽量避免用抗生素。

　抗生素在防治微生物感染性疾病上，确实具有一定的效果。但是如果抗生素使用不当，甚至滥用抗生素，就会造成严重后果。抗生素的主要问题有以下几点：

　(1)发生过敏反应：几乎大部分抗生素都有发生过敏反应的可能，最多见的就是青霉素、链霉素、多粘菌素、灰黄霉素等，其过敏反应主要表现为发热、皮疹，血管神经性水肿、淋巴结肿大、哮喘、过敏性休克。

　(2)出现毒性反应：链霉素、多粘霉素都对第八对脑神经有明显毒性，表现耳聋、眩晕等；氯霉素可引起白细胞减少、再生障碍性贫血等；卡那霉素、庆大霉素可出现肾脏损害；四环素、红霉素可导致肝肾损害及恶心、呕吐等胃肠道反应。

　(3)引起二重感染：长期使用抗生素可以破坏体内正常细菌的微生态平衡，导致某些致病菌的过度生长繁殖，给患者带来新的危害。

　(4)耐药菌株的产生：抗生素使用不合理，就导致耐药菌株增加，如金黄色葡萄球菌、大肠杆菌、绿脓杆菌等很容易发生耐药，给治疗带来困难。

　(5)浪费金钱和粮食，也给病人带来痛苦和不必要的经济损失。许多抗生素的生产过程，需要粮食来培养产生抗生素的微生物，生产1吨青霉素要消耗44～140吨粮食，所以滥用抗生素也等于浪费粮食。在不需要使用抗生素时，使用抗生素，使病人多花了医疗费用，由此而产生的副作用，也使病人受到不必要的痛苦。

　（6）合理使用抗菌药物、遏止细菌耐药已是刻不容缓的全球性问题［4］，需要全球、全人类的共同努力。护士，虽然没有处方权，药物知识也许不如药师全面，微生物学知识不如检验人员丰富，但我们的优势是和病人接触最多，我们可以运用我们的知识，在留取微生物学标本、药物的使用、不良反应的观察、健康教育方面发挥我们的特长，为推动合理使用抗均药物尽我们的努力。

　 3 抗生素的现状与发展

　3.1抗生素增长率

　 近年来，世界抗生素市场的平均年增长率为8%左右，全球抗生素的市场份额约为250～260亿美元，各大制药企业纷纷投入巨资进行抗生素药物的研发，使抗生素新品不断出现。在中国医药市场中，抗感染药物已经连续多年位居销售额第一位，年销售额为200多亿元人民币，占全国药品销售额的30%，全国6700国家药品生产企业中，有1000多家生产各类抗生素，产品竞争异常激烈3。

　3.2头孢菌素的发展

　 我国的头孢菌素产业自上世纪80年代以来得到了长足的发展，特别是在进入新世纪的这5个年头里，领域的发展更是日新月异，领域内的竞争也更加充分。在国际市场抗生素新品种不断涌现的背景下，产品的生命周期大大缩短，这就给众多的新品种提供了展示的机会。像被国际权威机构看好的头孢他啶、头孢哌酮钠/舒巴坦钠，都有不俗的市场表现。诸多有质量和技术优势的企业将在市场上有更加不俗的表现［5］。

