机电产品国际招标投标实施办法

第一章 总则 第一条 为了规范机电产品国际招标、投标行为，建立公开、公平的图际招标、投标竞争机制和公正的评标准则，根据《中华人民共和国招标投标法》、国务院批准的《机电产品进口管理暂行办法》、《国务院办公厅印发国务院有关部门实施招标投标活动行政监督的职责分工的通知》（国办发[2000]第34号），特制订本办法。     

卫生部甲类大型医用设备集中采购工作规范（试行）

第一条为规范甲类大型医用设备集中采购管理,保障采购质量和采购价格合理,依据《中华人民共和国招标投标法》、《中华人民共和国政府采购法》、《机电产品国际招标投标实施办法》等相关规定,制定本规范。     

浅谈医疗设备的采购

我国涉及医疗设备采购的法律法规主要有《中华人民共和国政府采购法》和《中华人民共和国招标投标法》，以及财政部的《政府采购货物和服务招标投标管理办法》和商务部的《机电产品国际招标投标实施办法》，这两部法律和两个办法，是我们进行物资采购活动的主要法律依据。     

军队医疗设备实行集中招标采购的特点及前景

为适应国家社会主义市场经济发展和军队质量建设要求,充分发挥军队集团购买优势,根据《中华人民共和国招标投标法》、国家对外贸易经济合作部《机电产品国际招标投标实施办法》规定,从1999年起,总后卫生部连续4年委托中招国际招标公司组织了X线诊断设备等进口医疗设备的军队集中公开招标采购工作,从1999～2002年,先后有220个医疗卫生机构参加了军队医疗设备集中招标采购,采购金额呈逐年上升趋势,年平均增长18%。4年来,有115个厂商的346种机型参加了投标,41个厂商的82种机型中标,共招标采购医疗设备600余台(套),总计近8000万美元。整个采购…     

伍平阳:医用耗材集中招标采购是怎样进行的

“看病难,看病贵”是目前老百姓反映的突出问题。2004年,卫生部组织了8省市医疗机构高值医用耗材集中招标采购,2005年1月实施后,采购的总体价格下降了。广东省卫生厅组织的2006年中央、省属驻穗医疗机构医用耗材集中招标采购工作也将开始。对于这次集中招标采购的准备工作、参加招标的医疗机构、招标采购目录的编制等情况,本刊记者对广东省第二人民医院设备科主任、2006中央、省属驻穗医疗机构医用耗材集中招标采购工作小组组长伍平阳先生进行了采访。     

一次性医疗物品集中采购招标的后期医院管理

一次性医疗物品集中招标同任何一个新生事物一样，招标中也出现了一些值得注意的问题，如一次性医疗物品集中招标后期的医院管理工作显得十分突出。在处理这些问题中，笔者总结了一些经验，其中最重要的是院领导的重视并积极支持，集体把关，处理好各种问题。在健全组织及制度，把好入库关、使用关，存贷管理，临床使用督导等招投标中的各个环节，才能使招投标取得实效，达到招投标的目的。     

医疗产品集中招标采购问题的思考

药品集中招标采购工作,一直在政府部门的推动下进行,其本意是为了减少中间环节,降低药价,使老百姓得到实惠,减少招标过程中出现的各种腐败,但事与愿违,不但起不到降低要价的作用,反而带来很多的负面影响。本文主要通过典型的事例论述药品集中招标采购工作出现的一些问题,分析这些问题带来的后果,然后针对问题提出如何规范药品招投标的行为。     

实施“阳光工程” 推行招标采购

为从源头上纠正医药购销中的不正之风,彻底解决药品购销中的虚高定价、暗箱操作和收受回扣等问题,从2000年上半年开始,作为全省试点单位,我市率先在全市8个市直医疗卫生单位实行药品集中招标采购制度,较好地遏制了医药购销中的一些腐败现象的滋生和蔓延的势头,此举被社会各界称为消除腐败的“阳光工程”。这项“阳光工程”实施一年来,先后开展集中招标采购9次,参招药品610种,中标总金额1508万元,共有来自全国6个省市的185家医药厂商报名参与公开招标投标,其中178家正式参与投标,158家分别中标。通过实行集中招标采购,药品价格平均下降19.8％,药品采购费用节省298万元,医药厂     

浅谈医疗设备招标采购

随着我国市场经济的发展,采购行为规范管理是十分必要的,它有利于推动市场经济的发展,达到公平、公正、公开的竞争目的.国家经贸部于98年颁布了有关“机电产品招标管理的办法“,并从2000年开始实施.从而改变了过去的各自为战的采购方法.……     

医疗器械招标采购方式的探讨

近年来,我国医疗器械的采购量一直以十位级的速度逐年递增,采购金额也随之不断增加。同时,自2000年我国实施招投标法以来,通过招投标方式完成采购过程也渐成趋势。虽然招标采购在我国正式实施的时间不长,但在政府的大力推广和法规制度的积极完善中,目前所取得的成效也是相当显著的。医疗器械纳入招标采购范围后,如何合理运用这一采购模式,掌握好招标采购不同具体实施方式的特点,以顺利完成采购工作,提高采购的时间效率和资金使用效率便要求我们在探索中不断改革、磨合,逐步适应、成熟。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

The human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

Worker education in the primary prevention of occupational dermatoses

This paper reports the evaluation of a skin care education programmeconducted on a fine chemicals manufacturing site where over1,000 employees are located. Approximately 60% are involvedin chemical manufacture. Over a 12 month period production staffreceived training in prevention of occupational dermatoses linkedto a site-wide poster initiative. The incidence of new casesof occupational dermatoses fell from 0.055 (70 cases in 1,277employees) to 0.021 (27 cases in 1,277 employees) before andafter the intervention respectively (p<0.0001). After otherfactors such as chemicals handled, observer bias and changesin reporting related to socioeconomic climate were taken intoaccount it is concluded that this study demonstrates the importanceof worker education as a tool for primary prevention of disease.Training materials such as video and poster presentations maybe effectively used in the chemical manufacturing industry asan adjunct to prevention and control of exposure to substanceshazardous to the skin. Such methods may also be used in otherindustries where there are significant risks of dermatoses.     

Regional Variation in Travel-related Illness acquired in Africa,March 1997–May 2011

To understand geographic variation in travel-related illness acquired in distinct African regions, we used the GeoSentinel Surveillance Network database to analyze records for 16,893 ill travelers returning from Africa over a 14-year period. Travelers to northern Africa most commonly reported gastrointestinal illnesses and dog bites. Febrile illnesses were more common in travelers returning from sub-Saharan countries. Eleven travelers died, 9 of malaria; these deaths occurred mainly among male business travelers to sub-Saharan Africa. The profile of illness varied substantially by region: malaria predominated in travelers returning from Central and Western Africa; schistosomiasis, strongyloidiasis, and dengue from Eastern and Western Africa; and loaisis from Central Africa. There were few reports of vaccine-preventable infections, HIV infection, and tuberculosis. Geographic profiling of illness acquired during travel to Africa guides targeted pretravel advice, expedites diagnosis in ill returning travelers, and may influence destination choices in tourism.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.