Medical care in unlicensed combat sports: A need for standardised regulatory frameworks

ObjectivesTo explore the provision of medical care at ‘unlicensed’, full-contact amateur and lower-level professional combat sports competitions in England.DesignQualitative, mixed methods.MethodsObservations totalling 200 h of fieldwork shadowing medical professionals at 27 individual combat sports events, alongside formal, semi-structured interviews with 25 medical professionals, 7 referees and 9 promoters/event staff.ResultsPractices and standards vary widely. Event organisers and promoters often have very little understanding of how different types of medical practitioners operate. They rarely, if ever, check that the staff they are hiring are qualified, sometimes resulting in unqualified staff being used to provide medical cover at events. Venues are often poorly equipped to accommodate basic medical procedures. Patient confidentiality is very often compromised. Medical professionals often have limited autonomy within the combat sports milieu and may find themselves marginalised, with their judgements overruled by non-medical staff during competitive events. Some practitioners are cognisant of the dangers such working environments pose to their professional reputations and livelihoods, but remain working within combat sports regardless.ConclusionsDespite pockets of good practice, the lack of standardised rules for medical care provision creates substantial risks to athletes, to practitioners and the standing of the profession. The development and implementation of standardised, enforceable regulatory frameworks for full-contact combat sports in England is urgently needed.     

Réglementation de la recherche médicale en France

In France, clinical research involving human beings is regulated by the Jardé’s law since November 2016. The law distinguishes interventional and non-interventional studies. Both need to be authorized by a Persons Protection Committee. Studies performed on medical data collected during standard clinical care are not considered as studies involving human beings. Medical data are personal data. French Data Protection Authority National has an important role, guarantying the respect of regulation on personal data. We summarize in this article the different types of studies and the role of regulatory authorities.     

Genome insights of mercury methylation among Desulfovibrio and Pseudodesulfovibrio strains

Mercury methylation converts inorganic mercury into the toxic methylmercury, and the consequences of this transformation are worrisome for human health and the environment. This process is performed by anaerobic microorganisms, such as several strains related to Pseudodesulfovibrio and Desulfovibrio genera. In order to provide new insights into the molecular mechanisms of mercury methylation, we performed a comparative genomic analysis on mercury methylators and non-methylators from (Pseudo)Desulfovibrio strains. Our results showed that (Pseudo)Desulfovibrio species are phylogenetically and metabolically distant and consequently, these genera should be divided into various genera. Strains able to perform methylation are affiliated with one branch of the phylogenetic tree, but, except for hgcA and hgcB genes, no other specific genetic markers were found among methylating strains. hgcA and hgcB genes can be found adjacent or separated, but proximity between those genes does not promote higher mercury methylation. In addition, close examination of the non-methylator Pseudodesulfovibrio piezophilus C1TLV30 strain, showed a syntenic structure that suggests a recombination event and may have led to hgcB depletion. The genomic analyses identify also arsR gene coding for a putative regulator upstream hgcA. Both genes are cotranscribed suggesting a role of ArsR in hgcA expression and probably a role in mercury methylation.     

美国互联网售药监管及对我国的启示

利用互联网宣传、销售假药、劣药、违禁药物等违法行为给人们的用药安全带来严重威胁。网上售药现存问题已经引起相关人员的重视,如何有效监管网上药品销售行为,保证公众用药安全,成为各国政府药品监督管理的一项重要课题,本文应用文献研究法和比较分析法,通过中美在互联网售药方面监管比较,对完善我国的相关监管措施提出的建议。     

论非战争军事行动中的军医伦理问题

非战争军事行动纷繁复杂的现实处境与高度敏感的社会关联性造就了军医特殊的伦理处境。这给军医带来全新的伦理道德困惑与伦理情感冲击。非战争军事行动中军医伦理原则包括：社会主义人道主义原则、最大生命效益原则、生物一心理一社会的整体观原则。非战争军事行动中军医伦理规范包括：履行军医宗旨，全力抢救伤员、区别救治对象，关怀脆弱人群、加强协同合作，勇于承担风险、谨慎创新并举，提升技能保障、改善生存条件，提高生命质量。并就此提出若干的伦理原则与伦理规范，以期为军医的医疗实践提供一定的伦理指导。     

杨运宽调神意守针法

调神意守针法是将针法守神法和道家意守法结合起来，促使针刺得气后循经感传甚至气至病所，激发患者潜在的调整功能。杨运宽教授常运用此针法治疗某些痛证、神经系统疾病及慢性难治性疾病，可获得较一般针法更好的疗效。本文详细介绍了这一针法的操作方法和临床应用。     

关于我国医疗器械质量体系法规建设的思考

本文阐述了建立和完善医疗器械质量体系法规的重要意义,对国内、外医疗器械质量体系法规的进展情况进行了分析,并就我国"医疗器械生产企业质量管理体系规范"的法律地位、实施主体与行政许可的关系与医疗器械质量认证的关系等问题进行了讨论。