　3.3抗生素临床使用

　 临床上基本每一个科室，每一个专业的医生都在使用抗生素，它的使用率是非常高，对于感染，包括病毒感染，细菌的感染，寄生虫的感染，支原体、衣原体等微生物感染都需要使用抗生素。我们平常的很多疾病也确实属于感染性疾病，如普通的感冒，上呼吸道的感染，泌尿道的感染，皮肤的感染，但他们引起的感染原是不同的，上呼吸道80-90％是病毒感染，而泌尿道的是细菌感染。如果是病毒感染我们要用抗病毒的抗生素，如果是细菌感染就要用抗细菌的抗生素。在医院里抗生素的使用占总量的30-50％。其中一部分是需要使用的，另外一部分属于不合理使用。除了医院，老百姓的家里都会有抗生素存在，药店里的很大一部分也是抗生素。在我国抗生素的使用是非常广泛的，其中肯定有很多不合理之处，这就需要进行严格的、科学的指导管理。在欧美的发达国家抗生素的使用量大致占到所有药品的10％左右。而我国最低的医院是占到30％，基层医院可能高达50％。抗生素滥用是我们不可回避的问题，究其原因有以下几方面：第一，由于处于社会初步发展阶段，国家的研究能力、原创能力不强，药品以仿制为主，众多的药厂都在生产抗生素。第二，同一种抗生素有上百家的药厂家生产，这样市场销售就可能存在恶性竞争，这种竞争会导致抗生素不合理使用的情况出现。第三，医学发展专业分工越来越细，每个医生都有自己专业方面的问题，抗生素是常用药专业性不如本专业那么强，这样就会存在误用或者滥用的情况。第四，患者和患者家属习惯性服用抗生素治病。比如感冒了，按照医学的观点，很多感冒都属于病毒感染，严格意义上来讲，没有什么有效的药物，只是对症治疗，不需要使用抗生素。但大家可能都有过这种经历，感冒以后习惯性在药店买一些感冒药，同时加一点抗生素来使用。实际上抗生素在这个时候是没有用处的，是浪费也是滥用。第五，我们国家药品规定方面的问题，很早以前就分了处方药和非处方药，抗生素应该属于处方药，但在药品销售过程中，大家去买药的时候有人需要出示处方吗？除了中药的药剂，西药只要讲出名字就可以买到，甚至有医药超市让自己选药，这样准确性会高吗？无疑会导致抗生素的滥用。第六，抗生素在畜牧业的大量使用。我们经常会听到我国出口的食物被检测出一些抗生素的残留而拒绝在海关之外的报道。据我了解，在畜牧业使用抗生素的量远远超过人类使用量的总和。在环境中有比较多的抗生素存在，那环境中的细菌早已接受过抗生素，已经产生耐药性了，人体如果再获得耐药菌的感染治疗就比较困难。这不光是我们国家的问题，也是个全球性的问题。

　结论 国家食品药品监督管理局已下发了关于开展抗菌药物合理使用的宣传活动的通知，号召民众不要自买抗菌药，在医生的指导下合理使用抗菌药。这是对人民负责任的举措，大家应该积极参与，不只是专业的医务人员需要合理地使用抗生素，普通的民众和患者也要有合理使用的意识，要在医生的指导下使用，不要盲目地自己购买抗生素使用。这样才能促进我们国家抗生素的合理使用，避免药物的不良反应，细菌耐药的不断加剧。

　参考文献：

　［1］袁桂清.抗生素专家提出：正确的病原学诊断是抗生素合理应用的基础［Ｊ］.中华医学杂志，2002，11（21）：1511.

　［2］胡万方，胡运新，杨峻青.头孢菌素类抗生素致过敏性休克55例分析.医药分析，2002，21（9）：600.

　［3］　黄凯文.113例头孢菌素类药物致过敏性休克中文文献分析.中国误诊学杂志，2001，1

　［4］陈雪华，胡必杰.临床微生物学科如何促进抗菌药物合理应用［Ｊ］.中国医院，2004，8（8）：23.

　［5］王伟.抗生素的现状与发展。《首都医药》，2003，（3）：26-30

　［6］陶佩珍.抗疱疹病毒药物研究进展[J].中国新药杂志,2003,12:253-257

　致? 谢

　 通过这次毕业设计让我深刻的体会到了学习更多知识的重要，也让我更加重视我所学专业的重要性，现在是竞争激烈的时代，我们只有不断的充实自己才能够在这样社会抬头挺胸的说我知道，我会，我可以，我能行。

　论文的完成标志着五年的大学时代即将结束，也意味着，新的生活又将开始了。有许许多多的舍不得，也有许许多多的感谢要说。?

