关于进一步做好医疗机构药品集中招标采购工作的通知

为贯彻落实国务院办公厅转发国务院体改办等八部门《关于城镇医药卫生体制改革的指导意见》(国办发[2000]16号)和《关于印发医疗机构药品集中招标采购试点工作若干规定的通知》(卫规财发[2000]232号)精神,积极稳妥地做好医疗机构药品集中招标采购工作,根据各地试点工作情况,现就有关问题进一步明确如下: 一、药品集中招标采购的主体 医疗机构是药品集中招标采购的主体。经办机构应根据医疗机构提出的集中招标采购药品的品种、规格、数量、质量和服务等,组织招标活动。 有关部门要积极推动药品集中招标采购工作,建立药品集中招标采购的工作制度,加强对医疗机构药品集中招标采购的管理和监     

军队医疗设备集中招标采购的实践与特点

医疗设备招标采购是政府采购的一个重要组成部分,它是指采购单位委托国家认可的招标机构,在财务、纪检、审计、法律公证等有关部门的监督下,以法定的方式、方法和程序,购买医疗设备及其服务。是一种对公共采购进行管理的制度,是国家、军队采购政策、采购程序、采购过程及采购管理的集中体现。无论是西方发达国家还是我们国家,实行招标采购是市场发展到一定规模,由无序走向有序,由不规范走向规范的必然产物。我院几项设备参与了全军集中招标采购,笔者在实践中有以下几点体会。1 军队医疗设备集中招标采购的意义 总后卫生部从1999年…     

让医疗机构合理分享集中招标采购的好处

正确处理患者和医疗机构之间的利益关系,是药品集中招标采购政策的核心问题.现行政策反复强调合理分配集中招标采购的好处,要求把集中招标采购的好处大部分让利给患者,兼顾医疗机构招标采购的积极性.对医疗机构由于实行集中招标采购减少的药品收入,要通过调整医疗服务价格予以合理补偿.这一利益分配原则无疑是正确的,但医疗机构对具体政策措施并不满意.究其原因,是因为现行政策措施使医疗机构无法合理分享集中招标采购的好处.     

让医疗机构合理分享集中招标采购的好处

正确处理患者和医疗机构之间的利益关系．是药品集中招标采购政策的核心问题。现行政策反复强调合理分配集中招标采购的好处，要求把集中招标采购的好处大部分让利给患者，兼顾医疗机构招标采购的积极性。对医疗机构由于实行集中招标采购减少的药品收入，要通过调整医疗服务价格予以合理补偿。这一利益分配原则无疑是正确的，但医疗机构对具体政策措施并不满意。究其原因，是因为现行政策措施使医疗机构无法合理分享集中招标采购的好处。     

医院物资采购管理模式及效果评价

目的探讨医院物资采购管理模式并初步评价运行效果。方法在医院原有物资采购管理模式基础上参考相关文献建立以集体招标、集中采购的医院物资管理模式,评价模式运行后各类招标采购金额节约率的变化情况。结果2009年至2012年设备服务类招标采购金额节约率分别为8.2%,14%,14%和13%。基建工程/总务修缮类招标采购金额节约率分别为19%,5%,26%和3%。耗材类（单价招标）采购金额节约率为8%-34%（2009年）和1%-28%（2010年）。其他类招标采购金额节约率为12%（2010年）和26%（2011年）。结论集体招标、集中采购的医院物资管理模式对建设节约型、效益型医院具有十分重要的意义。     

项目管理方法在公立医院招标采购工作中的应用

目的优化医院招标采购的流程管理,公平、公正、合法合规地进行招标采购工作。方法将项目管理的方法运用到招标采购的流程中,使整个招标采购过程阶段节点明晰,环环相扣,有条不紊。结果完善的流程实现了招标采购全过程的可控性和可监管性,降低了医院的采购成本,提高了工作效率。结论医院招标采购流程的项目化改造,为医院的采购工作提供了科学合理的方法,进一步改进了医院采购工作。     

药品集中招标采购效果评价

本文对影响药品集中招标采购的因素及其实施效果进行分析评价，找出存在的问题及其原因，并提出了相应的改进措施：加强对药品集中招标采购工作的组织领导，强化新药的审批和管理，扩大药品集中招标采购覆盖面，加强医院用药规范管理，适当减少议价药品零售价降价幅度，继续完善医疗服务补偿机制，规范药品集中招标采购工作。     

认真学习两法,公开、公平、公正采购医疗设备

医疗设备的招标采购已被医疗单位越来越多的广泛采用,认真学习招标采购的法律、法规,努力掌握招标采购的规则对医疗单位设备管理者日趋重要.我院近几年委托招标公司进行了多种形式的招标采购,有国际招标、政府招标采购、公开招标、竞争型谈判、询价采购、单一来源采购.采购的设备有CT、ECT、彩超、影像设备、检验设备、手术室设备、ICU设备、科研设备、网络设备等.     

公立医院招标采购对学科建设的影响

学科建设是医院建设的基础和核心工程,是医院核心竞争力提升的必要条件,学科建设的提升需要高质量的物力配备作为条件支持,而招标采购作为医院运营管理机制的重要组成,在服务学科建设方面发挥着关键性的作用,招标采购质量直接作用着学科建设质量、进程、结果。该文从公立医院招标采购切入,探讨对医院学科建设的影响和需要改进的措施。     

检验试剂二次招标采购实践与分析

探讨了检验试剂二次招标采购的实际意义,分析了规范检验试剂招标采购的特点、优势,指出了检验试剂二次招标采购是新时期疗养工作的一种创新与实践,在纠正检验试剂使用与采购责权混淆状况、建立科学的招标采购机制、防范医药购销领域的不正之风、提高经济效益以及节约采购成本方面具有重要作用。     

Biological effects of small air ions: a review of findings and methods

A wide variety of effects of exposure to small air ions have been reported, but these are difficult to evaluate because of limitations in experimental design and control. These limitations are discussed, and trends in the literature are reviewed. It is concluded that small air ions are likely to have biological effects, that these effects may be related to polarity, and that where effects occur they are likely to be small in magnitude and difficult to detect reliably.     

Nutrition and cancer The role of nutrition in the causation of cancer

A link between diet and cancer of a number of varied sites has been observed. The link is probably best documented in colorectal cancer; a plausible mechanism has been proposed and has been tested. A group of hormone-related cancers have been correlated with dietary fat. A group of tobacco-related cancers have also been related to dietary fat, presumably by a different mechanism. Some cancers have been related to alcohol consumption whilst others have been associated with malnutrition in general. This is not, therefore, a homogeneous picture but shows a varied role of diet in disease. It will have been noted that most of these dietary related cancers are diseases of affluence and are associated with ‘overnutrition’. The same diet, however, is associated with low infant mortality and appears to be protective against the more severe effect of virus infections. It may be, therefore, that we should not be hasty in modifying our diet and should first ensure that the benefits that accrue from our current diet are not lost in the change.     

Birth and social class: Northern Thai women's lived experiences of caesarean and vaginal birth

This paper, based on in-depth interviews with Thai women in Northern Thailand, contributes to a sociological understanding of women's childbirth discourses. The findings indicate that the lived experiences of birth differ between individual women. It clearly shows that social resources such as financial resources and education play a salient role in shaping the embodied experience of birth among women in Northern Thailand. Because of their 'everyday lifestyle', middle class women have more control over the experience of childbirth than that of the rural poor women. Middle class women are able to choose where to give birth, have access to private care and actively seek medical technology as a way to have control over their birth. Their material resources enable their choices. These choices seem to be denied to the rural poor women. But not all rural poor women are passive victims of their material resources. No matter how limited the resources women have, they use them. Hence, there are some poor women who actively seek birthing care that enables them to have more control. But regardless of their social positions (urban middle class or rural poor), obstetric interventions are commonly experienced, and most women perceive caesarean birth in a positive light. Several discourses are employed to explain these findings including women's interpretations of their lived world including risk and the medicalisation of childbirth in Thailand. Taking a feminist standpoint, I argue that differences between women need to be taken into account in providing care to women in childbirth so that sensitive and appropriate birthing care can be achieved.     

Advantages and disadvantages of killed and live poliomyelitis vaccines.

Decision-making on the use of poliomyelitis vaccines in the WHO Expanded Immunization Programme, and particularly in the developing nations, needs to be based on an understanding of the epidemiology of poliomyelitis in different parts of the globe. Even with two safe and effective kinds of poliomyelitis vaccine available, poliomyelitis has by no means been eradicated from the world. In developed countries that are considered well-vaccinated, certain sectors of the population may be inadequately protected against risk of infection by indigenous or imported wild polioviruses. In developing nations that are in transition toward an epidemic phase of poliomyelitis, wild polioviruses will continue to be a threat until thorough immunization is established and maintained. Killed-virus poliomyelitis vaccines have proved to be effective in certain countries that have used them exclusively; these are small countries with excellent public health systems, where coverage by the killed vaccine has been wide and frequent. Live vaccines, administered to hundreds of millions of persons during the past decade, have also been remarkably safe and effective. However, in certain warm-climate countries induction of antibodies in a satisfactorily high proportion of vaccinees has been difficult to accomplish. The advantages and disadvantages of each kind of poliomyelitis vaccine need to be weighed with respect to the particular setting in which a vaccine has been or will be used.     