　感谢所有教育过我的老师！你们传授给我的专业知识是我不断成长的源泉，也是完成本论文的基础。

　另外，我还要感谢全班同学给予我的关心和无私的帮助。谢谢你们陪我走过这样的一段青葱岁月，谢谢你们一路给我的支持和帮助。最后祝大家身体健康，心想事成、万事如意、工作顺利！

　County economic work conference leadership speech:The main task of the twenty-six session of the six plenary meeting of the county the county economic work conference this time, by the party's eighteen and eighteen Third Plenary Session of the spirit as a guide, carry out and implement the central and provincial economic work conference on rural work conference and the three session of the seven plenary session of the party to expand the spirit of the meeting, the total summary of last year the work, analysis of the current situation, the deployment of this work, further strengthening the development of consensus, to mobilize the whole county county, deepening reform and innovation, to work against poverty, accelerate the transformation of leapfrog, promote scientific development, struggling to write a new harmonious beautiful mountains and show a prosperous civilization to build a new building. The following chapter * *, according to the county Discussion of the views of the Standing Committee, I focus on four aspects of the problem:* * * years, the county to seriously implement the central decision-making arrangements and real, in accordance with the "high position, as a typical tree, catch catch up with speed for a breakthrough, five in one overall grasp to raise human resources to promote overall leap", firmly grasp for the project, investment, industry, structural adjustment, Emegumi Mio, promote harmony, agency the county economy presents the social development to catch up, are balanced development, promote the overall, a good momentum of sustained rise.According to Article 11 priority, economic construction full speed. Focusing on the development of this priority service, set up the market idea is constantly refined, can the implementation of major projects, efforts to expand the investment, vigorously develop the non-public economy, to ensure the continuous healthy and rapid development of the county economy, investment in fixed assets investment, industrial added value. Fiscal income, per capita net income of farmers and other major economic indicators maintained two digit growth. According to the "3341" project engineering, proved reserves pre project 4744, * * 4, for central heating in the west, the South Cave Temple landscape Avenue, oil oil road lifting column ten key counties Project smoothly, investment projects to promote the transformation of the pull, supporting further highlights the role; to promote in Honghe oilfield Mton construction, careful implementation of natural fiber cotton industry a reconstruction and expansion of the two phase, Huarun home ceramics, ceramics, Zhengda feed class three, class 44 full load keep the production, operation and sales booming, the cotton industry has become the city after the coal transport and one employment value-added industry; Xiping railway through infiltration through operations, Jing Road opened to traffic vehicles, further highlights the * * traffic hub; Longyuan red fruit trade company successfully introduced, for the first time now * * fruit Direct export; is a production company 300 thousand tons of feed production line, Yurun Group * * broiler breeding district built colonization production, forming a "" company + farmers "model of development, in promoting the transition to farming aquaculture has taken a solid pace; vegetable industry focus management promotion and marketing docking. Rui Jing River area, vegetable mould scale continues to expand, Wang Rui Feng, and other heavy key towns" village village layout, sudden breakthrough "strong momentum; Yudu Kang family, Wang twenty shop center village construction into the industry, ecological, cultural, tourism and other factors, the tour group construction community management, Set a benchmark for the new rural construction, the construction of new rural county in the two end of the pilot beam to keep the innovation and enhance the momentum.To accelerate the reform and innovation, political construction steadily. The reform and innovation as the core of the heart, coagulation unite together in political construction, to create a good environment for the county's development. Constantly improve the working mechanism, support people's congresses, governments, CPPCC Standing Committee work, to further improve and perfect the sub division of responsibility, the full implementation of the county led the pack leader catch the township, contact departments, corporate responsibility system; established a comprehensive assessment of the five one "approach, the implementation of Rural Township, Department of secretary of the party organization work the honesty and democratic appraisal system, encourage encourage creative work for the Department of Township, village cadres, and constantly improve the performance assessing and Industry Development Linked incentive mechanism, the formation of winds are strong enough, good momentum and seek common development; communication mechanism and establishment of provinces and cities, "double" units, actively seek the support of docking project, the implementation of funds, with the country, the province, has injected new impetus to realize synchronous well-off. To strengthen the grassroots base,, take the two push an election "and" direct push elections ", complete the general village" two committees ", earnestly carry out the development of village level financial clean-up, to fully implement the party, government and village affairs, expand the people's right to know, participation and supervision rights; in-depth implementation of the four on two open" the work of law, and constantly improve the base By election procedure, public consultation and accountability mechanism, promote the masses in industry development, community governance, realize self management, public affairs and public welfare undertakings in the development of self service. To promote the reform of key areas of heavy water, and comprehensively promote the city comprehensive law enforcement, business, food and drug supervision system reform, reasonable the adjustment of discipline discipline inspection and supervision, procuratorate organs, quality inspection departments, strengthen the integration of industry and commerce, service functions, improve administrative efficiency; further promote reform into the right system of rural financial reform and development of collective forest, rural development and further enhance the vitality.Focus on financial integration and development of cultural construction, accelerate the pace of fast. Seize the province's heritage of Chinese civilization, Chuang Chuang District building, Dayun Temple unearthed cultural relics and Buddhist relics "Millennium" such as opportunity, efforts to promote cultural tourism integration development. Efforts to enhance the level of planning, and employ high quality planning and design units, the county cultural tourism development planning < > and < > the overall planning of the cloud temple, reported the provincial culture to enhance the coordination of regulation to promote the leading group approved in the province, the city within the province, forming a "west of Dunhuang, East * *" consensus, for my county with rich historical and cultural resources to promote the economic structure turn around, The development of the way to find a starting point. And constantly improve the implementation of the system of scenic spots, water conservation and construction of Tian exhibition hall construction, built the South Cave Temple before a square and landscape Avenue, meticulously made jade Kang Jia Wang Cun, twenty shop ecological tourism demonstration village, Wu Huan Martyrs Memorial Hall preparatory work disabilities progress smoothly and, to further improve the system of tourism attractions. Strengthen the protection of cultural relics, the temple unearthed cultural relics protection such as the focus, to carry out a full survey of cultural relics, registration, maintenance and other work, find out the county cultural relics protection and the status quo. Continue to strengthen publicity and promotion, in order to Buddha seselj "Millennium now "As an opportunity to successfully held the inauguration cum Dayun Temple Buddha relic Lian in deep mining method; mother of Queen Mother of the west culture, held the fifth cross strait Coast West Queen female culture seminar by Chinese intangible cultural heritage center initiative, the West Queen's birthday was established as the Chinese mother's day, I determine the county as the" international mother queen mother of the west culture the research base in Beijing; the success of the Gansu Buddhist Culture Research Seminar * *, established Chinese and international Fobao Holy Buddha relic research center position, CCTV and Macao and so on a number of media for the depth, resulting in extensive influence at home and abroad, visibility and influence * * * culture brand The sound is further improved.Efforts to improve the people's livelihood and social construction fruitful. Adhere to the people-oriented, pay more attention to social construction, efforts to improve the people's livelihood security barrier level. Careful measures do Huimin practical, "double", agricultural loans, and poverty alleviation development province in the practical handling of solid and effective, especially Jing Hebei road construction, the implementation of the county the 521 thread road reconstruction project, to solve the problems of the masses along the way group years of difficulties and problems, to speed up the development of the country along along conditions. Promote the overall development of social undertakings, adhere to the priority of education development, construction completion of recruit students * * 4, 13 kindergartens expansion and expansion is completed and put into use, 45 schools of food Hall fully completed, a substantial increase in the number of on-line books over the entrance general; all the full implementation of the rural health service "ten full coverage", the county food and drug supervision system for continuous improvement; regarded attaches great importance to the work of family planning, the national population and family planning interests to guide policy system construction demonstration county through the provincial inspection;; multi expansion the coverage of social security, technology, radio and television undertakings developed. Continue to deepen the "double" action, in accordance with the "village is linked industry, household income is linked to help" ideas, deepening the "not rich first help, together with the well-off society" theme of practical activities, to build a market wide wide Base platform, connection with the farmers, new farmers' professional cooperative economic organization with 121, capital cooperatives 10, first rich guide staff and poverty benefit object to establish the node mechanism, for rich people to fulfill their social responsibilities, to realize their own value to build a platform for poor farmers to get rich extension expand the ways find the starting point, for all levels of cadres to carry out work. To strengthen social governance, to construct the scientific governance pattern of society as the direction, to the township