Role of selenium in the etiology and prevention of diseases (review)

The data of reports by Russian and foreign authors on the biological effect of selenium are summarized. Some investigations have revealed its high toxic and carcinogenic properties in the selenium-rich biogeochemical provinces. Low-selenium diet has a human unfavourable impact. Recent studies have provided evidence for that is severe selenium deficiency in the environmental objects and foodstuffs virtually throughout the former USSR. At present selenium is recognized to be an essential trace element for human health. Selenium preparations in therapeutical doses have high antioxidative and anticarcinogenic activities. The types of medicinal plant materials that has a pronounced capacity to selectively accumulate selenium from the soil have been defined. Moreover, there are medicinal plants which are selenium concentrators that have high biological accumulation coefficients. Experimental and clinical findings indicate that selenium-containing drugs and medicinal plants should be recommended as an compulsory food additive in selenium-deficient areas for treatment and prophylaxis.     

Critical review of current and emerging quantification methods for the development of influenza vaccine candidates

Significant improvements in production and purification have been achieved since the first approved influenza vaccines were administered 75 years ago. Global surveillance and fast response have limited the impact of the last pandemic in 2009. In case of another pandemic, vaccines can be generated within three weeks with certain platforms. However, our Achilles heel is at the quantification level. Production of reagents for the quantification of new vaccines using the SRID, the main method formally approved by regulatory bodies, requires two to three months. The impact of such delays can be tragic for vulnerable populations. Therefore, efforts have been directed toward developing alternative quantification methods, which are sensitive, accurate, easy to implement and independent of the availability of specific reagents. The use of newly-developed antibodies against a conserved region of hemagglutinin (HA), a surface protein of influenza, holds great promises as they are able to recognize multiple subtypes of influenza; these new antibodies could be used in immunoassays such as ELISA and slot-blot analysis. HA concentration can also be determined using reversed-phase high performance liquid chromatography (RP-HPLC), which obviates the need for antibodies but still requires a reference standard. The number of viral particles can be evaluated using ion-exchange HPLC and techniques based on flow cytometry principles, but non-viral vesicles have to be taken into account with cellular production platforms. As new production systems are optimized, new quantification methods that are adapted to the type of vaccine produced are required. The nature of these new-generation vaccines might dictate which quantification method to use. In all cases, an alternative method will have to be validated against the current SRID assay. A consensus among the scientific community would have to be reached so that the adoption of new quantification methods would be harmonized between international laboratories.     

Dietary protein and calcium loss; a review

For several decades, high levels of dietary protein have been suspected to induce hypercalciuria. This increase has been found to be independent of the protein source. Intestinal calcium absorption appears to be increased by the high protein levels; serum calcium levels are not affected. Researchers have found varying effects on calcium balance; some have found that calcium balance is decreased, some have found no difference. Renal handling of calcium does appear to be altered; there is both a decreased renal tubular fractional reabsorption of calcium and an increased glomerular filtration rate. There are some data to suggest that these alterations may be due to the levels of sulfur-containing amino acids in diet. There are other data indicating that changing insulin levels may produce the hypercalciuria. Animal research suggests that there may be an increase in small intestine mucosal surface area.     

Modern biotechnology: a review of current regulatory status and identification of research and regulatory needs

Modern biotechnology encompasses many technologies. The one that has generated the most public interest is that of genetic engineering. The field has advanced dramatically since the early 1970's, when concern was so high that a moratorium was declared on research using recombinant DNA. Today there are numerous products such as human growth hormone, interferon and monoclonal antibody diagnostic kits on the market. Despite the obvious benefits of these products, there are still concerns over the environmental application of genetically engineered organisms. Many countries have assessed their existing legislation to ascertain its adequacy to regulate such intended releases. Numerous international organizations are becoming involved as well, and optimistically, regulations that are being developed in various countries may be harmonized. These activities have identified several areas where more information is required, including microbial taxonomy and classification, pathogenicity in target and non-target species, environmental behavior and risk assessment processes. Consensus at this time appears to be that our predictive capabilities are still developing and that new organisms should be evaluated on a case-by-case basis.     

Multiple sclerosis and birth order.

Studies on the birth order of patients with multiple sclerosis have yielded contradictory conclusions. Most of the sets of data, however, have been tested by biased tests. Data that have been submitted to unbiased tests seem to suggest that cases are more likely to occur in early birth ranks. This should be tested on further samples and some comments are offered on how this should be done.