level and village level social service community management as the focus, product actively adapt to the economic structure, organizational form, the trend of diversified values Tie, and carry out the management of rural "three movement", "five independent, three cooperation" for action and "a study of three visits three" the main theme of practical activities, promoting social comprehensive governance, in-depth investigation and handling of the spear of contradictions and disputes, to crack down on illegal crime, the social stability and development to optimize the environment.Adhere to the comprehensive combination of governance, improve the level of ecological civilization. Ecological construction mode of innovation, to continue to expand the ecological effect, and strive to build the ecological brand, the construction of ecological civilization step pace significantly accelerated. Forestry development efforts of the increase, to control the key areas of green and heavy key River Basin as the focus, carefully implement the whole basin destroy, surface mountain ecological restoration, forest road facilities and villages Tuen green, complete ecological afforestation, mu, ecological barrier function is growing. The environment restoration by Ti Tianjian to accelerate the pace of construction, small watershed management, the governance and the construction of high standard basic farmland for heavy emphasis, additional land acres, national water Soil conservation ecological civilization County created by the provincial approval; in energy development and pollution of heavy industrial enterprises focus on emission reduction as the focus, pay close attention to the implementation of environmental protection measures, environmental quality improved significantly. The effectiveness of county county village of environmental governance, vigorously implement the "five force change three construction and reconstruction to carry out comprehensive renovation, village environment comprehensive improvement of the rural environment, dirty, chaotic, and poor problem in some key areas to be solved.Outstanding pioneer leader, continue to strengthen party building. The main building and development of the theme on the buckle, positive innovation carrier, and strive to build the brand, and the scientific level of Party Construction in a step by step improvement. To strengthen ideological and political construction, organization of Party members and cadres to seriously study and implement the party's general secretary of the Third Plenary Session of the eighteen and Xi Jinping series of important speech, enhance ideological and political quality of cadres and Party members at all levels of ability to lead the development of; extensive "China country dream" publicity and education, and actively promote the "harmony", "Ten Star" filial piety "of mass spiritual civilization creation and evaluation, public citizen morals and socialist core The construction of value system. The whole heart constantly strengthen comprehensively strengthen the building of grassroots organizations, to force "five hundred points" building integrated joint demonstration project, carefully build the "Jing water pioneer" brand building, earnestly carry out the exhibition "home hand in hand to build well-off dream" theme activities, and constantly improve the working mechanism of township town Party committee the base, the grass-roots party construction work was significantly improved;; set up in Germany for the first to have both ability and political integrity, and attention to conduct, advocate hard work, outstanding performance, recognized by the masses "selection guide, on the part of the Township Town, the Department team has been adjusted, so that a number of pragmatic style, outstanding performance. The masses of the public That cadres be reused;; the full implementation of village cadres remuneration growth mechanism, hiring 150 student village cadres, selected 54 outstanding young cadres to serve the village, 15 outstanding college-graduate village official in Shandong Weifang square, study tours, stimulate the work of cadres working force. Continuing to strengthen cadre style construction, the full implementation of the central "eight regulations" and the relevant provisions of province, city to beg, carry out the "effectiveness storm" actions, streamline meeting documents, reduce public official reception, strictly control three funds charges, and resolutely put an end to waste waste, actively carry out the clean room, clean car and normative appraisal standards commend Other special activities, work style continued to improve. Must strengthen clean government, strict accountability, honest government, political party cadres standards, leading leading cadres a pair of responsibility and the political conversation system, education, system, supervision and punishment as the main content of the punishment and prevention system to establish an effective, long-term mechanism of anti-corruption corruption tends to improve, to accelerate the development of the creation of a good environment.The scientific study situation, is the premise and basis of doing all the work. The thorough analysis of the situation, we feel deeply felt, at present, my county is in advance in the crucial period of reform, the transition across the reversal period, the critical period of accelerated development period, even in the golden period of economic development period, superposition the policy of opportunity, the release period after hair advantage, pressure and hope coexist, opportunities and challenges coexist. Can seize the opportunity, meet the challenge, while avoiding disadvantages, to smooth profits, to complete our duties, given the history, is a major issue to be in-depth thinking of the entire County. We should not only in Gu Qing review summary Wake up the understanding of their own difficulties and problems in the development existence, and clarify the opportunities and challenges in the macro situation, but also in the future in the development of law and to grasp and accurately judge the characteristics of order stage, actively adapt to the change trend, firmly establish the "feel, hardship, seize the opportunity to tackle, firm speed up the development of" faith, struggling to write beautiful beautiful chapter. The spectrum of a prosperous civilization and harmonious construction of the new policeHow to recognize the hardship, is to ask questions, identify the crux of the self pressure. The ancients said: "calamity, died of happiness". Facing the new situation of development, we should not only summarize the experience and results, more important is to find out the questions, recognize the gap. For many years, through the tireless efforts of the whole county my county, the economic and social development has made remarkable achievements, but in accordance with the requirements of the new situation and measure, the total economic output is small, the development, open development level is low, the crux of the problem, some of the problems restricting the development has not been fundamentally solved. One is the depth of the development of industrial agriculture is insufficient. Pass. Through exploration and practice, the team and the county cadres and the masses, and the three leading industry begun to regulate livestock scale, benefit initially apparent. But universally exist imperfect market mechanism problem, is still in the standardization of production, market operation, the initial industrialization stage. The fruit industry to expand the amount of quality and efficiency brand is facing many challenges, because in the affected area of cultivated land constraints, the scale of the surface does not have the advantage, we must strengthen management, improve the efficiency of the efforts in depth development, cultivating cluster composition articles, or in a passive situation in the region will be competitive. The animal husbandry industry still to support the project, large pile planting, Small cell model, the total size of small, large fluctuations in the market, the overall efficiency is not high. The government funded the construction of vegetable industry shed, not fully play the role of the masses of the main problems are still very prominent, narrow coverage, low, benefit. By the industry, due to location, influence, historical factors. The industrial economy is small, benefit benefit low, investment and industrial economy main index only rely on the Red River oilfield, natural fiber cotton industry and other enterprises, industrial "short board", "short legs" in the short term is difficult to be solved. It is the third industry, since ancient times is that the west is * * the gateway to Changan City, known as a drought in Eastern Gansu Wharf reputation, section third has the advantage of industry development potential. In recent years, richly endowed by nature of development practice, although Pingding Xiping railway, high-speed, west east gas pipeline and other projects have been completed, but only just play channel role, role of logistics industry development of the * * * pull action is not obvious, not due to the birth of the logistics industry system, but not very good will * * regional advantages into economic advantage. The two is the construction of urbanization is a heavy task. The county is an important joint to promote the development of county urban-rural integration and "leading". In recent years, our development in the county has done a lot of work, but because of by soilfor the national strategy of developing the West, Yibin city as "Yangtze towns" and Southern towns, have become areas of Sichuan, Yunnan and Guizhou provinces central city location advantages, will take Chengdu, Chengdu, Chongqing, Chongqing's

　County economic work conference leadership speech:The main task of the twenty-six session of the six plenary meeting of the county the county economic work conference this time, by the party's eighteen and eighteen Third Plenary Session of the spirit as a guide, carry out and implement the central and provincial economic work conference on rural work conference and the three session of the seven plenary session of the party to expand the spirit of the meeting, the total summary of last year the work, analysis of the current situation, the deployment of this work, further strengthening the development of consensus, to mobilize the whole county county, deepening reform and innovation, to work against poverty, accelerate the transformation of leapfrog, promote scientific development, struggling to write a new harmonious beautiful mountains and show a prosperous civilization to build a new building. The following chapter * *, according to the county Discussion of the views of the Standing Committee, I focus on four aspects of the problem:* * * years, the county to seriously implement the central decision-making arrangements and real, in accordance with the "high position, as a typical tree, catch catch up with speed for a breakthrough, five in one overall grasp to raise human resources to promote overall leap", firmly grasp for the project, investment, industry, structural adjustment, Emegumi Mio, promote harmony, agency the county economy presents the social development to catch up, are balanced development, promote the overall, a

相关关键词： 抗生素合理用药培训